III. ROUND THREE by RonaM C. Simons
"I do not choose to know that!" Harry Secombe's tag line in The Goon Show, a popular BBC radio series of the '50s
The Culture-Bound Syndromes was written in the hope of moving discourse about a group of odd behaviors in a direction more suggestive of testable hypotheses than has usually been the case. It seemed to me and to Charles Hughes that on the subject of the syndromes individually and collectively there were entirely too many words about words; that it would be useful to propose a way to focus again on the phenomena that the words were about. As both Hufford and Kenny observe, The Culture-Bound Syndromes deliberately contains juxtaposed opposing views of many of the syndromes, and as both note, the selections, juxtapositions and commentaries are intended to make the book rather more than the sum of its parts. By breaking down the extravagantly heterogenous category of "culture-bound syndromes" into more manageable parts, Hughes and I propose a new way of defining the field of inquiry. Hufford, I gather, thinks that this is useful. Kenny, I gather, mistrusts the enterprise.
As Kurt Vonnegut so often has said, "and so it goes." Since in inviting this commentary Dr. Good requested brevity, I will not here comment further on Hufford's critique. He and I work with congruent paradigms, and I think he has explained what the book is about charitably and accurately. I will also say only a little about Kenny and Hufford's comments on Dr. Hughes' work. It stands on its own merits, and needs no special defense. I should mention though that as Hufford notes (but Kenny seems to miss), Hughes discusses the application of DSM-III criteria to the individuals who have been indigenously diagnosed with culture-bound syndrome names, not to the conceptual entities which constitute the syndromes or the taxa. Further, he does not advocate application of DSM-III criteria to cases. Rather he explores in the context of each of the syndromes what happens when such application is attempted. His discussions of the problems inherent in this approach and of its sucesses and failures not only reveal the strengths and limitations of DSM-III but also illuminate the theoretical problems inherent in any attempt to reconcile highly disparate classification systems. I suspect that many readers will find Hughes' discussions of DSM-III the most interesting and useful portion of the book.
And so to Kenny and round three of our ongoing debate. A principal Culture, Medicine and Psychiatry 12 (1988) 525--529.