More on Americans exporting mental illness

My previous post, Exporting American mental illness, on Ethan Watters’ New York Times Magazine article, came together pretty quickly, in a few-hours’ rush of thinking, writing, and mistyping. Nevertheless, I’m glad I posted it because I really liked Watters’ original article, even though I took issues with attributing too much causal power to specialists’ knowledge about mental illness. I didn’t consider my original piece to be a ‘critique’ as I fully suspect many of my issues might have been addressed in the book-length version.

cartoon by Gary Larson

Over at Somatosophere, Eugene Raikhel has a great post on the original article. He’s very generous to my hurried effort but goes on to add in some really good discussion of multi-causal models in psychological anthropology and how difficult it actually is to think about complexity. He agrees with my brief piece (with one caveat that I would concede), but really goes on to take the discussion to a more sophisticated consideration of the question:

“How should anthropologists and cultural psychiatrists deal with this kind of complexity?” Is it enough to gesture toward complexity, calling it a “flow” or an “assemblage” and listing its various elements (as I’ve done above), or should we try to understand the various specific mechanisms through which what we often call macro-processes (like “globalization” or “industrialization”) shape the ways individuals experience and articulate their distress?

Raikhel goes on to discuss three different conceptual and concrete ways to try to link up these scattered forces into local explanations, drawing on Ian Hacking, Laurence Kirmayer and Norman Sartorius, and Tanya Luhrmann. All three are excellent examples of researchers doing the hard yards of making these links between macroscopic and psychological processes, between biology and culture on different levels. I won’t rewrite in less extensive form Raikhel’s excellent piece; just go to the original.

But I also want to point out the Raikhel, like me, really praises Watters’ original effort. Raikhel has a couple of key points of disagreement in the assumptions about modernity and stress and about the psychiatric ‘gray out’ that’s occurring with globalization, but he keeps these in perspective. I’m happy to criticize science journalists when they write stupid dreck, but the discussion of the Americanization of mental illness is quite thorough even though it’s reaching out to an audience that might not have run into this sort of anthropological analysis of psychiatry before; it’s a great piece to alert the public to the subtleties of human brain-culture-belief interactions (which we tend to call ‘neuroanthropology’ around here).

4 thoughts on “More on Americans exporting mental illness

  1. Thanks for the link to my post and for the kind words, Greg. I think that we’re in agreement about Watters’ article being a very well researched and nuanced piece of science journalism.

    I’ve noticed that some people commenting on the article on various blogs have argued that Watters doesn’t pay enough attention to the role played by pharmaceutical companies in promoting new disease categories. This strikes me as less of an issue, given that 1) this has already been covered in the popular media over the past few years and 2) Watters’ article is original for its focus on the way that experiences of distress, or at the very least symptom presentations, are changing — not just biomedical classifications.

  2. Interesting discussion !

    I recall that one of my early Master’s dissertation idea was to look at the mental health part of the process underwent by refugees who apply for the asylum seeker status, more specifically in relation to the concept of war trauma. The process is framed by specific criteria and people won’t get the status if they don’t meet these criteria. In the case of trauma, relevant criteria are constructed at the intersection of medical (yes, definitely strongly influenced by the DMS from the USA) and bureaucratic cultures. I quickly realised I would never be given the necessary authorisation from the relevant doctors to be able to conduct this research, even though several refugees who were in such situations had agreed to speak to me (a random encounter with one such woman was how I got interested in the topic in the first place). I think that is the kind of field that is incredibly difficult to access as a student (yes, I was – and still am – of the naive, enthusiast and let’s-try-it-anyway persuasion), but I’m tempted to think it’s tricky even as a official researcher backed up by a legitimizing university institution.

    It does not surprise me to see that much exciting medical anthropology material was produced by people who are in medical professions themselves, i.e. insiders, even if this sometimes comes with various biais as some of these researchers end up working under questionable epistemological frameworks in order to be able to conduct their research, whether it’s the funding or instutional culture that implies it (I would think that Kapferer’s Star Wars article is very relevant to some of the issues pertaining to medical anthropology). So, it was interesting to observe how these guys kept sending the ball elsewhere, saying oh but this is not up to me, you need to see this other person, etc. I’m not sure why they felt so threatened, I was not really interested in coming up with a transcultural critique of how medical services handle that part of the process, but more so with how refugees responded to it. I’m under the impression that it’s much more interactive than we could think.

    Anyway, I quickly moved on to work on something else, which turned out to be great, but this little research experiment was still an interesting experience in terms of how protective medical bodies can be on that very topic. And I would think there is a direct link between that and the fact that these issues don’t really make it in popular science journalism. I agree with you, this was a very good article for that matter, thanks for posting it.

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