Crazy Like Us: The Globalization of the American Psyche Paperback – March 22, 2011

Ethan Watters is a journalist who writes particularly about mental health. The premise of this book is that American understandings about the mind and the self, particularly ideas about mental illness and treatment, are being aggressively promoted and replacing traditional beliefs and practices in nonwestern societies. You might think this is a good thing, a sign of progress or modernization, if you believe Americans know more than the rest of the world about mental health. Watters clearly does not. He is of the opinion that psychiatry is culture-bound: that each society has developed its own idioms of distress and culturally meaningful forms of treatment, and Western psychiatry is rapidly destroying them. The American narrative of the moment is a particularly banal one that thoughts and feelings are just a batch of chemicals that psychiatrists can alter with drug therapy. Watters is well-read on the subject, and he has gone around the world to talk to researchers who are questioning the Western narrative. He has written an exceptionally clear, engaging, and persuasive book. As a psychological anthropologist trained in psychiatry, there is little here that I did not learn as a student thirty years ago, but this is the first book I would recommend to anyone who wants to explore the relationship between psychology and culture. It clearly challenges the prevailing premise of universalism, that the psychology and psychiatry of people everywhere is essentially the same and that culture is largely irrelevant.

Ethan Watters, an American journalist explores in his book Crazy Like Us, the globalization of American based mental illnesses such as anorexia, schizophrenia, PTSD, etc. In his book he explores four different types of illnesses and allows the reader to see just how much impact the American definitions and symptoms of these mental illnesses have had on other societies.
He is able to keep his readers captivated by incorporating the stories of people who are inflicted with this disorder. He also allows the reader to see how the disorder progressed from having a cultural specific identity to being manipulated into an entirely new being. One of his first examples is that of anorexia in China, at first the reason behind the disorder was completely different from our own, that was until it became exposed to the population.
Which is where Watters introduces the concept of western technology and science. In his book he stakes the claim that because of the advanced science and technology possessed by the United States, leads to less economically stable countries to embrace ideas that are foreign to them without thinking how it will affect their cultural background. He proves this point several times in the book, whether it be the United States influencing the introduction of a mental illness to another country, or the use of data collected in the United States in order to push a new SSRI.
Watter’s takes a topic that is what some would call near and dear to individuals of the United States, as mental illness is becoming a more prominent issues, and showing how it is negatively affecting societies that have not been introduced to these ideas. Meaning that no these societies quite possible did have these disorders in their society but before the globalization of their symptoms and definitions they had an entirely different meaning. They became something new instead of what they had always been. The reader sees then when reading chapter three of schizophrenics in Africa, the disorder was always there just never given a name or symptoms addressed to it. Instead it was just a burden to bare from God. Which is where the reader gets to see how the society accepts and treats the disorder.
Watters book is very well constructed and easy to lose oneself in because of the stories he tells of others, and does not bog down the reading with countless studies done, or scholarly information that takes away from the meaning. If one is interested in anthropology, and medical studies this is definitely a book to read. It not only touches base with American culture, but several other cultures, and also gives the reader a taste of the medical aspects of the world. It also allows the reader to see a more in depth view of medical companies and how sometimes these companies are not out for the betterment of individuals; they are out for the betterment of their wallets. Watters took a unique topic and allowed the individuals stories speak for themselves on how globalization has left a devastating footprint on numerous societies; a footprint that some individuals may not be able to recover from.

Crazy Like Us: The Globalization of the American PsycheA 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.