English Mental health and gender-based violence English version | Page 145

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PART III : THEORY

3 . Culture and understandings of trauma

Theoretical approach
In Part I and in Part II we discussed the psychological and physical symptoms that traumatised people may present , and some of the ways in which survivors can be helped to manage their suffering .
Here we look at different attitudes to psychological trauma that we might meet in different countries and settings around the world . Physiological reactions to traumatic events are everywhere the same but cultural responses differ widely . It is therefore essential to understand the influence of culture on the survivors we seek to help , and recognise that our own attitudes also influence how we feel and think .
Why do people react differently because of their ‘ culture ’?
The American Heritage Dictionary of the English Language defines culture as : “ The totality of socially transmitted behaviour patterns , arts , beliefs , institutions and all other products of human work and thought characteristic of a community or population ”.
According to another definition , culture is “ an integrated system of learned behaviour patterns which are characteristic of the members of a society and which are not a result of biological inheritance ” ( Hoebel 1966 ).
Culture enables people who can empathise to relate to each other , to form communities , and transfer ideas , values , and ways of living down the generations . It “ communicates the knowledge and skills a community needs to survive over time ”. By means of our culture and cultural language , we ‘ learn ’ how to interpret different social situations , including our reactions to traumatic events and how to cope with them .
One therefore has to keep in mind that what is considered healthy in one society may be thought harmful in another . The American Psychiatric Association has defined what it calls ‘ Culture-Bound- Syndromes ’ or CBS ( American Psychiatric Association 1994 , DSM-IV Text Revision , appendix I ). These are generally folk diagnostic categories in specific societies or culture areas that aim to explain the meaning of certain repetitive , patterned , or troubling experiences and observations ( American Psychiatric Association 1994 ). It is characteristic of such syndromes that they cannot be defined in terms of objective changes in body organs or functions , and that they are not found in other cultures . These illnesses tend to carry psychological or religious overtones .
The term CBS is controversial , because it might imply that ‘ culture bound syndromes ’ are confined to societies that are the object of ethnographic study ( normally indigenous communities ), as if those (‘ us ’) who study those societies are ‘ culture-free ’ ( Guarnaccia and Pinkay 2008 ). Western societies are not , of course , culture-free . In recent years , researchers have become more aware that PTSD and other stress-disorders vary widely across different cultures .
Many of the examples of CBS that have been studied involve dissociative or somatic syndromes ( in western terms ), frequently linked to trauma histories . The Nervios in Latin America , Spell in the Southern United States , Zar in North Africa , and qi-gong psychotic reactions in China all share cross-cultural similarities . In so-called Possession Trance Disorders one person ’ s identity is replaced by another ’ s .