Interpreting culture and psychopathology: Primitivist themes in cross-cultural debate

Abstract

Interpreting the cross-cultural incidence of psychopathology is a focus of continuing debate. This paper explores the lineaments of that debate and its underlying premises concerning difference and distance. Primitivism--a body of ideas, images and vocabularies about cultural others--is characteristically employed to represent non-Western peoples. But it is more fundamentally concerned with the way the West understands itself in contradistinction to these others. It is shown to be a major source of the images used to think about mental illness, and of the intellectual traditions which have constituted cross-cultural psychiatry as a comparative discipline. Psychiatric primitivism employs two opposing perspectives, which we have labelled 'Barbaric' and 'Arcadian' respectively. They are the source of contradictory assertions concerning the relationship between culture and mental illness. They provide the framework which structures contemporary research into the cross-cultural incidence and course of schizophrenia, shaping its methodology, its rhetoric, the strategies by which data are interpreted, and the conclusions which it draws. We demonstrate a convergence of themes whereby images of society, person and mental illness come to signify each other. This is epitomized in three of cross-cultural psychiatry's principal subject areas: amok, shamanism, and the therapeutic quality of 'traditional' society.

(Ng)amukRevisited: Emotional Expression and Mental Illness in Central Java, Indonesia

“…This desire to achieve a 'culture-free' classification system (Prince & Tcheng-Laroche, 1987) has informed much of the psychiatric research on amuk (Lucas & Barrett, 1995).…”

Primitivising Anorexia: The Irresistible Spectacle of Not Eating

“…'All', Torgovnick argues, 'take the West as norm and define the rest as inferior, different, deviant, subordinate, and subordinateable ' (1990). Lucas and Barrett (1995) demonstrate how psychiatry is implicated in this particular configuration of knowledge. They examine three principal (but by no means definitive) subject areas of cross-cultural psychiatry (amok, the therapeutic potential of 'traditional' society, and the shaman), arguing that 'psychiatric primitivism' has been invoked as an explanatory framework in each.…”

Cultural health beliefs in a rural family practice: A Malaysian perspective

“…14 It is important to see folk healers in a balanced way and to avoid both over-idealisation -seeing them and the communities they work among as natural and holistic, living in peaceful harmony with nature and with one another -and overcriticism -seeing them and their communities as somehow primitive, degenerative, incompetent and underdeveloped. 15 Patients seek the care of traditional healers if western treatment does not bring relief, if the diagnosis bears a negative prognosis (long-term or incurable illness) or if surgery is advised. The traditional treatment may either replace or be used along with western medicine -a mix and match approach.…”