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The currents and movements during the past decade in investigations of etiologic factors in deviant thought and behavior have been lively in both organic and psychological directions. The investigation of biochemical and neurophysiologic factors derives its renewed vigor from recent advances in psychopharmacology, biogenetics, and the neuro-physiology of perception and cognition. The psychological picture is enriched by analysis of the patients socio-cultural milieu. It is hoped that linkages between the two approaches will eventually emerge to provide more definitive and holistic clues to the riddles of psychiatric illness.
In the West, the infusion of the social sciences with psychoanalysis sparked the proliferation of culture and personality studies (Singer 1961). This development was inevitable, since every social science must eventually reckon with individuals and individual variations in behavior. Only by analyzing these variations can the reality and meaning of norms be understood and saved from being mere convenient abstractions (Sapir 1938). In return for being revitalized, the social sciences have rewarded psychiatry with broader knowledge about and insight into the role of the cultural and social factors in crystallizing and precipitating psychological experience. Such knowledge has immeasurably enhanced the understanding of the emotionally disordered individual.
The interrelation between culture and mental health and the dynamics of how socio-cultural factors contribute to illness may be extracted from the statements of the following psychoanalysts, anthropologists, social psychiatrists, and psychologists:
Frieda Fromm-Reichman (1950), emphasizing the interpersonal factor, says:
The patient’s selection of subject matter for repression and dissociation, according to my thinking, is determined by the existing cultural standards governing his life. His medium of adherence to these standards is their acceptance by the significant people in his immediate environment and in his group.
Marvin Opler (1967) explains what makes for a healthy and a disordered person in a culture:
The distinction between health, on the one hand, and one typical form or another of illness in a culture is not merely between those who communicate, and those who do not or those who fulfill needs, and those who have been thwarted. In each case, though quite opposite paths of symbolization, adjustment, and communication have been utilized, both have derived from different aspects of the cultural realities. In the one case, the adjustment of internal necessities and external conditions has been mediated by regulative principles, defenses, modes of communication, and cultural symbols and values, cognitive attitudes, regulative principles, precepts and defenses have been critically effected by the stresses inherent in the cultural scene. In the most serious illnesses, we see an individual drawn finally into lines of conflict that are be sure, but mark a warfare between the self and ‘those others” now dimly perceived, distorted, misunderstood and hated as values and standards attenuate, grow weak, and lose their persuasive quality. We may thus speak not only of weaknesses in individuals and in families, but in cultural values.
Eric Wittkower and Jacob Fried (1959) state their position utilizing psychoanalytic concepts:
Certain drives and infantile experiences are common to all human beings though variations in degree and quality occur. Parental values, attitudes and controls which reflect cultural tradition are, by precept and example, implanted in, and incorporated and absorbed by, the ego of the child and form the core of his conscious and unconscious super ego. Consequently the culture does not only represent the fabric of the ways of living of the society n which we live but it also has its counterpart in our inner world. In line with this argument culture conflict has its battleground in the inner as well as in the outer world.
Gordon Allport (1965) highlights the struggle of the individual between conforming with cultural norms and being true to himself:
True, we obey conventions of modesty, decorum, and self-control, and have many habits that fashion us in part as mirror-image of our home, class, and cultural ways of living. But we know that we have selected, reshaped, and transcended these ways to a marked degree.
The crying, rejecting, and anger of a young infant as well as the negativistic behavior of the two-year-old are primitive indications of a being bent on asserting itself. All his life long this being will be attempting to reconcile these two modes of becoming, the tribal and the personal: the one that makes him into a mirror, the other that lights the lamp of individuality within.
To summarize, culture affords the individual ego support through its system of values, not only as they exert influence through child rearing practices and in the shaping of his personality, but also in reaffirming personal goals and in providing with guidelines to indicate the manner in which they may be fulfilled. On the other hand, the culture, particularly that one which is in transition, may no longer be relevant to individual aspirations and, instead of providing support, may serve as the source of stress. One may therefore expect that where culture is out of step with the individual, and vice versa, more emotional upheavals, will ensue.