Pathologies of the West

Psychiatry conventionally regards spirit possession and dramatic healing rituals in non-European societies as forms of abnormality if not mental illness. Roland Littlewood, a psychiatrist and social anthropologist, argues that it is necessary to take into account both social process and personal cultural meaning when explaining psychiatric illness and "deviant" behavior. Littlewood brings anthropological and psychiatric literature to bear on case studies of self-poisoning, agoraphobia, hysteria, chronic fatigue syndrome, post-traumatic stress, male sexual violence, and eating disorders. He contends that Western psychiatric illnesses are themselves "possession states"—patterns by which individual agency is displaced through an idiom of alien intrusion whether of a spirit or a disease.Pathologies of the West is simultaneously an original approach to psychiatric illness in its international perspective and an introduction to recent developments in the social anthropology of medicine. It examines critically the relevance of phenomenological, structural, and ethological approaches to understanding extreme personal experience. Littlewood argues that anthropology must not simply provide a cultural alternative to sociological critiques of medicine—psychiatry itself should take into account the ways in which cultural values are acted out by individuals.

This is a volume of interpretations by a gifted observer of clinical phenomena in relation to the sociocultural contexts in which they occur. Entertaining and, one suspects, often clinically useful, the interpretations reflect the erudition and experience of the interpreter.

Roland Littlewood is a clinical psychiatrist and Professor of Anthropology and Psychiatry at University College London. He is the joint director of the college's Centre for Medical Anthropology and a past President of the Royal Anthropological Institute. His books include Aliens and Alienists; Intercultural Therapy; The Butterfly and the Serpent; Readings in Cultural Psychiatry; Religion, Agency, Restitution; and Pathology and Identity, which was awarded the Wellcome Medal for Anthropology as Applied to Medicine.