How culture shapes your mind — and your mental illness
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THERE IS AN obvious value in standardization — two different clinicians should be able to look at the same patient and come up with the same diagnosis. And there are biological mechanisms at work that cross cultures, ethnicities, and genders.
Even framing an apparent disorder as disorder could present problems: For one thing, what may look like mental illness in one culture might not in another. It might look like spirit possession or a voice from God. In a significant study published in 2015, Stanford anthropologist Tanya Luhrmann and her colleagues compared how people who met the criteria for schizophrenia in the United States, Ghana, and India considered their auditory hallucinations. The Americans largely perceived their voices as intrusions, violations of their individual mental sanctity, while Ghanaians and Indians had predominantly positive relationships with their voices — Ghanaians tended to hear the voice of God, while Indians described their voices as playful and friendly.
Researchers suggested the difference may be in how “American cultural emphasis on individual autonomy” shapes the response to auditory hallucinations as both a violation and a symptom of a disease, rather than as possibly more benign people or spirits; Ghanaians and Indians, on the other hand, were “more comfortable interpreting their voices as relationships.” Whatever the reason, they suggested, the evidence demonstrated that “everyday, socially-shaped expectations alter not only how what is heard is interpreted, but what is actually heard.” This has implications for how schizophrenia is treated, they suggested, citing evidence that schizophrenia treatments in developing nations tend to have better outcomes than in more developed nations. “More benign voices,” she says, “may contribute to more benign course and outcome.”
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