Academic journal article Indian Journal of Psychiatry

Indianizing Psychiatry - Is There a Case Enough?

Academic journal article Indian Journal of Psychiatry

Indianizing Psychiatry - Is There a Case Enough?

Article excerpt

Byline: Ajit. Avasthi

Psychiatry is different from all other branches of medicine as it pertains on "psyche" which is intangible, effervescent and indefinable. It is influenced by interviewer and client's communication skills, personality, socio-cultural beliefs and interpretations. The inference of "normal" and "abnormal" varies across cultures and understanding of the cultural nuances is an integral part of understanding psychopathology. Knowledge gained in one culture cannot be extrapolated completely to another culture. Indian psyche is distinct as it is has been influenced by various invaders into the country, collectivism and interdependence. Because of all these factors, presentation of mental illness is different in the Indian culture and many a times it is difficult to fit patients into the categories developed by the Western world. Similar factors also influence attitude towards treatment seeking and visit to magico-religious healers and those practicing alternative system of medicine. Moreover, the principles of Western psychotherapy cannot be applied to the Indian subjects. Compared to West, family plays a vital role in all major decision in an individual's life including his treatment and care. They bear the major burden and take up the responsibility of care of the persons with mental illness and dampen the effect of limited resources. These families cope by trusting and passing on the responsibility to almighty. Hence, there is a need for Indianization of psychiatry.

Introduction

The thought that becomes paramount in our mind is that after all what is so special about Psychiatry amongst medical sciences, that one may consider something as fantastic as Indianizing it. The answer lies in the core concept of Psychiatry, that is, it is the study of abnormal human psychology or the human mind. The psyche, unlike the different parts of the human body, is intangible, effervescent and indefinable. When one tries to detect abnormalities in it, the age-old medical tradition of inspection, palpation, percussion and auscultation becomes inadequate. Diagnosis of disorders in Psychiatry depends mainly on "listening" to clients instead of the physical examination and investigations which form an integral part of medicine in general. Thus, diagnosis in Psychiatry cannot remain uninfluenced by the interviewer and client's communication skills, personality, socio-cultural beliefs and interpretations. We must remember that no man is alike and man's search for sameness in this diversity has led to the development of different cultures, traditions and religion in this world. People from different socio-cultural and religious backgrounds tend to interpret the human psyche differently and the label of "abnormality" is influenced by the definition of "normality" decided by these cultures. We will not enter into the controversies of what is "normal" human psychology as this is a never ending debate. It may suffice to say that this definition varies across culture, religion and customs and therefore recognition of psychiatric disorders can be different across these cultures. If we look at the Major Depressive Disorder, touted as one of the commonest psychiatric morbidities all over the world, its core concept of "excruciating psychological pain" is undoubtedly a vague expression leaving a lot of scope for individual and group variation in its manifestation. To further illustrate the difference of Psychiatry from other branches of medicine, I draw upon one of my favorite analogies - Diabetes Mellitus. Like many psychiatric disorders, it is chronic, treatable but not curable, requiring lifelong monitoring and personal adjustments. However, despite all these similarities, it is a "physical disorder", the reason being the presence of a tangible and demonstrable cause which renders uniformity in diagnosis and treatment, irrespective of the person's socio-cultural background.

Biological psychiatrists will argue that there is sufficient evidence today regarding mental illness being brain disorders. …

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