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'Crazy Like Us,' Ethan Watters 

When it comes to cultural imperialism, the DSM-IV is just as bad as the golden arches

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In Hong Kong, anorexia barely existed. In Sri Lanka, massive disasters didn’t result in American-style Post Traumatic Stress Disorder. In Japan, sadness wasn’t depression, it was something respected, something almost noble.

At least until well-meaning American psychologists got involved.

American psychiatry, you see, swears by the DSM-IV, the diagnosis guide for all sorts of mental maladies. The DSM-IV is a book written by mostly Western, First World psychologists, and developed by studying mostly Western, First World subjects.

Problem: Different cultures form different minds. Different minds suffer from different sicknesses.

In Crazy Like Us: The Globalization of the American Psyche, Ethan Watters reveals how American psychological solutions, when applied to foreign cultures, have actually propagated American psychological problems around the globe. The treatments ended up causing the diseases. It was the breathless warnings about anorexia from American psychologists in Hong Kong newspapers, Watters argues, that made thousands of Hong Kong teenage girls see anorexia as a new avenue to express emotional distress. It was marketing from American pharmaceutical companies, Watters argues, that caused thousands of Japanese suddenly to see minor melancholy as a problem.

It’s all fascinating stuff, especially when Watters compares the present with the psychological landscapes of the past, where women would regularly suffer from “hysteria” and men would wander, unconscious, in “fugue states.”

If pop-sociology superstar Malcolm Gladwell (The Tipping Point, Blink) had written this book, most of the pages would have been filled with anecdotes. Watters, thankfully, balances narrative and exposition in a perfectly satisfying ratio.

The organization of each chapter, however, is frustrating. Instead of clearly laying out the psychological differences between cultures and the negative impact of the American influence at the beginning of each chapter, he forces the reader through a chapter-long, meandering lead-up to his thesis.

And once he begins discussing mustache-twirling pharmaceutical reps, the book takes a polemical turn. It’s a fine polemic, sure, but most of the tangents about corporations ignoring problematic studies and whitewashing side effects belong in another book entirely.

Here they subtract from the more fascinating cautionary tale of Crazy Like Us: Good intentions mixed with cultural ignorance make for deadly medicine. 

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