Folk Psychiatry and Psychoanalysis

The study of ethnopsychiatry, also called folk psychiatry or transcultural psychiatry is becoming increasingly relevant to American psychiatry and psychoanalysis, since field studies of preliterate cultures can be done in this country, with no need to travel to distant and exotic lands. Massive migration of third-world peoples—precipitated by economic or political revolutions, and geographic proximity, in the case of Mexico, Puerto Rico, Cuba, Haiti and Central America, are in part responsible for this phenomenon. The majority of recent immigrants came from rural areas, and most of them are part and parcel of preliterate societies. It is well-known that migration, cultural shock and the conflictual process of acculturation may play important roles as psychosocial stressors in the causation of mental illness. Therefore, the treatment of these problems is important, but understanding is hindered by monocultural assumptions of mental illness, negative stereotypes and problems of prejudice stemming from racism, discrimination and xenophobia.

Clinicians who are not aware of cultural differences when evaluating or treating patients from another culture run the risk of misinterpreting, not only their symptoms, but also their response to treatment. Yamamoto and collaborators (1968) found that minority patients are likely to be misdiagnosed and to receive less preferred modes of treatment. The sheer complexity of individual, family, cultural, and social variables tends to discourage the use of a uniform approach. Nevertheless, there appears to be a consensus about the validity of a transactional approach. The latter assumes that there