feminisation of the subject nation yielding inevitably to the masculine authority of the imperial powers. (2010). Instead, the conditions of indigenous women in relation to mental disorders were subsumed under those of generic male conditions, with rare exceptions, such as that shown towards the phenomenon of latah in the Malayan regions, defined as a nervous affliction characterised by involuntary verbal and bodily repetitions, frequently obscene in nature (Winzeler, 1995).
Latah, in its passive, imitative, non-voluntary and mechanical manifestations, was seen primarily as a disorder of Malay and eventually Dayak women (Spores, 1988; Winzeler, 1995). Ronald Simons (1996) by contrast, argues that latah is not a condition confined to a specific culture or region solely, but is far from being unknown as a startle response in the West as well. Culture merely dictates the form and degree of the reaction, as well as conferring whatever benefits (or otherwise) may be conferred upon the ‘sufferer’. If correspondingly downplayed in the West, latah appears to have a distinct social role to play in Southeast Asia (Simons, 1996). In this vein, Aihwa Ong (1990) describes how latah, once traditionally associated with older Malay women, has become a common feature amongst young Malay, female industrial workers caught between conflicting, cultural gender norms. Here latah appears to act both as a generalised indicator of tension as well as a possibly that of resistance to these political and cultural contradictions.
Colonial enthusiasts, both contemporary and historical, have long expressed curiosity about such local phenomena as koro: an hysterical anxiety that the sufferer’s genitals or nipples are fatally receding, and the phenomenon of amok as well. These were being increasingly viewed as simply bizarre local manifestations of known European disorders, albeit demonstrated at a more basic, primitive level (Littlewood, 2001; Mo et al., 1995); although one serious outbreak of koro in Singapore was noted as late as 1967 (Ng and Chee, 2006). Winzeler (1995) goes on to argue that this perceived tenuous commonality with Europeans and their mental disorders would not suspend European value judgements concerning Malayan people and their propensities towards mental illness.
In Malayanist versions of Orientalism, sensuality and femininity … were seldom raised, but instability was given great emphasis. It was axiomatic that Malays, Javanese and other Malayan peoples were by nature ‘sensitive to the slightest insult,’ ‘volatile,’ preoccupied with maintaining balance and composure and so forth. Such psychological tendencies were held to be in part a matter of inherent character and in part a consequence of despotic political rule and a rigidly hierarchical social order that was to be changed through the creation of a new way of life under European guidance (Winzeler, 1995: 4).
In this analysis, therefore, colonial rule could be seen as imposing a fundamentally civilising and benevolent power on territorial possessions that would sweep away regional and traditional tyranny, and bring order and medical help to local populations, a view which Ernst (2010) dismisses as mere mythology. The issue of amok demonstrates this point in its description, as attributed to an English physician in 1891, as being a ‘blind furious homicidal mania’ that was ‘peculiar to the Malay race’ (J Teoh, 1971: 20).
Amok was considered not only a disorder of the Malay (as well as the Javanese) individual but one that was peculiar to men and dishonoured men at that.
When the Malay feels that a slight or insult has been put upon him … He broods over his trouble, till, in a fit of madness, he suddenly seizes a weapon and strikes out blindly at everyone he sees - man, woman or child, often beginning with his own family (Swettenham, 1906: 143).
Murphy states, however, that incidents of amok increased in parallel with the colonisation of settlements by Europeans in the eighteenth and early nineteenth century (1973). Although in rural areas amok was still considered an honourable response to intolerable triggers, in the Europeanised urban areas, the social factors were ignored in favour of explanations pointing towards insanity or perhaps somatised physiological conditions. By the 1930s a general diagnosis of schizophrenia was applied to the condition, which by this time had become comparatively rare (Murphy, 1973). The marked decline of cases of amok, standing in comparison with its former and rising prevalence, conforms with Golberg’s observation that the medicalisation of madness could usefully be employed to support State policy, in this case that of colonialism (Goldberg, 1999).
Western responses to amok were divided, with opinions varying between whether this sort of indiscriminate slaughter could be classified as plain crime or insanity; medical opinion eventually veering towards the latter (Hatta, 1996; Spores, 1988). Commensurate with Murphy and Winzeler’s arguments, for Spores the gradual demise of amok was related to the enormous social changes taking place in feudal Malaya through the imposition of colonial law and order. This, combined with the medicalisation of amok, resulted in colonial authorities branding the amok runner a lunatic rather than a notorious anti-hero, with all the associated stigma that this conjured up for Europeans and imparted to colonial subjects (McCulloch, 2001).
The colonial psychiatrist therefore found himself in the powerful position of becoming the undisputed ‘arbiter of deviance’, redefining behaviours previously thought of as little more than local oddities towards classifications of mental disorders, from mild neuroses and hysterias, to the seriously deviant and criminally insane (Romanucci-Ross, 1997a: 18).
Psychiatry, with its function of defining, maintaining and ‘treating’ psychological disorder, often identified in the context of social disorder, provides the scientific basis and the legislative and therapeutic justification for a particular approach in dealing with madness. Furthermore, by asserting its expertise in dealing with madness, psychology provides the glue that binds the individually deviant behaviour in the socially sanctioned procedures for incarceration (Sashidharan and Francis, 1993: 98).
Psychiatric opinions could therefore be seen as a useful tool, one that aided and empowered colonial authorities to apply methods of control towards labelled deviant individuals on the grounds of civil order.
The anthropological and medical curiosity towards regional behaviours reframed as ‘mental disorders’ have continued to excite psychiatric interest for Western and Western-trained psychiatrists. In the mid to late twentieth century interest in the so-called ‘cultural-bound syndromes’ generated large-scale research intent on establishing classifications that were strongly reminiscent of the endeavours of colonial psychiatry:
The extent to which such patterns could be fitted into a universal schema depended on how far the medical observer was prepared to stretch a known psychiatric category (Littlewood, 2001: 4).
Consequently, the interest in culture-bound syndromes can be read as providing continuing examples of perceived ‘otherness’ for Western observers, which become dislocated from the meaning associated with their manifestations. Culture-bound syndromes are viewed as strange exotica and reinterpreted within a framework of classification to make them more intelligible to unfamiliar audiences. According to Naomi Selig (1988: 96) the spate of cross-cultural psychiatric studies looking at the incidence of schizophrenia globally in the 1960s continued to exemplify the modern day ‘colonial stance’.
The attempt to identify universals in mental illness formed the basis of the World Health Organization (WHO) International Pilot Study of Schizophrenia in 1966. A significant finding to come out of this report was that, contrary to expectations, diagnosed schizophrenics in some developing countries had a better prognosis of recovery than those in the developed countries of the West. A follow-up study two years later supported this finding (Sartorius et al., 1977). Other psychiatric studies in cross-cultural variables have specifically attempted to focus on the connection between psychiatric disorders and the ‘sociocultural’ environment using very large statistical samples of ‘different groups of people’ (Leighton and Murphy, 1966: 3). Both the WHO report of 1966 and cross-cultural psychiatry have been subjected to sharp criticisms, largely on methodological grounds. Kleinman (1988: 14-15) points out how disease
