Culture Change and Psychological Stress

Regardless of where each of us may be based, we all share the experience of cultural change and the conflicts resulting from such change. In particular, our work confronts us with the painful consequences of such changes: how the resulting conflicts affect individuals. It is the price of being human and vulnerable, of opting to be with others instead of staying in isolation, and of being ourselves the instruments of such changes. It is a price we all have a part in paying.

Neither the psychiatrist nor his patient is exempt from the burden. The only difference between them is that the responsibility for recognizing and defining the nature and extent of culture change and identifying the significant encounter points between culture and psyche rests with the helping person. When a patient asks his psychiatrist, “Can you help me?” not only is he asking that he be accepted as a person but also that his being a person be understood within the context of his own definition of his personhood. This in turn is derived from the way he has experienced the world around him and how he hopes to continue to experience it. The doctor-patient relationship itself has to be defined first in the patient's term; otherwise there would be no patient to treat. For help to be effective the doctor has to appreciate how the patient interprets his current cultural realities, within the context of what he has been taught to perceive in the world around him, and to utilize such realities to his best interest. Otherwise what results is something familiar to all of us—namely, whatever the doctor is doing, suggesting, or recommending makes no sense at all to the patient.

Nowhere is this more imperative than in a setting where rapid socio-cultural change is occurring, with no indication of how, when, or where the change will evolve and proceed. It is like having the rug pulled from under one's feet—one does not know whether to fall forwards or backwards or to either side or where one may catch a hold.