Paste your essay in here.. Introduction
What is culture?
Culture refers to the traits and awareness of a set of people, who share the same language, food, religion, community, arts and music. The word “culture” is extracted from a French term, which is evolved from the Latin “colere,” which means to nurture or cultivation. The different kind of cultures are Western culture, Eastern culture, Latin culture, Middle Eastern culture, African culture which is also divided into two cultural groups: North Africa and Sub-Saharan Africa. Many countries have people (immigrants) from different places with different cultures. The cultural diversity grows as the population of the countries expands. For example Jazz music was originated in the United States but has diffused to a lot of different cultures. Almost every culture listens to jazz music and enjoys it. The famous and the most favourite food ‘pasta’ is Italian but every person from different culture eats it and has found different ways and recipes to enjoy it. Though mostly every culture is open to try food, clothes, music and various things of different culture, some cultures are still very rigid and conservative.
Every culture has a different approach towards mental illness. Western societies such as United States see sickness as something that requires immediate use of advanced technology to identify and treat the disease whereas other societies believe that the ailment is due to some paranormal or psychic phenomena and encourage prayers or other spiritual forces. In Asian cultures the name of the family and maintaining the consonance is an important value. So, the Chinese patients prefer to hide any illness or discomfort in order to maintain their reputation and social standing among their social circles.
The term psychotherapy has been extracted from an Ancient Greek psyche (ψυχή) which stands for “breath; soul; spirit” and therapeia (θεραπεία) “medical treatment; healing”. According the Oxford English Dictionary psychotherapy defines it as the treatment of the personality or the mind by using psychological methods. Psychological therapy (also shortened to psychotherapy) refers to a form of treatment that involves a client talking to a therapist who is trained so as to help the client overcome difficulties. It is widely observed that it is the relationship between the client and the therapist that has the most significant influence on the outcome and the progress of the therapy (Rogers, 2013). Psychological therapies fall into various categories that include humanistic therapies, which place an emphasis on self-development at the ‘here and now’ by encouraging the patient to think about his feelings and thoughts; behavioural therapies, which place an emphasis on behaviours and cognitions; psychodynamic and psychoanalytical therapies, which place an emphasis on the unconscious patterns of relationship that have developed from the client’s childhood; relationship therapy which places an emphasis resolving issues that exist between people such as couples or family members; and arts therapy, which utilises creative arts within the process of therapy (NHS, 2016).
As such, different cultures have different approaches to psychological therapies. Lo & Fung (2003) observed that psychotherapy that has been developed in the west may not be directly in line with other cultural contexts. In line with that observation, this paper will assess two distinct cultures, the American culture and the Chinese culture, and discuss the differences in their approaches to psychological therapy. The two cultures chosen are distinct in many ways that will be discussed in the main body of the paper. Journal articles, books, published reports and relevant internet sources will be used.
Differences between the American and the Chinese cultures in their approaches to psychological therapies
The American (United States) and Chinese cultures are different in many ways. From Hofstede’s analysis, China has a high power distance, low levels of individualism, low levels of uncertainty avoidance, low levels of indulgence and high long term orientation (Hofstede Centre, 2016a) whereas the United States has low power distance, high levels of individualism, higher levels of uncertainty avoidance than China, higher levels of indulgence and low long term orientation (Hofstede Centre, 2016b)
Figure 1: Cultural comparison between United States and China
Source: (Hofstede Centre, 2016a; Hofstede Centre, 2016b)
The cultural differences have impacts on the approaches to psychotherapy between the two cultures.
Levels of individualism and their effects on seeking for psychotherapy help
On the Hofstede’s aspects of individualism, American culture is more individualistic whereas the Chinese culture is less individualistic. This means that many of the psychotherapy patients in China would view their problems as coming last, while many of the psychotherapy patients in the US would view their problems as coming first. Even though the Chinese culture with regards to the levels of individualism is socially valuable and adaptive for the Chinese culture at large, it may also keep patients from China from proactively seeking for help and taking an approach that is constructive to the life and emotional problems that they have. In the same contexts, patients from America may be more proactive in seeking help from a psychotherapist to deal with the life and emotional problems. Olfson & Marcus (2010) observed that the percentage of the American general population who used psychotherapy in the United States stayed relatively stable at 3.37% in the year 1998 and 3.18% in the year 2007, however psychotherapy assumed a less prominent role as an increasing number of patients requested for psychotropic medications without necessarily needing psychotherapy (Olfson & Marcus, 2010).and in relatively the same period, only less than 1% of the Chinese nationals have actively sought for psychotherapy treatment. This shows that the level of individualism of a culture has an impact on whether a patient from that culture will seek for psychotherapy treatment.
Differences in Cognitive-Behavioural Therapy (CBT)
CBT is a type of psychotherapy whereby negative thought patterns regarding the self and the universe are challenged so as to change undesirable patterns of behaviour or for the treatment of mood disorders like depression. CBT is one of the highly used therapies in America advocated by professionals in mental health. In America and much part of the western world, CBT has been used due to its basic tenet that a person is what he thinks he is, and this is obtained from the basic principles of behaviour and cognition (Dobson, 2012). CBT encourages its participants to maintain and develop a positive outlook concerning their experiences through an increase of skills for coping such as minimizing thoughts that are depressing (Hamblen, 2010). One of the derivatives of CBT, which is Rational Emotive Behavioural Therapy (REBT) is the most common in China according to Hodges & Oei (2007) whereas psychodynamic and psychoanalytic therapies are not as prominent in China as they are in the United States, according to a much earlier study by Cheng (1993).Hodges & Oei (2007) observed that the reason for the prominence of the REBT in Chinese culture is because the REBT’s framework matches the traditional values of the Chinese culture, which seek an approach that is solution-focused and direct from an expert that is authoritative, rather than a solution that encourages the patient to explore their inner self (Cheng, 1993). With an increase in the number of educated Chinese psychotherapists, there are increasing concerns being raised as to whether the psychotherapy approaches that are widely used in western cultures like UK and US, such as psychodynamic and psychoanalytic therapies, are suited for the people of China with the background of the Chinese culture (Sue, 1998).
Influences of Taoism in Chinese culture and Pragmatism in American culture
Taoism refers to a religious, ethical and philosophical tradition originating from China which places an emphasis on harmonious living with the ‘Tao’, which also means ‘way’. The principles of Taoism have been entrenched in the Chinese culture for many years, and are relevant in this paper as Tseng et al. (2012) observed that cultural factors are very important in the mental health of an individual. Ji et al. (2010) further observed that the perceptions regarding an illness’ symptoms and causes vary between individuals possessing different cultural beliefs. As such, indigenous psychological therapy with infusions of Taoism has been perceived to be more effective in China than the psychotherapy practised in western countries. As such, in Chinese culture, psychological therapy takes the form of Chinese Taoist Cognitive Psychotherapy (CTCP) which combines the elements of Taoist philosophy with cognitive therapy (Zhang et al., 2002). In a study conducted by Zhang et al. (2012) for Chinese patients having generalized anxiety disorder (GAD), it was empirically shown that CTCP was more effective in the treatment of GAD as compared to benzodiazepines, a class of psychoactive drugs, for patients with GAD in China. In CTCP, the patient’s treatment is based on eight principles originating from Taoism, which are defined in detail by Qian et al. (2001). During the CTCP treatment, the Chinese patient asks the psychotherapist for guidelines and explanations, in contrast to behaviours like self-exploration which are advocated for in the culture of the United States (Zhang et al., 2002). The main objective behind the inclusion of the eight Taoist principles in the cognitive psychotherapy is for the regulation of the adverse impacts on the patient, for the correction of any resultant maladaptive behaviour and for using the Taoist principles for the treatment of psychological problems (Feng et al. 2011). Mao & Zhao (2011) observed that CTCP as an approach to psychotherapy has become widely accepted in China, and the Taoist values are especially helping the cause of adopting the CTCP. This can also be observed as stemming from the culture of China whereby the Chinese nationals are more susceptible to accepting a didactic approach to psychotherapy using the Taoist values, where they seek for instructions and encouragements from a practitioner and they tend to value hierarchy (Zhang et al., 2002).
Pragmatism is a philosophy/ culture that began in the United States around the late 19th century and it rejects the notion that the purpose of thought is to mirror, represent or describe reality (Rorty, 2013). Whereas Taoism is very prominent in Chinese approach to psychotherapy, Pragmatism is also highly prominent in the American approach to psychotherapy. In the American context, the approach to psychotherapy is at times thought to be based on the ‘pragmatic theory of truth’ one whose main assumptions are that the effectiveness of a psychotherapy treatment is enough evidence for the truth regarding the interpretation of what occurs during each level of the treatment. As such, whereas Taoism in the Chinese approach to psychotherapy encourages the client to seek for answers and guidance from the medical practitioner, the American approach to psychotherapy encourages one to undertake a self-exploration of the issues that affect him.
The culture of ‘Face’ and Stigma in China and America
In the Chinese culture, one issue that is very prominent is the concept of ‘Face’. Face refers to the reputation or social standing of a person amongst his or her peers. As such in China, the concept of