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What Culture Bound Syndromes Say About Ensuring Healthy Adolescent Development

I have decided to devote my life to adolescent developmental psychology because I believe not enough is done to ensure their mental health


  • A culture bound syndrome is a mental illness specific to a culture
  • They are created by the varying environments in every culture
  • Each one provides information on what environmental factors to avoid in society for the purpose of improving mental health
  • Bronfenbrenner’s ecological systems theory provides a way to conceptualize where an adolescent’s environment is failing or supporting them
  • Brief explanation of the Ecological systems theory
  • Bronfenbrenner’s model can help identify cultural problems that lead to culture bound syndromes and mental illness in general

Different Environment, Different Symptoms

Some people treat mental illness as a purely internal process, but that does not match up with reality. The environment has a huge effect on the development of illnesses and the symptoms which present themselves. Within this context, environment means external stimuli that are present in the life of an individual. For example, your teacher’s bad temper and your place of employment are both part of your environment. Two countries can have radically different environments and different stimuli often equate to different behaviors or responses. Japan has a nearly diametric culture to the US, for example, and some of their mental illnesses have different symptoms than ones in the US. The most common form of schizophrenia in America is paranoid schizophrenia, while in Japan it is hebephrenia a.k.a disorganized schizophrenia. And if you consider that the environmental stressors on adolescents and young adults are completely different in these countries, it makes sense. As an analogy, if you bake a crust that you have kneaded for 20 minutes, you end up with a pizza crust. Knead for 0 seconds and you have a lean pie crust, a completely different food with the same ingredients. In the same way, different cultures produce different symptoms even though the “ingredients” in each case is always a human mind and a human society. And further, there are also illnesses that are specific to different cultures.

Primer on Culture Bound Symptoms

These are called culture bound syndromes. The unique conditions of Japan often leads cultural psychology classes to focus on the island when discussing culture bound symptoms, and I am not a fan of reinventing the wheel. One thing to understand about the environment of Japan is that the duty to bring honor to the family name is applied young and with feverish intensity on a daily basis. There is actually currently a suicide epedimic of people that feel they’ve failed their family and to restore honor or to escape the emotional distress they see no option other than suicide. One (unhealthy) defense mechanism from this intense pressure is for an individual to withdraw from all responsibilities and society all together, never leaving their room. This prevents or delays suicide in exchange for a massive loss in quality of life. This illness, referred to as hikikomori, is most strongly correlated to problems in interpersonal relationships and suicidality. Someone with these symptoms in the US might develop a panic disorder or severe social anxiety. Same “ingredients”, different food. Adolescents can stop going to school in Japan and Parents are also more willing to take care of dependent adult children, contributing to this illness being able to consume someone that develops it. Hikikomori usually emerges in adolescence, similar to other severe mental illnesses we are more familiar with. It can last a lifetime or just a few years. I have personally been nearly “house locked” because of anxiety and suicidality, but I was able to get through it because of responsibilities outside of the home. Every inch of ground you give to an illness that keeps you from leaving your house makes recovery harder. So, if you are allowed to cede all the ground possible and never leave your room, even to spend time with family or go to school, recovery slips further and further out of your reach every day. The unique environment of Japan makes this all consuming mental illness possible.

The Significance for Developmental Psychology

All of that is to illustrate the point that wealthy countries with high rates of mental illness tend to have environments conducive to the festering of mental injuries. A society that wants to raise mentally healthy adolescents, both to improve their quality of life and to reduce the instances of severe mental illnesses in adults, must adapt their environment to be conducive to mental health instead. One way we can conceptualize the environment of an adolescent is with the ecological systems theory.

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Bronfenbrenner Ecological Model

Bronfenbrenner ecological model

Bronfenbrenner ecological model

Example of an Unhealthy System

The concentric circles here represent social elements of the child’s environment; as they move away from the circle representing the self, the institutions become less directly related to the child, but more powerful. A healthy micro and mesosytem is somewhat in control of the parents, educators and other caregivers in a child’s life. I will throw myself and my high school under the bus to illustrate what an unhealthy mesosystem is like. In high school, I developed multiple severe mental illnesses and began to just sleep through class. Sometimes I would sleep in the common area until the resource officer made me get up. My microsystem here was the school and my parents. My parents made me go to school and the school made me go to class, so they were doing everything a healthy microsystem should do, however, the mesosystem in my life was not helpful. Teachers and administrators told my parents that I had attention problems and I eventually ended up on stimulants, so no more sleeping through class. They did not report on my overwhelmingly obvious signs of decline into mental illness. I started experiencing severe mental illness at 13 and my parents found out about it when I was 18 and told them myself. My parents would communicate constantly with the school and the school barely communicated back while withholding important information. This is an example of an ecological system failing to address adolescent mental health concerns. An efficacious mesosystem could have dramatically improved my quality of life then and blunted the edge of the illness I experience now. An environment less conducive to mental illness includes a strong micro and mesosystem maintaned by the adults in a child's life.

How to Use This Model to Learn From Culture Bound Syndromes

Back to culture bound syndromes, the existence of hikikomori in Japan is a severe warning for what harm an institutional failure of microsystems can bring. Parents in Japan are taught the way to raise a happy and successful child is by applying more and more pressure to make them perform their best and become resilient. If a part of a microsystem is propagating poor mental health instead of supporting the child, that is like a building not only losing a support beam, but having extra weight piled on top of it. That makes it easier to see how this dramatic culture bound system is possible. And provides a warning to the rest of the world on how not to run a child’s microsystem. The example of the culture bound syndrome of hikikomori illustrate the direction cultures can go to increase the mental well being of their inhabitants.

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