Culture and the Individual

Culture and Mental Illness

Definitions for Mental Illness

• Patterns of behavior and feeling that are out of keeping with cultural expectations that bother the person who acts and feels them and/or that bother others around the person.

• This implies a statistical model of recognizing mental illness.

Models for Explaining Mental Illness

Organic/Medical model - something is wrong biochemically and treatment should correct the chemical imbalance

Psychogenic model – disturbances in the self that affect the an individual’s ability to function psychologically, socially and culturally

Culturally derived model – behaviors and personality traits that deviate significantly from cultural norms

Questions about Mental Illness Cross-Culturally

• Is mental illness present in all cultures?

• Is there more mental illness in modern complex societies or in traditional, non-literate cultures?

• Are some societies harder to live in and therefore produce more mental illness?

• Are different societies characterized by different types of mental illness?

Laindjura Case Study

Murngin Tribe, Arnhem Land, Australia• Laindjura is a killer and sorcerer• Claims to have murdered many people• Murders could not have happened as he

describesEG. Tomahawking a young girl between the eyes, pushing his arm up

through her vagina, pulling out some of her intestines, grasped her heart, collected some of her heart’s blood, sprinkled ants on the girl’s intestines, then pushed the intestines back into the body and repaired all wounds so that nothing was visible. Told the girl that she would die in two days. She gathered lilies, laughing with other women and died two days later.

Laindjura Case Study

Murngin tribesmen describe Laindjura as:

“a good hunter, an excellent wood carver who had several wives and a number of children.”

He was considered perfectly normal in his society.Is he mentally ill if the rest of society sees him as normal?

Culture Bound DisordersWindigo

• Chippewa, Cree, Montagnais-Naskapi Indians in Canada – both males and females

• Cannibalistic impulses, delusions, nausea, anorexia, insomnia

• Delusions about other people turning into edible animals

• Belief that affected person is possessed by a cannibal giant with a heart or entrails of ice

• Actual cannibalism does occur in some cases, usually with a close family member eaten

• Windigo sufferer frequently killed by members of the group

Culture-Bound Disorders

Ghost Sickness

Affects Kiowa Apache men and women

Occurs at the time of mourning

85% of adults report having the syndrome

Fear of ghosts

Cannibalistic fantasies

Attacked by ghosts

Culture-Bound DisordersGeneral symptoms

Easily frightenedCompulsive imitative behavior (echopraxia)Compulsive imitative speech (echolalia)

LatahAffects women in SouthEast AsiaAffects men in Mongolia

ImuAffects elderly Ainu women in Northern Japan

SakaAffects women in Kenya, Africa

Culture-Bound DisordersAmok Disorders

SymptomsExtreme agitationRunning aimlesslyJumping up and downBreak with realityIncrease in respiratory and circulatory activitySweating and a decrease in skin temperature

PibloktoqArctic cultures

Wild Man New Guinea

AmokIndonesia

Recognizing Mental Illness Cross-Culturally

• Hospital admission rates

• Using criteria developed from patients in modern Western culture

• Using dysfunction and discomfort in everyday life as a criteria

Treating Mental Illness

All therapies

mobilize a sense of hope

include rituals that make patient feel like something effective is being done

Active vs quiet therapies

Individualistic vs community-based therapies

Active Treatment

Abreaction Therapies

Work the patient up into a state of excitement leading to exhaustion and collapse

Symptoms sometimes disappear on recovery

Similar effects to electric shock treatment

Active Treatment

Ho’oponopono Traditional Hawaiian Society

Group therapy that involves everyone in the household.Group focuses on the problem, with each

person taking a share of responsibility for the problem.Meeting lasts until a complete resolution is

reached

Active Therapies

• Mexican American Curandera – Girl is depressed and suicidal– Treated at hospital without success– Physical trial component– Psychological component– Social support component

Quiet TherapiesMorita Therapy

Patient spends 4-7 days in bed isolatedNo talking with anyoneNo meeting with anyoneNo reading, writing, mediaNo eating between meals

Patient spends 3-7 days out of bed isolatedSame above plus no physical exerciseWrites in a diary that is critiqued by a doctor

Patient spends 7-29 days isolatedSame above with assigned chores

Patient can shop and do some reading (no literature, philosophy)

Quiet TherapiesNaikan Therapy

Patient is required to

review his/her life

think about what he/she has received

meditate about whether he/she deserves this

Lasts 7 days from 5:30am to 9:00pm

Counselor interviews patient periodically to assure compliance with rules

Goal is to

get patient back into a responsible position in society

instill a renewed sense of gratitude and respect.