This paper examines four drug rehabilitation systems in Malaysia from an organizational perspective. It focuses on authority structures in rehabilitation centres and their impact on rehabilitees' identities. The findings show that there are important differences between government-run and private centres in terms of administration and approach to therapy. Some policy implications are derived from a comparison of these systems.
Turner's concepts of structure and anti-structure are applied to the culture-bound syndromes to demonstrate that they are dialectical aspects of cultural reality, The Malay cases of amok, latah and possession hysteria are discussed as instances of anti-structural behaviors that dramatize role-reversals and role-enhancement. The performers of these behaviors are not subjected to the Malay code of moral conduct. The supernatural ethos in Malay culture plays an important role in shaping tolerance towards them. Although this tolerance has been gradually eroded as a result of the introduction of Western psychiatry, the anti-structural status of these syndromes has not faded away but has assumed new meanings in terms of psychopathology.
This discussion of an episode of mass hysteria in a Malay college in West Malaysia examines stress and conflict in relation to the interpretive process within a specific social setting. Unlike previous studies, which conceptualize mass hysteria as a cathartic response to accumulated stress, the present study treats stress as a matter of definition in a specific sociocultural context rather than as an objective given from which predictions can be made. Objections are raised to the logic of explanations that attribute mass hysteria to environmental stress. What is of concern is how meanings are assigned to events that are experienced as stressful, how participants and observers explain these events, and the consequences that follow from their interpretations.