Indian Culture and Psychiatry

Article excerpt

Byline: Shiv. Gautam, Nikhil. Jain

'Culture' is an abstraction, reflecting the total way of life of a society. Culture uniquely influences mental health of people living in a given society. Similarity in thinking and understanding of mental health across the ancient cultures has been observed. Studies which relate to the demographic factors, cultural factors influencing presentation of illness, diagnosis of the illness-culture bound syndromes and influence of the cultural factors and the belief system on psychopathology, stigma and discrimination towards the patient have been reviewed. An attempt has been made to critically look at the research on culture and psychiatry in different areas. There is a need for culturally oriented modules of non-pharmacological management.

Introduction

'Culture' is an abstraction, reflecting the total way of life of a society. It is a precipitate of the group's history and an expression of its adaptation to the physical environment. It refers to the shared patterns of beliefs, feeling and behavior and the basic values and concepts that members of the group carry in their minds as guides for the conduct. Besides social relationships, economics, religion, philosophy, mythology, scriptures, technology and other aspects of living contribute to the culture. Culture is constantly in the process of change and it is transmitted from one generation to the next. All societies have it though their styles vary from one group to another. [sup][1]

The term "culture", which is a keystone in psychiatry, is plagued by confusion because of a lack of concise, universally acceptable definition. In fact at least one hundred and sixty different definitions exist. Culture is thus best conceptualized as a totality, composed of a complex system of symbols possessing subjective dimensions such as values, feelings, and ideals and objective dimensions including beliefs, traditions, and behavioral prescriptions, articulated into laws and rituals. This unique capacity of culture to bind the objective world of perceived reality to the subjective world of the personal and intimate, lends it, its powerful role as expressor, mediator, and moderator of psychological processes and, ultimately, emotional disorders. [sup][2]

Culture uniquely influences mental health of people living in a given society. Mental health problems, from presentation of illness to course and outcome, at every stage are influenced by cultural issues. Large numbers of patients get referred to the physician or psychiatrist of their cultural milieu as he/she can understand the patient and his psyche due to the understanding of cultural factors which influence the disease and healing process.

No culture confers absolute immunity against psychological vicissitudes. The forms of psychiatric disorders are identical in all cultures though the content of symptoms differ. For example, an Indian peasant when deluded complains of being possessed by a demon, while his western counterpart believes that his mind is being manipulated by electronics. It was believed a few decades ago, that people from oriental cultures experienced little or no stress. Mental illness and stress-related disorders like heart disease, high blood pressure, diabetes,cancer and suicide behavior were considered to be less frequent amongst them. This really is not so. Transcultural studies indicate that populations, exposed to a rapid onslaught from other cultures experience a cultural shock resulting in a high degree of mental and social stress. [sup][1]

Understanding of mental health in different cultures

Conceptually, if we look at the ancient culture, there are four cultural streams that are prominently seen. The Indian, Egyptian, Roman and Chinese culture. One similar phenomenon observed regarding mental health problems in all of them is the impact of supernatural on the human mind. The understanding of illness also in different cultures interestingly has been perceived as an imbalance of humors leading to problems of mind and body. …