幻聴と文化（Tanya Luhrmann） - Living, Loving, Thinking, Again

Clifton B. Parker “Hallucinatory 'voices' shaped by local culture, Stanford anthropologist says” https://news.stanford.edu/2014/07/16/voices-culture-luhrmann-071614/

2014年の記事。
Tanya Luhrmann さん*1、統合失調症患者の幻聴経験と文化との関係について語る。 Luhrmann さんは心理人類学者で、ペンテコステなどの憑依文化*2の研究家。米国（カリフォルニア）、印度（チェンナイ）、ガーナ（アクラ）の統合失調者の比較研究を行った。
先ず、米国の精神科医は、患者の幻覚経験の報告を有意味な言説として重視しない傾向があるという；

In an interview, Luhrmann said that American clinicians “sometimes treat the voices heard by people with psychosis as if they are the uninteresting neurological byproducts of disease which should be ignored. Our work found that people with serious psychotic disorder in different cultures have different voice-hearing experiences. That suggests that the way people pay attention to their voices alters what they hear their voices say. That may have clinical implications.”

For the research, Luhrmann and her colleagues interviewed 60 adults diagnosed with schizophrenia – 20 each in San Mateo, California; Accra, Ghana; and Chennai, India. Overall, there were 31 women and 29 men with an average age of 34. They were asked how many voices they heard, how often, what they thought caused the auditory hallucinations, and what their voices were like.
“We then asked the participants whether they knew who was speaking, whether they had conversations with the voices, and what the voices said. We asked people what they found most distressing about the voices, whether they had any positive experiences of voices and whether the voice spoke about sex or God,” she said.

印度やガーナでは幻聴はポジティヴな出来事として経験される傾向が強いのに対して、米国ではネガティヴな出来事として経験される傾向が強い。印度やガーナでは患者にアドヴァイスする親族の声が屡々経験される；

The striking difference was that while many of the African and Indian subjects registered predominantly positive experiences with their voices, not one American did. Rather, the U.S. subjects were more likely to report experiences as violent and hateful – and evidence of a sick condition.
The Americans experienced voices as bombardment and as symptoms of a brain disease caused by genes or trauma.
One participant described the voices as “like torturing people, to take their eye out with a fork, or cut someone’s head and drink their blood, really nasty stuff.” Other Americans (five of them) even spoke of their voices as a call to battle or war – “‘the warfare of everyone just yelling.'”
Moreover, the Americans mostly did not report that they knew who spoke to them and they seemed to have  less personal relationships with their voices, according to Luhrmann.
Among the Indians in Chennai, more than half (11) heard voices of kin or family members commanding them to do tasks. “They talk as if elder people advising younger people,” one subject said. That contrasts to the Americans, only two of whom heard family members. Also, the Indians heard fewer threatening voices than the Americans – several heard the voices as playful, as manifesting spirits or magic, and even as entertaining. Finally, not as many of them described the voices in terms of a medical or psychiatric problem, as all of the Americans did.
In Accra, Ghana, where the culture accepts that disembodied spirits can talk, few subjects described voices in brain disease terms. When people talked about their voices, 10 of them called the experience predominantly positive; 16 of them reported hearing God audibly. “‘Mostly, the voices are good,'” one participant remarked.

ガーナ文化では身体から遊離した魂が語ることが受け容れられている。
Tanya Luhrmann さんはそうした差異を、文化における「自己」のあり方の差異に還元しようとする；

Why the difference? Luhrmann offered an explanation: Europeans and Americans tend to see themselves as individuals motivated by a sense of self identity, whereas outside the West, people imagine the mind and self interwoven with others and defined through relationships.
“Actual people do not always follow social norms,” the scholars noted. “Nonetheless, the more independent emphasis of what we typically call the ‘West’ and the more interdependent emphasis of other societies has been demonstrated ethnographically and experimentally in many places.”

この記事では”Individual self vs. the collective”という見出しが使われているけれど、これはちょっとミスリーディングなのではないかと思った。個人主義か集団主義かというよりも、個人或いは「自己」が本質として社会関係を超越したものとして捉えられているのか、社会関係に「織り込まれ」ている、或いは埋め込まれていると捉えられているのか。

*1:http://luhrmann.net/ See eg. https://en.wikipedia.org/wiki/Tanya_Luhrmann