'Mental Illness in the Modern World: The Cultural Connections' - Live Dialogue

Session Details

Guest Name

Dr. Yusuf Progler

Profession

Professor

Subject

Mental Illness in the Modern World: The Cultural Connections.

Date

Wednesday,Oct 2 ,2002

Time

Makkah
From... 18:30...To... 20:00
GMT
From... 15:30...To...17:00

Name

Host. -

Profession

Question

Submit your questions.

Answer

.

Name

M. Yusuf -

Profession

Student

Question

I have heard some where on the news that world health organization (don't quote me on that)classifies psychological disorders as the as the third leading disease type in the world and at the rate that is is growing that these types of diseases might actually take the lead in twenty five years time. What is your take into why this epedemec is growing and what ways can we use to curb it?

Answer

Thanks for the question. You are right, the World Health Organization has paid a lot of attention lately to mental illness. One study found that the incidence of schizophrenia has increased 45 percent in developing countries since 1985, and another study found that women suffered from depression on average twice as often as men, with ratios in some places as high as 9-1. These studies, in addition to a lot of other recent research, have prompted the WHO to predict that depression will become one of the most disabling disorders on a planetary scale by the year 2020, second only to heart disease. What is interesting is that, unlike other debilitating illnesses of the past, the top two of the future while not be microbial or viral; they are essentially cultural diseases. Heart disease is more prevalent where people smoke, eat fatty foods and live a sedentary lifestyle, and depression is increasingly being linked to identity crisis and other cultural factors, despite the psychology industry insisting upon the genetic basis of such diseases. Some psychologists and psychiatrists have taken heed of these warnings, and are beginning to reorient their work toward cultural and social factors in the prevalence of mental illness. Several studies have made connections between culture and psychological dysfunction. For example, a study published in the Archives of General Psychiatry in 1998 found that among Mexican immigrants to the US, the incidence of mental illness increased the longer they stayed. These, and many similar studies are fascinating and alarming at the same time. I think before we can talk about prevention or curbing the problem, we have to better understand it, and understanding mental illness in the modern world entails grasping two issues: 1) how mental illness is defined over time and across cultures and who does the defining, and 2) accepting the recent evidence that the causes of many mental problems lie outside a person's head, e.g. in the realm of culture and society.

Name

Shilla - United States

Profession

Question

Human societies have always had people with mental illnesses among themselves, but they lived among other people. It is just in modern world that we see special places for them to keep them far from others. I wonder if it has really been a cure, or it made the problem worse. Do you have any idea on this?

Answer

You are onto an important point that needs to be centralized in this discussion: the definition of mental illness, as well as its treatment, has changed over time. As you suggest, there was a time in the West, for examples that "fools" and others what might be called mentally ill people today roamed the streets and were part of society. At some point, basically with the rise of rationalism and the Enlightenment, these people were suddenly seen as a threat, and then we see the birth of institutionalization and confinement, with the earliest attempts being setting to see the strange in behavior, in what was known as a "Ship of Fools" that would endlessly float about the canals and seaports of the west world with their unwanted cargo, who would not be taken off the ship until they were "cured" or until they died. Soon, more efficient means of confining people were developed with the birth of the asylum. Several fascinating books detail this history, but the point is that there is no objective or consistent definition of what it means to be "crazy" or "insane" or "psychotic," and that taken as a historical question these terms tend to define people who did not fit the social order of the day. How and why these people were confined is an interesting story, but the point to remember is that there is not really a "cure" for something about which we do not really have an objective diagnosis, that rather than a medical problem, what we are talking about is a social and cultural problem, that of order and conformity. Now, different societies deal with disorder and non-conformity in different ways, and in some societies they choose to diagnose these people as ill and in need of confinement or treatment. An interesting research project needs to be done that takes these questions and runs them across cultures, over time, since most of the work that has been done in this area is on the history of mental illness and insanity in the West.

Name

Reza - Pakistan

Profession

Question

Salam dear professor! I have always this question in my mind that how we classify some people to have mental illness. Is it the same in all cultures and societies?

Answer

I addressed some of this in the last answer, or one of the answers, I am not sure of the order in which they will appear. But basically, yes, you are correct, there is no single consistent definition of mental illness, even within the Western world, where with the birth of modernity it has increasingly become a preoccupation. As I said before, it seems bound up with notions of social order and cultural conformity, more so than any objective scientific definition. And, in recent times, with the rise of multi-billion dollar psychiatric drug industry, it is even more difficult to really know who is sane and who is not, since doctors and drug companies stand to profit immensely from larger numbers of "sick people." And, you are correct to ask this as a comparative question, since it does differ significantly across cultures. Take, for instance, the resent malady inscribed upon children: "attention deficit disorder." It is a dis-order, a lack of order, and comes primarily from the inability or unwillingness of children to sit still for hours of excruciatingly boring schooling for years on end, among other factors. On any given day in the United States and Canada, there are over five million children taking powerful psychostimulant drugs to treat ADD, with Ritalin being the most commonly proscribed, and the US and Canada account for a staggering 95 percent of Ritalin consumption world wide. This problem began to receive some public scrutiny, and some investigations revealed collusion between drug companies and medical researchers, while evidence of "cures" were based on subjective data from, you guessed it, teachers, who of course will say it works, since their "problem" students now sit in a stupor and are no longer hyperactive. This is an immense issue and all I can do now is urge you to read widely on this problem, and to ask questions like, why are so many Americans on drugs, like Ritalin, Prozac and others, and are these treating ailments or are they just creating ailments.

Name

Mustafa - United States

Profession

Teacher

Question

What types of mental illness have been documented historicaly that muslims suffered from (pre-modernity)

Answer

That is a great question, certainly one for the historians to mine, but let me say briefly that you will find the same kinds of ideas, that a crazy or insane or mentally ill person in any culture and society at any time tends to be some one does not fit the existing social order or who does not conform to prevailing cultural norms. Did not the Qur'an address this, when it says that the Prophet, upon whom be peace, was not crazy or bewitched? In other words, his revelation of the words of Allah Most High had been interpreted by the existing society at the time of evidence of him being crazy. Now, unless you are a fanatical Orientalist, no one would today say such a thing, and Islam is recognized as one of the great religions of the world. But the society at the time of the Arabs saw the message of Islam as evidence that the messenger was crazy. Maybe that society was "crazy," not the Prophet! But you see the point, the whole concept of mental illness is cultural defined, and that definition changes over time. So even if you find evidence in the Muslim history on the prevalence of one or another kind of mental disorder, you would still have to think about what were the criteria for making those judgments.

Name

Shadi - Iran

Profession

Question

In spite of all claims of developing sciences, it seems that the modern world has made the problem of mental illnesses more complicated. Have human history had the kind of mental illnesses we see in modern world?

Answer

I'm glad everyone is asking historical questions, since the first thing you will find when you study this history is that there is no consistency in how societies defined or understood what we are calling mental illness. The only consistency seems to be that it was applied to people who some how did not "fit in," who were saying or doing things that were seen as "abnormal," and the innovation with the birth of modernity is that these abnormalities became criminalized. More recently, they have become medicalized, so we only lock up the really crazy people, whoever they are, and give drugs to the rest. It is a complicated issue because societies are complicated, and they change over time in regard to values and beliefs, as well as diagnoses and treatments. What is new in modernity is the large-scale industrial diagnosis and treatment of these people, and whenever you have an industry and an attending bureaucracy, you tend to find an increase, or a perpetuation of the issue that it is supposed to be treating or controlling. Pre-modern societies did not have these industries, so they had "less" mental illness. However, I do believe it is not simply an issue of definitions, since there do seem to be a lot more unhappy and depressed people in recent years, and many have begun to look, as I have said earlier, to modernity itself as a causal factor in some of the more prevalent mental illnesses, such as depression.

Name

Yassin - United States

Profession

Student

Question

What is the relationship between stress and materialistic view to the world?

Answer

There are many ways to pursue this line of inquiry. In short, it seems pretty clear that the materialistic lifestyle is stressful, what has been called the "rat race" in some places, working to make money to spend on possessions. Modern humans are feeling more and more dead, though they still walk around, eat, procreate and work. But inside they are dead. Look at the alarming rate of suicide in the affluent and modern societies. People are unfulfilled, and the kind of fulfillment being foisted off by consumer culture is a material fulfillment, which can never be satisfied, the desire for the pleasures of this world can never be satisfied, so one will always want more, if that is one's sole goal. But even if one could fulfill all one's desires, there end result is still emptiness, since we are talking about a spiritual emptiness here. To feel alive, many people are turning to last ditch efforts, like sex and drugs, which give a quick rush of being alive, but which do not satisfy the inner emptiness, which then leaves the ultimate attempt at feeling alive, which is bringing about one's own death by one's own hand. Most people who commit suicide, or attempt it, in the West say they do so because of social or cultural factors, they are ugly, fat, unpopular, lonely, unfulfilled. Does this count as mental illness? Again, I ask you to consider the question, "is it possible for a society to be sick?"

Name

Hahya - United States

Profession

Student

Question

Is there any connection between capitalism and the many mental problems that many in the West struggle with?

Answer

Many scholars have made such connections, that the work and spend rat race brings mental illness of one sort or another. In fact, studies by the World Health Organization and those published in major journals like the Journal of the American Medical Association are beginning to agree with what historians and sociologists have said for a while, that the modern lifestyle causes illness of various kinds. One study, published in JAMA in 1992, found the rate of depression increased in countries that were modernizing, despite dramatic improvements in medical infrastructure. In other words, as a nation adopts the modern lifestyle, its people getter sicker, both mentally and physically, and the two major debilitating diseases predicted for the next two decades are essentially lifestyle ailments -- heart disease and depression -- which increase with the increase of the trapping of modernity. Some have been prompted to label the modern Western lifestyle, and especially its American consumerist variant, as a "toxic culture."

Name

Khalil -

Profession

Question

What do you think the percentage of mental illness in the West in, specific, means? Is there something in the upbringing of the children that brings this on? Or the societal structure? Please comment.

Answer

Again, we have to be careful not to normalize the present definitions of mental illness, since this changes with the times. For instance, a new kind of "mental illness" emerged in the past twenty years, with the increase of conversions to Islam or the rediscover of Islam by the youth of Muslim societies. Parents worried that their children are some how sick for wanting to follow Islam in the modern world are sometimes supported by psychiatrists who prescribe sedatives and other drugs. You can find this tragedy in Muslims societies that are trying to curb Islamic revival, such as Turkey and Jordan, or in the West, where Islam is seen as a threat to Christian culture. The tendency to medicalize different or abnormal behavior has increased in recent years, and so we find now, in some cases, that simply being a Muslim is equated with some form of mental illness. Again, I ask the question, is it not the society that does this which might be considered sick? We have to be very careful about how we understand and adopt treatments for something as slippery, and politicized, as mental illness.

Name

Ali - United Arab Emirates

Profession

Journalist

Question

I don't know why in modern world, they marginalized people with mental illnesses, and as a result of the same civilization, as is mentioned in the first question and answer, mental disorders are growing in numbers. I am afraid of the time that the majarity of people would be mentally ill and then it is they who should marginalize those without mental disorders! Where the modern world is going?

Answer

You are expressing some of the same ideas that I think we should all be thinking about. One way to understand this is to ask, what threat is the mentally ill person? What harm can they cause? The psychologist R. D. Laing once asked who was more dangerous to species survival, the well-adjusted bomber pilot or the insane person who thinks the bomb is inside their head? He also wonder about how we could see travel to the moon as sane, when people who travel to the inner depths of their consciousness could be seen as insane. Is it a sane society that develops and threatens to use weapons capable of planetary immolation? Was the Cold War an exercise in sanity? They even called it the MAD doctrine, Mutually Assured Destruction. That sounds to me like the work of a sick mind, and certainly some one who thinks and acts on such a belief is a much, much bigger threat than the fool who walks around drooling on himself.

Name

Mira - United Arab Emirates

Profession

Student

Question

Salaam Ustad. Since we are living in a Globalizing 'modern' world, communication has become extremely important. The faster the better. Internet has not only become a tool, but it somehow replaces real life. I personally think that Internet, and Internet relationships may cause mental illness and disorders. Would you agree with me regarding that? And how do you explain the negative effects of 'modern world' internet relations, and its connection to some mental problems, such as depression. Thanks!

Answer

Big question, and it is in some ways an issue of the cart and the horse, which comes first. Is it that Internet addiction causes mental illness, or that mentally damaged people are attracted to the Internet, with apologies to all of us currently online! But your question is sincere, and you have noticed that there does seem to be a pathological relationship that some people can have with computers, and chatting, that there can be a form of addiction to these interactions. I am not sure where the line of mental illness should be drawn, though. In some sense, too much Internet, like too much TV, could be considered anti-social, and a person may spend time on their Internet relationships than on face-to-face relationships. But in other case, the Internet has allowed people normally isolated from wide ranging communicative experiences from engaging in what the philosopher Baudrillard called "the ecstacy of communication." We humans like to communicate, and one could ask your question about the telephone. Certainly, in the early days of mass use of the phone, people may have been seen as sick because they spent too much talking. The difference with the net, of course, is that is it difficult to know whom you are really communicating with, and that maybe is dangerous, spending untold hours online with strangers, who may not even be who we think they are. But does this count as mental illness? It comes back to the issue of how we define normal and abnormal on one level, but on another level it requires asking moral and ethical questions, like what is the harm and who benefits. So, very quickly, a diagnosis of mental illness gets intertwined with other social, political and economic issues, which is the point I have been trying to make here.

Name

Mustafa - United States

Profession

Teacher

Question

Salam ,
Whats your take on the islamic perspective that having commited some major sin results in mental illness?

Answer

Good point, we can look at how different cultures understand mental illness, and certainly in Islamic culture there is way to understand this by explaning it as the result of sin, or some other supernatural phenomenon, like the sihr, hasad and the presence of jinn. In fact, the Arabic word for insane or crazy is "majnoon" which is related to the world "jinn." So does being crazy in the Islamic perspective mean that one is possessed by the jinn? Yes, in some cases, you will find people making a traditional diagnosis like that, and usually these people are not locked up or medicated, as they would be in the West, but they are treated with the Qur'an. In another view, our own deeds come back to haunt us, so having committed a major sin can certainly make one feel out of touch, and even seek help, which in most cases would also be the Quran, and salat and dua. If we are true to our religion, we should in fact look at these as very real factors in how well feel in terms of mental health, though people trained in the Western sciences would tend to see this as superstitious. Again, it comes back to what is socially acceptable and what is not, how socially unacceptable people are treated, whether they seek their own treatment or if they are forced to submit to treatment by others. In some places, sihr is even acceptable as a plea in criminal cases that the person was made to commit an act of crime due to sihr. But there is also an industry cropping up around this, too, and so even though it is Islamic or traditional, its implementation by human beings is subject to particular social norms.

Name

Anud - United Arab Emirates

Profession

Student

Question

Hello Professor Progler. Could one's culture be the cause of mental problems? Or is it the adopting of foreign cultural values that causes some kind of disorder? Tribal people are less vulnerable to mental illnesses. Do you agree with that?

Answer

Big issues you raise here. I have been arguing that culture is a causal factor in mental illness, both in the way we view mental illness and in what causes it. Yes, one's own culture could be a cause of mental illness, and that is felt particularly so in the tension between generations. Parents of a child who seems more assertive or bold or adventuresome than is culturally acceptable may tend to see that child as some how ill. Similarly, adoption of foreign lifestyles can be implicated in illness. I cited earlier the studies of Mexican immigrants in the US, which found that the longer they stayed the less healthier they got, and similar studies are underway with other immigrant groups, asking the questions, "Is American culture toxic?" Similarly, studies have found that as societies modernize they are more prone to illnesses that were unknown, or behaviors, such as drug use, suicide, and promiscuity. I think this needs calm meditation and time spent in reflection to really ask ourselves, are we heading for disaster by following the enticements of the Western culture, and especially its American variant, being sold to us daily via TV? Is that what we really need? What do we need? What is healthy and wellness? What does it mean to be happy? And who decides?

Name

hasan -

Profession

Question

Assalamo alaykom

can you address the issues of mental health and addictions? in terms of cause and effect which is which?

Do you think that perservatives, the way factory produced animals are fed dead meats and hay and own excrements ,etc is a reason for the way illness has accelated in modern world?

Answer

Mental health and addictions are certainly related, and one finds a great deal of addictive behavior in modern consumer societies, addiction to drugs, alcohol, sex, TV, the internet, practically anything, people seem addicted. Why? I think it is a sad social commentary that addiction is so prevalent, but we have to be careful not to medicalize it, not to see these essentially cultural behaviors as somehow genetically decreed. Of course, that does raise the issue of biological pathology, as in the case of "mad cow disease," to which you allude. That is known to result from feeding cows the discarded body parts and offal of animals, which was thought up by a (sane?) scientists who found the growth hormones they use to make cows fatter faster worked better if the cow was fed a high protein diet, and so they turned herbivorous cows into carnivores. The disease circulated by eating diseased brains of other cows, but how the disease got there is another story. Perhaps we don't need to even know that, perhaps it is enough to know that cows and chickens and other industrialized animals get sick when they eat each other, and why is that so surprising? Now, this is a modern illness, which by the way may be able to pass to humans who eat the carnivorous cows, which results from industrialized farming methods, and other "sane" behaviors.

Name

Samer - United States

Profession

Question

Is it true that the more advanced the world becomes, the more mental illnesses occur? Does complex technology cause such illnesses? Or is it the absence of close human interaction?

Answer

Your questions are somewhat rhetorical, aren't they? They contain their own answers. Yes, of course, there is a correlation between forms of mental illness and the technological lifestyle, the research supporting that is extensive, and I have mentioned some of it already. But you and another useful dimension here, that we may get sick from the absence of close human contact. This is worth looking in to, and several psychologists have suggested the modern birthing practices, for example, separating the baby from its mother and medicalizing the birthing experience, have set humans on the path to mental illness and alienation, that lack of breast feeding and other physical contact between mother and infant in those early years is psychologically destructive, that the various forms of institutionalization we subject our youth to are creating alienated people deprived of close contact. There is quite a bit of literature on this, and it is convincing. I would only add another facet to this, that alienation from the natural world is also a causal factor in madness, that the more we isolate ourselves from the creation of which we are apart, the more alienated we become from reality, from ourselves, and from each other. This is less extensively discussed, which reflects the anthropomorphic tendencies of modernity that plants and animals only matter as food. But what does it mean when we grow up in plastic cribs, wandering through concrete mazes and eating frozen food? Surely this cannot be good for mental or physical health. It seems obvious, yet we continue to isolate ourselves.

Name

Mustafa - United States

Profession

Teacher

Question

Salam ,
Whats your take on the islamic perspective that having commited some major sin results in mental illness?

Answer

I think I already answered this one, but thanks for reminding us of the importance of keeping our own tradition at the forefront of such discussions.

Name

Omer -

Profession

Question

You have mentioned that that there is no consistent definition to what is termed as "insane" except the fact that they tended to people who did not fit in society, is there any hope that a definition can be reached or are we doomed to subjectivism in our approach to this issue. The implications are important especailly in the realm of law and resposibility where the people wo are deemed insane are no longer legally responsible and hence cannot be punished for crimes.

Answer

Excellent point, and this cuts to the heart of the issue, and reinforces my basic point that it is, as you say, a subjective phenomenon. You could look at legal history and see the emergence of legally sanctioned definitions of insanity that absolve people of criminal acts, and it is not just in the West. I have seen cases where people are absolved of crimes because court accepted a defense based on sihr. Part of the problem, and this is a feature of modernity in many ways, is that we are addicted to definitions, that we require precise, often overly precise definitions, in order to engage in thought, almost to the point of worshipping definitions. My point is the propensity toward definitions is part of the problem, especially when those definitions become intertwined with economic, social, political, or, as you add, legal systems. Is there any hope of arriving at the most objective definition of insanity? Well, you would need to think about the implications of such a prospectus, what that would do to law, which is basically a negotiated process, especially in the West. Most importantly, who will decide on this definition, who benefits from it and who suffers. I think to focus on the small crimes is misleading in the context of my argument, that in the scope of things a single murder or robbery is not very consequential, when you have seemingly sane people threatening each other with weapons capable of murdering millions. I would like to see that enter our discussion of insanity. And also the way industrial societies destroy their environment. Except for pigs, humans are the only animals that foul their own habitats. Isn't that insane? Is it sane to spend billions to plant an American flag on the moon when millions of children die of starvation or from diseases that can be cured for a few pennies? Can we consider the American pilots who dutifully bomb Muslims into oblivion in Iraq and Afghanistan to be sane? Is it sane to inflict 50 years of punishment on the people of Palestine, and culminate that sordid history electing a war criminal and known murderer as prime minister? Can we say that those who welcome him and shake his hand are sane? I am afraid of those kind of sane people. I think we have to expand our scope of what talk about as insanity in order to include those kinds of acts.

This seems like the last question, so let me say thank you to everyone for participating. Mashallah, you all asked very stimulating questions, and I hope my responses were in some small way beneficial. Looking forward to seeing you all another time, and if you want to continue this discussion you can send me email at yusefustad@hotmail.com or you might want to join the Multiversity Group at groups.msn.com/multiversity. Take care, see you...