The globalization of American psychology

I know it’s bad form, but I’m going to quote myself, from yesterday’s entry:

For those of us who are trained in the US system and interested in global mental health, I can’t think of anything more important than developing a critique of our own failures. Let’s not globalize American medication or our rejection of empirically supported treatments.

And today, I open up my New York Times magazine, and voila: The Americanization of Mental Illness. (Am I controlling the New York Times through my blog?)

Ethan Watters presents a summary of his soon to be released book “Crazy Like Us: The Globalization of the American Psyche” and it’s worth a read. I won’t rewrite the whole piece here, but his essential argument is the good faith efforts of Euro-American mental health care practitioners is serving to change how people in other cultures view non-normative behaviors, and that’s not all good. He makes it clear that he is not belittling mental illness or the suffering that accompanies it, and that he respects Western medical science’s contribution to examining the mechanisms of mental illness. Here’s his follow-up:

Whatever the trigger, however, the ill individual and those around him invariably rely on cultural beliefs and stories to understand what is happening. Thoe stories, whether they rely on spirit possession, semen loss or serotonin depletion, predict and shape the course of the illness in dramatic and often counterintuitive ways… 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.

This is good cultural psychology, and it’s great to see it’s getting fair play. Watters goes on to present research showing that the mental health literacy movement’s push to destigmatize schizophrenia by presenting it as a “brain disease” actually has the opposite effect, and how the medicalization of mental illness (as opposed to viewing it as a psychosocial problem) can result in the formation of a sufferer identity rather than as someone suffering from an affliction.

I encourage you to read the article, but I can’t resist a few quotes here. A Chinese psychiatrist is interviewed about an epidemic of Western-style anorexia in Hong Kong, and sums up the larger problem thusly:

As Western categories for diseases have gained dominance, micro-cultures that shape the illness experiences of individual patients are being discarded… The current is too strong.

Describing the anemic section of the DSM-IV given to non-Western mental illness categories:

Illnesses found only in other cultures are often treated like carnival sideshows. Koro, amok and the like can be found far back in the American diagnostic manual (DSM-IV, Pages 845-849) under the heading “culture-bound syndromes.” Given the attention they get, they might as well be labeled “Psychiatric Exotica: Two Bits a Gander.”

And here’s the kicker, on our exporting the culture that Judith Warner discussed yesterday:

The ideas we export often have at their heart a particularly American brand of hyperintrospection — a penchant for “psychologizing” daily existence. These ideas remain deeply influenced by the Cartesian split between the mind and the body, the Freudian duality between the conscious and unconscious, as well as the many self-help philosophies and schools of therapy that have encouraged Americans to separate the health of the individual from the health of the group. These Western ideas of the mind are proving as seductive to the rest of the world as fast food and rap music, and we are spreading them with speed and vigor.


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