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.
