Jane Sternbach-- Response to Mental Illness

Jane Sternbach

4/30/12

Sociology of Globalization

Response to Globalization of Mental Illness

            These readings about mental illness clearly illustrate the ways in which some mental illnesses are socially constructed. The fact that a drug company can change an entire society’s perception of an “illness” to suit their capitalistic needs, shows that these are socially constructed phenomena.

            The chapter on Depression in Japan did a great job illustrating the ways in which American views of medicine and science can impact a society. During the section on the development of depression in Japanese society through out history, the author shows the different phases the disease went through; each theory going in an out of favor on the basis of science. I really liked the quote on the last page when one of his interviewees said, “Some people say that this relationship between the researchers and drug companies is a kind of prostitution. I agree” (p.248). How can we say that scientific proof is objectively true when there is clearly an agenda behind it?

            Another interesting aspect of the chapter was the reference to the DSM and whether the world’s psychiatry should be standardized by it. It is obvious to me that different culture experience things differently, and something that we call clearly pathological and disordered here in our culture, is considered just a way a being in another culture. However, the fact that the DSM is seen as transcendent of culture is a scary thought. Some proof that the DSM is definitely influenced by culture, and is not a completely objective tool, is that Homosexuality was listed as a disorder in it until 1986! Who knows what we will look back on as a ridiculous entry in the DSM in 26 years from now? This of course brings up the question of whether all mental illnesses are socially constructed or not. If not, where is the line drawn?

            Also, back to the standardization of the world, which can sometime be referred to as globalization, I think this chapter shows that a one-size-fits-all model is not really helpful to anyone but Western corporations. However, it is also clear that society can be made to fit such a model by these corporations, which reminds me of the Jihad vs. McWorld article. Is this chapter just an exemplification of McWorld?

            The chapter on anorexia was also very interesting but harder to wrap my head around. In the United States, there is a clear correlation between societal ideals of thinness and girls’ developing disordered eating to fit into that societal norm. The fact that the girls in Hong Kong were less likely to have been influenced by these western ideals, is proof that there is more than one reason for anorexia in the world. The girls that Lee was treating did not fit the DSM’s symptom checklist for anorexia, however, they were clearly starving themselves, which is the same basic thing that girls in the U.S. are doing. This, to me, is further proof that we should not standardize the world based at all, but especially not based on the DSM. This issue of labeling the phenomenon reminds me of the article we read about dowry murders and domestic violence. Two things that are the same thing, but across borders are given different labels and different connotations. There is no reason that we shouldn’t consider dowry murder domestic violence, and there is no reason that we shouldn’t consider what these girls in Hong Kong are doing anorexia (even if it doesn’t fit the checklist).

Thomas Schrader - Health and Globalization - 4/30/12

            These two chapters from “Crazy Like” tie in to my final paper topic on language, and how Western language is possibly redefining other cultures.  The author explains that it took more than fifty years for anorexia to be named, categorized, and popularized by Western mental health professionals. Similarly, when it comes to depression, there are critical differences how Japanese cultures define this concept, which they refer to as Yuutsu or ki ga fusagu.  These native terms refer more to bodily sensations, which differ drastically from home Westerners mainly define depression as a mental health issue.

            Initially, I was very troubled by the idea that the West may be actually responsible, in part for increases not only in the diagnoses of depression, but also in the actual cases of the disease just so they SSRI drug can be sold for profit. This drug has not even proven to be effective in most cases. Nonetheless, it has proven profitable. Accepting depression as a disease only came through heavy marketing tactics, ones that worked on both ordinary citizens and doctors’ perception. In some ways, it inspired people to see their doctors rather than rely on themselves or families to get better if something was actually wrong. With the rates of suicide in the region, this is definitely a good thing. But saying these people are “depressed” doesn’t hold much meaning under the cultural context. So cultural conception surrounding depression were able to be shifted over time, not necessarily to help people but to sell a basically ineffective drug. This is not so much surprise as the West has come to the rescue before in 1859 during the cholera epidemic, increasing the validity of Western science in this region.  Globalization of medical concepts has therefore created a constant worry “over the slightest changes in their health, and [have] consequently become more vulnerable to illness.” The author is basically saying that now that this dialogue has become ingrained, in part, to the public consciousness, it is increasing the levels of illness.

            What was most concerning was that the medicine has not even shown to work or even increases ones risk for suicidal thoughts. Once a society that was built on “affinity for states of sadness” and melancholy is now oversensitive to fears of a harmful disease. It is not to say that there was not already a high risk for suicide, depression, and death in Japan before this, but it has not helped. In the West, it is clear that we could not see why Japan would not benefit completely from our insistence on providing medical advice. Clearly, however, there is more about the culture we have yet to fully care to explore.

            Anorexia is another misunderstood medical condition. In the U.S. and other Western countries, it has been accepted as a result of harmful media messages and images which mostly women (though men too) have internalized. To a degree these images are assumed to make us become fat-phobic. For individuals who internalize this feeling to a more intense degree, eating disorders can form. The researcher the author discusses, however, noticed a very different symptoms cluster when it came to diagnosing anorexia in Hong Kong. Among the affected, the girls were not trying to obtain a certain image of beauty nor were they afraid of getting fat. That sort of meaning did not come through the interviews that were done. The culture they come from is not one that builds off this notion of beauty. Many of the girls weren’t even from cities but from more rural areas. Thus, Western media did not seem to be the defining factor that led these girls to anorexia. The girls knew what they were doing; they did not see themselves as fat. Again, it seems that cultural meanings are very different even when it seems that we are all talking about the same thing.

            What was sad was that this condition did not even have a name. This too, I feel, is harmful for these individuals. How do you diagnose a problem or talk to someone about a personal problem when it has no name, no meaning within their culture? From West, meaning was given but it was supplemented with certain false messages and causes as well. It didn’t translate over entirely clear.

            Hopefully, research like this is not completely ignored. Sensitivity must be included when trying to start a dialogue about such serious issues. The Western way is not the only way, that is for sure.

Monica Butler - 4-30 - Crazy Like Us

Monica Butler - 4-30 - Crazy Like Us 

The two chapters of Crazy Like Us both explored the psychological implications of eating disorders and depression in the context of local realities, culture, and globalization. Many of the observations written about summed up the influence of globalization on the world of psychiatry. Watters quotes Kirmayer’s concluding points that he made at the GlaxoSmithKline conference: “in constant transaction and transformation across boundaries of race, culture, class, and nation. In this context, it is important to recognize that psychiatry itself is part of an international subculture that imposes certain categories on the world that may not fit equally well everywhere and that never completely captures the illness experience and concerns of patients” (197). The cultural understanding of depression and anorexia can be transformed by the media messages and global messages that are implicated by cross-cultural relations. The capitalist driven pharmaceutical company can exploit this once they understand the cultural importance surrounding psychological diseases. Likewise, the takeover of Westernization through the media has dominated the research behind the cause of Anorexia. The local cultural implication of these diseases in the Eastern world have been blinded and, as a result, make it difficult for us to properly diagnose these diseases. 

To address the first chapter, The Rise of Anorexia is Hong Kong, Watters attempts to address the cultural atmosphere of Hong Kong and the political changes that have occurred and caused stress since the overturn of British rule. The women that Dr. Lee treats have symptoms of Anorexia that are much different than those of American girls. They do not see themselves as fat, they have less body dysmorphia, they are not often perfectionists, and they do no often come from more well-to-do circumstances. Lee found that more often than not, anorexia was a result of a recent emotional trauma. 

It is important to look at the local cultural implications that parallel the rise in the disease among young women in Hong Kong. With increasing globalization comes the penetration of western culture. During the 1990s emigration from China was common and the interdependence and support system of an extended family began to break down, causing a shift toward individualism. Which we characterize as a prevalent characteristic of the US and the West. These “local realities,” as Watters describes, and rapid social change have negative implications on the sanity of young girls in China. Could this be a cause for anorexia? The stress of growing up in a world of instability and the uncertainty of a future in the one of the World’s/the World’s most competitive countries? When describing the origin of anorexia Lee points out, "There may therefore be no true natural history of [anorexia nervosa], but rather a social history at a given time and place, a perspective which questions radically the biomedical assumption that there is a 'core problem' with [anorexia nervosa]." Lee attributes anorexia to a social problem entirely and continues to conclude that the Western suggestion that it is a “fear of fatness” is not possible in the cultural context of China. Fatness has never been something that has been viewed negatively in the culture. With the publicity surrounding the subject in 1994 came the sand storm of the media trying to decipher the disease. Calling upon Western research and Western reasoning without introducing cultural realities. In doing so they have brushed over the core-problems of the disease and make it more difficult to divulge into the psychological causes. It is important to explore the social contention behind the disease instead of allowing the Western ideals of the disease infiltrate the local research. 

Similarly the other chapter focused on another psychological disease, depression. Depression has been recognized as a disease in America since the post WWII era. However, in Japan, it has traditionally been more stigmatized. In Japanese culture there is more focus on understanding emotion on a less extroverted scale. Watters introduces a quote by Lock that helps better understand the emotional state of the Japanese experience. “Unlike anger and irritability, which both disrupt harmony and threaten the social order, sadness, grief, and melancholy are accepted as an inevitable part of human life and even welcomed at times for their symbolic value, as a reminder of the ephemeral nature of this world. An association between melancholy and the weather reinforces sad feelings as natural and unavoidable and hence as states not induced solely through human exchange” (212). I think this quote is important to understand how the Japanese emotional state is more directly related to the spirit, nature, and the human experience. It is less associated with the western explanations that lie in the precision of science. Because this is true, it was smart for GlaxoSmithKline to spend their money on researching the cultural experience of the Japanese culture. However, their intentions were not set out to cure the disease. Watters even concludes that the drugs may have caused more suicides, and it is questionable if they even work. If both GlaxoSmithKline and we understand that the experience of depression for each culture is different, wouldn’t that mean that the drugs would not be universal because the symptoms are not universal? Research into drugs that actually work must take into account the cultural problems and the neurological problems. “By applying a one-size-fits-all notion of depression around the world, Kirmayer argued, we run the risk of obscuring the social meaning and response the experience might be indicating” (196). As the first quote indicated (“in constant transaction and transformation across boundaries of race, culture, class, and nation. In this context, it is important to recognize that psychiatry itself is part of an international subculture that imposes certain categories on the world that may not fit equally well everywhere and that never completely captures the illness experience and concerns of patients” (197).)We cannot look at these diseases through a globalized eye. The effect of cultures is too important to ignore when analyzing mental diseases. 

Rachel Becker

Rachel Becker

April 30, 2012

Both of Ethan Watters' (2010) chapters for this week presented disorders that I thought I knew about and then made it clear that I didn't know nearly as much as I thought. It had honestly never occurred to me that Anorexia could present in more than one format. Calling it a disease suggests that its course will be the same for each person and in each case. And as for depression, I had never thought of the disease as something that people had to be convinced they had. For both of these disorders – how are symptoms and treatment different when there is no public conception of the disease? How is this informed by a global spread of information? And is this sharing of information helping more than it is harming?

Based on our earlier discussions on body alterations – both surgical and through products – it would not surprise me to hear that eating disorders were on the rise anywhere. Watters (2010) says that he saw an abundance of ads for “health care regimens” including cream to remove cellulite and pills to suppress appetites. It strikes me as incredibly misleading that these would be for health at all – both are totally normal aspects of the human body. So, right from the start it is clear that our conceptions of what it means to be healthy and what we want people to look like don't have people's best interests in mind. Advertisements that feature skeletal women are equally damaging. They send the message that you must resemble them in order to be famous, and of course people are famous are considered to be ideal. The average person obviously wants to emulate the idolized; that is why the celebrity endorsements are so important and influential.

Again, because I thought of Anorexia as a disease, I thought of it as concrete. When I was in high school one of my best friends was suffering from Anorexia and I, therefore, received a bit of a comprehensive education on the disease as she went through treatment/hospitalization. It seemed to me that the disease started from an internal struggle. I saw how information about the disease was discussed online and how that could easily become global. There are pro-ana websites where people could share tips and encourage each other to recover or continue dieting; it was all very competitive. Anorexia is a strange thing because it is both an individual struggle and something that a community has formed around. All anorexics have something in common, after all. Watters (2010) explains that Lee found the entire process to be incredibly addictive and found that he felt superior to other people; there is a level of control that can be very comforting and empowering. In the West, Anorexia provides an identity. This is an entirely different perspective than what Watters (2010) presents. In Hong Kong, prior to the highly publicized deaths that Watters (2010) discusses, Anorexia was an extremely isolated disease. Now, I suppose, that my conception of Anorexia has to include that this the basic sentiment of the disease – a physical feeling of blockage that is not necessarily related to a desire to be thin and that can exist entirely separately from a social discourse.

Watters (2010) cautions that in diagnosing a disease, we risk an increase in cases of it. The influence of the west is so great that our definitions carry over; we assume that what we write in the DSM will apply to all Americans, let alone the rest of the world. In diagnosing an illness, it is validated both for doctors and for patients. It creates a “feedback loop.” Watters (2010) also says that we have a limited number of symptoms to “choose” from when we are experiencing inner turmoil. He says, “When someone unconsciously latches onto a behavior in the symptom pool, he or she is doing so for a very specific reason: the person is taking troubling emotions and internal conflicts that are often indistinct or frustratingly beyond expression and distilling them into a symptom or behavior that is a culturally recognized symptom of suffering” (p. 32). Interestingly, when a symptom becomes too common as a sign of suffering, it tends to fade away. It isn't considered to be suffering in the same way if everyone has it. This made me think that maybe no one has Bulimia or Anorexia, but rather are enacting symptoms for a larger reason. This is a huge concept, and something that I am still grappling with. This article really challenged my preconceived notions of mental illness, especially when Watters (2010) pointed out that traits we consider sickness could have been revered in the past. This takes everything is relative to a new level.

The most interesting part of Watters' (2010) chapter on depression in Japan was the idea that depression had to be sold as a concept, let alone a disease that had to be treated. In the west, we spend a lot of time and money distancing ourselves from our bodies and our symptoms. You can take a pill for almost anything and we are incredibly trigger happy with prescriptions. This is now increasingly true in Japan as well. Watters (2010) says, though, that in the east, it is considered essential to feel sadness – it can make you a wiser person. Depression is not an easy illness to diagnose. There is, by definition, a fluidity and an abstraction to it. I wonder now if this is partly intentional so that the diagnosis, and then prescriptions, can apply to more people. Watters (2010) has made it abundantly clear that disease is a business. We would rather treat our symptoms individually than look at the greater picture. I am now wondering how much of the way our medical system is conducted and conceptualized has to do with profit over patient wellness. I would hypothesize that most of the system is designed without the patient in mind.

When discussing the route that the medicalization of depression took into Japan, the World War II disease of neurasthenia is the clear precursor. It was a disease of the elites, which means that the disease became “trendy.” It also means, as is the case with all things that affect the upper class, that the disease got more attention and more interest in treating it. Neurasthenia became Japan's “national disease” despite its Western origin very quickly (Watters 2010). This transition has not been nearly as smooth with current definitions of depression. Watters (2010) says that Japanese and Americans feel depression differently, and therefore talk about it differently. Should diseases that might manifest with different symptoms all fall under the umbrella of the same disease? This is true for Anorexia, too. If something can have such drastically different outputs, who is it helping to categorize them all together? It seems to me that it is only helping to over simplify and results in many intricacies being missed.

4/30 post

Greg Demetriou

I think Waters’s article is a perfect example of the importance of critically thinking about reality. In respect to depression, a one size fits all mentality will not serve all those affected by depression worldwide. This is 100 percent due to the fact that our social beings are products of society, and not of individual decisions. Waters articulates that different cultures feel different symptoms of depression. Specifically Waters explains, “In short, beliefs about the cause, symptomatology, and course of an illness such as depression tended to be self-fulfilling. Explanatory models created the culturally expected experience of the disease in the mind of the sufferer.” (pg. 195) As depression is explained as the manifestation of problems with society depression as a whole become a very complex diseases. That is to say, depression is unique in the fact that it is experienced with inexplicable frequency, and the symptoms present are unique to the individual. As the symptoms are unique to individuals they reflect a larger problem with some aspect of society. This truly complicates the disease for health care providers, especially compared to other diseases. If a person has a heart attack doctors can almost always derive the cause, and there is a standard medical protocol to go about treating that person. With depression the world standard or usual cannot exist because it is an individual experience. As is the case, a through comprehension of the larger society can help these professionals combat the symptoms of depression.

            In terms of globalization, I cannot help but feel that the western influence, specifically the American influence, is the source of an uprising in people with depression. I say this because the standard for depression in America is questionable at best. I am not saying that there are not people who legitimately have depression, and need medication to treat their symptoms. I am stating that the combination of a culture of instant gratification, and overt displays of its most deviant behaviors, prompts doctors to reach for the prescription pad with little to no hesitation. Waters explains, “Kirmayer documented how feelings and symptoms that an American doctor might categorize as depression are often viewed in other cultures as something of a  "moral compass," prompting both the individual and the group to search for the source of the social, spiritual, or moral discord.” (pg. 196) This direct testament to the ultra-liberal standard for depression in America must have an affect on people in other countries, especially because there is so much money to be made in the medication. I know this article talked about how the researchers at the particular drug company wanted input from people who understood society. But that was not so they could ultimately help patients. It was so they knew what symptoms with which their advertisements lead.

            Convincing people they are sick and then charging them an arm and a leg to treat them is exploitation. The problem is it is masked by doctors and is rooted on a legitimate health issue. When drug companies focus treatment on selling prescriptions instead of treating disease they develop an ability to control consumers. When Dr. Jonas Salk discovered the vaccine for polio he did not make any money off of it. He maintained that a discovery like that was for the betterment of all people and not for his individual economic benefit. I know that times have changed dramatically from that point in history, and ultimately these people making money off these drugs are geniuses. They were able to exploit the insecurities of a culture and sell them quick fix pills at an outrageous price. In a recent project I did on depression is found out that Prozac became the most popular drug in the world in about ten years. Again, I am not saying that there is not a legitimate need for anti-depressants. But it is impossible to not realize that some cases of depression are the products of societal influence then legitimate chemical imbalances in the brains of those on the medications. Waters coins the term “Cultural diversity of human suffering” (pg. 196) to explain that there is not a universal band-aid that can be placed on depression. The diversity to which he refers is the manifestation of problems with society. When reality is critically analyzed those problems do not seem as pressing as they once did. People all across the world are constantly weighed down by their problems. Instead of going to a doctor it might be more helpful to see which of those problems is apart of immediate reality and which are one projected by society.

            The issue of anorexia is complicated as a male. The most interesting quote I came across in the reading was when Waters explains, “It didn't take much reading between the lines, however, to perceive a high degree of confusion and ambivalence surrounding the issues of female body image, sexuality, youth, beauty, and aging.” (pg. 11) As I read these words I began to think about the recent media that I have consumed and what those pieces of media said about female body image. As I thought back I was interrupted by the realization that I could not remember a single thing about male body image messages. I realized that the most influential aspect of male privilege is the multiplicity of male body images projected through media and society. White males are seen many prestigious positions, and all those men are different shapes and sizes. When I see a male model I do not think to my self, “that’s what my body should look like.” The same is the case when seeing a professional athlete, or any other male who can be judged based on his body.

            The truly interesting aspect of the male, female body image paradox is that it is actually getting easier for males. As media progresses there are more and more limitations on what the media considers to be a beautiful female body image, and identity. Conversely, male representations in media are expanding. There are movies about the underachieving, out of shape, loser guy who ends up with a beautiful woman and lives happily ever after. It seems as though the more issues women face the less men have too. This ridiculous cycle needs to be broken through education. At the end of the article Waters explains, “Indeed he notes that he has lost four patients to the disease, two by starvation and two by suicide.” (pg. 60) The consequences of these body image issues are irrefutable horrible. The projection of media that has caused this pattern to develop cannot be blamed on one particular aspect of media because it is a culmination of repetitive tendencies. This very real pressure felt by these girls has to be combated with a thorough distinction between what is real and what is not. Even though female celebrities may look a certain way that body type is not real because no one but a celebrity can spend that much time on their body. I am not attempting to simplify the larger issue; I am stating that a healthy understanding of body image issues is the job of society. The problem is due to an onslaught of identical media, and the solution has to be just as pervasive as the source of the problem. 

Emotions and Illnesses

Allison Terlizzi

            The two chapters from Ethan Watters’ book, “Crazy Like Us” explored the globalization of psychological disorders, anorexia nervosa and depression. These disorders have manifested themselves in Western countries, and to understand the ways they are expressed on a global level, we have to look at them without using a Western lens. It is the cultural beliefs, practices, and influences within different social and historical contexts that have led to different psychological characteristics to be expressed in patients with these disorders even if two people across the globe have the same disorder.

            In “The Rise of Anorexia in Hong Kong”, Watters explores Dr. Sing Lee’s experience studying anorexia nervosa in patients in Hong Kong. What he found was that women were starving themselves for different reasons than exist in the West, and the disease also elicited different physiological responses in the body. Often, it occurred in lower class women who were low achievers and did not experience obsessing over food quantities and portions. In addition, they did not feel fear of being fat and losing weight was not a way for them to become more attractive (Watters, 18). For one of his patients named Jiao, she experienced a loss of love in her life, which contributed to the onset of anorexia. Many patients like Jiao experienced “the refusal to eat as a physical symptom: a literal blockage of [their] throats (26)”.

            Dr. Lee also said, “Mental illnesses do not exist independent of social and historical context (35)”. There is no natural history of the disease, but a social history at any time and place. Because anorexia was never declared as a legitimate disorder, there was a lack of research on the disease. There also was not very much public awareness of the disease, leading to its rarity (37). Charlene was another patient he studied who collapsed on the street due to organ failure because of anorexia. Her death symbolized the point in time when the public’s knowledge of the disease and their acceptance of it grew (44).  Lee determined that by 1977, fat phobia had become the most important reason for self-starvation to occur (50). This means there was a noticeable change in the expression of the disease that more closely matched Western expression. Thus, two groups emerged for research: the women with hysteria who had no desire to eat and women who conformed to the Western expression of the disease characterized by fat phobia. Watters says, “the women attracted to the disorder when there is exists a cultural template for the behavior inevitable far outnumber the women who come to food restriction on their own (51)”. This is important because once it had become culturally acceptable to be anorexic, women used the disease to manifest their feelings of unhappiness and anxiety for example, as a sort of vehicle for expression. It had become acceptable and increased in prevalence.

            Ultimately, the Western categories for the disease remain dominant and anorexia is rarely studied outside of this context. Before reading this article, I had assumed that women across the world had been influenced by Western standards of beauty, such as in the case of the Fijian women, and had developed eating disorders because of these same reasons. My main issue with this article is that I felt as though since the women in Hong Kong and American women refuse to eat for two different reasons, can we call their disorder the same name? What I mean by this is, if Chinese women reported the tightening of their esophagus and unsettling stomach which is clearly a physical feeling, and American women reject food because they don’t want to become fat which is an emotional feeling, how are they the same disorder? While anorexia will lead women in both countries to reject food and lose extreme amounts of weight, the causes of this are very different.

            In the chapter, “The Mega-Marketing of Depression in Japan”, Watters starts by discussing Dr. Lawrence Kirmayer’s experience at the International Consensus Group on Depression and Anxiety, a conference in Kyoto in 2000, the purpose of the conference being to find out what scholars knew about how cultures shape the illness experience (190). People in Japan had a completely different conception of what depression is compared to the West, making it unlikely that Japanese people will want to take a drug associated with this disorder. The Japanese describe depression differently than we do, calling it “a mental illness that was as chronic and devastating as schizophrenia (193)”. In order to market drugs to the Japanese, we first must the question of how the culture has shaped the illness itself. Then, through advertising, the public’s attitudes about the disease can be influenced.

            Kirmayer suggested that every culture has a type of experience that is in some way parallel to the Western conception of depression, defined as “a mental state and set of behaviors that relate to a loss of connectedness to others or a decline in social status or personal motivation (194)”. However, all cultures have their own unique expressions, descriptions, and understandings for these mental states (195). For the Japanese, because it wasn’t socially acceptable to have depression, people will be unwilling to categorize themselves as depressed and thus will not take treatment. The frequency of depression began to rise rapidly in Japan over the next few years after this was explained.

            The spread of mental illness in Japan started with neurasthenia, which included symptoms of insomnia, lack of concentration, eye fatigue and the feeling of a heavy pot being on one’s head (204). This disorder carried little social stigma and afflicted the “elites”, so it became trendy to have it. It was also depicted as a symptom of modernization and people who had it were considered to embody modernity. I thought this section of the article was most fascinating because when do we ever look at a mental disorder and consider it to be trendy? Being able to experience the effects of modernity in this case was a “problem” that needs “treatment” and if you have this problem, you are “cool”.

            One of the most surprising and important things about this reading was the discussion of how the Japanese and Americans were not only describing the symptoms of depression, but were feeling the symptoms in different ways. This alludes to the differences between how the Japanese and Americans conceived of the nature of the self.  While Americans experienced the self as isolated within the individual mind, the Japanese conceive of the self as less individualized and more connected, dependent on social and environmental contexts (211). This is a reason for why the symptoms of depression, and what people define depression as, are expressed differently in both cases.

            In the case of Oshimo, who died by hanging himself, the Japanese public remained split on whether suicide was a meaningful act with moral intent, or was an act of someone who was mentally ill (219).  This comes back to the denial of the Japanese to accept mental health disorders as a cause for concern and treatment.

            The Japanese have mega-marketed drugs to treat depression to appeal to people by saying they will become like Americans, but no conclusive scientific data has come out that has proved if these drugs work or not. Has Westernization caused the placebo effect to arise in the Japanese who take these medications because they want to become more modern?

Globalization of the American Psyche Maggie Nelsen

Globalization of the American Psyche

                Reading about the marketing of depression and thereby anti-depressant drugs in Japan demonstrated quite disturbingly the extent of the global capitalistic drive. Mega pharmaceutical corporations go as far as orchestrating and lavishly financing international conferences just to glean the best insight on their target consumer, in this case depressed Japanese (more like, how to convince the Japanese they are depressed enough to take their drug). I am no businesswoman, but while reading this I couldn’t understand why companies would waste serious money and energy to try and create a market that does not exist…Why not just go to a different region of the world where the population is respondent to anti-depressants? Trying to sell a product (which is already geared toward a minority population) to a nationality which has a strikingly different cultural conception of the products use and purpose seems like an illogical business plan. GlaxoSmithKline would practically be better off selling their product in Denmark (allegedly the world’s ‘happiest’ place). Nevertheless, pharmaceutical executives steamed ahead with the campaign. 

                Just as when we looked at domestic violence, women’s NGOs in Pakistan, and other feminist issues in India versus the US, while the same problems occur in both countries, solutions cannot be universally applied. Those readings from a couple weeks ago demonstrated the importance of cultural context and cultural relevancy to national issues; one cannot transport an issue, strip away the context and examine or equate it to a similar problem in another foreign country. That context is crucial to understanding the issue and alleviating the problem. These corporations are not just introducing a drug, but trying to impose a western perception of mental illness and psychology that is not familiar or resonating with the Japanese people.  This whole phenomenon makes the situation uneasy because it is a demonstration of western supremacy and imperialism, which at this point the Japanese especially are sick of.  Japan is known as a cultural importer—it has been for centuries; however, Japanese also has a historically subordinate relationship to the United States. Most Japanese are probably left with a bitter taste in their mouth so to speak, having mega corporations swoop in to impose new drugs and cultural perceptions on them.

                This article has definitely gained new relevancy in light of the Fukushima earthquake and nuclear power plant disaster just one year ago. After the earthquake, there was minor tension between the US and Japan over disputed mileage in which people should stay away from the power plant. (US government said 50 miles, Japanese said less). Americans also perceived the Japanese as ‘getting back up on their feet’ in no time because of the Japanese stereotypes of Japanese people being “emotionless”, “robotic”, capable, prideful, etc. Both these examples illustrate the cultural misconceptions the west still holds of Japan. Many Western reporters wrote of all the cases of PTSD which would flood the Japanese prefecture effected—yet the catastrophe, just over a year ago, demonstrated that the Japanese are still not familiar with or cultural respondent to the idea of “Post-Traumatic Stress” or the like. While this article seems to give the impression that the corporations were semi-successful in importing the idea of depression as a common aliment, the earthquake last year demonstrates otherwise.

                The findings of Dr. Lee in The Rise of Anorexia in Hong Kong, was startling and intriguing. His patients with eating disorders are clearly distinct from the western type. He found that these women, from the very young teen years to early middle age, understood the extent of their gauntly, unhealthy, bodies in danger—even more, they desired to gain weight/look healthier but just had no desire to eat. This is a far cry to say the least from anorexia in the West. In addition, the severity of weight loss among Lee’s Chinese patients is shockingly even worse. In the US, a 5’ 3’’ woman would be considered anorexic at 85, 90 pounds; one of Lee’s patients of the same height weighed an astonishing 48 pounds…Yet, Chinese and Hong Konger clinicians and doctors continue to diagnose these girls as suffering from Western media infiltration which demand skinny, beautiful, thin women. But this is clearly not the case, especially for many of the patients who hail from rural Chinese villages, which are less exposed to western media. Just as with depression in Japan, Lee testifies: “Mental illness, specifically anorexia, do not exist independent of the social and historical context…”(35). Lee urges that if doctors continue to talk about symptoms of anorexia and other similar illnesses (like depression) as universal, they will completely miss the real, more localized/cultural origins that actually cause these diseases in many people: “clinicians were adhering to a foreign diagnostic manual at the expense of understanding both the patient’s subjective experience and the cultural meaning specific to Hong Kong at that time. If they became blind to the local realities of their patients, he feared they would have no hope in treating them”(36). This is the key misunderstanding which is relevant to both depression in Japan and anorexia in Hong Kong and China. While I certainly agree with this recognition/analysis, I think Lee also has to tread carefully when examining cultural and historical factors which could foster and cause depression or starvation. It can be dangerous to look towards culture to rationalize why people are starving themselves or become depressed, at the risk of perpetuating cultural stereotypes of that country or people. That is the only thing which is not mentioned really in these two chapters which I think is important to keep in mind.

                

Bodies and Labor Post

Rachel Becker

April 23, 2012

Moodle Post – Sex Tourism

            Wonders and Michalowski (2001) serves as an excellent overview of sex tourism as a global practice.  They say that, “Cross-border tourism typically reverses this pattern [less advantaged people migrating to more developed countries in search of opportunity] as privileged bodies from industrialized nations cross into less developed ones in search of exotic pleasures and a little (highly controlled) danger” (Wonders and Michalowski 2001; p. 548).  In this way, migration is defined as an act for the less privileged.  They are allowed to work and to provide pleasure and comfort for others.  Tourists can afford to vacation, to take a break from their lives and purchase pleasure.  Because we are operating both under a culture of consumption and a culture of privilege, we feel entitled to this practice and to get as much of it as we feel we need.  We expect our needs to be fulfilled.  This raised the question for me of why anyone feels entitled to use anyone else for self-satisfaction, exotic or otherwise.  These tourists feel that they are being open minded and experiencing new things while really just validating their pre-existing beliefs.  It certainly has something to do with capitalism – sex tourists feel that they are paying for a service and that entitles them to appreciate it without shame.  In fact, Wonders and Michalowski (2001) point out that the “global sex industry is worth ‘at least $20 billion a year and probably many times that’” (p. 549).  That is the largest reason that little has been done to slow this practice. 

            Wonders and Michalowski (2001) quote other authors in writing about Thailand.  They say, “’Thailand is like a stage where men from around the world come to perform their role of male supremacy over women and their white supremacy over Thai people’” (p. 550).  In this way, not one but two forms of privilege are being enacted and taken advantage of – race and gender.  This blends nicely into Thomas Fuller’s (2010) article titled, “A Thai City of Sleaze Tries to Clean Up.”  Again, I have an issue with this title.  It may very well be a sleazy city, but it seems like horribly biased journalism to present that as the only option within the city.  Fuller (2010) writes, “If Las Vegas is Sin City, Pattaya is a bear hug from Lucifer himself” (p. 1).  There is nothing about that sentence that isn’t sensationalist and a massive generalization.  I also wondered who got to decide that it was a city of sleaze – that seems like a privileged position to be able to make that call.  And I was not surprised at all to find that it was US soldiers who took a quiet and beautiful fishing town and turned it into a city of depraved hedonism.  Still, though, it is foreigners who frequent this city and make their economy possible; it can’t come from within.  I found it particularly telling that the director of the Pattaya branch of that Thai tourism office was so blunt about this.  He said, “’You talk about sustainable development, how about prostitutes?  They have been around for a very long time,’ Mr. Niti said.  ‘We can’t close down the go-go bars.  It’s a free country.  Besides, it makes money’” (Fuller 2010; p. 3).  This raises a few questions.  Are we really to believe that nothing can be changed just because it has been existence for a long time?  And this may be a free country (is it?), but are these women free at all?  Are they free from disease and free to decide when they get pregnant?  I have no idea.  Lastly, this ties back into the Wonders and Michalowski (2001) article – why is this country so different from Amsterdam?

            I was very interested in the dichotomy explored in Davidson and Taylor’s “Fantasy Islands” between the sexualities of women of color and those of White women.  According to this article, they are often perceived as two entirely different entities.  Here, men of all races are thought to be acting on racial socializations that promote women of color as naturally sexual whereas White women are repressed.  At the same time, when White women aren’t quiet about what they want from a sexual partner, they are seen as demanding and too much work.  Davidson and Taylor say, “’With an increasingly active global feminist movement, male-controlled sexuality (or female passivity) appears to be an increasingly scarce resource’” (p. 454).  In this way, men looking to prostitutes is the fault of women again.  Here, the connotation is that they do not satisfy sexually and have in fact joined up in order to empower themselves and be hostile to men.  Women of color are viewed as the other in this situation and that is especially dangerous because it dehumanizes them and leaves them in an incredibly vulnerable situation.  At the same time, sex tourists often want affection from the women they are seeing and are paying for the illusion of desire.  It’s a weird disconnect between wanting totally aggressive, objective sex and wanting a connection with a person who you are not willing to treat as a person.  The women in Taylor’s (2006) article do something very similar when they want sex and to be made to feel attractive by much younger men who they are paying to flatter them.  These authors also raised the issue of sex tourists helping the women they hire by supporting them financially.  Although we see in the case of Pattaya that this industry was started by US soldiers and we are therefore responsible, these men that they are continuing to help these women to survive.  Again, they are merely paying for a service that they would be engaging in anyway because they are so primitive.  It is a very similar narrative between the female and the male sex tourists – how much agency can the people they are seeing really have?

            The idea of a nanny, especially a live-in one, has always been a little strange to me.  I understand that mothers need and deserve help with their children, but I wonder when a line is crossed and that person is more bonded to their child than they are.  An entirely other level is added to this when mothers leave the Philippines to raise children in other countries, leaving their children to be raised by poorer Filipino women.  Again, I understand that this could be the more reasonable financial decision, but how is this possibly a more reasonable solution?  What does this do to children?  To a mother’s bond with each set of children?  It all seems horribly confusing and upsetting.  I also thought Taylor’s (2006) point that, “in its commodification, the worth of reproductive labor declines in society… ‘When performed by mothers, we call this mothering… when performed by hired hands, we call it unskilled’” (p. 562).  Of course, this is to say that we give any value to mothering to begin with.  

Jane Sternbach-- Bodies and Labor

Jane Sternbach

4/23/12

Sociology of Globalization

Response to Bodies and Labor

            The theme of this week’s readings is clearly bodies: the commodification, exploitation, and globalization of them.  Each author discussed a different way in which globalization has impacted the movement, use, and availability of bodies around the world.

            Parrenas gave a description of the ways in which gender roles can effect globalization and the global economy. She discusses the way that women in more developed, postindustrial countries have the resources to pay someone (a female someone) else do the devalued reproductive labor, so that she has more time to be in the productive economy earning the money to pay the woman who raises her kids. These women who are doing the reproductive labor travel from all over the world, but Parrenas discusses Filipina women specifically, and leave their families, or reproductive labor responsibilities, in someone else’s hands. Basically if your family has enough money, then you have the right to be raised by someone, otherwise your mother is too busy raising someone else’s child. Something that I found interesting is that regardless of level of development or economic prosperity, societies all over the world expect that women do the double shift of working outside the home for a paycheck, and then working inside the home to keep it running. Parrenas says that in the United States, if a man makes less money than his wife, he is less likely to share the housework (p.568). This is what creates the demand for the migrant domestic workers. In other words, if we had more gender equality in the united states, and all over the world, it wouldn’t matter if your parents were rich or poor, you would be able to be raised and taken care of by someone in your family. Something that she doesn’t mention is the cultural implications of children being raised (at least in part) by women from other cultures. It would be interesting to find out if those children then grow up to do with their mothers did, and hire a migrant domestic worker, or if they are somehow socialized differently because of the cultural differences?

            Wonders and Michalowski discuss the ways the globalization has lead to the creation and expansion of sex tourism through out the world, but specifically in Amsterdam and Havana. The authors say that sex tourism arises from global forces and global connections. In their discussion of Amsterdam, something that I found interesting was the way that sex tourism was an industry, not just a few prostitutes employing themselves. I have been to Amsterdam and can say that that assessment is 100% correct. In certain parts of the city, you cannot walk down the street without being bombarded with offers to buy sex itself, or other sexual paraphernalia. I also thought it was interesting the majority of the prostitutes in Amsterdam are not from Amsterdam and the majority of their clients are not Dutch. So, the sex tourism industry is completely globalized to the point where it almost doesn’t matter that it’s in Amsterdam because the Dutch are pretty much uninvolved.

            Wonders and Michalowski’s discussion of the sex tourism trade in Havana was also very interesting. It was a nice contrast between the two places. Where Amsterdam has an overt sex industry, Havana has a subtle sex trade that in addition to commodifiying bodies, it also commodifies intimacy. It reminds me of an article I read for my Sex, Gender, and Society class about a town in the Dominican Republic where women from all over the country travel to to become a foreign businessman’s escort with the hope that he will eventually want to take her away from her home and marry her. These marriages would rarely happen, and when they did they wouldn’t work out because of the tremendous power differential inherent in the relationship.

            I found Taylor’s article the most interesting out of all of this week’s readings. It is not really news that women’s bodies are being commodified and sold to men to exert their power over. That scenario fits perfectly within the gender constructs that are prevalent throughout the world, and definitely commonplace in the United States. However, the idea that women are exerting their economic independence from men, and the power that comes from that, over men of color abroad makes sense but is still surprising. On the one hand it is good to see women taking control over their sexuality, and not just being passive reciepients of men’s sexuality. On the other hand, it is troubling that these white women are exploiting the poor, black men in the Caribbean. Exploitation in general is troubling, but with the long history of black men’s bodies being exploited, this phenomenon is particularly problematic.