Our Most Troubling Madness

Schizophrenia has long puzzled researchers in the fields of psychiatric medicine and anthropology.  Why is it that the rates of developing schizophrenia—long the poster child for the biomedical model of psychiatric illness—are low in some countries and higher in others? And why do migrants to Western countries find that they are at higher risk for this disease after they arrive? T. M. Luhrmann and Jocelyn Marrow argue that the root causes of schizophrenia are not only biological, but also sociocultural.
 
This book gives an intimate, personal account of those living with serious psychotic disorder in the United States, India, Africa, and Southeast Asia. It introduces the notion that social defeat—the physical or symbolic defeat of one person by another—is a core mechanism in the increased risk for psychotic illness. Furthermore, “care-as-usual” treatment as it occurs in the United States actually increases the likelihood of social defeat, while “care-as-usual” treatment in a country like India diminishes it.

Schizophrenia has long puzzled researchers in the fields of psychiatric medicine and anthropology.  Why is it that the rates of developing schizophrenia—long the poster child for the biomedical model of psychiatric illness—are low in some countries and higher in others? And why do migrants to Western countries find that they are at higher risk for this disease after they arrive? T. M. Luhrmann and Jocelyn Marrow argue that the root causes of schizophrenia are not only biological, but also sociocultural.
 
This book gives an intimate, personal account of those living with serious psychotic disorder in the United States, India, Africa, and Southeast Asia. It introduces the notion that social defeat—the physical or symbolic defeat of one person by another—is a core mechanism in the increased risk for psychotic illness. Furthermore, “care-as-usual” treatment as it occurs in the United States actually increases the likelihood of social defeat, while “care-as-usual” treatment in a country like India diminishes it.

List of Illustrations
Foreword - Kim Hopper
Acknowledgments
Introduction - T. M. Luhrmann

1. “I’m Schizophrenic!”: How Diagnosis Can Change Identity in the United States - T. M. Luhrmann 2. Diagnostic Neutrality in Psychiatric Treatment in North India - Amy June Sousa
3. Vulnerable Transitions in a World of Kin: In the Shadow of Good Wifeliness in North India - Jocelyn Marrow
4. Work and Respect in Chennai - Giulia Mazza
5. Racism and Immigration: An African-Caribbean Woman in London - Johanne Eliacin
6. Voices That Are More Benign: The Experience of Auditory Hallucinations in Chennai - T. M. Luhrmann and R. Padmavati
7. Demonic Voices: One Man’s Experience of God, Witches, and Psychosis in Accra, Ghana - Damien Droney
8. Madness Experienced as Faith: Temple Healing in North India - Anubha Sood
9. Faith Interpreted as Madness: Religion, Poverty, and Psychiatry in the Life of a Romanian Woman - Jack R. Friedman 10. The Culture of the Institutional Circuit in the United States - T. M. Luhrmann
11. Return to Baseline: A Woman with Acute-Onset, Non-affective Remitting Psychosis in Thailand - Julia Cassaniti
12. A Fragile Recovery in the United States - Neely A. L. Myers

Conclusion - Jocelyn Marrow and T. M. Luhrmann
Notes
Bibliography
Contributors
Index