Recovery From Schizophrenia: Psychiatry And Political Economy

166 SCHIZOPHRENIA IN THE THIRD WORLDwonder, can features of schizophrenia in the West be attributed to similartreatment?HIGH STATUS IN PSYCHOSISIt seems strange in retrospect that tuberculosis should have been such a romanticand genteel illness to eighteenth-and nineteenth-century society that people offashion chose to copy the consumptive appearance. 79 Equally curious, the featuresof psychosis in the Third World can, at times, lead to considerable elevation insocial status. In non-industrial cultures throughout the world, the hallucinationsand altered states of consciousness produced by psychosis, fasting, sleepdeprivation, social isolation and contemplation, and hallucinogenic drug use areoften a prerequisite for gaining shamanic power. 80 The psychotic features areinterpreted as an initiatory experience. For example, whereas poor Puerto Ricanswho go to a psychiatric clinic or insane asylum are likely to be highly stigmatizedas locos (madmen), people who suffer from schizophrenia who consult a spiritualistmay rise in status. Sociologists Lloyd Rogler and August Hollingshead report:“The spiritualist may announce to the sick person, his family, and friends that theafflicted person is endowed with facultades (psychic faculties), a matter of prestigeat this level of the social structure…” 81The study indicates that Puerto Ricans with schizophrenia who consultspiritualists may not only lose their symptoms, they may also achieve the status ofmediums themselves. So successful is the social reintegration of the male PuertoRicans with schizophrenia that, after some readjustment of family roles, theirwives found them more acceptable as husbands than did the wives of normal men.Similar folk beliefs exist in Turkey. Dr Orhan Ozturk, a psychiatrist in Ankara,writes:A person may be hallucinated or delusional, but as long as he is notdestructive or very unstable he may not be considered insane…. Such aperson may sometimes be considered to have a supernatural capacity forcommunication with the spirit world and may therefore be regarded withreverence and awe. 82Ruth Benedict tells us that Siberian shamans who dominate the life of theircommunitiesare individuals who by submission to the will of the spirits have been curedof a grievous illness…. Some, during the period of the call, are violentlyinsane for several years; others irresponsible to the point where they have tobe constantly watched lest they wander off in the snow and freeze todeath…. It is the shamanistic practice which constitutes their cure. 83