The following was written back in May of 2010 for a course in Medical Anthropology.
America Through Medical Anthropology
American Culture-Bound Syndromes
A perspective that does not acknowledge that culturally bound syndromes exist in America would be one that does not understand how influential the environment is on one’s health. Using the holistic perspective that does not delineate between the cultural environment, psychological functioning, physiological processes, and the individual’s experienced state of well-being, one could justify that all illness and disease are culturally bound to one degree or another.
The eating disorders that plague many of the young American women today can be seen as direct manifestations of the cultural pressures that are put upon these young women. The unnaturally thin body image that the American culture projects through its media, results in an unnaturally distorted perspective about body image in young female (young males as well) American’s minds. America does not have a monopoly on these eating disorders but there are cultures that do not have this type of health problem.
Taking a closer look at the eating disorder of anorexia nervosa the self-destructive nature of this culture-bound syndrome becomes very concerning. The cultural pressures surrounding body image convince these young women that they will be beautiful only if they are extremely thin and it seems that they never achieve the desired thinness. The reality that these projected cultural beliefs can be embodied and taken to their absolute extreme is an example of how a culture can be manifested into a maladaptive physical form.
Examining the potential symbolic meanings that underlie this culturally constructed disorder is disturbing to say the least. At the cultural level, the body image that is being projected to these young women is arguably an unhealthy example that is a statement of conditional love. These young women are being told that they must be on the verge of starvation and be willing to inflict an almost masochistic lifestyle upon themselves to fit into the mold of beauty that is being presented. Is this some kind of twisted patriarchal oppression on the future mothers of America? This self-destructive message that these young women are embodying is symbolic of a self-destructive culture that is abusing its maternal power and source of reproduction. The underlying message of conditional love, which is the motivator and enabler for this extremely destructive syndrome to be expressed at the physical level, is a product of a culture that is lost in the stuff that holds its material world together. The skin and bones of these abused women’s physiques represent a culture that is wasting away from within because of its beliefs.
Deviant Behavior – When Normal Is Dysfunctional
A society’s perspective on sanity, deviance, and insanity could be summarized as a graded scale of going along or not going along with the status quo that has been set by its cultural institutions. To truly examine what is sane behavior in any context, it is important to acknowledge that reality is a socially constructed realm that is experienced psychologically different due to its subjective nature. What do we consider sanity, deviance, and insanity here in America? I find some of the potential answers to this question extremely revealing, honestly disturbing, and symbolically representing humanity’s condition of struggle.
Analyzing what is considered normal in this American cultural context can be a powerful baseline of comparison when trying to establish what is not normal. The normalcy of this consumer driven materialistic society suggests that the locus of orientation for its members lies without the individual. That is, the source of purpose, identity, emotions, and thus reality exists outside of the person. This misidentified master frame of reference is at the root of the social structures and cultural themes that quantify what is normal and what is abnormal here in America.
If it is possible to step back from the American reality and observe the cultural institutions that are maintaining the external locus of orientation, one starts to see fundamental contradictions within what is considered sane, deviant, and insane. American capitalism and individualism appear to be some of the driving forces within this contradiction of norms. Take the corporate elite of Wall Street for example, on one side they represent the ultimate level of success within this free market society, they have worked their way to the top. On the other side of this virtual reality of contradiction they represent a neurotic hoarder that has lost touch with reality and does not know when enough is enough. Since they are hoarding the holy American dollar within a societal structure that could be called the religion of capitalism, it is perceived by the masses as being more socially acceptable. In this example the cultural themes of capitalism and individualism have not only distorted the psychological perspectives of these elite they have distorted the social norms that these elite function within. If America were more of an egalitarian society, which valued the health of the society’s members more than the individual, this type of behavior would be viewed as one of the highest crimes and definitely a form of insanity. I am sure that the DSM does not have a code for the culture-specific psychoses that could be classified as the American-greed syndrome because that would suggest a level of self-reflectivity that this culture does not own.
Holding individualism up to the light it becomes apparent that this fundamental institution of the American culture has deep roots within the collective American psychoses. The very stigma associated with being a weak individual that needs help, perpetuates and exacerbates the mental illness that has blanketed our society. When the misidentification of the locus of orientation is coupled with this culturally self-imposed barrier to mental well-being, it becomes very obvious that this American culture is insane by its very design. Unfortunately there is a strong self-fulfilling loop of feedback between the cultural themes that support the cultural institutions and the psychological functioning of the societal members that co-creates this state of collective mental illness. In my mind the real question is - what is it going to take to wake up the masses to the delusion of reality that is being experienced and called normal? Unfortunately, or fortunately depending one’s perspective, I believe it will take some form of creative destruction to break the possessive spell (the American schema) that individualism and capitalism has cast upon this rich society that is full of suffering.
Medical Pluralism – The Healing Power of Choice
Medical Pluralism is growing stronger within the diverse and multicultural American free market of medicine. Just as personal beliefs affect how an individual views their illness they also affect what type of healer to seek out for help with their healing. For example, an individual’s religious beliefs can be instrumental in the type of medical system that they ascribe to and utilize. Does the individual believe that the source of healing is within themselves or without themselves? The potential answers to this question can be viewed as forks in the road that lead to very different types of treatments and outcomes.
The power and central role of one’s beliefs with regards to healing, becomes a strong factor in the choices of the techniques that will be employed by the individual. The more heterogeneous a society is the more medical pluralism will need to exist within it to accommodate the different cultural themes. It is interesting to look at medical pluralism as a natural form of a culture’s adaptation to its internal changes from external sources (e.g. immigrants from foreign cultures importing their beliefs). With this example, the level of medical pluralism that exists within a heterogeneous society would indicate how open the culture is to change and its willingness to adapt to its new members.
The American cultural institution of medicine that is predominantly of the biomedical type has been ethnocentric to the other healing modalities that are trying to coexist with biomedicine. The oppression that has accompanied this ethnocentric cultural institution is symbolic of the oppressive nature of the American majority on the different minorities. The social tensions that arise from any type of oppression can lead to healthy social changes. It is in the best interest of the American cultural institution of medicine to open up more willingly to medical pluralism. In a nation that is becoming more culturally diverse it would be a wise choice of adaptation.
Health Insurance and The Cultural Institution of Insurance
The cultural institution of health insurance here in America could be viewed as a culturally bound syndrome of societal insecurity. Before examining health insurance specifically, I think a collective analysis of the master frame of reference that has created the ideology of insurance is in order. At the root of the American insurance industry is the ideology of amassing wealth, which is born from the psychological state of anxiety and worrying about the unknown future. The denial of the present moment as being the fertile ground where solutions are created for the future’s problems is the ideology that enables insurance to exist. This materialistic culture that views all things as being the locus of reality, has to rely on external forces such as health insurance for its well-being. In a perverse way health insurance is how this society proactively approaches its health; health is viewed as a commodity and therefore paying into health insurance is paying forward into one’s state of health.
One cannot separate the dysfunctional state of the health care industry from the existence of the health insurance industry. Has the health care system become overly dependent on the use of high-tech treatments and procedures because of the deep purse of health insurance? Insurance is very similar to a lottery; this is an interesting aspect of insurance to examine with regards to its relationship to the health care system. It is also critical to acknowledge the underlying influence of tort liability within the industry of health insurance. The reality of hitting it big through the American legal system has a dirty hand that is pulling many of the strings that are causing the high costs of health care and thus health insurance. Without the concentration of financial resources that health insurance creates the health care industry could not operate at its current level of financial reward. The cost of health insurance is dependent on the cost of health care and the cost of health care is dependent on the cost of health insurance; this self-fulfilling loop that enables continually increasing costs is creating more wealth within our society but at what cost, out health?
The commodification of the human being within this culture and the world at large has manifested into health care being about profits and not about healing or well-being. This disturbing factor of the reality that this commercialized culture has created is not only antithetical to the real well-being of its society it is the cultural schema that writes the disturbing script of the play that is American illness. As long as the members of this society look outside themselves for the locus of well-being it does not matter if every one of them has unlimited access to health care through health insurance, the society will become increasingly ill.
Reeducation is the key to breaking down the barrier that is keeping this system of health care and its system of insurance in a treatment-centered mode as opposed to a more desirable prevention-centered one. This reeducation process must happen at all levels of the system and especially within the institution of medical education. This reeducation process that is required before our system of health care can become a holistic system of well-being, is a radical change in the current curricula. This new curricula must address the importance of social relations on one’s state of well-being; we cannot be healthy without healthy social relations. There is an even bigger barrier to the realization of this needed reeducation process within the American culture, socioeconomic inequality and the elite separatist ideologies that have created the environment of social stratification.
America’s Culture of Drugs – Good Drugs vs. Bad Drugs
When examining the state of drugs in America the catch phrase of “drugs and alcohol” comes to mind. These three simple words that make up a common sound bite of American linguistics, speaks volumes about the cultural significance of how drugs are viewed in America. What makes one drug legal and another illegal? Are all legal drugs socially acceptable and all illegal drugs socially taboo? The answers to these questions get at the complexity of the relationship between a society and the culture that it functions within, but the short answer would have to be – money. Legal drugs are those that support the structure of capitalism and its manufacturing processes. Illegal drugs are those that are not so easily managed through the institution of capitalism and potentially have a foreign element to their usage. These statements are obviously oversimplifications, but they do get at some of the truths behind this complex issue.
Examining the social considerations behind what makes a drug good or evil within our culture is partly veiled with the health-care industry’s version of what is considered medicine and what is considered recreational drug use. If a drug has medicinal properties or more importantly marketable properties, it is labeled medicine and if not it is labeled as a hard drug that is a part of the deviant, undesirable, and evil aspects of our society.
Drugs and humans have a long-standing relationship and drugs possess a large amount of political power within human societies. One needs to look no further than how America has treated marijuana, cocaine, and alcohol to see how politically powerful drugs are and how the power is wielded by the elite and those that follow their leadership. Cocaine and marijuana are classic examples of how drugs that have legitimate medicinal properties have been used as political tools against ethnic groups like African Americans and Mexican Americans. The image of these drugs was purposefully tarnished, to in turn tarnish the image of these ethnic minorities. This overt use of drugs in the American cultural institution of racism is not the only reason to illegalize these drugs; the war on drugs is big business! That is, a drug does not need to be made legal for the system of powers to profit off its existence. Just maybe, it is more profitable for some drugs to be the sacrificial lamb of society’s guilt over being a bunch of drug addicts?
In a society that believes in the existence of good and evil and the need for a villain in order for the followers of the status quo to feel like the hero, some drugs must be thrown under the bus for the greater good. It is interesting and fruitful to link this topic with the general mental health of America; the stigma of treating mental illness through medication is implicitly done through the self-medication ritual of consuming alcohol that is performed in bars and lounges across America. Medication in this country is not about healing or wellness, it is about the money and social control.
The following was written in November of 2009 for an anthropology course on American Culture.
The American medical industry is one of the largest and, currently, most debated cultural institutions of America. In 2000, the World Health Organization ranked the health system of the U.S. as number thirty-seven out of its nearly two hundred member states. It is very interesting and concerning that America, who is one of the world’s richest industrialized countries, is not near the top of the world’s health statistics. Why is this so? The American Academy of Family Physicians reports that two-thirds of all office visits to family physicians are due to stress-related symptoms. Considering that visits to family physicians make up one-forth of all office visits in America, this is a profound statistic. Could one reason be the general anxiety associated with health in this culture? Or is the unhealthy state of Americans simply a reflection of an unhealthy culture? I see two of the main root causes of this unhealthy state, being individualism and capitalism. My real concern about this cultural institution is the very paradigm on which it is based. The biomedical model of medicine is generally based on the assumption that we are biological machines that achieve a state of health by the manipulation from external forces. This materialistic ideology is one of the themes that can be read through the cultural text that is the American medical industry. The emerging biopsychosocial medical model is one that is based on the complex relationships between the body, mind, and society. This model challenges the very basis of American medicine and possibly the American culture at large. The purpose of this paper is not to criticize American medicine, but rather to look at the cultural beliefs that have created it and support it.
Looking at the current state of American medicine one should not be surprised that it is in the dismal state that it is. Americans have long been in the habit of throwing money at problems and expecting them to go away. Why should the problem of being sick, be any different? This band-aid approach to medicine appears to have a couple of main roots holding it in place, one of which is the general superficial nature of the material world and consumerism. The strong ideals of form, that permeate the American culture bolsters this ideology and approach. There is a polar difference between curing a disease and healing its cause. The external locus of the biomedical model primarily reacts to the signs and symptoms of disease. This shallow perspective on medicine is not capable of creating health, only fighting disease.
If one looks at the American medical industry as a cultural text the linguistics that are used tell a story of aggression and hate. There is a war against disease in this culture that is being waged in the name of conquering all! This ideology appears to be a remnant of imperialism and frontierism. The belief that one can kill a disease or wipe out an infection, speaks volumes about this culture’s world schema. If it cannot be bought, just kill it! The habits of the heart of the American culture are coming out loud and clear here. There is more belief in the destructive power of violence than in the healing power of love.
The American medical industry is addicted to technology. Its foundation is built upon it. There is a very interesting relationship that appears to be between the technology and the medical industry. Technology could be likened to the golden chains of this industry. The glorious shiny gadgets of technology do not only restrict medicine in this culture, they blind it. The ridiculously high cost of medical technology does not make for a healthier population but rather limits the population’s access to health care. Another aspect of the restricting nature of this dependency on technology is the limitation on creative thinking and open mindedness. The mind frame that is created from this codependent relationship with technology is part of the rigidity that is resisting the biopsychosocial model of medicine. Technology would better serve the health care system if it were viewed as a tool, nothing more, and not as the basis of the methodology.
This very brief but revealing description of the cultural institution of medicine here in America, shows a deeper problem of ideology than it does of inefficient practices. I am the most concerned about how the current debate over health care is about the dysfunction of the practice and delivery but not about the dysfunction of the ideology behind the practice and delivery. I find it interesting how there is an apparent parallel between this situation and the band-aid approach. This would give weight to the observation that the American culture is superficial by nature.
To truly analyze this cultural institution I believe it is critical to look at individualism and capitalism’s direct involvement. Individualism could be said to be a product of the same ideology that gave birth to the biomedical model of medicine. The belief in an individual’s success and health not being connected to the greater whole of society is the basis of individualism. The American individual is generally more concerned about their physical appearance than the actual state of their health. The strong emphasis that this culture puts on what a successful individual looks like, appears to be contributing to an unhealthy population. The individual’s role as the consumer that keeps capitalism on its steady path of growth plays a very interesting role here. The never-ending cycle of wanting more, that is the main psychological fuel-source of consumerism, plays an integral part in America’s dysfunctional relationship with the health care system. This can be seen in the extreme use in pharmaceuticals and cosmetic surgery. The deeper and more profound relationship between individualism, capitalism, and American medicine lies within the belief that we can fill ourselves up from the outside. The external origins of health, happiness, satisfaction, and purpose, which this culture of materialism holds true, is what makes this relationship thrive. Capitalism’s role in the American medical industry is so arbitrary it could actually be overlooked because it is so ingrained in every aspect of this culture. Capitalism may be the main reason that the medical industry is in the business of treating sick people instead of promoting healthy living by people. This is a business that requires that there be a line of unhealthy people that need help. If the masses became healthy, the current medical industry would fail and failure is unacceptable within the world of capitalism. The lack of attention on healthy lifestyle practices and preventative medicine within the health care system is a reflection of the society’s lack of commitment to living a healthy lifestyle.
Looking at the dysfunctional state of medicine here in America one could point to a conspiracy theory quite easily. I do not believe this is the case, at least not in full. I do think that some aspects of the industry, the pharmaceutical in particular, are using the avenue of capitalism to take advantage of the situation. But couldn’t one argue that capitalism, practiced as it is, is a conspiracy? I choose to believe that this dysfunctional state is primarily due to ignorance. This is a dirty and demeaning word in this culture and the stigma that is attached to it is what makes those that fear being ignorant, guilty of it. This interesting paradox of the state of ignorance in this culture is arguably the strongest root of its unhealthy health care system. This ignorance that I am referring to is on both sides of the medical business transaction.
The Journal of the American Board of Family Medicine has published two key reports that speak to the presence of a severe disconnect. In 2002 “Mind-Body Medicine: State of the Science, Implications for Practice” Concluded: “There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions.” I am using this conservative perspective to show that even the medical industry is somewhat aware that there is a deeper truth within the state of health. This is interesting, but what is even more interesting and telling of the bigger picture is what was presented with their 2006 report “Barriers to the Integration of Psychosocial Factors in Medicine: Results of a National Survey of Physicians” Concluded: “These results suggest the need for more comprehensive training in the role of psychosocial factors in health. In addition, the finding that physicians identify lack of time and inadequate reimbursement as significant barriers suggests that the current health care delivery system may, in many respects, be antithetical to the biopsychosocial model.” The conclusions of these reports, as conservatively stated as they are, thrust the real problem of the American medical industry to the forefront. These reports are just a preview of the revolution in consciousness that is starting to take place.
In conclusion, the observation that there is only one problem in this world and that is with consciousness seems to be very appropriate here. There is a profound disconnect that lies beneath the dysfunction of this cultural institution. This disconnect, and subsequent dysfunction, are very symbolic of the greater beliefs, practices and state of the American culture. The mending of this disconnect will potentially be looked at as one of America’s greatest accomplishments, or biggest failures. Transcending the stigmas that are associated with ignorance and mental illness are critical for this connection to take place. The truth about medicine is buried so deep in this culture it will probably take some creative destruction for it to be actualized. The truth that it speaks is simple and cuts through all the convoluted arguments about how complicated the reality of our health care system is. Individualism, practiced to the extreme, is a weed that must be pulled in order for the interconnectedness of personal health and social health to be realized. The revolution in medicine, switching to the biopsychosocial medical model, will come in the form of a paradigm shift or it will not come at all. I am encouraged by the future that this type of new medical model would bring. A cultural institution of medicine that is based on the biopsychosocial relationships can only happen if the larger society equally shares the belief. If this happens, it has the potential of transforming the very structure of society. Education, of a different tune, is the best medicine for America and its institution of medicine.
Online Sources:
World Health Organization, 2000 ranking of the world’s health systems, http://www.who.int/en/
If it is possible to step back from the American reality and observe the cultural institutions that are maintaining the external locus of orientation, one starts to see fundamental contradictions within what is considered sane, deviant, and insane. American capitalism and individualism appear to be some of the driving forces within this contradiction of norms. Take the corporate elite of Wall Street for example, on one side they represent the ultimate level of success within this free market society, they have worked their way to the top. On the other side of this virtual reality of contradiction they represent a neurotic hoarder that has lost touch with reality and does not know when enough is enough. Since they are hoarding the holy American dollar within a societal structure that could be called the religion of capitalism, it is perceived by the masses as being more socially acceptable. In this example the cultural themes of capitalism and individualism have not only distorted the psychological perspectives of these elite they have distorted the social norms that these elite function within. If America were more of an egalitarian society, which valued the health of the society’s members more than the individual, this type of behavior would be viewed as one of the highest crimes and definitely a form of insanity. I am sure that the DSM does not have a code for the culture-specific psychoses that could be classified as the American-greed syndrome because that would suggest a level of self-reflectivity that this culture does not own.
Holding individualism up to the light it becomes apparent that this fundamental institution of the American culture has deep roots within the collective American psychoses. The very stigma associated with being a weak individual that needs help, perpetuates and exacerbates the mental illness that has blanketed our society. When the misidentification of the locus of orientation is coupled with this culturally self-imposed barrier to mental well-being, it becomes very obvious that this American culture is insane by its very design. Unfortunately there is a strong self-fulfilling loop of feedback between the cultural themes that support the cultural institutions and the psychological functioning of the societal members that co-creates this state of collective mental illness. In my mind the real question is - what is it going to take to wake up the masses to the delusion of reality that is being experienced and called normal? Unfortunately, or fortunately depending one’s perspective, I believe it will take some form of creative destruction to break the possessive spell (the American schema) that individualism and capitalism has cast upon this rich society that is full of suffering.
Medical Pluralism – The Healing Power of Choice
Medical Pluralism is growing stronger within the diverse and multicultural American free market of medicine. Just as personal beliefs affect how an individual views their illness they also affect what type of healer to seek out for help with their healing. For example, an individual’s religious beliefs can be instrumental in the type of medical system that they ascribe to and utilize. Does the individual believe that the source of healing is within themselves or without themselves? The potential answers to this question can be viewed as forks in the road that lead to very different types of treatments and outcomes.
The power and central role of one’s beliefs with regards to healing, becomes a strong factor in the choices of the techniques that will be employed by the individual. The more heterogeneous a society is the more medical pluralism will need to exist within it to accommodate the different cultural themes. It is interesting to look at medical pluralism as a natural form of a culture’s adaptation to its internal changes from external sources (e.g. immigrants from foreign cultures importing their beliefs). With this example, the level of medical pluralism that exists within a heterogeneous society would indicate how open the culture is to change and its willingness to adapt to its new members.
The American cultural institution of medicine that is predominantly of the biomedical type has been ethnocentric to the other healing modalities that are trying to coexist with biomedicine. The oppression that has accompanied this ethnocentric cultural institution is symbolic of the oppressive nature of the American majority on the different minorities. The social tensions that arise from any type of oppression can lead to healthy social changes. It is in the best interest of the American cultural institution of medicine to open up more willingly to medical pluralism. In a nation that is becoming more culturally diverse it would be a wise choice of adaptation.
Health Insurance and The Cultural Institution of Insurance
The cultural institution of health insurance here in America could be viewed as a culturally bound syndrome of societal insecurity. Before examining health insurance specifically, I think a collective analysis of the master frame of reference that has created the ideology of insurance is in order. At the root of the American insurance industry is the ideology of amassing wealth, which is born from the psychological state of anxiety and worrying about the unknown future. The denial of the present moment as being the fertile ground where solutions are created for the future’s problems is the ideology that enables insurance to exist. This materialistic culture that views all things as being the locus of reality, has to rely on external forces such as health insurance for its well-being. In a perverse way health insurance is how this society proactively approaches its health; health is viewed as a commodity and therefore paying into health insurance is paying forward into one’s state of health.
One cannot separate the dysfunctional state of the health care industry from the existence of the health insurance industry. Has the health care system become overly dependent on the use of high-tech treatments and procedures because of the deep purse of health insurance? Insurance is very similar to a lottery; this is an interesting aspect of insurance to examine with regards to its relationship to the health care system. It is also critical to acknowledge the underlying influence of tort liability within the industry of health insurance. The reality of hitting it big through the American legal system has a dirty hand that is pulling many of the strings that are causing the high costs of health care and thus health insurance. Without the concentration of financial resources that health insurance creates the health care industry could not operate at its current level of financial reward. The cost of health insurance is dependent on the cost of health care and the cost of health care is dependent on the cost of health insurance; this self-fulfilling loop that enables continually increasing costs is creating more wealth within our society but at what cost, out health?
The commodification of the human being within this culture and the world at large has manifested into health care being about profits and not about healing or well-being. This disturbing factor of the reality that this commercialized culture has created is not only antithetical to the real well-being of its society it is the cultural schema that writes the disturbing script of the play that is American illness. As long as the members of this society look outside themselves for the locus of well-being it does not matter if every one of them has unlimited access to health care through health insurance, the society will become increasingly ill.
Reeducation is the key to breaking down the barrier that is keeping this system of health care and its system of insurance in a treatment-centered mode as opposed to a more desirable prevention-centered one. This reeducation process must happen at all levels of the system and especially within the institution of medical education. This reeducation process that is required before our system of health care can become a holistic system of well-being, is a radical change in the current curricula. This new curricula must address the importance of social relations on one’s state of well-being; we cannot be healthy without healthy social relations. There is an even bigger barrier to the realization of this needed reeducation process within the American culture, socioeconomic inequality and the elite separatist ideologies that have created the environment of social stratification.
America’s Culture of Drugs – Good Drugs vs. Bad Drugs
When examining the state of drugs in America the catch phrase of “drugs and alcohol” comes to mind. These three simple words that make up a common sound bite of American linguistics, speaks volumes about the cultural significance of how drugs are viewed in America. What makes one drug legal and another illegal? Are all legal drugs socially acceptable and all illegal drugs socially taboo? The answers to these questions get at the complexity of the relationship between a society and the culture that it functions within, but the short answer would have to be – money. Legal drugs are those that support the structure of capitalism and its manufacturing processes. Illegal drugs are those that are not so easily managed through the institution of capitalism and potentially have a foreign element to their usage. These statements are obviously oversimplifications, but they do get at some of the truths behind this complex issue.
Examining the social considerations behind what makes a drug good or evil within our culture is partly veiled with the health-care industry’s version of what is considered medicine and what is considered recreational drug use. If a drug has medicinal properties or more importantly marketable properties, it is labeled medicine and if not it is labeled as a hard drug that is a part of the deviant, undesirable, and evil aspects of our society.
Drugs and humans have a long-standing relationship and drugs possess a large amount of political power within human societies. One needs to look no further than how America has treated marijuana, cocaine, and alcohol to see how politically powerful drugs are and how the power is wielded by the elite and those that follow their leadership. Cocaine and marijuana are classic examples of how drugs that have legitimate medicinal properties have been used as political tools against ethnic groups like African Americans and Mexican Americans. The image of these drugs was purposefully tarnished, to in turn tarnish the image of these ethnic minorities. This overt use of drugs in the American cultural institution of racism is not the only reason to illegalize these drugs; the war on drugs is big business! That is, a drug does not need to be made legal for the system of powers to profit off its existence. Just maybe, it is more profitable for some drugs to be the sacrificial lamb of society’s guilt over being a bunch of drug addicts?
In a society that believes in the existence of good and evil and the need for a villain in order for the followers of the status quo to feel like the hero, some drugs must be thrown under the bus for the greater good. It is interesting and fruitful to link this topic with the general mental health of America; the stigma of treating mental illness through medication is implicitly done through the self-medication ritual of consuming alcohol that is performed in bars and lounges across America. Medication in this country is not about healing or wellness, it is about the money and social control.
The following was written in November of 2009 for an anthropology course on American Culture.
The Cultural Institution of "American" Medicine
The American medical industry is one of the largest and, currently, most debated cultural institutions of America. In 2000, the World Health Organization ranked the health system of the U.S. as number thirty-seven out of its nearly two hundred member states. It is very interesting and concerning that America, who is one of the world’s richest industrialized countries, is not near the top of the world’s health statistics. Why is this so? The American Academy of Family Physicians reports that two-thirds of all office visits to family physicians are due to stress-related symptoms. Considering that visits to family physicians make up one-forth of all office visits in America, this is a profound statistic. Could one reason be the general anxiety associated with health in this culture? Or is the unhealthy state of Americans simply a reflection of an unhealthy culture? I see two of the main root causes of this unhealthy state, being individualism and capitalism. My real concern about this cultural institution is the very paradigm on which it is based. The biomedical model of medicine is generally based on the assumption that we are biological machines that achieve a state of health by the manipulation from external forces. This materialistic ideology is one of the themes that can be read through the cultural text that is the American medical industry. The emerging biopsychosocial medical model is one that is based on the complex relationships between the body, mind, and society. This model challenges the very basis of American medicine and possibly the American culture at large. The purpose of this paper is not to criticize American medicine, but rather to look at the cultural beliefs that have created it and support it.
Looking at the current state of American medicine one should not be surprised that it is in the dismal state that it is. Americans have long been in the habit of throwing money at problems and expecting them to go away. Why should the problem of being sick, be any different? This band-aid approach to medicine appears to have a couple of main roots holding it in place, one of which is the general superficial nature of the material world and consumerism. The strong ideals of form, that permeate the American culture bolsters this ideology and approach. There is a polar difference between curing a disease and healing its cause. The external locus of the biomedical model primarily reacts to the signs and symptoms of disease. This shallow perspective on medicine is not capable of creating health, only fighting disease.
If one looks at the American medical industry as a cultural text the linguistics that are used tell a story of aggression and hate. There is a war against disease in this culture that is being waged in the name of conquering all! This ideology appears to be a remnant of imperialism and frontierism. The belief that one can kill a disease or wipe out an infection, speaks volumes about this culture’s world schema. If it cannot be bought, just kill it! The habits of the heart of the American culture are coming out loud and clear here. There is more belief in the destructive power of violence than in the healing power of love.
The American medical industry is addicted to technology. Its foundation is built upon it. There is a very interesting relationship that appears to be between the technology and the medical industry. Technology could be likened to the golden chains of this industry. The glorious shiny gadgets of technology do not only restrict medicine in this culture, they blind it. The ridiculously high cost of medical technology does not make for a healthier population but rather limits the population’s access to health care. Another aspect of the restricting nature of this dependency on technology is the limitation on creative thinking and open mindedness. The mind frame that is created from this codependent relationship with technology is part of the rigidity that is resisting the biopsychosocial model of medicine. Technology would better serve the health care system if it were viewed as a tool, nothing more, and not as the basis of the methodology.
This very brief but revealing description of the cultural institution of medicine here in America, shows a deeper problem of ideology than it does of inefficient practices. I am the most concerned about how the current debate over health care is about the dysfunction of the practice and delivery but not about the dysfunction of the ideology behind the practice and delivery. I find it interesting how there is an apparent parallel between this situation and the band-aid approach. This would give weight to the observation that the American culture is superficial by nature.
To truly analyze this cultural institution I believe it is critical to look at individualism and capitalism’s direct involvement. Individualism could be said to be a product of the same ideology that gave birth to the biomedical model of medicine. The belief in an individual’s success and health not being connected to the greater whole of society is the basis of individualism. The American individual is generally more concerned about their physical appearance than the actual state of their health. The strong emphasis that this culture puts on what a successful individual looks like, appears to be contributing to an unhealthy population. The individual’s role as the consumer that keeps capitalism on its steady path of growth plays a very interesting role here. The never-ending cycle of wanting more, that is the main psychological fuel-source of consumerism, plays an integral part in America’s dysfunctional relationship with the health care system. This can be seen in the extreme use in pharmaceuticals and cosmetic surgery. The deeper and more profound relationship between individualism, capitalism, and American medicine lies within the belief that we can fill ourselves up from the outside. The external origins of health, happiness, satisfaction, and purpose, which this culture of materialism holds true, is what makes this relationship thrive. Capitalism’s role in the American medical industry is so arbitrary it could actually be overlooked because it is so ingrained in every aspect of this culture. Capitalism may be the main reason that the medical industry is in the business of treating sick people instead of promoting healthy living by people. This is a business that requires that there be a line of unhealthy people that need help. If the masses became healthy, the current medical industry would fail and failure is unacceptable within the world of capitalism. The lack of attention on healthy lifestyle practices and preventative medicine within the health care system is a reflection of the society’s lack of commitment to living a healthy lifestyle.
Looking at the dysfunctional state of medicine here in America one could point to a conspiracy theory quite easily. I do not believe this is the case, at least not in full. I do think that some aspects of the industry, the pharmaceutical in particular, are using the avenue of capitalism to take advantage of the situation. But couldn’t one argue that capitalism, practiced as it is, is a conspiracy? I choose to believe that this dysfunctional state is primarily due to ignorance. This is a dirty and demeaning word in this culture and the stigma that is attached to it is what makes those that fear being ignorant, guilty of it. This interesting paradox of the state of ignorance in this culture is arguably the strongest root of its unhealthy health care system. This ignorance that I am referring to is on both sides of the medical business transaction.
The Journal of the American Board of Family Medicine has published two key reports that speak to the presence of a severe disconnect. In 2002 “Mind-Body Medicine: State of the Science, Implications for Practice” Concluded: “There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions.” I am using this conservative perspective to show that even the medical industry is somewhat aware that there is a deeper truth within the state of health. This is interesting, but what is even more interesting and telling of the bigger picture is what was presented with their 2006 report “Barriers to the Integration of Psychosocial Factors in Medicine: Results of a National Survey of Physicians” Concluded: “These results suggest the need for more comprehensive training in the role of psychosocial factors in health. In addition, the finding that physicians identify lack of time and inadequate reimbursement as significant barriers suggests that the current health care delivery system may, in many respects, be antithetical to the biopsychosocial model.” The conclusions of these reports, as conservatively stated as they are, thrust the real problem of the American medical industry to the forefront. These reports are just a preview of the revolution in consciousness that is starting to take place.
In conclusion, the observation that there is only one problem in this world and that is with consciousness seems to be very appropriate here. There is a profound disconnect that lies beneath the dysfunction of this cultural institution. This disconnect, and subsequent dysfunction, are very symbolic of the greater beliefs, practices and state of the American culture. The mending of this disconnect will potentially be looked at as one of America’s greatest accomplishments, or biggest failures. Transcending the stigmas that are associated with ignorance and mental illness are critical for this connection to take place. The truth about medicine is buried so deep in this culture it will probably take some creative destruction for it to be actualized. The truth that it speaks is simple and cuts through all the convoluted arguments about how complicated the reality of our health care system is. Individualism, practiced to the extreme, is a weed that must be pulled in order for the interconnectedness of personal health and social health to be realized. The revolution in medicine, switching to the biopsychosocial medical model, will come in the form of a paradigm shift or it will not come at all. I am encouraged by the future that this type of new medical model would bring. A cultural institution of medicine that is based on the biopsychosocial relationships can only happen if the larger society equally shares the belief. If this happens, it has the potential of transforming the very structure of society. Education, of a different tune, is the best medicine for America and its institution of medicine.
Online Sources:
World Health Organization, 2000 ranking of the world’s health systems, http://www.who.int/en/
(2000 was the last year this ranking table was produced by the World Health Organization.)
American Academy of Family Physicians, http://www.aafp.org/online/en/home.html
Journal of the American Board of Family Medicine, 2002 and 2006 Reports, http://www.jabfm.org/cgi/reprint/16/2/131?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=mind+body+medicine&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
http://www.jabfm.org/cgi/reprint/19/6/557?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=mind+body+medicine&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
The following was written back in October of 2009 for an anthropology course on American Culture.
The American Conflict with Unity and Diversity
An important defining characteristic of the American culture would have to be that of individualism. I believe that American individualism is at the heart of this cultural value conflict and must be looked at to understand this issue. American individualism is not synonymous with community or the unity of a community. The egocentric perspective of this individualism does not foster a sense of unity or the idea that the whole is greater than the sum of the parts. I do however believe that it is somehow tied to the diversity of the citizens of America and has grown out of their superficial differences. I say superficial because at our essence of being, I believe that we all want the same things like justice, equality, freedom, peace, compassion, charity, and love. I see a connection between the ideology of individualism and the concept of “in groups” and “out groups” that modern psychology has identified. The belief in “us and them” or “the other group” comes from first believing in the identity of an individual. I know that this sounds paradoxical, but to believe in the individual is to focus on the superficial differences of the individuals and not see the underlying interconnectedness that is the unity of humanity. To believe in anything but the one group of humanity is to first believe in some level of the individual as separate from humanity. I think that the stronger the belief in the concept of the individual the more apt one is to have a separatist perspective. This cultural value conflict gets at the heart of the challenges that culture presents to the human species. Our biology is given, but our cultural beliefs are learned. It is this learning of ideologies like “unity verses diversity” that the conflict arises from.
Along side individualism I see the competitive nature of the American culture, to the point of dysfunction and neurosis, as being a large contributor to this conflict. In my opinion, competition is an outdated primitive behavioral trait of humanity that should be reexamined. An individual with a strong competitive drive does not create a sense of unity amongst any group. Most Americans are long past the reality of having to survive on a daily basis and this reality should put the American competitive nature on review. In regards to the subject of surviving, I think that America at large has lost touch with reality. There seems to be a lot of confusion in this culture about the differences between wants and needs. The greed of capitalism has clouded our vision and sent us way off course!
Pluralism and particularism are also underlying perspectives within this greater conflict. Cultural pluralism welcomes the diversity that has made America what it is and has become the organizing principle of this society. The particularistic viewpoint is one of exemplifying the differences amongst the many ethnic groups that make up the broader multicultural American culture. Modern day psychology has discovered that the tendency to use categories and to see life separated into particular types is a natural part of human information processing. It is only when this categorizing puts people into “the other group” that there is a problem. This is where special interest groups, of the ethnic or social sort, can actually do damage to the unity and the peace that comes from it. By preaching the importance of pride of ethnicity, color or social group, all that is being done is fortifying the separating and judging of the differences amongst us. This is separatism! I see a somewhat new form of separatism as being extremely pro one group and disregarding all the others. This is more of a passive-aggressive form of separatism that is just as damaging to the unity of our nation. This also fans the flames of the past oppression and injustices against minority ethnic and social groups. Focusing on the apparent differences between us all, does not bring us closer together, it does not create peace. Focusing on these differences creates chasms in the social structure of our society. Our society, and our world for that matter, needs more social bridges that span our differences and much fewer ideological trenches being dug to divide us.
I am not suggesting that we all bury our heads in the sand in regards to the challenges that ethnic, social and racial differences pose. The denial of the past and present oppressive separatism has been instrumental in the construction of this cultural value conflict. I am suggesting that these differences be seen as they are, ideological and learned, they are not concrete. This brings me to one of the most significant aspects of the human condition that could be argued as the root of all humankind’s problems, a problem with consciousness. When an individual identifies with their mind and therefore their ideologies, conflicting ideologies are viewed as personally threatening. When we view the mind as a tool and not the seat of our very existence we can view the thoughts, ideas and beliefs that we have from a more observational point of view. Putting down one’s own beliefs, even temporarily, can be very frightening and requires a tremendous amount of courage, which seems to be in a short fall in this culture. The short answer to this problem would be to not take ourselves so seriously. The longer and more complicated and definitely controversial answer is to actually learn whom we really are, to get to know our true self. We are much more than these minds and bodies.
One way to look at the cause of this cultural value conflict is to look at where culture comes from. It is learned. Up until the 1960’s the majority of the American educational system was of the male Anglo-Saxon theme. This was a very narrow and unrepresentative view of history and taught that through assimilation we all become Americans. The main problem with this is, that if you are not a white male you might not agree with what this system is saying or producing. In recent decades there has been a lot of work and effort put towards changing this critically weak aspect of our society. “Diversity Within Unity: Essential Principles For Teaching and Learning In a Multicultural Society” Phi Delta Kappan; Nov 2001, was co-written by a panel that consisted of two psychologists, a political scientist, a sociologist, and four specialists in multicultural education and was the result of a four year project. They came up with twelve essential principles with five categories that address this issue. In the Student Learning category – “Principle 3. The curriculum should help students understand that knowledge is socially constructed and reflects researchers' personal experiences as well as the social, political, and economic contexts in which they live and work.” This principle addresses the critical aspect that culture is learned and being aware of it is very powerful! I think that this principle also addresses the fact that the educational institution is not the infallible source of information. I see this essential principle as being critical in helping students who are citizens and the future leaders, to develop and keep an open frame of mind. In the Intergroup Relations category – “Principle 6. Students should learn about stereotyping and other related biases that have negative effects on racial and ethnic relations.” Stereotypes are so prevalent in this American culture and to not see the fallacy that lies within them, and the social damage that they cause, is unjust. “Principle 7. Students should learn about the values shared by virtually all cultural groups.” These principles address the dangers of using categorical judgments and the fault in not seeing oneself in others. This article made it clear to me that for America to find unity within diversity we must look within our educational system. It also reaffirmed the idea, at least in my eyes, that education is at the root of all cultural conflicts and that the solution to all these types of conflicts starts with education. This was an inspiring article that gave me new hope for our educational system and the citizens that it produces.
Why can’t there be unity within diversity? If one sets personal agendas aside and accepts that we are all in this together, it is more than possible. We are all citizens of a diverse nation that has been built on the very foundational concept of unity within diversity. Unity does not mean uniformity. I believe that mistaking unity for uniformity muddies the waters within this cultural value conflict. The old school ideology of America being a melting pot where all subcultures are assimilated into one homogeneous culture fosters the idea of uniformity. Unity is more in line with a sociocentric point of view than the egocentric individualistic stance. Unity is seeing oneself in others and knowing that we all desire the same basic things from life. America definitely has a cultural value conflict with unity and diversity but I say it stems from a basic misunderstanding of what unity is all about and the importance of diversity. The greed and self-infatuation of American individualism is not a sustainable path for America, or for the world. America has been a world innovator of democracy and human rights and much of the world looks to America for what it represents. Multiculturalism, unity and diversity are all foundations of a truly democratic society. If America is going to mature as a democratic nation it will have to deal with this internal conflict at some point. The biggest threat to any group of people is the one from the inside that is not being acknowledged or dealt with. I see this cultural value conflict as the tip of the iceberg so to speak. When looked at on the surface, the unity and diversity conflict represents a very small portion of the larger conflict that lies below it. I see American capitalism, as it is being practiced, as one of the largest roots that this conflict rises from. The individual American capitalist ideology seems to be contrary to the sociocentric rooted unity principle. I think that one reason that unity and diversity is such a strong cultural value conflict here in America is due to the very perspective that it is being viewed through. The idea that these two cultural values are conflicting is the main conflict. Americans tend to have very definitive perspectives, based on clear judgments and known factors. I see this perspective as being very unnatural and not sustainable. There are aspects to the Eastern philosophies that appear to be much more in line with the natural way of things. Where paradoxes are accepted as being the way things are. The Taoist concept of Wu-wei, which can be translated into “mutual rising” and is a theoretical cousin to the Chinese concept of the Yin-Yang polarity, is the perspective that sees the truth of unity within diversity. At its roots, this is what the American democratic system is based on, the complementary balance of opposing political viewpoints. Somewhere along the way in America this has been forgotten or conveniently overlooked. In his book “Tao The Watercourse Way” Alan Watts sums this concept up by writing “north and south, are different aspects of one and the same system, and that the disappearance of either of them would be the disappearance of the system.” My point and perspective is based on the belief that the humankind is destined for peace, because it is our true nature. Unity and diversity fit together like the symbol of Yin-Yang, they complement and support each other, where by they create a balanced society.
“No culture can live if it attempts to be exclusive.” Mahatma Gandhi. I have a lot of respect for the wisdom that Gandhi was tapped into. I think that this quote really speaks to the historically fundamental problem that most of the dominant cultures face when they do not see the intrinsic value of diversity. I believe that fear of the unknown is at the root of all racism, separatism, and assimilationism. I truly believe that the solution to this cultural value conflict of unity verses diversity, lies within the educational process. Not just the institutionalized educational state run system but also the more important family-run system as well. How a person and a nation views this type of issue is an extremely telling cultural text that speaks volumes about the core beliefs that are behind the view. I believe in the saying that, “the best way to judge a society is to look at how it treats its weakest members” and that it is very applicable here. America is facing some tough decisions that revolve around the debate over unity within diversity, healthcare and immigration being a couple. I see how America chooses to deals with its cultural value conflict of unity and diversity as a potential historical human rights benchmark. I think that we will be able to look back and see this as a turning point not only for America, but also for the rest of the world who are attentively watching. I just hope and pray that we all turn in the right direction.
This topic is very dear to me and it is one of the main reasons that I am back in school at forty years of age. I see topics like this as being critical to the survival of the human species and the entire biosphere that support its existence. I am fascinated with studying the American cultural phenomenon and see its problems, as great opportunities to help all of humankind. I look forward to working and writing on this topic further.
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“Multiculturalism – E Pluribus Plures”, American Scholar, Summer 1990, Diane Ravitch
“Diversity Within Unity: Essential Principles For Teaching and Learning In a Multicultural Society”, Phi Delta Kappan; Nov2001, Vol. 83 Issue 3, p198 & 200
“Tao – The Watercourse Way”, Pantheon Books, New York 1975, Alan Watts
“Unity and Diversity in Multicultural Societies”, International Labour Organization 2005, Bhikhu Parekh
