What it means to have a culture-bound syndrome

If you tell a distressed woman that her suffering is a culture-bound syndrome, perhaps citing examples that she would find bizarre, you shouldn’t expect a pleasant and understanding response. It sounds dismissive, like saying it’s “all in her head” or a manipulative tactic to garner sympathy.

There have been a flutter of articles about culture-bound syndromes in the wake of the DSM-5 publication, and a piece on the The Guardian (Are mental illnesses such as PMS and depression culturally determined?) seems to have inspired this one on Jezebel and then this one on Slate.  There are many good links in the articles and I recommend clicking if you’re interested in the topic.  But what comes through to me in some sections of the writing and definitely in the comments is the attitude that if an illness is culture-bound, it’s not real.  Many of the comments are defensive, daring others to say that what they’re experiencing is a lie.  This can be complicated by a mainstream understanding that something “cultural” is something shared, yet (to use the main example from the articles) not every woman in Western cultures has PMS or experiences it in the same way. Does this mean that those who do are exaggerating for effect or making it up?

No.  However, we start to wade into the swamp of the “really real” where I so often find myself lost. I know I’m not alone in struggling to understand what it means for someone to have a culture-bound syndrome and I’d make a mess if I tried to unpack a lot of theory.  However, I think it’s a common mistake to see these syndromes as only a way of expressing emotions that don’t have another path of release. I’m more inclined toward the notion of local biologies, where societal and cultural expectations play a role, but so can genetics and epigenetics, diet, and environment.

We do a disservice by pointing out the culture-bound syndromes of others without inclusively evaluating those that might be our own (not at higher levels of study, but certainly in lower levels and mainstream articles). It wrongly puts Western culture in a position of rationality and superiority, smiling at the quaint confusion of others, rather than questioning our own socially accepted conditions that are proving to be non-universal and WEIRD (Western, Educated, Industrial, Rich, and Democratic).

Mash Season 9 Episode 16: The Red/White Blues

http://gorillavid.in/blidnlmigqg8

Alternate, in case that link has issues: http://www.1channel.ch/external.php?title=MASH&url=aHR0cDovL2dvcmlsbGF2aWQuY29tL2NuYS9kY3B1eHhyc2k4OXQ=&domain=Z29yaWxsYXZpZC5jb20=&loggedin=0

(Both are gorilla but 2 separate uploads)

Start at 7:11 to play; if you have time, watch until the end as a health note finishes the episode. (Each episode is only about 23-25 minutes long) In this episode Springtime has come in Korea which means malaria. Unfortunately not everyone can take the medicine…for reasons you’ll have to see.

Still slightly confused about the outcome of the video? A medication that reacts poorly to people and communities of African and Mediterranean decent? Primaquine was created in 1946, it was tested during WWII on volunteers, soldiers, and prisoners of war. It was seen early on that those who were African-American had a hemolytic reaction to the medication, (though it was also noted there there were a few cases of Caucasion reactions also). After that doctors were given the warning not to use Primaquine or only in sparing amounts in those of African decent. It became a ‘race warning’, later by the time of the Korean war those who had Mediterranean background were included and recently those in the Middle East (Iraq and Iran) have been added to the list…. But is it a race issue? In fact it is not, what the Primaquine is reacting to is an allele called Glucose-6-Phosphate Dehydrogenase. Those with the allele have a hemolytic reaction when they use Primaquine. To make it very clear…. EVERYONE has the ability to have this allele. So why does it appear to create a race affect visually in those that have a shared community background for lineage or decent? Those who read my previous post may know where this is going…. that’s right! Cross-Protection! James V. Neel explains it in his article Are Genetic Factors Involved in Racial and Ethnic Differences in Late-Life Health?

‘The sickling alleles and the G-6-PD deficiency alleles are representatives of balanced polymorphisms. Homozygosity for the hemoglobin S allele is usually inconsistent with reproduction because the homozygotes usually die in childhood. Homozygosity for a G-6-PD deficiency allele (or hemizygosity in the case of a male) by no means confers the handicap of sickle cell anemia but must still be regarded as impairing the fitness of the homozygote. But in both cases, the alleles have a positive side, conferring resistance to malaria, and the frequency of the allele in a population is determined by a balance between positive and negative selective forces.’

Translation? Environment, environment, environment! This allele provides a protection against Malaria. So those in a community that have the allele and Malaria in their environment will see an upsurge of the allele in procreated generations because those without the allele may not to survive as well without the added protection. Non-alleles will be less likely to procreate a new generation when dead from the extra benefit of protection.  When more members of a community, line of decent, or group heritage have an allele it can make it appear that their ‘race’ may be more or less susceptible then others to things, when in fact this is a result of environment messing with allele spikes. Nor does it matter that the allele itself may be what causes a separate disease or condition. Its protection might be an unintentional side effect of the primary disease or condition or a protection mechanism against other diseases wiping out the primary disease or condition. So the appearance that Primaquine is not advised in certain ‘races’ is deceptive. The health label has since been changed to read that it is not advised in those with the Glucose-6-Phosphate Dehydrogenase allele else wise hemolytic shock may occur or those with similar conditions. For a long time though it was treated as a race issue from the naked eye when in truth the culprit was microscopic…. but universal.

Additional Readings…

Do windmills cause illness?

Here in the US, a lot of the complaints about wind farms that make news focus on aesthetics: wealthy shorefront property owners don’t want the huge turbines interrupting their view, as in the Cape Wind controversy.  Even the 2012 documentary Windfall (trailer here and available on Netflix), about turbine installations in the rural New York town of Meredith, focused mainly on the issues of neighbor vs. neighbor fighting, corporate interests, and home values.  Though issues of environmental impact get casual mention, US coverage is usually about the money.

In other parts of the English-speaking world, the main controversy seems to be about illness.  This article from the UK’s MailOnline cites US researchers when establishing a scientific grounds for the the illnesses which, the author admits, “you might be tempted to dismiss it as a hypochondriac’s charter or an urban myth.”  To our east, Health Canada is responding to increased pressure by conducting a $1.8 million dollar study of wind farm noise in Ontario, where this news report was filmed:

There’s also this longer news piece about claims of wind farm illness in an Australian town called Waubra:

On the other hand, there are plenty of voices saying that wind farms are not correlated with illness: governments, energy companies, and this public health professor from Sydney, Australia who has made a list of seventeen studies of wind turbines that point to little or no impact on health. In a second article, he equates the phenomenon to mass hysteria, mentioning that no complaints of illness were made until after hundreds of turbines were already deployed.

There are examples in the urban myths recorded by Dr. Jan Brunvand that might resonate with this situation: the teenager who fried herself in a (newly popular) tanning bed, the old lady who didn’t understand how her (brand new) microwave worked when she popped in her wet poodle to dry it off, etc.  Television will hurt your eyes and cell phones will give you brain cancer.  New technology — and I think the gigantic turbines are different enough from previous generations of windmill to qualify — can confuse and frighten us.   Perhaps there are other factors that are leading to the discovery or exacerbation of the illnesses people near wind farms are mentioning.

Personally, I find the turbines lovely to watch at a distance, but I certainly wouldn’t want to live in the throbbing shadow of one, with that low pulse of sound all day and all night.  Is this a case where we’ve rushed ahead too quickly because of financial and social (environmental) pressures, without considering human factors, or is it a case of “modern technology illness”?

A Cure for Violence

Hi everyone:

I hope your weekend is going fan-tastic! For my first post, I found a story on violence and an age-old question tied to it… is is possible to stop violence before it occurs? Is there a cure for violence? I find it utterly fascinating, especially coming from a Sociology background. I hope you enjoy it.

http://www.bbc.com/future/story/20120913-searching-for-a-cure-to-violence