In-class essay May 5

In class essay

Topic: How have the eating habits of Americans in the 21st Century come to resemble those of Native Americans who lived centuries ago?
A. Preparation
1. Find research on the topic, then use research method #2 or #3 (research log or double-entry journal)
2. Type it and bring it to class Tuesday.
3. Practice writing the essay (out of class)
B.
1. Bring this to class Thursday: On an index card, write the works cited entry of your source on one side. On the opposite side, write one (ONLY ONE): a paraphrase or a quotation which you will use in the in-class essay (this should be no longer than 3-lines and not written in mice prints).
2. You will write a 1.5 - page essay on the topic. In it you will incorporate your source, which you can copy from the index card. The remainder of your essay will be in your own words. At the end of the essay, you will write the works cited entry, copied from your index card.
Your essay will be graded on cohesiveness, organization, word choices, correct citation methods, and use of standard written English.

HW for May 3

HW: 1. Bring in an annotated article on traditional Native American diet. Write a 1/2 page summary about the article.
2. Read pages 190-196 for possible May 3 quiz.

Paraphrasing

Paraphrase: Write It in Your Own Words

Summary:

This handout is intended to help you become more comfortable with the uses of and distinctions among quotations, paraphrases, and summaries. This handout compares and contrasts the three terms, gives some pointers, and includes a short excerpt that you can use to practice these skills.

Paraphrasing is one way to use a text in your own writing without directly quoting source material. Anytime you are taking information from a source that is not your own, you need to specify where you got that information.

A paraphrase is...

Your own rendition of essential information and ideas expressed by someone else, presented in a new form.

• One legitimate way (when accompanied by accurate documentation) to borrow from a source.
• A more detailed restatement than a summary, which focuses concisely on a single main idea.

Paraphrasing is a valuable skill because...
It is better than quoting information from an undistinguished passage.

• It helps you control the temptation to quote too much.
• The mental process required for successful paraphrasing helps you to grasp the full meaning of the original.

6 Steps to Effective Paraphrasing

Reread the original passage until you understand its full meaning.

1. Set the original aside, and write your paraphrase on a note card.
2. Jot down a few words below your paraphrase to remind you later how you envision using this material. At the top of the note card, write a key word or phrase to indicate the subject of your paraphrase.
3. Check your rendition with the original to make sure that your version accurately expresses all the essential information in a new form.
4. Use quotation marks to identify any unique term or phraseology you have borrowed exactly from the source.
5. Record the source (including the page) on your note card so that you can credit it easily if you decide to incorporate the material into your paper.

An example to compare

The original passage:

Students frequently overuse direct quotation in taking notes, and as a result they overuse quotations in the final [research] paper. Probably only about 10% of your final manuscript should appear as directly quoted matter. Therefore, you should strive to limit the amount of exact transcribing of source materials while taking notes. Lester, James D. Writing Research Papers. 2nd ed. (1976): 46-47.

A legitimate paraphrase:

In research papers students often quote excessively, failing to keep quoted material down to a desirable level. Since the problem usually originates during note taking, it is essential to minimize the material recorded verbatim (Lester 46-47).

A plagiarized version:

Students often use too many direct quotations when they take notes, resulting in too many of them in the final research paper. In fact, probably only about 10% of the final copy should consist of directly quoted material. So it is important to limit the amount of source material copied while taking notes.

A note about plagiarism: This example has been classed as plagiarism, in part, because of its failure to deploy any citation. Plagiarism is a serious offense in the academic world.

 

Notetaking

Notetaking

            The notetaking stage is an oft-neglected phase of writing a good research paper, as many students think of notetaking as a tedious waste of time and prefer to work directly from their sources. However, taking notes and responding to source information BEFORE you begin writing the research essay is a beneficial way to make sense of information, take stock of your current sources, figure out how you will use the information you are gathering, transform the information into material that can be used directly in your essay, catalog your response/analysis/conclusions about source information, and avoid plagiarism. It is this notetaking stage, the stage that happens between gathering sources and writing the research paper, that is nearly as essential as composing the draft of the paper itself. Taking notes carefully will save you time in the long run and help you to produce a better essay. Just think: rather than staring at a huge pile of books and periodical articles as you begin writing your first draft, you’ll be working with a typed document in which you have already extracted the best information from the sources and have thought in advance about how you can use that information. 

 

To take good notes, you need to get to make use of three basic methods for working with source material: PARAPHRASE, SUMMARY, and QUOTATION. These three tools will help you pull usable information from a source and transform it into paper-ready material. But, remember, to be an active researcher, you need to do more than write down source information. You also need to analyze and respond to that source information, so that you can compare it to information from other sources, think about what you believe it means, identify potential biases of an author, draw conclusions based on the facts you are reading, and decide how you will use the information in your essay. That’s why the best sorts of notetaking methods involve two parts: One, summarizing, paraphrasing, or quoting source information; and Two, responding to that source information.

 

Choosing a Notetaking Method

There are several beneficial notetaking methods, and which one you choose will depend upon your preference and your instructor’s requirements. Below are just a few of the many ways you could organize your notes.

 Method #1: INDEX CARDS

An index card system appeals to the most organized of students, though they’re not for everyone. Some students find them tedious or tend to lose the cards; they also require retyping, so they take a little more time. However, they do have a number of good qualities that make them unique. Benefits of index cards include:

 ·   PORTABILITY: if you don’t have a laptop, you can easily schlep a few index cards to the library, write some notes, and bring them back home without having to check out any materials or spend your precious change on photocopies.

·   FLEXIBLE ORGANIZATION: Index cards are small and usually contain one main idea, so you can shuffle them around, reorder them, pile them up, etc. as inspiration (and your paper’s organization) dictates.

 

To create index cards:

1.                  Gather up your BEST SOURCES so far. It’s OK if later you decide not to use some of these or find others, but try to locate quality sources so you don’t waste time.

2.                  On one large index card, write the bibliographic citation (in correct MLA style).

3.                  On a second card, write a NOTE from the source in the form of summary, paraphrase, or quotation. Try to go for a variety when you write notes; don’t use ALL quotes, or ONLY summary. It’s best to label each of the entries with an S for summary, a P for paraphrase, or a Q for quotation so you can remember what you are working with later on. Be sure to cite page numbers indicating where you got the source information so that you can successfully cite that borrowed information parenthetically if you do decide to use it in your essay.

4.                  On the back of the card, write YOUR RESPONSE--questions, comments, interpretation, clarification, and feelings about the source material that you’ve chosen. Avoid brief, overly simplified responses like “I agree” or “This is important.” Think about using the following questions to guide your responses: 

 

·   What is most striking about this material?

·   How does it compare to facts or studies or opinions given in other sources?

·   Does it support your point of view, or argue against it?

·   Do you have personal experiences, observations, or interview material that supports or contradicts this information?

·   What does the author mean? What is being implied that perhaps is not stated?

5.                  Repeat this process until you have pulled all the usable material from one source, then move on to the next.

 

Method #2: The Research Log

The research log will feel much more organic and free-flowing than making index cards, as it takes more of a narrative approach.

 

To create a research log:

1.      Gather your BEST SOURCES so far. It’s OK if later you decide not to use some of these or find others, but try to locate quality sources so you don’t waste time.

2.      At the top of the page, type the bibliographic citation (in correct MLA style) for your first source.

3.      Begin by capturing your initial response to the entire source. Does it seem believable? Credible? What seemed most convincing? Least convincing? How does the source compare to other sources you’ve read? Write about a paragraph.

4.      Follow your initial response paragraph with source notes: summary, paraphrase, and quotation (don’t forget to record the page numbers) directly from the source. Be sure to also put your quotes in quotation marks, so you don’t inadvertently plagiarize. You will want to choose the information that is most important and most relative to your topic. This section shouldn’t contain your own opinion, just source information.

5.      Follow the source notes with one more paragraph called the source reconsidered, that details your further response to what stands out in the source notes you have just taken. It’s more specific than the initial response and should deal with particulars from within the facts and opinions you’ve pulled from the source.

6.      Repeat this process until you have pulled all the usable material from one source, then move on to the next.

 

Method #3: The Double-Entry Journal

The double-entry journal tends to be a research instructor favorite, since it asks students to find usable material within a source and respond to it immediately and analytically.

To create a double-entry research journal:

1.      Gather your BEST SOURCES so far. It’s OK if later you decide not to use some of these or find others, but try to locate quality sources for the journal so you don’t waste time.

2.      At the top of the page, type the bibliographic citation (in correct MLA style) for your first source.

3.      Type a SOURCE entry from the source that contains important information you could use in your essay. The entry from the source should be in the form of summary, paraphrase, or quotation. It’s best to label each of the entries with an S for summary, a P for paraphrase, or a Q for quotation so you can remember what you are working with later on. Be sure to cite page numbers indicating where you got the source information so that you can successfully cite that borrowed information parenthetically if you do decide to use it in your essay.

4.      Under the source entry, add YOUR RESPONSE questions, comments, interpretation, clarification, and feelings about the source material that you’ve chosen. It’s good to label your response with an R so that you remember to take credit for it in your essay. Avoid brief, overly simplified responses like “I agree” or “This is important.” Think about using the following questions to guide your responses: 

·   What is most striking about this material?

·   How does it compare to facts or studies or opinions given in other sources?

·   Does it support your point of view, or argue against it?

·   Do you have personal experiences, observations, or interview material that supports or contradicts this information?

·   What does the author mean? What is being implied that perhaps is not stated?

·   Does the author show some personal bias here, or does it seem objective?

·   What additional questions does the information raise in your mind that you could further look into?

·   How will the information fit into the larger scheme of your essay?

9.      Repeat this process until you have pulled all the usable material from one source, then move on to the next.

 

REMEMBER: With all of these notetaking methods, the response is the hard part! Really think about the material that you’ve chosen and respond to it intelligently and formally. The better your response, the more likely you can use it directly in your essay. Your goal is to create as much material for your research paper as you can, so the more work you do now, the less you’ll need to do when you’re ready to start your first draft.

April 26 HW

A. 1. What is one source of support you have (other than Watters), and

how does it support your claim?
2. What background information can you insert?
3. What strong/figurative language can you use to intone your stance?
4. What is your hook?
5. What is your thesis? Does it state what your claim is and what the main

 issues are? 

 

B. Bring in a typed outline of your essay.

Due April 19

1, From the blog, read and print "The Americanization of Mental Illness" (or you can Google and print it), annotate it, and bring it to class Tuesday. Also, type a 2/3 page summary about it.

2. Read pages 78 -- 100 in the textbook

Essay 2 -- Due April 28

Essay #2: The American Brand of Crazy

Globalization is one of the most important social forces in our lives today. More than ever before in human history, people all over the world are listening to the same kinds of music, eating the same kinds of food, wearing the same kinds of clothing. Many of the lifestyles and fashions that people worldwide are adopting originated in the world’s wealthiest countries, especially the United
States. America has a huge influence on the culture of other places: just think of the places all over the globe where people eat McDonald’s hamburgers and drink Cokes, where people wear Nike shoes and watch Hollywood movies.

In an article in New York Times Magazine, Ethan Watters argues that America has another important export for the other countries of the world: our view of mental illness. According to Watters, Americans commonly assume that mental illnesses like depression are the same all over the world. However, Watters contends that these conditions are in fact culturally constructed—that is to say, different cultures view depression very differently. And, for better and worse, the American concept of what depression means has started to dominate the whole globe.

For this out-of-class essay, I’d like you to read Watters’ argument carefully. The name of the article is “The Americanization of Mental Illness,” and it appeared in New York Times Magazine on January 8, 2010. Once you have read the piece, I’d like you to write an essay evaluating and responding to a claim Watters makes in the end of his article: “Some philosophers and psychiatrists have suggested that we are investing our great wealth in researching and treating mental illness — medicalizing ever larger swaths of human experience — because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.” What does this claim mean? Is it true? What evidence does Watters produce to support it? What other evidence from other sources can you find that also supports this claim (or that undercuts it?) This part of the essay needs to be between 900 and 1000 words.

A second part of the essay will be the last page (before the Works Cited page). On this page you will place a cartoon (about 1/3 of the page) on the issue that your essay is about, and then write a rhetorical analysis of the cartoon. Refer to the textbook and the questions we practiced for the homework readings for a guideline.

In grading this paper, I will evaluate your performance on all six criteria from your “What Makes a Good WR 122 Essay?” sheet: focus, development, audience awareness, organization, correctness, and effective research. Regarding the last two criteria, I’m expecting that your paper be as clean and as well edited as you can make it. I expect your paper to be word processed with 11 point type, double-spaced, in an academic font such as Times New Roman, with no spelling errors, and proofread. Regarding grammar, I will be evaluating your performance on all of the aspects of Standard Written English. Regarding citations, you will need to refer to between three and four recent (2006 or later) periodical articles from the MHCC database (you should include the article from New York Times Magazine as one of these). Both the in-text citations and Works Cited page should appear in correct MLA format.

The Americanization of Mental Illness

AMERICANS, particularly if they are of a certain leftward-leaning, college-educated type, worry about our country’s blunders into other cultures. In some circles, it is easy to make friends with a rousing rant about the McDonald’s near Tiananmen Square, the Nike factory in Malaysia or the latest blowback from our political or military interventions abroad. For all our self-recrimination, however, we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.

This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places. In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro, which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that brings forth dissociative episodes of laughing, shouting and singing.

The diversity that can be found across cultures can be seen across time as well. In his book “Mad Travelers,” the philosopher Ian Hacking documents the fleeting appearance in the 1890s of a fugue state in which European men would walk in a trance for hundreds of miles with no knowledge of their identities. The hysterical-leg paralysis that afflicted thousands of middle-class women in the late 19th century not only gives us a visceral understanding of the restrictions set on women’s social roles at the time but can also be seen from this distance as a social role itself — the troubled unconscious minds of a certain class of women speaking the idiom of distress of their time.

“We might think of the culture as possessing a ‘symptom repertoire’ — a range of physical symptoms available to the unconscious mind for the physical expression of psychological conflict,” Edward Shorter, a medical historian at the University of Toronto, wrote in his book “Paralysis: The Rise and Fall of a ‘Hysterical’ Symptom.” “In some epochs, convulsions, the sudden inability to speak or terrible leg pain may loom prominently in the repertoire. In other epochs patients may draw chiefly upon such symptoms as abdominal pain, false estimates of body weight and enervating weakness as metaphors for conveying psychic stress.”

In any given era, those who minister to the mentally ill — doctors or shamans or priests — inadvertently help to select which symptoms will be recognized as legitimate. Because the troubled mind has been influenced by healers of diverse religious and scientific persuasions, the forms of madness from one place and time often look remarkably different from the forms of madness in another.

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That is until recently.

For more than a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma. There is now good evidence to suggest that in the process of teaching the rest of the world to think like us, we’ve been exporting our Western “symptom repertoire” as well. That is, we’ve been changing not only the treatments but also the expression of mental illness in other cultures. Indeed, a handful of mental-health disorders — depression, post-traumatic stress disorder and anorexia among them — now appear to be spreading across cultures with the speed of contagious diseases. These symptom clusters are becoming the lingua franca of human suffering, replacing indigenous forms of mental illness.

DR. SING LEE, a psychiatrist and researcher at the Chinese University of Hong Kong, watched the Westernization of a mental illness firsthand. In the late 1980s and early 1990s, he was busy documenting a rare and culturally specific form of anorexia nervosa in Hong Kong. Unlike American anorexics, most of his patients did not intentionally diet nor did they express a fear of becoming fat. The complaints of Lee’s patients were typically somatic — they complained most frequently of having bloated stomachs. Lee was trying to understand this indigenous form of anorexia and, at the same time, figure out why the disease remained so rare.

As he was in the midst of publishing his finding that food refusal had a particular expression and meaning in Hong Kong, the public’s understanding of anorexia suddenly shifted. On Nov. 24, 1994, a teenage anorexic girl named Charlene Hsu Chi-Ying collapsed and died on a busy downtown street in Hong Kong. The death caught the attention of the media and was featured prominently in local papers. “Anorexia Made Her All Skin and Bones: Schoolgirl Falls on Ground Dead,” read one headline in a Chinese-language newspaper. “Thinner Than a Yellow Flower, Weight-Loss Book Found in School Bag, Schoolgirl Falls Dead on Street,” reported another Chinese-language paper.

In trying to explain what happened to Charlene, local reporters often simply copied out of American diagnostic manuals. The mental-health experts quoted in the Hong Kong papers and magazines confidently reported that anorexia in Hong Kong was the same disorder that appeared in the United States and Europe. In the wake of Charlene’s death, the transfer of knowledge about the nature of anorexia (including how and why it was manifested and who was at risk) went only one way: from West to East.

Western ideas did not simply obscure the understanding of anorexia in Hong Kong; they also may have changed the expression of the illness itself. As the general public and the region’s mental-health professionals came to understand the American diagnosis of anorexia, the presentation of the illness in Lee’s patient population appeared to transform into the more virulent American standard. Lee once saw two or three anorexic patients a year; by the end of the 1990s he was seeing that many new cases each month. That increase sparked another series of media reports. “Children as Young as 10 Starving Themselves as Eating Ailments Rise,” announced a headline in one daily newspaper. By the late 1990s, Lee’s studies reported that between 3 and 10 percent of young women in Hong Kong showed disordered eating behavior. In contrast to Lee’s earlier patients, these women most often cited fat phobia as the single most important reason for their self-starvation. By 2007 about 90 percent of the anorexics Lee treated reported fat phobia. New patients appeared to be increasingly conforming their experience of anorexia to the Western version of the disease.

What is being missed, Lee and others have suggested, is a deep understanding of how the expectations and beliefs of the sufferer shape their suffering. “Culture shapes the way general psychopathology is going to be translated partially or completely into specific psychopathology,” Lee says. “When there is a cultural atmosphere in which professionals, the media, schools, doctors, psychologists all recognize and endorse and talk about and publicize eating disorders, then people can be triggered to consciously or unconsciously pick eating-disorder pathology as a way to express that conflict.”

The problem becomes especially worrisome in a time of globalization, when symptom repertoires can cross borders with ease. Having been trained in England and the United States, Lee knows better than most the locomotive force behind Western ideas about mental health and illness. Mental-health professionals in the West, and in the United States in particular, create official categories of mental diseases and promote them in a diagnostic manual that has become the worldwide standard. American researchers and institutions run most of the premier scholarly journals and host top conferences in the fields of psychology and psychiatry. Western drug companies dole out large sums for research and spend billions marketing medications for mental illnesses. In addition, Western-trained traumatologists often rush in where war or natural disasters strike to deliver “psychological first aid,” bringing with them their assumptions about how the mind becomes broken by horrible events and how it is best healed. Taken together this is a juggernaut that Lee sees little chance of stopping.

“As Western categories for diseases have gained dominance, micro-cultures that shape the illness experiences of individual patients are being discarded,” Lee says. “The current has become too strong.”

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Would anorexia have so quickly become part of Hong Kong’s symptom repertoire without the importation of the Western template for the disease? It seems unlikely. Beginning with scattered European cases in the early 19th century, it took more than 50 years for Western mental-health professionals to name, codify and popularize anorexia as a manifestation of hysteria. By contrast, after Charlene fell onto the sidewalk on Wan Chai Road on that late November day in 1994, it was just a matter of hours before the Hong Kong population learned the name of the disease, who was at risk and what it meant.

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Credit Alex Trochut

THE IDEA THAT our Western conception of mental health and illness might be shaping the expression of illnesses in other cultures is rarely discussed in the professional literature. Many modern mental-health practitioners and researchers believe that the scientific standing of our drugs, our illness categories and our theories of the mind have put the field beyond the influence of endlessly shifting cultural trends and beliefs. After all, we now have machines that can literally watch the mind at work. We can change the chemistry of the brain in a variety of interesting ways and we can examine DNA sequences for abnormalities. The assumption is that these remarkable scientific advances have allowed modern-day practitioners to avoid the blind spots and cultural biases of their predecessors.

Modern-day mental-health practitioners often look back at previous generations of psychiatrists and psychologists with a thinly veiled pity, wondering how they could have been so swept away by the cultural currents of their time. The confident pronouncements of Victorian-era doctors regarding the epidemic of hysterical women are now dismissed as cultural artifacts. Similarly, illnesses found only in other cultures are often treated like carnival sideshows. Koro, amok and the like can be found far back in the American diagnostic manual (DSM-IV, Pages 845-849) under the heading “culture-bound syndromes.” Given the attention they get, they might as well be labeled “Psychiatric Exotica: Two Bits a Gander.”

Western mental-health practitioners often prefer to believe that the 844 pages of the DSM-IV prior to the inclusion of culture-bound syndromes describe real disorders of the mind, illnesses with symptomatology and outcomes relatively unaffected by shifting cultural beliefs. And, it logically follows, if these disorders are unaffected by culture, then they are surely universal to humans everywhere. In this view, the DSM is a field guide to the world’s psyche, and applying it around the world represents simply the brave march of scientific knowledge.

Of course, we can become psychologically unhinged for many reasons that are common to all, like personal traumas, social upheavals or biochemical imbalances in our brains. Modern science has begun to reveal these causes. Whatever the trigger, however, the ill individual and those around him invariably rely on cultural beliefs and stories to understand what is happening. Those stories, whether they tell of spirit possession, semen loss or serotonin depletion, predict and shape the course of the illness in dramatic and often counterintuitive ways. In the end, what cross-cultural psychiatrists and anthropologists have to tell us is that all mental illnesses, including depression, P.T.S.D. and even schizophrenia, can be every bit as influenced by cultural beliefs and expectations today as hysterical-leg paralysis or the vapors or zar or any other mental illness ever experienced in the history of human madness. This does not mean that these illnesses and the pain associated with them are not real, or that sufferers deliberately shape their symptoms to fit a certain cultural niche. It means that a mental illness is an illness of the mind and cannot be understood without understanding the ideas, habits and predispositions — the idiosyncratic cultural trappings — of the mind that is its host.

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EVEN WHEN THE underlying science is sound and the intentions altruistic, the export of Western biomedical ideas can have frustrating and unexpected consequences. For the last 50-odd years, Western mental-health professionals have been pushing what they call “mental-health literacy” on the rest of the world. Cultures became more “literate” as they adopted Western biomedical conceptions of diseases like depression and schizophrenia. One study published in The International Journal of Mental Health, for instance, portrayed those who endorsed the statement that “mental illness is an illness like any other” as having a “knowledgeable, benevolent, supportive orientation toward the mentally ill.”

Mental illnesses, it was suggested, should be treated like “brain diseases” over which the patient has little choice or responsibility. This was promoted both as a scientific fact and as a social narrative that would reap great benefits. The logic seemed unassailable: Once people believed that the onset of mental illnesses did not spring from supernatural forces, character flaws, semen loss or some other prescientific notion, the sufferer would be protected from blame and stigma. This idea has been promoted by mental-health providers, drug companies and patient-advocacy groups like the National Alliance on Mental Illness in the United States and SANE in Britain. In a sometimes fractious field, everyone seemed to agree that this modern way of thinking about mental illness would reduce the social isolation and stigma often experienced by those with mental illness. Trampling on indigenous prescientific superstitions about the cause of mental illness seemed a small price to pay to relieve some of the social suffering of the mentally ill.

But does the “brain disease” belief actually reduce stigma?

In 1997, Prof. Sheila Mehta from Auburn University Montgomery in Alabama decided to find out if the “brain disease” narrative had the intended effect. She suspected that the biomedical explanation for mental illness might be influencing our attitudes toward the mentally ill in ways we weren’t conscious of, so she thought up a clever experiment.

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In her study, test subjects were led to believe that they were participating in a simple learning task with a partner who was, unbeknownst to them, a confederate in the study. Before the experiment started, the partners exchanged some biographical data, and the confederate informed the test subject that he suffered from a mental illness.

The confederate then stated either that the illness occurred because of “the kind of things that happened to me when I was a kid” or that he had “a disease just like any other, which affected my biochemistry.” (These were termed the “psychosocial” explanation and the “disease” explanation respectively.) The experiment then called for the test subject to teach the confederate a pattern of button presses. When the confederate pushed the wrong button, the only feedback the test subject could give was a “barely discernible” to “somewhat painful” electrical shock.

Analyzing the data, Mehta found a difference between the group of subjects given the psychosocial explanation for their partner’s mental-illness history and those given the brain-disease explanation. Those who believed that their partner suffered a biochemical “disease like any other” increased the severity of the shocks at a faster rate than those who believed they were paired with someone who had a mental disorder caused by an event in the past.

“The results of the current study suggest that we may actually treat people more harshly when their problem is described in disease terms,” Mehta wrote. “We say we are being kind, but our actions suggest otherwise.” The problem, it appears, is that the biomedical narrative about an illness like schizophrenia carries with it the subtle assumption that a brain made ill through biomedical or genetic abnormalities is more thoroughly broken and permanently abnormal than one made ill though life events. “Viewing those with mental disorders as diseased sets them apart and may lead to our perceiving them as physically distinct. Biochemical aberrations make them almost a different species.”

In other words, the belief that was assumed to decrease stigma actually increased it. Was the same true outside the lab in the real world?

The question is important because the Western push for “mental-health literacy” has gained ground. Studies show that much of the world has steadily adopted this medical model of mental illness. Although these changes are most extensive in the United States and Europe, similar shifts have been documented elsewhere. When asked to name the sources of mental illness, people from a variety of cultures are increasingly likely to mention “chemical imbalance” or “brain disease” or “genetic/inherited” factors.

Unfortunately, at the same time that Western mental-health professionals have been convincing the world to think and talk about mental illnesses in biomedical terms, we have been simultaneously losing the war against stigma at home and abroad. Studies of attitudes in the United States from 1950 to 1996 have shown that the perception of dangerousness surrounding people with schizophrenia has steadily increased over this time. Similarly, a study in Germany found that the public’s desire to maintain distance from those with a diagnosis of schizophrenia increased from 1990 to 2001.

Researchers hoping to learn what was causing this rise in stigma found the same surprising connection that Mehta discovered in her lab. It turns out that those who adopted biomedical/genetic beliefs about mental disorders were the same people who wanted less contact with the mentally ill and thought of them as more dangerous and unpredictable. This unfortunate relationship has popped up in numerous studies around the world. In a study conducted in Turkey, for example, those who labeled schizophrenic behavior as akil hastaligi (illness of the brain or reasoning abilities) were more inclined to assert that schizophrenics were aggressive and should not live freely in the community than those who saw the disorder as ruhsal hastagi (a disorder of the spiritual or inner self). Another study, which looked at populations in Germany, Russia and Mongolia, found that “irrespective of place . . . endorsing biological factors as the cause of schizophrenia was associated with a greater desire for social distance.”

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Credit Alex Trochut

Even as we have congratulated ourselves for becoming more “benevolent and supportive” of the mentally ill, we have steadily backed away from the sufferers themselves. It appears, in short, that the impact of our worldwide antistigma campaign may have been the exact opposite of what we intended.

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NOWHERE ARE THE limitations of Western ideas and treatments more evident than in the case of schizophrenia. Researchers have long sought to understand what may be the most perplexing finding in the cross-cultural study of mental illness: people with schizophrenia in developing countries appear to fare better over time than those living in industrialized nations.

This was the startling result of three large international studies carried out by the World Health Organization over the course of 30 years, starting in the early 1970s. The research showed that patients outside the United States and Europe had significantly lower relapse rates — as much as two-thirds lower in one follow-up study. These findings have been widely discussed and debated in part because of their obvious incongruity: the regions of the world with the most resources to devote to the illness — the best technology, the cutting-edge medicines and the best-financed academic and private-research institutions — had the most troubled and socially marginalized patients.

Trying to unravel this mystery, the anthropologist Juli McGruder from the University of Puget Sound spent years in Zanzibar studying families of schizophrenics. Though the population is predominantly Muslim, Swahili spirit-possession beliefs are still prevalent in the archipelago and commonly evoked to explain the actions of anyone violating social norms — from a sister lashing out at her brother to someone beset by psychotic delusions.

McGruder found that far from being stigmatizing, these beliefs served certain useful functions. The beliefs prescribed a variety of socially accepted interventions and ministrations that kept the ill person bound to the family and kinship group. “Muslim and Swahili spirits are not exorcised in the Christian sense of casting out demons,” McGruder determined. “Rather they are coaxed with food and goods, feted with song and dance. They are placated, settled, reduced in malfeasance.” McGruder saw this approach in many small acts of kindness. She watched family members use saffron paste to write phrases from the Koran on the rims of drinking bowls so the ill person could literally imbibe the holy words. The spirit-possession beliefs had other unexpected benefits. Critically, the story allowed the person with schizophrenia a cleaner bill of health when the illness went into remission. An ill individual enjoying a time of relative mental health could, at least temporarily, retake his or her responsibilities in the kinship group. Since the illness was seen as the work of outside forces, it was understood as an affliction for the sufferer but not as an identity.

For McGruder, the point was not that these practices or beliefs were effective in curing schizophrenia. Rather, she said she believed that they indirectly helped control the course of the illness. Besides keeping the sick individual in the social group, the religious beliefs in Zanzibar also allowed for a type of calmness and acquiescence in the face of the illness that she had rarely witnessed in the West.

The course of a metastasizing cancer is unlikely to be changed by how we talk about it. With schizophrenia, however, symptoms are inevitably entangled in a person’s complex interactions with those around him or her. In fact, researchers have long documented how certain emotional reactions from family members correlate with higher relapse rates for people who have a diagnosis of schizophrenia. Collectively referred to as “high expressed emotion,” these reactions include criticism, hostility and emotional overinvolvement (like overprotectiveness or constant intrusiveness in the patient’s life). In one study, 67 percent of white American families with a schizophrenic family member were rated as “high EE.” (Among British families, 48 percent were high EE; among Mexican families the figure was 41 percent and for Indian families 23 percent.)

Does this high level of “expressed emotion” in the United States mean that we lack sympathy or the desire to care for our mentally ill? Quite the opposite. Relatives who were “high EE” were simply expressing a particularly American view of the self. They tended to believe that individuals are the captains of their own destiny and should be able to overcome their problems by force of personal will. Their critical comments to the mentally ill person didn’t mean that these family members were cruel or uncaring; they were simply applying the same assumptions about human nature that they applied to themselves. They were reflecting an “approach to the world that is active, resourceful and that emphasizes personal accountability,” Prof. Jill M. Hooley of Harvard University concluded. “Far from high criticism reflecting something negative about the family members of patients with schizophrenia, high criticism (and hence high EE) was associated with a characteristic that is widely regarded as positive.”

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Widely regarded as positive, that is, in the United States. Many traditional cultures regard the self in different terms — as inseparable from your role in your kinship group, intertwined with the story of your ancestry and permeable to the spirit world. What McGruder found in Zanzibar was that families often drew strength from this more connected and less isolating idea of human nature. Their ability to maintain a low level of expressed emotion relied on these beliefs. And that level of expressed emotion in turn may be key to improving the fortunes of the schizophrenia sufferer.

Of course, to the extent that our modern psychopharmacological drugs can relieve suffering, they should not be denied to the rest of the world. The problem is that our biomedical advances are hard to separate from our particular cultural beliefs. It is difficult to distinguish, for example, the biomedical conception of schizophrenia — the idea that the disease exists within the biochemistry of the brain — from the more inchoate Western assumption that the self resides there as well. “Mental illness is feared and has such a stigma because it represents a reversal of what Western humans . . . have come to value as the essence of human nature,” McGruder concludes. “Because our culture so highly values . . . an illusion of self-control and control of circumstance, we become abject when contemplating mentation that seems more changeable, less restrained and less controllable, more open to outside influence, than we imagine our own to be.”

CROSS-CULTURAL psychiatrists have pointed out that the mental-health ideas we export to the world are rarely unadulterated scientific facts and never culturally neutral. “Western mental-health discourse introduces core components of Western culture, including a theory of human nature, a definition of personhood, a sense of time and memory and a source of moral authority. None of this is universal,” Derek Summerfield of the Institute of Psychiatry in London observes. He has also written: “The problem is the overall thrust that comes from being at the heart of the one globalizing culture. It is as if one version of human nature is being presented as definitive, and one set of ideas about pain and suffering. . . . There is no one definitive psychology.”

Behind the promotion of Western ideas of mental health and healing lie a variety of cultural assumptions about human nature. Westerners share, for instance, evolving beliefs about what type of life event is likely to make one psychologically traumatized, and we agree that venting emotions by talking is more healthy than stoic silence. We’ve come to agree that the human mind is rather fragile and that it is best to consider many emotional experiences and mental states as illnesses that require professional intervention. (The National Institute of Mental Health reports that a quarter of Americans have diagnosable mental illnesses each year.) The ideas we export often have at their heart a particularly American brand of hyperintrospection — a penchant for “psychologizing” daily existence. These ideas remain deeply influenced by the Cartesian split between the mind and the body, the Freudian duality between the conscious and unconscious, as well as the many self-help philosophies and schools of therapy that have encouraged Americans to separate the health of the individual from the health of the group. These Western ideas of the mind are proving as seductive to the rest of the world as fast food and rap music, and we are spreading them with speed and vigor.

No one would suggest that we withhold our medical advances from other countries, but it’s perhaps past time to admit that even our most remarkable scientific leaps in understanding the brain haven’t yet created the sorts of cultural stories from which humans take comfort and meaning. When these scientific advances are translated into popular belief and cultural stories, they are often stripped of the complexity of the science and become comically insubstantial narratives. Take for instance this Web site text advertising the antidepressant Paxil: “Just as a cake recipe requires you to use flour, sugar and baking powder in the right amounts, your brain needs a fine chemical balance in order to perform at its best.” The Western mind, endlessly analyzed by generations of theorists and researchers, has now been reduced to a batter of chemicals we carry around in the mixing bowl of our skulls.

All cultures struggle with intractable mental illnesses with varying degrees of compassion and cruelty, equanimity and fear. Looking at ourselves through the eyes of those living in places where madness and psychological trauma are still embedded in complex religious and cultural narratives, however, we get a glimpse of ourselves as an increasingly insecure and fearful people. Some philosophers and psychiatrists have suggested that we are investing our great wealth in researching and treating mental illness — medicalizing ever larger swaths of human experience — because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.

If our rising need for mental-health services does indeed spring from a breakdown of meaning, our insistence that the rest of the world think like us may be all the more problematic. Offering the latest Western mental-health theories, treatments and categories in an attempt to ameliorate the psychological stress sparked by modernization and globalization is not a solution; it may be part of the problem. When we undermine local conceptions of the self and modes of healing, we may be speeding along the disorienting changes that are at the very heart of much of the world’s mental distress.

Correction: January 24, 2010

A biographical note for the author of an article on Jan. 10 about the influence of American ideas on the treatment of mental illness abroad misidentified the publisher of his new book. Ethan Watters’s ‘‘Crazy Like Us: The Globalization of the American Psyche’’ was just published by Free Press, not Basic Books. The article also gave an outdated name for a patient advocacy organization that has supported a biomedical view of mental illness. It is the National Alliance on Mental Illness, no longer the National Alliance for the Mentally Ill.

Ethan Watters lives in San Francisco. This essay is adapted from his book “Crazy Like Us: The Globalization of the American Psyche,” which will be published later this month by Free Press.

A version of this article appears in print on January 10, 2010, on page MM40 of the Sunday Magazine with the headline: The Americanization of Mental Illness. Today's Paper|Subscribe