Between Trauma and the Sacred: The Cultural Shaping of Remitting-Relapsing Psychosis in Post-Conflict Timor-Leste [Hardcover]

The relatively frequent occurrence of rapid onset and very brief, but often florid, psychotic states, with periodic recurrence, alongside relatively low rates of PTSD and chronic psychosis, were unexpected findings from the 2004 East Timor Mental Health Study, conducted in the context of the countrys recently won independence and in the wake of the atrocities endured in the protracted fight for sovereignty. Further unanticipated was the frequent association of recurrence with the time of the new moon (fulan lotuk) and other times or places of sacred (lulik) or associated cultural significance. The perceived violation of culturally sacrosanct lulik obligations often also appeared to foreshadow the initial onset of such patterns of distress. Significant episodes of trauma and loss appeared a hidden feature of affected individuals histories, which we argue have become symbolically entwined with local cultural understandings of ritual obligation, sacredness, and taboo.