Cultural Psychiatry

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During this first century of Western psychotherapy, arguments among and between the schools of psychotherapy have dominated discourse. The psychotherapy of the next century is likely to place theory and associated techniques in their appropriate, practical places in the psychotherapy outcome puzzle.

The power of Superman's spell endures mightily, and the values of truth and justice he communicated through comics, and then television and movies continue to pass undiminished from generation to generation.

The important thing about teachers listening to Ebonics is for them not to equate it with the students' being stupid, says Alvin Poussaint, M.D., professor of psychiatry. "It means they've learned a way to speak in their community or home that's a natural way for them to speak, which they then carry with them to school." While the language is part of who they are and their connection to their community, it doesn't absolutely have to exist to preserve a black identity.

The state of North Carolina has relatively liberal policies regarding petitions for involuntary commitment. If such documents bear words like "dangerous" or "mentally ill," even in the most nebulous sense imaginable, the police will surely locate the relevant individuals and dutifully bring them to the emergency department. This generosity of interpretation produces some sticky situations for the lucky ED resident of the day.

As a practicing psychiatrist, I have watched with growing dismay and outrage the rise and triumph of the hegemony known as biologic psychiatry. Within the general field of modern psychiatry, biologism now completely dominates the discourse on the causes and treatment of mental illness, and in my view this has been a catastrophe with far-reaching effects on individual patients and the cultural psyche at large. It has occurred to me with forcible irony that psychiatry has quite literally lost its mind, and along with it the minds of the patients they are presumably supposed to care for. Even a cursory glance at any major psychiatric journal is enough to convince me that the field has gone far down the road into a kind of delusion, whose main tenets consist of a particularly pernicious biologic determinism and a pseudo-scientific understanding of human nature and mental illness.

Psychotherapy is as old as civilization. Literally soul therapy, the term is a misnomer, since soul is a mystical notion and what is meant is the whole person. The misnomer also survives in the name psychiatry, literally soul medicine. Yet nobody is crusading against psychiatry and psychotherapy because soul is unscientific. What is important is that psychotherapy and psychiatry are job descriptions that refer to what we actually do when as providers or recipients of the service called psychotherapy, we use words to convey meaningful messages to each other, or to evoke desirable acts from each other.

Historically, cult refers to a system of worship and more specifically to an innovative religious system, as opposed to a sect, which is a breakaway group from an established religion. During the past 30 years, however, cult has taken on a pejorative connotation arising from disasters such as Jonestown and Waco, and hundreds of media reports of individuals and families devastated by involvement in cults.

Paraphilias as defined by DSM-IV, are sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors (of at least six months' duration) that are considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning.