Exploring Culture-Bound Therapy.

What works and what doesn't?

Photo by Iluha Zavaley on Unsplash

Everyone needs a therapist. At least, that’s the trending notion amongst modern WEIRD (Western, Educated, Industrialized, Rich, and Democratic) people.

As I mentioned in “Do I need Therapy?”, understanding yourself is like understanding a country—sometimes, you need to look from the outside in. We can do that through meditation, psychedelics, travel, social bonds (which we explored last week), and therapists.

Yet, many people aren’t convinced therapists are the best option because shrinks can be sales-driven, “usually need therapy themselves,” or create a dependency link. Of course, one could argue that therapists teach you techniques for being self-dependent. The problem is that the techniques that work in one culture can be detrimental in another.

In his book Crazy Like Us: The Globalization of the American Psyche,

Ethan Watters

argues that applying Western mental health treatments globally has often led to less effective outcomes for mental illnesses in non-Western regions and may have unintentionally introduced conditions to areas where they were previously didn’t exist.

For example, anorexia did not manifest in the same way in Hong Kong until the concept was recently introduced, leading psychiatrists and clients to interpret certain symptoms through a possibly mistaken Western lens. Similarly, posttraumatic stress disorder (PTSD) was not prevalent in Sri Lanka after the 2004 tsunami until Western aid workers (with good intentions) convinced locals that they must be experiencing it.

As the social historian

Edward Shorter

puts it:

Each culture provides a "symptom pool" of recognized and discussed symptoms that lead people to express their inner conflicts in a familiar language. Providing people with different conceptions of mental illness may lead them to express their own psychological difficulties in symptoms that are consistent with those conceptions.

That’s why it’s essential to understand how healing practices differ around the world before suggesting a therapy that has worked for you.

Western psychotherapy typically traces its origins to Western Europe, notably Sigmund Freud, who launched psychoanalysis in the late 19th century. Freud proposed that psychological difficulties often stem from unconscious conflicts and fears. He argued that these issues are best treated by exploring memories and traumatic experiences in depth during individual sessions, with the therapist helping to interpret them. And yes, Freud’s interpretations sometimes came down to a young boy's desire to eliminate his father and to have sex with his mother. So, let’s move on.

When psychoanalysis reached the United States in the 20th century, Carl Rogers modified it, emphasizing a client-centred approach where therapists aid in self-discovery. Since then, many psychotherapeutic approaches have emerged, the most common being cognitive behavioural therapy, which involves restructuring thoughts and alleviating adverse reactions through controlled exposures. Additionally, biological explanations and treatments for mental disorders have become more prevalent in psychiatry. Despite their diversity, these Western perspectives commonly rely on the client's ability to engage in a psychological discourse grounded in shared cultural meanings.

Yet, for similar reasons a Westerner hires a therapist, an Indigenous person might turn to a family member.