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How does culture shape the expression of mental illness or anamolous mental states? I've explored that questions several times at Neuron Culture, sometimes provoking sharp objections to the idea that culture has any effect at all on the expression of psychosis — some people are just crazy, the response goes, and culture has little or nothing to do with it. Some of that response was due to poor argument on my side; I tried to make it move substantive in Batman Returns: How Culture Shapes Muddle Into Madness.
In Hearing Voices in Accra and Chennai, a recent talk broadcast at the Culture Mind Brain conference, Stanford's Tanya Luhrmann looks at roughly this same issue through another prism: that of the voices people with schizophrenia sometimes hear. It shows yet another example of how both the experience of what we call schizophrenia and other people's response to it vary by culture.
A couple weeks ago I was delighted to find a more comprehensive piece by Luhrmann at Wilson Quarterly, Beyond the Brain, in which she looks at how mainstream psychiatry's biological model of schizophrenia is starting to recognize this heavy influence of culture, with increasing recognition of schizophrenia as a "biocultural" phenomenon. Luhrmann's opening account of one particular patient, Susan, shows how different responses from culture can shape the course of schizophrenia, even within the U.S.:
The idea that culture shapes the experience and expression of anomalous mental states is also explored in Ethan Watters' Crazy Like Us: The Globalization of the American Psyche, and with particular directness in the blogosphere lately by N, a blogger who at the fascinating Ruminations on Madness often examines the sometimes ill fit of our culture with his/her schizophrenia. N responded to the Batman shootings with the extraordinary piece maeror meror, which I wrote about in Batman Returns: How Culture Shapes Muddle Into Madness. S/he now responds to Luhrmann's "Beyond the Brain" essay with Return of the Social: Rewriting the recent history of schizophrenia — a post that adds value by taking exception to some of Luhrmann's argument without dismissing it. Among the many striking things there:
I find this a bracing pair of reads. The current jabbering about the relationship between madness and violence might improve if more people were familiar with the ideas raised in these essays. Both essays might strike newcomers to the discussion as dense at points, and the differences between the two authors obscure or academic, as Luhrmann and N disagree on where we are in the pendulum swing between environmental and biological causes of madness. But it seems safe to say they would agree that — as the recent Culture, Mind, Brain conference suggests — there's more attention now to seeing how environment (including culture) and biology work together, and less on an either-or explanation.
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Edits: Jan 15, 2013: Corrected a few typos, changed a muddy phrase or two, and removed a couple redundancies.