Insanity, Difference, and Cross-Cultural Psychiatry

Indirect rule complicated the problem. This system of government, rarely practiced in actuality, theorized that the best form of colonial rule was to allow the "natives" to govern themselves except insofar as certain customs were repugnant to the mores of European culture and religion. Under such rule, colonial psychiatrists were constantly at pains to define and redefine "customs" and figure out what were "deviations" from the norm. Under such a system, "the mad could only be defined by close reference to the particular norms and customs of a 'tribal' group" (Vaughan, 102). So how would you decide, for instance, when a particular murder was criminally inspired or simply the result of insanity?

This distinguishing between "types" of delusion seems short-sighted on the part of the colonial officials. (Although of course, it is always easy with hindsight to point out the mistakes of others.) Madness does not occur in a vacuum. Rather, it occurs at a particular time in history, in a particular political and social context. People who suffer from mental illness will have delusions according to when and where they live and the ideas that are familiar to them. An individual who grows up educated in a classical Western style, no matter whether he or she is Indian or African or American or British, might possibly have delusions involving, say, Hamlet. An individual who has never heard of Hamlet could not possibly have delusions involving him.

"'[D]elusions' must be contextualized politically," argues Jonathan Sadowsky. "For delusions are not formed at random." Sadowsky presents Isaac O. as a case in point. Isaac O., an asylum patient in Nigeria, was institutionalized after he stripped himself of clothing, believed he was a police officer, and attacked a couple of people, apparently randomly. At one point, he stated that he had "purchased a motor car for a million pounds." This last relatively minor point, says Sadowsky, is significant because it shows how he "appropriated two prominent symbols of British power and encroachment (money and cars) at one stroke" (90).

But it's important not to simplify the psychiatric practices, theories, and processes that occurred in Africa. Some psychiatrists did try to explain the different "forms" of madness through the theory of "acculturation."

This theory attributed the rise in madness to Africans' confusion over the clash of cultures. Certain illnesses could be explained by the stresses of African "tribal" customs. However, others could be explained by the strains and

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