United States medical officers who witnessed Puerto Rican soldiers going into states of “anxiety, rage, psychotic symptoms, and unpremeditated suicidal attempts (Gherovici 29)” originally coined the Puerto Rican Syndrome (PRS). The symptoms were applied to Puerto Ricans specifically because the medical officers believed it was a cultural phenomenon that was only exhibited by these soldiers returning from the Korean War. The United States medical officers ultimately placed Puerto Ricans in a zone as exhibiting hysteria from their cultural experiences prior to going into war; it was said to develop from “common folk beliefs,” multiple personality disorder and even “an indication of a higher rate of organic brain disorder among Puerto Ricans (Gherovici 30).” To the medical officials and psychoanalysts the application of this disease was considered a culture-bound syndrome that developed through their social environment, however Gherovici also notes “the syndrome taken globally is often described as a ‘normal’ reaction within Hispanic culture (31).” Thus, it is evident that there have been cases made that construct the symptoms of PRS as strictly Puerto Rican but also evidence that shows these symptoms as seen on a more global scale. Ultimately though, the definition of PSR by the U.S. medical officers “superficially stereotyped an entire national group and transformed a customary experience into a serious mental health problem with an eccentric location. Thus the Puerto Rican Syndrome was coined as a new illness category for an otherwise culturally accepted normal manifestation (Gherovici 35).” The invention of Puerto Rican Syndrome by Western ideology labeled Puerto Ricans exhibiting these symptoms as having a severe mental disorder that needed psychiatric treatment and ignored the same manifestations of symptoms in U.S. veterans and thus made the mental illness a cultural bound syndrome that was most certainly seen in other veterans as Post-Traumatic Stress Disorder (PTSD) (Gherovici 33-34).
The problem with applying this mental disorder to Puerto Ricans is that it redefines these once culturally accepted experiences. In “Picturing the Brain Inside, Revealing the Illness Outside” Cohn argues that for patients who are able to see their symptoms materialized through brain scan pictures “the images might instrumentally redefine patients’ everyday experiences of illness (Cohn 67).” As Cohn explains there are several meanings that can be attributing to these images, for instance the ability to provide “proof” to families and friends that there is a concrete reason for their mental illness. “The image both locates and contains the illness but consequently allows it to move to the external and in so doing can now be a social object (Cohn 77).” As Cohn exhibits applying an image to a mental disorder creates a different experience for the patient; thus applying a westernized mental illness to a culturally different group of people also changes their experience. PRS ultimately, “[accepted] the scientific validity of an ‘imported’ diagnoses for ‘domestic’ manifestation. [Puerto Rican physicians] readily adopted a new diagnosis that rendered pathological an experience that was socially normative and personally normal (Gherovici 36).”
It was evident that the U.S. army psychiatrists and medical officials relied on “the American scientific model that overemphasized the validity of the foreign diagnostic category and underestimated the interpretations of their [Puerto Ricans] own culture (Gherovici 38).” The U.S. army officials were able to medicalize their interpretative and ignored the cultural and political environment and implications (Gherovici 38). Cohn argues that when “patients who are committed to using the scans as way of radically rethinking their illness actually have new difficulties to face (Cohn 80).” In the same sense Puerto Ricans exhibiting hysteria, originally culturally acceptable, are forced to rethink their mental illness in terms of Western science and in turn effects how they perceive their experiences (as stated earlier). In Young’s article, “A Description of How Ideology Shapes Knowledge of a Mental Disorder (Posttraumatic Stress Disorder)” the same concept is evident in how the treatment program reshapes their illness to correspond to the ideology and therapeutic work. Young argues that although most patients say they have had positive behavioral changes this could be simply because of change in environment, “The point I [Young] want to underline is that these changes do not develop over the course of the treatment program, but appear at or soon after admission” and the “therapeutic changes…may be rooted in circumstances, especially abstinence, that are not specific to the treatment program (Young 112-123).” PRS has done the same to Puerto Rican soldiers because it has forced them to change their mentality of what they are experiencing and transforming it to a medical condition, which changes their “treatment program.”
Gherovici states that, “symptoms grouped under the label Puerto Rican syndrome produce antagonistic and inappropriate classification because they do not constitute coherent symptom sets. In fact, the invention of the Puerto Rican Syndrome has been purely ideological (Gherovici 70).” This is also evident in how patients receiving their brain scans view their mental illness afterwards. “The scans inescapably are an entanglement of both the moral and biological dimensions of what is identified as mental illness (Cohn 81).” Cohn argues that science places a meaning on the brain scans that in turn gives the patient a means of interpretation—their illness is more real if they can see it and show it to others, although this also presents many changes on how the validity of their illness is perceived by society. In the Institute for the Treatment of PTSD veterans are subject to a particular ideology that shapes how they enter the program, must acknowledge their issue and how it development and relive traumatic situations in order to cope with their mental illness. In this institute patients are suppose to get better through strict rules, running a program that places mental burdens on staff, uses staff that do not have a whole lot of training in order to produce and restructure the knowledge of the individual suffering from PTSD (Young 117-118). The institute uses their ideology to “medicalize the past” and in turn helps patients use this to take “moral responsibility” for the present. By medicalizing mental illness in these three situations it has ultimately changed the experience for Puerto Rican war veterans, bran scan viewers and male veterans at this specific institute for Vietnam veterans.
