Culture-bound syndromes and psychiatric classification: A philosophical perspective
In the past half a century, transcultural psychiatrists have drawn attention to the many patterns of aberrant behavior and troubling experience that do not seem to fit in with Western European and North American conceptions of mental disorder. Such patterns are called culture-bound syndromes (CBSs) because they are often limited to specific societies or socio-cultural areas. Typical examples of such syndromes include ‘exotic’ conditions such as Zar, ie a North African kind of possession, and Koro, ie a typically Southeast Asian affliction dominated by the fear that the penis is fatally shrinking into the body. In recent years, some researchers have proposed to expand the category of CBSs to also include syndromes described by Western psychiatry, such as multiple personality disorder. ??CBSs made their first official entry in Western psychiatry in 1994, with the publication of the fourth and provisionally last edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. In an appendix to this, a working definition of CBSs is provided, alongside a concise glossary of strictly non-Western syndromes. While at CRASSH, I will investigate what this glossary’s appearance tells us about the process of constructing the DSM, as well as about the assumptions concerning the nature of DSM’s disorder categories. I will defend the view that all mental disorders, including those officially listed in this glossary, can only be found in certain places and certain times, implying that all mental disorders should be considered as culture-bound syndromes.
Pieter Adriaens is a Visting Fellow at CRASSH, Michaelmas 2011.
He is a Research Council Postdoctoral Fellow in the Institute of Philosophy at the University of Leuven. He is also Co-Principal Investigator, Research Foundation Flanders. His postdoctoral training included work at the National Institute of Health (USA), the Department of Philosophy and History of Science at the University of Cambridge, and the Institute of Evolutionary Sciences at Université de Montpelier. He is the author of The Use of Madness: Essays in Darwinism and Psychiatry (2008 Voorberg/Leuven: Acco).