Mental Illness

Throughout this week’s readings and lectures, we can better understand that the definition of mental illness varies in every culture, and it’s dependent also on their explanatory model. In cases involving mental illness, a person’s explanatory model is particularly important because there may not be any outward, visible symptoms of the illness (Kleinman, 1988). As we learned in lecture, today we have the diagnostics and statistical Manuel of mental disorders, otherwise known as the DSM. Known as the Bible of psychiatric, the DSM has five different volumes describing mental disorders and in the latest version there are about 300 disorders listed. Over time the DSM has changed and now it tries to explain disorders in terms of symptoms and behaviors, and also it explains that these disabilities it came from a problem in the brain not a relationship problem. Looking back at the first version, the terms old fashioned. An example of this is homosexuality being listed as a Sociopathic disorder due to traumatic parent and child relationships, while today it’s not even on the list. The DMS today looks at Understanding the biological disorder like, for example depression and the chemical imbalance that it is.

This can also effect how someone can go about getting treated. In The Spirit Catches you and you Fall Down by Anne Fadiman, the author tells the story of a women that lived in a third world country that had very specific beliefs and cultural norms. She birthed 13 children on her own on what she had, and lost most of them. She finally had her last child in a hospital, which was a very different experience and went against some of her views. This relate back to the fact that the DSM is a reflection out of a culture form, which is, arises instead of scientific”. Working with a patient as a doctor is like an art form especially deciding their course of treatment. In chinease medicine, their culture argues that listening to the patient and meeting their mental needs is just as important. Listening to your patient is actually proven to make them feel better.

A bad example of this is in The Illness Narratives. The doctor in the scenario doesn’t listen to his patient when she tries to explain to him details of her home life, because he just wants to her about the medical issues. “He believes her main issue is her salt intake. On the other hand, based on a cultural belief, her mother told her to drink pickle juice to help with “high blood”, a folk illness” (Kleinman, 1988). These are just a few examples of how culture and explanatory models affect their health outcomes and treatment options.

Mark Griffiths, “Region airs disease: A brief overview of culture bound syndromes” Dr. Mark Griffiths Blog, June 25, 2012,

Kandula, Namratha. “The Patient Explanatory Model.” The Health Care Blog. June 11, 2013. Accessed July 13, 2016.

Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Straus, and Giroux, 1997.

2 thoughts on “Mental Illness

  1. Hi Julie!
    One thing that stood out to me in your post was this quote: “an example of this is homosexuality being listed as a Sociopathic disorder due to traumatic parent and child relationships, while today it’s not even on the list.” This just goes to show how culture, environment, and times can influence explanatory models. Homosexuality – while still a controversial topic in today’s American times – is much more universally accepted than it was when the first edition of the DSM was created. Evidently, it is now no longer even listed in the DSM. To me, this shows a correlation between what is culturally and socially accepted and then what is scientifically printed!
    I noticed that you also pointed out a similar revelation to mine above in your “The Spirit Catches you and you Fall Down” paragraph. I loved that you incorporated this into your post because I, too, often noticed my thoughts drifting back to that novel while constructing this weeks blog post! I did not end up utilizing quotes from that source in my post and am happy that you did! It seemed to be relevant to the topic, I just ran out of room sadly!
    It was very interesting to see your viewpoints and how they agreed and differed with the thoughts that were going on in my own head. Thank you for the intellectual challenge!
    Great post!

  2. Hello Julie,

    I too agree that listening to a patients explanatory model is proven to make them feel better. Not only that but, listening to the patient can also hep doctors make more accurate diagnoses. A lot of physicians believe that their learned knowledge over powers the patients personal experience with a health issue. A prime example took place my sophomore year. I woke up one morning with a really bad head ache so I decided to call Olin Health Center. The nurse that I spoke to was very unhelpful. Not only did she try to diagnose me over the phone, but she also wouldn’t let me explain what was going on! She assumed that I had a head ache from stress due to upcoming finals week. Before I could refute her statement, she put me on hold. I ended up hanging up and going to urgent care. I told the doctor that I was drunk the night before and I hit my head on my desk when I tried to climb into my lofted bed. I was later diagnosed with a minor concussion and was administered ibuprofen for the pain relief. This is a prime example on why explanatory models are extremely important to doctors and patients. It’s important to doctors because diagnoses become more accurate. It’s important to patients because they receive the correct treatments.

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