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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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10 Abnormal Behaviors and Culture


There is no dark side of the moon, really.

Matter of fact, it’s all dark.

Pink Floyd

The etiology of most abnormal behaviors is unknown, however, the modeling effect of cultural views on abnormality and its culturally-sanctioned manifestation or transformation is obvious. The same pathology may display behavioral alternatives, depending on its interaction with the environment. The prevalence of impulse control disorders varies, for instance, between 0.3 and 25 % of the global population.113 With clear evidence of a neurobiological substrate of impulse control, such a huge variation—from being extremely rare to affecting one quarter of the general population—is a sign of the different faces of pathology. In cultures that are permissive towards alcohol and drug use, impaired impulse control can manifest itself through abuse and addiction; while in cultures that are restrictive towards drinking and addictive substances, it may acquire the form of angry outbursts or either personality or affective pathologies. We found in a Bulgarian sample that alcohol abuse could be an alternative to borderline personality disorder in a cultural context that is stricter with regard to challenging behaviors than it is to drinking.155 The peculiar cultural equivalents of common underlying pathologies are intrinsic to abnormal behaviors and applicable to anorexia, paraphilias, severe adaptation reactions, and other illness metamorphoses.

10.1 Alcohol and Drugs

The need for intoxication of any kind (euphorization, sedation, or altered consciousness) is timeless and universal. There has never been a...

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