The most broadly used formal models for recognizing, identifying, and treating mental illness, emotional discomfort, and disorders are based in Western criteria, and defined by a manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Ally & Laher, 2008). These models are incredibly useful, and are changed over time as we learn more and more about human psychological functioning. However, such ethnocentric approaches do not account for the dominant role of culture in the identification and experience of wellness or unwellness, and in the approach to treatment. It is critically important that practitioners and professionals providing therapeutic services be aware of and sensitive to the role of culture in an individual’s experience. Just as important is the individual’s awareness of how their own culture affects their experience, and the ability to draw on one’s own culture for strength and resilience in healing.
Culture, whether defined by ethnicity, location, religion, or other features, provides us with much of our individual perceptions of the world. We are taught how to view ourselves in relation to others and the larger community, and how to give meaning to all manner of experiences. Culture also tells us what is good and healthy, and what is not; which behaviors are acceptable and which are not. Thus, experiences and expressions of wellness or disorder must be culturally bound. One’s cultural context will have an enormous role in how that individual experiences their emotions and mental states, as well as how that individual defines those experiences (Sarkar & Punnoose, 2017). What one person might identify as being depressed, another might identify as being tired, and still another might identify as the work of an evil jinn (spirit) or a spiritual imbalance. Further, the experience of symptoms differs across cultures. Using the depression example - in the Western world, depression is experienced primarily as a mental state, whereas in Southeast Asia, it is most often felt as a physical, or somatic, state (Sarkar & Punnoose, 2017).
Many cultures even have their own mental and emotional experiences, or illnesses, which are specific to the cultural context. These are called “culturally-bound syndromes.” For example,on the Indian subcontinent and other regions of Southeast Asia, Dhat Syndrome arises in young men as severe distress or anxiety around perceived loss of semen (Prakash & Kar, 2019). In Nigeria, individuals who have great mental demands in their lives might experience “brain fag,” or an inability to think clearly and concentrate (Ayonrinde, Obuaya, & Adeyemi, 2015). These are just a few of the many culturally-bound syndromes which occur all over the world, and are great evidence that culture impacts mental and emotional well-being.
Culture also has a profound impact on how treatment and healing are approached, and even on what is defined as treatment and healing. Traditional approaches to healing often include religious or spiritual rituals, or close reliance on an individual’s family or community group. Practices such as temple healing, giving prayers to specific objects, or exorcism all may function as part of healing and have a positive effect on individuals. Traditional or faith healers are often an important part of such practices, helping to provide legitimate healing to community members. Many such healers and spiritual or cultural leaders support the idea of collaboration with psychotherapy practitioners in healing (Ally & Laher, 2008). Many see ills and disorder as arising from two or more places or parts of a person, including the mental, physical, and spiritual. Drawing on the resources provided by psychotherapy professionals as well as the strengths and resources of culture and traditional practices, might just form the best support network for healing (Gopalkrishnan, 2018).
As mentioned at the beginning of this post, it is important that professionals providing therapeutic services be aware of cultural context when working with individuals, and offer safe space for cultural perceptions and practices. It is also very valuable for individuals, when seeking therapy, to honor their own culture, and the strengths and support their culture provides for healing. Taking all of these approaches together offers a strong foundation for self-exploration, improving experience, and understanding one’s own healing process.
References:
Ally, Y. & Laher, S. (2008.) South African Muslim faith healers perceptions of mental illness: Understanding, aetiology and treatment. Journal of Religious Health, 47(1), 45-56.
Ayonrinde, O.A., Obuaya, C., & Adeyemi, S.O. (2015). Brain fag syndrome: A culture-bound syndrome. BJ Psych Bulletin, 39(4), 156-161.
Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and
practice. Public Health, 6:179.
Prakash, O., & Kar, S.K. (2019). Dhat syndrome: A review and update. Journal of Psychosexual Health, 3-4(1), 241-245.
Sarkar, S., & Punnoose, V.P. (2017). Cultural diversity and mental health. Indian Journal of Social Psychiatry, 33(4), 285-287.