A new intriguing idea about the pernicious influence of the West on the rest of the world is to be found in the work of an author who is not even concerned with such fantasies as neo-liberalism, unfettered capitalism and the instant universal applicability of Western-style democracy. Rather, Ethan Watters writes about the global Americanisation of madness and clinical diagnostic methods. But his model is clearly applicable to how the West, in particular the US, comes to spread its ideologies by crowding out equally valid and often more pertinent indigenous discourses. In a forthcoming book, Crazy Like Us: The Globalisation of the American Psyche, Watters examines how Western psychiatry comes to alter not only the 'scientific' perceptions and treatments of patients in non-western societies but, more intriguingly, how the patients' own symptoms change in order to match those described in American and Western diagnostic manuals. Ahead of its publication, Watters set forth his strange but powerful thesis in a recent article in The New York Times. Most interestingly, he begins with the experience of prominent Chinese University research psychiatrist Sing Lee, a pioneer in the study of anorexia nervosa among Hong Kong patients. In the late 1980s, Lee started noticing a peculiar, or Hong Kong-specific, form of anorexia. His patients frequently did not eat because they felt their stomachs were bloated. Unlike their American counterparts, most did not intentionally diet, or perceive themselves as fat. Then everything changed when Charlene Hsu Chi-ying collapsed on November 24, 1994, in a busy street and died. The anorexic teenager's death whipped up a media frenzy and health scare. Newspapers quoted experts who had never met Hsu but confidently commented that she suffered from a 'classic' - that is, American - form of anorexia. Reporters started looking up American diagnostic manuals and quoting from them. Soon enough, anorexia, an extremely rare condition in Hong Kong until then, started cropping up as more and more patients came to mimic typical American symptoms. 'Western ideas did not simply obscure the understanding of anorexia in Hong Kong,' wrote Watters. 'They also may have changed the expression of the illness itself. The presentation of the illness in Lee's patient population appeared to transform into the more virulent American standard. By 2007, about 90 per cent of the anorexics Lee treated reported fat phobia. What is being missed is a deep understanding of how the expectations and beliefs of the sufferer shape their suffering.' Students of French philosopher Michel Foucault's study of the history of Western psychiatry would not be surprised by Lee's and Watters' findings. But theirs is also a valuable model of how Western notions of free markets and democracy are spread. One political analogue to the madness thesis is how the struggle of mainlanders against the state is often dogmatically cast as a struggle for democracy. In reality, such demands are more often made for good governance; a very different thing. The parents of children who died in shoddily built schools in the Sichuan earthquake and of those harmed by tainted milk formula; owners of so-called 'nail houses' fighting corrupt developers; revulsion against official corruption; the rise of a critical middle class - these have not necessarily led to demands for democracy, but for official responsibility and better governance. Because words like 'democracy' are such powerful blanket terms, they create a mental template that makes it possible to ignore local conditions, history and future options. They come to be uncritically accepted and advocated by many disaffected Western-educated or -influenced locals who have lost touch with their own traditions and sometimes even their first language; such people come to see every social and political ill in their society through the prism of democratic phraseology, a set of one-size-fits-all conceptual labels that crowd out critical thinking itself. Or, as a friend puts it in more graphic terms, such paralysing concepts are 'the pseudo-intellectual vapourware of the West'. Alex Lo is a senior writer at the Post
