Culture and Mental Illness

07 May 2010

Our topic for this week is Culture and Mental Illness.  Our aim is to consider the ways in which culture influences and shapes the very idea of mental illness and the also the way culture conditions the way particular mental illnesses express themselves. 

Start  with the way culture shapes the very idea of what counts as a mental illness.  Take the case of koro.   Koro is mental disorder, characterized by a debilitating fear that that one’s genitals are retracting into ones body and that once they are fully retracted you will die.   You don’t find many instances of in Western societies.   But Southwest Asia koro epidemics have been known to break out.   There was such an epidemic in 1984-85 in Guangdong, China.  And between 997 and 2003 in several different West African nations,  there were local outbreaks of koro-like panics.   Koro seems to be at least partly based on a set of culturally specific beliefs about sexuality.   Most koro sufferers appear to be immature, younger men, who lack self-confidence, who engage in a lot of auto-erotic activity, and who suffer extreme guilt and anxiety as a consequence.  Culturally conditioned views about sexuality seem to play an important role in causing  their guilt and anxiety to express themselves in a certain way.

One could think that it makes little sense to call koro a mental disease at all.  Koro seems very much like a form of culturally conditioned fear or panic or something.  But is that enough to make it a mental disease?   A mental illness, one might think,  is is something that happens to you because your brain goes haywire in a certain way  -- like in schizophrenia, for example.   A mental disease isn’t something that happens to you because you have weird beliefs.   Indeed, if you look up koro in the Diagnostic and Statistical Manual – the book that covers all mental health disorders for both children and adults --  you will find koro listed there.  But you’ll find it listed toward the back of the book --  with what are called  “culture-bound syndromes.”   That’s a way of recognizing koro and its cousins, like amok, which was once prevalent in Maylasia,  or zar, which occurs mostly in the Middle East,  are real things – sort of.   But it’s also a way of saying that they are not quite your garden variety mental disorders,  more or less directly rooted in the physiology of the brain 

 But  this isn’t to suggest that only certainly weird and exotic conditions are shaped and influenced by culture.  Take schizophrenia. Though there is some disagreement about what exactly Schizophrenia consists in, nobody would deny that schizophrenia is something real and something really devastating.   And it occurs everywhere, not just in this or that culture.  But even a disease as “transcultural” as schizophrenia seems to be culturally and socially conditioned in certain ways.     Schizophrenics often suffer from various kinds of delusions.  And  it wouldn’t be at all surprising if the content of those delusions were keenly sensitive to locally culturally  shaped beliefs and practices.

On the other hand, we need to be careful here too not to overstate the case for actual cultural variations in the way mental illnesses express themselves.  Just like with everything else in our the rapidly globalizing economy, there are forces that threaten homogenize away cultural differences --  including cultural differences in the way we experience, treat, and understand mental illness.  In fact, this week’s guest is Ethan Watters author of Crazy Like Us: The Globalization of the American Psyche.  He argues that the American Psychiatric establishment is, in effect, changing the way mental illness is experienced, treated, and understood, around the globe. Is the rising hegemony of the American model of mental illness noticed by Watters  a good thing or a bad thing?  Does it represent scientific progress or a kind of cultural imperialism?    Would it be better to let a thousand cultural flowers bloom in the treatment, understanding, and experience of mental illness?  Those are just some of the questions we hope to address. 

Comments (4)

Guest's picture


Friday, May 7, 2010 -- 5:00 PM

Wow! the "koro" mental illness is an eye opener. D

Wow! the "koro" mental illness is an eye opener. Did not realize the great impact of cultural milieu is to mental illness and how much it shapes the way mental illness evolves in society...I personally believe it is not a good or bad thing...we cannot make a judgemental attack on how it shapes our globalization and how it hinges on how we label it as cultural imperialism or scientific progress... this is interesting.. thanks for making philosophy talk one of the best programs in opb not to mention fresh air is also my favorite!

Guest's picture


Sunday, May 9, 2010 -- 5:00 PM

Perhaps two "absolutes" in the issue of 'mental di

Perhaps two "absolutes" in the issue of 'mental disorder' are with reason and mood. Problems with reasoning seem to be 'reasonably' definable in terms of standard ability to engage in logically accurate thought. As always there are gray areas in that it's not always strictly a matter of logical or illogical conclusions based on accepted facts, but inability to dependably evaluate empirical evidence, such as validly establishing koro as a genuine illness. That aspect seems a part of mood problems where fear of consequences such as with koro distorts an accurate evaluation of data.
Mood characteristics and their effect on assessment of empirical data appear the most culturally dependent and are at the basis of such peculiarities as the old tarantula street panics in Italy, fast food establishments or rap music, both now also spread to Italy.

Guest's picture


Tuesday, June 1, 2010 -- 5:00 PM

"We don't know what Schizophrenia consists of but

"We don't know what Schizophrenia consists of but we know it is devastating", etc.
First of all, what Schizophrenia "really is" can only be of interest to the theoretical reductionist. Anything the reductionist comes up with will be independent of and irrelevant to the phenomena itself. And we certainly don't know that "it" is "devastating" as nothing has been identified to be devastating. Even the meaning of "devastating" isn't apparant.
At the end of the day all that psychology offers when dealing with "koro", schizophrenia, etc., are a circular round of synonymous metaphors such as "going haywire", "disorder", "dysfunction" and circular reasoning such as "we know that it is a brain dysfunction because there are symptoms of a devastating illness, and we know that they are symtoms because there is a brain dysfunction."
We need to be clear about "illness". Illnesses are never found, they are an approach. Anything that falls under the umbrella of illness is assumed to be entirely destructive and physically independent of personhood. This certainly can't be said of either koro or schizophrenia.

Guest's picture


Sunday, August 22, 2010 -- 5:00 PM

Mental illness is something self-implementing. It

Mental illness is something self-implementing. It is brought to a person's genre forcefully rather than coming naturally. You should be relax, joyous and tentative to keep yourself always happy and free from mental burden to avoid mental illness.