Sunday Times 2
How schizophrenia is shaped by our culture
People suffering from schizophrenia can often hear imaginary voices so terrifying that they are left traumatised.
One American patient described the voices as ‘like torturing people, to take their eye out with a fork, or cut someone’s head and drink their blood.’
A study has now found that these voices can be shaped by culture, with Western cultures experiencing far more disturbing psychotic episodes.
People suffering from schizophrenia can often hear imaginary voices so terrifying that they are left traumatised. One American patient described the voices as 'like torturing people, to take their eye out with a fork, or cut someone's head and drink their blood' (Reuters)
Schizophrenia is a severe brain disorder that can cause people to hear ‘voices’ that other people don’t hear. It affects about one per cent of the global population over the age of 18. Many people in Western cultures have reported hearing voices claiming other people are reading their minds, controlling their thoughts or plotting to kill them.
In Africa and India, however, these hallucinatory voices appear as harmless and even playful, according to the study by Stanford University in California.
While there’s no cure for schizophrenia, this study suggests that therapies urging patients to develop relationships with their imaginary voices could prove useful.
As part of the study, Professor Tanya Luhrmann interviewed 60 adults diagnosed with schizophrenia; 20 each in San Mateo, California; Accra, Ghana; and Chennai, India.
Overall, there were 31 women and 29 men with an average age of 34, who were asked about their relationship with the imaginary voices. While many of the African and Indian subjects registered largely positive experiences with their voices, not one American did. Instead, the U.S. subjects were more likely to report experiences as violent and hateful
For instance, they spoke of their voices as a call to battle or war – ‘the warfare of everyone just yelling.’ The Americans mostly did not know who spoke to them and they seemed to have less personal relationships with their voices, according to Professor Luhrmann. But among the Indians in Chennai, more than half heard voices of kin or family members commanding them to do tasks.
‘They talk as if elder people advising younger people,’ one subject said. That contrasts to the Americans, only two of whom heard family members.
The Indians also heard fewer threatening voices than the Americans – several heard the voices as playful, as manifesting spirits or magic, and even as entertaining.
Finally, not as many of them described the voices in terms of a medical or psychiatric problem, as all of the Americans did.
In Accra, Ghana, where the culture accepts that disembodied spirits can talk, few subjects described voices in brain disease terms.
When people talked about their voices, 10 of them called the experience predominantly positive; 16 of them reported hearing God audibly. ‘Mostly, the voices are good,’ one participant remarked.
The difference may be down to the fact that Europeans and Americans tend to see themselves as individuals motivated by a sense of self identity, said Professor Luhrmann.
Whereas outside the West, people imagine the mind and self as interwoven with others and defined through relationships.
In America, the voices were an intrusion and a threat to one’s private world – the voices could not be controlled.
However, in India and Africa, the subjects were not as troubled by the voices – they seemed on one level to make sense in a more relational world. Still, differences existed between the participants in India and Africa; the former’s voice-hearing experience emphasised playfulness and sex, whereas the latter more often involved the voice of God.
‘The difference seems to be that the Chennai and Accra participants were more comfortable interpreting their voices as relationships and not as the sign of a violated mind,’ the researchers wrote.
The research, Professor Luhrmann observed, suggests that the ‘harsh, violent voices so common in the West may not be an inevitable feature of schizophrenia.’
The findings may be clinically significant, according to the researchers and adds to research that shows specific therapies may alter what patients hear their voices say.
© Daily Mail, London
| THE US VS INDIA AND AFRICA
African and Indians registered largely positive experiences with their voices, but not one American did. In America, the voices were an intrusion and a threat to one’s private world – the voices could not be controlled. However, in India and Africa, the subjects were not as troubled by the voices – they seemed on one level to make sense. The Americans mostly did not know who spoke to them and they seemed to have less personal relationships with their voices. But among the Indians in Chennai, more than half heard voices of kin or family members commanding them to do tasks. Several Indians also heard the voices as playful, as manifesting spirits or magic, and even as entertaining. The difference may be down to the fact that Europeans and Americans tend to see themselves as individuals motivated by a sense of self identity, said Professor Luhrmann. Whereas outside the West, people imagine the mind and self as interwoven with others and defined through relationships. |