Interpreting culture and psychopathology: primitivist themes in cross-cultural debate

Interpreting the cross-cultural incidence of psychopathology is a focus of continuing debate. This paper explores the lineaments of that debate and its underlying premises concerning difference and distance. Primitivism--a body of ideas, images and vocabularies about cultural others--is characteristically employed to represent non-Western peoples. But it is more fundamentally concerned with the way the West understands itself in contradistinction to these others. It is shown to be a major source of the images used to think about mental illness, and of the intellectual traditions which have constituted cross-cultural psychiatry as a comparative discipline. Psychiatric primitivism employs two opposing perspectives, which we have labelled 'Barbaric' and 'Arcadian' respectively. They are the source of contradictory assertions concerning the relationship between culture and mental illness. They provide the framework which structures contemporary research into the cross-cultural incidence and course of schizophrenia, shaping its methodology, its rhetoric, the strategies by which data are interpreted, and the conclusions which it draws. We demonstrate a convergence of themes whereby images of society, person and mental illness come to signify each other. This is epitomized in three of cross-cultural psychiatry's principal subject areas: amok, shamanism, and the therapeutic quality of 'traditional' society.