One of my favorite weekend activities is catching an hour or two of Book TV. Ethan Watters, the author of the new book, Crazy Like Us: The Globalization of the American Psyche was on from San Francisco talking about his book and his recent article in The New York Times Magazine. What Watters is basically saying is that Americans are exporting the way they think about mental health and illness to the rest of the world and, at the same time, pushing the major treatments used in the US on other countries and cultures—whether they like it or not and whether those explanations and treatments are culturally appropriate or not. Watters’ other major point is that by pushing our view of mental illness and associated treatments on everyone else we are imposing our cultural perspectives and values about mental health and illness at the expense of local and indigenous cultural perspectives. He compares loss of diverse cultural perspectives about mental health with loss of biodiversity. It is an interesting comparison and underscores the importance of how we think about and explain things.
How we think about things matters. An explanation is like a path—it leads somewhere. All of us have explanations or ways we make sense of things, but typically we don’t look closely at those explanations to see where their implications take us. Consider bipolar disorder, for example. Let’s say you are a neuroscientist and you are interested in how the part of the brain called the amygdala seems to function in persons with bipolar by becoming overactive in response to certain kinds of stimuli and by taking longer to quiet down. The neuroscientist’s explanation about the role of the amygdala is going to lead down the path of trying to figure out why the amygdala is so excitable in people with bipolar and what can be done to dial it down. Now let’s say you’re a mother of a young adult with bipolar and your child has been having a lot of difficulties lately. You blame yourself for your child’s bipolar even though you have been told by everyone that it’s not your fault. You blame yourself anyway and think about all the things you should have done differently when your child was growing up. Your explanation is taking you down a painful path of self-blame and recrimination. Now let’s say you have bipolar and your manic, you haven’t slept in days, but you’re clearing the decks of piles of work, you’re feeling great, and your way of making sense of the experience is that you wish you felt like this all the time because you’re getting everything done. This explanation leads you to keep on working, avoid sleeping, and perhaps become more manic. If you are an evolutionary psychologist, you might explain bipolar disorder as an effective adaptation to the seasonal requirements of life in a hunter-gatherer society and see bipolar conditions in modern America as adaptive given our prizing of individualism and individual accomplishment.
In his New York Times Magazine article, “The Americanization of Mental Health,” Watters cited the research of Sheila Mehta at Auburn University and others from around the world which concluded that the biomedical explanation of mental illness actually increased social distance between people rather than decreased it. Decreasing social distance between those without mental illness diagnoses and those with them has been the hope of those promoting a medicalized view. In other words, this line of research suggests that explaining mental disorders as brain disorders or as illnesses actually had the opposite effect of the intended one—instead of reducing stigma and increasing acceptance, people seemed to want less contact with the person with mental illness, not more. Certainly the jury is still out on this topic and more research is needed to find out what the real world effects of varying explanations of mental disorders are, but Watters has unearthed some intriguing findings.
So what’s the point of this discussion of explanation which is a topic from a philosophy of science class? The point is that how we explain important things like mental conditions to ourselves and to others has far-reaching effects. I recommend caution in grabbing at the explanation du jour because popular explanations typically lack complexity and explanations that lack complexity offer only a single path to travel down. People with bipolar conditions and their families deserve the respect of being offered complex explanations rather than one-dimensional cut and dried ones. They deserve that respect because they need to have many paths to travel down in their efforts to understand their bipolar condition and its meaning for them and their families and their lives—unique and particular meanings for their lives that are not one-size fits all and that have room enough for understanding the gifts that such diagnoses can bring along with the challenges.
You can leave a response, or trackback from your own site.
Dale Hankins at 5:24 am on
February 6th, 2010“…they need to have many paths to travel down in their efforts to understand their bipolar condition and its meaning for them and their families and their lives…”
AMEN.
I have been treated for bipolar disorder for 12 years and my psychological work up indicates that I likely suffered from BP from early childhood. One of my main gripes about treatment is the “all or nothing”, “black or white” outlook of those involved in the mental health field. Many therapists are vehemently opposed to medications, many psychiatrists are dismissive of therapists, and many neuroscientists view my brain the same way a mechanic looks at my car. I try to learn more about my illness in order to be more proactive in its treatment, but this is very difficult. People often are so interested in proving that their theory or treatment is the ONE single correct one that I feel like I am being torn asunder…who am I to believe? Some days I feel like telling all mental health professionals to go …. themselves. I would do so if it would accomplish anything and if I could do it without being sent back to the hospital. So, here I go; put one foot in front of the other…take the pills, see the therapist, do what I can to help another person. Maybe one day the professionals will begin acting like professionals. 
Last reviewed: 2 Feb 2010
Copyright © 1992-2012 Psych Central. All rights reserved.
Site last updated: 10 Feb 2012
|
