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

Review by Bruce Bower

Watch out world — here comes American culture waving a manual of psychiatric diagnoses. Soon, everyone from Hong Kong schoolgirls to Sri Lankan villagers will think about mental health and illness in the same homogenized way. In Crazy Like Us, journalist Ethan Watters makes a case that this monolithic scenario could happen, a disturbing specter for psychiatrists who study how people in different parts of the world define and treat problems classified as mental disorders in the West.


Watters explores several disturbing instances of Western mental health ideas gone awry in non-Western nations. He describes teenagers in Hong Kong who began refusing to eat after hearing from Western celebrities and researchers that anorexia is the modern way for young people to express distress. In another case, an influx of Western trauma counselors labeled Sri Lankan tsunami survivors with post-traumatic stress disorder. This individual-centered diagnosis conflicted with that culture’s emphasis on meeting social responsibilities to feel better.

It’s not clear from these instances, though, that people around the world are passively abandoning local beliefs in favor of a one-size-fits-all biomedical disease model of mental illness. Even in the United States, psychiatrists heatedly debate this approach. Watters notes that he doesn’t want to portray traditional cultures as “right” and Westerners as “wrong” in treating mental illness, but at times he comes awfully close.

The export of Western notions of mental illness to other societies deserves close scrutiny, as Watters argues. So does the argument that this phenomenon will erase cultural contrasts.

Free Press, 2010, 306 p., $26

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