Evolution of Cultural Perspectives on Mental Illness

Throughout the history, mental illness has been viewed by most cultures across the world in religious or spiritual context. Mental illness was misunderstood to be possession by devil, spirit or as a curse, or as an attack of sorcery or black magic, mentally ill were at times mislabelled as witches. When the causes of mental illness were poorly understood, religious, magical and mystical healings became very popular with charms, talismans and other delusive means. Holes were drilled in the head to release the evil spirits and mentally ill people were burned to death in the European countries during medieval periods (Kemp & Williams, 1987). In Morocco mental illness was thought to be “caught” like a cold. While walking casually, one may absent-mindedly step on a bit of sorcery on the path or accidently drink it thus “catching” a mental illness. In one sense, blaming evil takes the responsibility off the individual who is mentally ill as it implies that the victim is innocent and is not at fault for one’s condition. But on the other hand it breeds fear, of the individual who is ill as well as of the possibility of becoming afflicted similar to the victim. The victims of mental illness were often ostracised, chained or locked up in dungeons which made their conditions worsen rather than improve.

The seventeenth century is known as the age of reason and the eighteenth century as the age of enlightenment as reason and scientific method came to replace faith and dogma to a great extent. The need to support assertions using scientific data and evidence was emphasized by scientists and philosophers. Such a scientific attitude towards mental disorders contributed in understanding mental illness scientifically and harboured increased compassion for the people who were suffering from mental illnesses. By the eighteenth century “madness” began to be seen as beyond the control of the person. Because of this, thousands of mentally ill people confined to dungeons of daily torture were released to asylums where medical forms of treatment began to be investigated. Today, the medical model are the driving force in diagnosing and treating psychopathology. However, the global scenario is far from scientific in understanding mental illness. Today in some African cultures it is believed that while inattentively stepping on the substance of sorcery, can cause mental illness (Asonibare, 1999). People belonging to Buddhism and some forms of Hinduism that adhere to the reincarnation and karma philosophy do believe that mental illnesses are caused by the wrong doings in their previous births. Some of the Vietnamese who are not educated attribute a number of supernatural causes for mental illness, including possession by spirit, black magic, astrological misalignment or Buddhist Karma philosophy (Nguyen, 2003). For the indigenous Cordillera people in the Philippines, besides a variety of causes of illness, malevolent spirits and witchcraft are the major causes of mental illness (Janetius, 2003).

The archetypal psychology of Carl Jung sheds light on this perplexed, poor culture-sensitive classroom phenomenon further. The archetypal patterns that are in our mind are part of cognitive bases of human beings. These archetypal patterns in human mind could be compared to a computer operating system on which the education as software executes the functions. The inherited and modified archetypes which reflect a person’s culture are portrayed through mythology, religion, art, architecture, rituals and social and traditional customs. On this operating system education based on Western concepts could create a ‘program conflict’ - a conflict between cognitive foundations and the input education. Therefore culture-sensitive classroom and local theory based curriculum are important steps in planning and preparing an indigenous therapy model.

The Western counselling and therapy modules that are popularized all over the world today do not fit to the needs of people from another culture. Therefore, an effective counsellor and therapist should work in harmony with background influences of human conditions specifically the tradition, life-world, environmental and geographic condition of the clients. In this context psychologists and mental health professionals often talk about cross-cultural and culture-specific approach in counselling. Cross-cultural psychology views culture simply as a site of variations for human behaviour, whereas, culture-specific psychology considers culture as the birthplace for psychological processes, an essential tool in therapy. Therefore, psychologists are becoming aware of cultural relativism and focus increasingly on cultural contextualization in understanding and answering human behaviour and mental health issues. It is true that the diagnostic manual of mental disorders (DSM-5) that is widely used as a standardised tool of classification of mental sickness encourages clinicians to be culturally sensitive in their therapeutic approaches. One source of difficulty in cross-cultural counselling arises from the fact that the counsellor and the client have different ethnic backgrounds. Ethnicity has by itself a stimulus value to both the counsellor and the client, reflective of the existing relations in a given society. Another source of difficulty in the cross-cultural counselling is that counselling is a product of Western civilization, therefore culture-specific approach, in the form of Multicultural counselling is highly recommended today.