ARTICLEIn this issue of the South African Journal of Psychiatry, Hassim and Wagner offer an ambitious and far-reaching paper that surveys recent literature on 'culture' and 'psychopathology' . Their stated objective is to suggest ways in which culture can be 'incorporated into the applied utility of psychopathology formulation' , [1] a concern motivated by the increasingly accepted position that culture is central to psychiatric theory and practice.The authors derive a number of themes from the reviewed research: the importance of incorporating the cultural context into clinical practice; the various ways in which culture influences psychopathology; and the evolving (and, I must add, myriad) definitions of the concept of culture. It is the last theme, perhaps more than the others, that caught my attention: if we can't define our central terms, agree on what they mean or, at least, explicitly state how we intend to use them, then the utility of the investigation of cultural influences on psychopathology is undermined from the outset by the lack of conceptual clarity. The authors are clearly aware of this, as evidenced by a question they pose in the introduction to their paper: 'How … does one operationalise culture and psychopathology as constructs?' Owing to the central importance of this question, in this commentary I will be focusing on it, particularly on the concept of culture, and in the process will try to suggest answers to complement the authors' own.
'Culture'Culture is a complex and multifaceted concept. Not only is it a staple in several academic disciplines such as anthropology, sociology, and cultural studies, it is also common in the vernacular. In anthropology in particular, the concept is central and stands to the discipline in the way that 'power' stands to sociology or 'energy' to physics. Yet for all its importance, culture refuses to be pinned down within a narrow range of uses and definitions. In their famous survey of the concept, Kroeber and Kluckhon provided over 150 definitions of culture available at the time.[2] Neither do the problems of the concept stop at its impossible richness. Since the 1980s, critical voices within anthropology have rejected the way in which culture is used to 'essentialise, exoticise, and stereotype those whose ways of life are being described' , [3] with some voices calling for the abandonment of the concept and others, while aware of its problems, conceding that it cannot be erased from academic and social life.Given these issues, working with the concept of culture is bound to be difficult. Hassim and Wagner start the paper by endorsing a broadly semiotic definition of culture as a body of beliefs and symbols, [1] yet later appear to be using culture in a different sense. Statements such as 'all cultures experience psychopathology' and 'individuals from minority cultures' (note the plural), suggest a usage denoting groups or populations. These two senses of culture are distinct from each other and it is important that they are kept apart. As I will indicate,...