![]() In much of this work, mindfulness is understood as a mode of awareness that is present-centered and nonevaluative. Mindfulness meditation and other techniques drawn from Buddhism have increasingly been integrated into forms of psychotherapeutic intervention. ![]() This introductory essay considers the meanings of mindfulness meditation in cultural context and the uses of mindfulness as a therapeutic intervention in contemporary psychiatry and psychology. The papers in this issue of Transcultural Psychiatry explore the implications of a cultural and contextual view of mindfulness for continued dialogue between Buddhist thought and psychiatry. Extracting techniques like mindfulness meditation from the social contexts in which they originate may change the nature and effects of the practice. However, in the societies where it originated, mindfulness meditation is part of a larger system of Buddhist belief and practice with strong ethical and moral dimensions. This form of awareness is assumed to have intrinsic value in promoting positive mental health and adaptation by interrupting discursive thoughts that give rise to suffering. In much of this work, mindfulness is understood as a mode of awareness that is present-centered and non-evaluative. As the number one cause of disability worldwide, according to the World Health Organization, the pharmacologic treatment of depression deserves respect and an open mind to those interventions that have been proven to work. This organic authenticity it seems is the primary indicator that one is following his or her “true self.” I argue that an unmedicated self, while suffering from depression, is not the true self and that rather the “true self” is that person who has been lifted from depression by medications such as Prozac, which leads to a more meaningful and productive life. Critics of Prozac and the SSRIs, such as Charles Barber, Carl Elliot, Nassir Ghaemi, and David Healy, decry the loss of sadness as a vital organ to one’s authenticity. This paper belies that notion, promoting the benefits of SSRIs, namely for the relief of depressive symptoms, which leads to a fuller and more meaningful life. Many science writers think that taking drugs such as Prozac for depression betrays one’s authenticity. The strong interconnections of values framed at one level with those at other levels means that there are likely to be unavoidable tradeoffs between different values or desired short and long-term outcomes (like maturation, depth of personality, and social responsiveness versus energy, efficiency and happiness). ![]() Important ethical issues reside in the links between these levels. But it also reveals some more basic facts about what it is we treat when we give antidepressant medication.I will explore the ethical relevance of cultural influences on the use of antidepressants through considering the problem on three different levels of analysis: (1) the varieties of depressive experience as they unfold in specific cultural worlds and value systems (2) the psychobiological adaptation and narrative re-construction of the self and (3) the political economic context of the pharmacological treatment of depression. This was a temporary anomaly related to the history of psychiatry and the relative lack of development of widely available mental health services. How are we to judge transformations of self caused by drugs? Is a more functional self or happier self more real? Does our “true” self have any meaning other than the self we prefer and endorse or that others agree to hold us to?In this chapter I explore some these questions by considering the delayed of use of antidepressants in Japan. Some of these people state they “feel like a new person” or, more paradoxically, that they have finally found their real or true self. SSRI antidepressant medications like Prozac seemed to offer the prospect of regulating dysphoric mood among many people who were formerly viewed as having temperamental or characterological traits that rendered them shy, inhibited, or melancholic.
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