A Cross-Cultural Perspective

CULTURAL ISSUES were included, although in a limited fashion, in the diagnostic manuals ICD-10 (World Health Organization, 1992) and DSM-IV (American Psychiatric Association, 1994). As Fabrega (1995) points out, the study of the cultural sciences as they pertain to psychiatry offers a necessary corrective to the increasing impersonality and reductionism that has come to characterize the neurobiological approach. A major enterprise in cultural psychiatry in recent years has been the integration of clinical science and anthropology (Minas, 1996). This paper is also an attempt to make such an integration. It deals with a psychological phenomenon that is rooted in the cultural life of a wide variety of peoples and which has only recently come to the attention of Western researchers, in spite of a long European tradition in research on Altered States of Consciousness (Beringer, 1927; Stoll, 1947). There is a current view that accepts the existence of different levels of reality, according to the state of consciousness (level) which an individual is in at the moment. Normal daily consciousness (the ordinary state of consciousness) gives access to an ordinary reality, but altered states of consciousness, for example, in dreaming, permit contact with a nonordinary reality. Less familiar forms of consciousness are those categorized under the general designation of altered states of consciousness (ASC). These should be understood as altered or modified in relation to the waking state of consciousness, since this ordinary state of consciousness can be considered, itself, an unusual state, impossible to maintain for long, and secured only by a modicum of perceptual intake and continuous interior discourse (Gowan, 1978). In fact, a discrete fluctuation in the ordinary state of consciousness exists, giving rise to what Tart (1975) calls discrete states of mind. An ASC is present when there is a deviation in subjective experience or psychological functioning from certain general norms for that individual, recognized by the subject or observers (Kokoszka, 1987; Ludwig, 1966). Some authors (Dittrich, von Arx, & Staub, 1986) add some other features to this basic definition: