Race Renounced, Culture Arraigned: The Case of the So-Called Culture-Bound Psychoses

Abstract

Scanning the literature on culture and disease in developing regions of the world, one is struck by a peculiar paralogism. Ethnopsychiatric studies and psychodynamic anthropological formulations suggest that the ills of the impoverished are largely psychogenic, psychosomatic and culture-induced. A high frequency of mental disease, once linked to racial infantile mentality, is now imputed to a 'cultural personality' generally predisposed to a poor tolerance of anxiety, to somatising social distress and conflict, or to acting out unresolved tension through aggressive panic or hysterical de-viance (cf. Stoller 1969; Wittkower and Termanson 1969; Obeysekere 1970, 1977; Leighton 1982; Kleinman 1980). The high incidence of diseases manifesting mental symptoms among populations of Southeast Asia in general and the poor in particular is indisputable. But is a significant proportion of this morbidity actually due to a kind of cultural deficit? What of the ecological, biochemical and genetic factors involved in the dynamics of mental disorder?