In his new book The Geography of Madness travel writer Frank Bures explores “how our ideas can kill us, how our beliefs can save us and how these things quietly determine the course of our lives.” His quest to understand culture-bound syndromes led him to Nigeria, Borneo, Singapore, China and beyond. In these places Bures pursues “fox ghosts and lizards that crawl under your skin, poison pork and poisoned minds.” He becomes fascinated with the world’s strangest syndromes, exploring how one culture could believe something that would appear entirely out of the realm of possibility to another. Here Bures helpfully answers our questions about everything from the common experience of culture shock to the less common occurrence of penis theft.
Longitude. You describe your first experience of culture shock as an exchange student in Italy. How do you define culture shock and what led you to explore the idea further?
Bures. The term “culture shock” isn’t used much these days by people who study it, mainly because of its negative connotation. It implies “shock” is a bad thing, while most people who go through it don’t have long-lasting negative effects; they have positive ones. The current term is “acculturation stress,” which means the stress of not being in your own culture; of knowing all the things we take for granted; and of trying to get through the day without all the scripts you usually follow.
Longitude. Do you have any advice for the traveler reeling with “acculturation stress?” Is there any remedy or preventative measure to be taken?
Bures. Acculturation stress is generally more an issue for people who are living in a foreign culture than people who are passing through it. But no doubt there are similarities, in that people employ different “acculturation strategies.” One of those strategies is called “separation,” which means the rejection of the new culture in favor of your home culture. Others use an “assimilation” strategy, which means they the reject their home culture in favor of the new one. But the strategy that seems to be the healthiest, and which has the most long-term benefits, is called “biculturalism,” in which you learn the new ways of thinking, speaking and interacting and retain your old ones. If successful, this can mean having two separate identities, which can help you see things more creatively through the rest of your life. For the traveler more generally, I would just advise to act like you would in any guest’s home, because that’s where you are.
Longitude. What culture-bound syndrome that you came across in your travels most surprised or amused you?
Bures. One that is more interesting to me is voodoo death, first because it’s fascinating, and second because it has so many permutations, even in American culture. It’s the idea that believing in your own death can, in some way, bring it about. You can see this effect many places, including in the Framingham Heart Study, where women who believed they were at risk from heart disease were 3.6 times more likely to die of heart attacks than women with the same risk factors but who believed they weren’t.
Longitude. You spend a chapter on “American Maladies,” revealing how some illnesses many Westerners assume are biological may be culturally influenced or defined. How did you parse the biological and cultural maladies of a culture you are immersed in?
Bures. The place where biology ends and culture begins can be hard to pinpoint, but it gets clearer when you look beyond your borders. There you can get an idea of what syndromes don’t exist in other places, or exist differently, or at different rates. In any of those cases, culture enters as part of the question. The more difficult thing to do is figuring out how that works. What is culture, and how does it factor in this equation? If you put a finer point on the definition of culture, as I tried to do, it becomes less problematic.
Longitude. Do you feel defining an illness as “cultural” rather than “biological” undermines its validity?
Bures. No. Only in a biomedical culture like ours, where we believe physical things are real and mental things are not. But even here, if you accept mental states as contributors to physiological states, it becomes less of a dilemma.
Longitude. By the end of the book you begin to equate culture with the stories we tell ourselves and those around us. Where did you see narrative influencing the syndromes you researched?
Bures. Here’s an example: In the 1980s, people in the meatpacking industry started reporting cases of “cumulative trauma syndrome,” or carpal tunnel syndrome. As these got more attention, the condition started spreading to other industries, like auto assembly, textiles, apparel manufacturing, electronics and newspaper publishing. More recently there haven’t been many stories about carpal tunnel syndrome in the news, and cases have fallen. While it’s almost impossible to to prove that stories about CTS are part of the cause (i.e, that they have some interaction with our biology that resembles a feedback loop) but it’s hard to see how this isn’t the case when you watch these conditions rise and fall throughout history.
Longitude. Why was traveling to the places where some of these syndromes occurred a necessary part of your research?
Bures. We tend to think we know much more than we do about the world. Sometimes only by going there can we understand how little we know. In China I was told things by experts that, a few hundred miles down the road, I would find out were not true at all. If I had any hope of discovering if koro still existed in the places I’d read about, I knew I had to go there. Longitude. Window seat or aisle?
Bures. Window, always.
Longitude. While you spend much of your book pursuing the fascinating phenomenon of koro or “magical penis theft,” were there other illnesses you came across that you plan to research more?
Bures. There are many. But I felt like I got to the root of my question about these things, which was about how narratives in our culture affect our self-concept, and how this is both helpful and harmful. Next I want to look at how narratives are used to unite and divide us.
Longitude. Where to next?
Bures. Rwanda to revisit the genocide. Guyana to find Dark Shamans. Michigan to throw my hat in the ring at the annual rock skipping championship. Third photo credit: Marian Rosenberg