One of the ongoing controversies about the relationship between culture and psychopathology has to do with the long-reported tendency of Asian psychiatric patients to primarily manifest and express psychological distress with somatic symptoms. Cultural differences in symptom expression have been the focus of studies on somatization. “Somatization is a term originally tied to a psychodynamic theory of illness causation in which psychological conflict was transformed or transduced into bodily distress” (Kirmayer & Young, 1998). Young & He (2002) imply that the absence of organic findings to explain patients’ reported symptoms suggest the possibility of a somatoform disorder. However, the common complaints usually do not satisfy the stringent DSM-IV-TR criteria for somatization disorder and can be categorized more closely to undifferentiated somatoform disorders. The most common theories propose that the low rate of reporting psychological problems and high rate of overemphasizing bodily symptoms among Asians compared to other ethnic groups may reflect cultural rather than cognitive preferences (Lin & Cheung, 1999; Chun, Eastman, Wang, & Sue, 1998). This is most evident in studies of various culture-specific syndromes such as the two Korean folk syndromes listed in the Diagnostic and Statistical Manual of Mental Health Disorders (American Psychiatric Association [APA], 2000): hwa-byung and shin-byung. Hwa-byung is literally translated into English as “anger syndrome” and attributed to the suppression of anger, disappointment, grudges, and unfulfilled expectations and the symptoms include insomnia, fatigue, panic, fear of impending death, dysphoric affect, indigestion, anorexia, dyspnea, palpitations, generalized aches and pains, and... ... middle of paper ... ...that this view of somatization as a mark of psychological primitivism can be used against the patients by disqualifying and invalidating their somatic symptoms and expressions of distress. I recognize that issues that are relevant to the mental health of any cultural or ethnic group is multidimensional and complex. Despite the impossibility of generalizing any individual’s experience over that of another, I believe han is undeniably embedded in the deepest alcoves of the Korean psyche and soul which shapes and operates on so many levels—from the largest and highest historical-national level to the personal innermost-mindset of a Korean individual. In this brief and space-limited paper, I selectively reviewed research findings that were most relevant for further exploring the meaning of somatization and expression of han by Koreans in the field of psychopathology.
Dr. Stanley Sue is an Asian American clinical psychologist whose research focus is on Asian American minorities. Dr. Sue was born in Portland, Oregon and was the third of six children to his Chinese immigrant parents. As a child “his first career ambition was to repair televisions, but soon he got bored with shop classes. Then, he developed great fascination with psychotherapy and the idea of helping emotionally disturbed individuals (Rockwell 2001).” Dr. Sue recalled, “I told my parents that I wanted to become a clinical psychologist, not fully knowing what a clinical psychologists did (Rockwell 2001).” He also remembered what his father said and thought after making this declaration: “My father, who was born in China, said, ‘What is that?’ He couldn’t believe that people would pay me to listen to their problems – indeed, he wondered if I could make a decent living (Rockwell 2001).”
Culture is a collection of religion, traditions, and beliefs that are passed down from generation to generation. Culture is created and maintained through the repetition of stories and behavior. It is never definite because it is continuously being modified to match current trends, however, historical principles are still relevant. With respect to mental illness, culture is crucial to how people choose to deal with society and the methods used to diagnose and cope with mental illnesses. In Watters’ The Mega-Marketing Depression of Japan, he focuses on how Japan and other cultures define depression, but also displays how the influence of American treatments in eastern countries eventually becomes the international standards. Even though the
The Hmong people, an Asian ethnic group from the mountainous regions of China, Vietnam and Laos, greatly value their culture and traditions. The film “The Split Horn: Life of a Hmong Shaman in America” documents the seventeen year journey of the Hmong Shaman, Paja Thao and his family from the mountains of Laos to the heartland of America. This film shows the struggle of Paja Thao to maintain their 5000 year-old shamanic traditions as his children embrace the American culture. Moreover, the film shows that one of the major problems refugees like Paja Thao and his family face upon their arrival to the United States is conflict with the American medical system. Despite the dominant biomedical model of health, the film “The Split Horn” shows that
Measuring depression in different culture is a complicated task, “there is a need for tools for multicultural mental health primary in order to promote communication and improve clinical diagnosis” (Lehti et al, 2009). This results indicated that there is still a need for a tool to accurately measure depression in patients from different countries/cultures. Each culture is unique in its very own, and certain abnormal behavior can only be found in certain culture. For instance, in western society we have the histrionic personality disorder, in which an individual desperately seek out attention, while in Japan, there is a phenomenon called “hikikomori” is an abnormal behavior where a person would go great length to avoid any social contract at any means. This abnormal behavior is similar to the avoidant personality disorder, however hikikomori is more severe. “Hikikomori is used to refer to group of young people who have withdrawn from social life and have had no relationships outside of family for a period in excess of six months.” (Furlong, 2008). The long period of time to be withdrawn from society is quite serious and will have many psychological damage. Another factor that is important when looking at abnormal behavior is the gender. The gender of an individual have play an important role in shaping the diagnosis and the diagnostic feature of these symptoms.
The Diagnostic and Statistical Manuel of Mental Disorders, Fifth Edition (DSM-V), describes somatoform disorders as a group of related mental health symptoms that are characterized by a patient’s presentation of multiple, current somatic symptoms that are distressing or result in significant impairment of daily functioning. A somatic symptom is the presentation of physical illness or distress that would appear to have a medical basis but which cannot be explained by either a general medical condition, direct effect of a substance, or any other mental health disorder. Patients who suffer from somatoform disorders firmly believe that the pain they are experiencing stems from a physical problem rather than a mental one; indeed, that is a fundamental aspect of the disorder. Somatoform disorders range from a simple and persistent pain disorder to hypochondriasis, which involves persistent anxiety over the existence of a serious illness, to conversion disorder, which involves the actual loss of a bodily function from excessive anxiety over the perceived ailment. (DSM-V, 2013)
The results suggested that Ms. M is vulnerable to emotional disruptions. Specifically, she is often confused by situations in which emotion is involved, experiences feelings more intensely than others, and struggles bringing closure to emotional situations. In addition, she is not very careful about modulating her emotional discharges, which is noticeable to others. Moreover, Ms. M may be experiencing some significant anger, which influences her overall view of her environment, and affects her decision making, problem solving, and coping. Her anger also hinders her from having close relationships with others. Ms. M’s emotional issues are causing her to experience some distress. Her distress may manifest as depression, anxiety, apprehension, or other various issues (i.e., lethargy and insomnia). Moreover, she is often confused by her feelings and inconsistently uses them to make decisions. In addition, Ms. M may deal with her feelings on an intellectual level, which creates a sense of denial where she is unable to comprehensively understand the impact of situations. Overall, Ms. M suffers from the presence of a very painful emotion, which has negatively impacted her psychological functioning. It will effect attention, concentration, thinking, and
In conclusion, somatoform disorders must be treated with caution. Upsetting a patient or even digging too far to find information or a cause of a disease could potentially make the patient even worse. Those professionals using the DSM-V on a regular basis must be aware the changes and the progression the DSM will continue to make. Different symptoms may include pain, gastrointestinal complaints, sexual symptoms and neurological problems. Different disorders include somatization, hypochondriasis, conversion, body dysmorphic disorder, pseudocyesis, and both pain and undifferentiated somatization in conjunction with PTSD.
In the Asian community, a directive, structured, goal-oriented, problem-solving approach that focuses on alleviating specific symptoms is usually preferred. Asian clients expect therapists to give concrete advice and view the therapist as a knowledgeable expert and authority figure. (Paniagua,
Schildkrout, Barbara. “Unmasking Psychological Symptoms: How Therapists Can Learn To Recognize The Psychological Presentation Of Medical Disorders”. n.p.: Hoboken, N.J. : John Wiley & Sons, c2011., 2011. USMAI Catalog. Web. 12 Nov. 2013.
Cultural differences can conflict with diagnosing in different countries mental health disorders aren’t even recognised and there is also a stigma attached to mental health problems making people resistant to seek help or treatment. Diagnosing can also be difficult due to problems such as in one culture hearing voices can be totally normal yet in others this could mean your schizophrenic. (Hayes,2000)
By any measure, The Memoirs of Lady Hyegyong, known as Hanjungnok (Records written in silence), is a remarkable piece of Korean literature and an invaluable historical document, in which a Korean woman narrated an event that can be described as the ultimate male power rivalry surrounding a father-son conflict that culminates in her husband’s death. However, the Memoirs were much more than a political and historical murder mystery; writing this memoir was her way of seeking forgiveness. As Haboush pointed out in her informative Introduction, Lady Hyegyong experienced a conflict herself between the demands imposed by the roles that came with her marriage, each of which included both public and private aspects. We see that Lady Hyegyong justified her decision to live as choosing the most public of her duties, and she decided that for her and other members of her family must to be judged fairly, which required an accurate understanding of the her husband’s death. It was also important to understand that Lady Hyegyong had to endure the
Asian Americans are always shown to have a relatively low rate of substance abuse among all the ethnic groups in the US (Kim, Ziedonis, & Chen, 2007). In fact, studies suggest that Asian American youth are more vulnerable for emotional and social difficulties than youth of other races or ethnicities (Wong et al. 1998). As a group of immigrants, Asian American youth often face acculturation stressors like low self-esteem, high depression and anxiety and social isolation, and more and more studies have reported various behavior problems among Asian American youth, like gang activities (Zhang, 2002), a rapid increase in juvenile crime (Le, 2002) and a significant increase in violence.
3) Surgeon General's Report: "Mental Health- Culture, Race, Ethnicity" . A supplement to "Mental Health: A Report of the Surgeon General 1999."
This essay concerns emotions and controversial arguments based on whether emotions are universal or a learned phenomenon. Most of the research in to cross cultural Psychology surround their attention on the biological aspect of emotions as being the primary source of the occurrence of emotions and has been the subject of numerous studies. However, culture is also known to affect and provoke emotional experiences. This essay will discuss the position of emotions from a Universalist view and from a cultural view. The following approach will focus on the universality of emotions.
In this interview Ben Bagley asks Theresa Han about the difference between Korean and American culture. Theresa is a teenager who recently moved to the United States so she has an excellent perspective for understanding the differences and similarities between these countries.