I don't want to spam people, and will eventually make a special "psychology" filter. Please comment if you especially do or don't want to be on it. Otherwise, I will take my best guess. I will not be hurt if you don't want to be spammed with billions of notes on scholarly articles!

I'm reading an essay by Arthur Kleinman, "How Is Culture Important for DSM-IV," dissecting its extreme cultural biases and blind spots. Great stuff.

Brief notes follow - note that this is all simplified and primarily meant as notes to myself.

- The most clearly culturally universal mental illness are schizophrenia, bipolar disorder, major depression, and a set of anxiety disorders including panic disorder and OCD. Many others are solely western culture-bound phenomena. However, the course and symptoms of all illnesses may differ enormously across cultures. Schizophrenia is more severe and long-lasting in industrialized areas; non-western people often experience depression as a far more somatic illness, sometimes with no "depressed mood," and if they do experience that, may describe it as "emptiness/soul loss" rather than "sadness."

- Many cultures have normal experiences which may be misidentified as psychosis, from evangelical Christians who may normally be tempted by the Devil to Plains Indians who hear the voices of recently deceased relatives. Many cultures have normative experiences of being possessed, hearing voices, communicating with God, etc.

- Questions to ask clients/patients:

1. What do you call your illness? Is it an illness?
2. What do you think caused it?
3. Why did it start when it did?
4. What does your illness do to you? How does it work?
5. How severe is it? Will it have a short or long course?
6. What do you fear most about this illness?
7. What are the main problems that your illness has caused for you?
8. What is the normal treatment for this illness? What are you expected to do when you have this illness?
9. What do you hope to receive from treatment?
10. Are you following the prescribed treatment? If not, can you explain why?

I think these are great questions. Kleinman suggests making them part of a proposed cultural axis, to be asked to all clients, not just the ones who are singled out as "culturally different."
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jjhunter: Watercolor of daisy with blue dots zooming around it like Bohr model electrons (Default)

From: [personal profile] jjhunter

I'd love to be in on a psych filter, especially since I've been reading a number of Kleinman articles lately.
rydra_wong: Lee Miller photo showing two women wearing metal fire masks in England during WWII. (Default)

From: [personal profile] rydra_wong

On filter, plz

Plains Indians who hear the voices of recently deceased relatives.

IIRC, there's research indicating that this is quite common in people in general (even when it's not supported by the culture).

There's been some quite interesting and thought-provoking work on non-psychotic voice-hearing going on over the last few decades.

Re: On filter, plz

From: [personal profile] em_h - Date: 2011-10-11 08:43 pm (UTC) - Expand

Re: On filter, plz

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Re: On filter, plz

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Re: On filter, plz

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Re: On filter, plz

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Re: On filter, plz

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Re: On filter, plz

From: [personal profile] kore - Date: 2011-10-12 03:41 am (UTC) - Expand
giandujakiss: (Default)

From: [personal profile] giandujakiss

I want to be on it! (Back in the day, I majored in psych ... it's been so long...)
yatima: (Default)

From: [personal profile] yatima

Yes please! And omg the questions. I am in the middle of Anne Fadiman's "The Spirit Catches You and You Fall Down," whose conclusion is essentially that asking these questions might have saved a child's life.
l_elfie: (Default)

From: [personal profile] l_elfie

this is fascinating. i'd love to be on a filter.
umbo: B-24 bomber over Pacific (Default)

From: [personal profile] umbo

I want to be in the filter! Also, some of us would argue that evangelical Christians tempted by the Devil actually are delusional, but we are sadly in the minority....
mildred_of_midgard: (Default)

From: [personal profile] mildred_of_midgard

I read this and went "yes", and then it made me think about things I hadn't thought through before. So here are my thoughts on the subject.

A purely rationalist approach might distinguish delusional from mistaken on the basis of perception vs. belief. Using that criterion, an evangelical Christian who perceives an external voice as talking to him/her is delusional. An evangelical Christian who believes that the Devil inspires his/her desires to e.g., have sex that said belief system does not approve of, holds a mistaken belief about the origin of these internal desires, but is not delusional.

To illustrate the difference more dramatically, an evangelical Christian who believes that God caused a giant earthquake in order to punish people is mistaken. An evangelical Christian who perceives an earthquake when there is none is delusional.

This purely rationalist approach of "Your angels, your devils, and your dead relatives are just as nonexistent as your pink spine-dwelling dragons" might classify you as delusional if you believe you're Napoleon because God told you so, and mistaken if you believe you're God because you *know* the way some people *know* their real gender, or because that many members of your cult can't be wrong.

Yet the word "delusion" would probably be applied to anyone who believed they were God in a non-culturally normative context, because the use of the word evolved in a culturally-informed setting, not a purely rationalist context.

In a psychological setting, cultural normativity has great relevance, above and beyond the purely rationalist stance. Humans, being social animals, derive much of their knowledge and belief system from other humans. So a modern-day Westerner who believes that an individual 2,000 years ago was an incarnated deity who rose from the dead occupies a different mindset than a person who believes that their next door neighbor is an incarnated deity risen from the dead. Both are equally factually wrong. But the psychological difference is striking enough to warrant a different word. Moreover, "culturally normative" is a continuum, which is why you end up with different people wanting to put "tempted by the Devil" on different sides of the delusional/nondelusional line. Belief in a Devil who takes an active part in life and can be perceived is certainly less normative now in Christian thought than several hundred years ago, but it's more normative even now, given its history, than other beliefs that the same individuals could hold, or the same belief held by individuals in a different cultural context.

Forgive me if I'm belaboring the obvious, but I'm using impromptu essay-writing to work out my own thoughts on certain nuances. Which I suppose is more culturally normative than carrying around a fake bluetooth headset to work out your thoughts aloud in public, though an equally valid method. ;)
adrian_turtle: (Default)

From: [personal profile] adrian_turtle

This is a wonderful set of questions, and I'm starting to think it might be valuable for medical professionals to ask them to new patients generally, not just in situations that look like mental illness. Imagine the different kinds of answer women might give in early pregnancy.
lenora_rose: (Baby)

From: [personal profile] lenora_rose

If the questions (Other than possibly part 2 of question 1) rephrase it as something other than "illness". One of the things that has come under a lot of criticism for good reason in the medical system *is* treating pregnancy as a medical symptom. (Something definitely changing, if my experience and a significant amount of collected but anecdotal data can be considered useful).
boundbooks: Zhang Ziyi (cookie monster cupcakes go nom nom)

From: [personal profile] boundbooks

I would totally love to be on it!
mme_hardy: White rose (Default)

From: [personal profile] mme_hardy

"8. What is the normal treatment for this illness? What are you expected to do when you have this illness?"

I think, as a Western person, I would be livid when a psych* asked me this question, as I am when other doctors ask it. "I don't know, I'm not the one who went through graduate school and residency, *you* tell *me*."

* -iatrist or -ologist or social worker or whatever.

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tevere: Jihae, solemn with hint of smile (Default)

From: [personal profile] tevere

On the same topic, I found Crazy Like Us: The Globalization of the American Psyche to be interesting. It's very much a pop psych book, rather than a scholarly one, but it looks at a handful of different mental illnesses in non-Western cultures, and how they're traditionally understood (and how recognition, treatment and even the expression of these illnesses have sometimes changed, not necessarily for the better, with the influence of Western models of understanding). IIRC, some of the examples were anorexia in Hong Kong, PTSD in Sri Lanka and schizophrenia in Zanzibar.

I would be interested in being on your psych filter too, if you don't mind.
oursin: Brush the Wandering Hedgehog by the fire (Default)

From: [personal profile] oursin

I'd like to be on the filter, please. (I wouldn't say that all I know about psychology/psychiatry I learned from cataloguing the papers of psychoanalysts, there's also been a fair amount of hanging out with historians of psychiatry.)
sonia: Quilted wall-hanging (Default)

From: [personal profile] sonia

Hi, I don't comment often, but do read your posts, and am very interested in psychology. Can I be on your filter please?
the_rck: (Default)

From: [personal profile] the_rck

I'm interested in the psychology filter if you don't mind. I don't comment often, but I am reading with interest.
forestofglory: E. H. Shepard drawing of Christopher Robin reading a book to Pooh (Default)

From: [personal profile] forestofglory

I'd like to be on the pych filter too.
oyceter: teruterubouzu default icon (Default)

From: [personal profile] oyceter

I'd love to be on the filter!!
cougarfang: (Default)

From: [personal profile] cougarfang

I'm another lurker coming out of the woodwork! :) May I be on the filter, please?
cpolk: (Default)

From: [personal profile] cpolk

I would be extremely interested in this filter, very much.
lferion: (FL_Dandelion)

From: [personal profile] lferion

I would like to be on the filter, please.

This is very interesting to me, on several different levels.
movingfinger: (Default)

From: [personal profile] movingfinger

I would like to be included on your filter, both here & at LJ. Thank you.
staranise: A star anise floating in a cup of mint tea (Default)

From: [personal profile] staranise

I love your psych posts. I want on the filter. I also want to beg you, if you don't want this stuff publicly linked to your name, to start a different journal where you post it because oh, I want to point other people to it and I couldn't do that if it was friendslocked.

I love these questions. I think it would be incredibly valuable for more psych programs to teach ethnopsychology--to take a few different cultures and specifically teach how they conceptualize personality formation, healthy psychological functioning, and psychopathology. I kind of hit on this in a roundabout way--a lot of anime and manga just had me scratching my head until I understood both the aesthetic principles at play in the writing, and Japanese conceptions of personality formation.

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From: [personal profile] staranise - Date: 2011-10-11 11:51 pm (UTC) - Expand
daidoji_gisei: (Default)

From: [personal profile] daidoji_gisei

Please add me to the psych filter.
holyschist: Image of a medieval crocodile from Herodotus, eating a person, with the caption "om nom nom" (Default)

From: [personal profile] holyschist

I like your psychology posts! They are interesting.
mildred_of_midgard: (Default)

From: [personal profile] mildred_of_midgard

You can probably tell I want to be on the filter! My desire to comment on your posts frequently exceeds my time/energy to do so after work, but I definitely read them all. Moreover, I want everyone on my friends list to spam me with billions of notes on scholarly articles all the time. You're just the only one obliging me so far. ;)
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