Socio-cultural factors may engender different definitions and responses to essentially identical experiences (Zola, undated). Culturally acquired systems of meaning, communicated through native language and other symbol systems, have representational, affective and directive functions, capable of shaping particular interpretations of reality (Fabrega, 1989). Culture-bound cognitive and linguistic representations of illness constrain individuals' interpretive and behavioural options in response to symptoms. These vocabularies acquire the status of unquestioned objective reality (Angle & Thoits, 1987), while learned cognitive structures, through which bodily experience are filtered, determine interpretation of deviations from culturally defined physical and mental health norms (Angle & Thoits, 1987), indicating that manifest appearance and social consequence of psychopathology may differ cross culturally (Fabrega, 1989). These cognitive structures, mediating illness labelling and help- seeking behaviour, have been recognised as central determinants of orientation to pathology (Angle & Thoits, 1987). Identifying precursors to the formation of these cognitive structures may be instructive in understanding culturally determined approaches to psychopathology.
The curative practices of a society constitute a cultural system involving lay beliefs and practices, indigenous folk medicine and often modern technical medicine (Chrisman & Kleinman, 1983 in Angle & Thoits, 1987). Ideas based on the traditional medical system may be so integral to individuals' beliefs that they are never consciously considered, yet may be primary determinants of response to psychopathology (Barrett, 1994). Professional labelling of pathology reinforces cultural concepts when diagnoses are communicated to others (Angle & Thoits, 1987). Orientation to pathology determines the trajectory of the culturally sanctioned treatment protocols, (Zola, undated), defining therapeutic and social experiences of patients (Fabrega, 1989).
In the past, most westerners interpreted their bodily states according to folk medicine, and now according to modern medical and scientific conceptions of disease (Angle & Thoits, 1987). It follows that individuals encountering different socio-cultural environments interpret psychophysiological symptoms according to their respective medical system's understanding.
The transcultural psychology objective of identifying manifestations of disturbed behaviour in various cultures and attempting to incorporate them into a pre-existing, presumably universal, pathological classification (Draguns, 1973) is largely undertaken within a western oriented psychiatric medical model (Draguns, 1973). Differences based on culture are acknowledged, however this medical paradigm remains the dominant framework for cross-cultural comparison. If a culture's traditional medical system influences experience and attitude to psychopathology, examining the tenants of that paradigm is integral to understanding the cultural psychological milieu. When considering the experiences of cultures, such as many Asian societies, whose traditional medical systems have evolved over millennia in a philosophical environment diametrically opposed to the dualistic, western, Cartesian paradigm, this is particularly pertinent. Many western ideological presuppositions are alien to the Asian ethos. Exclusive reliance on western psychology can only lead to an incomplete and distorted understanding of Asia, its people and culture (Ho, 1998). Asians are now confronted by stereotypes about themselves generated by western researchers, as well as their Asian counterparts, relying on imported psychology (Ho, 1998).
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