The European Research Journal 2022 DOI: 10.18621/eurj.1081253
Culture and mental health: a Turkish perspective
Department of Psychology, Istanbul Ticaret University, Faculty of Humanities and Social Sciences, Istanbul, Turkey
Culture and mental health are intertwined concepts. Culture should be regarded as the set of distinctive, spiritual, material, intellectual, and emotional properties of a society or a social group, encompassing lifestyles, ways of living together, value systems, traditions, and beliefs, in addition to art and literature (UNESCO, 2002). Culture consists of different components, including ethnicity, race, religion, age, sex, family values, and the location of the country. It should also be noted that culture is not a static phenomenon. Defining a culture specific to a certain ethnicity, country or region is often not a realistic approach. Many factors, such as the location of a certain city of a country or a certain region of the said city, as well as the inhabitants’ occupational, economic and family positions, have an impact on lifestyles. Globalization, migration, acculturation, assimilation and transition cultures create significant heterogeneity in the very same society. Mental health can be defined as a state of balance that individuals experience both intra-personally and also with other people within their environment. In modern times, we have come to witness that the world we live in transforms at a speed that is challenging to human nature, rapid changes destroy the usual patterns, social ties evolve into ties established in the virtual world, perception replaces reality, and artificial intelligence-like elements turn into new management tools. The spirit of the new century, while flattering human instincts, compresses authenticity,
Colidarity and peace into ceremonial sentences. Keywords: Culture, mental health, Turkish perpective
Culture and mental health are intertwined concepts (1). Culture should be regarded as the set of distinctive, spiritual, material, intellectual, and emotional properties of a society or a social group, encompassing lifestyles, ways of living together, value systems, traditions, and beliefs, in addition to art and literature (UNESCO, 2002). Culture consists of different components, including ethnicity, race, religion, age, sex, family values, and the location of the country (2). It should also be noted that culture is not a static phenomenon.
Defining a culture specific to a certain ethnicity, country or region is often not a realistic approach. Many factors, such as the location of a certain city of a country or a certain region of the said city, as well as the inhabitants’ occupational, economic and family positions, have an impact on lifestyles. Globalization, migration, acculturation, assimilation and transition cultures create significant heterogeneity in the very same society.
Mental health can be defined as a state of balance that individuals experience both intra-personally and also with other people within their environment (3). In modern times, we have come to witness that the world we live in transforms at a speed that is challenging to human nature, rapid changes destroy the usual patterns, social ties evolve into ties established in the virtual world, perception replaces reality, and artificial intelligence-like elements turn into new management tools. The spirit of the new century, while flattering human instincts, compresses authenticity, solidarity and peace into ceremonial sentences.
Multi-channel, rapid flow of information and changes in family structure and values are dazzling even for people a generation ago. Right at the turn of the new century, we are blown away by the winds of postmodernity, that is, an era “post truth”.
It is a subjective feeling of inadequacy and restlessness, a state of boredom, weariness, powerlessness, and discouragement. Current issues, stress, speed, and loneliness are often frustrating. Therefore, not surprisingly, stress is one of the top health risks of the 21st century.
Sometimes, culture can also be a stressor of psychopathology and can activate mental problems in individuals who have a predisposition to a mental pathology (4). Common causes of demoralization include belonging to disadvantaged classes, poverty, violence, unemployment (5) and authoritarianism (6). The “tend and befriend” attitude is suggested to have evolved as a typical female response to stress (7).
Chronic depression is a long-lasting, fluctuating, low-intensity state of depression that a person experiences as a part of their usual self. Such cases, where the disease/health boundary is not clear, present mental health professionals with a challenge: mental problems intertwined with or originating from personality pathologies and resistant to treatment or even diagnosis (8).
Although its prevalence in the society is limited (9), chronic depression turns into a lifestyle, sometimes a subculture element, and overlaps with human unhappiness. Chronic depression is fairly common in individuals who are exposed to social stress and have a low education level (10).
It can be said that in most cultures, individuals prone to depression at times form a subcultural group or gather in such groups. Since individuals in such situations do not seek help, the gravity of the problem is overlooked. The mental well-being of those who belong to groups of satanism, nihilism, anarchism, political and social violence, as well as followers of arabesque and some metal music, is always controversial. Listening rates of music that imposes violence, aggression, discrimination, nothingness/nihilism can provide clues about the prevalence of psychological problems in the society (11).
ROADS TO THE BLUES…
FIRST TRAUMA/ FIRST PAIN
The arrival in a cold and hostile world from a warm and sheltered mother’s womb is defined as a traumatic separation by some psychoanalysts (12). Mystics talk about the sadness of being cut off from God and thrown to earth. Sufi philosopher Rumi uses the moaning sound of Ney, which was plucked from the reed, as a metaphor for this pain (13).
FAMILY: GREAT ADVANTAGE, GREAT RISK
While healthy families are a reliable and indispensable line of defense for their members, broken and restless families create significant mental and behavioral problems in children (14).
In our strongly traditional society, families’ devotion to their children is widely applauded, however, this exaggerated attention can impair the child’s individuation as well as coping abilities. Children’s mental health is adversely affected not only by those who are oppressive and disciplined, but also by families who make an effort to ensure that their children do not “stand on their own legs” (15). This can result in children transform into people who cannot live on their own, who cannot make decisions, who cannot take on responsibilities, who are insecure, weak, and sometimes prone to crime.
The attitude of first glorifying children and later complaining about them is a common Turkish family attitude.
Globalization and unlimited communication possibilities raise people’s expectations in terms of better living standards. The resulting inconsistency between desires and reality increases the tension. Cultural imperialism, human-made disasters have a potential tsunami effect on our lives. Some real, some distorted consumption displays are reflected to the public, and these can cause new feelings of disappointment, self-pity or anger in some people every single day. Young people and adolescents are the most at risk in today’s era of rapid communication and change, so to speak, they are on a knife-edge in this regard.
Poverty can be a clear cause of depression through triggering social stress (16). The most suitable segment of society for individuals to feel peaceful, balanced and comfortable is known to be the middle class. On the other hand, most people in vulnerable socio-economic segments are also able to protect their mental health by accepting the conditions in which they were born and raised, by showing solidarity and having realistic and small expectations (8).
Values, sincere human relationships and the effect we have on others always have a significance in terms of mental health. The determinant effect of the rule “it’s other people that make people sick” (17) is increased in societies where tolerance and altruism are minimized.
Urbanization negatively affects family structure and support systems. In societies where people’s trust in one another is severely damaged, we see that this mental support too, which is of great importance, diminishes. All practices that do not prioritize trust and respect for people are irritating and lead to “diseases/disturbances”.
Cultures and traditions play an important role in identity formation. The middle classes have so far carried the tradition with moderate and humane interpretations. In traditional societies, however, this human intimacy may carry the risk of “lack of ability to keep the appropriate distance”, in addition to the psychological benefit it provides.
Solid and irrational cultural-traditional elements can darken the atmosphere in which people live and create an intense spiritual pressure on them. Sexism is practiced with incredible normality and inhumanity in some regions where the means of claiming rights are limited. For women in these places, spiritual growth is out of the question. In particular, the double standard of “honor” code of ethics produces appalling results (18).
Pathological thoughts of guilt and sinfulness may diminish as traditions move to a more rational and gentle plane. In our culture, the depressive personality profile focused on self-sacrifice and the love, wishes and expectations of others overlaps with the definition of being a “good person”.
The weakening of moral values was leveled off by the strengthening of law in the West. In underdeveloped countries, however, the law has only been the demand of the weaker groups. Therefore, legal or moral values have remained valid and important only for those with little power.
From a generalist point of view, it can be said that helplessness, dependence, resignation, emotionality and a structure of a “communion” come to the fore in Eastern societies, while self-confidence, ambition for success, independence, objection, rationality and individuality are dominant elements of culture in Western societies.
RELIGIONS AND IDEOLOGIES
Religion can produce many mental health-enhancing cognitions. Moreover, it is often protective against alcohol, substance abuse, and stressful life events that are more commonly seen in the secular world. However, some religious beliefs, such as Catholicism and Judaism, impose guilt in ways that negatively affect mental health. Some religious groups may downplay psychological treatments and interpret these diseases as God’s punishment, leading to devastating results for individuals (19).
Some delusional symptoms and compulsive rigidities can be considered as signs of “religiosity” and can have devastating consequences in terms of religion as well. Today, shamanistic practices such as contact with the jinn, casting spells, incense-amulets have turned into a tool for exploiting mental problems. Mystical, mysterious, and sometimes pathological approaches that equate ignorance with belief can confuse people and thus lead them to devalue ways of seeking scientific remedies.
The unhealthy way of interpreting the verses of the Qur’an for one’s own self and the verses of punishment for others is the most harmful epidemic in the Islamic world. Radical/fanatic groups can make religion a tool of separation, polarization and conflict rather than a unifying one. It is possible to call this the “personalized or grouped” form of religion. In every age, many greedy and some mentally ill people who claim to speak for God have used the concept of “sin” as a stick to psychologically beat people, instilling despair, fear and distrust into them.
LETTING RELIGION INTO THE WAILING
As in Christianity and Judaism, mourning and grief formed the basis of religious life in some Islamic sects. These groups practice their religion within a sadness that could be found in a funeral. Constantly cited traumas instill a “no laughter” culture in religious people. The saying, which is part of our culture, “to make honey out of pain” is actually a cry from the nooks of traumatic centuries.
The “afflicted” approach not only predisposes people to depression, but also offers depressive individuals an attractive ground where they can perceive their illness as “good deeds”.
Hundreds of obsessional/phobic rituals infiltrating religions, filling and clamping life with superstitions and ghosts, can mask the original religious thought.
Hymns, in the form of bad and intensified adaptations of arabesque music, create a deep belief confusion in people, along with arbitrary approaches that distort religious messages with subjective elements of personalities or politics. After all, for a society with a poor education level, it is much more comfortable to “believe what the elders say” than to actually research it.
How sad it is that people of the same religion call killing each other jihad (!)
MYSTICISM: THE COMFORT OF SLOWNESS
Mysticism exists in all religions, but it is dominant in Middle Eastern and Far Eastern beliefs. Emerging as a reaction to an over-attachment to worldly life, it has fostered a culture of renunciation, and of trivializing the world or oneself.
Mysticism sometimes can overlap with laziness, and bless pathological behaviors and folk narratives. Both to consider perceptual changes observed in mystics as psychosis and to consider psychosis as a “saintliness” can lead to dramatic results.
Until the 12th century, the sects have been the centers of solution in the political, economic and social turmoil in the majority of the world. From the eighteenth century onwards, with the acceleration of social turmoil and the creation of an atmosphere of pessimism and despair, the sects regained their functional and reactionary qualities. Although the sects were originally a reaction against the collapse and corruption, they could not stay away from being a part of the corruption themselves (20).
Concepts such as Doomsday, Mahdi, Messiah, fairies, spells, miracles, ghosts, and omens are subjective and vague concepts, to which those who object can be declared as unbelievers. Some people may leave their school, work or home due to scheduled doomsday scenarios.
Whether religious or secular, people with similar lifestyles in Turkey are positioned in different “communities” and are alienated from others.
Religious communities are also examples of extraordinary spiritual and social support that emerged with the principle of solidarity in goodness. Naturally, excessive empowerment/growth of these groups can also increase degeneration, thus feeding external or intrapsychic conflict instead of spiritual support.
Some communities have severely criticized approaches to religion that are different from their own. These groups can use cruel expressions such as “infidel, apostate, irreligious, profane, perverted, traitor” against other religious groups, despite not using these against anyone else. It is thought-provoking that in the struggle for power, some religious groups resort to ways that Islam deems as despicable as murder, such as blaming, stigmatizing, envy, backbiting, lying, slandering. What really happens is related to anger and self-interest rather than religion. The justification of violence in the name of religion has thrown the development and chemistry of the mind of the Islamic World into disorder.
Religious discourse with violence, abuse and confusion has decreased in the West due to rationalism and secularism.
IDEOLOGIES: MODERN RELIGIONS
In modern times, we have seen the rise of “false religions” such as militarism, fascism, technology, nationalism, consumerism, fundamentalism, new ageism, asceticism, and psychologism (21)
Although ideologies, i.e. “straitjackets put on our intellect” (22), fascinated mostly anxious and insecure people (23) with their strange prophets and left, several mysterious types of faith still continue to exist with similar followers.
The fact that the world is unfair and will never be fair has turned ideologies into “the religion of the oppressed or the angry”. Through their own clergy, they developed a fierce and ruthless super-ego, declared countless “traitors” and “renegades”, instilled in people an excessive sense of guilt, and ruthlessly shed blood. They shook the established orders, but every revolution only spawned new dictators and oppressed every individual whether or not they were different from them.
TURKEY: THE BATTLEFIELD OF PREJUDICES
Centuries of defeats, losses, tensions that are remnants of poverty and ignorance, authoritarian attitudes, thirst for fair share, disappointments, traumas laid the groundwork for the language of anger and hatred, polarization and conflict. This ground seriously damaged both social culture and mental health of individuals.
The carriers of the original culture and traditions disappeared. Two different social structures were formed, separated from each other by their value judgments, culture, perception of the world and political preferences (24). In this vein, a headline in the New York Times was shocking: “In Grief (Great Ankara massacre) and in Triumph, (Nobel Chemistry prize) Turks Remain Divided” (25).
Extremist groups that despised reconciliation within a closed-circuit, bi-communal “community” network disrupted social peace. The broad masses of people who wanted to live together were frightened and in despair. We still live in a shallow intellectuality where we fight over which leader from the past is the most superior.
We have only one condition to love people and to be tolerant (!) towards them: they must be one of us. A language of political confrontation rather than understanding the other, a “victim” psychology full of irrational-emotional reactions… This blind fight darkens our world and our souls.
Turkish society has reached a partial level of democracy awareness with the short periods of freedom it has enjoyed in every ruling period since the foundation of the Republic. However, it has produced a society that operates with new tensions, restrictions of law and human rights and a spiral of “trauma-polarization” due to the administrations that soon became authoritarian. “Not speaking up in order to survive” behavior and submission create a joyless, insecure society. High masculinity shows its depressive effect in Turkey, as in many other countries (26).
Since an effective legal system and sound institutions have not been established, authoritarianism continues to change hands in Asian-Middle Eastern countries. This fuels sociopolitical conflicts and unrest (27).
MODERNISM: GLOBAL CULTURE/SOCIAL MEDIA
Globalization has rapidly blurred the traditional structure of culture. Especially in cultures in transition, rapid acculturation and deculturation caused a return to more defensive and fundamentalist values and increased tensions. Traditional support systems have worn down, and conflict, restlessness, and mental problems have increased between individuals who are acculturated and those who are not, even within the same family (28).
In today’s world, people are living in a plastic and narcissistic age that is increasingly associated with destructive competition, greed for consumption, income gap and individualism. A frightening illusion of freedom with no reference… We are no longer exposed to real events and people, but to images in the media.
According to 2021 statistics, 4.2 billion people are social media users, that is, 53% of the world’s population (29). While social media expands individual freedoms, especially the freedom to receive information, it is also an atmosphere that produces fear through false information flows, perception operations directed by different sources, information theft, crime, terrorism, hate speech, myths, distortions, lies and speculation (30).
Turkey ranks high in the world with up to eight hours of internet use per day (31). It is not very promising that the Turkish society is ranked 104th among 150 countries in the 2021 World Happiness Index (32), and 8th in the Most Angry list (33).
Social media use has been reported to be associated with depression and anxiety in youth and adolescents (34).
Social media affects our sleep, lifestyle and interpersonal relationships, as well as the addiction it creates, the constant distraction with hundreds of messages containing messy information every day, and the fact that it confronts us with problems all over the world. Social media is the world’s largest and most complex garbage dump with its information and noise pollution, surprising perspectives, and competition/comparison/show/consumption-oriented structure. At the same time, it is also an arena of “zombification” in which disidentification and plastic phenomena are role models.
In this regard, it is mandatory to take the social media education as a starting point for an evaluation.
POSTMODERNISM: THE COMFORT OF LIFE WITHOUT A HERO
A new era began with the realization that heroes are no different from ordinary people. Postmodernism is an objection to Western culture and “grand narratives”, “grand projects”, “grand principles”. It rejects both rationality, positivism/objective reality, value systems and the sanctity of concepts such as universality and freedom. It relativizes not only morality but also science, and is based on self-reference.
Post-modernism emphasizes the disappearance of beliefs and optimism about art, literature and scientific ethics after the Second World War: criticizing everything and everyone, considering almost nothing as correct, being normless and unprincipled.
The characteristics of post-modern consciousness can be defined as emptiness, pessimism, apathy, skepticism (35).
The quest to loosen the restrictive bonds of tradition has put humanity under risk of breaking away from healthy bonds as well.
UNPRECEDENTED SPEED OF CHANGE!
The most important problem of the age is the unprecedented change. The data produced in a single day in recent years is many times more than in the past. Those who dominate the data have also begun to dominate the societies.
We cannot find the time to adapt to this rapid change with our minds, habits and institutions. Many areas, including family, work, school, friendships, customs, trade, have shifted to very different areas. The habits and rules taught as recently as yesterday are falling into disuse in a very short period of time.
Rapid change produces fear and meaninglessness: “We went so fast that our souls are left behind.” I wonder if we completely broke the value system while trying to stretch values? Have we murdered our conscience while softening the super ego?
1. Sam DL, Moreira V. The mutual embeddedness of culture and mental illness. Online readings in psychology and culture. Unit 10.2.; 2002. Retrieved from httb:// works.bepress.com/david_sam/27.
2. Eshun S, Gurung AR. Introduction to culture and psy- chopathology. In: Culture and mental health: Socio cultural in- fluences, theory and practice. Eshun S, Gurung AR. Eds. West Sussex: John Wiley & Sons, Ltd., Publication; 2009: pp.3-18.
3. Sartorius N. Foreword. In: Culture and mental health: a com- prehensive textbook. Bhui K, Bhugra D, eds.. Edward Arnold Ltd: London; 2007: pp.xv-xvı.
4. Gurung RAR, Andela R-W. Stress and mental health. In:. Cul- ture and Mental Health Sociocultural Influences, Theory, and Practice. Eshun S, Gurung RAR, eds., Blackwell Publishing Ltd: London; 2009: pp.35-54. Unprecedent Speed of Change!
5. Kinderman P, Schwannauer M, Pontin E, Tai S. Psychological processes mediate the impact of familial risk, social circum- stances and life events on mental health. PloS One 2013;8:e76564.
6. Anuradha. S, Kumar RU. Effects of oppression on mental health. Eur J Mol Clin Med 2020;7:4902-5.
7. Taylor SE, Klein LC, Lewis BP, Gruenewald TL, Gurung RA, Updegraff JA. Biobehavioral responses to stress in females: tend- and-befriend, not fight-or-flight. Psychol Rev 2000;107:411-29.
8. Aşkın R. Kronik Depresyon. Psikiyatri Temel Kitabı. HYB Basım Yayın. Ankara, 2007.
9. Keller MB, Klein DN, Hirschfeld RM, Kocsis JH, McCullough JP, Miller I, et al. Results of the DSM-IV mood disorders field trial. Am J Psychiatry1995;152:843-9.
10. Husain N, Gater R, Tomenson B, Creed F. Social factors as- sociated with chronic depression among a population-based sam- ple of women in rural Pakistan. Soc Psychiatry Psychiatr Epidemiol 2004:39:618-24.
11. Miranda D, Claes M. Musical preferences and depression in adolescence. Int J Adolesc Youth 2007;13:285-309.
12. Otto Rank. Doğum Travması. (Çevirmen Sabir Yücesoy). Metis Yayıncılık, İstanbul, 2017.
13. Mevlana Celaleddini Rumi. Mesnevi. Akçağ Yayınları: İstan- bul, 2016.
14. Behere AP, Basnet P, Campbell P. Effects of family structure on mental health of children: a preliminary study. Indian J Psy- chol Med 2017;39:457-63.
15. Sümer N, Gündoğdu Aktürk E, Helvacı E. Anne-Baba Tutum ve Davranışlarının Psikolojik Etkileri: Türkiye’de Yapılan Çalış- malara Toplu Bakış. Türk Psikoloji Yazıları 2010;13:42-59.
16. Mossakowski KN. Dissecting the influence of race, ethnicity, and socioeconomic status on mental health in young adulthood. Res Aging 2008;30:649-67.
17. Sullivan HS. The Interpersonel Theory of Psychiatry. WW Norton&Company, New York, 1953.
18. TBMM. Töre ve namus cinayetleri ile kadınlara ve çocuklara yönelik şiddetin sebeplerinin araştırılarak alınması gereken ön- lemlerin belirlenmesi amacıyla kurulan (10/148, 182, 187, 284, 285) esas numaralı Meclis Araştırma Komisyonu Raporu 2005. https://www.tbmm.gov.tr› sirasayi › donem22 › yil01
19. Goffredo B, Simon D. Religion and mental health . In: Cul- ture and Mental Health. A comprehensive textbook. Bhui K, Bhugra D. eds., Edward Arnold Ltd: London; 2007: pp.47-53.
20. Taş K, Güvendi T. Din ve Dünyevileşme Bağlamında Türk Toplumunda Tarikat ve Cemaatler. Tabula rasa Felsefe & Teoloji dergisi 2020; 34, Online Yayın, 01.03.2021
21. Drazenovich,G, Kourie C. Mysticism and mental health: a critical dialogue. HTS Teologiese Studies / Theological Studies, 2009;66, Art. #845, 8 pages.
22. Meriç C. Bu ülke. İletişim Yayınları: İstanbul, 2004.
23. Stone WF, Schaffner PE. The Psychology of Politics. Springer&Verlag: New York, 1988
24. Çarkoğlu A, Toprak B. Değişen Türkiye’de Din, Toplum ve Siyaset. TESEV Yayınları: İstanbul, 2006.
25. Gazete Vatan. “Ne keder ne de zafer birleştirdi Türkleri’’. 13.10.2015.
26. Arrindell, WA, Steptoe A, Wardle J. Higher levels of state de- pression in masculine than in feminine nations. Behav Res Ther 2003;41:809-17.
27. Prasadarao PSDV. International Perspectives on Culture and Mental Health. In:. SCulture and Mental Health Sociocultural In- fluences, Theory, and Practice. Eshun S, Gurung RAR, eds., Blackwell Publishing Ltd: London; 2009: pp.149-78.
28. Bhugra. D. Concluding remarks. Globalization, culture and mental health. Int Rev Psychiatry 2014;26:615-6.
29. Bayrak H. Dünya İnternet, Sosyal Medya ve Mobil Kullanım İstatistikleri. Dijilopedi, 3 Şubat 2021.
30. Fuchs C. Sosyal Medya. Eleştirel bir Giriş. Çev. Saraçoğlu D, Kalaycı İ. NotaBene Yayınları: İstanbul, 2016.
31. We are social and Hootside. Digital in 2021 Raport.
32. Kerem Congar. Dünyanın en mutlu ülkeleri listesi açıklandı: Türkiye 11 basamak geriledi. Euronews. 19.03.2021. 33.http://cdn.cnn.com/cnn/2019/images/04/25/globalstateofemo- tions_wp_report_041719v7_dd.pdf.
34. Keles B, McCrae N, Grealish A. A systematic review: the in- fluence of social media on depression, anxiety and psychological distress in adolescents. Int J Adolesc Youth 2020;25:79-93.
35. Vattimo G, The end of modernity: Nihilism and Hermeneutics in postmodern culture. Johns Hopkins University Press: Baltimore, 1988.
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Conflict of interest
The author disclosed that they did not receive any grant during conduction or writing of this study.
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