Cultural psychiatry in historical perspective

Abstract

EDITORS' INTRODUCTION The evolution of cultural psychiatry over the last few decades has been an interesting phenomenon to observe. Psychiatry is perhaps one of the younger disciplines of medicine. The coming of age of psychiatry as a profession was clearly linked with the development of training and laying claim to a knowledge base which gradually has become more evidence based. The period between the two world wars led to greater questioning of social factors in the aetiology and management of psychiatric disorders. In the UK at least, social psychiatry as a discipline became clearly established and produced impressive studies on life events and their impact on phenomenology, attachment and other social factors. In the last two decades, it would appear that social psychiatry has transmogrified into cultural psychiatry. Kirmayer, in this chapter, maps out the history of cultural psychiatry as a discipline. In addition, he raises the concerns related to this discipline, especially related to universality of psychopathology and healing practices, development of diverse service needs to black and ethnic minority groups and analysis of psychiatric theory and practice as products of a particular cultural history. Culture has been defined as a civilizing process which, in European history, Kirmayer asserts, had to do with the transformations from migratory groups to agrarian societies to city states and, eventually, nation states. The definition of culture in this context was related to standards of refinement and sophistication. The second definition of culture has to do with collective identity, which is based on historical lineage, language, religion, genetics or ethnicity.