I just finished reading Ethan Watters book, Crazy Like Us – The Globalization of the American Psyche, which I bought after listening to him on fora.tv.

I wouldn’t recommend the book unless you have a special interest in mental health issues. His fora.tv talk, however, is worth listening to.

The book is well written and documented. Watters main point is that the West is exporting its conception and treatment methods of mental illnesses, disrespectfully of cultural differences. He analyses 4 different cases: anorexia in Hong Kong, PTSD in Sri Lanka, schizophrenia in Zanzibar, and depression in Japan.

Some issues were of particular interest.

– Living with a person who is mentally ill (p. 151-4): Watters explains how the schizophrenic Kimwana’s family was accepting her condition and allowed her “to drift back and forth from illness to relative health without much monitoring or comment”. A team of researchers found that mental patients with schizophrenia have higher relapse rates if their family were critical, hostile and emotionally overinvolved—self-sacrificing, extremely devoted, overprotecting, or intrusive.

– Locus of control (p. 162-5): another researcher distinguishes people with internal vs. external locus of control. The first category think “of themselves as captains of their own destiny” while the latter believe “that the course of their lives [is] largely influenced by factors outside of themselves”. She “found that relatives who [are] highly critical of the mentally ill family members were those with an internal locus of control”. I agree with this classification: my experience is that people who don’t understand what it means to be mentally ill think that staying sane is a sign of strength and blame the mentally ill for not trying hard enough. To my mind one definition of being mentally ill is that you’ve lost that very strength—the willpower to stay sane. Blaming the loss seldom solves anything, quite the contrary.

– Society’s acceptance of mental illness (p. 172-3): Watters points out the irony of the fact that at the same time as mental illness is increasingly recognised as a disease vs. a weakness of character, its stigma has grown: “the perception of dangerousness surrounding the mentally ill has steadily increased”.

– Brain chemistry (p. 177-8): trying to explain mental illness purely by brain chemistry is scarily dehumanising. Moreover, if brain chemistry is controlling the moods and feelings of the mentally ill, it also does so for the mentally sane. “When we fall in love, get jealous, feel the joy of playing with a child, or experience religious ecstasy we do not describe the experience to friends as a fortunate or unfortunate confluence of brain chemicals. Yet we continue to suggest that the narrative of brain chemistry will be useful in lessening he stigma associated with a mentally ill person. What could be more stigmatizing than to reduce a person’s perceptions and beliefs to the notion that they are “just chemistry”?. It is a narrative that often pushes the ill individual outside the group, allowing those who remain in the social circle to […] view the ill person as almost a different species.”