Christopher D. Frith

“Because so many of our beliefs depend upon the culture we share with others, diagnosing patients from other cultures raises many problems. If hearing voices talking to you is a widely shared experience within a culture, then this experience cannot be treated as a sign of schizophrenia. On the other hand, people from within the same culture can easily recognize the kind of experiences that would be considered signs of madness.

In Northwick Park Hospital there were many patients who were adherents of religions with which the staff were not familiar – fundamental Christian sects as well as branches of oriental faiths. We could not be sure if it was reasonable for a man belonging to a Christian sect founded in California in 1962 to believe that by wearing a half-pound cross on a wire round his neck he pleased God, who would then pass him messages by directing his eyes to particular biblical texts. We could not be sure if it was reasonable for a devout Hindu to interpret individuals and animals in the local setting as manifestations of Krishna reborn. Reading accounts of the beliefs of adherents to these sects did not help us, but the relevant spiritual leaders, on the basis of a few moments’ conversation, could state with confidence that these ideas were due to illness. We therefore made a practice of always consulting them. Typically they considered that the patient believed literally in what was intended as a metaphor. The patients’ ideas were much too concrete.”
― Christopher D. Frith, Schizophrenia: A Very Short Introduction