Before we can begin exploring deviations from the norm as it relates to a specific culture, it is extremely important that we define exactly what is meant by the word culture. Culture is defined as the customary beliefs, social forms, and material traits of a racial, religious, or social group. It could also be defined as the set of shared attitudes, values, goals, and practices that characterizes an institution or organization. (culture, 2010)
As with any definition, it comes with limitations. Given the changing nature of our social world and given the efforts of individuals to adapt to such changes, culture can best be viewed as an ongoing process, a system or set of systems in ﬂux. (Lopez & Guarnaccia, 2000, p. 574) Constant change is the rule with and within any given subset or group of people. Any generalization regarding a population should come with a specific guideline as to whom it would apply, and more specifically, over what period of time the cultural generalization encompasses. Attempts to freeze culture into a set of generalized value orientations or behaviors will continually misrepresent what culture is. (Lopez & Guarnaccia, 2000, p. 574) While the representation may prove valid for a period of time, it is inevitable that the research will date itself; thereby propagating the perpetual need for new and innovative research.
A related limitation of the values-based definition of culture is that it depicts people as recipients of culture from a generalized “society” with little recognition of the individual’s role in negotiating their cultural worlds. A viable definition of culture acknowledges the agency of individuals in establishing their social worlds. (Lopez & Guarnaccia, 2000, p. 574) Simply because I am a white male from Omaha doesn’t necessarily mean that I have assumed all the traits that could be used to label or otherwise describe that general population. Exceptions are abundant in every generalization about a specific populace.
An important component of this perspective is the examination of intra-cultural diversity. In particular, social class, poverty, and gender continue to affect different levels of mental health both within and across cultural groups. (Lopez & Guarnaccia, 2000, p. 575) In order to be truly inclusive of all the various aspects a culture has to offer, we would have to adopt a multi-layered approach to our cultural studies. We all wear many hats, and it is a disservice to not examine all of them. Similarly, it is unfair to assume that those intra-cultural differences affect different cultural populations the same.
Culture is linked to the way emotions, mental distress, social problems, and physical illness are perceived, experienced, and expressed. Beliefs about what constitutes illness and what can be done about it vary considerably across cultures. (Bhui & Dinos, 2008, p. 411) We have established that in some cases a diagnosis has the potential to become a self-fulfilling prophecy. Even a correct diagnosis may have a negative impact on a specific client. The cultural connotations associated with a specific diagnosis can play a role in the effect it has on your individual client. Before we diagnose, need to consider the socio-cultural context of the illness. For example, a mental health diagnosis may have real implications for a member of the US Armed Forces.
As immigration into the United States continues to accelerate, we must ready ourselves for the influx of clients from the underdeveloped, or the developing world. Mental health diagnostic constructs and subsequent treatment practices designed in developed countries are often used in the provision of care in the developing world and in care practices for ethnic minorities, asylum seekers, and refugees. However, there are concerns about the limitations of using mono-cultural outcome measures in these culturally diverse contexts. (Bhui & Dinos, 2008, p. 411) Our interview process is currently dependant on interviewing and subsequently interpreting the responses from our clients. Given the complexities of our global community, it is suitably difficult to make underlying cultural assumptions.
In closing, while there are definitive benefits to the standardization of diagnosis techniques, we need to understand and appreciate that those standard one size fits all solutions may not always been the most appropriate way to proceed with accessing the mental state of a culturally diverse client.
Bhui, K., & Dinos, S. (2008, Dec). Health beliefs and culture: Essential considerations for outcome measurement. Disease Management & Health Outcomes, 16(6), 411-419. Retrieved from http://ezproxy.bellevue.edu:80/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=36400847&site=ehost-live
Lopez, S. R., & Guarnaccia, P. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51(1), 571-598. Retrieved from http://web.ebscohost.com.ezproxy.bellevue.edu/ehost/pdf?vid=6&hid=113&sid=f275d2f9-b3c8-458b-9968-29981a5cf4c1@sessionmgr114
culture. (2010). In Merriam-Webster Online Dictionary. Retrieved March 16, 2010, from http://www.merriam-webster.com/dictionary/culture