Devereux] MOHAVE ETHNOPSYCHIATRY AND SUICIDE 19 



can also occur, e.g., in the course of a delirium resulting from some 

 toxic or infectious condition (van Wulff ten-Pal the, 1936). 



(2) As regards specifically the noncorrespondence of occidental 

 and Mohave nosological categories, it is partly due to the fact that 

 some of the theories underlying these two systems differ quite radi- 

 cally. Modern nosological categories were originally derived from 

 descriptive, nondynamic psychiatry. For example, the cornerstone of 

 Kraepelin's (1919) concept of schizophrenia was the belief that this 

 disorder was incurable. Hence, at one time any permanent and not 

 obviously organically determined mental disorder was almost auto- 

 matically diagnosed as schizophrenia, or as a condition close to it. If a 

 seemingly genuine schizophrenic did recover, this was often deemed 

 prima facie evidence that his illness had been misdiagnosed. A linger- 

 ing survival of this view is the distinction made by some contemporary 

 psychiatrists between incurable "process schizophrenia" or "nuclear 

 schizophrenia" on the one hand, and curable "schizophrenic reaction 

 types" on the other hand. By contrast, those recent psychiatric 

 nosologies that are formulated in terms of the psychoanalytic frame 

 of reference are based essentially on a classification of the underlying 

 psychodynamics, rather than on symptomatology or prognosis. 



As regards Mohave nosological categories, they, like psychoanalytic 

 nosologies, are essentially derived from the distinctive etiology im- 

 puted to each illness. Moreover, the informants' descriptions of Mo- 

 have clinical entities often seem rather coherent, although one must, 

 of course, envisage the possibility that this coherence may be the acci- 

 dental product of several factors that may now be listed : 



(a) The patient's knowledge of what disease he is supposed to be 

 suffering from, and his knowledge of what is expected to occur in 

 such an illness, may produce a kind of unconscious "malingering" 

 of the expected set of culturally prepatterned symptoms. The basic 

 dynamics of this unconscious adjustment to the expected or pre- 

 scribed "pattern of misconduct" (Linton, 1936) (i. e., illness) were 

 discussed elsewhere (Devereux, 1956 b) and need not be repeated in 

 this context. 



(b) There may occur an automatic imputation of expected symp- 

 toms to a patient suffering from a disorder that "must have been" 

 caused by a given "pathogenic" entity, as defined by the Mohave. 

 Thus, it is permissible to suspect that a person who did not heed 

 warnings to avoid a lake believed to be full of hikwi :r snakes, would, 

 no matter what illness he may finally contract, be diagnosed as a case 

 of hikwi :r hahnok, and a description of his condition would then 

 be quite likely to include not only the symptoms that he did, in fact, 

 have, but also the symptoms that, given the nature of his diagnosis, 

 he should have had. 



