Effects of Culture on Psychiatry - Research Paper Example

Inserts His/her Inserts Inserts Grade (12, 04, The Effects of Culture on Psychiatry Introduction Culture has a huge role to play in human life as all social interactions are dictated by cultural values. Culture may be termed as a set of beliefs that govern a particular group of individuals. In this essay we will try to understand the influence of culture on mental illness. The aim is to better understand different cultures and their presuppositions about mental disorders so that psychiatrists can treat patients belonging to these cultures in an effective manner. Culture has a significant influence on health and perception of illnesses. Mental disorders are no different, in fact due to lack of awareness these disorders are not understood properly in all cultures. In this essay symptom presentation of mental disorders will also be discussed along side with the preventive and treatment approaches used by different cultures. All these things are important for a medical practitioner and will help him or her in providing optimal care to patients belonging to different culture. In this essay Indian culture, African culture, Chinese culture and Arab culture will be discussed and their effect on field of psychiatry will be elucidated. African Culture and its effect on Psychiatry Introduction African Continent is inhabited by around 1 Billion people and is home to different cultures and customs. Due to diversity of African culture it is important here not to over generalize anything. The people of Africa are not very developed and most of them live below or very close to the line of poverty. Poverty is an evil ubiquitous in Africa despite of the fact that continent is rich of natural resources. African continent is backward when it comes to education. There are not many avenues for higher education and therefore literacy rate is quite low. This is a very important point as it plays a key role in assessing mental disorders. Because of lack of education and knowledge health care information in general and mental illness information in particular is not widely known to the people of Africa. Mental Disorders and their Cultural Representation African culture is characterized by magical tales of spirits and superstition is prevalent in the culture. Magic is considered a reality and is a justification for a host of different events. Although urban regions have developed to a certain extent but still the common beliefs about sickness and diseases have not changed, and still illnesses are associated with evil spirits or with the bad actions of an individual (Okasha, A.2002). Mental disorders are also treated in a similar manner. They are considered to be sent by God or the evil spirit or Karma to punish people for their sins in the past or present life (BBC, 2002). African culture, with its belief system of superstitions and magic, easily externalizes mental disorder to supernatural beings. Reasons for Cultural interpretation of Mental Disorders There are many reasons for such lurid treatment of mental disorders. Firstly these disorders are ubiquitous in Africa because of inadequate nourishment and unhealthy lifestyle. There is not enough awareness about normal curable diseases like cholera and typhoid so focusing on mental disorder is not possible. The culture adds to this problem as it provides sensational justification about how ghosts or other supernatural creatures are the reason of mental disorders. Secondly the causes of mental disorders are considered supernatural because it is a way for African people to find answers (Okasha, A.2002). Human beings are always in search for answers in order to satisfy their inquisitional urges. Uncertainty is not desirable for anyone; not even the uneducated. Because African people cannot find any rational justification of the mental diseases they make up their own reasons and this is how they create their own, sub standard, realities. Symptoms Some of the common symptoms of mental disorders in African culture are lack of trust, weight loss, hallucinations etc. Also non sensible behavior is seen in the mentally sick like roaming in streets and making strange noises (BBC, 2002). These symptoms are seen as signs of mental disorder by the African society. Treatment of Mental Disorders Treatment of mental disorders in African culture is unique and somehow very efficient. African culture is a collectivist culture and people live in families and tribes together. The interaction between people is more and therefore any bad event like death of a family member or any other incident is accompanied by a sympathies and care of many people. The caring element of African culture is a very good healing method for mental patients. Also traumatizing events do not depress people that much because relatives and friends are with them. This is a form of traditional support for mental patients and does wonders in healing mental disorders (Okasha, A.2002). There are also other treatment methods of African people like they go to traditional witch doctors for help (BBC, 2002). These local experts try to heal the patients by observing a range of practices but these practices are not always helpful. These experts also give medicine in different forms but again the effectiveness of these medicines is seriously doubtful. How Psychiatrists can treat African mental patients? In order to work with African people psychiatrists should understand the culture of Africa and should avoid any kind of brain drain. Techniques specific to African culture are required and only then treatment will work. First doctors will have to purge the patient from beliefs in the supernatural. Patients will have to believe in the psychiatrist and only then treatment can work. A relationship of trust should be created with the patient as it will help him being open about his or her problems. Families can help greatly in this regard and therefore families should be also be given advice on how to deal with the patient. As discussed before collectivist cultures have their own way of healing therefore it can serve as an added advantage to the practitioner when dealing with African patients. Indian Culture and its effect on Psychiatry Introduction Indian culture is also very rich and dates back to thousands of years and is deeply motivated by the religion Hinduism. The effect of Hinduism is profound on culture of India. A particular belief system has been contributed to Indian culture by Hinduism. The diversity of Indian culture is great and art, marriage, family systems, dance, cuisine and literature highlight this diversity. India is also a very poor country where more than 80 percent people live below the line of poverty. Health care system of India is also not very developed and this is accompanied by a very low life expectancy rate (but higher than African countries). Population of India is more than 1 billion people and that alone indicates the problem of the country. Cultural Representation of Mental Disorders Religion is the main theme that underlies all beliefs in Indian Culture. It is a binding source of the people of the region. Indian people believe in spirit of God and that makes them believe that mental disorders are also a product of such spirits (Niaz, S. 2008). The belief in religion and rituals makes people in India believe that the cause of mental sickness is ghosts or spirits. These spirits and ghosts are seen as coming from God himself. Another problem with Indian culture is that it is highly male oriented. Indian society is a patriarchal society and therefore the treatment of women is not very good (Niaz & Hassan, 2006). Women are considered inferior beings and they are not given equal rights. Women therefore are more prone to mental illnesses in Indian culture. This is because they are always cornered and due to this have a very low self esteem. The perception of the society is that women are weak and therefore any unwanted act of women is associated with a mental disorder. This is another form of unique representation of mental disorder. Any act of women that is considered undesirable is conceived as the work of a supernatural spirit (Niaz & Hassan, 2006). Mental disorders are therefore also used as a tool to vent out frustration on the weaker sex of the society. Reasons of Cultural Representation of Mental Disorders The ancient stories of ghosts and spirits are prevalent in Indian culture it forms the basis of the belief that mental disorders are nothing but a product of these Godly spirits. The religious system of India is such that it is governed by religious priest or Pundits. These people make full use of the illiteracy of people and exploit people in the name of religion (Niaz & Hassan, 2006). It is actually these Pundits who make people believe in such horrendous stories and superstitions. There is monetary benefit for these Pundits and this is why they beguile people in believing the tales of supernatural. The main problem of Indian culture is the lack of education. Anything that is not wanted is associated with some supernatural factor. Women, due to immense subjugation and sometimes domestic violence, suffer from depression and mental disorders and they are taken to religious healers in order to ‘purge their spirits from evil’. Women have no other options but to create multiple personalities in order to protect their self esteem. Symptoms The symptoms of mental disorders in India can range from shouting or crying to hurting people and anti social behavior (Niazi, S. 2008). These symptoms are usually found in women because of their decreased self esteem. Men are perceived as sign of respect for a family and therefore are preferred. Male child is preferred over female child and a woman who gives birth to a female child is considered unlucky. Even this can be termed as a symptom of a mental disorder in Indian society. Treatment of Mental Disorder in the Culture Treatment of the mental disorder is done mostly by abuse. Temples are used for the purification of soul and women are beaten badly. The idea is that evil spirit will go out of the body after getting the beating. The idea is that women are weak therefore the evil spirit can easily capture their soul. The medical systems of Indian culture like Ayurveda are also used to heal the patient (Niaz & Hassan, 2006). How to treat an Indian mental patient? The feeling of guilt is the first thing that a psychiatrist has to counter when dealing with Indian mental patients. The patient will have a very low self esteem and they will think of themselves as doomed souls. They will internalize all the problems and will blame themselves for their issues. First the self esteem of the patients will have to be worked and then they can be treated. With this first step half of the treatment would be done because the main problem is low self esteem in mental patients of India. Chinese Culture and its effects on Psychiatry Introduction Chinese culture is one of the oldest cultures in the world. It is also a very complex culture due to the rich history of Chinese nation. There are many ethnicities living in China and each has its separate cultural values. Chinese belief system is mostly influenced by Confucianism and Buddhism. Their ideas about purpose of life and life hereafter are widely accepted by the people of China. The oldness of Chinese culture has brought many superstitions in the lives of Chinese people. The influence is passed from generations to generations in the form of folk stories and customs. We cannot hold any one factor responsible for the presence of superstitions in the Chinese society. Religions, philosophers, folk tales, history, all have their due share in creation of supernatural beliefs that prevail in the Chinese culture (Tom & Ann, 2000). Cultural Representation of Mental Disorders The beliefs of the Chinese people about life hereafter, religion and their ancestors are important to understand, because understanding of Chinese people about mental disorders is directly influenced by these beliefs. Chinese people believe that what is happening to them today is because of their past deeds. If they are suffering then it is because of their past transgression and the onus of present situation is not only limited to individual but past bad deeds of any family member can also cause pain to the whole family (Yip, K-S. 2005). In such a belief system justification for a mental disorder is very easy… It comes from Nature itself as a method of punishment. Chinese culture does not have witches or evil spirits rather these supernatural entities are seen in positive light. They are an extension of God and nature, and are always just in their treatment of an evil person (Yip, K-S. 2005). Other beliefs about mental disorders include demon possession. But this cannot be compared by African and Indian culture because the basis for this comes from the Chinese culture itself and not the religion. It can be said that the belief in the supernatural is more precisely defined in the Chinese culture as compared to other cultures. In African and Indian culture everything is a product of human thinking and assumptions while in China culture has more defined supernatural beliefs (Tom & Ann, 2000). Reasons for Cultural Representation of Mental Disorder The reason for cultural representation of mental disorder is that Chinese people have a tendency to internalize any unexpected problem they face (Yip, K-S. 2005). This causes people to believe that mental disorders are something uncontrollable and they come as a wrath of God or supernatural. This makes mental disorder a social stigma in the society and no one is willing to accept that he or she is suffering from any mental disorder. Symptoms The symptoms of mental disorders vary in the Chinese culture. Depression, obsessive compulsive disorder and bi polar disorders are not treated mostly and therefore they are not considered symptoms of mental disorder (Yip, K-S. 2005). Extreme behavior like violent actions towards family members, and severe fits are considered symptoms of mental disorder. Symptoms come up in the form of Somatization in Chinese culture. These unexplained symptoms are actually in a form that is acceptable in the Chinese society and are mostly aimed at obtaining attention (Tom & Ann, 2000). Treatment of Mental Disorders in Chinese Culture Preventive treatment used by the family in response to mental disorders is not satisfying at all. The reason is that family does not want to accept that there is a problem with a family member so instead of treating the patient he or she is forced to behave in normal manner and is kept in home, hidden from the society. This causes severe depression in patients of mental diseases and this may be one of the reasons for high suicide rates in China (Yip, K-S. 2005). Also economically the families are not very rich therefore they are not able to afford good health care so they cannot do anything about the disease. The local medicine system of Chinese culture is also developed so this is used as a treatment method for the sick. This treatment sometimes works for the patient (Tom & Ann, 2000). The reason for this is that the China is also a very collectivist society. People live together in extended families and bond between the family members is strong. How to treat a Chinese mental patient? There is an important lesson for psychiatrists in all this. They will first have to teach the patient and family that the problem exists. Realization is absent in most patients so if they are realized that they are suffering from a disorder and that is curable then it will be a great. Families should also be talked to and they should also be informed that the problem is not supernatural and it is curable. Psychiatrist should also try to connect with the patient and the family. Because patient will come from a collectivist culture, it will be easy to open him and discuss his problems. A relationship of trust should be developed and secrets of patients should not be passed to the family members. All these steps will be necessary in treating the mental patients of Chinese culture. Psychiatry in Arab Culture Introduction Arab culture is another diverse culture and it expands over many countries. Arabian societies are very old as well and they have ruled many regions of the world throughout history. Arab culture is very rich and art forms and foods are features of Arab culture. Islam deeply influences Arab culture and it defines many customs and beliefs of Arabian societies. Arabian societies are closed societies and law and order is generally good. One of the main issues of Arab culture is that female gender is not treated equally. Men are perceived to be powerful and are head of the family (El-Islam, 2008). They are the decision makers and women are treated as second degree citizens. Gender inequality is very high in Arabian societies and this is a problem because this makes women more prone to health issues and mental disorders. Cultural Representation of Mental Disorders The beliefs about mental disorders are shaped by Islam, the religion of Arab world. It is also based on superstitions and God is supposed to hurt the wicked. This is how mental disorders are explained in the culture. Even though there are no financial constraints on the families but still they do not go to doctors because they think it will give bad name to their family. Mental disorders are considered a stigma and all information is not shared from the doctor (Savaya, R. 1995). This is rather extraordinary because in all of the cultures discussed above financial constraints is one of the reasons of creation of supernatural explanations of mental disorder. Women are main victims of mental disorder because they are kept enclosed in homes and are not allowed to go out without their fathers or husband (El-Islam, 2008). Any mental problem does not receive psychiatric attention and because of this the situation deteriorates. Arabian people living in different regions also face the same difficulty (Savaya, R. 1995). Reasons for Cultural Representation of Mental Disorders Religion plays a part in this but it is because of lack of discussion that this problem exists in Arabian societies. Also the decision to go see a doctor lies not with the patient or the whole family. It is usually decided by the head of the family. He decides whether to go to a hospital or not. Social embarrassment is essential when patients are taken to hospitals for mental health care because society considers mental disorders as taboos. People try not to talk about these disorders and understanding is very low. Symptoms Symptoms of mental disorders include thought control (possessed by Satan), delusion, depression and preoccupation with death (El-Islam, 2008). Also excessive thinking is not considered as something desirable. Transgressions from the cultural norm are also sometimes considered as symptom for mental disorder. Anything that cannot be explained is also considered a mental disorder or work of Satan. Because God is considered just every bad thing is associated with work of Satan or devil. Treatment of Mental Disorders in Arab Culture The initial treatment procedure of mental disorder is mainly religious. Patient is sent to religious priests and they treat the patient by using religious scripture (Savaya, R. 1995). Beating is not uncommon but it is no ubiquitous too in Arab culture. Usually family is suggested to ask for God’s forgiveness and recitation of holy book is advised. The second step of treatment involves going to doctor of eastern medicine. He is trusted more than regular doctors. Medicines given by ‘Hakeem’ sometimes cure patients but when it comes to mental disorder even Hakeem considers it out of the world. In all this process family plays a key role and they are involved with the patient at all times. A reason why children are rarely patients of mental disorder is that they are pampered greatly in the collectivist Arab culture. A major problem in treatment of Arab mental patients is that women cannot be treated by male doctors and this is very strongly practiced (El-Islam, 2008). Because of this too women patients are less likely to come to hospital. Also women are not highly educated so this becomes a problem as there are very few female doctors. How Psychiatrist should treat Arab mental patients? A psychiatrist should keep in mind the nature of beliefs of Arab people. Their beliefs should not be refuted because Arab people are very religious in nature. They hold their religion very sacred and therefore will not tolerate anything against it. Doctors will have to tell them that they are sick and this can be treated. They should be forced to take medicines because Arabian people give in to pressure of doctors (El-Islam, 2008). Also it should be made sure that everything should be told to the patient in steps. The first goal of a psychiatrist should be to see the patient for the second time. After this a relationship of trust may develop. Doctors should also note that women are considered to be inferior to men so men should be told to take care of the female patient. Men should be told how the disease can be controlled because he will be taking decisions in the house so the important person is the father or husband of the female patient. Proper culturally synonymous techniques will be required to treat an Arab mental patient. Conclusion Different cultures have different interpretations of mental disorders. Lack of education, information and resources forces them to believe in supernatural phenomenon. Religion plays a part in this because it reinforces the belief that supernatural entities are present in this universe. This belief forms the basis of misconceptions about the mental disorders. In all uneducated societies mental disorders are not understood properly and they are associated to the devil or the evil spirit. These beliefs are also used as a scapegoat and they soothe the patient and his or her family by externalizing the cause of the problem. Cultural values should always be kept in mind when treating mental patients of different culture. 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Family Care giving Of Clients with Mental Illness in the People’s  Republic of China (Part 2: Current Situation), International Journal of Psychosocial Rehabilitation. 10:1, pp. 35-42, 2005. Print. Read More