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Culture and Psychopathology

The Anthropology of Mental Illness

Georgi Onchev

The book sets itself the ambitious task of exploring the relationship between human culture and the phenomenon of mental illness, that which has embarrassed, fascinated, and challenged educated minds throughout the centuries. Various manifestations of this phenomenon are examined in specific cultural contexts, presented with notable competence, and illustrated with memorable descriptions of clinical cases. (…) The book and its author have many merits—the capacity to present a highly specialized subject in an intelligible, absorbing, and simultaneously profound manner; respectable erudition and academic self-discipline; and the notable skill of handling different domains of knowledge, among others. The most remarkable quality, however, is the author’s concern both for the reader—who is carefully led into quite unknown and still frightening territory—as well as for his protagonists, the mentally ill. All told, I believe that this book will be of interest not just to students of psychiatry, psychology, and anthropology, but also to a broader circle of readers who are excited by the wretched and admirable destiny of being human.

Haralan Alexandrov

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5 The Culture-Psychopathology Relationship


What we observe is not nature itself, but nature exposed to our method of questioning.

W. Heisenberg

Culture and psychopathology share common characteristics. They have a common ontology: both are over-biological systems and ways of interpreting either collective (culture) or individual (psychopathology) experience and behavior. They also have a common epistemology: their leading traits are not entirely realized consciously by participants, and may be more apparent to an external observer, while insight into both of them requires putting oneself in “other people’s shoes”. Culture, undoubtedly, influences all aspects of symptomatology: from its genesis, manifestation, and recognition, to the meaning attributed to it, and the way help is sought out. Many cultural distinctions have biological reasons. Sickle cell anemia is most prevalent in the Mediterranean and Africa, and though it protects against malaria, it unfortunately predisposes patients to psychosis. Tularemia is also quite frequently found in the Mediterranean, and it plays a role in the rise of some psychoses, as well. Annual hours of sunshine have a direct effect on depression and suicides and are at the basis of vast differences between populations at the equator, moderate latitudes, and the poles. Infectious diseases historically have played a considerable role in the rise of different psychopathological forms, as well as in their alteration in pace with changes or the eradication of diseases. The massive prevalence of infectious diseases in the Third World, and absence in developed countries, sustains even today great dissimilarities in these two worlds’...

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