Cultural and Transcultural Dimensions of Psychoanalysis

Culture is an ever present element of human existence. Social, psychological, biological, and cultural dimensions form an intricate unit that cannot be naturally divided. The peculiarity of culture lies in the fact that it defies biological determinism, since it is exclusively transmitted by learning, imitation, and other means of person to person contact. Included in the cultural dimension is a virtually instinctive way of picking up attitudes and precepts without conscious awareness akin to the psychoanalytic phenomenon of transference.

It is my contention that culture tends to modify two key psychological phenomena, namely, cognition and affect. Also each culture and subculture encourages somewhat different prescriptions when it comes to experiencing, displaying, and sharing emotions. The scale of emotionally recommended expressions of feeling covers a wide range of openness or concealment, outright tabus, dramatizations, and frequent double-bind attitudes.

The cultural dimension of clinical psychiatry and psychoanalysis as a therapeutic parameter in its own right has not yet found universal appreciation. This in spite of the fact that interest in the cultural aspects of mental disorders is of long standing.

Around the turn of the century Kraepelin concerned himself with the cultural aspects of psychiatry in spite of his primarily biological orientation. Kraepelin conducted a field study in the Dutch East Indies with the aim of exploring potential cultural factors relating to the occurrence, frequency, and symptomatology of mental disorders. No particular reference was made by him as to methodology when he reported that only a small number of the natives of Java suffered from manic-depressive illness and only a few fell victim to melancholia. His important conclusion was that depressions when they occurred in that setting were quite free of preoccupations with guilt feelings or “sinfulness” as he called it.