Schizophrenia Across Time and Borders: Cultural Influences on the Disorder

Historically, what we now know as schizophrenia has been perceived differently across time and cultural contexts.

In different cultures (and at different times) the same experiences can be seen either as special gifts or pathological experiences – symptoms of psychotic illnesses and disorders. Those who in the West are referred to as psychotics or schizophrenics, in other cultures can be considered healers or shamans.

It is notable that some religions were started by ‘experiencers’ of an ultimate, beyond ‘normal’ reality, who were inspired by voices or visions revealing mysteries, for instance, the Quakers and Shakers, the Seventh Day Adventists, Paul on the road to Damascus, Mohammed, Moses (Tobert 2010). Keighley (1999) writes about Florence Nightingale who heard the voice of God in 1837, inspiring her to start the health services in the UK. And it is not only the founders of religions or some special persons who are the only one to have these and similar experiences. In fact, in the course of their lives, many people have some sort of experiences of a reality beyond and encounter the divine (Clarke 2008).

Altered states of consciousness: mental problems or spiritual states?

Different cultures interpret what is ‘normal’ differently. In some, altered states of consciousness, trance, etc. are seen as signs of mental problems, while in others these same phenomena are considered to be highly spiritual states.

The concept of "visibility" in cultures implies embracing and nurturing these experiences. In such cultures, it would be considered abnormal not to have a connection with the spiritual side of life, whereas other cultures suppress these experiences and condition individuals to only accept culturally approved concepts. Any deviation from these norms is labelled as abnormality.

The most notable disparity in the interpretation of "experiencers" can be observed in the Western diagnostic classification of mental disorders, such as the DSM. Certain diagnostic criteria for conditions like schizophrenia, for instance, align closely with the altered states of consciousness that shamans are able to voluntarily achieve when they perform their rituals. Research on spiritual and religious experiences suggests a tendency to pathologise unfamiliar experiences, as those around them fail to comprehend them fully (Tobert 2010).

Fernando (1991) suggests that as ‘self-control’ is considered very important in the West, mystical or trance states (associated with the ‘loss of ego control’) are inevitably seen as pathological, that leads to over-diagnosing of people of African, Hispanic and Native American origin with psychosis or schizophrenia.

The medical and psychological pathology interprets hallucinations as ‘inherently abnormal’ and caused by a disease of the mind. Thomas (1997) provides evidence that social, economic, political and cultured factors are inextricably linked to the nature of schizophrenia and that it is social factors that have a significant influence on the diagnosis and outcome of schizophrenia, with those living in a non-industrial society having a better outcome. For example, 50% of people with schizophrenia are cured in India and Africa, compared with 25% in Britain and 6% in Denmark.

In many cultures, traditional healing practices and beliefs play a significant role in the treatment and management of schizophrenia. These practices may include spiritual ceremonies, herbal remedies, or rituals aimed at restoring balance and harmony.

Thus, cultural factors, including cultural beliefs and mistrust of Western medicine, can significantly impact the diagnosis and assessment of schizophrenia.

Miscommunication or misinterpretation of symptoms due to cultural differences can lead to underdiagnosis, misdiagnosis, or delayed treatment.

When it comes to schizophrenia, cultural attitudes and misconceptions can play a significant role in shaping how individuals and communities perceive the disorder. Unfortunately, many cultures still hold stigmatizing views that contribute to the marginalisation and discrimination of people living with schizophrenia. From the belief that schizophrenia is a result of personal weakness or bad karma to the stereotype of violent behaviour, such misconceptions can have detrimental effects on individuals' self-esteem, relationships, and overall well-being.

SOURCE: Bogdashina O. Autism and Spirituality: Psyche, Self and the Spirit in People on the Autism Spectrum.