Making space: Spirituality and mental health

This paper was the Mary Hemingway Rees Memorial Lecture, delivered at the XXIst World Assembly for Mental Health, Vancouver, Canada, 2001. The author had recently completed a period of appointment as the New Zealand Commissioner for Mental Health. In this lecture, the author puts in a moving plea - as a survivior of mental illness - for considering both spirituality and mental health in terms of the experience of the self. She talks about the value of communication particularly by sharing experiences via personal stories. The author goes on to contrast communication and control, and to emphasize the importance of making space in order to accept our own and others' imperfections and vulnerabilities. Attention is drawn to the work of Baruk (1978, 1998, 1999, 2000). She also discusses the way in which mental illness can lead to spiritual progress, and ultimately to mental health. The original version of the talk contained further pictorial illustrations; for technical reasons it would be difficult to reproduce all of them here in the journal. Most of the illustrative material consisted of photographs by the author, including the two photographs that are reproduced in this paper.     

Changing physical appearance preferences in the United Arab Emirates

Rapid economic growth in the United Arab Emirates (UAE) has impacted traditional ways of life rooted in Bedouin traditions and Islamic values. Research undertaken within the UAE suggests that a thin body-image ideal is widespread, as are abnormal eating attitudes and extreme dietary behaviours. However, this regional research has been exclusively cross-sectional, precluding conclusions about the temporal dynamics or nascence of these phenomena. This study explores changes in physical appearance preferences in the UAE over the past two decades. Interviews were undertaken with five khatabaat (marriage brokers), who were asked to report the attributes typically requested by those seeking wives, both now, and in the past. Thematic analysis of these data highlighted differences between the attributes currently deemed desirable, and those deemed desirable in the recent past. These findings are discussed in the context of the nation's rapid socio-economic change, and their implications for body-image and eating-related problems.     

Intuition as a Healing Modality: Historical and Contemporary Perspectives

This article examines intuition as an archetypal, cultural-spiritual healing modality. It builds on the notion of intuition as a reality founded on the archetypal calling to become a healer. Consideration is given to a variety of intuition traditions as well as contemporary understandings of intuition based on natural scientific evidence. Intuition needs to be understood within the context of practice for appropriate use.     

A critical engagement with the DSM-5 and psychiatric diagnosis

Classifications in psychiatry can result in the reification of hypothetical approaches, arbitrary categorisation and social injustice. This article applies a social constructivist approach to critique the DSM-5 as a neurobiological model of psychiatric diagnosis which ignores psychosocial factors such as poverty, unemployment and trauma as causes of mental distress. It challenges the universality of psychiatric diagnosis and proposes that cultural psychiatry's framing of ‘culture-bound syndromes,’ or ‘cultural case formulation’ guidelines, is oversimplified. Use of the DSM in the South African context risks perpetuating injustice by labelling and stigmatising people who have in the past been racially stigmatised by apartheid. In culturally diverse South Africa, psychiatric diagnosis should take into account alternative explanatory models that provide a more balanced view of the complex and dynamic relationship between biological and sociocultural forces in the manifestation of psychopathology.     

A Cognitive-Behavioural Treatment Programme for Conduct Disorder: The Case of Tumeleng

This article presents a case study of a teenager with conduct disorder (CD) using a cognitive-behavioural treatment programme for anger and aggression. Unique features of the case included comorbid expressive language disorder and a history of multiple traumatic brain injuries, and a Tswana (Botswana) ethnic/cultural background. Indications for successful treatment were the participant's intrinsic motivation to change and be accepted by his peers, and his good memory. Factors that contraindicated successful treatment were the absence of his parents, due to his attending boarding school and comorbidity. The case provides evidence for the efficacy of cognitive behavioral therapy (CBT) for CD in an adolescent of a Tswana background with comorbid expressive language disorder and history of multiple head injuries.     

From personal sexuality bias to the life orientation classroom: bridging the gap with cultural intelligence

The emotive nature of teaching sexuality and culture is widely acknowledged. However, a working model to promote the teaching of sexuality with sensitivity to both learner needs and community social norms is required. This paper proposes to position cultural intelligence as a means to promote the active, as opposed to reactive, nature of teaching sexuality within a multicultural environment. Specifically, cultural intelligence's components of knowledge, mindfulness and behaviour seem particularly pertinent to a pedagogy which aligns with the active change of modern sexualities.     

Reflections from a damaged discipline: Adorno,religious radio,and the critique of historical reason

The Psychological Techniques of Martin Luther Thomas' Radio Addresses (Adorno, 2000) echoes Adorno's analogous critique of the culture industry by detecting an ideological effect, prior to any given content, intrinsic to the form of radio religion. Notwithstanding the text's narrowness, I argue that Adorno's analysis of Thomas' ‘fait accompli technique’—presenting claims as previously established certainties—was both typical of his work and insightful for issues in cultural criticism. First, it refused subjectivist reductions of sociological effects to false consciousness. Second, it warned that historicism runs the risk of repeating the fait accompli when it treats what exists empirically as the only possible reality, or when it treats empirical givens as representatives of a future redemption. I argue that Adorno's dismissal of religious radio was consistent with his critique of positivism, and that the Thomas study models an historicist methodology that refuses, against its own logic, to reduce otherness to its own categories.     

A Case Study: A Discussion of Depression,Ambivalence, Attachment,and Culture Portrayed in the Therapeutic Environment

ABSTRACT

This paper uses object relations theory to conceptualize and manage the complexities of a home-based case that was followed for a period of six months. It discusses maternal depression in relation to the caregiver role, self-harm, and self-determination. The client's ambivalence issues are addressed, with particular emphasis on transference and countertransference issues in the relationship and the use of transitional space and objects. Also discussed is the effect of maternal depression and ambivalence on mother-infant attachment, with the introduction of interaction-guidance as a treatment modality. An examination of cultural differences and the concomitant ethical implications that arose in the treatment process is provided. Finally, therapeutic implications and reflexivity are addressed.     

Parental Attitudes,Attachment Styles,Social Networks,and Psychological Processes in Autism Spectrum Disorders: A Cross-Cultural Perspective

In this study the authors used a cross-cultural approach to examine parental attitudes, attachment styles, social networks, and some of the psychological processes involved in Autism Spectrum Disorders (ASD). Fifty-two children (aged 4–11 years) took part in the study: 30 Italians (15 with ASD and 15 controls) and 22 Cubans (11 with ASD and 11 controls). Findings indicated significant differences between the two cultural groups in terms of the structure of the children's social network and parental attitudes toward their children. However, the mother–child attachment relationship and cognitive and emotional functioning of the study participants were independent of culture.