Title: Critical Aspects of psychotherapy
1Critical Aspects of psychotherapy
- Multicultural Aspects of Therapy
2This lecture will consider
- Historical perspective
- counselling/psychotherapy in society today
- western theories
- non-western helping/healing
- bereavement
3Historical perspectives
- 1554 West Africans in London
- 1770 18000 black slaves
- 1851 727326 Irish immigrants
- 1880 60000 Jewish immigrants
- 1947 120000 Polish immigrants
- Commonwealth
- Vietnamese Eastern European
4Counselling/psychotherapy today
- Listening
- empathy
- caring
- training
- professional bodies (BPS BACP)
- Relate Samaritans Drugline Childline
5Western theories
- Philosophy
- medicine
- psychiatry
- psychology
- counselling/psychotherapy
- Freud Jung Adler Klein Beck Ellis
Meichenbaum Rogers Maslow
6Non-western helping/healing
- Religion/philosophies
- alternative/complimentary therapies
- beliefs/attitudes/practices
7Religions/philosophies
- Judeo-Christian
- Islam
- Hindu
- Buddhist
- Sikh
- Rastafarian
- Pagan
8Alternative/complimentary
- Reflexology
- osteopathy
- chiropractic
- aromatherapy
- Reiki
- Iridology
- shiatsu
9Alternative/complimentary (2)
- Chinese Traditional Medicine
- acupuncture
- herbs
- astrology
- Feng Shui
10Beliefs/attitudes/practices
- Gender
- pain
- diet/nutrition
- rituals
- normal/abnormal
11culture
- Many definitions shared social-psychological
nexus of beliefs and values which provides
guidelines for ones actions and gives meaning to
their actions - Sharma (1996)
- transcultural therapy-relationship/process in
which therapist/client belong to different
cultures (ibid)
12Mental illness culture
- culture implicitly and explicitly defines social
psychological reality Sohan 1996 - therefore is behaviour acceptable/unacceptable
- Marsella 1985 states that cultures vary in their
perceptions of reality - non-western groups- mystical states
depersonalisation visions deviant belief more
tolerated
13Cultural definitions
- Unacceptable/deviant behaviours may be due to
- genetics/biochemical imbalance
- supernatural
- deficient diet
- socio-economic conditions
14Culture therapy
- Interventions may in some way be suggested by the
culture - immoral behaviour-church attendance
- sorcery/evil spirits-certain individuals
responsible for therapeutic role
15stigma
- Kleumann 1977 mental illness great stigma for the
chinese - Rock 1982 British females emotions then
somatic symptoms - Indian/Pakistani females somatization
16Bereavement
- Arie 1981 death treated with indifference in
ancient times - emotional reactions increased in the 17th century
- control of emotional displays
- 1800 death seen as peaceful and pleasant
17Western death customs
- Death customs in the western worlds emphasize
denial - mourning customs no-longer upheld
- no pause to ark the death of a person
- life carries on
- efforts to deny death are not working
- hopes and miracles pursued
18Life above death
- Person who is dying is expected to be as cheerful
as possible and involved in life - this gets carried over into the mourning
process-there is no set ritual - mourn.but not for too long
19Is grief normal
- Grief Worder 1991 normal reaction to loss
- mourning process is the process grieving person
goes through - bereavement is adaptation to loss
- mourning is a cultural response to grief
20- 1917 Freud stated grief was not pathological
overcome after a time interfering with it was
useless possibly harmful - 1940 Klein mourner goes through a transitory
manic/depressive state and overcomes it
21How do people cope
- Lindemann 1941 normal reaction to a distressing
situation - symptoms waves of physical distress lasting 20
minutes to 1 hour - SOB sighing empty feeling in stomach weakness
tension poor appetite feelings of unreality
withdrawal from others preoccupations with image
of deceased
22- Thoughts of negligence anger guilt
- restlessness
- length of grief reaction is dependant upon a
persons success in completing grief work - Marris 1958 Widows in London inability to
acknowledge loss - Gorer 1965 n80 15/never forgot never get over
loss
23- Parkes 1972 griefprice one pays for lovegrief
and joy are both parts of life - Lopata 1973 20 not over husbands death did
not expect to get over it - Glick Weiss Parkes 1974 men women respond
differently men lost a part of themselves.
Women felt abandoned
24- Bell 1971 older widows more problems than
widowers - women more financial hardships
- less opportunity to remarry
- loss of role of wife more important to them
than that of husband for men
251985 Obershaw myths of grieving
- Not something people get over
- people get through it by working at it
- not wait for time to heal
- doesnt think that people go through demarcated
stages of grief - no steady forward movement
26stages
- Pollock 1961 x 2
- Westberg 1973 x 10
- Engel 1961 x 6 shock disbelief developing
awareness restitution resolving the loss
idealisation the outcome
27Stages of dying
- Kuber-Ross 1969
- denial-it cant be happening to me
- bargaining just one more chance
- anger life is unfair
- depression it is hopeless
- acceptance peace readiness to move one
28Briese Farra 1984
- Grief theory based on phases is misleading
- no-one goes through them sequentially
- proposed alternate way more acceptable to men
less emphasis on emotions - based on life components
- self others work community transcendence
- dependent on stresses/responsibilities/priorities
- invest more in some components
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