Indigenous Multi-cultural Mental Health (PTSD (Cross cultural diagnosis…
Indigenous Multi-cultural Mental Health
What is culture? "Systems of knowledge, concepts, rules, and practices that are learned and transmitted across generations"
Culture and subjective experience
E.g. Himba tribe can identify different colours to standard Western cultures' colour perceptions
Coolie tribe - only 1/2000 have depression, lack of depression is due to 1. Sun 2. Exercise 3. Sleep 4. Eating 5. Social connection 6. Rumination (obsessional thinking)
Race - based on superficial physical criteria; Ethnicity - based on socio-cultural, linguistic, historical and geographical criteria
Ethnocentrism - looking at the world through ones' culture's lenses
Whiteness in Psychology - WEIRD = western, educated, industrialised, rich, democratic societies that dictate the history of psychology
Monoculturalism - based on assumptions that Western cultural values are 'normal'
79-86% of Cambodians
High levels in refugees who have experienced trauma
Timeline - first known as hysteria only experienced by women --> Freud then stated men can have PTSD from repressed memories --> WW1 shell shock --> 1920s Germans believed it was an excuse to get compensation --> 1980 PTSD first in DSM --> 2017 trauma related disorder section in DSM
Symptoms: memories of experience, avoidance, hyperarousal, etc
Cross cultural diagnosis issues
Conception of memory - are memories useful to forget the traumatic experiences (like Holocaust survivors) or not (Sudanese refugees)?
Colonises experience, 'masks' social and moral imperatives
Culturally Bound Disorders
Susto - means a fright or shock, intense heat rises up into your body (somatic - bodily symptoms) from emotional trauma found in many Latin American cultures
Example of a Hmong child with epilepsy whose parents thought it was spiritual, lack of understanding from doctor, led to tragedy
Hikkokirmoi - Japanese mental disorder where people can stay inside a room for years
Khyal cap (wind attack) - similar symptoms to a panic attack, "thinking too much" --> "weak heart" --> "Khyal cap"
Explanatory Models of Illness
Explains the patient's view of the cause of condition, timing of symptom onset, the effect of the condition on the body, its history, appropriate treatments, stigma, fear and access to care
Signs > symptoms > preliminary treatment > appropriate healer > diagnosis > probable cause > treatment > success of treatment > cure > continuation of symptoms (can go backwards through the model)
Vulnerabilities - low socioeconomic/educational/employment status, lack of recognition for work, discrimination, experience of trauma/torture, institutionalised violence, war/deprivation, gender based violence
Women - cultural isolation, separating from family, family violence, continued fear, poverty, lack of transport
Children in detention - family responsibilities, language competence, conflict with elders, cultural divide b/w old and new generations
Implications for Professionals
Avoid stereotyping, develop expertise, group counselling, care in local community,
Must deal with biases, awareness of cultural difference, client's word view, develop appropriate help-giving practices
Western treatment compared with tribal treatment "It doesn't involve sun, music, community, nothing external/physical"