Dancers perform on stage as the English National Ballet rehearse 'Coppelia' at the Coliseum on July 22, 2014 in London, England. Photo: Ian Gavan/Getty Images
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Hearing disembodied voices as violent or helpful depends on culture, study finds

A Stanford study has found that those who hallucinate voices are influenced by the culture they live in, with differences in mood and tone depending upon where in the world they live.

Ethan Watters's 2010 book Crazy Like Us: The Globalization of the American Psyche details how mental health conditions around the world have changed thanks to globalisation. What the American medical establishment understood as the model of an illness, its causes and even its symptoms, became how it was experienced elsewhere.

For example, Sing Lee, a psychiatrist in Hong Kong, spent much of the late 1980s and early 1990s studying anorexia. His patients did not deliberately avoid eating - in fact, “they complained most frequently of having bloated stomachs”. Then, in 1994, a teenage girl collapsed and died in the middle of a busy street, and the local papers reported her anorexia with language straight from American medical dictionaries:

Western ideas did not simply obscure the understanding of anorexia in Hong Kong; they also may have changed the expression of the illness itself. As the general public and the region’s mental-health professionals came to understand the American diagnosis of anorexia, the presentation of the illness in Lee’s patient population appeared to transform into the more virulent American standard. Lee once saw two or three anorexic patients a year; by the end of the 1990s he was seeing that many new cases each month. … By 2007 about 90 percent of the anorexics Lee treated reported fat phobia. New patients appeared to be increasingly conforming their experience of anorexia to the Western version of the disease.”

While cultural conditioning is an easily acceptable notion, the idea that our mental health is similarly conditioned can feel a little strange. This is because it belies our understanding of illness, especially mental illness - with modern medicine, we’re accustomed to thinking of the human body as a machine, and treatment for disease as akin to the physical repair of a worn-out mechanism. Our inability to completely model a human brain means we’re also groping in the dark when it comes to modelling mental health as only a physiological phenomenon.

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is the most infamous example of this problem - in theory, the definitive catalogue of mental health, and the standard reference for any psychiatric diagnosis. In practice, it conflates everyday personality traits with disorders, relying on changeable mood to decide whether those traits are bad or not. In response to the publication of the most recent edition, DSM-V, the British Psychological Society issued a statement criticising its premise:

The putative diagnoses presented in DSM-V are clearly based largely on social norms, with 'symptoms' that all rely on subjective judgements, with little confirmatory physical 'signs' or evidence of biological causation. The criteria are not value-free, but rather reflect current normative social expectations. Many researchers have pointed out that psychiatric diagnoses are plagued by problems of reliability, validity, prognostic value, and co-morbidity."

The manual also “misses the relational context of problems and the undeniable social causation of many such problems”. (This was best skewered by Sam Kriss, who reviewed DSM-V as if it’s a Borgesian dictionary of the dystopian, written by an anonymous author intent on dehumanising its subjects.)

It’s within this context that we should welcome a study, led by anthropologist Tanya Luhrmann of Stanford University, which has found that the nature of aural hallucinations change relative to the local culture of the person experiencing them. Americans who hear disembodied voices are more likely to report them as violent, or “bombardment”; Indian and Ghanian participants more often reported the voices they heard were “playful” or even “entertaining”.

All of the participants in the study had been diagnosed as schizophrenic, with 20 each from San Mateo in California, Accra in Ghana and Chennai in India. All participants, from all three locations, reported both positive and negative experiences with hallucinated voice - yet while the Ghanaians and Indians reported predominantly positive experiences, the Americans all said their experiences were mostly negative.

Crucially, too, Americans perceived their hallucinations as symptomatic of a deeper disease, whether innate or because of a traumatic experience - while 11 of the Indian participants described their voices as deceased relatives giving advice or commands, and 16 of the Ghanaians reported hearing the voice of God.

The voices were treated as a “magic”, “playful” or “entertaining” more often than not, and only some participants saw them as manifestations of a mental illness; the Americans, in contrast, heard voices describing violent imagery, “torturing people” or a “bombardment”, an “assault”, or even a “call to war”. “[The] harsh, violent voices so common in the West may not be an inevitable feature of schizophrenia,” Luhrmann said in a statement.

The study, published in the British Journal of Psychiatry, It gives extra weight to criticisms of mental illness which don’t take account of external, social factors - and to the influence of a model of mental health on the manifestation of an illness. Luhrmann said: “The difference seems to be that the Chennai and Accra participants were more comfortable interpreting their voices as relationships and not as the sign of a violated mind.” As the interpretations didn't seem to correlate with either religious belief or urbanisation, she suspects the underlying cause for this is that Americans were less community-minded than the others. This is speculation, and requires further investigation, but it does point the way to new possibilities in treating schizophrenia and disembodied voices, with the possibility that "befriending" them could lessen their impact.

Ian Steadman is a staff science and technology writer at the New Statesman. He is on Twitter as @iansteadman.

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How can Britain become a nation of homeowners?

David Cameron must unlock the spirit of his postwar predecessors to get the housing market back on track. 

In the 1955 election, Anthony Eden described turning Britain into a “property-owning democracy” as his – and by extension, the Conservative Party’s – overarching mission.

60 years later, what’s changed? Then, as now, an Old Etonian sits in Downing Street. Then, as now, Labour are badly riven between left and right, with their last stay in government widely believed – by their activists at least – to have been a disappointment. Then as now, few commentators seriously believe the Tories will be out of power any time soon.

But as for a property-owning democracy? That’s going less well.

When Eden won in 1955, around a third of people owned their own homes. By the time the Conservative government gave way to Harold Wilson in 1964, 42 per cent of households were owner-occupiers.

That kicked off a long period – from the mid-50s right until the fall of the Berlin Wall – in which home ownership increased, before staying roughly flat at 70 per cent of the population from 1991 to 2001.

But over the course of the next decade, for the first time in over a hundred years, the proportion of owner-occupiers went to into reverse. Just 64 percent of households were owner-occupier in 2011. No-one seriously believes that number will have gone anywhere other than down by the time of the next census in 2021. Most troublingly, in London – which, for the most part, gives us a fairly accurate idea of what the demographics of Britain as a whole will be in 30 years’ time – more than half of households are now renters.

What’s gone wrong?

In short, property prices have shot out of reach of increasing numbers of people. The British housing market increasingly gets a failing grade at “Social Contract 101”: could someone, without a backstop of parental or family capital, entering the workforce today, working full-time, seriously hope to retire in 50 years in their own home with their mortgage paid off?

It’s useful to compare and contrast the policy levers of those two Old Etonians, Eden and Cameron. Cameron, so far, has favoured demand-side solutions: Help to Buy and the new Help to Buy ISA.

To take the second, newer of those two policy innovations first: the Help to Buy ISA. Does it work?

Well, if you are a pre-existing saver – you can’t use the Help to Buy ISA for another tax year. And you have to stop putting money into any existing ISAs. So anyone putting a little aside at the moment – not going to feel the benefit of a Help to Buy ISA.

And anyone solely reliant on a Help to Buy ISA – the most you can benefit from, if you are single, it is an extra three grand from the government. This is not going to shift any houses any time soon.

What it is is a bung for the only working-age demographic to have done well out of the Coalition: dual-earner couples with no children earning above average income.

What about Help to Buy itself? At the margins, Help to Buy is helping some people achieve completions – while driving up the big disincentive to home ownership in the shape of prices – and creating sub-prime style risks for the taxpayer in future.

Eden, in contrast, preferred supply-side policies: his government, like every peacetime government from Baldwin until Thatcher’s it was a housebuilding government.

Why are house prices so high? Because there aren’t enough of them. The sector is over-regulated, underprovided, there isn’t enough housing either for social lets or for buyers. And until today’s Conservatives rediscover the spirit of Eden, that is unlikely to change.

I was at a Conservative party fringe (I was on the far left, both in terms of seating and politics).This is what I said, minus the ums, the ahs, and the moment my screensaver kicked in.

Stephen Bush is editor of the Staggers, the New Statesman’s political blog.