A Cultural Psychological Theory of Mental Illness, Supported by Research in Saudi Arabia

Abstract

This article proposes a theory of psychological disturbance (mental illness) as a cultural phenomenon. The theory is based on -and extends --the general cultural psychological theory of Vygotsky, Luria, and Leontiev, as well as the specific social approach to psychopathy of Fromm, Foucault, Laing, and Rieber. We demonstrate that the psychodynamics of individual disturbances are shaped by normative, macro cultural factors, such as gender norms, religious doctrine, family structure, architecture, and clothing. We illustrate this cultural psychological analysis of individual psychology with a case study of a 25 year old Saudi obsessive compulsive patient in Riyadh backed by 50 interviews with students about family relations in Saudi Arabia. We discuss the therapeutic and political implications of our cultural theory of psychological disturbance.Keywords: mental illness, cultural psychology, Saudi Arabia, Vygotsky, Saudi family, Islam, OCD, scrupulosity, macro cultural factors, hajib, gender, Leontiev, emotions, political, ideology, cross-cultural psychology, psychological anthropology 218 Ratner Introduction to Cultural PsychologyIn this paper, we draw upon the general cultural psychological perspective developed by Urie Bronfenbrenner, Vygotsky, Luria, A.N. Leontiev, and Carl Ratner, along with a specific cultural view of psychopathology articulated by Eric Fromm, Foucault, Laing, and Rieber, to provide a framework for a theory of psychological disturbance/mental illness. 1 We explain its scientific potential for comprehending mental illness, its therapeutic application, and its political potential for mitigating psychological distress.Bronfenbrenner conceptualized psychology as formed by a network of cultural factors. He conceptualized this network as a set of concentric circles with micro level interactions surrounded by meso-level factors, and ultimately by macro cultural factors which are social policies, overarching patterns of ideology and organization of the social institutions common to a particular culture or subculture. "Public policy is a part of the macro system determining the specific properties of exo-, meso-, and microsystems that occur at the level of everyday life and steer the course of behavior and development" (Bronfenbrenner, 1979, pp. 8-9; Ratner, 1991, pp. 172-178).In his article "Activity and Consciousness" (available online: http:// www.marxists.org/archive/leontev/works/1977/leon1977.htm)Leontiev (1977) says: "Despite all its diversity, all its special features, the activity[Tatigkeit] of the human individual is a system that obeys the system of relations of society. Outside these relations human activity does not exist.How it exists is determined by the forms and means of material and spiritual1 In this paper we use psychological disturbance interchangeably with the more widely used term mental illness. We are cognizant of the terminological difficulties of these terms and do not wish to address them here. We are using these terms non-technically to refer to the panoply of severe, ...

Effects of Parental Favoritism on Depression and Aggression in Saudi Arabian Adolescents

“…This pattern of sex-biased perception of parents has been observed in a sample of college students in the United States and Canada (Salmon et al, 2012), as well as in a sample of children and adults seen in a counseling clinic in the United States (Kiracofe & Kiracofe, 1990) and are in agreement with the findings of Ratner and El-Badwi (2011), who reported that Saudi boys perceived their mother as more compassionate than their father.…”

“…Ahmed et al (2010) reported that males in Saudi Arabia and Egypt perceived their mothers as being less accepting of sons than of daughters and felt they were closer to their fathers than to their mothers (Al-Rowais, Al-Faris, Mohammad, Al-Rukban, & Abdulghani, 2010). Findings in other studies with Arab populations (Sayid, 2000;Zaidan, 1990) do not support this observation; for example, Ratner and El-Badwi (2011) found that Saudi males believed that their mothers were more receptive and caring than their fathers.…”

“…It is possible that when a the child behaves with aggressiveness this causes parents' disfavoritism, yet, equally, it is possible that one parent adopts the other parent's point of view about, and behavior towards, the child. In the case of the parent-child relationship in Saudi Arabia, the mother may do what the father does, either to please him or because she values his judgment (Ratner & El-Badwi, 2011).…”

“…Therefore, wives obey their husbands, and accept and support the husband's dominant role in the family even when they do not agree with his decisions. Brothers control their sisters and monitor their behavior with the approval and encouragement of mothers (Ratner & El-Badwi, 2011). In this study I examined whether or not differences in family structure in Saudi Arabian and Western societies lead to different associations of parental favoritism, gender, and child outcomes.…”

Mental Health Care in Saudi Arabia: Past, Present and Future

“…If a family escort (mehrum) is present (i.e., father, mother, husband, sibling), a woman may meet with a male psychiatrist, psychologist, psychiatric social worker or counselor, although there may be no physical contact including hand-shaking. The expressions of mental illness are heavily influenced by every one of these religious and cultural factors, and approaches to mental health care must take them into account [85].…”