Thomas Ramey Watson

Psychiatry’s blindness to culture

Viewed over history, mental health symptoms begin to look less like immutable biological facts and more like a kind of language. Someone in need of communicating his or her inchoate psychological pain has a limited vocabulary of symptoms to choose from. From a distance, we can see how the flawed certainties of Victorian-era healers created a sense of inevitability around the symptoms of hysteria. There is no reason to believe that the same isn’t happening today. Healers have theories about how the mind functions and then discover the symptoms that conform to those theories. Because patients usually seek help when they are in need of guidance about the workings of their minds, they are uniquely susceptible to being influenced by the psychiatric certainties of the moment. There is really no getting around this dynamic. Even Insel’s supposedly objective laboratory scientists would, no doubt, inadvertently define which symptoms our troubled minds gravitate toward. The human unconscious is adept at speaking the language of distress that will be understood.

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The trick is not to scrub culture from the study of mental illness but to understand how the unconscious takes cues from its social settings. This knowledge won’t make mental illnesses vanish (Americans, for some reason, find it particularly difficult to grasp that mental illnesses are absolutely real and culturally shaped at the same time). But it might discourage healers from leaping from one trendy diagnosis to the next. As things stand, we have little defense against such enthusiasms. “We are always just one blockbuster movie and some weekend therapist’s workshops away from a new fad,” Frances writes. “Look for another epidemic beginning in a decade or two as a new generation of therapists forgets the lessons of the past.” Given all the players stirring these cultural currents, I’d make a sizable bet that we won’t have to wait nearly that long.

Article by Ethan Watters a contributor to This American Life, Mother Jones, and Wired, is the author of Crazy Like Us: The Globalization of the American Psyche.

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This is why I believe that labeling people is often counterproductive in therapy and coaching. Too often the labels are trendy. It’s best to realize that we can–and many have done through history–use different terms to express the issues and problems, just as various religions use different terms to express similar notions. To me, moving beyond the terms to problem solving is what’s important.

Btw, such trendiness prevails in various fields of study, literature too.

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