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Relationship between culture and psychopathology
Essays on cross cultural mental health
Essays on cross cultural mental health
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Culture is a collection of religion, traditions, and beliefs that are passed down from generation to generation. Culture is created and maintained through the repetition of stories and behavior. It is never definite because it is continuously being modified to match current trends, however, historical principles are still relevant. With respect to mental illness, culture is crucial to how people choose to deal with society and the methods used to diagnose and cope with mental illnesses. In Watters’ The Mega-Marketing Depression of Japan, he focuses on how Japan and other cultures define depression, but also displays how the influence of American treatments in eastern countries eventually becomes the international standards. Even though the According to Kirmayer, “...every culture has a type of experience that is in some ways parallel to the Western conception of depression…” (Watters 517). He proves this by explaining how a Nigerian man “might experience a peppery feeling in his head” (Smith 517) or how symptoms of depression in an American Indian project as feelings of loneliness. Depending on the location of the country and the language used to describe distress, symptoms of depression varies from region to region. He described this as “explanatory models” that “created the culturally expected experience of the disease in the mind of the sufferer” (Watters 518). In other words, the cause of depression is different for every country and thus each person experiences and describes depression in a way that matches their culture and environment. American researchers and clinicians often overlook culturally distinct symptoms because Americans classify depression in terms that might contradict the standards of other Kitanaka introduced two ideas Endogenous Depression and typus melancholicus. Endogenous depression is a “crippling type of psychosis believed to be caused by a genetic abnormality” (Watters 520). It was compared to an internal ticking time bomb that would go off let depression run its course. Introduced by Hubert Tellenbach, Typus melancholicus was a personality type that fit the behavior of Japanese individuals. “Typus melancholicus mirrored a particularly respected personality style in Japan: those who were serious, diligent, and thoughtful and expressed great concern for the welfare of other individuals and the society as a whole” (Watters 520). It’s reasonable to believe that this personality type is one of the reasons for depression in Japan. Sadness or depression was viewed as a way of creating stronger connections with family and their community. Kirmayer noted that personal hardships build character and connected it to the “Buddhist belief that suffering is more enduring and more definitive of the human experience than transient happiness…” (Watters 522). Therefore the Japanese culture admired the melancholic personality type and saw sadness as an enlightened state. The reality of depression in their culture wasn’t as serious as the western culture because depression was seen as an inevitable characteristic of life. The
As an expat child having gown up and lived across three continents-politely labelled as a third culture kid, but in reality not belonging to any one culture-I doubt if my own parents would understand me let alone a doctor in another country. My mother suffers from trichotillomania and on visiting a psychiatrist in a foreign country, he mentioned not seeing this disease often in his country: he had made her feel at once both alienated and awkward, and not likely to trust his diagnosis or his treatment. I have seen her throwing her medication away- Pharmacotherapy cannot work without psychotherapy-and the demands of psychotherapy seem to be only increasing when you add a complex cultural element to it. Gold and his brother argue that both biological and social factors contribute to psychosis. In the field of psychiatric and behavioural sciences this would call for physicians skilled in appreciating all sorts of cultures and environments and while this may seem a tall order, a first step towards a solution would lie in acknowledging the role and importance of such external stimuli. Doctors cannot know it all but at least when they give a label it will be real. In a field where labels tend to stick and where the social stigma attached to mental illness is still considerable, it is worth while for doctors to make more informed diagnoses. Diagnoses that we can
Kleinman, A. 1980. Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. University of California Press.
The dominant biomedical model of health does not take into consideration lay perspectives (SITE BOOK). Lay perspectives go into detail about ordinary people’s common sense and personal experiences. A cultural perspective, like the Hmong cultures perspective on health, is considered a lay perspective. Unlike the Hmong culture, where illness is viewed as the imbalance between the soul and the body, the dominant biomedical model of health views health in terms of pathology and disease (SITE THE BOOK). Although the Hmong culture considers spiritual and environmental factors, the dominant biomedical model of health only looks at health through a biological perspective, and neglects the environment and psychological factors that affect health. Depression in the U.S. is a medical illness caused by neurochemical or hormonal imbalance and certain styles of thinking. Depression is the result of unfortunate experiences that the brain has difficulties processing (SITE 7). Unlike the Hmong culture, where Hmong’s who are diagnosed with depression report the interaction between a spirit, people diagnosed with depression in the Western culture report themselves to having symptoms such as feeling tired, miserable and suicidal (SITE
Measuring depression in different culture is a complicated task, “there is a need for tools for multicultural mental health primary in order to promote communication and improve clinical diagnosis” (Lehti et al, 2009). This results indicated that there is still a need for a tool to accurately measure depression in patients from different countries/cultures. Each culture is unique in its very own, and certain abnormal behavior can only be found in certain culture. For instance, in western society we have the histrionic personality disorder, in which an individual desperately seek out attention, while in Japan, there is a phenomenon called “hikikomori” is an abnormal behavior where a person would go great length to avoid any social contract at any means. This abnormal behavior is similar to the avoidant personality disorder, however hikikomori is more severe. “Hikikomori is used to refer to group of young people who have withdrawn from social life and have had no relationships outside of family for a period in excess of six months.” (Furlong, 2008). The long period of time to be withdrawn from society is quite serious and will have many psychological damage. Another factor that is important when looking at abnormal behavior is the gender. The gender of an individual have play an important role in shaping the diagnosis and the diagnostic feature of these symptoms.
Hikikomori can be perceived as a manifestation of Japanese democracy, in which the good society is imagined as cohesive, protective and secure, rather than one in which the individual can freely exercise the right to be different. But that is not always so. Schools, families and the sphere of mental health care have focused on producing social inclusion, but have discouraged citizens from being labeled as ‘‘different’’, even when such a distinction could aid them.[5] For example, Japan’s postwar education and health care encouraged relative equality and common social values, as a key to a healthy and productive society. However, society offers limited and constrained substitutes to mainstream social practise. Mental health is often described as a matter of an individual’s attitude (ki no mochiyo ¯), so it is important to keep in good spirits. The over-arching cultural value is attached to being active and participative, and if one fails to do so they are considered “different”. As a result a more diffuse assumption is that mental degeneration, whether in the form of mental illness, senility or even suicide, is, at least in some part, voluntary. [3] This approach to depression does not recognize nor does it emphasize psychological, developmental or even familial issues that were potentially at play in the youth. Instead, the stress is almost exclusively placed on healing through
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures shares the journey of cultural illiteracy from the Hmong and American side. Fadiman states, “In 1995, for the first time, the national guidelines for training psychiatry residents stipulated that they learn to assess cultural influences on their patients’ problems,” (Fadiman 270). Though the unfortunate events that occurred were definitely able to avoid now, at the time, there was no standard set of actions and procedures to take in order to provide the best health care to different cultures. Fadiman truly succeeded in showing the reader that good intentions and compassion must be weighed more heavily when analyzing events and the consequences must be met with an objective eye.
Mental illness is more common than one would like to believe. In reality, one in five Americans will suffer from a mental disorder in any given year. Though that ratio is about equivalent to more than fifty-four million people, mental illness still remains a shameful and stigmatized topic (National Institute of Mental Health, n.d.). The taboo of mental illness has an extensive and exhausting history, dating back to the beginning of American colonization. It has not been an easy road, to say the least.
The proficiency-supportive cultural beliefs in Japan about depression helped form metaphors that collectively glorified the state of being depressed, which produced a common appreciation and praise to those afflicted. Previous to the western drug companies alteration of the country’s beliefs regarding depression, “The personality typus melancholicus… influenced psychiatric thinking in Japan” (Watter 520). The common Japanese understanding of the mental illness was an idea that created a connection between the “respected personality style in Japan: those who were serious, diligent, and thoughtful (Watters 520) and the state of melancholy. The nation’s interpretation of depression spawned a belief, not acknowledging the mental condition as an illness or disease but an inherent mental status from a
Buddhism is a beautifully complex religion that since its widespread introduction to Japanese culture by the end of the seventh century has made enormous impacts and direct influences on the government and cultural practices of society (Hoffmann 36). The Japanese death poetry composed by Zen monks and haiku poets, compiled by Albert Hoffmann, is an excellent literary explication of the Japanese attitude towards death. This attitude is most notably derived from Buddhism, the main religion of the Japanese people. Even Japanese citizens who are not literal Buddhists still embrace the philosophies that have now become instilled in the cultural history of Japan due to such a heavy Buddhist influence on government and education throughout the centuries.
Poor mental health means the person is weak, and shameful and it is considered a punishment for the wrong doings of the ancestors. Asian Americans are reluctant to seek help for mental illness because of the stigma. Also, the Asian culture stresses stability and harmony while maintaining composure and control of feelings and behavior. Any behavior seen as abnormal threatens that stability and harmony. If an Asian patient does seek treatment for mental health issues, the provider needs to take into consideration that antidepressants and antipsychotics metabolize slower in persons of Asian
Katon, W., and Sullivan, M. D., (1990) Depression and Chronic Mental Illness. Journal of Clinical Psychiatry, v.51. pgs. 8-19
Culture-bound syndrome is a broad normality that incorporates certain behavioral, affective and cognitive phenomenon seen in different cultures. The phenomena are irregular from the common behavior that the individual of that culture might exhibit. The dynamic nature of the category makes it difficult to define and has lead a dispute on what would be the most proper name and definition for it. The DSM-IV (appendix I, p.844) defines culture-bound syndrome: recurrent, locality-specific patterns of aberrant behavior and disturbing experience that may or may not be linked to a particular DSM-IV diagnostic category. Many of these patterns are indigenously considered to be “illness”, or at least disorders, and most have local culture names. People
Depression is well known for its mental or emotional symptoms. Symptoms for depression include: persistently sad or unhappy mood, loss of interest or pleasure in previously enjoyable activities, difficulty concentrating, remembering, making decisions, anxiety, feelings of guilt, worthlessness, helplessness, and thoughts of death or dying. “People who have endured a major depressive episode describe the experience as a descent into t...
As the rate of immigration increases from Latin America, so should the understanding of the population and their understanding of mental health and coping skills used to prevent depression and remedy it. It is known that Latin American residents do have a lower rate of depression in comparison to that of North America. Those who immigrate to North America whom may not have had any previous problems with depression before immigration have a higher probability of reporting depression the more they assimilate. It is the goal in this study to identify coping mechanisms and differences in lifestyle that have an impact on the differences in depression levels in the individuals studied. Implications of the study could cause further reduction in depression and depressive symptoms with the individuals studied (Office of the Surgeon General,
Mental illness is the condition that significantly impede with an individual’s emotional, cognitive or social abilities (Savy and Sawyer, 2009). According to (Savy and Sawyer, 2009) neurological, metabolic, genetic and psychological causes are contributing factors for various types of mental illness like depression, schizophrenia, substance abuse and progression of condition. An elaborate system known as DSM-IV-TR gives a classification system that acts to separate mental illness into diagnostic categories based on the description of symptoms of illness (Savy and Sawyer, 2009). The exact primarily causes of mental illness are complicated, however, it seems to occur in a psychologically and biologically prone individual, in the trigger of environmental and social stress (Elder, Evans and Nizette, 2007).