I have recently started reading the book Crazy Like Us by Ethan Watters, which investigates psychological disorders across cultures. Interestingly, different cultures have documented disorders that are extremely dissimilar from those in the western Diagnoses and Statistical Manual. As westernized beliefs, culture, and knowledge have spread with globalization, so have western psychological disorders such as anorexia, post-traumatic stress disorder, and depression. Rates of these disorders in nonwestern countries have increased dramatically in recent years.
Watters’s first section focuses on anorexia in Hong Kong. He tells the story of a girl who, after being left by her boyfriend, goes through severe depression and stops eating. Consequently, she looses weight until she eventually dies of starvation. While this appears to be a clear case of anorexia, the patient did not show the same symptoms as western anorexia nervosa. For example, she did not have a skewed body image and she was not obsessed with food, quantity, or calories, which is common in anorexic patients in the US. In addition, she insisted that physical pain prevented her from eating. Prior to the western version of anorexia nervosa being a well-known disorder in Hong Kong, the few patients with anorexia presented with these atypical symptoms. However, once the western notion of anorexia spread to Hong Kong in the 1990’s, the number of anorexic women increased dramatically and their symptoms conformed to those we associate with the disorder, such as fear of weight gain and distorted body image.
Watters’s description of the girl who died of anorexia prior to the spread of westernized anorexia to China leads to several questions. Why were her symptoms so different? Is this a different disorder altogether? Why did the nature of the disorder change once the western symptoms were known in Hong Kong? Returning to Seung’s theory of the connectome, how do culture, values, and expectations shape connectomes? The disorder cannot be entirely genetic, or the symptoms of anorexia in Hong Kong wound not have changed and the rates would not have increased. Why are certain connectomes more susceptible to certain psychological disorders? If it breaks down to an awareness of the disorder, and using the disorder as a cry for help, then perhaps the neurological changes that occur are a consequence of people subconsciously committing themselves to a disorder. Perhaps in this case, knowledge weakens instead of empowers individuals.
Watters, E. (2010). Crazy like us: The globalization of the american psyche. New York, NY: Free Press.