Cultural Perspectives on Psychological Trauma

PTSD is only a chronic condition if it is iatrogenically (mis-)treated as only, or primarily, a psychiatric issue. 

by Ruwan M. Jayatunge

Culture consists of traditions, values, customs, folklore, rituals, and artifacts that help to make meaning of the physical world and its transmitted primarily through language and everyday interactions. These cultural factors frequently play as trauma buffers and help the victims to come to terms with psychological suffering. The essential point about the concept of culture is that culture constructs our reality. It is the template that guides our perceptions (Marsella, 2010).

Mabalingwe Nature Reserve, Bela-Bela, South Africa [ Photo: Simon Hurry/ Unsplash]

Psychological trauma is a very complex and damaging factor to the human psyche. It is a unique individual experience and the individual’s interpretation is mostly based on his subjective experience. Individual differences in posttraumatic response have been known to the mental health clinician for many decades. Numerous psychologists indicate the close association between trauma and cultural factors. Some argue that the impact of trauma and trauma recovery sometimes depends on cultural factors as well. Therefore, the victims of trauma should be treated in a culturally appropriate manner.

Batista & Wiese (2010) argue that trauma must be considered within a culture because it is the cultural context that shapes the life experiences including the ones that are considered traumatic. No culture is immune to the pain and suffering caused by catastrophic or life-threatening events, but there are important cultural differences in how these events are interpreted and dealt with. (Watters 2010)

The Interpretations of and reactions to trauma can vary by culture. Some psychologists view PTSD symptoms as a social construction more than a description of a medical fact. According to Ed Tick, the author of the groundbreaking book “War and the Soul,” PTSD is a soul wound, and he has counted over eighty terms from languages around the world to describe what we now call PTSD. Clinical psychologist Roger Brooke (personal communication, 2012) says that what we call PTSD is the social construction of a universal human experience misguidedly constructed as a psychiatric issue.

For authors such as Shay, Tick, Hillman, Brooke, and others, the psychological wounds of war are in essence moral and spiritual wounds to that sustaining ground of human life people have traditionally called the soul. According to Tick, traditional warrior cultures understood traumatized combat veterans as initiates in need of further initiation so that they could be spiritually transformed into warrior elders and cultural guardians. They need the traditional healing themes of purification, making peace with the dead, restitution in the community, and honored status as veteran warriors.

According to Tick and Brooke, PTSD is only a chronic condition if it is iatrogenically (mis-)treated as only, or primarily, a psychiatric issue. According to Brooke, psychotherapy works best if it picks up those traditional themes in new and appropriate cultural ways, both in therapeutic conversations and in groups. The presence of civilians in such groups is sometimes resisted by veterans but is more helpful than they typically imagine it will be. The presence of civilians bridges the gap to the civilian world and is a process in which the civilian community shares the burden of the violence that has been done in its name. Another crucial aspect of healing is, for Brooke, that the veteran “owns” his experience in combat, and takes it up as a task to understand the lessons learned and to integrate these into the rest of his or her life.

The relationship between trauma and culture is an important one because traumatic experiences are part of the life cycle, universal in manifestation and occurrence, and typically demand a response from the culture in terms of healing, treatment, interventions, counseling, and medical care……… The concept of traumatic stress and the multidimensional nature of cultures requires a conceptual framework by which to address core issues that have direct relevance to understanding the nature of trauma as embedded within a culture and its assumptive systems of belief and patterns of behavioral regulation. ( The Lens of Culture -John P. Wilson).

Summerfield ( 1999) argues that when it comes to the issue of cultural differences and posttraumatic syndromes (e.g., PTSD) it cannot automatically be assumed that advances in Western psychotherapeutic techniques can be exported and applied to non-Western cultures.

Ruwan M. Jayatunge is a medical doctor, Author and an Associate Professor