The Globalization of Psychiatry - Universalizing Our Mental Illness

We believe that the United States is the leading edge for the discovery and treatment of mental illness. Instead, a remarkable article in the New York Times, The Americanization of Mental Illness, reveals that although Americans "worry about our country’s blunders into other cultures...we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad." [The following is quoted drectly from the article by Ethan Watters.]

"This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places. In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro, which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that brings forth dissociative episodes of laughing, shouting and singing.

"The diversity that can be found across cultures can be seen across time as well [within our own culture]. . . .

"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."

In other words, the mental illnesses we regard as biological imperatives are cultural creations that we are exporting around the world (the same holds for alcoholism and addiction), and we then point with satisfaction to the results as proving our assumptions.

[Only the initial introduction and the summary paragraph are original to this post. The rest is transcription of Ethan Watters' original writing in the Times, which is identified and linked up front in the post.]