This article was submitted to the Transcultural Psychiatry Special Interest Group Newsletter in November 2016 but it didn´t get published.
The very existence of this Transcultural Psychiatry Special Interest group in the Royal College of Psychiatrists shows the increasing convergence between Psychiatry and Anthropology. On the one hand, Psychiatrists are becoming more and more aware of the impact of culture (the object of study of Anthropology) on mental health. Cultural bound syndromes such as koro, berserk, etc, have been traditionally described in “the other”, in non-industrialized cultures. More recently, as Western Psychiatry learns to look at itself, this approach has been used to describe clinical presentations associated with the industrialized cultures, such as anorexia nervosa or the burn-out syndrome (Helman, 2007). Also, the cultural impact on the way specific conditions are experienced and expressed is being investigated. Namely, culture conditions whether depression is perceived as mental or somatic and the words used to describe it (Banerjee et al, 2016). Culture also affects treatments, with electroconvulsive therapy being used in some countries (like the UK) and not in others (like Italy) and figures like Psychiatrists, Psychologists, priests and shamans having different roles in addressing mental suffering depending on the culture which hosts them. Another point of convergence can be seen in that while Psychiatry has traditionally concerned itself with individuals, some currents within it are addressing groups for therapy and even the culture of communities as in systemic therapy (Bateson, 1972) and Social Psychiatry (Jones, 1952).
On the other hand, Anthropology has also evolved closer to Psychiatry. While the classical model depicts an Anthropologist like Malinowski who is not supposed to react to or interfere with the culture being studied (1922), the development of Applied Anthropology entails a more interventionistic approach which tries to make things better for the population under study. Even if words like “healing” are not applied to the work of the Anthropologist while they are frequently used in relation to that of the Psychiatrist, the converging tendency seems clear.
However, it needs to be noted that Psychiatry and Anthropology are grounded on distinct paradigms (Kuhn, 1962) which are not only different but might at times be difficult or impossible to compatibilize.
A key concept in addressing the paradigmatic differences between Anthropology and Psychiatry is cultural relativism. While early Anthropologists like Tylor and Morgan, following evolutionist models represented a progression of culture towards the most advanced stage of the industrialized West in a clearly ethnocentric approach, the classical paradigm in Anthropology is solidly grounded in this cultural relativism. Cultural relativism is the assumption that culture emerges in order to adapt to a specific environment and that no culture can be considered as superior to other.
It is remarkable that the notion of cultural relativism prevented institutional Anthropology from supporting the International Declaration of Human Rights (Herskovits, 1947; United Nations, 1948) considering that a statement of values represented the culture which produced it (the West) but could not be considered superior or be imposed to other cultures with different values.
On its part, Psychiatry has no difficulty in incorporating the notion of Human Rights considering that certain principles can be conducive to mental health while others are not. Actually, the distinction between health and disease, which is central to the Medical and Psychiatric paradigm, when it is applied to cognitions, behaviours or relationships is contrary to the notion of cultural relativism.
It has to be noted that within Psychiatry there are minority movements that reject the stark distinction between health and disease, like Psychoanalysis, and that there are even currents that rely on cultural relativism to assert that even the traditionally considered as most pervasive psychotic symptoms, auditory hallucinations, must not be considered pathological or worse that the more prevalent alternative (Mind, 2016)
In conclusion, although Psychiatry and Anthropology are coming progressively closer and can fertilize each other, they are based on different paradigms and their Hegelian synthesis does not still appear on the horizon.
References
Banerjee, S. Ghosh, S. Chowdhury, A. N. (2016). Expression of Depression in Bengali Language and Culture. Transcultural Psychiatry Special Interest Group Newsletter. Royal College of Psychiatrists.
Bateson, G. (1972). Steps to an Ecology of Mind. The University of Chicago Press.
Helman, C. (2007). Culture, health and illness. Fifth Edition. London: Hodder Arnold.
Herskovits, M. J. (1947). American Anthropologist 49(4) 539-43
Jones, M. (1952). Social Psychiatry. London: Tavistock.
Kuhn, T. (1962). The Structure of Scientific Revolutions. The University of Chicago Press.
Malinowski, B. (1922). Argonauts of the Western Pacific. London: Routledge.
Mind. Voices and Visions. Downloaded from the worldwide web http://www.hearing-voices.org/wp-content/uploads/2012/05/Parents-Booklet-1-Intro_web.pdf on the 12th of November 2016
Universal Declaration of Human Rights (1948). United Nations General Assembly. Paris.
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