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
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