Culture-Specific Pathology: Biological v. Psychological Basis

Across societies we see human universals of disease but we also see apparent illness experiences unique to regions and belief systems. These culture-bound illnesses suggest that some illnesses may exist exclusively in a certain society and are unique based on the cultural traits of that society. These culture-bound phenomena are especially relative to the time and place they exist. Within a society, social roles and stressors can play a strong role in the creation and definition of an illness episode or syndrome. Societies possess a culturally formulated “symptom repertoire” that can unconsciously determine the expression of an abnormal experience such as illness. Further, a healer will facilitate which symptoms are considered appropriate to the society and influence how individuals form their perception and expression of their illness. These factors can create the distinct syndromes we ostensibly, and perhaps erroneously, observe as culture-bound syndromes. There are pathogens in existence that can affect any human on the globe. There is certainly physiological variation among populations, genetic instances of resistance, and other such biological differences, so pathogens may influence an individual’s body uniquely per person. Beside this idiosyncratic factor is the influence of culture. All illnesses are likely universal but their manifestation, interpretation, and expression are locally and culturally understood. This is very salient when we look at psychological illness. A good example is schizophrenia. It varies so widely from society to society, yet at its underlying structure it is the same problem in the human brain. The surface structure of an illness like this has broad variation relative to the afflicted’s sociocultural environment. Another psychological example is phii pob. This is quite specific to certain Thailand societies but the physical details of the illness are something that any human can experience. It stems from social conflict and anxieties. Similar to phii pob is susto. It too is a cultural mode of dealing with some social conflict. The pathogen or underlying cause is universal; it is the actual, outward expression that is “bound”. It seems that evidence of culture bound disorders mainly derive from psychological illnesses. This leads me to think that the fully cultural mind, rather than the mostly physical body, is where the illusion of culture bound disorders comes from. The mind is idiosyncratic and also shares exclusive perceptions and knowledge through culture. Naturally, a mental or somatic illness will be uniquely manifested, expressed, explained, and perceived relative to an individual’s culture and personality. So, to say that culture-bound disorders exist is somewhat of a manipulation, or perhaps a misinterpretation, of human variation. It does not seem to me that the disorders we see in a society are necessarily produced by that society’s culture, but are rather more closely an epiphenomenon of culture itself. A society’s “symptom repertoire” is just a cultural trait and it strongly shapes the entire illness experience. Essentially, culture-bound disorders as a concept is not very useful. The relativity of illness is intrinsic to human experience. I feel that we can demarcate illnesses as distinct or unique to a society but to name them as culture-bound disorders, or syndromes, is useless at least and redundant at best.

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