The cultural framework matters in psychotherapy.

Psychotherapy grew out of Western intellectual traditions that began with the psychoanalytic treatment offered by Freud and his followers. The cultural background from which his theories grew limited the usefulness of psychoanalysis in other cultures. Freud’s practice and subsequent thinking derived from his patients who were largely middle class Jewish neurotic women living in Vienna at the turn of the 20^th century. While some aspects of psychoanalysis may indeed prove universally useful, theories based on such a limited cultural sample created problems when applying the concepts of psychoanalysis within other European cultural groups, and even more issues in transferring the therapy to the rest of the world. Since abnormality is framed within cultural values, treatment is linked to the therapist’s knowledge and application of cultural understandings in treatment (Langman, 1997).

Freud’s theory of personality and psychoanalytic treatment approach may have been entirely appropriate within the cultural framework of the middle class Jewish community in Vienna in the early part of last century, but not easily transferable to other cultures where distress is not considered a matter of internal dynamics. Some cultures believe that psychological distress is the result of somatic problems or in other cases is attributed to living out of harmony with nature or because the patient believes he/she is being possessed by evil spirits. Although many of these assumptions are superstitious, nevertheless the client’s behavior is based on these beliefs that are rooted deeply in a cultural worldview. However, it seems to the rational mind that perpetuating superstition by the therapist lend the beliefs an air of authenticity. At the same time stress in the patient may increase if a therapist familiar with the cultural perspective begins treatment by attacking the veracity of the superstitions beliefs.

In collectivistic cultures the focus is on relationships with others whereas in psychoanalysis the focus is on treating the individual. A focus on the self in collectivistic societies could be considered abnormal, and obsessing about the self dysfunctional within interdependent societies. However, some aspects of all therapeutic approaches have value and are transferable within a framework of cultural sensitivity. Does that mean that therapists must buy into superstitions and irrationality of the local culture? That is an open question since therapy is about adjustment and getting along in society. However, if getting along means therapy that encourages conformity to irrational beliefs that present an ethical problem for Western trained therapists. Nevertheless, many patients are not able to confront the larger existential issues of irrational religious beliefs (Azhar & Varma, 2000). Cultural values suggest that group therapy that includes mixed genders would be a nonstarter in tradition-bound societies like Saudi Arabia.

Date: 2015-01-11; view: 835