Crazy Like Us: The Globalization of the American Psyche

by Ethan Watters

just ten possible cases

rare

uncommon

Her extreme sadness over her lost love had caused her liver function to break down,

let go of the unhealthy energy that surrounded the memory of her lost love.

“Despite the long-standing hypothesis that a greater exposure to Western values leads to an increased risk for eating disorders,

presents no compelling evidence for such a relationship.”

lower level of Western acculturation

higher

local forms of anorexia were often markedly different from the DSM version of the disease,

inability to chew.

Shorter believes that psychosomatic illnesses (such as leg paralysis at the turn of the twentieth century or multiple personality disorder at the turn of the twenty-first) are examples of the unconscious mind attempting to speak in a language of emotional distress that will be understood in its time.

need of expressing their psychological suffering

onto a behavior in the symptom pool, he or she is doing so for a very specific reason: the person is taking troubling emotions and internal conflicts that are often indistinct or frustratingly beyond expression and distilling them into a symptom or behavior that is a culturally recognized signal of suffering.

Because the patient is unconsciously striving for recognition and legitimization of internal distress, his or her subconscious will be drawn toward those symptoms that will achieve those ends.

The only meaningful components of treatment are understanding the patient’s life and creating a motivation for the person to change. Does a medical diagnosis help with these goals? I am not convinced it does.”

Off the podium, some eating disorder experts will admit to a deep insecurity about the possibility that their work might be to some degree counterproductive.

how the professional discourse on eating disorders keeps these behaviors in the symptom pool is problematic on a number of levels. As evidenced in Hong Kong, we

the only hope lies in a deep understanding of each patient’s subjective experience.

Western assumptions about eating disorders were not only steamrolling local variations but also potentially acting as a vector, both spreading these illnesses and shaping their expression.

“The DSM and Western categories for disease have gained such dominance. In the process, microcultures that shape the illness experiences of individual patients are being discarded.

avoidance, numbness, and hyperarousal.

Wentz assumed, as do many Western mental health specialists who focus on trauma, that the psychological reaction to horrible events is fundamentally the same around the world.

there were signs early on after the tsunami of a cultural disconnect between the ideas surrounding the Western conception of PTSD and Sri Lankan beliefs.

The professors acknowledged that “disaster zones attract ‘trauma’ and ‘counseling projects,’” but they pleaded with the arriving army of counselors not to reduce survivors’ experiences “to a question of mental trauma” and the survivors themselves to “psychological casualties.”

“A victim processes a traumatic event as a function of what it means,” they wrote. “This meaning is drawn from their society and culture and this shapes how they seek help and their expectation of recovery.” Trauma reactions aren’t automatic physiological reactions inside the brain, they suggested, but rather cultural communications.

was a deep understanding of “what the affected people were signaling by this distress.”

seemed confused, even concerned, when the local population didn’t behave the way they’d expected.

With so many counseling and trauma treatment programs and PTSD researchers arriving in the country every day, the situation on the ground soon turned chaotic.

it’s hard to escape the feeling that these various efforts had about them the energy and excitement of a gold rush.

everyone who wanted to demonstrate their acumen in healing trauma or perform large-scale studies of PTSD felt obligated to be on the scene.

The failure to manage one’s social responsibilities—to find and fulfill a place in the group—was identified as the primary symptom of distress and not a consequence of an internal psychological

The simple but mind-bending truth is that mental illnesses such as PTSD can be both culturally shaped and utterly real to the sufferer.

The researchers concluded that the diagnosis of PTSD could not effectively communicate this type of shared cultural suffering, “given the multiplicity of ways peoples and societies live through massive trauma, express their distress and suffering, and assign meaning to the human experience.”

largely discredited the power of local healing practices, as well as resiliency, coping and survival strategies.”

We take their cultural narratives away from them and impose ours.

The risk, she concluded, is that “trauma counseling services will further destabilize a local cycle of containment of major outbreaks of violence.”

Western ideas behind

It would be tragic and ironic if Western-style trauma counseling ends up sparking violence between ethnic groups and clans that already have reason to hate each other.

This research into what was called “expressed emotion” suggested that schizophrenics often got worse when surrounded by family members who were constantly critical of their behavior or showed intense and intrusive concern about their condition.

no one had yet found a convincing explanation for the cross-cultural differences. Indeed

“There are too many of us and this place is too noisy,” she said emphatically.

“I do like being on my own,” she once told McGruder. “Being with people I feel like I am tangled with them. I

Western psychologists and psychiatrists have promoted the biomedical approach

Even patient and family advocacy groups such as the National Alliance for the Mentally Ill in the United States and SANE in the United Kingdom have consistently promoted the idea that mental illnesses should be viewed as medical illnesses, as “diseases of the brain.”

When asked to name the sources of mental illness, people from every country studied are increasingly likely to mention “chemical imbalance” or “brain disease” or “genetics” as part of the cause of mental illness. These

It turns out that those who adopted the biomedical and genetic beliefs about mental illness were most often those who wanted less contact with the mentally ill or thought of them as dangerous and unpredictable.

Genetic arguments make the person appear even more ‘at risk’ and threatening.”

or “I had a disease just like any other which affected my biochemistry”

we may actually treat people more harshly when their problem is described in disease terms.…