Why Indian Mental Health Professionals Must Embrace A Culturally Informed Practice

Why Indian Mental Health Professionals Must Embrace A Culturally Informed Practice

As the younger generation gets more comfortable with seeking therapy, new avenues of discourse about mental health open up. We are starting to gain awareness of self-help practices, healthier coping mechanisms, and tools to handle distress, anxiety and depression in a way that wasn’t possible before. The internet has played a role in this development. There’s a vast network of psychologists and psychoanalysts participating in generating infotainment-based content. Skits about guides and observations in the psychological spectrum with insight and humour can be found on many social media accounts of mental health practitioners -turned- digital creators.

“The systematic neglect of culture is the single biggest barrier to advancing the highest attainable standard of health worldwide”, say the authors of a major new report on culture and health, led by Professor David Napier, a leading medical anthropologist from University College London (UCL), UK, published in The Lancet.

We come across different schools of thought from Jungian psychoanalysis to Behaviorism on the internet. However, an important aspect of human experience that remains unaddressed is culture. The cultural background of an individual affects everything in terms oftheir agency from their perceptions, beliefs and values to their ambitions, and moral systems. And since India is such a diverse country, the notable differences we see from state to state in cuisines, languages, values, and expressions can consequently be extended to the influences on the behaviour of its residents. Simply adding some demographic information can significantly shift how we think about these behaviours. Information that we use to learn more about personality disorders offers a particularly striking example of the need to consider cultural factors in defining mental illnesses since personality disorders are also broadly defined by patterns of behaviour that deviate from cultural expectations.

But it’s not as simple as it sounds. Knowing a person’s ethnic background or their history of immigration and oppression doesn’t provide enough information to really understand the meaning of their behaviours and relationships. For example, we might assume that a family from the state of Kerala, considered intellectually forward and indulging in dialogues vital to social reform, will show a lesser degree of orthodoxy or conservatism than a family from Bihar that might not be as progressive a state. A child of the first family might still show signs of the same orthodoxy that we assumed to be a trait of the second one and vice versa because the family, not too unrealistically, might adopt values opposing to the community they live in. Cases of exception like these do exist, where a father figure of a particular family living in a place dictated by patriarchal structures still turns out to be a feminist refusing to give in to the norms around him.

These examples illustrate that we cannot simply stereotype people and make sweeping assumptions about them purely based on their cultural background. While this might suggest to you that cultural information is irrelevant and we should just focus on the unique experience of the individual, this would also be problematic and incomplete because to truly understand the experience of the children from those families, we must know that the parents’ level of emphasis on independence or progressiveness may be relatively uncommon within their cultural community. The level of enmeshment the children exhibit would likely carry a different meaning if they come from a family living in a community that emphasises independence. It becomes a matter of how with or against the grain of the culture a family moves. So in other words, in order to really develop a full understanding of mental health, we must develop an understanding of the individual in the context of their community.

Such nuances probably aren’t even considered when it comes to the Indian diaspora. People who now live in western countries seek therapy from practitioners in the west who aren’t fluent in cultural norms that influenced their patients and their families back home. In fact, mental health professionals in our own country skip this fundamental aspect. They cover childhood and generational trauma, Anima (the feminine image in the male psyche) and Animus (the masculine image in the female psyche), and behavioural patterns all too well but miss the cultural element entirely which is the setting in which the individual grows up and is later affected by.

Consider the fact that what is considered a trait of mental illness in one culture, time or era might be normative in another. That is such a major variable. It decides what kind of help you need in order to live a balanced, functional life. Not too long ago women were treated for hysteria and given lobotomies just for being expressive whereas, in this era, a once acceptable medical practice seems downright deplorable. People experience it all the time when they spend a part of their life alienated in their community, feeling like the odd one out, but move, and find that there’s nothing wrong with them.

Cultural context is everything. And the rewards of a culturally informed approach to learning about mental health include greater open-mindedness, increased understanding of experiences different from one zone to another and less stereotyping, something a divided world like ours could sorely use.

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