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American Anthropologist

[70, 19681

tween cultural factors and mental illness and with the native ideas concerning mental illness. Thus, the traditional concerns of culture-and-personality research (or, in Hsus phrase, of psychological anthropology) are redistributed in this scheme, some of them falling outside of it altogether. This is also seen in Bastides claim that each of these fields has its characteristic methods, statistics being the primary tool of sociology and the case history that of psychiatry, whereas anthropology is characterized by its concern with that which is different or other (a&ri16) (p. 60). Clearly, anthropologists have engaged in statistical work and in analyscs of life histories and not all their studies have concerned the other or exotic. The body of Bastides book is a broad survey of a large number of specific studies in the sociology of mental illness. Most of these were carried out by sociologists in the United States. They cover such broad categories as ecology and rural urban differences in regard to mental illness, ethnic and religious differences, and family structure and familial status. The review of this vast literature is compact, competent, and useful. However, as the author points out, the studies under review are highly specific and diverse, each with its own methodology and assurnptions. There are virtually no replications, and it is generally impossible to draw any conclusions from these microscopic investigations with reference to any larger macrocosm. While this approach characterizes American sociological research, it is not Socwlogie des maladies menlales. ROGER BASTIDE. unique to it, and in addition to some British studies, (Nouvelle Bibliothkque Scientifique.) Paris: some German and French studies under review show Flammarion, gditeur, 1965. 282 pp., 29 illustra- the same pattern. Part of the difficulty of producing generalizations tions and tables. 20 I?. (paper). from this scattering of small studies (une poussikre Rmewed by ERIKA BOWGUIGNON, ddtudes the author calls it) resides in the divergent The Ohio Slate University theoretical orientations of the researchers. Bastide The aim of this book is stated most clearly by the turns to Ruth Benedicts classic paper, Continuities author in the very last sentence of the volume: to and Discontinuities in Cultural Conditioning, to prove that insanity is essentially a social thing, suggest a resolution of one argument among students that therefore it is as much the subject of socio- of neurosis. He sees Benedicts approach as permitlogical analysis as of psychiatric analysis (p. 278). ting the development of a true theory which would The author begins his work hy assessing the present reconcile the difference between the psychoanalysts state of the growing interdisciplinary field known as who explain neurosis through infantile experience social psychiatry. He reviews its various definitions and those who see its sources in the structure of and finds them heterogeneous, diverse, and wanting. modern society. Benedicts thesis, he tells us (p. 217), He then proceeds to distinguish (pp. 14-19, and helps us to understand how the social effects are passim) three fields of study: (1) social psychiatry, added to the earlier effects of the family on the indithe science of the morbid social behavior of indi- vidual. Thus it is the discontinuities of modern viduals suffering from mental disorders (p. 14, society that bring about neurosis, whereas there are where psychiatrie speciale apparently should read continuities in many primitive societies and conhs psychiatrie sociale) ; (2) sociology of mental ill- sequently no neuroses. T i sweeping assertion goes ness, which is only interested in collectivities and indeed beyond Benedicts claim. To escape from the microsociology of empirical, groups (p. 15); and (3) ethnology of mental illness or ethnopsychiatry (p. 16). The latter is a field of statistical studies, Bastide proposes a structuralist ethnology and not of ethnopsychology, or abnormal study of mental illness, which takes its point of deethnopsychology, which, in its turn, is a field of parture with Durkheim (p. 229 ff.) and Mauss in the social psychiatry, as defined above. Ethnopsychia- concept of the symbol and which finds its elaboration try, in the authors view, deals with the relation be- in the work of LCvi-Strauss. I n the work of the latter little caution, the speculations of a psychoanalyst, Margolin, that the Utes [which band remains unspecified, and this one reference is incomplete], that most unhappy of all peoples (p. 298), now suffer more frequently from neurosis than any other human group because they are unable on the reservation to discharge the Iextreme aggressiveness that was bred into them by eztreme selection pressure . . during the comparatively few centuries when the Prairie Indians led a wild life consisting almost entirely of war and raids (p. 244). If Margolin and Lorenz had looked a t neuroses in a variety of other modern Indians, including some from traditionally more peaceful groups, and also a t the often shameful history of White contact, they might be less impressed by the biological factor in the Utes troubles. Excesses like this in Lorenz are easy for an anthropologist to pick at, but they do not necessarily invalidate his basic thesis about the instinctive nature of human aggression. If Lorenz, as I believe, is basically right, anthropologists must renounce the position of cultural relativity that some cultures have aggression and others do not-or not much. Our task then becomes rather to see how the aggressive instinct is channeled in the life cycle, even in outwardly peaceful societies. This view will not meet universal immediate acceptance, but Lorenz would probably cite the fury of his critics as further proof of the correctness of his thesis.

Book Reviews
he finds the suggestion for a study of the interrelationship between the normal and the pathologic within organized wholes (p. 232). This refers both to the symbolic activity involved in mental illness and to the place of the deviant within the social system. Thus the mentally ill may be considered as providing a synthesis, a middle term, between the contradictory elements of the system (p. 251); a middle term which is required by the dualism of structural analysis. The role of the sociology of mental illness . . consists in emphasizing this third term, that is, to relate the madman and those who treat him to the total field which defines both the criteria of madness and those of recovery (p. 256). Since collective consensus defines the madman and his recovery, this appears to be a strong statement of cultural and social relativity of the normal and the abnormal, yet elsewhere (pp. 78-79) Bastide sides with Devereux against Benedict on this issue. In summary, modern science is seen as having made three contributions to the sociology of mental illness, two of which come from structuralism and one from both history and ethnology. Structuralism, in addition to viewing insanity and the insane as part of a social system, also provides a concern with formal qualities rather than an emphasis on content. Here, however, Bastide finds a difficulty in the manipulation of metalanguages by the insane and in the retreat by schizophrenics into silence and gesture language, which structuralism has not yet learned to treat. The contribution of history and ethnology is seen in the variability, which it reports, of illnesses in relation to myths and beliefs, so that delirium and delusion may be seen as integral parts of collective representations (p. 263). The book is rich in allusions, suggestions, and leads, in addition to its extensive review of the literature, and only an indication of this wealth of materials has been possible here. A bibliography and an index, in addition to the large number of footnotes, would have been helpful.


methodological adequacy of the various studies ranges from the journalistic reports of, as Dr. Leighton would have it, itinerant psychiatrists to the thoroughly reasoned and carefully validated work of full-time, field-studying scientists. Murphy, Leighton, and their collaborators assume that there are universally occurring forms of deviance, especially the mentally deficient, those persons who indiscriminately kill others, those who behave with uncontrollable excitement, and those who evidence severe senile deterioration. The authors give a very clear and relatively unequivocal Western classification of the diagnostic clustering of symptoms that would seem to be usable in almost any culture. For the evaluation of the more culturally determined and situationally responsive psychoneurotic and psychophysiological reactions, a screening instrument utilizing basic questions regarding health and subjective feelings and perceptions of bodyfunctioning is used in some of the reported studies. Edward Thomas, in his discussion on the use of physiologic indicators to detect psychiatric disorder, points out that emotions are symbolically organized physiologic reactions which respond frequently to stimuli from a psycho-social-cultural environment. Hence it should be possible, using certain intervening variables, to arrive at a correlation between the presence of such stimuli and the existence of what is conceptualized as individual psychiatric disorder. Thomas also offers a provocative suggestion for the use of blood serum pooling techniques to assess physiologically the emotional state of a social class or other definable group in a society. One of the basic and significant themes of the Murphy and Leighton work is the correlation across cultures between psychiatric disorder and sociocultural disintegration, rapid acculturation and low socioeconomic position. I n general this correlation seems to hold particularly for those psychiatric problems diagnostically labelled as personality or character disturbance, psychoneurotic and psyMagic, Faith, and Healing: Studies in Prirnitiuc chosomatic reactions. But this is precisely the area Psychiatry Today. ARI KIEV, ed. Foreword by where the orthodox disease model may have to be Jerome D. Frank. New York: The Free Press of altered drastically by social decision, not only beGlencoe (Macmillan), 1964. xvii, 475 pp., chapter cause it may be an illogical and misleading connotes, figures, index. $7.95. ceptualization of deviance, but also because the Approaches lo Cross-Cultural Psychiatry. JANE M. effective therapeutic response to such deviance is eds. not medical psychiatric treatment but intelligently MURPHYand ALEXANDER H. LEIGHTON, Ithaca: Cornell University Press, 1965. xxvi, 406 informed social and political action. I n fact, my only quarrel with the scholarly pp., biographical notes on contributors, 2 charts, thoroughness and comprehensive adequacy of 5 figures, index, 8 tables. $9.75. Leightons work is the implicit and explicit adReviewed by EDWARD STAINBROOK, herence to a disease model of psychiatrically-defined University of Southern California deviance. Ari Kievs compilation of studies on what he The collected diverse contributions in these two books attempt to apply Western psychiatric theory suggests is folk psychiatry is a widely-sampling and epidemiologic methods to an assessment of report on psychiatric theory or practice in many psychiatric disorder and treatment in several differ- societies. The confessional practice of American ent preindustrial societies. The theoretical and Indians, magic healing in Central India, psychiatric