Devereux] MOHAVE ETHNOPSYCHIATRY AND SUICIDE 223 



our regarding his symptoms and general condition as suggestive of 

 a genuine schizophrenia. ^Miile it is admittedly extremely hazard- 

 ous to make a psychiatric diagnosis at a distance, it is my conviction 

 that he simply developed a deceptively schizophrenia-like transitory 

 confusional state, of a type known to occur in primitive society. 



On a more general level — and speaking from years of experience 

 with Indians hospitalized in neuropsychiatric wards — I am firmly 

 convinced that, due to cultural differences, also reflected in differences 

 in etlinic character, far too many Indians are wrongly diagnosed 

 as schizophrenics. The following examples will illustrate this point. 



(1) One Plains Indian case, so misdiagnosed, was published in great detail 

 (Devereux, 1951 a, and 1951 i) . 



(2) Another Plains Indian, also misdiagnosed as a schizophrenic, became 

 violent only after being subjected to shock "therapy," but made a prompt re- 

 covery when, at my insistence, he was given a brief supportive psychotherapy. 



(3) An educated Plains Indian woman, presented at a staff conference, was 

 diagnosed by all nonanalysts, except one, as a schizophrenic, and by all analysts 

 as a hysterical psychosis. A subsequent psychoanalytic study of this woman 

 supported the latter diagnosis (Devereux, 1953 b) . 



(4) An experienced psychiatrist, who had done a great deal of work with 

 psychotic Indians, told me of a Navaho, who had been locked up in a cell for 

 years, because he was diagnosed as a homicidal paranoid schizophrenic. Yet, 

 when this physician released him from his cell and gave him ground privileges, 

 the patient made a prompt recovery and was able to return to the Reservation 

 (Devereux, 1942 c). 



Cases like this could be multiplied indefinitely and force one to 

 express serious concern over the current tendency to diagnose both 

 Indians and other "primitives" (Laubscher, 1937, etc.) far too readily 

 as schizophrenics, on the basis of entirely inadequate data, and also 

 because of a lack of real understanding of cultural and character- 

 ological differences. Such misdiagnoses are especially deplorable in 

 view of the fact that, given the financial, and often also linguistic, im- 

 possibility of giving "natives" intensive psychotherapy, many of them 

 are unnecessarily subjected to shock "therapy" and perhaps even to 

 lobotomy, both of which appreciably reduce the colorfulness, multi- 

 dimensionality, and general level of functioning of the patient, and, 

 in most cases, simply make him more "manageable." 



CASE 64: 



Preliminary note. — For various reasons it was necessary to disguise the iden- 

 tity of the Mohave Indian whom I propose to call "John Smith." 



One way of disguising data likely to betray the subject's identity is to distort 

 them, or to replace real occurrences with similar but invented incidents. These 

 means of disguising facts are psychologically unsatisfactory, because every 

 omission, distortion, or substitution affecting the data automatically distorts 

 also the psychological climate of the case history and disrupts the subtle internal 

 logic of the events. 



