July 21, 2008

Publication: Irish Independent Health & Living

Date: Monday, July 21, 2008 Page: 9

Headline: Proof mental illness is not a by-product of Western society

In THE 1960s there was a growth in what came to be known as the anti-psychiatry movement, a socio-political ideology that was led by people such as RD Laing, David Cooper and Thomas Stzats. While each had their own perspective on psychiatry, all three agreed that mainstream psychiatry was wicked and that mental illness was the product of society rather than a scientific reality. Laing believed that mental illness was the product of faulty family dynamics, while Cooper contended that mental illness stemmed from the ills of society and only Marxist revolution would ultimately eliminate it.

Cooper even went to South America which he believed was ripe for social revolution and hence a mental illness-free zone. Some 50 years later, aspects of this are being addressed in a recent study of Quichua healers from the Ecuadorian Andes. The traditional healers of this tribe are known as Yachactaitas and they see those with problems from Some are sent by their families, some by their communities and others ask to be seen themselves when they appear to have problems that are not physical in origin. The question that begs to be asked is: to what extent are these traditional healers identifying what Western psychiatrists would deem a major psychiatric disorder?

A very interesting study published in the May issue of the British Journal Of Psychiatry asked and answered this question by examining the behaviours and symptoms described by the natives seeing the Quichua healers. Of course labels such as schizophrenia or depressive illness are not recognised specifically, as such, by the local healers but they do identify what they term the "llaqui". These were conditions whose problems were translated as "victims of malignant spirits" fright on approaching "bad places" and "heart pain" resulting from life events or sorcery. The study involved interviews with 50 individuals from the local villages who had been seen and diagnosed by these healers high in the Andes in rural Ecuador. Ninety per cent were peasant farmers and more than 50pc were illiterate. Fifty-four per cent were male. Following the consideration of the local healer, these people were interviewed. The interviewers were local, medically trained doctors. A research interview of a type used in Western style epidemiological studies of psychiatric illness was translated into the local language so as to allow comparison with the conditions delineated by the local healers. The results were fascinating since none of those seen by the healer was considered free from psychiatric or physical illness using Western diagnostic crite- ria. Specifically, 82pc were considered to be depressed, 44pc had hypochondri acal conditions and 40pc anxiety states. In addition, more than 80pc had parasitic infections. So, the authors conclud ed, all of those seen and being treated by local healers met criteria for Western type psychiatric disorders and most had concurrent physical illness also.

This overlap between two different diagnostic paradigms (one traditional, one Western) is important and demonstrates that mental illness isn't simply a construct of the developed and wealthy Western civilisations but represents a universal phenomenon occurring in different cultures, ranging from those that are highly traditional to those that are highly complex. Prior to the present study similar results, spanning the past decade, were obtained among the Serer tribe in Senegal, among the Maori in New Zealand and among natives in Laos. The importance of these studies is that they point to the existence of similar symptoms, across a variety of cultures, to those that we in the West call mental illness. Some like David Cooper, were he alive, would undoubtedly continue to dispute the existence of mental illness and to ascribe it as a chimera, stimulated by our modern society or by forces within it. Science and anthropology tell us otherwise. Alas, metal illness exists and effects people universally.

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