To close the Buffett Institute Faculty & Fellows Colloquium, Rebecca Seligman spoke to a room crowded with professors, students, and Northwestern community members about cross-cultural mental health. More specifically, her talk used the examination of dissociation to illustrate larger issues in studying mental health across cultures. Dissociation is triggered by highly stressful experiences that are injurious to self and allows people to protect themselves from extreme emotion. In a dissociative state, an individual lacks volitional control over actions and often will not remember the events that take place.
The first case study presented by Seligman was Mrs. T, a 28-year-old Sikh woman living in Montreal. She was referred for psychiatric assessment because of distress she was experiencing and dissociative episodes in which she would not recognize her husband and could not care for her young child. The second case was Jalita, a Brazilian woman living in impoverished conditions under high stress. She visited a psychiatrist and also had been going into trances like Mrs. T.
Both women occupied socially and politically marginal situations and suffered from depressed affect and anxiety. Both experienced shaking, rigidity, chills, dizziness and orientation. Though the psychiatric symptoms of these two women seem very similar, the differences between their cultures largely dictated the course of their treatments.
In the case of Jalita, in Salvador, Brazil, the culture contained a spirit possession religion in which the spirits displace consciousness and occupy the bodies of individuals. Jalita’s symptoms indicated the need for her to be initiated into the religion. She was able to find meaning in her symptoms and classify them as the work of powerful spiritual others, pointing the psychiatric causes away from internal reasons. Her symptoms, which would typically be seen as distressing and disordered, became functional in her social context.
Mrs. T, however, did not express her distress in a culture that made sense of such symptoms with religious or spiritual explanations. Rather, hers was a case of textbook pathological dissociation and she was not empowered in the same way Jalita was. Her dissociation violated ideas and norms of the culture in which she lived, and as such, was rendered dysfunctional.
Through the investigation of these two cases, larger themes in cross-cultural mental health were illuminated. The most salient takeaway was that pathology is relative and the classification of disorders depends largely on context. Expression of distress is loaded with cultural and social meaning, which can provide valued social roles for individuals like Jalita or leave those like Mrs. T disenfranchised. After Seligman’s talk, it became clear that the study of mental health on a global scale requires a critical understanding of the meaning created by psychological symptoms and the healing or harming powers this meaning may have.