Schisms In Schizophrenia

Stanford anthropologist Tanya Luhrmann investigates how culture affects people’s experience of schizophrenia:

[S]he interviewed adults with schizophrenia who live in three different places: Chennai, India, Accra, Ghana, and San Mateo, California. She asked each person to describe his or her auditory hallucinations—how many voices they heard, what the voices said, where they felt the voices were coming from.

Luhrmann found many similarities across the three cultures, but also some important differences. The people from Ghana and India generally found hearing voices to be a positive experience, describing the voices as benign and playful, involving sex, or as spiritual encounters. The 20 people interviewed in California expressed opposite sentiments, describing the voices as angry, hateful, noisy, and violent. One American subject described the voices as giving directions “like torturing people, to take their eye out with a fork, or cut someone’s head and drink their blood, really nasty stuff.”

The differences across cultures, Luhrmann argues, can be explained by several factors. In India and Ghana, people were more likely to hear what they thought of as voices of family members, while in the U.S., schizophrenics tended to regard the voices as strangers, which made them more threatening. She thinks this could reflect differences in family structure—extended families are tighter in Ghana and India than they are here, where we’re more likely to live alone.