Schizophrenia has long puzzled researchers in the fields of psychiatric medicine and anthropology. Why is it that the rates of developing schizophrenia—long the poster child for the biomedical model of psychiatric illness—are low in some countries and not others? And why do migrants to Western countries find they are at higher risk for this disease when they arrive? Tanya Luhrmann argues it is because the root causes for schizophrenia are not only biological, but also sociocultural.
This book gives an intimate, personal account of the different experiences living with serious psychotic disorder in the U.S., India, Africa, and South East Asia. It introduces the notion that social defeat—or the physical or symbolic defeat of one person by another—is a core mechanism at work in the increased risk for psychotic illness. Furthermore, “care as usual” as it occurs in the U.S. actually increases the likelihood of social defeat, whereas “care as usual” in a country like India diminishes it.
Tanya Marie Luhrmann is currently the Watkins University Professor in the Anthropology Department at Stanford University. She has been elected to the American Academy of Arts and Sciences, and has been the recipient of a John Simon Guggenheim Fellowship.
Tanya Marie Luhrmann (born 1959) is an American psychological anthropologist best known for her studies of modern-day witches, charismatic Christians, and psychiatrists. She received her AB summa cum laude in Folklore and Mythology from Harvard-Radcliffe in 1981, working with Stanley Tambiah. She then studied Social Anthropology at Cambridge University, working with Jack Goody and Ernest Gellner. In 1986 she received her PhD for work on modern-day witches in England, later published as Persuasions of the Witch's Craft (1989). In this book, she described the ways in which magic and other esoteric techniques both serve emotional needs and come to seem reasonable through the experience of practice.
Her second research project looked at the situation of contemporary Parsis, a Zoroastrian community in India. The Parsi community enjoyed a privileged position under the British Raj; although by many standards, Parsis have continued to do quite well economically in post-colonial India, they have become politically marginal in comparison to their previous position, and many Parsis speak pessimistically about the future of their community. Luhrmann's book The Good Parsi (1996) explored the contradictions inherent in the social psychology of a post-colonial elite.
Her third book, and the most widely acclaimed, explored the contradictions and tensions between two models of psychiatry, the psychodynamic (psychoanalytic) and the biomedical, through the ethnographic study of the training of American psychiatry residents during the health care transition of the early 1990s. Of Two Minds (2000) received several awards, including the Victor Turner Prize for Ethnographic Writing and the Boyer Prize for Psychological Anthropology (2001).
Her fourth book, When God Talks Back: Understanding the American Evangelical Relationship with God (March 2012), examines the growing movement of evangelical and charismatic Christianity, and specifically how practitioners come to experience God as someone with whom they can communicate on a daily basis through prayer and visualization.
Other projects she is working on include a NIMH-funded study of how life on the streets (chronically or periodically homeless) contributes to the experience and morbidity of schizophrenia.
Not based on the book, but T. Luhrmann and I both are oscillating on the same frequency in regards to the etiology and epidemiology of schizophrenia. Without delving into the neuroscience and the epigenetics of it all, T. Luhrmann describes various case studies on how schizophrenia is treated in various countries from the U.S to India to the U.K and etc.
"In India, doctors deemphasize diagnoses and the biomedical specifics of what are essentially grave conditions, like schizophrenia. They don’t talk about diagnoses or treat diagnoses as important, at least when interacting with their patients. As a result, they leave many possible ways to imagine the future intact. This may widen the range of possibilities for living in the present."
So interesting. As someone who's getting accustomed to seeing psychosis from a biomedical point of view, it's refreshing and thought provoking to understand the whole a little more clearly through an anthropological lens.
Good case studies showing how schizophrenia develops in different cultural contexts. Particularly good on the stigma of schizophrenia in the Western world and its impact on patients.