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April 9 - May 23, 2020
For Americans the old joke has become bizarrely true: wherever we go, there we are.
We are engaged in the grand project of Americanizing the world’s understanding of the human mind.
Over the past thirty years, we Americans have been industriously exporting our ideas about mental illness.
Because the troubled mind has been perceived in terms of diverse religious, scientific, and social beliefs of discrete cultures, the forms of madness from one place and time in history often look remarkably different from the forms of madness in another.
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the DSM (the “bible” of the profession, as it is sometimes called), has become the worldwide standard. In addition American researchers and organizations run the premier scholarly journals and host top conferences in the fields of psychology and psychiatry.
What motivates us in this global effort to convince the world to think like us? There are several answers to this question, but one of them is quite simple: drug company profits.
They have shown that the experience of mental illness cannot be separated from culture.
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.
“Patients unconsciously endeavor to produce symptoms that will correspond to the medical diagnostics of the time,”
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.
“Mental illnesses, specifically anorexia, do not exist independent of social and historical context,”
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.
The idea that people from different cultures might have fundamentally different psychological reactions to a traumatic event is hard for Americans to grasp.
“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.
Behind this effort to influence the Japanese response to the disaster was a deep certainty commonly shared by traumatologists that the rest of the world doesn’t pay nearly enough attention to mental health and that other cultures lack crucial knowledge that Americans possess.
It takes a willful blindness to believe that other cultures lack a meaningful framework for understanding the human response to trauma.
By isolating trauma as a malfunction of the mind that can be connected to discrete symptoms and targeted with new and specialized treatments, we have removed the experience of trauma from other cultural narratives and beliefs that might otherwise give meaning to suffering.
Intending to break cycles of violence, Western beliefs about trauma and healing may be poised to spin them back into motion.
Why did people diagnosed with schizophrenia in developing nations have a better prognosis over time than those living in the most industrialized countries in the world?
The most obvious differences between cultures were in the delusions and hallucinations experienced by those with schizophrenia. These harrowing visions and disembodied voices were often distorted reflections of the phobias and fascinations of specific cultures.
The brain disease narrative would make it less likely that the public would attribute the onset of mental illness to an individual’s life choices or a weakness of character.
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.
What could be more stigmatizing than to reduce a person’s perceptions and beliefs to the notion that they are “just chemistry”?
Just as neurasthenia was considered a mark of distinction among certain elite groups, suicides among similar groups were often excused or even admired as expressions of the purity of the Japanese character.
What worries many researchers is that the makers of pharmaceutical drugs such as SSRIs have gained remarkable control over the creation and presentation of the scientific data that purport to show that these drugs are safe and effective.
Cultures become particularly vulnerable to new beliefs about the mind and madness during times of social anxiety or discord.
If the irony isn’t already obvious, let me make it clear: offering the latest Western mental health theories in an attempt to ameliorate the psychological stress caused by globalization is not a solution; it is a part of the problem.
