You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
A detailed case of pathological mourning is presented in order to illustrate how the common threads among cultural beliefs, fantasies, impulses, and conflicts can be identified and utilized in diagnosis and psychotherapeutic treatment. Cultural beliefs and clinical symptoms are treated as interdependent communications of personal meaning.
The importance of a thorough consideration of cultural factors in the psychological treatment of patients from different ethnic/racial backgrounds has been stressed by numerous researchers and clinicians (Abel, Metraux, and Roll, 1987; Idowu, 1985; Kiev, 1964; LeVine and Padilla, 1980; Madsen, 1964; Marsella, 1982). Indeed, failure to consider cultural factors in the delivery of mental health services has been described as a form of “cultural oppression” (Sue, 1978).
Culture, as the framework of reality perception, shapes both the inner conflict and symptom presentation of its members (Comas-Diaz, 1981; Kiev, 1972). Frieda Fromm-Reichmann (1960) suggested that even the selection of subject matter for repression and dissociation is determined by the accepted cultural standards of significant people in the community. Personal beliefs and behaviors are not typically considered pathological if they are socially determined (i.e., to see, hear, or believe things as others do), such as a spirit possession at a religious ceremony (Murphy, 1978).
One measure of psychopathology then is the degree of cultural appropriateness of one's beliefs and behaviors as measured against the reaction of significant others. The practice of folk healing and/or adherence to spiritual belief systems as mechanisms to avoid or relieve stress must therefore be carefully evaluated within the context of the culture and community in order to determine the appropriateness of such beliefs and related behaviors (Madsen, 1964).