Diversity Conversation: Author Ethan Watters and Professor Dillon Carr

(music)>>Welcome to “Diversity
Lecture Conversations.” My name is Dillon Carr. I’m a professor of
anthropology here at Grand Rapids
Community College, and my guest today
is Ethan Watters. He’s an author
and a journalist who is gonna be giving the
Diversity Lecture talk tonight on his most recent work…
his book titled “Crazy Like Us– “The Globalization of
the American Psyche.” So welcome, Ethan.
>>Thank you.>>And welcome to Grand Rapids,
your first time. For a little background
information, in case you’re not
aware of his work, “Crazy Like Us”– it was
on my summer reading list. So that was kind
of a treat, and it really kind of
looks at aspects of the way in which the American ideas of
the psyche and mental illness– really Western ideas
about that– how they sort of
become exported into these cross-cultural
contexts in here. And really the conflict
that sort of emerges when you encounter non-Western
ideas of mental illness and mental health. And really, the thing that
struck me reading the book, you have these four different
cases that you focus on, it was really just the
tremendous breadth to which that
phenomenon is occurring and the different contexts, and really the different
mechanisms in which that process is happening
in there. So I was wondering, in
terms of when you were putting the book together,
researching it, did any one of those
four situations kind of surprise
you the most? Or what kind of
jumped out at you?>>So I began– the
idea for the book came when I was up at
McGill University talking to a medical
anthropologist up there, and he was talking about
how he was invited out by GlaxoSmithKline in 2001
when they were talking about getting Paxil
into that culture. And not only getting
Paxil into that culture, but fundamentally changing
the way Japan thought about depression
and sadness states. And he told me this
remarkable story, and I realize that that
clearly is one vector for how the West
changes other cultures. We manufacture
most of the drugs, and then, in selling them
to other cultures, we not only often
sell the drug, but we sell the idea
of what the illness is. Particularly when it
comes to mental illnesses. That vector probably
would surprise no one. Like, the idea that a drug
company would want to do that, would want to take a
best-selling drug like Paxil, take it to
another culture. So I thought that that was
an important story to tell. It was one of the fundamental
four stories of the book, but I also wanted
to see other vectors. What other ways were
these cultural ideas getting across cultures,
because there’s many of them. So I looked to things like
how celebrity influences, ideas, conceptions of mental
illnesses in different places, and how that goes
across cultures. Are medical interventions such
as when we had the tsunami in the Indian Ocean, we went over there with
lots of trauma counselors. So our ideas of PTSD were
sort of borne on that wave of people that
went over there. So I was literally–
just as you say, I was looking for different
and surprising vectors. And the most
surprising one– I think probably the most
interesting one for me was the PTSD and the
trauma counseling abroad. We do it with such–
we do it– it’s such a wonderful
thing that we try to do when we see suffering
in other cultures. But I think once
you understand– you know, when we go over
there with just a week notice or ten-day’s notice, and we don’t understand
the language, we don’t understand the cultures
or the modes of grieving, the ways that they, in
that particular culture, understand suffering
after trauma. I think you begin to see it
as a little problematic. One researcher asked me to
sort of imagine it in reverse, and he said, “Imagine after 9/11
if shamen from Mozambique “came over and begin knocking
on doors of the survivors “of the 9/11 tragedy
and said, “‘I need to lead you through
these certain rituals “‘so that you could release
the spirit of your dead.'” And how would
that sound to us? Would that make
any sense at all? And of course,
it wouldn’t. But it seems to me
we do pretty much the similar thing
in reverse. And I think we do it
because we think what we have to offer
is science. We think that PTSD is sort of
a newly discovered disease. That we know about it
more than other people, and we need to inform the
rest of the world about it. And I think once you
begin to understand that cultures
around the world, cultural meaning after
a bad event matters, and it matters
to the symptoms, but it matters also to the
modes of healing you look for. And once you
understand that, I think the sort of
interventions we have abroad become quite
problematic.>>And it kind of dovetails
into my next question is, as an anthropologist
reading the book, once of the key themes
that I kinda drew from it was really a pretty
sharp critique of that biomedical
paradigm. The idea, then, that if it’s got
a strong scientific basis to it, it’s got to be sorta
objectively truthful regardless of the
cultural context in which you impose
that in there. So around this talk,
one of the questions I kinda posed for my students
to kind of think about is really thinking
what this relationship between culture
and biology, particularly in terms of
how I would say affects human behavior in terms of
how much of our behavior would be sort of
culturally conditioned, how much becomes sort
of really something that’s situated almost entirely
in terms of a cultural context. And really kinda
frame that with– it’s not that
hard to pick up the science section
of the newspaper. Sometimes, you hear,
“Scientists discover the gene “that controls…” kind
of fill in the blank.>>Right.
>>And I was wondering if you could kind of
share your thoughts on what you think
that relationship is, and maybe, since you
do a lot of writing in this kind of
topical space, is how might your
thoughts on that have changed over your career?
>>Right. I mean, certainly, there’s no
culture that’s more advanced in terms of understanding
the biomedical underpinnings of diseases. And we’re getting better
at the understanding of the biomechanics
of the brain. It’s remarkable to think
that– it was in 1970 that lithium
came out, and it was, in terms of
a drug that could prove that the brain was
influenced by chemicals, or that mental illnesses could
be influenced by chemicals is this remarkable drug. It was fairly effective
for antidepressive and manic depression
and other states. But since 1970, the drugs
affecting mental illness has been a very
problematic road. It has not been the
march of progress everyone had hoped
it would be. That said, whatever
we know about that, and whatever advances
we have in our culture, I do think we have an
obligation to share them. And so, I think it’s–
and even with that example of depression in Japan and
the introduction of Paxil, I think there are many things
that are problematic about that. But there is
some suggestion that after the
introduction of Paxil, which was followed
very closely by Prozac and some other SSRIs, that suicide rates have
leveled off in Japan. So, it’s not necessarily
like we’re the bad guys imposing on
other cultures. In fact, what is often happens
is that other cultures are really reaching
out to us for this. Like we– they believe
we have the technology and are advanced
in these areas, and they very much
want to adopt it. So I’ve talked to people
that have gone abroad, like doctors and
researchers, with the sincere hope
that they were gonna learn from another culture, they
were gonna take the back seat. And in many instances,
you go to another culture and you literally get
handed the microphone and put on the stage,
and they ask you, “What do you know
that we need to know “about the mind and drugs?”
and so forth. So it’s not a matter of us
sort of imposing our will on other cultures. Oftentimes, it’s
a matter of them wanting that
very same thing. So I think it’s sort
of on us to understand the limitations
of these drugs, and to be very
clear about them… not only with
other cultures, but with our own
culture, as well. So there’s deep problems
with SSRIs and suicidality and many other medical
drugs for mental illness have huge side effects and
are deeply problematic. And we need to be clear about
that within our own culture, and perhaps that will
help us when we go to other cultures and
introduce these ideas.>>Do you see this kind
of working in reverse, sometimes, too? Obviously, the examples, other than maybe the
GlaxoSmithKline example where everything else really
was a good-natured desire to legitimately
help in context, but do you ever see
sort of any examples or hear suggestions about
sort of the opposite way in terms of traditional
medical knowledge or systems coming back
to the United States and providing a
similar exchange. If they’re desiring for our,
essentially, scientific or biomedical
information, are there ways that maybe we can
inform our own understanding?>>Absolutely, and you
see this not many times in specific interventions
with specific illness, but movements
like mindfulness… which is becoming very
much the word of the day. Clearly comes from
Eastern traditions of how to think about
meditation and mindfulness. And I think– but I think if there’s
one thing other cultures have to share with us, I think, in the West, we
have this pretty clearly– this sorta egocentric
notion of the self. We think of the self as
within our own brain. We’re in charge
of ourselves, and we make the
decisions in the world. We move through the
world as individuals. And in other cultures,
the self really belongs as part of
the group. You are more your
place in the group than you are
the individual. And I think,
in some ways, that’s what the rest of
the world has to teach us about the human self, because I think they’re
fundamentally right. I think the idea that we
are this individuated self, that we don’t think
like our culture things, or we get to choose how we
think, even in the culture. I think it’s
fundamentally incorrect. I think we
are actually– even as we think of
ourselves as individuals, our culture is the
water we swim in, and we can’t not think
like our culture thinks. And I think there’s some
interesting research that’s just coming out
that suggests that that’s true in
other cultures, and these socio-centric
notions of the self, but it’s also true
in America. So I’m hoping that new
research that comes out will begin to sort of influence
and inform the discussion about how we think about
the self in America. And I think it’s high time that
we sort of learn the lesson.>>Yeah, I think your
example in the book with the way schizophrenics
experience better outcomes, in some ways, in developing
countries is, I think, a great example
of that.>>That was really
a remarkable result. This was a World Health
Organization study that went over several decades
that charted the outcomes with people that had
experienced psychotic breaks to see how they did. Not only how they did
with their illness, but whether they got married,
whether they had a job, whether they stayed
with their families, whether they were
institutionalized. On and on and on,
outcome after outcome. And compared them with people
in developed countries. And what it found to pretty
much everyone’s surprise, I think, is that people
in developing countries often did much better
on all those outcomes. And that should lead us–
like, that alone– that result alone should set
us back a little bit and say, “Okay, if the outcomes are
better in these other places, “what are they doing
that’s different? “And what are we doing
that might be worse?” And to really
look at that. And I think there’s a lot
of research around… how, in other cultures,
there’s lower levels of what’s called
“expressed emotion” around these
diseases. I think it goes back to our
notion of the egocentric self. The idea that we become unstuck
through a psychotic break. That we’re become utterly
permeable to ideas and notions that exist around us, that we
can’t keep our self together. That is an idea
that challenges the American self
of sense deeply. Other cultures, say in Zanzibar
where I traveled to talk with this anthropologist
about this exact phenomenon, the notion that spirits
might possess you is a pretty
common one. So everyone is,
to degrees, possessed by spirits
at different times. Maybe they get angry. Maybe they lose
their cool. They’re momentarily possessed
by jinns or genies. So in that
cultural context, the person that has
the psychotic break is sort of normalized
in a way. They are like us only
more so, in some ways. So they are allowed to–
they can stay within the sort
of family unit, stay within the narrative
about the culture. There’s a place
for them. And that tends to be
hugely helpful over time. And unlike in the
United States, when someone has a
psychotic break here, very unusual that they can,
then, function in any way within that family unit
or within a job or within a
community setting. They suddenly
become the “other.” So when you look at these
narratives in cross cultures about where the line is between
pathology and normalness, I think the fundamental
line is, like… does that narrative put
them outside of the group, or does it keep them
inside the group? And even with things
like schizophrenia, you can have narratives
that keep the individual within the group, as opposed
to sort of allowing you to see them as
the “ill other.”>>Yeah, and you talked to a lot
of mental health practitioners, and that becomes one of
the key issues with it is that stigmatization
of mental illnesses. And if you’re in a
context where that stigma doesn’t necessarily get
applied to the individual, but it’s viewed as
more external factors like spirit possession, then you really allow
them to stay connected to the social group.>>In some ways, it takes
the guilt and the shame that an individual or a family
might take on themselves and allows them to put it on
this sorta social narrative that we all agree on. “This happens
to everyone. “It’s just happening a little
more to this family member.” And it allows certain
space for both the family and the individual to
keep that lower level of expressed emotion
around the illness. It’s less concern.>>Several of your books–
“Crazy Like Us” obviously one, but then you’re probably most
well-known for “Making Monsters” and some of your writing on
the recovery memory movement. (indistinct). I remember we were
reading that, and then reading
“Crazy Like Us,” and then sorta looking at
your bio, and it was like, “This guy really has
a lot of critique “of common social psychology
and psychiatry practice,” and then I was reading towards
the end of “Crazy Like Us,” and you mentioned
you’re actually married to a psychiatrist.
>>Yes, yes.>>Does your wife know
you’re making these books?>>(laughing)
Yes. She really– you know, the
first couple of books, “Making Monsters,”
it’s worth mentioning because it is where I
started this whole thing. This was the recovered memory
movement in the early ’90s where women by
the thousands were going into
psychotherapy settings and coming out with
these believed memories of child abuse, but also
satanic cult stories. Very often, then, displaying
these remarkable symptoms of multiple
personality disorder, which is now called
identity disorder.” And it was clear to me
in writing that book that we critique
that movement, those ideas that led to
those beliefs and behaviors, saw them to be
culturally-based, saw them to be
utterly iatrogenic– created in the
therapeutic setting. But it did leave me with
this question with MPD, when you see these people
switching between personalities a very florid
traumatic symptoms, right? It left me with
a question… to what extent are other
mental illnesses, in some ways, also shaped by the
cultural expectations. And it took me years
of thinking about that and years of
thinking about, “Well, how do you know
whether that was happening? And really, the
two answers are… you either look across cultures,
or you look across time, and you see how these
change in different cultures or change
across time. So those books
really did lead me to where I am today,
intellectually. And I did marry
a psychiatrist, which people did
think was funny, because those first couple
books were very critical of fundamental premises that
were being within psychiatry. But there were a lot of people
within those professions, my wife among them, that was
horrified by the mistakes that were being
made at the time. And this last book, I have
to say, of “Crazy Like Us,” all the heroes are the
cross-cultural psychiatrists who are learning
these things. And there are people
within the profession that would still like to
think of the human mind as being the same
around the world, and this assumption
that if mental illnesses are not the same
around the world, then other cultures
need to catch up with our understanding
of them. And you do find that, but I think the smartest
people in the field– and that’s been largely
the reaction with the book. The field of psychiatry has
been remarkably receptive to it, with this idea that this is
something new we’re learning, that culture is deeply
impactful on how our symptoms come about because they
are languages of suffering that we learn
to express, and those languages
change from time to time. They’ve been
very receptive. So my wife is very
proud of the last book and doesn’t think of it as a
critique of her profession, I think.>>Do you– or did you
intend these kind of books to be a critique
of psychiatry? Or do you see them
in conversation with the discipline?>>Yeah, you know, the
first one, “Making Monsters,” was definitely the idea was
seeing a unique wrong happening, and the idea was, like, my
co-author Richard Ofshe and I were gonna document
what was happening, and, in doing so, we were going
to lock some very bad people inside the building
and just burn it down. We were gonna– it was a very aggressive book
about something we felt was really– that was
bad that was happening to patients
and families. We did learn when you
attack a belief system that is very much already
barred from any criticism– like, that was one of
these belief systems where you just could not
second guess it, in any way, or you were out
of the group. You know, whether
people listen to you– I mean, I think we changed
the cultures, in general, with that book and
a couple other books and some very good pieces
of journalism, changed the way people thought
about that controversy. But whether it changed
minds within the field, the people that really believe
that there were satanic cults everywhere
killing babies… you know, to have
that sort of belief requires that you turn off the
rest of the world a little bit. But in general,
I think, my interests sort of more
broadly speaking, is, “How does culture
influence cognition?” So you could see that across
pretty much everything I’ve written. With the fundamental
outcome of… I believe that
the human mind does not as much
think for itself as mimics culture. That is literally the great
thing about the human mind, is not that it’s the
best problem-solver, the biggest thinker. It’s that we
mimic culture, and culture carries
information within it. And that’s what the human
mind does, fundamentally. And that’s– and that’s
sort of my– finding that and ways
of writing about that in different areas is really
what I’m excited about.>>So you’re kind of
expanding on that course or theoretical sort of focus.
>>Yeah.>>And you talk about
aspects of hysteria a lot, and I think that’s
probably a good disorder then, that I
think manifests that change across time and
change across culture that you–>>Absolutely. You can see hysteria is
a great one to point out, because you can
look back at it. And the mental health
profession– we’re all really
good at looking back and seeing in the
rearview mirror, “Oh, culture was so
impactful on that.” So with hysteria, you see
incorrect assumptions about the
woman’s anatomy, beliefs about
women’s inferiority, fear of female
sexuality. You see all those
currents under– sorta motivating and
moving that disorder, and it was
remarkably popular. Tens of thousands
of women. clinicians would know it in
a second when they saw it. It was these very
florid symptoms again of sensitivity to
touch, fainting, grotesque body movement,
all these things. Couldn’t be more
clear at the time. And then, it simply
sort of drifts away. So that’s a group– you can
see examples across history. The rise of anorexia in
certain times and places. They come
and they go, and I think the problem
I have is that the mental health
profession, in general– I think, culturally
speaking, for the rest of us, we can look back and see
it in the rearview mirror, and say,
“Oh, dear. Those guys,
those clinicians, “those journalists,
those patients– “they were so
influenced. “Poor people. “They were so influenced by
those cultural currents,” and we seem incapable
of learning the lesson, which is that those same
influences are happening to all our diseases
right now. Those same things
are in play. Much more difficult
to see it in real time than it is to see it
20 years ago with MPD or 100 years ago
with hysteria. So the trick is,
let’s not just see the mistakes of the
last generations. Let’s learn the lesson
that is implicit in there, which is culture
impacts symptomatology. That’s not gonna be
some sort of crazy cure to mental illness. The point is that if we
understand that relationship, we will then suddenly
have this magic cure. Undoubtedly
won’t be true, but we will understand
these illnesses better. And we’ll understand
a little bit more about when the next sorta
“fad illness” rises. Like, we can sort of see
it more clearly, I think.>>I’m gonna kind of shift
gears a little bit now. We have a lot of
undecided students here at Grand Rapids
Community College, and I always find that
they really get excited talking to people in terms
of trying to figure out how you got to
where you are. Today, trying to figure
out a career direction, or sort of a
career arc. I wonder if you would be
able to share a little bit– like, how’d you get into writing
about these types of things and journalism? Was that something you
always set out to do, or was this kind of
fell into your lap?>>That’s an interesting
question, and, for me, it was
made more problematic by the fact that I am
moderately dyslexic. So writing, for me,
as a kid– and reading– was always extremely
difficult. I was always very much
behind other people. And I got around it
in a number of ways. One, I think when I
began to get around it was when I realized that writing
is difficult for everyone, regardless of whether
you’re dyslexic or not. It’s super
difficult to do. And it’s not worth doing if
you’re simply communicating the ideas you
already have. What writing does is allow
you to learn what you know about something
in a new way. It allows you to find ideas,
not simply communicate them. And if you think
of it in that way, it’s worth the
pain of doing. Like, “I’m going to really
discover what I know about this “through the process
of writing.” So I’m always– whatever
career path people are on, I’m always encouraging
people to make writing part of that
career path, because good writing
is good thinking, in the same way good math
is good statistics. It is really connected
to how we think.>>See, I’m going to play this
every time my students ask about that writing
assignment I gave them.>>Right– and so, yeah–
you could tell them, like– you know, I have an
office in San Francisco I started
20 years ago. We now have
33 offices and about 55 writers use
the space every month. And for every
one of these– all full-time
professional writers– and for every single one of
them, the blank page is a trial. And the first draft
is horrible. For every single
one of them. So just to know that–
because I think people, especially amateur writers
or beginning writers, they see how hard it is,
and they think, “Well, I must not
be good at this. “This is so hard.”
(music) It’s just hard
for everyone. And the joy of writing
is rewriting and seeing your ideas
synthesize and come out better
on the next draft and the next draft
and the next draft. And it can be,
at different points, especially in the
second and third drafts, a really joyful
process. But the first draft?
Always difficult. But really
worth doing. Yeah.>>Okay, I think we’re
getting pretty close to being up
for time. So I just want to thank you
for your willingness to come and have this
conversation.>>It is my pleasure.>>Looking forward
to the talk tonight.>>Yeah– me, too.
>>Excellent. Thank you very much.
>>Thank you. (music)

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