It all started, as it often does, in a bedroom. The moment I stepped foot on my CouchSurfing host’s sticky floor, he hurried me to his windowless bedroom.
I had just taken a 17-hour (€46.96) Blablabus from Barcelona to Montpellier to Turin and walked ninety minutes through San Salvarlo (the quintessential district of Turin's nightlife) to Lingotto (the old-Fiat-employee-now-broke-student neighbourhood) with three bags weighing twenty kilos.
Since my CouchSurfing host had warned me of his Chinese roommate’s social anxiety—the fact she was Chinese is an important fact I’ll reveal later—I walked into the first pastry shop I saw and bought a Torta Di Nocciole (a humble Piemontese hazelnut cake), thinking that sweets would ease my presence.
Apparently, she was unable to leave her room to accept the cake I bought her. It also became clear that she was incapable of doing dishes, clearing the table, or any cleaning-related matter.
Call me spoiled, but I didn’t want to stay much longer—not that I had a choice. Since I wasn’t allowed to be in the apartment without him, I had to get up at 4:00 AM as he went to work.
After killing time at a Calisthenics park, I made my way to my new CouchSurfing host’s part of town, Crocetta (one of the wealthiest parts of town full of refined Art Nouveau buildings, large pedestrian areas, and people dressed in ways that put my scummy-ass to shame).
That same Calisthenics Park is where my built-up rage and anxiety almost led to an Italian prison.
By the way, if you’re here for the travel writing, stay tuned; that will be unveiled next week in “Turin’s Cuisine, Parks, and Divinity: The External Journey.”
As I mentioned in “A Planster’s Healing Journey,” art and travel, like all good relationships, are a mirror into the soul. I hope my articles and stories provide that mirror on my quest to the North of Sweden as I explore the therapeutic effects of slow travel.
Alright, without further adieu…
ANXIETY!
Before we get into my personal mental health journey in Turin, let’s take a look at some culture-bound anxiety disorders.
Although the question of what conditions could be labelled as disorders is often challenging, the question becomes even more difficult when behaviours are considered problematic in one culture but not in another.
Dhat Syndrome is a disorder often observed in several South Asian cultures. It’s a belief among young men that they are leaking semen, which causes them to be morbidly anxious because semen is primarily viewed as a very precious commodity, and an excessive loss of it is feared to result in serious illness.
Without the set of culturally shared beliefs regarding semen, sexual activity, and health that are prevalent among South Asians, the entire category of Dhat Syndrome would likely be rather meaningless to most North Americans and to North American psychiatrists.
Koro is a clinical syndrome in various South and East Asian countries, particularly in southern China. It’s a morbid fear that one's penis is shrinking into one's body. Hence, why it’s called "head of a turtle” in the Malay language. It is far less common among women, in whom it tends to manifest as a similar fear that one's nipples are shrinking into one's body.
Koro meets the criteria for a culture-bound syndrome because of its symptomology, although it is unclear what cultural factors affect its prevalence. One interpretation is that it's grounded in a classical Chinese medicine account of how an imbalance of yin and yang can cause the genitals to retract. However, some American men stoned on weed have also reported their penises shrinking into their bodies.
It seems that components of koro may be universally accessible; however, they only seem to manifest as a clinical syndrome within certain cultures where people are aware of the disorder's existence.
Malgri is a syndrome of territorial anxiety identified among various Australian aboriginal groups. When afflicted individuals enter the sea or a new territory without engaging in the appropriate ceremonial procedures, they believe that they are invaded by a totemic spirit that makes them physically sick, tired, and drowsy.
Agonias is an anxiety disorder identified among Portuguese and Azoreans in which people report a wide array of different symptoms, including a burning sensation, a loss of breath, hysterical blindness, sleep, and eating disorders.
Kufungisisa, which translates as "thinking too much" in Shona, a language spoken in Zimbabwe, is another condition associated with anxiety. People believe that their minds have been damaged by excessive thinking, leading to panic attacks and irritability. Variants of this condition are found in several cultures in Africa, the Caribbean, and among Native Americans and East Asians.
Ataques de nervios is a condition most identified with Puerto Ricans, in which emotionally charged settings, such as funerals or family conflicts, lead to palpitations, numbness, and a sense of heat rising to the head.
And finally, let’s get back to the lady who didn’t accept my cake…
Social Anxiety Disorder
One of the most common anxiety disorders is social anxiety disorder (previously known as social phobia).
We all occasionally suffer social fears as we find ourselves in situations where we realize that we stand to look foolish. But for those with social anxiety disorder, these fears escalate, causing them to avoid such situations altogether, significantly impacting their lives. Yet, how social anxiety affects your life depends on culture.
For example, in East Asian cultures, where saving face and social harmony are highly valued, there are likely greater concerns and anxieties about potentially embarrassing situations than in North American cultures.
Some symptoms of social anxiety, such as being shy, are also perceived less negatively in Asian contexts than in Western ones, perhaps because they are culturally normative. For example, Chinese children who were evaluated as shy were viewed more positively by their peers and teachers, whereas Western children who were considered as shy were more likely to be rejected by their peers.
Additionally, research suggests that among both East Asians and Westerners, heightened social anxiety is linked to interdependence, while independence is correlated with lower levels of social anxiety.
The links between interdependence, independence, and social anxiety raise the possibility that people might view social anxiety disorder as less of a problem in Asia than they do in the West. Indeed, although East Asians tend to score higher than Westerners on measures of social anxiety, epidemiological surveys find far less evidence of people who meet the clinical criteria of social anxiety disorder in East Asia than in the West.
How can we resolve the paradox that Asian Americans report more evidence of social anxiety symptoms than European Americans but that East Asians are less likely to be diagnosed with a full-blown social anxiety disorder than Americans?
One possibility is that social behaviour norms differ between East Asia and the West. In general, Western social norms entail more direct communication, extraversion, and self-promotion than East Asian norms.
People who grow up learning East Asian social norms but later end up in a Western social context might feel more anxious because the norms they were raised with differ.
At the same time, when people's social anxieties do become problematic, there is evidence that the symptoms are presented differently across cultures.
There is a disorder that a Japanese psychiatrist identified in the early 20th century termed taijin kyoufushou (TKS). This term roughly translates as a phobia of confronting others. It is akin to social anxiety disorder, as both involve a fear of looking like a fool in front of others, and both respond well to the same antidepressants like Auvoxamine.
However, the symptoms of TKS are quite distinct from social anxiety disorder. People with social anxiety disorder tend to be preoccupied with anxieties about how they will look like fools in social situations and how everyone will publicly discover their faults. In contrast, TKS includes various physical symptoms, many psychosomatic, such as excessive blushing, increased body odour, sweating, and an intense gaze.
The major worry of people with the offensive type of TKS is how uncomfortable and tense others will feel around them because of the imagined repulsiveness of their physical faults. This focus on the discomfort of others has led TKS to be labelled as an "altruistic phobia.”
It is distinct enough from social anxiety disorder, and it is rare enough outside of East Asia (it has more recently been identified in Korea and mainland China) that it is regarded as a "culture-bound" syndrome, similar to conditions like dhat, koro, and amok.
In sum, social anxiety disorder is a universal syndrome. However, in East Asian contexts, many symptoms are so prevalent that they might be considered somewhat normal rather than abnormal conditions. And who’s to say what is right?
What’s definitely wrong is letting your anxiety turn into rage, which is what I did at the Callisthenics Park after RideMovi (a bike share platform) charged me an extra 10 euros for not taking a picture of where I parked the bike, which I couldn’t do because their app stopped working. I immediately reached out to their support team, but instead of waiting a few hours for a reply like the non-traumatized person I was a few months ago, I sent six more emails, left three scathing reviews, and made my IBS flare up.
Actually, my IBS has been acting up since trying to forgive infidelity, facing my masochistic tendencies, and, of course, dealing with bureaucrats. Endless paperwork has made it difficult to rent out my apartment on Airbnb and afford this trip, and so, here I am, spending hours a day researching the cheapest possible options to travel while working around my student’s schedules and writing this newsletter.
I have not found made time for somatic exercises, ice baths, nature walks, or my mental health in general, so something as small as a 10 euro charge is enough to make me explode—a side of myself I didn’t know was there.
Maybe slow-travel-related stress is needed to show me my dark side. After all, we need to see and confront our dark side to grow.
But what does my IBS induced by anger and anxiety have to do with Italian cops and prisons? Let’s just say one thing I hate about Europe is the lack of public washrooms. And yes, there are cafes, but when you suffer from IBS, you can’t always get to them in time. You can put two and two together.
Stick around.
What is the root of your anxiety?
Do you think culture has influenced your anxiety?
What are your relaxation techniques?
Tell me anything else.
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Whoa, I am so sorry about the troubles you're having. When you set out on this journey, I never imagined this being part of it. I hope things improve -- and please stay out of Italian prisons, or any other prisons!
Great piece. Good to know I'm not that only nomad with IBS. ironically, I find Europe's bathroom situation heaven compared to the US, although I will get used to the rimless toilets.