Rod Dreher

Utterly fascinating report from Ethan Watters, writing in The New York Times. Excerpt:

In any given era, those who minister to the mentally ill — doctors or shamans or priests — inadvertently help to select which symptoms will be recognized as legitimate. Because the troubled mind has been influenced by healers of diverse religious and scientific persuasions, the forms of madness from one place and time often look remarkably different from the forms of madness in another.
That is until recently.
For more than a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma. There is now good evidence to suggest that in the process of teaching the rest of the world to think like us, we’ve been exporting our Western “symptom repertoire” as well. That is, we’ve been changing not only the treatments but also the expression of mental illness in other cultures. Indeed, a handful of mental-health disorders — depression, post-traumatic stress disorder and anorexia among them — now appear to be spreading across cultures with the speed of contagious diseases. These symptom clusters are becoming the lingua franca of human suffering, replacing indigenous forms of mental illness.

More, quoting a doctor in Singapore who studied the way American-style anorexia suddenly started showing up in young women there:

What is being missed, Lee and others have suggested, is a deep understanding of how the expectations and beliefs of the sufferer shape their suffering. “Culture shapes the way general psychopathology is going to be translated partially or completely into specific psychopathology,” Lee says. “When there is a cultural atmosphere in which professionals, the media, schools, doctors, psychologists all recognize and endorse and talk about and publicize eating disorders, then people can be triggered to consciously or unconsciously pick eating-disorder pathology as a way to express that conflict.”


In the end, what cross-cultural psychiatrists and anthropologists have to tell us is that all mental illnesses, including depression, P.T.S.D. and even schizophrenia, can be every bit as influenced by cultural beliefs and expectations today as hysterical-leg paralysis or the vapors or zar or any other mental illness ever experienced in the history of human madness. This does not mean that these illnesses and the pain associated with them are not real, or that sufferers deliberately shape their symptoms to fit a certain cultural niche. It means that a mental illness is an illness of the mind and cannot be understood without understanding the ideas, habits and predispositions — the idiosyncratic cultural trappings — of the mind that is its host.

Because the American medical system — including universities, hospitals, pharmaceutical companies, etc. — so thoroughly dominates the global study of mental illness, and because American popular culture is so powerful throughout the planet, and because American-dominated mass media now has global reach — we may be vectoring our own mental illnesses to people throughout the world. Imagine the various forms of media as disease vectors. Understand what’s being claimed here: the claim is not that Western morals and values are corrupting others, but that mental illness is passing into those other cultures.
I’m sorry to keep going back to the anthropologist Wade Davis, but in a lecture I heard him deliver a few years back at Southern Methodist University, he spoke of how we have a number of examples of primitive cultures in which the people simply lost the will to live after coming in contact with the overpowering Western culture. This is not exactly what Ethan Watters is talking about, I don’t think, but perhaps it’s on the spectrum.
This raises an interesting question in my mind, related to the research I did last summer on my Templeton Cambridge fellowship. As I looked into Traditional Chinese Medicine, I found that advocates of its practices in the West have only had limited success reproducing results in laboratory conditions (with acupuncture, much better success than with herbal and other therapies). The obvious explanation for this is that it doesn’t work as well as they think. But might there be something else at play here? Might the connection between the mind and the body be more complex than we think, and that some people — and people within some cultures — be more able to be healed by certain kinds of therapies because their minds are more open to them? Culturally, I mean. I’m not really talking about faith healing, though maybe, in one sense, I am. If mental illness — actual, observable symptoms — can be brought about by contact with a culture in which this or that form of mental illness has been observed, is it not at least theoretically possible that forms of healing can work better on people whose psyches have been formed by certain cultural traditions?
You might say, “Well, yes, through a placebo effect,” and you might be right. Still, healing is healing. I’m not offering a conclusion here, just raising the question.

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