When Schizophrenia Isn’t a Mental Illness

Culture may play a huge role in how schizophrenia manifests, according to one study published in a leading British psychiatric journal. It interviewed 60 adults diagnosed with schizophrenia – 20 each from the U.S., Ghana, and India – and found one stark difference between the nationalities: while American subjects were likelier to report violent, sadistic, and hateful voices, most of the subjects from Africa and Asian claimed to hear generally positive voices – which not a single American reported.

The Indians and Ghanaians generally found that their hallucinations reminded them of loved ones or benevolent spirits, and that they were playful, entertaining, and even encouraging. “Mostly, the voices are good,” said one Ghanaian participant; “I have a companion to talk [to]…I need not go out to speak. I can talk within myself!” reported an Indian subject with a laugh.

Moreover, while American sufferers had an adversarial or fearful relationship with their hallucinations — subsequently doing everything they could to ignore or resist them — those from Ghana and India instead developed real human connections with their voices, even if they did not like them.

The authors of the study believe that this unusual disparity comes down to societal values: Americans, who place much more importance on individuality and independence, saw these voices as intrusions into their sacred autonomy. By contrast, Asians and Africans are generally more collective and community-oriented, and thus viewed the voices as just another member of their social network – to the extent that they did not even consider themselves mentally ill.

The study may provide some useful insights into better schizophrenia treatments, as it is currently incurable. Some therapies are taking the “Eastern” approach of having patients develop relationships with their voices to negotiate and keep them under control. One such therapy reportedly helped a young Dutch man whose voices kept tormenting him to study Buddhism. Instead of fighting his demons, the man cut a deal with them, saying he will study Buddhism, but for just one hour a day; the idea worked, and the voices were so reduced that the man was able to lessen his dose.

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