Social Change, Stress and Mental Health in the Pearl of the Alps: A Systemic Study of a Village Process

329 Pages·1979·8.03 MB·English

by  Dr. Gottlieb Guntern (auth.)

Monographien
aus dem Gesamtgebiete
der Psychiatrie
22
Psychiatry Series
Herausgegeben von
H. Hippius, Munchen . W. Janzarik, Heidelberg
C. Muller, Prilly-Lausanne
G. Guntem
Social Change, Stress
and Mental Health in the
Pearl of the Alps
A Systemic Study of a Village Process
With 45 Figures
Springer-Verlag
Berlin Heidelberg New York 1979
Dr. GOTTLIEB GUNTERN
Psychiatrie Oberwallis und Psychosomatische Abteilung,
Oberwalliser Kreisspital,
CH-9900 Brig-Glis
ISBN-13: 978-3-642-88193-0 e-ISBN-13: 978-3-642-88191-6
DOl: 10.1 007/978-3-642-88191-6
Library of Congress Cataloging in Publication Data. Guntern, G. 1939-. Social change,
stress, and mental health in the Pearl of the Alps. (Monographien aus dem Gesamtgebiete
der Psychiatrie-Psychiatrie series; 22) Bibliography: p. Includes index. I. Social psychiatry-
Switzerland--Saas-Fee. 2. Saas-Fee, Switzerland--Social conditions. 3. Saas-Fee, Switzer
land--Statistics, Medical. 4. Psychology, Pathological--Social aspects. 5. Social change-
Psychological aspects. 1. Title. II. Series: Monographien aus dem Gesamtgebiete der
Psychiatrie ; 22. RC455.G86. 30\.29'494'7. 79-19790
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© by Springer-Verlag Berlin Heidelberg 1979.
Softcover reprint of the hardcover I st edition 1979
The use of registered names, trademarks, etc. in this publication does not imply, even
in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
2125/3130-543210
I dedicate this book to the village of Saas-Fee, also called
"The Pearl of theA Ips ". Its history provoked my keen interest,
and its structure, past and present, taught me more about
life and human fate than I could have anticipated.
Foreword
I first became acquainted with Dr. Gottlieb Guntern's work at several scientific symposia
and was impressed by the way he combined originality and imagination with the proper
use of careful, multidisciplinary epidemiologic approaches.
Dr. Guntern has attacked some of the cardinal aspects of the consequences, in terms
of health, well.being. and social function, of rapid social change in an originally isolated
rural community - a phenomenon that is occurring at an accelerating rate in developing,
as well as in developed, countries.
This worldwide problem is approached by Dr. Guntern in a holistic manner. Health
and social function are seen as integrated elements of human existence and are studied
accordingly. His analysis of social events and their consequences for health and well
being in a small Alpine village can serve as a paradigm for the study of the process of
social change and its various consequences elsewhere.
In view of the problem's importance and being impressed by the thoroughness and
ingenuity of Dr. Guntern's multifaceted approach, I encouraged him to make the study
available to an international readership. Dr. Guntern's book is warmly recommended
not only to epidemiologists, sociologists, anthropologists, and psychiatrists, but also
to all those interested in psychosocial and psychosocially induced problems in today's
and tomorrow's environments.
Stockholm, July 1979 Lennard Levi, M.D.
Director
Laboratory for Clinical
Stress Research
It is wonderful the way a little town keeps track of itself and
of all its units. If every single man and woman, child and
baby, acts and conducts itself in a known pattern and breaks
no walls and differs with no one and experiments in no way
and is not sick and does not endanger the ease and peace of
mind ot steady unbrocken flow of the town, then that unit
can disappear and never be heard of But let one man step out
of the regular thought or the known and trusted pattern, and
the nerves of the townspeople ring with nervousness and
communication travels over the nerve lines of the town. Then
every unit communicates to the whole.
The Pearl
John Steinbeck
Preface
This study attempts to shed some light on one of the dark spots on the descriptive
explanatory map of the contemporary social science. In general, political power, money,
decisionmaking. information processing, and cultural events are concentrated in the big
cities. City life seems to be the life form of our centrury. The question is whether or
not this is really the case.
Today more than two-thirds of the world's population live in rural areas. Only few
conceptual maps are available describing this territory. There is no coherent systems
of coordinates to be spread over the rural areas. This seems to be a conceptual lag of
the social sciences.
Comparatively little is known about the life-styles of rural populations and their
existential problems. These gaps of knowledge are easily filled with projections. Rural
areas are often perceived as scattered fragments of an Arcadian paradise or as the back
yard of society. Both assumptions constitute the end of continuum. They indicate
inadequate information. Better information would yield a picture which places rural
areas more adequately. In my opinion, the social sciences should try to build bridges
over the gulf which separates rural minorities from big cities. This is a difficult cndeavor
because we deal with a process and not with an immovable object.
Life, one aspect of the great cosmic dance. means change and evolution. Life is a
never-ending spiralic process. There are stages in the process when recalibration is
needed, when readjustment of all the subsystems and the system as a whole seem to be
of vital importance for a given population. A rapidly increasing speed of social change
constitutes one of the possible stages of this process. Not every human system is capable
of finding an adequate readjustment within the necessary time span. A system lacking
the capacity for adequate recalibration is a system in crisis. The crisis is apparent to the
observer who tries to look behind the folkloristic make up of the presupposed Garden
of Eden or behind the fence of the pressupposed backyard.
Since World War II, more and more rural areas have become industrialized and urban
ized. The advent of tourism is one of the many socioeconomic processes affecting
villages, towns, and whole rural areas in many parts of the world. In my view, the impact of
tourism on the mental and physical health of given populations during the phase of dis
equilibration should be one of the important fields of social research.
Saas-Fee is a village in the Swiss Alps with a native population of less than 800.
Following the construction of a road in 1951, it opened the doors for mass tourism
which increased the population considerably at times. 1951 was the time marker of the
rapidly increasing speed of social change which had started at a slower speed before.
This social change created major problems of a psychosocial and psychosomatic nature.
x
The Saas-Fee study is a follow-up study aimed at the investigation of social change,
stress, and mental and physical health in a circumscribed human system - a mountain
village. A full and concrete description of these changes is the central goal of my inves
tigation. The methodological goal of my investigation is to demonstrate the systemic or,
as I prefer to call it, the syngenetic approach; an approach which aims at the elucidation
of the relationships between the subprocesses of social change in the different supra
systems and subsystems of the village. The guidelines of my approach are threefold -
I will try to avoid reductionism, which often explains complex social phenomena by
reducing them to the features of one element; I will try to show the manifold roots of
the social phenomena and their determinants within the web of relations between the
innummerable interconnected processes; and, finally, I hope to avoid the role of Pro
crustes, who adapted a changing and complex reality to the dimensions of his cognitive
bedstead which rigidly withstood accommodation to the reality it was supposed to
encompass.
This book describes the village process from the prehistoric time, when the first
settlers arrived, until 1970. From a purely psychiatric point of view, it is a cross-sec
tional study analyzing the mental health of the population in 1970. The next cross
sectional study will be made in 1980, followed by another cross-sectional study every
decade.
Acknowledgments
In one way or another, there were many individuals involved in the present study. It is
virtually impossible to mention, or even to remember, everybody who has offered advice,
criticism, or some kind of feedback since I started the investigation in 1968. Thus, I
will mention only a few persons whose contributions were especially helpful for the
realization of this book.
Professor Christian Mueller, M.D. director of the Clinique Psychiatrique Universi
taire of Lausanne gave me much support, guidance, and directions; he offered sugges
tions and criticisms which shaped this study in many aspects; he organized two leaves of
absence without which I could not have written this book.
Werner Fischer, Ph. D., sociologist of the Centre Psychosocial Universitaire of Geneva
gave practical advice concerning methodological problems; he organized the codification,
processing, and elaboration of the data of the questionnaire. Mrs. Brooke, Hopital San
doz, University of Lausanne, was a part-time consultant for statistical questions. Profes
sor Raymond Battegay, M.D., director of the Psychiatrische Universitiits-Poliklinik of
Basel reviewed the original formulation of the questionnaire. Mrs. Wyss, librarian of
the Clinique Psychiatrique Universitaire of Lausanne was very helpful in the organization
of the bibliographic material.
To all these persons I express my gratitude for their help and cooperation.
I am also indebted to Dr. rer. pol. Anton Bellwald, Brig, an economist whose informa
tion was crucial for the understanding of the economic process in Saas-Fee. I am
grateful to Beat Mutter, director of the Schweizerische Kreditanstalt of Zurich, for his
information concerning banking policies of Switzerland.
XI
I wish to express my gratitude to Paul Parin, M.D., Zurich, an ethnopsychoanalyst,
for suggestions and advice.
Professor Lennart Levi, M.D., director of the WHO-Laboratory for Clinical Stress
Research, Karolinska Institue of Stockholm, read the manuscript and suggesting modi
fications and theoretical clarifications. I am extremely grateful for his critical help.
Part of this study was made possible by a research grant from the Swiss National
Foundation for Research; I express my gratitude for this financial contribution which
enabled me to work 6 months exclusively at the elaboration of the data gathered during
the different field observations.
I should also like ot thank to Mrs. Marcia Vitiello, Philadelphia, who read the first
draft of the English manuscript which I had translated from its original German version
and who suggested stylistic corrections. My special thanks go to Mrs. Mary Daniels,
Ph. D., Philadelphia, who edited the book and whose critical mind proposed many a
clarification.
Last, but not least, I wish to express my deep gratitude to the whole population of
Saas-Fee. Without the friendly and openminded cooperation of the villagers of Saas
Fee, this study could not have been made.
San Francisco, July 1979 Gottlieb Guntern
Contents
Conceptual Framework and the Methods of Investigation
1. General Introduction .................................. 2
1.1 Accelerated Social Change in Rural Areas . . . . . . . . . . . . . . . . . . . .. 2
1.2 Syngenetic Approach to the Study of Saas-Fee ................ " 4
1.3 Rural Areas as a Scien tific Problem ......................... 6
1.3.1 Historical Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6
1.3.2 Myth of the Healthy Country Life . . . . . . . . . . . . . . . . . . . . . . . . .. 8
1.4 Antithesis of Rural Versus Urban Areas ..................... 8
1.5 Social Change in Rural Areas ............................. 10
I .6 Rural Areas in Crisis? ........ ......................... 11
1.7 The Village as a Habitat of Regeneration. . . . . . . . . . . . . . . . . . . . .. 11
1.8 The Village as an Object of Research. . . . . . . . . . . . . . . . . . . . . . . .. 12
2. Theoretical Problems of Social Change . . . . . . . . . . . . . . . . . . . . . .. 14
2.1 Concept of Social Change. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2.2 Definitions of Social Change .............................. 15
2.3 Theories of Social Change ............................... 16
2.3.1 Functions of a Theory of Social Change ................ . . . . .. 17
2.3.2 Sufficient Conditions for a Theory of Social Change . . . . . . . . . . . . .. 17
2.3.3 Actual State of the Theories of Social Change .................. 18
2.4 Factors Responsible for Social Change ....................... 20
2.4.1 Structural-Material Factors ............................... 21
2.4 2 Cultural Factors ................................. 22
2.5 Agents of Social Change ................................. 23
2.5. J Carriers of Role . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
2.5.2 Psychological Qualities of the Role Carriers . . . . . . . . . . . . . . . . . . . . 24
2.6 Factors Retarding Social Change . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2.7 Consequences and Manifestations of Social Change ............... 25
2.7.1 Transformation of the Instrumental Complex .................. 26
2.7.2 Change of Adaptive Structures ............................ 26
3. Problems of Methodology ............................... 28
3.1 From the First Field to the Fonnulation of an Adequate Conceptual
Framework . . . . . . . . . . . . . . . .. ....................... 28
3.2 Problems of Methodic Pluralism ...... . ................. 30