Culture-Bound or Construct-Bound?

Abstract

The several syndromes discussed in this book exist in a kind of “twilight zone” of psychiatric phenomena, having variously occasioned puzzlement, controversy, or dismissal from detailed analysis. The puzzlement about the syndromes has its source in the bizarre characteristics of the behavior displayed. If (as is usually the case) the frame of comparison is the Western-derived system of psychiatric diagnostic categories, these syndromes are, at least phenomenologically, unfamiliar ways of being “crazy”. From that point of view, they are instances of deviant deviance! The controversy exists over whether such episodes or patterns of behavior are simply culturally-based and different, yet “normal”, ways of acting, or examples of “authentic” disease and disorder. And the dismissal may occur when such syndromes are summarily assigned to categories of disorder already established in Western nosology without any fine-tuning to capture possible culture-specific meanings or symbolism of the behavior necessary for a valid categorical assignment.