One view of people with mental illness is that they operate outside of society. While the sane among us observe social mores and pay at least some heed to what other people think of us, the mentally ill live in worlds of their own.
Surprising new research on schizophrenia suggests, however, that people with mental illness may have stronger, stranger ties to their societies than we commonly assume. In a new article in the British Journal of Psychiatry, Stanford anthropologist Tanya Luhrmann explains that for schizophrenics experiencing auditory hallucinations, the cultures they live in shape the voices they hear in their minds.
Most psychiatric research is conducted by scientists. Luhrmann argues, though, that the same psychiatric condition can express itself differently in different cultures, which is where anthropologists come in. For this study, she interviewed adults with schizophrenia who live in three different places: Chennai, India, Accra, Ghana, and San Mateo, California. She asked each person to describe his or her auditory hallucinations—how many voices they heard, what the voices said, where they felt the voices were coming from.
Luhrmann found many similarities across the three cultures, but also some important differences. The people from Ghana and India generally found hearing voices to be a positive experience, describing the voices as benign and playful, involving sex, or as spiritual encounters. The 20 people interviewed in California expressed opposite sentiments, describing the voices as angry, hateful, noisy, and violent. One American subject described the voices as giving directions "like torturing people, to take their eye out with a fork, or cut someone's head and drink their blood, really nasty stuff."
The differences across cultures, Luhrmann argues, can be explained by several factors. In India and Ghana, people were more likely to hear what they thought of as voices of family members, while in the U.S., schizophrenics tended to regard the voices as strangers, which made them more threatening. She thinks this could reflect differences in family structure—extended families are tighter in Ghana and India than they are here, where we’re more likely to live alone
A second factor has to do with basic differences in how people in the study thought of what it mean to hear voices in the first place. In the U.S., people considered the voices to be expressions of an illness or defect, while in Ghana and India, they were willing to think of the voices as coming from disembodied spirits or God. This suggests that how you think about a condition like schizophrenia can go a long way to determining how you experience it. It also points toward another way of thinking about people with mental illness: They exist outside of society, and from that vantage, they’re able to tell us truths about the way we live.
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