Mental disorders such as depression and autism are generally viewed in one of two lights, either as something neurological or something psychological. Cultural anthropology obviously has greater affiliation with the psychological side, and biological anthropology with the neurological. The same split is true in psychiatry, ably demonstrated by Tanya Luhrmann’s Of Two Minds, which, to radically simplify, describes the fight between talk-therapists and pharmaceutical-dispensers. (Still, at least this anthropologist wishes Luhrmann had gone beyond ethnographic description of fields to tackle the same problem that both anthropology and psychiatry embody—bridging the nature/nurture or biology/culture split.)
But is this way of dividing things, an enculturated mind versus an epigenetic brain, an accurate description? Recent research suggests no.
The January-February 2008 Harvard Magazine’s cover story is on autism, with one section entitled “Beyond the Genome,” which opens: “During the past few decades, most scientific research into the causes of autism has been focused on the structural wiring of the brain and on the genes that control it (28).” However, as this sidebar indicates, clinicians and researchers have “begun to ask whether disturbances in children’s broader bodily systems may be influencing, or even causing the disruption in their brain (28).”
Margaret Bauman, associate professor and pediatric clinician at Massachusetts General Hospital, says: “Many kids with autism have gastrointestinal problems that may affect their behavior. But because these kids are often nonverbal or hypoverbal, they have trouble conveying their discomfort or localizing their pain.” The article notes that Bauman “believes that researchers need to pay attention to close attention to the pattern of physiological problems that attend the autistic syndromes of a significant portion of children.” When these physical problems are treated, often children stop banging their heads or moving their bodies in reaction to the physical distress. “It turns out that when you treat the medical problem, in many cases the aggressive and self-injurious behaviors abate,” Bauman says.
Brandon Kohrt, in a 2005 Ethos article on co-morbidity, somatization, and depression in Nepal, presents a similar argument, but focused more on the mental/cultural side. A prominent group of anthropologists has long argued that somatization, the physical expression of mental problems such as depression, is more prevalent in non-Western cultures, whereas as in the West, we present the psychological symptoms associated with depression (e.g., low affect). Kohrt et al. note, however, that “few of these studies have rigorously considered possible physical explanations before diagnosing cases as somatization. For example, bodily complaints may result from comorbid nonpsychiatric physical illness as opposed to psychological distress exclusively (125).” After presenting some convincing evidence on co-morbid physical illness, such as arthritis, diabetes, and vitamin deficiency, they write that the “ethnographic cases suggest an intimate link between physical and mental health (142),” a conclusion I have seen reached in other research as well. Kohrt et al. conclude by arguing “Only through biologically and culturally grounded investigation of somatic presentation of mental illness across cultures will we be able to uncover a more accurate picture of the mechanisms by which individuals come to experience and express distress (143-144).”
Sounds like a good plan to me. Alongside that enculturated mind and epigenetic brain, there is a body. George Berkeley and Samuel Johnson? I refute it thus!