Adapting Western Therapeutic Models to Work with Non-Western Cultures
Clinical Master Class Evening held on 15 May 2013
These recorded lectures are available to be viewed for a small fee at Psychevisual.
A Self Psychological Model and its Relevance to the Cross-Cultural Management of Trauma
Dr Raymond Tint Way
Psychoanalyst Henry Krystal discussed the core experience of trauma as a surrendering to the inevitability of death and destruction. A new psychological theory, Kohutian Self- Psychology, offers a new perspective on cause and meaning of trauma in trans-cultural contexts, providing a new treatment modality, in which Empathic Attunement is used. Kohut theorised that trauma represented the loss or absence of a self-object and the consequent affect overstimulation and self- fragmentation, leaving the self vulnerable to further trauma. The therapist needs a reliable grasp of the client’s culture and lived experience to assist his/her expression of past trauma.
Migrants and refugees often bring a sense of loss and separation from their homelands, and some refugees from war-torn countries have had traumatic experiences. Reaching this complex group poses a therapeutic challenge, in view of the barriers to pathways to care, including the pathoplastic effects of culture on symptom formation and expression, differing patterns of health -seeking, and issues concerning transference , countertransference and the use of trained interpreters and bilingual workers.
This clinical master class evening presentation will discuss the theoretical underpinning of trauma and its management in a cross-cultural context, with reference to self-object theory and my clinical experience as a psychotherapist in dealing with Burmese migrants and Karen refugees from the Thai –Burma border.
Utilising Culturally Adapted CBT with Non-Western Clients: A Case Study of a Muslim Iraqi Woman
Cognitive Behaviour Therapy (CBT) is a widely utilised technique in the treatment of trauma that can be adapted for refugees affected by war, loss and dislocation. Nooria Mehraby illustrates the application of CBT with traumatised refugees with a case study of a 49 year old illiterate Mulsim Iraqi woman who lost two children during the Iraq war and another after arrival in Australia. She presented with an intense grief reaction, depression, anxiety and PTSD symptoms.
A safe therapeutic environment was provided in order for her to work through her grief while managing her anxiety. CBT techniques such as relaxation, psycho-education and cognitive restructuring were used with the client, congruent with her cultural beliefs and expectations, utilising cultural and religious metaphors to enhance the application of CBT techniques.