Category Archives: Culture

What’s Really Wrong with DSM-5

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

Are Human Emotions Universal?

4 Replies

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.

Continue reading →

Love, Madness, Terrorism: Connected?

1 Reply

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.

Continue reading →

Identity Construction and Cultural Madness