Category Archives: Culture

Gender and Neuroscience

By Liah Greenfeld

Readers’ comments to my recent post raised for me some questions about an important topic: gender. I don’t know how to answer these questions, but it seems interesting to ruminate—chew—on them, and I invite you to do so with me. Perhaps, you will have answers. The comment that specifically drew my attention to the issue was an angry one: The person who sent it strongly disagreed with my suggestion that the actions of many so-called “home-grown jihadists” or “Muslim extremists” in the West are very similar to those of mentally ill perpetrators of violent crime, and that, because their dedication to Islam is often of a recent date, it may not be Islam at all that motivates them, but their mental illness. The commenter called me various names and asked, in so many words, how someone with a Ph.D. can doubt that a wicked and, among other evil things, “misogynistic” religion such as Islam, which advocates the subjugation of women, is the motivation behind heinous crimes such the recent Boston Marathon bombing or the beheading of a soldier in London.

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Is Depression A Real Disease?

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By Liah Greenfeld

Last month’s issue of The British Journal of General Practice contains an editorial “Depression as a culture-bound syndrome: implications for primary care” by Dr. Christopher Dowrick, Professor of Primary Medical Care at the Institute of Psychology, Health, and Society of the University of Liverpool. Dr. Dowrick claims that depression “fulfills the criteria for a culture-bound syndrome,” i.e. , one of the “’illnesses’, limited to specific societies or culture areas, composed of localized diagnostic categories,” like, for instance ataque de nervios in Latin America. In the case of depression the culture area affected is “westernized societies.” Putting the word “illness,” when applied to culture-bound syndromes into quotation marks indicates that Dr. Dowrick does not consider such syndromes real illnesses; it follows that depression–a culture-bound syndrome of westernized societies–is also not a real illness. Dr. Dowrick further argues that depression as a diagnostic category cannot be seen as “a universal, transcultural concept,” because it has no validity and utility, and it does not have validity and utility, because “there is no sound evidence for a discrete pathophysiological basis” for depression. I find myself in absolute agreement with Dr. Dowrick’s two specific statements above (that depression is a culture-bound syndrome of westernized societies, and that there is no discrete pathophysiological basis for this diagnostic category), and yet completely disagree with the implication that depression is not a real disease.

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Random Acts of Violence: A Common Psychological Profile?

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Bryan Bender, “US officials seek lessons in bombing catastrophe,” The Boston Globe

Government studies of previous large-scale attacks perpetrated by religious extremists, antigovernment groups, and the mentally disturbed have highlighted certain shared patterns, officials say. “When you take motivation out of it,” said one US official involved in reviewing the homeland security implications of the Boston attack, “the indicators that are apparent to people are in many cases common across the board. “In all of these cases there are opportunities for intervention. It may not be law enforcement at all times that is best suited to do it. It may be a teacher. It may be a faith leader,” the official said.

Liah Greenfeld:

Random criminality, especially in the last few weeks, has been on the mind of many Americans. What drives an individual to commit a violent crime against unsuspecting strangers? Why did James Holmes shoot up the Aurora theater? Was Adam Lanza acting out of childhood resentment? Were the Tsarnaev brothers religiously motivated? Is mental instability behind all violent acts?

Whether the explicit motive is political, religious, or personal, today’s random violent crimes have an overarching societal connection. Uncomfortable in their own skin and maladjusted, the individuals committing them are naturally discontented with their society and blame their deep personal unhappiness on it. Blaming one’s existential discomfort on factors unrelated to it is a kind of self-therapy. A story is constructed (usually borrowed from ongoing public discussions), which rationalizes one’s discomfort as reflecting an awareness of some general evil: corruption, injustice, imperialism, uncaring environment, what not. In cases of more severe distress, such rationalization alone does not sufficiently assuage it and must be acted upon. The individual may join an organization or movement dedicated to fighting a particular evil or be impelled, called, to act on one’s own – and led to murder. The thinking behind such acts bears the most distinctive mark of (schizophrenic) delusion: the loss of the understanding of the symbolic nature of human social reality and the confusion between symbols and their referents. People are killed because of what they represent, rather than because of what they do.

It is the randomness of such crimes that shocks us, making us eager to find a rational motive behind them. The only way to prevent them, however, is to understand how very widespread in our society the mental condition behind them is, and to be ready to intervene whenever the common psychological discomfort threatens to turn into a real disease. Such vigilance might save many more lives than have ever been taken by sick criminals, because it is essential to remember that this kind of violence is extremely rare and that the characteristic violence of the mentally ill is suicide.

Liah Greenfeld is the author of Mind, Modernity, Madness: The Impact of Culture on Human Experience

What’s Really Wrong with DSM-5

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By Liah Greenfeld

The essence of the DSM-5 consists in the modifications it introduces in the extensive psychiatric nosology, specifically adding diagnostic categories to diseases of unknown biological origin and uncertain etiology. But the real problem lies much deeper – in the understanding of such diseases itself. It is the problem with the old, fundamental, and universally accepted diagnostic categories of thought disorder- vs. affective disorders, or schizophrenia vs. manic and unipolar depression, on which all the other diagnostic categories of mental illness of unknown etiology, new and not so new, are based. DSM-5’s approach is similar to attempting to salvage a house, falling apart because it is built on an unsound foundation, by adding to it a fresh coat of paint and new shutters.

What Mind, Modernity, Madness does, in contrast, is to dismantle the structure, establish a sound foundation, and then rebuild the house on top of it. I begin by questioning and analyzing the fundamental diagnostic categories themselves, consider them against the existing clinical, neurobiological, genetic, and epidemiological evidence, bring into the mix the never-before-considered cultural data, and on this basis propose that the two (schizophrenia and manic-depressive illness) or even three (schizophrenia, manic depression, and unipolar depression) discreet diseases are better conceptualized–and therefore treated–as the same disease, with one cause, which expresses itself differently depending on the circumstances in which this cause becomes operative. Psychiatric epidemiologists, at least, have long suspected that “the black box of culture” is an important contributing factor in these diseases. However, as the phrase indicates, they lack the means to understand or even examine its contribution. By unpacking the “black box” (and showing, specifically, how it is reflected in the logically necessary structures of the mind, such as identity, will, and thinking self), I add a missing yet essential dimension to the diagnostic tool-kit, which the DSM-5, like the previous editions, disregards.

Modern Emotions: Aspiration and Ambition

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By Liah Greenfeld

The claim of this post is that such characteristic emotions as ambition, happiness, and love as we understand it today, which form the very core and define the emotional experience of so many of us, are not universal, but specifically modern in the sense of being a creation of the modern culture; that members of pre-modern societies were unfamiliar with them, i.e., did not experience ambition, happiness, and love; and that even at present these emotions play only a minor role in the emotional life of billions of people living outside modern Western civilization. The sources of these three emotions, in other words, are to be sought not in human nature, but in modern culture.

The focus of this post is ambition, while the following two posts will be devoted, respectively, to happiness and love. Still later posts will explain what in modern culture called these emotions into being. (I’d like to remind the reader that this blog is continuous, i.e., it follows the agenda set in the first post, with each new post continuing the arguments of the preceding ones.)

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Are Human Emotions Universal?

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By Liah Greenfeld

It is widely believed that human emotions, from love to ambition to pride or desire for freedom, for instance, are hardwired into our brain and that, therefore, both their range and their nature are universal, shared by humanity as a whole. This belief is wrong and itself reflects the fundamental universalism of modern Western, particularly American, thought and its tendency to consider all human consciousness and behavior as a function of biology. Both comparative zoology and comparative history show that, above the limited range of emotions we share, as animals, with other animal species, what moves human beings and makes them suffer in one culture or society may be dramatically different from the emotions shaping the living experiences in another one.

Emotions, or feelings, as the name suggests, are experienced through physical sensations. In this they differ from other mental experiences, usually called “cognitive.” The part of sensations in an emotion allows us to place it into one of three categories: primary emotions, secondary emotions, and tertiary emotions. Primary emotions are experienced through specific sensations and represent the direct reaction of the organism to the stimuli of its physical environment. They include such experiences as pain and pleasure, fear, positive and negative excitement (joy and anxiety), hunger and satiation, and their biological function is to increase the individual organism’s survival. It is clear that these primary emotions are common to humans and other animals.

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Love, Madness, Terrorism: Connected?

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By Liah Greenfeld

In the 16^th century, in England, several remarkable things happened:

Social mobility, inconceivable before, became legitimate and common;

The ideal of Romantic love between a man and a woman emerged and “true love,” as we understand it today, was added to the human emotional range;

The word “people,” which earlier referred to the lower classes, became synonymous with “nation,” which at the time had the meaning of “an elite”;

Numerous new words appeared, among them “aspiration,” “happiness,” and “madness”;

The English society, previously a society of hierarchically arranged orders of nobility, clergy, and laborers under the sovereignty of God and his Vicar in Rome, was redefined as a sovereign community of equals;

The nature of violent crime, personal and political, changed, with crime that was not rational in the sense of self-interested becoming much more common;

The attitude to pets, especially dogs and cats, changed, transforming these animals in many cases from living multi-purpose tools to our friends and soul-mates;

The pursuit of growth — rather than survival, as was the case before – became the goal of the economy;

Mental diseases which were later to be named “schizophrenia,” “manic-depressive illness,” and “depression” were first observed, shifting the interest of the medical profession, in particular, from other, numerous, mental diseases that were known since the times of antiquity.

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Identity Construction and Cultural Madness

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From the Harvard University Press Blog:

It sometimes seems as if each day brings a new raft of articles proclaiming yet another biological or genetic explanation for human behavior and activity. To Liah Greenfeld, that barrage is just a new bubble, and in Mind, Modernity, Madness: The Impact of Culture on Human Experience, she does her best to burst it. While not entirely dismissing biological factors in mental illness, Greenfeld argues that the phenomenon that was for a long time called simply “madness”—today’s schizophrenia, bipolar disorder, and major depression—is actually a symptom of modernity, an effect of our cultural environment. Continue reading →