[Download Pdf] ♋ Crazy Like Us: The Globalization of the American Psyche ♺ Garden-home.co

A woman tries to walk across a room, but collapses Another suddenly goes blind, for no obvious physical reason Victorian hysteria, clearly a product of a time when women lived highly constricted, repressed lives A veteran suffering from PTSD, on the other hand doubtless a real disease, immutable, applicable in all situations and cultures Not so, says Ethan Watters, who convincingly argues that all mental illnesses are circumscribed and molded by the cultures in which they occur A person who is distressed will express it by drawing from whatever pool of symptoms is available in his culture which may well be completely different from what is available in my culture.In Crazy Like Us The Globalization of the American Psyche, Ethan Watters, a veteran journalist who presented a scathing indictment of the recovered memory movement in Making Monsters, examines four illnesses in four parts of the world anorexia in Hong Kong, PTSD in Sri Lanka, schizophrenia in Zanzibar, and depression in Japan.These four illnesses and cultures are quite different from each other, but share something important none of them looked like the accepted Western clinical definition of the disease Anorexics in Hong Kong did not believe that they were fat, trauma sufferers in Sri Lanka tended to describe physical symptoms and damage to family relationships rather than psychological problems, schizophrenics in Zanzibar were believed to be possessed by spirits, and in Japan, milder forms of depression were not viewed as an illness that requires treatment.Watters describes a world far from the definitive sounding edicts of the DSM the diagnostical and statistical manual of psychological disorders, the handbook of Western psychology one in which distress is signaled in an enormous variety of ways The simple but mind bending truth, the anthropologist Allan Young explains, is that mental illnesses such as PTSD can be both culturally shaped and utterly real to the sufferer This world collides unhappily with the immutable disease view of much of the Western mental health establishment Anne Fadiman s The Spirit Catches You and You Fall Down makes a good companion read Western mental health professionals increasingly treat patients throughout the world, and are often far less helpful than they believe A Western trained therapist, unwilling to consider that a Hong Kong anorexic does not believe herself fat, is unable to hear what the patient is actually saying This is one problem with the globalization of the DSM An even larger concern is that in the course of describing an illness, particularly if the description is dispersed widely throughout a culture, therapists may actually create an illness where it did not exist before The local expressions of mental illness begin to disappear, and the clues that could have been gleaned from them are lost.Crazy Like Us is not a polemic against Western mental health care it is clear that competent Western therapists can be very helpful, under the right circumstances It is equally clear, though, that they can be distinctly unhelpful under the wrong circumstances, when they fail to understand that their definitions are not universal.This is especially clear in Sri Lanka, as American therapists rush to the scene of the tsunami, insisting that the local population has no understanding of trauma, and no idea how to treat victims The psychology professor Ken Miller suggests that we consider the opposite scenario, with Mozambicans telling 9 11 survivors which rituals they need to engage in to sever their relationships with deceased family members That the therapists earnestly believe themselves to be doing good makes these scenes no less disturbing They explain that large segments of the population will fall victim to PTSD, and that it is not necessary to understand Sri Lankan culture to make this prediction There is an obvious connection to Watters previous work, with echoes of the victim mentality that characterized the recovered memory movement in these PTSD predictions, as well as in the medicalization of very minor depression in Japan Human beings occupy a large spectrum, from fragility to resilience, and it s not clear why fragility should be the default option These therapists are, of course, wrong Sri Lankan history is sadly full of tragedy, and Sri Lankans have developed specific and effective methods of coping with it.In all of these cultures, a shift is underway to aWestern view of the mind Watters believes that a society is most susceptible to this influence when it is under a great deal of strain the Chinese takeover in Hong Kong, for instance, or the tsunami in Sri Lanka These changes do not happen on their own, but tend to be encouraged by outside agencies The most striking instance of Western intervention that Watters describes is a successful attempt by a consortium of pharmaceutical companies to change the definition of depression in Japan, through an enormous and society wide campaign The high regard in which U.S knowledge is held in much of the world makes such attempts to influence local mental health practices particularly effective and dangerous.From the U.S point of view, the culture blind promotion of Western ideas on the mind could appear to be a good thing Shift your vantage point a bit, though, and these efforts look misguided and even harmful This is a brilliant and genuinely paradigm shattering book. Neil s anthropology textbook had an amazing article adapted from this.I really really want to read this, and to readanthropologyDone Now I want to readby this author, too.What I really like is that he emphasizes reportage, leaving the interpretations mostly to us The data seems sound to me and you who have been reading my reviews know that I pay attention and the obvious conclusion seems justified And so I agree with Watters that this is an important issue and that this book needs to be read Western ideas about mental health are not the only ones, and often not the most helpful ones, either No matter the good intentions of activists on missions, if they try to fight the cultural traditions of patients and families, they are most likely doingharm than good.Even in the west, listento your own body and spirit than to your doctor, who is probably partially informed by sneaky campaigns on the part of drug companies Only you know what you really need for most mental illnesses and even for many other conditions That is to say, be sceptical of both SSRIs and of St John s Wort Of surgery and of acupuncture Etc.Anyway, back to the book There is currently no scientific consensus that depression is linked to serotonin deficiency or that SSRIs restore the brain s normal balance SSRIs broadly alter brain chemistry and actually have only been shown to help,than placebo, adult males One study showed that teens were five timeslikely to experience serious side effects including hospitalization and suicide attempts And the makers of Paxil are pushing this Western cultural story of depression on the Japanese people.In Zanzibar, the author spent time learning about the traditional cultural stories that were understood about people with schizophrenia and learning about how families coped with caring for a mentally ill family member Unlike in the West, they don t talk about brain chemistry And Watters quotes D.A Granger, who also points out that we don t talk about brain chemistry when we refer to healthy people and emotions The cultural story of the brain chemistry narrative is at least as unappealing and dehumanizing to many as was the idea that the person with a mental illness should be able to get better by applying willpower or should just snap out of it Particularly harmful are the practices that those Western aid workers who were interested in PTSD brought to Sri Lanka after the tsunami of 2004 Imagine our reaction, said Ken Miller, if Mozambican traumatologists flew over after 9 11 and began telling survivors that the needed to engage in a certain set of rituals in order to sever their relationships with their deceased family members How would that sit with us Would that make sense After all, it s not like the civil war in Sri Lanka hadn t given the citizens plenty of experience in dealing with trauma already.What may be most ironic is that the development of PTSD as a diagnosis came out of a politically agendized exploration of how Vietnam vets had a unique experience These psychoanalysts and veterans had no intention of carving out a diagnosis that could be applied to all victims of terrifying events, or even all soldiers who experience battle these veterans felt upset because they had been used, deceived, and betrayed After all, we already could talk about shell shock, debility syndrome, and other related ideas from previous wars.In a way the first exploration was the most startling to me I ve always wondered about Anorexia and other food disorders, not being able to even consider fasting myself, and Watters makes it very clear that fat phobia is a cultural story about something much deeper that tends to trouble girls and young women Putting a few pounds on fashion models would not be a cure all.On the whole the book is not only important, but it s both infuriating and sad because it s probably too late to protect other traditions from Western, particularly American, interpretations of mental illness But it s also just plain fascinating Very accessible and satisfying.Know that the issues of book are somewhat personal to me, and therefore some of what I ve said above is actually extrapolated and not actually directly in Watters book Still, I ve no doubt that my interpretations are valid and that we would not say that I did him a disservice.Obviously my five star rating indicates that I highly recommend this to anyone the least bit interested in psychology, health, globalization, and even to educators and first responders in diverse communities. [Download Pdf] ♴ Crazy Like Us: The Globalization of the American Psyche ♼ It Is Well Known That American Culture Is A Dominant Force At Home And Abroad Our Exportation Of Everything From Movies To Junk Food Is A Well Documented Phenomenon But Is It Possible America S Most Troubling Impact On The Globalizing World Has Yet To Be Accounted For In Crazy Like Us, Ethan Watters Reveals That The Most Devastating Consequence Of The Spread Of American Culture Has Not Been Our Golden Arches Or Our Bomb Craters But Our Bulldozing Of The Human Psyche Itself We Are In The Process Of Homogenizing The Way The World Goes Mad America Has Been The World Leader In Generating New Mental Health Treatments And Modern Theories Of The Human Psyche We Export Our Psychopharmaceuticals Packaged With The Certainty That Our Biomedical Knowledge Will Relieve The Suffering And Stigma Of Mental Illness We Categorize Disorders, Thereby Defining Mental Illness And Health, And Then Parade These Seemingly Scientific Certainties In Front Of The World The Blowback From These Efforts Is Just Now Coming To Light It Turns Out That We Have Not Only Been Changing The Way The World Talks About And Treats Mental Illness We Have Been Changing The Mental Illnesses ThemselvesFor Millennia, Local Beliefs In Different Cultures Have Shaped The Experience Of Mental Illness Into Endless Varieties Crazy Like Us Documents How American Interventions Have Discounted And Worked To Change Those Indigenous Beliefs, Often At A Dizzying Rate Over The Last Decades, Mental Illnesses Popularized In America Have Been Spreading Across The Globe With The Speed Of Contagious Diseases Watters Travels From China To Tanzania To Bring Home The Unsettling Conclusion That The Virus Is Us As We Introduce Americanized Ways Of Treating Mental Illnesses, We Are In Fact Spreading The DiseasesIn Post Tsunami Sri Lanka, Watters Reports On The Western Trauma Counselors Who, In Their Rush To Help, Inadvertently Trampled Local Expressions Of Grief, Suffering, And Healing In Hong Kong, He Retraces The Last Steps Of The Teenager Whose Death Sparked An Epidemic Of The American Version Of Anorexia Nervosa Watters Reveals The Truth About A Multi Million Dollar Campaign By One Of The World S Biggest Drug Companies To Change The Japanese Experience Of Depression Literally Marketing The Disease Along With The DrugBut This Book Is Not Just About The Damage We Ve Caused In Faraway Places Looking At Our Impact On The Psyches Of People In Other Cultures Is A Gut Check, A Way Of Forcing Ourselves To Take A Fresh Look At Our Own Beliefs About Mental Health And Healing When We Examine Our Assumptions From A Farther Shore, We Begin To Understand How Our Own Culture Constantly Shapes And Sometimes Creates The Mental Illnesses Of Our Time By Setting Aside Our Role As The World S Therapist, We May Come To Accept That We Have As Much To Learn From Other Cultures Beliefs About The Mind As We Have To Teach I read a lot of books about psychology and mental illness, but this book took what I already knew to a new level It discusses four different illnesses in four different cultures anorexia in Hong Kong, schizophrenia in Zanzibar, PTSD in Sri Lanka, and Depression in Japan.One of the fascinating premises promoted by this book is that when Western psychologists describe a typical western mental illness to another culture, their incidence of that illness morph into a version closer to ours I don t want to give too much away, but I ve always been fascinated by the existence of culturally specific mental illnesses like koro and amok and hysterical leg paralysis , and this presentation of our own culturally specific mental illnesses flipped everything around I genuinely felt my mind broadened.The only other book I ve read on this subject is The Culture of Our Discontent, but I think this book is better I liked that Watters chose four distinct subjects to cover, and covered them in depth I also felt that he managed to say we don t know as much as we think we know without getting too much into simple, primitive people have all the answers. What a potentially controversial read It has a lot of implications that under a certain light be considered offensive to people suffering from mental illnesses, people caring for them, and people attempting to cure mental illnesses I thought it was fascinating It discusses four case studies anorexia in Hong Kong, PTSD after the Christmas Tsunami in Sri Lanka, schizophrenia is Zanzibar, and depression in Japan I became aware of many beliefs I hold about mental health that I didn t even realize I had Beliefs that I assumed were factual, that I never even questioned, and that even now are hard to challenge I m still thinking what is my main takeaway from this book, but in any case I recommend it to anyone interested in mental health and cultural differences. Crazy Like Us is the most fascinating book I ve ever read about mental illness, and probably one of the best books I ve read this year I thought it would be a tough read, but found myself utterly caught up The writing is precise, thoughtful, humane, and erudite Watters thesis is that Western notions of mental illness are being exported to Africa and Asia, for intertwined reasons of profit and philanthropy, and this is changing the very nature of mental illness in the countries concerned The book provides convincing evidence to support this thesis through four in depth case studies Each focuses on a particular geographical location, cultural milieu, and category of mental illness Although I found all four deeply compelling, I think the most powerful concerned PTSD in Sri Lanka After the catastrophic tsunami in 2004, a range of organisations and individuals descended upon the country to try and treat the tsunami survivors for PTSD However, as the book explains, this demonstrated the culturally mediated nature of trauma and its treatment, as well as the neocolonialist arrogance of well meaning medical practitioners with zero local knowledge As Watters puts it Often these campaigns seemed to imply that the psychological consequences of trauma were similar to a newly discovered disease, and that local populations were utterly unaware of what happens to the human mind after terrible events The implicit assumption often left anthropologists shaking their heads in disbelief It takes a wilful blindness to believe that other cultures lack a meaningful framework for understanding the human response to trauma Most of the disasters in the world happen outside the West, says Arthur Kleinman, a medical anthropologist from Harvard University Yet we come in and we pathologise their reactions We say, You don t know how to live with the situation We take their cultural narratives away from them and impose ours It s a terrible example of dehumanising people Once one comprehends the cultural differences in psychological reactions to trauma, the efforts of the Western traumologists who rush into disaster zones on a few days notice begin to look somewhat absurd To drive this point home, psychology professor Ken Miller asked me to consider the scenario reversed Imagine our reaction, he said, if Mozambicans flew over after 9 11 and began telling survivors that they needed to engage in a certain set of rituals in order to sever their relationships with their deceased family members How would that sit with us Would that make sense Through these case studies, Watters makes deeply thought provoking points about the culturally mediated nature of mental illness Over the decades and centuries, mental distress has always existed but evolved in form As I gathered from My Age of Anxiety Fear, Hope, Dread, and the Search for Peace of Mind which I also highly recommend , the categorisation of depression and anxiety as different disorders only came about when drugs were developed to treat their symptoms Watters also points out that the categorisation of mental illness as biological in nature, an imbalance in the individual brain rather than having a social context, increases rather than reduces stigma The current argument is that situating mental illness in the biological realm gives it the same status as physical illness which is likewise stigmatised Watters cites research suggesting that emphasis on mental problems as physical disorders leads to greater fear and aversion towards the mentally ill than emphasis on social and experiential factors This of course links neatly to the wider individualism in Western culture, which frames mental illness as purely a personal problem, rather than a reaction to circumstances or society.Another case study in the book examines anorexia in Hong Kong and reads very interestingly with the excellent novel The Vegetarian Yet another investigates in Zanzibar the reasons for a persistent research finding, which I hadn t previously come across, that those diagnosed with schizophrenia in developing countries have a significantly better prognosis than those in the developed world The last damningly narrates how big pharma companies created a new concept of depression in order to sell SSRIs in Japan This sheds striking light on how Japanese notions of mental illness, and in particular suicide, were very different to those of the West before GlaxoSmithKline got involved The concluding chapter considers the future of mental illness and the DSM V, which was in preparation at the time Watters was writing It reminded me of this amazing review of the final DSM V as if it was a dystopian novel The Book of Lamentations Crazy Like Us ends as strongly as it began, with this statement If the irony isn t already obvious, let me make it clear offering the latest Western mental health theories in an attempt to ameliorate the psychological distress caused by globalisation is not a solution it is a part of the problem. By undermining both local beliefs about healing and culturally created conceptions of the self, we are speeding along the disorientating changes that are at the very heart of much of the world s mental distress I have tried to avoid making the cliched argument that other,traditional cultures have it right when it comes to treating mental illness All cultures struggle with these intractable diseases with varying degrees of compassion and cruelty, equanimity and fear My point is not that they necessarily have it right only that they have it different.I highly recommend this book, whatever your experience of mental illness, or lack thereof It asks very important yet rarely posed questions about the psychological toll of cultural homogenisation. So it s basically pop psychology anthropology and as such lacks a certain depth However, this is an interesting and convincing book about the cultural specificity of mental illness and the imperialism of a specifically Western, radically individualist, medical model of mental suffering I ve been pretty persuaded by the idea of symptom pools that each culture has its own pool of legible ways to express psychic distress, subconsciously taken up by sufferers since I first read about them in 2007 ish It s interesting to think about the ways in which speech, raising awareness can have material effects Also, and importantly, this book doesn t fall into the trap of a lot of critics of the medical model of mental health, i.e denying the materiality of the mind and proclaiming the supremacy of talk therapy which is of course also a culturally imperialist model of dealing with psychic distress It doesn t moralise about the choices of individuals trying to navigate their own mental illnesses, or proclaim one experienceauthentic or less mediated than another Recommended. A very readable and very interesting read I also heard the author in a radio interview you can find here It had never occurred to me that HOW mental illness and distress expresses itself is very tied in to one s culture, so that the same event a flood, a death, whatever requires different treatment, ritual, etc depending on one s culture The USA has pushed western psychiatry s and psychology s theories all over the world, but done next to nothing to figure out how much damage it s done to local peoples and their culture As the book says, It turns out we have not only been changing the way the world talks about and treats mental illness we have been changing the mental illnesses themselves This is a book for you if you have any of the following interests social justice e.g., protection of indigenous and non dominant western cultures anthropology history of and efficacy of western psychiatry mental and or physical health history and current events Kudos to my friends on goodreads who feel inspired enough to write full fledged reviews I simply can t muster the energy However, this book enraged me in a way few do and I feel compelled to share at least some of my thoughts Watters caught my attention with the pot shots he threw at the DSM in the NYT magazine earlier this year and I approached the book with cautious optimism Crazy Like Us follows along the same lines as his initial article, providing four examples of what anyone who has ever taken a multicultural counseling course could tell you culture bound syndromes exist Watters does not explain the syndromes, reveal how mental health practices in these countries deal with these cases, etc Rather, he spends about 200 pages belaboring the point that the good intentions of the West and the dreaded DSM are severely misguided True enough Yet, Watters writing is near histrionic and the constant hyperbole is tough to take with a straight face We erase this diversity at out own peril The problem with this book and others like it ie journalists writing about mental health is that they do not fundamentally speak the same language and make sweeping generalizations with the anecdotal evidence they happen to muster up An n of 1 proves nothing except that confirmatory bias exists. Well, this was certainly interesting From studying anthropology to working in international public health to studying psych nursing, this is right up my alley I appreciate some of what he is trying to say, in that transcultural treatment options are often not adequately tailored to each new specific culture To some degree, I also believe that mental illness is culturally determined, or at least expressed in the particular symptom pool of a time and place But I also have seen that medication can work wonders and that community remedies are not always helpful I talked to a Kenyan colleague who worked in mental health here and in Kenya and asked him about his experience with mental health care in Kenya I asked what types of programs and structures exist He told me that people with schizophrenia have a huge burden and live on the streets We know that historically all over the world people with schizophrenia have been killed and tortured, declared spiritually ill by their cultures, not always the revered shamans Watters finds In the US, many people believe vaccines cause autism, a culturally defined belief that results in children dying unnecessarily In my own experience working on a pilot program for cognitive behavioral therapy for orphaned children in Tanzania, we found that there were good local community programs similar to western models, actually but there simply were not enough resources to accommodate the orphaned population Now it may be possible that these children aren t actually bothered by the things we measured death of a parent, witnessing violence, receiving abuse, hunger, overburdened caregivers i.e that we were imposing non relevant western definitions of trauma but I highly doubt it We know at least anecdotally that these children have less education, lower economic status and often end up in sex work, but, hey, maybe that s a western idea of a bad life My point here is my struggle with anthropology At what point do you put theory aside and intervene In any decent intervention you work with the population to adjust it, but you will never fit every piece Does that mean we should never act The third point is that Watters is quite invested in traditional medicine in ways that the recipients might not be In my early travels I would be frustrated that people didn t value what I valued about their culture and wanted to Americanize with TVs, cars, and gasp clean water I think it is actuallypaternalistic to require a culture to conform to a static definition of traditional It is not my job to curate cultural value outside of my own experience Often requests for western health care, including mental health come from the populations themselves Final thought provoking bit At the very end of a harsh rant agains it, he mentions that his wife is an American psychiatrist WTF PS re Pharma Lifestyle drugs can be creepy Viagra and such , the patents can be infuriating, but, hello, antibiotics vaccines anti retrovirals insulin birth control and in my experience SSRIs, increase lifespan and quality of life exponentially.