For Frank Russell, reinterpreting his schizophrenia as shamanism helped his symptoms.

http://nautil.us/issue/58/self/a-mental-disease-by-any-other-name-rp

A Mental Disease by Any Other Name
By Susie Neilson

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According to the World Health Organization, schizophrenia is universal. “So far, no society or culture anywhere in the world has been found free from … this puzzling illness,” states a 1997 report.

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Adding to the complexity, schizophrenia looks different across cultures.6, 7 Several studies by the World Health Organization have compared outcomes of schizophrenia in the U.S. and Western Europe with outcomes in developing nations like Ghana and India. After following patients for five years, researchers found that those in developing countries fared “considerably better” than those in the developed countries.8 In one study, nearly 37 percent of patients diagnosed with schizophrenia in developing countries were asymptomatic after two years, compared to only 15.5 percent in the U.S. and Europe. In India, about half of people diagnosed with schizophrenia are able to hold down jobs, compared to only 15 percent in the U.S.9

Many researchers have theorized that these counterintuitive findings stem from a key cultural difference: developing countries tend to be collectivistic or interdependent, meaning the predominant mindset is community-oriented.10, 11 Developed countries, on the other hand, are usually individualistic—autonomy and self-motivated achievement are considered the norm.

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one study of “sociocentric” differences between ethnic minority groups within the U.S. found results suggesting that “certain protective aspects of ethnic minority culture”—namely, the prevalence of two collectivist values, empathy and social competence—“result in a more benign symptomatic expression of schizophrenia.”

“Take a young man with schizophrenia who’s socially unable to engage,” Keshavan says. “In a collectivistic culture, he’s still able to survive in a joint family with a less fortunate brother or cousin … he’ll feel supported and contained. Whereas in a more individualistic society, he’ll feel let go, and not particularly included. For that reason, schizophrenia tends to be highly disabling [in individualistic countries].” Individualist cultures also “[diminish] motivation to acknowledge illness and seek help from others, whether from therapists or in clinics or residential programs.” notes Russell Schutt, a leading expert on the sociology of schizophrenia.

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Whether or not Frank’s psychosis would have made him a shaman in another time or place, three central factors are present in the Dagara tribal intervention (early intervention, community, and purpose) that parallel the three factors that Keshavan, Schutt, Rosenheck, and others cite as complements to pharmaceutical drugs: early intervention,16 community support, and employment. Dick had perhaps missed the boat on the Dagara initiation ceremony, but Malidoma advised Dick to incorporate other aspects of his approach into his son’s life, including rituals and other purposeful activities.

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