"Hearing sounds" or "hallucinations", is a disease or a feature?
Western medicine believes that anyone who says he hears voices talking to him from an unknown source, usually suffers from psychosis, but this is not a result of everyone.
What can we learn those who deal with these hallucinations differently?
Imagine hearing votes, it is more common than you think. Studies that have been conducted for decades have shown that a large number of people who were not previously diagnosed with any psychological state - more than three quarters of the participants - suffer from hearing voices speaking to them from an unknown source.
In Western psychiatry, auditory hallucinations are one of the main symptoms of mental disorders, and for this the stigma that accompanies this type of mental health conditions is the frequency of some to publicly recognize the hearing of voices in their heads.
But some cultures accept these hallucinations, and even celebrate them, as they are seen as helping to preserve and guide people's safety.
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فكيف تتعامل الثقافات الأخرى مع الصحة النفسية؟ وهل يُمكن اعتبار الأشخاص الذين يعانون من سماع أصوات مجهولة، مختلفين؟
Tania Lorman, a professor of anthropology at Stanford University in the United States and author of the participating book, "Our most disturbing madness", says that the expectations formed by the culture, the environment and the people we grew up with affect whether or not people who suffer from hallucinations will be sick or not.
The diagnostic and statistical guide for mental disorders (DSM-5), which is the standard reference for diagnosing mental disorders in the United States, is listening to sounds as a major sign of schizophrenia.
However, in Western countries, some hallucinations are accepted more than others, as up to 80 percent of Americans and Europeans communicate with a vision, hearing, or a feeling of one of their deceased relatives.
In contrast, the tribes of the street in Ecuador are prohibited to imagine the missing family members, because they consider the visions, dreams and imaginations in which the deceased appears as a threat to the lives of the living.
Even sound hallucinations that are caused by eating an anesthetic substance vary according to different cultures. In the Amazon, the Seyna tribe believes that these hallucinations are an alternative experience, while the Al -Shawar tribe believes that daily life is and that the reality is what is seen during hallucinations.
People's personal response to hearing an internal voice can also be affected by culture. A comparison between psychiatric patients in the United States, Ghana and South India showed that the Americans were the most hateful of their internal voices, and they were usually unaware of the identity of the speaker.
While the patients in Chennai in India and Ukra in Ghana linked their internal voices to God or to family members sometimes, and they did not reject them according to the study conducted by Lorman.
More than half of the study participants from Chennai reported that they heard the voices of certain individuals from their families, and these voices provided them with practical advice and instructions for daily tasks, and were also present to reprimand.
These voices also asked the participants to go to stores, prepare food, and shower.
One of the participants said: "They speak like the elderly who advise young people," and another said: "This teaches me what I do not know."
For the participants in Chennai, the voices seemed more realistic, and only a few participants, they did not know the voice that addressed them, while some participants in Accra went further, and said that their inner voices had a positive impact.
"She commanded me to do right, if I had no sounds, I would have been dead for a long time."
However, the Americans were more likely to describe their voices as fictional, as one of the participating Americans said: "I don't think anything, I think it is just a way of thinking."
Some participants from Chennai talked about their fear of their voices, and that some voices may also be fun, which was not felt by any of the United States or Ghana.
Lorman says non -Western people are more likely to say that their minds are intertwined with others. For example, the Ghannans realize that they are associated with others through their relationships.
While many of the study participants acknowledged from Accra that hearing the sounds was one of the symptoms of mental disorder, but hearing these voices was more socially accepted, although Lorman adds that people in Ghana might hesitate to reveal their hearing of sounds because of the stigma that might bind them to magic.
Lorman says that some cultures accept, and even proud of people who suffer from hallucinations instead of considering them sick, and set an example of the people of Ghana, who considers hearing votes as a connection from God.
She adds: "In different parts of the world, some expect that they see the dead, speak to lives, and interact with the jinn."
While psychiatrists in the West during the twentieth century were trying to agree on how to define and diagnose various mental illnesses, anthropologists such as Ruth Benedict and Jin Murphy were recording how people who suffer from similar symptoms of acceptance and even honor in non -Western cultures were being dealt with.
For example, Murphy lived with the people of Esbia europa, a sub -group of native speakers from West Nigeria, where she noticed that they heard voices and trying to guide others to their source, although its source can only be the listener to know.
She pointed out that this seems relatively common between the people of Esbia europa, and neither disturbs the person who hears the voices nor who does not hear them.
Lorman says most cultures have words that express ideas that are transmitted from mind to mind. In English, we may say "risk", "magic" or "divine inspiration".
Lorman explains that human beings generally feel their ideas. But most of us are likely to have experiences that contradict this.
She adds: "Sometimes, we feel a strong dream as if he is conveying information from realism, sometimes, if you get angry with a person who is not with you in the room, and insults him, you may feel that this affects him."
Two personal characteristics, known as pores and indulgence, explain the reason for some people accepting external sounds and other phenomena.
The porous is a willingness to accept the possibility of external ideas into our minds.
At the same time, indulgence allows us to leave our real world and enter our imagination world, blurring the borders between our internal and external mental experience.
It is unlikely that people who enjoy a great deal of immediate indulgence are wondering about the truth of the experience, but rather they are more willing to ask what they may learn.
It may explain the willingness to accept voices and interact with them cultural differences in recovery from mental illness. In a study that compared the experiences of Nigerian and British schizophrenia, the British were more likely to hear abusive and aggressive sounds. In another research focused on Pakistani and British schizophrenia patients, the British were more likely to hear orders to kill themselves.
Some people feel their negative voices have medical consequences. Here, hearing the sound may become more dangerous and even be a disease.
In many studies, Americans were more likely to say that the voices he heard carried violent intentions. Some of the participants in the interviews told Lorman that their voices asked them to torture people and drink their blood, while others described voices calling them to fight.
Lorman notes that societal factors may explain this to some extent. The United States has a much higher armed violence rate compared to other countries. People with mental illness are more vulnerable to homelessness and their exposure to violence in the United States.
While working in an area of Chicago, which is the highest population density for schizophrenia patients in Illinois - outside prisons - Lorman began to feel curious about how culture affects people's experiences with psychosis.
Some people with psychosis live a mobile life, moving between different institutions and services such as prison, hospital, street, and shelter centers - and this pattern is referred to as the "institutional circle".
Lorman says they "hear voices telling them that people are watching them," she adds that "there are some people within this institutional circle they really chase them, make fun of them, and mock them."
The critical sounds are one of the most powerful indicators that lead to a clinical diagnosis with a psychotic disorder. Cultural differences may also affect how people recover from the disease.
In another study conducted on patients who hear voices in Chennai and a group of Montreal in Canada, they were followed over five years, it was found that Indian patients were more likely to choose to finish treatment after one year.
Indian patients also showed less negative symptoms, and they were more able to perform their functions in society, whether they are taking their medications or not.
Ashok Mala, a professor of psychiatry at McGill University in Montreal, notes that the concept of "the ability to perform a function in society" may be wider in India than in Canada, and therefore the ability to receive treatment was almost identical in terms of medications, condition management and cognitive behavioral therapy.
Mal explains that despite the effectiveness of antipsychotic drugs, they only partially contribute to treating symptoms of the disease.
"Anti -psychotic drugs are useful only in treating positive symptoms, which are symptoms that should not be present, such as delusions or hallucinations," according to Mal.
The negative symptoms are the absence of what should be present, such as emotional expression, the ability to generate ideas, and the ability to communicate socially with others.
The opposite is social withdrawal, lack of experience, feelings, etc. "The effect of medications on these symptoms is very little, if it is found," Mala says. In general, negative symptoms, such as a decrease in mood, respond badly to medications.
Mal notes that the social differences between India and Canada are somewhat explaining the difference in the success of treatments. For example, homelessness is less common among people with schizophrenia. This is due to the desire of families to keep mental illness within the family, so that any stigma associated with the presence of a family member with schizophrenia can be hidden.
And he confirms that marriage is a major concern for families, and that anything that may affect the possibility of children's marriage will be dealt with as a family.
Mala notes that families in Canada are interested in the care of their sons, daughters, siblings and sisters as much as they are in India. But he says that the legalization of communication with patients and his secrets may pose a problem.
He adds that the young man in North America can leave his house and cut off his contact more easily if he wants to. But this may lead to worse results.
Family interventions have proven effective in improving recovery from psychosis. "In Chennai, the patient rarely comes to the clinic without a member of his family. We assumed that this would lead to better results regarding negative symptoms. This is exactly what we found," says Mala.
As is the exact case between the definition of Western countries and the tribe of the street in Ecuador to communicate with the dead, what is considered a "natural" experience is strongly affected by our culture. When we look at how some people around the world celebrate those who hear voices, it may be more natural than we think.
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