Devcreuxj MOHAVE ETHNOPSYCHIATRY AND SUICIDE 241 



Bveu more disturbing is the fact that, with the sole exception of delusions, 

 the list of symptoms includes every single symptom characteristic of catatonia. 

 Otherwise stated, the clinical description of John's "catatonia" is simply too per- 

 fect to be convincing, since it is a well-known psychiatric fact that the "classical 

 textbook case' is the exception, rather than the rule, except in the case of the 

 so-called "ethnic psychoses" which are strongly prepatterned by the cultural 

 matrix in which they occur (Devereux, 195G b). Since true catatonia is not an 

 "ethnic psychosis" of the Mohave, it is hard to see how John — who is psycho- 

 logically a genuine Mohave — could have developed a textbook case of catatonia- 

 On the other hand the list of John's symptoms is perfectly compatible with a 

 textbook case of "transitory confusional state (hysterical psychosis)" which 

 is a genuine ethnic psychosis not only among the Mohave (pt. 2, pp. 50-54), but 

 also among most other primitives. 



Psychiatrist's diagnosis. — Acute schizophrenic state (catatonic type). 



Mohave diagnosis. — Uncertain. Some relatives suspected an ahwe: illness. 



Suggested correct diagnosis. — Transitory confusional state (hysterical psy- 

 chosis) dynamically related to the hysterias. This diagnosis is based on the 

 following considerations : 



(i) Pattern of life history. — The nature of John's childhood tantrums, the 

 character of his anxiety dreams (nightmares), the marked preponderance of 

 oedipally motivated "acting out" over preoedipally motivated "acting out," 

 adequate sexual-emotional functioning, the presence of genuine and lasting 

 friendships, the formation of at least one meaningful, tender, and durable union, 

 adequate functioning as a father, and the nature of the traumata that pre- 

 cipitated the psychotic break. 



(2) Personality structure. — An outgoing and friendly disposition, the absence 

 of shyness, withdrawal or compensatory pseudomanic hypersociability, the ca- 

 pacity to love, noucompulsive industriousuess, a nonobsessive sense of respon- 

 sibility, the absence of ruminative tendencies, the capacity for realistic initia- 

 tive, and the absence of excessive preoccupation with dreams and dreamlike 

 autistic experiences. The latter trait is especially significant, since, had John 

 been autistically inclined, both the shamanistic tenets of his culture and the 

 knowledge that, because of his tantrums, many Mohave expected him to become 

 eventually a shaman, would have facilitated the emergence of autism, had such 

 proclivities been present. What neurotic traits John did have were largely 

 hysterical in character. 



(3) The sudden onset and short duration of the psychosis. — Although modern 

 psychiatry no longer subscribes to Kraepelin's (1919) thesis that chronic mental 

 illness is practically synonymous with "dementia praecox" (schizophrenia), on 

 the whole a psychosis of short duration, with a sudden onset, and with highly 

 dramatic symptoms is not — or should not be — diagnosed as a schizophrenia, 

 unless a scrutiny of the patient's premorbid life history and personality makeup 

 discloses the presence of markedly schizoid traits. Since such traits cannot 

 be found in John's premorbid personality and life history, the short duration of 

 his psychosis militates against the diagnosis "schizophrenia." Otherwise ex- 

 pressed, the present writer agrees with many dynamic psychiatrists in question- 

 ing a recent tendency to label certain forms of hysteria and manic-depressive psy- 

 chosis as schizophrenias of the hysterical (or manic-depressive) type. 



(.4) Degree of recovery. — During his psychotic episode John was subjected to 

 a type of "treatment" which, in the opinion of many competent dynamic psy- 

 chiatrists, does not resolve the patient's internal conflicts, but simply suppresses 

 their outward, symptomatic manifestation, by bringing about a radical im- 



