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Review of Ethan Watters, Crazy Like Us: The Globalization of the American Psyche

The recent outbreak of swine flu bears evidence of our concerns about globalization of disease via air travel. This facility of transmission and the patient’s role as a “vector” raises significant global public health concerns as well as questions regarding how best to balance public health and individual freedom. What does not come to mind is global occurrences of mental illness, and presumably this is because we do not ordinarily think of mental illness as a condition that can be transmitted from person to person. If we do see a link between globalization and mental illness we would likely see the connection as indirect: globalization and the increasing demands of a global society can lead to alienation, anxiety, and stress which, in turn could lead to mental illness. One of the central themes in Ethan Watters book is that we should see a link between globalization and mental health in more direct terms. More specifically we should see how the West, and particularly the US, has been responsible for transmitting mental illness across the globe through the export of our own understanding of its diagnosis, symptoms and meaning. In this regard we have served as intellectual vectors of disease, “infecting” other cultures with our own peculiar notions of what it means to be mentally ill or mentally healthy, and we have thereby helped to undermine other cultures’ ideas about these notions. Furthermore, in so doing we have not only failed to see that our own notions and remedies may not be superior, in fact could well be inferior, to those of the cultures around us, but we have also sometimes unintentionally and sometimes deliberately increased the incidence of mental illness in these countries. Crazy Like Us is a thought-provoking, well-written and challenging book that I hope will help draw more attention towards global mental health concerns, and the impact that our particular understanding of the mind and mental illness is having across the world. I hope also that the book provokes interest in these issues within neuroethics. The book is divided into four main chapters: “The Rise of Anorexia in