Depersonalization and Depression from Yogic Perspectives
The values attached to symptoms of depression vary; the "generalization of hopelessness" central to Western diagnostic categories of depression is viewed as characteristic of a good Buddhist (Castillo, 1991a). "Given their willing participation in an accepted practice at the heart of Buddhist ways of thought, it would be perverse to describe successful practitioners as sick, or, more particularly, depressed" (Hahn, 1995, p. 34). Richard Castillo illustrates the necessity of characterizing a malady in relationship to desired cultural conditions and values. The development of Hindu yogis leads to the creation of co-conscious selves, ones that participate in and are engaged with the physical world. Castillo calls this co-conscious self "the personal self" (participating self, or j iva), and the one that is an uninvolved observing self, the transpersonal self (observing self, atman or purusha). The personal self performs actions in accordance with social norms and experiences sensations, thoughts, and emotions, whereas the transpersonal self observes but is uninvolved in experiences (Castillo, 1991a). The goals of yoga meditation are the separation of these two aspects of self and consciousness. This is accomplished by restraining the personal self, an achievement referred to as moksha, meaning "liberation." Liberation is achieved by a new awareness: witnessing events but not participating in them and becoming freed from the suffering that comes from identification with the things of the personal self and its attachments in the external world.
disorders, schizophrenia, organic dysfunctions), it is doubtful that many other categories are (Kleinman, 1988a). There are difficulties in assessing mental disorders across cultures because even biological conditions are experienced and evaluated differently by different groups (e.g., dyslexia in nonliterate societies). Cross-cultural perspectives reveal that Western psychiatric categories are not universally applicable but reflect Western cultural concepts of impairment and psychosocial dysfunction. Cultural differences in what is considered normal mean that the same conditions may be conceptualized and treated in different ways in different cultures—and with different consequences. The symptoms associated with the Western category of schizophrenia seem to be recognized as mental illness around the world, but responses to such symptoms vary considerably. In Western cultures, schizophrenia has a poor prognosis, with permanent disability the frequent outcome, but in non-Western cultures, prognosis is generally good (Castillo, 1997a). But even diagnosing schizophrenia is problematic. The World Health Organization found that only 37 percent of patients manifested all relevant diagnostic criteria for schizophrenia, illustrating how cultural differences affect how conditions are conceptualized.
Castillo (1997a) reviews the DSM criteria for schizophrenia to illustrate the cultural assumptions. Hearing voices could be considered a symptom indicative of schizophrenia, but this makes judgments about normal experience; in some places, hearing voices is considered normal, even saintly. Kleinman (1988b) suggests that schizophrenia is not
This yogic practice of detachment has been analyzed as a flight from worldly life because of failure and despair, a renunciation based on frustration and depression. This depression and hopelessness are not seen as pathological in this cultural context but rather as the characteristics of a "good Buddhist." The yogis' cognitive models, which view the world as consisting of suffering and pain, enable the experience to be seen as the achievement of great spiritual insight. This sets the stage for meditation as a tool to escape emotional distress, anxiety, and problems, allowing the individual to accept the conditions of life (suffering) without experiencing them.
This type of experience is viewed in Western psychiatry as depersonalization. DSM definitions emphasize the experience of being detached from one's own body and mind, a sense of being an outside observer of one's self. There is a sense of false reality, emotional detachment, even of being dead. Descriptions of these experiences by Western psychiatric patients parallel accounts of yogis, but Western patients feel panic and anxiety whereas the yogic practitioners view these experiences positively because they confirm their worldview. Failure to understand an experience in its cultural context misses the fundamental meaning for the person and consequently the nature of the experience. This problem plagues the diagnostic approaches of the DSM based on behavioral "symptoms" divorced from the cultural context of their production and personal experience. This problem is illustrated in the cross-cultural examination of the DSM diagnostic category of somatoform disorders.
found in all cultures, and Castillo indicates that in nonindustrialized societies, the symptoms are less severe and prognosis for successful treatment is much better (e.g., traditional care in Africa). What is relevant is not merely some generic disease or condition but how it is related to the broader social context. A universal nosology is possible only if it describes the variation in disease found in different cultural settings, the conditions reported in other cultural settings, contextual variation in sickness conditions, and the factors that modify their manifestations (Hahn, 1995). Subsequent examinations of somatization , the physical expression of psychological conditions, as well as depression in cross-cultural perspectives help to illustrate the fundamental role of cultural context in determining the nature of a malady or whether a condition even constitutes a malady. Different cultures value different conditions, making one culture's pathology another's paradise, as illustrated in "Biocultural Interactions: Depersonalization and Depression from Yogic Perspectives," where ignoring cultural context and values confuses enlightenment with depression.
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