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Culture therapy, medical treatment or psychoanalysing ?

How do we interpret and understand health ?

Published on: Friday 8 October 2004

Author : Nina GAREVIK

What is the essence of beeing human? How do we interpret and understand health? This article brings up aspects on health and consider psychoanalysing from another perspective than "its own" and brings up some dilemmas.

Theory is good; but it doesn’t prevent things from existing/Charcot, 1886.

I want to raise a question concerning culture. What is culture? Is it a common lifestyle? Do we have to believe in the same religion to share the same culture? Do we have to live in the same country? Or is it more superficial? Is it enough to dress the same, listen to same sort of music and eat the same sort of food? Culture is the pattern we are thinking in, understanding and interpreting life. In the first place we learn culture. Culture is the essence of being human. Many qualities of human life are transmitted genetically and common for all culture for example like how infants express hunger and pain. It is how we handle these expressions, which has cultural bound displays. This knowledge is learned from generation to generation and hardly questioned and often unconscious. Culture as language are “inhaled” from the first day in life.

Politics can be named as a “subculture” with special norms, conceptions and codes, -it is a special context to attend. Just as Psychology, Medicine and Religion for example. You can say Jesus analysed his own culture and “by pointing it out” he showed it could be very dangerous to have an “eye for the culture”. On a course I went to 1982 for recently recruited staff on a mental hospital, the course leader told us -“the hospitalisation” for patients and staff starts the first day. What I did not understand, (and not the course leader either)was that she was probably speaking about culture. She had noticed people changed from the first day they entered the door into that very special context as a mental hospital is. The psychiatric field has a lot of codes and patterns to adept to be accepted. You also have to invest a lot in a certain theory to survive in the field, something that will be very hard to give up.

So let us discuss some items of the theories of Freud. We can regard Freud as someone who took some steps from his own context (wich actually was Medicine) and interpreted some certain psysical symptoms as headaches, muscular pain, neuralgia, gastric pain, tics, vomiting, clonic spasms as expression of unresolved conflicts traced back to early childhood. He categorised and diagnosed these conditions into other names but he stuck with the medical way when explained unfamiliar appearence of behaving.

Freud postulated his Seduction theory as a result of hearing frequent reports from his female patients that their father had sexually abused them in childhood, usually. Hysterical symptoms were invariably caused by unconscious memories of sexual molestations in early childhood. One problem with this widespread and already deeply discussed theory which not has been enough illustrated is the cultural bounded phenomena which Freud did not took notice about. Hysteria does not exist as psychiatric diagnosis today. Women, does not need to express in that way any more. It may be the case; women express their anxiety in another way. They may cut them selves more frequently or suffers from anorexia. (Another diagnosis with close relations to culture- why does anorexia only exist in countries where the norm for biggest size is 38 for women and where you can’t go out without being offered food?) But the purpose of this article is to put some light on cultural aspects on the mental health.

In the western society we have a tradition to split research in quantitative and qualitative methods. Psychoanalysing has been for example criticized for not being able to show significant results. I will make one comment, it is hard to measure qualitative data with quantitative methods. But maybe different research fields could approach each other in a more broaden perspective? Specially when it comes to methods.

In raising children and treating people with psychiatric diseases we are constantly being questioned. Maybe we should begin to try to answer these questions instead of trying to explain (for us) a strange behaviour. Suffering from a psychiatric disease is not only being in a internal emotional struggle is also being put outside culture, either because of symptoms or because of direct conflict with existing norms and valuations.

Methods and theories consequences could bee evaluated buy researcher from different disciplines. A brilliant but an absolute example of that Ivan Illich gives us in his article L’obsession de la santé parfaite.

Maybe reaching optimal health has obsessed us. The western society makes us to great extent responsible for our health. We should eat the right food, exercise and avoid things which can make us sick. Today information also easily reach us, we are kind of living in a “society of information”. But there is a certain paradox, the fast information creates new psychiatric diseases as “burned out syndrome” and depression. Discussions concerning connections between Alzheimer’s and stress have been raised. But there is still one special field where you can be released from all forms of responsibility. It is when you enter the outward of a psycho analyser or you commit a crime under influence of a psychiatric disease, you will have to play the role as a victim.
I believe psychoanalysing has it’s largest dilemma in regarding patients as victims and it was never anything Freud took in consideration, as he was trained in the school of medicine. I also believe psychoanalysing must come out from their “laboratories” bring up the patients from the couches and put analysing in the right context. Otherwise psychoanalysing will create a different, other context from what the patients living their lifes in.

The result of the psychoanalysing will only be two separated context: the patient’s real life and the hours he/she spends with the psycho analyser. That is how new seduction theories can be created.

P.S.

References
- Magli Ida, Cultural Anthropology : An Introduction, Mc Farland and Company 2001.
- Freud-Breuer, On the Physicall Mechanism of Hysterical Phenomena (Preliminary Communication), Penguin, 1893.
- Freud S., Standard Edition of the complete psychological works of Sigmund Freud, Vol. 2. J. Strachey (Ed.). London: Hogarth Press, 1893.
- Ivan Illich, L’obsession de santé parfaite, Le Monde Diplomatique, March 1999.

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