ESHS/HSS Annual Meeting

Koro as a Paradigm in Transcultural Psychiatry

• In Event: Transcultural Psychiatry and the Sinophone Pacific

English Abstract

As cross-cultural mental health began to command widespread medical interest in the mid-20th century, in what ways did it emerge out of the dismantling of colonial psychiatry, reshape the professional status and agency of Asian psychiatrists, establish new understandings of non-Western cultures, and contribute to an epistemic shift in mental health science from classical biological models to a greater emphasis on cultural competency? My proposed entry point for answering these questions is the social history of a cultural-bound syndrome known as koro. Koro refers to a person’s overpowering belief that his genitalia is retracting and even disappearing.
Drawing on archival and published sources, I hope to chart the rise and fall of koro’s status as a “paradigm” for understanding all culture-bound syndromes in modern psychiatry. In the early period, Sinophone psychiatrists sustained a vibrant transpacific discourse about koro by melding Western psychoanalysis with sexual concepts from traditional Chinese culture. Starting in the 1970s, psychiatrists began to discover on a more frequent basis cases of koro outside Sinophone East Asia. Reports of koro came from all over the world—Great Britain, France, Canada, the United States, India, Georgia, Yemen, and Nigeria. These findings pushed Western and non-Western psychiatrists alike to acknowledge the increasing need to engage with anthropological perspectives in order to fully understand the development of certain mental health problems in culturally saturated contexts. Since the reform era, many physicians in China have reinvented the image of koro as a somatic disorder long diagnosed within the yin-yang theory of traditional Chinese medicine. Tracking how transcultural psychiatry has evolved over time and the emergence and decline of the culture-bound syndrome nosology unmasks a deeper history of the global circulation of knowledge between certain locations in Asia (typically dubbed as the “margins” of biomedicine) and the alleged “core” regions of mental health science. Similarly, scrutinizing koro’s reinvention as an age-old disorder calls into question essentialist constructions of Chineseness and Sino-centrism in contemporary medical practice.

Author

• Howard Chiang, University of California, Santa Barbara