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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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11 Culture Specific Syndromes


Nothing in Zanzibar is as it seems.

Dr. D. Livingstone

The designation “culture specific” is imprecise, because all psychiatric syndromes, even the organic ones, have their cultural specifics. In this provisional entity, transcultural psychiatry traditionally includes syndromes united only by the uncertain presumption that they are present in one culture, while uncommon in others. It is debatable which syndromes should be included here because there are innumerable nuances and variations. These states are exotic, ethnographic local behavioral idioms that reconstruct their meaning, which may seem obscure to the external observer, from the local cosmogony. They are also called psychogenic, hysterical, ethnic, or exotic psychoses, or culture bound, or culture reactive, syndromes.142, 145, 158 Schizophrenia and affective disorders, despite their marked cultural differences (sometimes to the extent of unrecognizability and diagnostic confusion), are universally known and accessible for examination with the so-called etic approach. Unlike them, and in favor of relativism, culture specific syndromes are evidence of cultural uniqueness and can be understood through the so-called emic approach (Chapter 5).

Whether these are indeed unique syndromes, formed by specific combinations of cultural heredity and peculiarities of biological isolates and climate, or variants of common syndromes, though significantly transformed by the abovementioned factors, is unknown. The combination between culture, biology, and geographical specifics in each of them is different, with each of these factors bearing a different relative weight. For this reason, their assignment to common categories or larger entities, such as psychogenic and...

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