Cultural Aspects of Psychotherapy

This paper deals with the relevance of cultural factors to the application of psychotherapy. It is divided into two parts: cultural psychotherapy and crosscultural psychotherapy. Cultural psychotherapy. Despite certain universal features, marked differences as regards intensity, quality and depth, exist in the forms of psychotherapy practised. Preferences in their choice crossculturally depend on differences in etiological views and on cultural and ideological differences. In many non-industrialized areas of the world, the belief prevails that mental illness is due to supernatural and preternatural forces, e.g. to angry deities, witchcraft or sorcery. In those countries shamans, priests and witchdoctors, in the accepted view, are much better qualified to deal with mental illness than scientifically trained doctors. The procedures which these healers adopt are partly of a physical and partly of a psychological nature. Factors of potential psychotherapeutic value inherent in their procedures include: naming of the supposed supernatural agent, suggestion reinforced by the high prestige of the native healers, projection of internal badness on the scapegoat or any other sacrificial animal, displacement of attack by killing an animal in lieu of a person, and penance by sacrifice. Because in many developing countries reliance on group approval predominates over superego pressure, therapeutic procedures are usually carried out in groups. The psychotherapeutic effect of cult ceremonies has been documented. Owing to the emphasis on individualism, rational thinking, scientific idolatry and tolerance of dissent, psychoanalysis found a fertile ground in the United States. It was rejected in authoritarian countries, such as Soviet Russia and Japan. Russian "pathogenic psychotherapy', and German 'autogenic training' ignore the unconscious, are ego directed and have a drill quality. In accordance with Marxist theory, work therapy figures prominently among psychotherapeutic measures in the Soviet Union. It is conceivable that the yoga component in autogenic training and the mysticism in Jung's analytic psychology and in existential psychotherapy appeal to the mystic leanings of Germans. In accordance with the teaching of Zen Buddhism, Morita therapy practised in Japan aims at acceptance of mental suffering rather than at restoration of mental health. Crosscultural psychotherapy. Application of Western psychotherapeutic procedures to non-Western societies gives rise to diff