Using examples to substantiate your argument, discuss the relevance of the concept of 'culture bound syndrome' to an understanding healing processes.

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Course: Culture. Health and Madness

Candidate number: 39118

Using examples to substantiate your argument, discuss the relevance of the concept of ‘culture bound syndrome’ to an understanding healing processes.

Introduction

 To understand a disease or illness, its symptoms, it is sometimes useful to know what it is called. Categorisation of diseases can be a first step of diagnosis when one sees a doctor or goes to hospital. It depends on the health system where one lives and gets welfare from the process of receiving sufficient welfare support to obtain complementary medicine can be difficult in both Western and non-western countries. However, complementary medicine (or so-called non-western medicine) has a different approach to treating patients: this is visible in the example of culture-bound syndrome.

 No single definition of culture bound syndrome exists, but there are many. Prince defines the culture bound syndrome as “ a collection of signs and symptoms, which is not to be found universally in human populations, but is restricted to a particular culture or groups of cultures. Implicit in the notion is the view that cultural factors play an important role in the genesis of the symptom cluster” (198). However most of the psychiatric diagnoses are based on the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. The latest one is called DSM-IV, and the psychiatric cases that cannot be found in this category are often called culture bound syndrome. In other words, categorisation is already Western or American based. If culturally bound term can diagnose some diseases as culture bound syndrome, there could be another way around.

So my argument through this essay will focus on the term culture bound syndrome, the convenient usage of the term in Western medicine. The inversion of culture bound syndrome theory, whereby phenomena like anorexia as seen as culturally-bound to Western cultures will be explored. Also this paradox could apply to the common psychiatric disease in North America, Attention Deficit Hyperactivity Disorder (ADHD).

Existence of culture bound syndrome

Culture bound syndrome exists in a “twilight zone” of psychiatric phenomena (Hughes). These phenomena constitute a western-derived system of psychiatric diagnosis categories, these syndromes are phenomenological, unfamiliar ways of thinking about mental illness. Sometimes these syndromes are called, “psychogenic psychoses” (Faergeman: 1963), “ethnic psychoses” and “ethnic neuroses” (Devereux: 1956), “hysterical psychoses” ‘Langness: 1967) and “exotic psychoses” (Yap: 1969). In other words, these phenomena are so unfamiliar to one in this case in Western culture or moreover American society, one cannot include them into a single category. They do not understand it and that is why they call it as “culture”. The definitions of culture bound syndrome are not only varied but also abstract. Also most of the psychiatric diseases are diagnosed by the American Psychiatric Association: the category is already culturally bound. The association itself is already culture bound; it cannot conceptually accommodate the syndromes (Hughes).

However if we posit the assumption that culture bound syndromes exist, one reason such syndromes have been of continuing interests may be that they highlight important questions relevant to several fields, e.g., psychiatry, psychology and anthropology, such as the differential contribution of biological and cultural factors in the etymology and shaping of mental disorders, the relativity of meaning across cultural contexts, and the potential generalizability of psychiatric classificatory schemes developed in one culture (ibid).

Yap  (1969) also suggested that two problems persist: firstly we do not know about the culture bound syndromes for us to be able to fit them into a standard classification: and secondly we cannot be sure that such a standard and exhaustive classification in fact exists. So called culture bound syndromes such as koro, latah and amok, when observed, are too different and rare to analyse and categorise into the DSM-IV, that is why they are named as culture bound syndromes. Yap suggested that to avoid stagnation in this field, it is necessarily to apply the concepts of clinical psychopathology to the analysis of these disorders, to integrate them into recognised classification of diseases if possible, or to broaden the classification if necessary (Yap: 1974.86).

The existing classification system in the west, is composed of two categories, the culture bound disease theory and the culture bound diagnosis theory. The former theory claims that the culture bound syndrome is a real medical condition, but that the probability of contracting that condition is culturally influenced. The latter theory’s claim is that the culture bound syndrome is a real medical condition, but that the probability of having that condition diagnosed as a culture bound syndrome is culturally influenced (Kopiec). To understand more about these theories, Hahn’s definition of culture is useful in the context of culture bound diagnosis theory. “Humans are bound by their cultures but rigidly. Culture is not the only binding principle; body, mind, society and the broader environment also bind…anthropologists claim too much for culture bound syndromes and too little for the ‘diseases’ staked out by Biomedicine”. Moreover a syndrome may be regarded as culture bound if particular cultural conditions are necessary for the occurrence of that syndrome. Thus the culture bound syndrome is thought not to occur in the absence of these cultural conditions. However some analysts of culture bound syndrome may regard specific cultural conditions as sufficient for the syndrome’s occurrence. If so, no conditions except these cultural ones are necessary to provoke the occurrence of the culture bound syndrome. (Hahn: 1995.41). Hahn criticises anthropology as an example of a discipline that does not follow the medical model and, therefore, he believes that its belief system is not valid. This is an important discussion. He also suggests that the culture bound syndrome is an incorrect way in which these patterns of behaviour are labelled and described. (Ibid. Kopiec). In his six steps of hypothetical ethnography, the observers who have undoubtedly western views return home with their prized possession: a new syndrome that, because it seems to be found only in the cultural setting from which they have returned, is labelled culture bound. Culture bound syndromes are residual; they are conditions that do not fit the nosological scheme of the Western observer. (Hahn.44).

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On the other hand, Karp believes that one’s culture causes the labelling of the culture bound syndromes. His discussion point is between Universalists and particularists. Universalists hold that culture bound syndromes are not limited to one particular culture; in contrast, particularists argue that culture bound syndromes are limited to one particular culture. Karp summarises that one’s particular culture causes the labelling of the culture bound syndrome. In his work, he demonstrated understanding of the fact that there are universalities, but that in terms of a specific type of behaviour being labelled, he feels that this is relative to particular cultures (Karp: ...

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