Page 191 - Creating Spiritual and Psychological Resilience
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160 Creating Spiritual and Psychological Resilence
and distance from the field of mental health, which is seen as too con-
trolled by physicians and too closely associated with the ills of an overly
biopsychiatric approach” (van Ommeren, Saxena, & Saraceno, 2005, p. 71).
The blending of integrative medicine, public health, and group psychology
into IPR is a framework to mitigate the challenges that are inevitable in
doing cross-cultural and transnational psychosocial work.
Background Obstacles and Challenges
In order to prevent an overly biopsychiatric approach, IPR is a framework
that accommodates the blending of psychosocial interventions. Still, psy-
chosocial interventions can be ill-fitting if local interventions are ignored
or Western interventions are not culturally adapted. Epistemologically, it
makes a world of difference that widely accepted interventions and protocols
are developed largely by those in Western settings, validated through ran-
domized control trials with Anglo-European populations seeking general-
izability, and configured by the philosophical underpinnings of modernism,
positivism, and logocentrism. Part of the cultural cost to a non-Westernized
person who avails herself of a Western intervention is that a survivor must
work (and possibly lose parts of herself) to adopt a self-concept that fits the
intervention’s terms of reference. Operationally, these interventions are then
superimposed (taken “off the shelf”) or lightly adapted for use cross-cul-
turally and transnationally with the hope that they bring benefit (and they
often do) without considering a wider palette of interventions that would
better take into account the local population (as possibly bringing substan-
tially more benefit). With a view toward mitigating these challenges, warn-
ings from leaders in the field include the folowing:
Box 2: ChallEngEs to Cross-Cultural and
transnational trauma intErVEntions
1. A World Health Organization (WHO) bulletin: “We need to remember
that the Western mental health discourse introduces core components
of Western culture, including a theory of human nature, a definition of
personhood, a sense of time and memory, and a secular source of moral
authority. None of this is universal” (Summerfield, 2005, p. 76).
2. “Off the shelf” intervention materials are difficult to use in diverse
settings because they are unknowingly embedded with cultural