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CULTURE & MENTAL ILLNESS.
Term Paper ID:20524
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Essay Subject:
Role of society in creating & defining psychiatric disorders, individual & cultural development, focusing on Freudian theory.... More...
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6 Pages / 1350 Words
6 sources, 8 Citations,
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Paper Abstract:
Role of society in creating & defining psychiatric disorders, individual & cultural development, focusing on Freudian theory.
Paper Introduction:
Various researchers and theorists have established a link between culture and mental disorders in several different ways. The essential relationship is established by Leighton and Hughes (1961), who note that mental disorder is considered to be the product of multiple factors so that while culture can be considered causative of some mental disorder, it should not be seen as the only cause even in a given instance. An examination of the issue shows the existence of a number of culture-bound syndromes which can be examined in the light of the culture producing them.
Leighton and Hughes define "culture" as a label for an abstraction encompassing the total way of life for a group of human beings. Some employ the word to mean a pattern of history which can be analyzed and understood without reference to the
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ReferencesAl-Issa, I. Environment and psychopathology (New York: Springer), pp. Hughes. (1989). Leighton and Hughesstate that culture determines the pattern of certain specific mentaldisorders, and there are names representing culture-specific disorders inanthropological literature pointing out disorders not part of the standardnomenclatures of Western psychiatry. The Culture-bound syndromes (Boston: D. Anexamination of the issue shows the existence of a number of culture-boundsyndromes which can be examined in the light of the culture producing them. Hughes (1961). For Sigmund Freud, human nature is hidden in the mind and isproduced by "the irremediable antagonism between the demands of instinctand the restrictions of civilization" (Strachey in Freud, 1961: p. Lebra (1976) notes that the culture-bound syndromes or culture-specific disorders highlight the critical linkage between culture andmental illness: Not only are there marked cultural variations in the frequency of mental disorders, but also there are vast differences in behavior content and culturally ascribed meanings (Lebra, 1976, ix).At the same time, Hughes (1989) notes that these syndromes exist in a sortof "twilight zone" of psychiatric phenomena. The essentialrelationship is established by Leighton and Hughes (1961), who note thatmental disorder is considered to be the product of multiple factors so thatwhile culture can be considered causative of some mental disorder, itshould not be seen as the only cause even in a given instance. It can thus become difficult to integrate them into Western nosologicalsystems. New York: W.W. The ego is the residence of theself, and the super-ego is the policeman of the self. Prince notes that Freud had separated some commonphobias of things feared by most Westerners to some extent (death, illness,and snakes, for example) from specific phobias of things or situationsinspiring no fear in the average Westerner, such as fear of public places.In Japan and Korea, social phobias are separated from agoraphobia and thehost of other simple phobias. The ego and the super-ego are closely boundtogether. Many of the syndromes we describe in Western psychiatryare culture-bound and not universal as we might expect if we did not docultural comparisons. Culture-bound syndromes, ethnopsychiatry, and alternate therapies. Civilization and its discontents. Al-Issa (1982) notes that culture-bound syndromes such asschizophrenia and depression have attracted much attention fromresearchers, more than any other psychiatric syndromes. How does culture affect psychiatric disorder? The connections are not alwaysclear or visible to the limited vision of the human being, but they arethere. Culture may also be thought to affectpsychiatric disorders through types of sanction or what is and is notallowed in a certain society. Leighton and Hughes define "culture" as a label for an abstractionencompassing the total way of life for a group of human beings. Baltimore: University Park Press.Freud, S. The super-ego develops as a response to the development ofcivilization. Freud finds that the community can also develop a super-ego thatinfluences cultural development. Indeed, the very concept of culture-specific syndromes calls intoquestion the meaning of mental disorder and whether any mental disorder isto be considered an "authentic" disease or disorder or simply a culturally-defined as well as generated conception. It would appear that there aresome truly debilitating mental disorders which would have to be consideredauthentic and which would be real disorders even if they had been caused bycultural influences, in conjunction with other influences. The concept of the phobia, for instance, is aculture-bound issue. The super-ego is harsh, and itsinteraction with the ego produces a sense of guilt which leads to a needfor punishment. 4).Human nature in the state of nature is thus one thing, while human naturein civilization has been reshaped and produces a different form ofalienation in the Freudian conception. The very existence of these syndromes, say some researchers,cannot be separated from culture-specific areas of stress and culture-specific situations (Al-Issa, 1982, 8). Social phobias are cultural because inJapan, for instance, offending or hurting may occur in many ways they wouldnot occur, or at least not in the same degree or with the same frequency,in Western culture (Prince, 1993, 59-61). Freud developed an extensive system of mental interactions and mentalcomponents that affect human behavior. However, thereis also a large gray area of disorders which may be perfectly normal oncethey are removed from a given cultural context. "Culture-bound or construct-bound?" In R.C. Prince (1993) notes that culture is a universal feature of the humanenvironment (55), and he then discusses various culture-bound syndromesthat may develop. Culture may produce mentaldisorders through processes of change. And the dismissal may occur when such syndromes are summarily assigned to categories of disorder already established in Western nosology without any fine-tuning to capture possible culture-specific meanings or symbolism of the behavior necessary for a valid categorical assignment (Hughes, 1989, 3). Culture may produce psychiatric disordersthrough certain child-rearing practices which influence personality.Freudian theory offers a means of organizing data from different cultureswith reference to such dimensions as toilet training, nurturing, control ofaggression, weaning, and encouraging independence, and it also offers a wayof interpreting cultural variations with regard to probable significancefor mental disorder among adults. (1982). Phenomenologically, these syndromes are seen as unfamiliarways of showing mental disorder and are thus episodes of deviant deviance: The controversy exists over whether such episodes or patterns of behavior are simply culturally=-based and different, yet "normal, ways of acting, or examples of "authentic" disease and disorder. Sikons and C.C. Leighton and Hughes also examine the meaning of "mental disorder" andfind that it includes all those behaviors, emotions, attitudes, andbeliefs usually regarded as in the field of psychiatry. Human nature includes a natural freedomof behavior that has to be curtailed in civilization, but this very act ofcurtailment leads to neuroses and other human responses to the guilt thatis created and the control that is exerted, or that is attempted to beexerted. This differentiation, of course, serves the practical purpose of enabling one to defend oneself against sensations of unpleasure which one actually feels or with which one is threatened (Freud, 1961, 15). Here, culture is a determinant force which follows its own lawsirrespective of individual psychology and which rests upon, rather thaninteracts with, human personalities. Freud writes: In this way one makes the first step towards the introduction of the reality principle which is to dominate future development. Culture may be thought to perpetuatepsychiatric malfunctioning by rewarding such malfunctioning in certainprestigious roles, such as shaman. Honolulu: East-West Center.Leighton, A.H. "Culture-Bound Syndromes: the Example of Social Phobias." In Ghadirian, A.M. Culture may affectthe distribution of psychiatric disorders through patterns of breeding.Finally, culture may influence mental disorders through patterns of poorphysical hygiene. and J.H. The control of the wishes and needs of the ego begins as asocial matter and then is internalized through the establishment of thesuper-ego. When the individual either indulges in certain behavior orrealizes a propensity for certain behavior that would be proscribed bysociety and challenged by the super-ego, the result is guilt and a desirefor punishment. "Cultures as Causative of Mental Disorder." In Causes of mental disorders: a review of epidemiological knowledge, Milbank Memorial Fund, New York.Prince, R.H. Reidel), pp. Norton.Hughes, C.C. Various researchers and theorists have established a link betweenculture and mental disorders in several different ways. Culture-boundsyndromes are often considered to be atypical forms of psychopathologyrather than specific cultural entities. Culture can also be thought of asproducing certain basic personality types, some of which may be especiallyvulnerable to mental disorder. (1966). 55-71.----------------------- 9 Some ways of dealing with culturepoint to the material artifacts produced by certain societies and to therelationship between patterns of livelihood and environmental resources.Culture can also refer to the shared patterns of belief, feeling, andadaptation which people carry in their minds as guides for conduct and thedefinition of reality. (1993). Culture may affect psychiatricdisorder through the indoctrination of members with particular kinds ofsentiments. As the individual develops duringthe life cycle, the ego, or the sense of self, changes from encompassingeverything to detaching itself from the external world and thus includingonly the inner world of the self. Freud sees a direct connection between the development of theindividual and the development of society. What we in the Westbelieve is aberrant behavior, people in other parts of the world may see asquite acceptable. The cultural development of society and the culturaldevelopment of the individual are at all times interlocked even though wemay not see how at the time. 86). (1976). Culture and psychopathology. Freud sees clear connections between culture and mental disorder, asnoted, and indeed he sees clear connections between culture and normaldevelopment. Someemploy the word to mean a pattern of history which can be analyzed andunderstood without reference to the human beings in whom it is encompassed. That is, it servesas the source of the conscience. Lehmann. Freud sees a relationship between the internal world and theexternal world that the ego has cast off through the super-ego: The super-ego torments the sinful ego with the same feeling of anxiety and is on the watch for opportunities of getting it punished by the external world (Freud: p. Culture can produce psychiatricdisorders through certain stressful roles. 3-24.Lebra, W.P. It is at this stage that the individual develops a conscienceand a sense of guilt. and H.E. The frame of reference forthese syndromes is the Western-derived system of psychiatric diagnosticcategories. The existence of culture-bound syndromes should serve asa caution about determining what is and is not normal in too narrow acultural structure, when cross-cultural studies might yield more evidenceand a better means of diagnosis. Culture may influence the development of mental disordersthrough the degree of impulse-repression it fosters. It may alsoinclude conditions such as brain syndromes and mental retardation, orconditions not primarily based on psychological experience but that aresubject just the same to the influences of culture through practices ofbreeding, diet, care of the ill, use of drugs or intoxicants, and thetraining of the defective child. These syndromes are recognized asbeing quite different from psychiatric syndromes in their onset,manifestations, and are specific to certain ecological and social settings.
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