The Americanization of Mental Illness

Rorsch Ethan Watters article from a few days ago in the NYT has gotten a fair bit of coverage:

AMERICANS, particularly if they are of a certain leftward-leaning, college-educated type, worry about our country’s blunders into other cultures. In some circles, it is easy to make friends with a rousing rant about the McDonald’s near Tiananmen Square, the Nike factory in Malaysia or the latest blowback from our political or military interventions abroad. For all our self-recrimination, however, we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.

Some thoughts on the piece from Greg Downey in Neuroanthropology:

Certainly, Western ideas about mental illness are directly affecting expectations of psychic distress around the world; see, for example, Vaughan at Mind Hacks discussing Did Antidepressants Depress Japan?. Here Vaughan highlights another force, one touched on by Watters but not explored; pure mercenary impulses, as drug companies try to persuade new markets that the individuals ‘need’ their products, suffering as they do from disorders of which they were previously unaware. Here, the idea that it’s just the ‘beliefs’ about illness held by therapists and authorities obscures the naked greed that goes into public relations campaigns designed to produced disorder.

My argument is not so much that Watters is wrong, as that culture is not just in the ideas people have about disease; these changes in mental illness are also provoked by the social, technological, and material world, for example, how the export of Western-style education affects childhood elsewhere (and thus illuminates ‘disorders’).

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