Ethnopsychiatry

Ethnopsychiatry is that branch of medical anthropology focally concerned with mental health and illness. Historically, ethnopsychiatry studied the theories and practices of “primitive” or folk psychiatries. Such work generally involved the application of then current western “psychiatric” (unmarked) “knowledge” and practice to the ethnopsychiatries of other cultures. The field of ethnopsychiatry was first delineated by Hungarian-born, French-educated and U.S.-trained psychoanalytic anthropologist and classicist George Devereux (né György Dobó) (1908–1985). His colleague, Dr. Louis Mars, a Haitian psychiatrist, coined the term.

In Devereux's original conception, ethnopsychiatry is double sided. First, it is “the systematic study of the psychiatric theories and practices of a primitive [sic] tribe. Its primary focus is, thus, the exploration of (a) culture that pertains to mental derangements, as (locally) understood” (Devereux, 1961, p. 1). Second, the field is the study of “culture and the abnormal.”

The ethnopsychiatric rubric now subsumes a wide variety of studies. They include works from the history and philosophy of medicine and psychiatry as well as from anthropology and allied social sciences. The merging of once distinct disciplines has been occasioned by the interpretive turn in the social sciences. The semantic or hermeneutic and cultural constructivist positions have served to deconstruct dominant discourses of Western medicines and open them to far-ranging analyses that expose the reality of the variety of professional psychiatries and their respective cultural cores. Early on, colonialist psychological projections could be seen as the bases of ethnopsychiatric investigations serving to (re)create notions of otherness of the externally and internally colonized.

Psychiatrists have assumed that Western nosologies and disease entities are universal. Whereas traditionally, ethnopsychiatry focused on folk systems almost exclusively, the “New Ethnopsychiatry” took as its subject all forms of ethnopsychiatric theory and practice, whether folk or professional, in the East or West. It further redefined the clinical encounter as an engagement between healer and sociocultural, historical representative rather than patient-as-biological-unit. This perspective represented an updating and a localizing of Devereux's original conception and sees professional systems of medicine as equally culturally constructed and situated in local cultural historical and moral contexts.

Ethnopsychiatric research now includes the application, as well as study of Western psychological, psychiatric, and psychoanalytic theories themselves in the investigation of psychic lives. Ethnopsychiatry today recognizes that a cultural, rather than a universal, psychology underlies specific folk or professional psychiatries. In anthropology and in professional ethnopsychiatries, the terms cross-cultural or cultural psychiatryare often used to refer to work at the interface of culture and mental illness and health.

[Page 863]In the New Ethnopsychiatry, the application of German, U.S.,or French psychiatric knowledge to another culture provides insight and data both on the psychiatric system from whose perspective the study is conducted as well as that system or systems serving as the object of study. The distinction between folk and professional ethnopsychiatries is now seen as one of degree, not of kind. The former term applies to an informal system that concerns an abnormal ethnopsychology and its treatment, while the latter refers to a formal such system that evidences licensing, educational institutions, written texts, and so on.

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