Tuesday, 6 May 2014

Cultural Syndromes and the Costs and Benefits of Imperfect Cognitions

Marion Godman
I’m a philosopher at the Academy of Finland Centre of Excellence in Philosophy of the Social Sciences and the University of Cambridge. I have been exploring the possibility that the human categories employed in psychology and the social sciences are not mere social constructions, but denote something real and epistemically useful to base a science on (or to use philosophical jargon, ‘natural kinds’). As part of my work I am keen to look more closely at particular case studies that engage scientists. One case that has challenged my realist project is that of cultural syndromes (or culturally bound syndromes).

At least on the face of it cultural syndromes hardly seem very scientific or very real. They represent conditions or disorders that do not occur in the human population at large, but instead seems connected to a particular time period and a particular culture. They also involve stories about the body that defy scientific fact. One well-known case in India, but also in other parts of Asia and the West, is dhat. It involves anxiety and a sense of doom about losing one's semen during the night. Another, in Cambodia is Kyol Goeu (‘Wind Overload’), a form of panic attack, believed to be caused by a wind-like substance within the body. Recently pre-menstrual syndrome (PMS) has also been proposed as a cultural syndrome on the grounds that there appears to be no clear link between women’s negative moods and the pre-menstrual phase of their cycles.

Despite their culturally contingent character many of these syndromes persist over several generations. Often people suffering from them also require medical assistance, which is recognized by resurgent research on the topic and the inclusion of several cultural syndromes in last year’s DSM-5 (APA, 2013). Their persistence may seem slightly paradoxical especially in our contemporary globalized society. If these syndromes are based on false accounts about what is going on in the body, why don't the sufferers simply change their beliefs when someone points out their falsity or oddity? And if they are prone to cause a lot of grievance within the population of a certain culture, why does the same culture not just get rid of the pretence behind these malaises?

In a recent paper (currently under consideration, contact me for a copy), I argue that we can only get to grips with the phenomenon of cultural syndromes and their persistence, if we acknowledge that they are not merely cultural artefacts, but means of coping and making some kind sense of overwhelmingly negative emotions, like anger, fear and so on. Most basic negative emotions exist in all cultures (although some might be induced by culturally specific circumstances such as the case of dhat), and can of course be beneficial and even adaptive in the right context. However in other situations, the experience of some negative emotions can overpower and even paralyze us. Just think of the devastating impact that the traumas due to the experience of war has on our psychology.

Rather than opt for a purely cultural construction model of cultural syndromes, I therefore suggest it might be useful to turn to theories of cultural evolution to understand the phenomenon. One insight from such theorizing is that the need to belong and gain an acceptance from one’s group might drive the retention of many seemingly maladaptive traits across generations. I suggest that cultural syndromes represent a socially sanctioned means of coping with the anger, distress and so on. In other words, the imperfect cognition in this case has the benefit of strengthening the affiliation with the social cultural group to which one belongs. This approval might even trump the epistemic benefits of having the right idea of what’s going on or how to cope -- indeed, in some cases it simply replaces no understanding at all!

But given these benefits, how might we then understand cultural syndromes as actual disorders that often require attention from medical professionals and treatment for alleviation? Just like in the case of distress and anxiety disorders more generally, negative emotions like fear, anger and anxiety make a real and important contribution to the trajectory of the cultural syndrome. For example, in the case of the Cambodian Kyol Goeu, the fear of disrupting the balance generates a hyper-vigilance to any sensation they may feel on standing. Because cultural syndromes have their basis in strong and disruptive negative emotions dispelling the myths involved might not only be ineffective; it may also mean that the sufferer loses out on the benefits attached to using a culturally endorsed model of what’s going on.

1 comment:

  1. Hi Marion,

    I would suggest checking out the end of Berger and Luckmann’s Social Construction of Reality (1967), where they mirror your take on psychology (I had just read them, which is why it was so fresh). Maybe your claims against social constructionist ideas regarding cultural mediated psychologies come against a later version of social construction, but I find it difficult to read Berger and Luckmann differently than how you present the problem. They talk more generally about the cultural instances of a psychological effect being “real,” whereas, as you are doing, and as it should be done, we need an analysis of how exactly certain cultural mediated psychologies create different emotional structures and cognitive structures as they embed into a web of beliefs and concepts. As with you, they go on to describe how a psychologist should treat a patient’s psychological beliefs and emotions within the cultural context that they arose. To not do so, may mean misdiagnosis; may mean presenting a different “socialization schema” that does not make sense within that individual’s other beliefs (and hence the emotional/cognitive structures that attach); or it may mean re-acclimating that individual to a thoroughly different cultural system, and in the process repositioning their emotional/cognitive structures, if such things are possible. They make claims that the “reality” or emotions of this individual will more than likely only make sense within that culture’s milieu of psychological analysis. That is, they would claim, that there are different and effective psychological analysis for varying cultural paradigms. In the end they refuse to speculate about a wider theory or about efforts to try get an overarching, cross-cultural psychology or cognitive science.

    A more broad message by Berger and Luckmann is about how the “social reality” hangs together within society and within an individual who has been socialized into that society. So they also give some coarse thoughts on how a dialectic process can play out regarding these psychological realities or emotions. They talk a little about how these culturally constructed psychologies respond to incongruity or competing belief systems, such as a psychologist who denies the validity of their cognitive beliefs or tries to reroute the emotional and cognitive effects of that belief.

    I also recall some kind of similar thoughts from Julian Jaynes in his Origin of Consciousness, some of his claims around trances and hypnotism, come to mind.

    Anyways, perhaps you were already aware of all that, but this is interesting work that could probably use more fleshing out.



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