Cultures in Conflict: 4. In US Psychiatry--Irrational Challenges to the Rational

"'Lucy the Elephant'
On the Atlantic Beach,
Near Atlantic City, NJ,
2003."












People from some cultures may do business or assimilate into mainstream US culture much more easily than others. Despite historical differences with Imperialist Japan as the 'Axis' nation which bombed Pearl Harbor in 1941 and drew the US into World War II, Japanese have successfully sold electronics, computers, and many other products in the US.

Many Japanese interpersonal issues also are important in the US. Japanese products have a good reputation for reliability at an affordable price. 'Taijin kyofu sho' describes an individual's intense fear that his or her body may displease others in appearance, odor, facial expression, or movements. These concerns, shared in the US, have helped to build the modern US personal hygiene industry of soaps, deodorants, lotions, and other products.

These more rational ethnic personal and interpersonal concerns are adaptive and economically useful in business and trade. Other cross-cultural issues may be irrational and disruptive.

'Lat ah' is known in Japan and in Indonesia, Malaysia, the Philippine Islands, and Russia's Siberia. 'Lat ah' involves dissociation or trances. 'Lat ah' complaints are consistent with US and European descriptions of schizophrenia and other thought disorders, often exhibited behaviorally. The 'lat ah' may complain of a hypersensitivity to their surroundings, then sudden fright, often accompanied by repetitive, stereotyped behaviors like 'rocking', cursing, and often describes their behaviors as being ordered by an inner voice as in 'command obedience' or a 'command phantasy'. Found with increased frequency in middle-aged women, a woman may physically or verbally abuse her child stating she had been told to do so.

In India, 'dhat' is severe anxiety, body discomfort, weakness, exhaustion. 'Dhat' is similar to 'sukra prameba' in Sri Lanka, and 'shon-k'-rui' in China.

Koreans exhibit 'hwa-byung', suppressed anger syndrome. Complaints may include difficulty sleeping, fatigue, panic, fear of impending death, unhappiness, indigestion, eating disorders, sometimes complaints of a mass in the stomach.

'Shin-bying' includes anxiety and complaints of body discomfort with a sense of being possessed by ancestral spirits. Similarly, Native American Indians complain of 'ghost sickness' with thoughts of death, deceased relatives or friends, bad dreams, body discomfort like suffocating, feelings of futility, confusion, hallucination and sometimes loss of consciousness.

'Zar' in Ethiopia, Somalia, North Africa, Egypt, the Sudan, Iran, and elsewhere in the Middle East, is the experience of spirits possessing the individual, with shouting, laughing, hitting head against a wall, singing or weeping. These hyperactive events may be followed by apathy or withdrawal, loss of interest in eating and usual life activities.

Current US internationalist politics and policies require much more interaction with individuals and tribes from other cultures, who exhibit many of these beliefs and behaviors. Larger immigrant populations in the US and US military and development personnel presence in war zones in these regions, influence more Americans than ever before. Being culturally very different, but involved in governmental reorganizations and the internal affairs of other cultures because of business interests vastly increases the risk of more spontaneous, irrational violence, in war zones or in development projects.

New immigrants to the US, some refugees from war-torn countries, and returning US soldiers, exhibit exotic symptoms and expand the social-welfare industry. Not only are there new psychiatric syndromes. There are increased requests for monthly disability checks from US governments and hiring preferences in a US economy already challenged by high unemployment.


Email mkrause381@gmail.com or mkrause54@yahoo.com to comment or request a copy of this or other blogs posted by mary for monthlynotesstaff on http://monthlynotes22.blogspot.com (http://monthlynotes.blogpsot.com through '22') on www.google.com. See http://monthlynotes18.blogspot.com or '19' for bloglist titles and URLs.

Reference: DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Ed. Allen Frances, MD, Chairperson, Robert L. Spitzer, MD, Special Advisor American Psychiatric Association, Washington, DC, 1994.

Graphic: An Original Photographic of "'Lucy the Elephant', on the Atlantic Beach, Near Atlantic City, NJ, 2003.', copyright, mkrause381gmail.com or mkrause54@yahoo.com.

Cultures in Conflict: 3. In US Psychiatry--'Running Amok'

Old Pier
On the Atlantic
Atlantic City, NJ,
2003.








Dramatic increases in immigration from exotic, non-North Atlantic, non-British, non-European, countries have created intracultural stresses and strains in US society. Psychiatry has not been immune to these other-cultural influences. Standardized scales of psychiatric diagnosis, also used as sources of medical insurance billing codes, DSM-IV ('Diagnostic and Statistical Manual-4th Edition') and ICD (International Code of Diagnosis) now include descriptions of exotic culture syndromes and symptoms.

Dissociative Disorders, previously psychiatric esoterica, include descriptions of a large number of unusual 'fugue' syndromes. Similar issues, such as travel from their native countries, issues about new or changed identities, and memory problems.

Differences in shared cultural understanding of the world arise because of, or as reflected in, differences in language and concepts expressible in the native language vs. the new language, American English, often are not considered in clinical psychiatry. Oddly enough, these issues are sometimes more often raised in TV travel ads: the Islander tells the American there is no word for that in his language, as the Islander sells the American traveller the vacation package.

The concept of cultural literacy, common traditions in art, literature, history, philosophy, and the role of 'non-linear' vs. more 'linear', logical forms and expressions of thought also are significant differences cross-culturally. These are many differences between traditional 'Western' vs. 'Eastern' and civilized vs. primitive views of people and the world around them.

A classic fugue state in a mainstream US citizen might involve a busy but forgotten trip. Despite airline ticket, hotel, or restaurant receipts or photographs documenting the weekend away, the person in a fugue state does not recall the trip.

Fugue states for Americans from exotic locations like the Hawaiian Islands, Alaska, the territory of Puerto Rico, or 'native American tribes' resemble syndromes of new immigrants from tribal culture countries of origin. These fugue-like states, 'Running' syndromes, include 'running amok', found in Western Pacific Islanders.

Most well-known of these syndromes in the general American English parlance is 'running amok'. An extremely disorganized company, with employer or employees not doing business as usual, not 'making sense', could be described as 'running amok'.

A Pacific Islander might complain of a sudden high level of activity, a trance-like state, potentially dangerous behavior, running or fleeing, followed by exhaustion, a long sleep, or amnesia for the activity. The likelihood of such symptoms increases during times of extremely stressful events, deaths in the family, divorces, war or natural disasters.

The person 'running amok' may tell of a period of brooding over some event or feeling about an event, for example after a perceived slight or insult. Then the 'amok' may have an outburst of violent, aggressive, or even homicidal behavior directed at people and objects.

Navaho 'tich 'aa'' and 'frenzy' witchcraft and the Arctic native 'pibloktoq are described in indigenous groups in the US, more frequently in men. 'Pibloktoq' in Arctic, sub-Arctic, Alaskan Eskimos too may begin with a withdrawn or irritable state for hours or days. Then abrupt extreme excitement occurs for 30 minutes with tearing off clothing, breaking furniture, shouting obscenities, eating feces, fleeing from protective shelters, or other irrational or dangerous acts. Frequently, after the excitement, there are convulsive seizures, then a comatose state occurs for about 12 hours. Typically, the 'pibloktoq' has no memory of the episode.

Similar episodes are self-described as 'falling out' (sic, 'I fell out') or 'blacking out', in the US, particularly in those from Southern US states and among Caribbean descendants. Periods of 'brooding' may or may not precede feelings of 'swimming in the head', lightheadedness or 'dizzyness', and complaints of 'can't see' with eyes open, 'can't hear', 'can't move' without signs of illness or injury.

New immigrants have brought new dissociative syndromes. Caribbean Latin American Latinos complain of 'ataque de nervios', with strongly expressed anger or rage, bodily feelings, trembling, uncontrollable shouting, screaming, stomach and bowel disturbances, headache, and even loss of consciousness.

Similarly, with 'locura', there may be incoherence, agitation, hallucination, disregard for 'rules of social interaction', with unpredictable, possibly violent behavior.

West African students complain of 'brain fag' (sic, fatigue) from 'too much thinking', with difficulty concentrating, remembering, head and neck pain, pressure, tightness, blurred vision, heat or burning sensations.

Violent 'borifee dehrante' starts in West Africans and Haitians with a sudden outburst of aggressive behavior, marked confusion, and agitation.

'Susta' or 'soul loss' involves the feeling that the soul leaves the body for days to years. Sickness, unhappiness, even death may occur. Greeks performed ritual healings to call the soul back to the body.

The 'Running Syndromes' have complicated psychiatric care and expanded the US 'social-welfare industry'. Many US citizens and new immigrants from other culures and countries of origin may have been taken in to US welfare and disability programs with psychiatric diagnoses. Some may have been diagnosed with personality disorders, some with paranoid schizophrenia, and some in mixed diagnostic categories. Other issues like alcohol, drug abuse, mental retardation/emotionally disturbed/developmental disorders may also be prsent. Some of these disorders are considered compensable disabilities, some are not.

US success, domestically and internationally, has depended on more linear, rational codes of behavior promoting productivity at work and control of emotions at work or school, while shopping, and in organized social activities like sports and hobbies. Demands of multicultural groups for 'acceptance', financial and other oompensation for very different, other-culture, more aggressive physical and emotive, behavior patterns have created substantial stresses and strains in US society.


Email mkrause381@gmail.com or mkrause54@yahoo.com to comment or request a copy of this or other blogs posted by mary for monthlynotesstaff on http://monthlynotes22.blogspot.com (http://monthlynotes.blogspot.com through '22') on www.google.com. See http://monthlynotes18.blogspot.com or '19' for bloglist titles and URLs.

Graphic: An Original Photographic of 'Old Pier On The Atlantic, Atlantic City, NJ, 2003', copyright mkrause381@gmail.com or mkrause54@yahoo.com.

Reference: DSM-IV, American Psychiatric Association, Ed. R. Spitzer, et.al.