Recommended on Gary Collins’ blog, I promptly reserved Crazy Like Us: the globalization of the American psyche by Ethan Watters at the library. When it arrived, I stalked/tormented those around me reading passages out loud and discussing the book at every meal. It’s informative and maddening.

We have the uneasy feeling that our influence over the rest of the world is coming at a great cost: loss of the world’s diversity and complexity. For all our self-incrimination, however, we have yet to face our most disturbing effect on the rest of the world. Our golden arches do not represent our most troubling impact on other cultures; rather, it is how we are flattening the landscape of the human psyche itself. We are engaged in the grand project of Americanizing the world’s understanding of the human mind.

Having (a) lived overseas and (b) invested a considerable part of the last ten years in the counseling profession, this book hit me smack in the kisser on both counts, leaving me wondering more often than was comfortable if I have done more harm than good. Watters used four primary examples:

  • Anorexia in Hong Kong
  • PTSD in Sri Lanka
  • Schizophrenia in Zanzibar
  • Mega-marketing of depression in Japan

The overriding themes in each case involved a desire to help but (faulty?) assumptions that people are the same the world over. Instead of going in and asking questions and learning about that culture, in each instance the “helpers” and the recipients often perceived western psychology to be superior to local customs and traditions. And it turns out that PTSD may not be true! As one who rushed in to help after the Sichuan Earthquake in 2008, I have had to ask myself the hard question: who was I trying to help? The Chinese or myself? Ouch.

Watters does not doubt that there are things going on psychologically or that there are people who truly want to help. The point he hammers is that mental illness, including obvious categories like PTSD, schizophrenia, and depression, are “every bit as shaped and influenced by cultural beliefs and expectations as hysterical leg paralysis, or the vapors, or zar, or any other mental illness ever experienced in the history of human madness.”

Lest you, like I, think that we, as culturally aware and sensitive people are above these assumptions, how is this for convicting: people diagnosed with schizophrenia have better outcomes in developing countries than in so-called developed ones. Why? This will be a gross simplification, but in general it’s determined by where the problem in seen as originating. If the primary problem is in the brain, as it’s generally seen in the West, then when people don’t take medicine or makes efforts to “get well,” we lose patience with  them. However, if you have an evil spirit plaguing you, well, that’s not your fault and there’s not much you can do about it. This attitude results in family members being far more patient towards those effected. Yikes. Who would have thought that being so “enlightened” might not be the way to go?

This is one of those books that I can sense has changed the trajectory of my thinking; no radical sharp right turns, but Crazy Like Us has at least brought some of my assumptions to the surface where, now,  I am at least aware of their presence.

What have you read that had wondering if you’d done more harm than good?

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  1. Laura December 29, 2011 at 12:23 am - Reply

    Darn it, I still haven’t read this book and you have reignited my interest yet again. I am so fascinated by this topic and am eager to have some discussions with the psychiatrist on my unit to see what he thinks about this.

    • Amy December 29, 2011 at 4:25 am - Reply

      Do!! I’d be curious to hear what he has to say… and of course what YOU think of it! Amy

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