Shame as a cultural index of illness and recovery from psychotic illness in Java

Most studies of shame have focused on stigma as a form of social response and a socio-psychological consequence of mental illness. This study aims at exploring more complex Javanese meanings of shame in relation to psychotic illness.

Six psychotic patients and their family members participated in this research. Ethnographic fieldwork was conducted in Yogyakarta, Indonesia.

Thematic analysis of the data showed that participants used shame in three different ways. First, as a cultural index of illness and recovery. Family members identified their member as being ill when they had lost their sense of shame. If a patient exhibited behavior that indicated the reemergence of shame, the family saw this as an indication of recovery. Second, as an indication of relapse. Third, as a barrier toward recovery.

Shame is used as a cultural index of illness and recovery because it associated with the moral-behavioral control. Shame may also be regarded as a form of consciousness associated with the emergence of insight. Further study with a larger group of sample is needed to explore shame as a 'socio-cultural marker' for psychotic illness in Java.