Cult Med Psychiatry. 1984 Mar; 8(1): 71-93.
Idioms of distress: kinship and sickness among the people of the Kingdom of Tonga.
"Idioms of distress" refers to the popular expression of emotional tension that arises in the relationship between 'sickness' and 'kinship'. By reference to case studies and discussions among the Polynesian people of Tonga, the author shows where such tension arises and how it influences the sickness process. Sickness is necessarily a collective phenomenon which can best be understood not simply as a clinical event, but as an experience that is part of the experience of 'family'. Various ways of expressing distress as a reflexive encounter between personal and cultural meaning systems are reviewed, as are several new concepts such as "doing sickness as kinship", and "turning" in the process of decision making in the kinship management of sickness. The explanatory models of sickness in Tonga are shown to encompass culturally sanctioned expressions of distress as part of of the adaptive coping mechanisms in that society. Distress frequently emerges in somatic form, as a number of studies have shown. However, the author emphasizes the "kinship meaning of sickness", "kinship management and sickness therapy", "the adaptive process of idiomatic expressions of distress", which are expanded here and offered as potential avenues for elaboration in other cultural milieu. Two aspects of the notion "idioms of distress" are noted, and the phenomenon is understood as a process which acts as a "prime mover" in social change.