Culture and the Individual

1. Culture and the Individual Culture and Mental Illness

2. 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.

3. 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

4. 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?

5. 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 describes EG. 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.

6. 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?

7. Culture Bound Disorders Windigo • 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

8. 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

9. Culture-Bound Disorders General symptoms Easily frightened Compulsive imitative behavior (echopraxia) Compulsive imitative speech (echolalia) Latah Affects women in SouthEast Asia Affects men in Mongolia Imu Affects elderly Ainu women in Northern Japan Saka Affects women in Kenya, Africa

10. Culture-Bound Disorders Amok Disorders Symptoms Extreme agitation Running aimlessly Jumping up and down Break with reality Increase in respiratory and circulatory activity Sweating and a decrease in skin temperature Pibloktoq Arctic cultures Wild Man New Guinea Amok Indonesia

11. 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

12. 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

13. 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

14. 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

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

16. Quiet Therapies Morita Therapy Patient spends 4-7 days in bed isolated No talking with anyone No meeting with anyone No reading, writing, media No eating between meals Patient spends 3-7 days out of bed isolated Same above plus no physical exercise Writes in a diary that is critiqued by a doctor Patient spends 7-29 days isolated Same above with assigned chores Patient can shop and do some reading (no literature, philosophy)

17. Quiet Therapies Naikan 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.