Crazy Like Us

I recently finished a very interesting book called "The Globalization of the American Psyche - Crazy Like Us" by Ethan Watters.  It tells how Americans have exported their understanding of mental illness and have imposed it on cultures with very different ways of relating to those illnesses.

The first section is about how anorexia was marketed in Hong Kong, yes, marketed.  To explain what this means - in late 1995, Princess Diana gave her famous interview confirming the rumors that she had suffered from bulimia for more than four years.  The newspapers covered this widely, of course, and bulimic behaviors spread like wildfire among adolescents.  Patients themselves often said that they tried vomiting etc. because they read or heard about it.  The chapter shows how similarly, anorexia barely existed and when it manifested, it was different than the American version, i.e. they weren't on a diet and were not interested in losing weight.

The problem is, the American DSM and Western medicine in general are highly respected in other parts of the world and so even when their patients do not fit American norms, they ignore that.

One of the important points that is made is that those who argue that increased incidence of a condition is due to its previously going unrecognized or underreported do not balance their assertion with the fact that when the media promotes a new disorder/condition/illness, people latch on to it and "discover" that they too are sick.  He has a fascinating part about the hysteria diagnosis in the late 19th century.  Do you know of anyone diagnosed with hysteria nowadays? No, because that condition with all its symptoms is no longer trendy.

The second section is about bringing PTSD to Sri Lanka after the tsunami.  Lots of well-meaning Westerners went there to help the natives avoid PTSD, completing ignoring the natives' culture and ways of dealing with traumatic events while foisting their mental illness ideas on them.  Amazingly, study after study published during the 1990's showed that early interventions were either ineffective or actually harmful!  "Early interventions sometimes appeared to be priming victims to experience certain symptoms."