Cultural Psychiatry: What’s Considered Normal Behavior in Your Culture?

In a previous post, I explained how medical anthropology is the anthropological study of health and illness. In this post, I’d like to talk a little about one of the major branches of medical anthropology, which is called cultural psychiatry. Cultural psychiatry is also known as cross-cultural psychiatry, and it is the study of mental illness in different cultures.

Cultural psychiatry is more focused on mental illness, rather than mental disease. What’s the difference? Well, in medical anthropology there is a distinction made between the two concepts of “illness” and “disease.” “Disease” refers more to the biological aspects of a condition, while “illness” refers to the experience of the disease, and the social and cultural aspects. Here’s an example, using the condition of dementia. Some scientists focus on the biological aspects of dementia, such as degeneration in the brain. Anthropologists instead focus on social and cultural aspects of dementia, such as the patient’s perceptions and the way others treat the ill person.

One thing that cultural psychiatry looks at is how each culture defines normal behavior and abnormal behavior. What is considered normal behavior varies throughout the world — it is not the same in each culture. And what is considered normal in a culture may change depending on things like age, gender, social class, and occupation. Normal behavior also depends on the context. For example, normal behavior at the workplace is probably not the same as normal behavior when you’re on vacation.

Here’s an example of how normal and abnormal can be different around the world. In American culture (along with many other Western societies), if you say that you are possessed by spirits, then you are considered abnormal. You would probably be diagnosed with a psychotic disorder. But in some African cultures, spirit possession is something that everyone believes in. And if you didn’t believe in this, then you would be considered abnormal.

So then, cultural psychiatry asks, if definitions of normal and abnormal behavior vary across cultures, can we make any generalizations about normal and abnormal behavior in humans in general? And, if normal and abnormal behavior varies across cultures, does that mean that our Western definitions of mental illnesses are not universal? Cultural psychiatry seeks answers to these questions and much more.

Some people think that the Western definitions of mental illness are universal, because they believe these illnesses have a biological cause. They believe that other cultures’ mental illnesses can be sorted into the categories that Western psychiatry has created. This is the biological approach.

Others believe that mental illness is a social thing, not necessarily a biological thing. These people say that culture defines what is a mental illness, so mental illnesses are not universal. They believe that mental illnesses are socially constructed. This is the social labeling approach.

Still others use the combined approach, which combines aspects of the biological approach and the social labeling approach. These people say that some abnormal behavior is universal, but the clinical presentation is influenced by culture. Here’s an example. This approach says that psychotic people are found around the world, but how the psychosis manifests is dependent on culture. So, someone in a tribal society who is psychotic may say that they are being controlled by witches, while someone in the United States may say that they are being controlled by aliens.

Another interesting thing to add to this discussion is that there are some mental illnesses that are found only in certain cultures. These are called culture-bound syndromes, and I’ll talk more about these fascinating illnesses in the next blog post.

Learn More

Want to learn more about cultural psychiatry and cultural ideas of normal vs. abnormal? Check out the Scientific American article, “Abnormal as Norm: Actions deemed odd, psychotic or even barbaric by one culture may be perfectly acceptable to another.”

Thanks for reading!