Last year, I read "Cracked" by James Davies, which articulated a lot of the questions I'd been having about the increasingly medicalized way mental health is talked about/understood (especially in Western countries).
There's this automatic, unquestioning way that depression (for example) is seen as an absolute fact ... 'it is a complex mental illness, with neurochemical (or social/personal) foundations, that can/must be treated through some form of therapy and/or medication. The end'.
And, to be really real, if I had to summarize what years of undergrad/masters' degrees in psychology have taught me about depression ... it wouldn't deviate too much from that.
"Cracked" examines that framing and treatment of mental illness and "Crazy Like Us" examines how it is being exported to developing countries (essentially through imperialism and capitalism) in 4 chapters that are each individual case studies (anorexia in Hong Kong, PTSD in Sri Lanka, schizophrenia in Zanzibar and depression in Japan) (and the 5th one is the summary/analysis).
The book infuriated and saddened me, because in both a serious and light-hearted way, I kept thinking, "White people really can't leave us alone".
In the chapter on PTSD in Sri Lanka, after a tsunami, the author explains how there were swarms of white western NGOs/psychologists/psychiatrists/counsellors with tests and quizzes and checklists, ready to study and diagnose these "inevitable" sufferers of PTSD, but when they were met with reluctance and responses that didn't fit into their strict DSM definitions and behavioral patterns of what PTSD should look like, they essentially imposed it on them, ignored/finessed studies that didn't yield the results they wanted/expected etc ... because beneath it all, there was the assumption that these primitive brown people don't know how to recognise, articulate or deal with trauma/stress/pain so, at almost any cost, they must be told and shown that they are suffering and only western science can save them, while simultaneously belittling and eradicating their cultures, histories, values, traditions and beliefs.
I remember having a conversation about "Depression in 'African culture'" about 4 years ago-ish with my older brother ... and his position was that depression is largely a Western construct and that Africans (side note: Africa is not a country) based on cultural, religious and social makeup and histories have different ways of thinking about and dealing with pain. My position, because I was a fresh first year psychology undergrad, was closer to "it is a complex mental illness, with neurochemical (or social/personal) foundations, that can/must be treated through some form of therapy and/or medication". I'm closer to my brother's position now ... that mental illness is nuanced ... and that it can't (and shouldn't) be understood or treated as this unilateral thing ... a thing that has been constructed and designed in western countries, in sequestered enclaves of elitism and whiteness and maleness and straightness ... a thing that is fixed and standardized ... a thing that erases politics, culture, history and economics.
Interesting fact, did you know that with schizophrenia (for example), recovery rates are 50% higher in developing countries than in "developed" ones?
Read "Cracked" first and then this book, trust me fam.
Some bars from the book:
It takes a wilful blindness to believe that other cultures lack a meaningful framework for understanding the human response to trauma.
'Most of the disasters in the world happen outside of the West ... Yet we come in and pathologize their reactions. We say, "You don't know how to live with this situation". We take their cultural narratives away from them and impose ours. It's a terrible example of dehumanizing people'.
Anorexia and eating disorders could tell us much about the pressure of women in different cultures if only their voices weren't being drowned out by Western narratives about the power of fashion, dieting and pop culture.
One meaningful way to compare cultural beliefs about mental illness is to ask this simple question: Which cultural beliefs tend to exclude the sufferer from the social group and which allow the ill individual to remain part of the group?