Crazy Like Us: The Globalization of the American Psyche [Hardcover]

Ethan Watters (Author)

Book Description

Release date: January 12, 2010

It is well known that American culture is a dominant force at home and abroad; our exportation of everything from movies to junk food is a well-documented phenomenon. But is it possible America's most troubling impact on the globalizing world has yet to be accounted for? In Crazy Like Us, Ethan Watters reveals that the most devastating consequence of the spread of American culture has not been our golden arches or our bomb craters but our bulldozing of the human psyche itself: We are in the process of homogenizing the way the world goes mad.

America has been the world leader in generating new mental health treatments and modern theories of the human psyche. We export our psychopharmaceuticals packaged with the certainty that our biomedical knowledge will relieve the suffering and stigma of mental illness. We categorize disorders, thereby defining mental illness and health, and then parade these seemingly scientific certainties in front of the world. The blowback from these efforts is just now coming to light: It turns out that we have not only been changing the way the world talks about and treats mental illness -- we have been changing the mental illnesses themselves.

For millennia, local beliefs in different cultures have shaped the experience of mental illness into endless varieties. Crazy Like Us documents how American interventions have discounted and worked to change those indigenous beliefs, often at a dizzying rate. Over the last decades, mental illnesses popularized in America have been spreading across the globe with the speed of contagious diseases. Watters travels from China to Tanzania to bring home the unsettling conclusion that the virus is us: As we introduce Americanized ways of treating mental illnesses, we are in fact spreading the diseases.

In post-tsunami Sri Lanka, Watters reports on the Western trauma counselors who, in their rush to help, inadvertently trampled local expressions of grief, suffering, and healing. In Hong Kong, he retraces the last steps of the teenager whose death sparked an epidemic of the American version of anorexia nervosa. Watters reveals the truth about a multi-million-dollar campaign by one of the world's biggest drug companies to change the Japanese experience of depression -- literally marketing the disease along with the drug.

But this book is not just about the damage we've caused in faraway places. Looking at our impact on the psyches of people in other cultures is a gut check, a way of forcing ourselves to take a fresh look at our own beliefs about mental health and healing. When we examine our assumptions from a farther shore, we begin to understand how our own culture constantly shapes and sometimes creates the mental illnesses of our time. By setting aside our role as the world's therapist, we may come to accept that we have as much to learn from other cultures' beliefs about the mind as we have to teach.

--This text refers to the Kindle Edition edition.

Editorial Reviews

From Publishers Weekly

If you thought McDonald's and strip malls were the ugliest of America's cultural exports, think again. Western ideas about mental illness-from anorexia to post-traumatic stress disorder, schizophrenia, general anxiety and clinical depression-as well as Western treatments have been sweeping the globe with alarming speed, argues journalist Watters (Urban Tribes), and are doing far more damage than Big Macs and the Gap. In this well-traveled, deeply reported book, Watters takes readers from Hong Kong to Zanzibar, to Tsunami ravaged Sri Lanka, to illustrate how distinctly American psychological disorders have played in far-off locales, and how Western treatments, from experimental, unproven drugs to talk therapy, have clashed with local customs, understandings and religions. While the book emphasizes anthropological findings at the occasional expense of medical context, and at times skitters into a broad indictment of drug companies and Western science, Watters builds a powerful case. He argues convincingly that cultural differences belie any sort of western template for diagnosing and treating mental illness, and that the rapid spread of American culture threatens our very understanding of the human mind: "We should worry about the loss of diversity in the world's differing conceptions of treatments for mental illness in the same way we worry about the loss of biodiversity in nature."
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From Booklist

During the last quarter-century, America’s cultural influence on foreign countries has become all too visible, with a McDonald’s opening on Tiananmen Square and remote African tribes sporting jeans and T-shirts. Perhaps less obvious, but no less worrisome, is the American exportation of mental illness documented in this unsettling expose by the coauthor of the recovered-memory critique, Making Monsters (1996). Watters emphasizes that different cultures have long had their idiosyncratic ways of handling stress that don’t necessarily conform to descriptions provided by the American Psychological Association (APA). Yet, because the APA’s treatment guidelines are increasingly being subscribed to and Western medicine’s recommended drugs prescribed by other countries’ health-care workers, such illnesses as anorexia and post-traumatic stress disorder (PTSD) are appearing in cultures previously unfamiliar with them. In making his case, Watters provides four carefully dissected case studies, those of anorexia in Hong Kong, PTSD in Sri Lanka, schizophrenia in Zanzibar, and depression in Japan. Ultimately, Watters argues, the loss of cultural diversity consequent upon this peculiar form of Americanization will be keenly felt. --Carl Hays

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Product Details

• Hardcover: 320 pages
• Publisher: Free Press; First Edition edition (January 12, 2010)
• Language: English
• ISBN-10: 141658708X
• ISBN-13: 978-1416587088
• Product Dimensions: 9.1 x 6 x 1.3 inches
• Shipping Weight: 1.1 pounds
• Average Customer Review: 4.5 out of 5 stars  See all reviews (42 customer reviews)
• Amazon Best Sellers Rank: #503,789 in Books (See Top 100 in Books)

More About the Author

Ethan Watters is the author of Crazy Like Us: The Globalization of the American Psyche. Before that he authored Urban Tribes, an examination of the mores of affluent "never marrieds" and coauthored Making Monsters, a groundbreaking indictment of the recovered memory movement. A frequent contributor to The New York Times Magazine, Discover, Men's Journal, Details, Wired, and PRI's This American Life, he has appeared on such national media as Good Morning America, Talk of the Nation, and CNN. He is a co-founder of the San Francisco Writers' Grotto, a cooperative writing workspace in San Francisco.

Most Helpful Customer Reviews

64 of 70 people found the following review helpful

5.0 out of 5 stars eye opening and heartbreaking January 11, 2010

By B. Allen

Format:Hardcover

Four thoroughly reported chapters make a devastating case. Many well-meaning people (who for instance flew to Sri Lanka right after the tsunami to help) and some straight-up money-driven forces (big pharma) have really failed to try to understand non-western ways that cultures deal with serious mental illness. It's a hubris very much in line with our other exports -- "democracy" to the Middle East, say -- but one that you'd think would be a little less egregious because of all the scientists involved. Hopefully this book, which was a smooth yet very detailed read, will spark a long-overdue debate. As a psychologist in training, I'm glad I read this book.

39 of 41 people found the following review helpful

5.0 out of 5 stars Eye-opening December 5, 2010

By Karen Franklin

Format:Hardcover|Amazon Verified Purchase

A successful virus is adaptive. It evolves as needed to survive and colonize new hosts. By this definition, contemporary American psychiatry is a very successful virus. Exploiting cracks that emerge in times of cultural transition, it exports DSM depression to Japan and posttraumatic stress disorder to Sri Lanka.

Journalist Ethan Watters masterfully evokes the heady admixture of moral certainty and profit motive that drives U.S. clinicians and pharmaceutical companies as they evangelically push Western psychiatry around the globe. On the ground in Sri Lanka following the tsunami, for example, hordes of Western counselors hit the ground running, aggressively competing for access to a native population "clearly in denial" about the extent of their trauma. Backing up the foot soldiers are corporations like Pfizer, eager to market the antidepressant Zoloft to a virgin population.

Watters has done his homework. Each of his four examples of DSM-style disorders being introduced around the world is rich in historical and cultural context. Despite their divergences, each successful expansion hinges on the mutual faith of both the colonizers and the colonized that Western approaches represent the pillar of scientific progress.

It is ironic that Americans are so smugly assured of the superiority of our cultural beliefs and practices, in the face of mounting evidence to the contrary. Do we really want others to emulate a country with skyrocketing levels of emotional distress, where jails and prisons are the primary sites of mental health care? Does our simplistic cultural metaphor of mental illness as a "chemical imbalance, " with human minds reduced to "a batter of chemicals we carry around in the mixing bowls of our skulls," represent true enlightenment?

Our implicit condescension is made explicit if we imagine the converse, one of Watters' interview subjects points out: "Imagine our reaction if Mozambicans flew over after 9/11 and began telling survivors that they needed to engage in a certain set of rituals in order to sever their relationships with their deceased family members. How would that sit with us?"

Not only is our missionary zeal condescending, it may be harmful. Watters provides evidence to suggest that the "hyperintrospective" and "hyperindividualist" model of Western psychiatry can be destabilizing to time-worn, tried-and-true indigenous healing practices, in some cases even producing the problems we naively believe we are combating.

"What is certain," Watters cautions in his conclusion, "is that in other places in the world, cultural conceptions of the mind remain more intertwined with a variety of religious and cultural beliefs as well as the ecological and social world. They have not yet separated the mind from the body, nor have they disconnected individual mental health from that of the group. With little appreciation of these differences, we continue our efforts to convince the rest of the world to think like us. Given the level of contentment and psychological health our cultural beliefs about the mind have brought us, perhaps it's time that we rethink our generosity."

Perhaps it is already too late to turn back the tide. Thanks to the exportation of Western diet and lifestyle, 19 out of 20 inhabitants of the tiny island of Nauru in the Pacific Islands are now obese. Previously hardy islanders are stroking out in their 20s and 30s. The globalization of the American psyche is more insidious, but perhaps in the end it will prove equally catastrophic.

Reading Crazy Like Us left me with a nightmare image of a homogeneous future world with McDonald's and Starbucks (see my review of Starbucked: A Double Tall Tale of Caffeine, Commerce, and Culture) on every corner, obesity gone wild, and Western psychiatry reigning supreme.

163 of 218 people found the following review helpful

2.0 out of 5 stars Interesting but biased and leaves too much out. January 14, 2010

By L. Post

Format:Hardcover

This book brings up many thought-provoking points about the arrogance and in some cases, damage of the Western exportation of ideas about the orgins and treatment of mental illness. But one of the author's main premises is that mental illnesses are different in different cultures and in different times. That's not the case. Some of how they are expressed may be different, and there may be some different variants, but accounts from the classical age of the Greeks and Romans on down the line all report clearly identifiable symptoms that could be clustered into affective disorders (depression, bipolar, etc.), thought disorders (schizophrenia and subtypes), and stress reactions (from withdrawal to eating disorders to PTSD). Symptoms of depression, mania, paranoia, and mental confusion have been documented for centuries. There may be many different human cultures on the earth, but we all have human brains.

Another of the author's premises is that the Western medicine for mental illness doesn't work well in other cultures. That may well be true, but the author doesn't show examples of where it has worked or given us any kind of qualified evidence-based, broad-based comparative study; he has only selected anecdotes that support his thesis. I think any attempt to use Western medicine of any kind in a community that is not receptive to it, or for which the doctors ignore or dismiss cultural healing traditions, has potential for unforeseen and even disastrous consequences. But if done with cultural sensitivity and offering options rather than dictating treatment, it could be very helpful to people who are suffering greatly.

Another bias seems to be against medication and "big Pharma," a call to arms that is very trendy right now, whereas in his previous book, "Therapy's Delusions," he lambasted talk therapy in favor of brain science and medication. Most people who are living successfully with mental illness in this culture will say that is a combination of medication and some supportive mode of therapy that helps them stay in remission and live normal lives--something that was rarely possible for those with severe mental illnesses before therapy and medications were invented.

The Western cultural emphasis on the individual and the "pull yourself up by your bootstraps" mentality is much more damaging to people who are vulnerable to mental illnesses than the Western psychiatry/psychology. If we could keep the Western insight into brain science and the Western meds AND therapies that actually work, AND add in or keep the tight-nit, ultra supportive families and communities of the old or developing world, those with real mental illnesses would be much better off. Whatever the type of care is, it's the quality of the human relationships that count.