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"How we define mental illness is one of the\u00A0most fraught issues in psychiatry; skeptics of the psychiatric establishment fear that broad definitions of mental illness could make people see their symptoms as more problematic than necessary. A\u00A0small paper\u00A0in the\u00A0British Journal of Psychiatry\u00A0adds to the debate, offering a new perspective on how schizophrenia is experienced across cultures.\nStanford anthropologist Tanya Luhrmann worked with a team of psychologists to interview 20 schizophrenics in three cities: San Mateo, California; Accra, Ghana; and Chennai, India. Most of the patients were in their thirties or forties and had been ill for years. There were important similarities across the board \u2014 almost everyone reported a mix of positive and negative experiences with their voices \u2014 but there were several cross-cultural differences in how patients experienced and interpreted their symptoms.\nSchizophrenics in California reported the most negative feelings about their voices; everyone Lurhmann spoke to used clinical language when talking about their voices, and no one said the overall experience was positive. Fourteen of the 20 patients admitted that their voices told them to hurt themselves or others. \u201CUsually, it\u2019s like torturing people, to take their eye out with a fork, or cut someone\u2019s head and drink their blood, really nasty stuff,\u201D said one. Only a few patients said they had personal relationships with the voices; just two regularly heard family members. Eight could never figure out who was speaking to them, and resorted to giving them\u00A0abstract names like \u201CEntity.\u201D\nIn Ghana and India, patients\u2019 experiences of schizophrenia were, relatively, more positive. They were more likely to report having intimate \u2014 and, they felt, constructive \u2014 relationships with the voices in their heads. In Chennai, interviewees rarely used clinical language like \u201Cschizophrenia\u201D or \u201Cdisorder.\u201D Most \u2014 13 out of 20 \u2014 regularly heard the voices of family members. \u201CThese voices behaved as relatives do: They gave guidance, but they also scolded,\u201D writes Luhrmann. \u201CThey often gave commands to do domestic tasks. Although people did not always like them, they spoke about them as relationships.\u201D Only four said their voices told them to do anything violent, and nearly half said their voices were, overall, a good thing. \u201CI like my mother\u2019s voice,\u201D said one woman. \u201CI have a companion to talk [to],\u201D said another. Only two Ghanaians said their voices tried to incite them to violence; just two used diagnostic labels, and half said the experience of hearing voices was overall positive. Most \u2014 16 \u2014 heard voices they attributed to gods or disembodied spirits.\n\u201CWe believe that these social expectations about minds and persons may shape the voice-hearing experience,\u201D wrote the authors.\u00A0\u201CThe difference seems to be that the Chennai and Accra participants were more comfortable interpreting their voices as relationships and not as the sign of a violated mind.\u201D The\u00A0American cultural emphasis on autonomy, the authors went on to hypothesize, shapes \u201Cnot only a clinical culture in which patients have the right to know, and should know, their diagnosis, but a more general cognitive bias that unusual auditory events are symptoms, rather than people or spirits.\u201D\nHave something to add to this story? Share it in the comments."^^<http://www.w3.org/2001/XMLSchema#string>
<http://mashable.com/2014/08/09/schizophrenic-voices/>