Culture and Trauma

What is Culture?

Anthony Marsella defines culture as a shared learned behavior that is transmitted from one generation to another to promote individual and group adjustment and adaptation. External presentations of culture are artifacts, roles, and institutions, while internal ones are values, beliefs, attitudes, cognitive styles, epistemologies, and conscious patterns. Culture is a changing, permeable, and dynamic system. It allows a broad range of hybrid, transitional forms, both between cultures and within one culture. We are all immersed in our cultural worlds and often unconscious of their impact on our thoughts and behavior.

Interplay of Culture, Psyche, and Trauma

The ways in which culture influences psyche in general and posttraumatic reactions in particular are multidimensional.

• Culture molds the construction of self; it influences symptoms, course, and outcome of posttraumatic reactions and shapes accounts for traumatic incidents.
• Culture influences explanatory models of experienced traumatic life events and determines help-seeking behavior and the type of help one is expecting. While survivors in individualistic, Western societies perceive symptoms of posttraumatic damage mainly as a psychological, medical issue and seek counseling, in non-Western cultures the symptoms may be attributed to a social or a spiritual problem and a different set of reparation strategies is sought. Further, in many non-Western cultures, the dualism of body versus mind is not a feasible [Page 184]paradigm, and expressing psychological concerns with somatic symptoms is the rule rather than the exception. Also, somatic symptoms may seem more acceptable and easier to communicate than psychological ones, because non-Westerners place value on interpersonal balance with an emphasis on avoiding interpersonal conflict.
• Culture influences making of a hierarchy of values and needs that underlie decision making. While the symptoms of PTSD are found in most populations exposed to traumatic stress, their significance and importance may vary considerably across different cultures, and survivors may be much more concerned with other symptoms of distress or daily life issues.
• Finally, culture shapes the individual, family, and larger systems' coping with and adapting to consequences of trauma.

Research in cultural psychiatry suggests that the individual reaction to trauma is a combination of the universal aspects of reactions (some PTSD complaints) with the culture-bound ones, and the unique life history of the trauma victim. The PTSD concept is viable only in the individualized, postmodern culture of the Western world. Imposing it across cultures is preposterous and can be viewed as an act of Western scientific colonialism.

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