Cultural Perspective in Indian Psychiatry

V^ulture though apparently elusive is always present in our day to day practice of psychiatry. A look at the history of cultural psychiatry amply demonstrates it. With the gradual and difficult entry of psychiatry into the realm of medicine came classification of various mental problems into disease entities. Proof of both scientific status and physical causation lay in finding universality of these diseases. Kraepelin himself as well as European psychiatrists, missionaries and anthropologists did find evidence of strange behaviour and locally defined illnesses which could not be explained through diseases or classifications known to them. In certain cultures depressions were found to be rare. Psychoses resembling schizophrenia were found to have dramatic onset and reversals. Since the 'natives' considered these phenomena to be due to spirit possession or sorcery, the doctors ignored them as of no consequence to 'real' psychiatry. On the other hand, the universalists saw diseases like schizophrenia, mania, hysteria etc. behind these conditions but in distorted or obscured forms which they thought were effects of 'culture'. In other words, whatever could not be understood did not exist for western eyes, at best they were incomplete or failed versions of the real or true forms. Culture, whose definition or understanding varied over the years, was said to be able to distort or failed versions of the real or true forms. Culture, whose definition or understanding varied over the years, was said to be able to distort or modify illnesses but that did not apply to western culture. Diseases found or recognised in the western mental hospitals were considered as standard or prototypical, uninfluenced by any external factors. The conjectures that hid behind these different attitudes were that peculiarities of mental diseases or their distortions among non-western peoples occur on account of their inadequate personality pattern, inadequacy of expression, undif-ferentiated emotions, primitive thought processes, ignorance and superstitions, or to put it bluntly, backwardness and underdevelopment. Even where these racist and biased views were not present, for example, with cultural relativists, conviction regarding the prototypes remained (Littlewood, 1989), no doubt behind all these there were philosophical dimensions of Logical Positivism, Enlightenment views, belief in the infallibility of science, scientism and so on (Chakraborty, 1991). The tragedy is that our understanding and clinical practices were greatly influenced by the prejudices of the seemingly superior culture which we took to be gospel truth, or rather scientific truth. Once we accepted imputation of …