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To understand trauma , we must consider not only different ‘ interpretations ’ of trauma-reactions but how the mind and the body are understood and interpreted in given cultural contexts . It is acknowledged that the West dichotomises the mind and the body , whereas many other cultures ( in Asia for example ) consider mind-and-body as a whole , which causes mental symptoms to appear as somatic sensations . Survivors who are unable to articulate their trauma or mental distress will often describe their symptoms in terms of pain . Somatisation is common among survivors from non-Western countries . Dissociation is also a frequent symptom of post-traumatic distress in non-Western societies , alongside depression , mood disorders and anxiety , with which the West is more familiar .
PART III : THEORY
In many places a mental illness is considered stigmatising or a character weakness . Sometimes a mental affliction is thought to be passed on genetically , leading to the belief that a survivor who displays symptoms of trauma puts the whole family at risk . Elsewhere , the disorganised , disruptive , impolite behaviour of a mentally ill person shames the family . In some Asian cultures , mental distress or illness are considered to be caused by loss of one ’ s soul or possession by evil or vengeful spirits . By Buddhists , suffering is often understood to be caused by fate ( karma ), itself the result of actions taken in a past life .
When we meet survivors we therefore have to deal with numerous interpretations or understandings of essentially identical bodily reactions to trauma . When addressing survivors who have a different cultural background , we have to be aware of our own cultural assumptions and values , and also of the possible presence of culture-bound syndromes . This means that helpers must be unusually sensitive to culture when they observe the behaviour of survivors , and must distinguish between culture and pathology as far as possible . Accurate and neutral observation is an essential skill . An ability to make sensitive inquiries about survivors ’ cultural routines and traditions , and family relationships , is another .
Often it is not possible to learn enough about the social culture and environment . Where this is so , helpers can enlist local people to explain and ‘ translate ’ local cultural practices and ‘ codes ’. It is important to be sensitive about these relationships too , because mediators may themselves be survivors of traumas , which assisting the helper may reawaken .
Some practical issues
Most humanitarian helpers lack wide international experience because they work in their own country and within their own culture . In terms of general advice , one should make sure that helpers :
• Are fully aware at all times of the cultural implications of interpreting trauma .
• Monitor for traumatic symptoms in the local people who help them .
• Monitor their own reactions .
• Are prepared for the possibility that they may be re-traumatised , or indirectly traumatised , when they listen to the stories of survivors they help . Training here might be especially important for local helpers .
The following advice may assist helpers to explore and manage the cultural dimensions of trauma
• Explore understandings of suffering and pain , and death and life , in the dominant local cultural group .
• If you do not speak the language fluently , acknowledge your limitations and ask survivors to tell you if you speak inappropriately or do something offensive .
• Be aware of culturally specific communication techniques ( eye contact , the integration of food and drink in discussions , the pace of conversation , body language , etc .).