The other day I was talking with my flatmate. She was a psychiatrist and the discussion moved to how psychological conditions and symptoms are entirely culturally and contextually dependent. Your behaviour must be inappropriate for your culture for it to be relevant to psychology. But this does not sit well with Dawkins’ definition of a delusion. The definition of a delusion is a steadfastly held wrong belief that is inappropriate to the culture. Dawkins wants to dismiss the latter part—the culturally dependent part—of that definition. This would define a delusion as any steadfastly held wrong belief. But it is a mistake to be so fast to do away with the context and culture.
Our discussion started—as do many others—about sex. It was about the psychological relevance of being a very sexually forward female. Moral dispersion aside, in the UK it is inappropriate to be a sexually forward female. From a psychiatric point of view, this behaviour is a sign of sexual abuse in early childhood or from an early partner (up to around the age of 15). The abuse manifests itself as feeling empowered by sexual encounters while being unable to relinquish that perceived control (notice the paradox of that not being real control). The belief in the relationship between sex and empowerment will be held steadfastly, sometimes in spite of how it makes them feel after each encounter. In Denmark, however, being sexually forward is culturally appropriate. The background of each country that leads to this difference eludes me, but Danish women often are forward. That is not psychiatrically-relevant and so is not a marker for sexual abuse. If we were to follow in Dawkins’ footsteps and erase the culture-specific part of the definition then psychiatry becomes very difficult: do we assume Danish women were sexually abused or do we miss the markers for abuse in British women?
Examples abound of how the same behaviour depends on context before it can be considered a mental issue. Mania, for example, is massive elation and feeling the need to be very charitable. These people are pathologically happy for a short time and could emotionally cope with any bad news. It is not a sustainable state. These people will give away their money, even if it is the last of their money; people have bankrupted themselves in 1 hour of mania. That is clearly insane, and it is based on delusions like having just won the lottery. However, if the maniac has won the lottery it is not psychiatric, it is normal. Without context, we don’t know which it is.
And this brings us to religion. The people of Africa who believe in witchcraft and voodoo are not delusional, they are simply wrong. Their beliefs are dysfunctional. But they are not deluded. In fact, in The God Delusion Dawkins gives reasons why an entire culture may succumb to dysfunctional beliefs: evolution has picked for those who can stand on the shoulders of the giants before them; it is an evolutionary advantage to listen to your parents or elder when they tell you which snakes bite or which berry is poisonous. But when an entire culture lacks knowledge about what a “poison” or “toxin” is, there is a place for “don’t eat that berry because it wants to kill you” instead of “don’t eat that berry because it has an organic chemical which disrupts the function and mechanics of your body”. Endowing things with sentience is the pathway to religion: eventually a culture endows nature itself with ideas of sentience. But just like the sentient berry, it’s a dysfunctional belief.
For the same reason we rely on cultural differences when practicing psychiatry and psychology, and the same reason those professions rely on context clues, we should allow that distinction to stay in place to distinguish between a steadfastly held wrong belief and a delusion.