Integration of Nonwestern and Western Healing Arts
Alusine M. Kanu, D.A.
There is a need to address the integration of nonwestern and western healing arts in health and healing. Similarities exist between indigenous healers in nonwestern and western practitioners. Both have diagnostic tools to help identify the nature of the prob-lem, and both provide interpretations to the patient, and both have treatment methods. If the concepts of multicultural pastoral counseling are broadened to include all of healing and all types of healers worldwide, the external validity of these concepts would be greatly increased. As Leong et al. (2000, p. 5) stated, "We need a global perspective that recognizes and is open to other cultures in other countries, whether on this continent or across the oceans or on the other side of the world."
A review of literature provides evidence of integration of nonwestern and western healing arts. In Social Psychology: Comparative Societal and Universal, Berry (1978, pp. 93-104) proposed that it is desirable and possible to explore these societal bases in a broad range of sociocultural systems and to integrate these local social psychologies into a wider-based discipline. Such an enterprise should proceed by employing the compara-ative method to test the usefulness of current social psychology (which is largely a Euro-American discipline) in other sociocultural settings, to develop new theories and data in these other settings and then to generate a more nearly universal social psychology that recognizes both cross-cultural communities and varieties in social behavior.
Bedeker (2007, pp. 231-143) reports that many of the approaches used in alternative or complementary medicine in North American and Western Europe have their origins in the long standing traditional forms of health and healing of what are now known as developing countries. As the health strategies used in traditional health systems (for example, Ayurveda and traditional Chinese medicine) have crossed national boundaries, they have come to be considered "alternative" to the dominant health care system. The international practice of integrating nonwestern and western healing makes at least two powerful and unique contributions. It reminds us that as members of the international community, we have a responsibility at least to be informed about the qualities of life and the struggles of people who live in other countries. Second, we have come to realize that we can learn from each other; we gain greater understanding about our own problems and their solutions when we build on ideas and information coming from many different sources.
Comparative studies can show clarity in describing the biomedical and traditional healing systems. Attribution to the biomedical should not imply that the traditional system incorporates them from a biomedical perspective. It is essential to consider all conclusions in the context of diagnosis. Analysis of biomedical systems reflects current treatment. Cultural familiarity shows practice in some nonwestern cultures. While recog-nizing some of the merits of the traditional system, researchers should also understand the ambiguities, paradoxes, and the full range of assistance.
A growing number of developing countries have come to recognize that rising health care costs compounded by the burden of the malaria and AIDS epidemics, point to the need for alternative approaches to meeting the basic health care needs of the population. This has contributed to resurgence of interest in traditional forms of health care and has led to a growth in research, new services and administrative programs and recognition of the primary health care role of traditional health care practitioners. Natural approaches to health care, be they alternative or traditional, depending on the country of practice, are to serve an increasingly important role in meeting the health care needs of the majority of the world's population in the twenty-first century. Serious national and international policy issues must be addressed in an integrative and comprehensive manner.
Like western pluralistic societies, non-western pluralistic societies also have multiple health belief and care systems. Variations in health conceptions and practices in such societies arise because of multiple enthnocultural groups within their national boundaries and because of incorporation of new cultures as a result of colonialism, immigration, and cultural hegemony. One important source of variation in health con-cepts of nonwestern societies is the pervasive penetration of western biomedical concepts and practices into the health care systems of these cultures.
Health concepts in pluralistic societies tend to reflect the sociohistorical contexts in which they occur. Western biomedical health concepts focus on disease as marked by pathophysiologic processes, while in some cases discounting spirituality as a part of well being. Nonwestern conceptions tend to be holistic in approach and view health as a ba-lance between the facets of the body, the mind, the spirit, and the natural environment. Moreover, religion and spiritualism are integral parts of nonwestern health conceptions.
In nonwestern societies, health practices often blend both natural and spiritual remedies. As in the West, special foods and home herbal concoctions are prepared, but unlike the West, these preparations are taken with appropriate spiritual blessing or rituals.Culture has received marginal consideration in health psychology even though the value of culture in human behavior in general, and health in particular, has had historical and contemporary recognition.
In western societies, health care policies, perspectives, and practices have received both positive and negative reviews. On the negative side, it has been suggested that health beliefs and practices in culturally pluralistic western societies are embedded in the western tradition. The consequences are (1) neglect of cultural and linguistic demo-graphics, (2) lack of consideration of cultural diversity in health service planning, imple-mentation and evaluation, (3) creation of discriminatory health service practices and disparities in access, utilization and outcome, and (4) marginalization of the indigenous health structures, beliefs, and practices of diverse cultures (Airhihenbuwa, 1995). On the positive side, there has been an increasing recognition of the value of multiculuralizing and embedding within a culturally pluralistic context (Dana et al., 1998).
There is much to learn from counseling professionals around the world. This includes learning about shared and indigenous perspectives in counseling worldwide, current research findings and conceptual models, and unique strategies of counseling around the globe. An opportunity to learn from international colleagues is one of the most exciting new developments within the multicultural counseling specialty. Increased international collaboration will have the potential to enhance counseling forever. As Heppner (2006, p. 169) claimed, international contact and collaboration will "enhance the sophistication of our research, expand knowledge basis, increase the range of counseling interventions, and in essence, increase counseling effectiveness across a wide range of populations."
In studying relationships between culture and behavior, three orientations can be discerned: absolutism, relativism, and universalism (Berry et al., 1992). The absolutist position is one that assumes that human phenomena are basically the same (qualitatively) in all cultures: honesty is honesty, and depression is depression, no matter where one observes it. From the absolutist perspective, culture is thought to play little or no role in either the meaning or display of human characteristics. Interpretations and assessments are made without alternative, culturally-based views being taken into account.
In sharp contrast, the relativist approach is rooted in anthropology with the assumption that all behavior is culturally patterned. It seeks to avoid enthnocentrism by trying to understand people "in their own terms." Explanations of human diversity are sought in the cultural context in which people have developed. Assessments are typically carried out employing the values and meanings that a cultural group gives to a phenom-enon. Comparisons are judged to be problematic and ethnocentric and are thus virtually never made. A third perspective is that of universalism. Here, it is assumed that basic human characteristics are common to all members of the species and that culture influences the development and display of them (i.e., culture plays different variations on these underlying themes).
To be effective multicultural counselors, individuals need to be able to tolerate ambiguity, be adaptable to new social and professional roles, and be flexible. It is necessary to use alternate counseling approaches and techniques to meet the needs of culturally different groups (Irey et al., 1987, pp. 195-204). Ramirez (1999) identified tasks for multicultural counselors: matching clients in an atmosphere of acceptance so clients will feel free to express their preferred cognitive and cultural styles and making a formal assessment of preferred styles through observation, reading a book that portrays a distinctive culture and noting socialization and interaction with others, and facilitating a group discussion and debriefing.
Qualitative methods provide rich descriptive information about a community or about individuals, usually accompanied by information about the context in which they function. This is particularly useful because qualitative refers to, among other things, focus group discussions, participant observation, and key informant interviews. Quantitative methods are particularly appropriate when the quantity of a phenomenon is of interest, such as frequency of behavior, intensity of an attitude, and the norms, especially when the purpose is to evaluate the association between two variables.
Traditional healers are likely to make a diagnosis and prescribe treatment based on assessment of the basic cause of illness, which is recognized as a psychosocial process that must be treated in the context of the individual's family, social network, and com-munity. In contrast, western health practitioners are more biopsychologically oriented with focus on treatment of disease, and usually treat the individual without attention to context (Lee, 1997, pp. 46-78). Issues of integrating nonwestern and western healing arts present many challenges to counselors. Some of the issues may include having practitioners understand the impact of their own past upon assumptions about culture, identity, ethics, and morals as these constitute considerable significance in the effectiveness of methods of healing. Practitioners should also understand the discriminatory nature and power imbalance of the relationship between dominant and minority groups in society and how such practices are perpetuated. It might also be helpful if practitioners learn about the culture that clients come from. Practitioners should also be open to a wide range of challenging and perhaps contradictory views of the world expressed by clients.
Diversity and inclusion are necessary for both western and nonwestern healing practices to be integrated. An inclusive environment requires integration to build and sustain cultures. Practices of diversity focus on clarifying diversity with vision and leadership. It is good practice to align systems, policies, and procedures to support diversity and inclusion. Practices of diversity integration in health and healing should include developing a global mindset that enables different cultures to compete and cooperate in a global environment with oneness and kindness of the human community.
Throughout the world, what is needed in the field of multicultural health and healing counseling is a new paradigm and a way of thinking and acting. Heppner (2006, p. 170) predicted, "In the future, the parameters of counseling will cross many countries and many cultures." More specifically, the accumulative knowledge basis in healing will be grounded in the scientific and applied discoveries of counseling professionals from all corners of the world."
Other integrated thoughts might include having theories and models of counseling to be extended or modified to incorporate a wide range of understanding and response modes to clients. Practitioners in both nonwestern and western cultures should continue to recognize and address the societal and political implications as well as emotional and psychological implications of clients' situations. Cultural relevance of indigenous healing practices should promote psychological, physical, and spiritual well being.
References
Airhihenbuwa, D. O. (1995). Health and Culture: Beyond the Western Paradigm. Thousand Oaks CA: Sage.
Berry, C. J. (1992), 4, 331-333.Cambridge UniversityPress.
Berry, J. W. (1978). Canadian Psychology Review Canadienne, vol. 19(2).
Bekeker, G. (1995). The Journal of Alternative and Complementary Medicine, 1(3).
Dana, R.H. (1998). Understanding Cultural Identity in Intervention and Assessment.Thousand OaksCA: Sage
Heppner, P. (2006). "The benefits and challenges of becoming cross culturally competent counseling psychologist," The Counseling Psychologist, 34, pp. 147-172.
Irey, A.E. (1987). "The multicultural practice of therapy: Ethics, empathy, and dialectics," Journal of Social and Clinical Psychology, 5.
Leong, T.T.L. et al. (2000). "Toward a global vision of counseling psychology," The Counseling Psychologist, 28, pp. 5-9.
Lee, E. (1997). "Chinese American Families," in Lee (Ed.), Working with Asian Americans: A Guide for Clinicians.New York:Guilford.
Ramirez, M. (1999). Mutlicultural Pschotherapy: An Approach to Individual and Cultural Differences.Needham Heights MA: Allyn and Bacon.
There is a need to address the integration of nonwestern and western healing arts in health and healing. Similarities exist between indigenous healers in nonwestern and western practitioners. Both have diagnostic tools to help identify the nature of the prob-lem, and both provide interpretations to the patient, and both have treatment methods. If the concepts of multicultural pastoral counseling are broadened to include all of healing and all types of healers worldwide, the external validity of these concepts would be greatly increased. As Leong et al. (2000, p. 5) stated, "We need a global perspective that recognizes and is open to other cultures in other countries, whether on this continent or across the oceans or on the other side of the world."
A review of literature provides evidence of integration of nonwestern and western healing arts. In Social Psychology: Comparative Societal and Universal, Berry (1978, pp. 93-104) proposed that it is desirable and possible to explore these societal bases in a broad range of sociocultural systems and to integrate these local social psychologies into a wider-based discipline. Such an enterprise should proceed by employing the compara-ative method to test the usefulness of current social psychology (which is largely a Euro-American discipline) in other sociocultural settings, to develop new theories and data in these other settings and then to generate a more nearly universal social psychology that recognizes both cross-cultural communities and varieties in social behavior.
Bedeker (2007, pp. 231-143) reports that many of the approaches used in alternative or complementary medicine in North American and Western Europe have their origins in the long standing traditional forms of health and healing of what are now known as developing countries. As the health strategies used in traditional health systems (for example, Ayurveda and traditional Chinese medicine) have crossed national boundaries, they have come to be considered "alternative" to the dominant health care system. The international practice of integrating nonwestern and western healing makes at least two powerful and unique contributions. It reminds us that as members of the international community, we have a responsibility at least to be informed about the qualities of life and the struggles of people who live in other countries. Second, we have come to realize that we can learn from each other; we gain greater understanding about our own problems and their solutions when we build on ideas and information coming from many different sources.
Comparative studies can show clarity in describing the biomedical and traditional healing systems. Attribution to the biomedical should not imply that the traditional system incorporates them from a biomedical perspective. It is essential to consider all conclusions in the context of diagnosis. Analysis of biomedical systems reflects current treatment. Cultural familiarity shows practice in some nonwestern cultures. While recog-nizing some of the merits of the traditional system, researchers should also understand the ambiguities, paradoxes, and the full range of assistance.
A growing number of developing countries have come to recognize that rising health care costs compounded by the burden of the malaria and AIDS epidemics, point to the need for alternative approaches to meeting the basic health care needs of the population. This has contributed to resurgence of interest in traditional forms of health care and has led to a growth in research, new services and administrative programs and recognition of the primary health care role of traditional health care practitioners. Natural approaches to health care, be they alternative or traditional, depending on the country of practice, are to serve an increasingly important role in meeting the health care needs of the majority of the world's population in the twenty-first century. Serious national and international policy issues must be addressed in an integrative and comprehensive manner.
Like western pluralistic societies, non-western pluralistic societies also have multiple health belief and care systems. Variations in health conceptions and practices in such societies arise because of multiple enthnocultural groups within their national boundaries and because of incorporation of new cultures as a result of colonialism, immigration, and cultural hegemony. One important source of variation in health con-cepts of nonwestern societies is the pervasive penetration of western biomedical concepts and practices into the health care systems of these cultures.
Health concepts in pluralistic societies tend to reflect the sociohistorical contexts in which they occur. Western biomedical health concepts focus on disease as marked by pathophysiologic processes, while in some cases discounting spirituality as a part of well being. Nonwestern conceptions tend to be holistic in approach and view health as a ba-lance between the facets of the body, the mind, the spirit, and the natural environment. Moreover, religion and spiritualism are integral parts of nonwestern health conceptions.
In nonwestern societies, health practices often blend both natural and spiritual remedies. As in the West, special foods and home herbal concoctions are prepared, but unlike the West, these preparations are taken with appropriate spiritual blessing or rituals.Culture has received marginal consideration in health psychology even though the value of culture in human behavior in general, and health in particular, has had historical and contemporary recognition.
In western societies, health care policies, perspectives, and practices have received both positive and negative reviews. On the negative side, it has been suggested that health beliefs and practices in culturally pluralistic western societies are embedded in the western tradition. The consequences are (1) neglect of cultural and linguistic demo-graphics, (2) lack of consideration of cultural diversity in health service planning, imple-mentation and evaluation, (3) creation of discriminatory health service practices and disparities in access, utilization and outcome, and (4) marginalization of the indigenous health structures, beliefs, and practices of diverse cultures (Airhihenbuwa, 1995). On the positive side, there has been an increasing recognition of the value of multiculuralizing and embedding within a culturally pluralistic context (Dana et al., 1998).
There is much to learn from counseling professionals around the world. This includes learning about shared and indigenous perspectives in counseling worldwide, current research findings and conceptual models, and unique strategies of counseling around the globe. An opportunity to learn from international colleagues is one of the most exciting new developments within the multicultural counseling specialty. Increased international collaboration will have the potential to enhance counseling forever. As Heppner (2006, p. 169) claimed, international contact and collaboration will "enhance the sophistication of our research, expand knowledge basis, increase the range of counseling interventions, and in essence, increase counseling effectiveness across a wide range of populations."
In studying relationships between culture and behavior, three orientations can be discerned: absolutism, relativism, and universalism (Berry et al., 1992). The absolutist position is one that assumes that human phenomena are basically the same (qualitatively) in all cultures: honesty is honesty, and depression is depression, no matter where one observes it. From the absolutist perspective, culture is thought to play little or no role in either the meaning or display of human characteristics. Interpretations and assessments are made without alternative, culturally-based views being taken into account.
In sharp contrast, the relativist approach is rooted in anthropology with the assumption that all behavior is culturally patterned. It seeks to avoid enthnocentrism by trying to understand people "in their own terms." Explanations of human diversity are sought in the cultural context in which people have developed. Assessments are typically carried out employing the values and meanings that a cultural group gives to a phenom-enon. Comparisons are judged to be problematic and ethnocentric and are thus virtually never made. A third perspective is that of universalism. Here, it is assumed that basic human characteristics are common to all members of the species and that culture influences the development and display of them (i.e., culture plays different variations on these underlying themes).
To be effective multicultural counselors, individuals need to be able to tolerate ambiguity, be adaptable to new social and professional roles, and be flexible. It is necessary to use alternate counseling approaches and techniques to meet the needs of culturally different groups (Irey et al., 1987, pp. 195-204). Ramirez (1999) identified tasks for multicultural counselors: matching clients in an atmosphere of acceptance so clients will feel free to express their preferred cognitive and cultural styles and making a formal assessment of preferred styles through observation, reading a book that portrays a distinctive culture and noting socialization and interaction with others, and facilitating a group discussion and debriefing.
Qualitative methods provide rich descriptive information about a community or about individuals, usually accompanied by information about the context in which they function. This is particularly useful because qualitative refers to, among other things, focus group discussions, participant observation, and key informant interviews. Quantitative methods are particularly appropriate when the quantity of a phenomenon is of interest, such as frequency of behavior, intensity of an attitude, and the norms, especially when the purpose is to evaluate the association between two variables.
Traditional healers are likely to make a diagnosis and prescribe treatment based on assessment of the basic cause of illness, which is recognized as a psychosocial process that must be treated in the context of the individual's family, social network, and com-munity. In contrast, western health practitioners are more biopsychologically oriented with focus on treatment of disease, and usually treat the individual without attention to context (Lee, 1997, pp. 46-78). Issues of integrating nonwestern and western healing arts present many challenges to counselors. Some of the issues may include having practitioners understand the impact of their own past upon assumptions about culture, identity, ethics, and morals as these constitute considerable significance in the effectiveness of methods of healing. Practitioners should also understand the discriminatory nature and power imbalance of the relationship between dominant and minority groups in society and how such practices are perpetuated. It might also be helpful if practitioners learn about the culture that clients come from. Practitioners should also be open to a wide range of challenging and perhaps contradictory views of the world expressed by clients.
Diversity and inclusion are necessary for both western and nonwestern healing practices to be integrated. An inclusive environment requires integration to build and sustain cultures. Practices of diversity focus on clarifying diversity with vision and leadership. It is good practice to align systems, policies, and procedures to support diversity and inclusion. Practices of diversity integration in health and healing should include developing a global mindset that enables different cultures to compete and cooperate in a global environment with oneness and kindness of the human community.
Throughout the world, what is needed in the field of multicultural health and healing counseling is a new paradigm and a way of thinking and acting. Heppner (2006, p. 170) predicted, "In the future, the parameters of counseling will cross many countries and many cultures." More specifically, the accumulative knowledge basis in healing will be grounded in the scientific and applied discoveries of counseling professionals from all corners of the world."
Other integrated thoughts might include having theories and models of counseling to be extended or modified to incorporate a wide range of understanding and response modes to clients. Practitioners in both nonwestern and western cultures should continue to recognize and address the societal and political implications as well as emotional and psychological implications of clients' situations. Cultural relevance of indigenous healing practices should promote psychological, physical, and spiritual well being.
References
Airhihenbuwa, D. O. (1995). Health and Culture: Beyond the Western Paradigm. Thousand Oaks CA: Sage.
Berry, C. J. (1992), 4, 331-333.Cambridge UniversityPress.
Berry, J. W. (1978). Canadian Psychology Review Canadienne, vol. 19(2).
Bekeker, G. (1995). The Journal of Alternative and Complementary Medicine, 1(3).
Dana, R.H. (1998). Understanding Cultural Identity in Intervention and Assessment.Thousand OaksCA: Sage
Heppner, P. (2006). "The benefits and challenges of becoming cross culturally competent counseling psychologist," The Counseling Psychologist, 34, pp. 147-172.
Irey, A.E. (1987). "The multicultural practice of therapy: Ethics, empathy, and dialectics," Journal of Social and Clinical Psychology, 5.
Leong, T.T.L. et al. (2000). "Toward a global vision of counseling psychology," The Counseling Psychologist, 28, pp. 5-9.
Lee, E. (1997). "Chinese American Families," in Lee (Ed.), Working with Asian Americans: A Guide for Clinicians.New York:Guilford.
Ramirez, M. (1999). Mutlicultural Pschotherapy: An Approach to Individual and Cultural Differences.Needham Heights MA: Allyn and Bacon.
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