Chapter 6 — Cultural understandings of mental health struggles and culturally appropriate responses
Each cultural grouping of the Just Therapy Team – Māori, Samoan and Pakeha – are involved in creating their own forms of culturally resonant responses to mental health struggles of their people. In this chapter, Tamailieutu Kiwi Tamasese shares the Samoan mental health project; a story of Flora Tuhaka’s therapy work with a Māori family is described; and some writings by Charles Waldegrave in relation to therapy as metaphoric reflection and a more theoretical paper about the challenges of culture to psychology and postmodern thinking.
First, let’s hear from Tamailieutu Kiwi Tamasese about the Samoan mental health project:
Honouring Samoan understandings of mental health and more
For many years, we have been working here in New Zealand with Samoan families who have migrated to this country. Many of the people who have consulted us have been suffering from what we would call ‘immigration trauma’ and yet have been diagnosed with any number of psychiatric conditions particularly various forms of psychosis. In receiving referrals from many places, including psychiatric hospitals, Samoan families have come to us bringing with them their medical files and diagnoses. Sometimes these families have also been accompanied by their psychiatrist and we have all talked together about these families’ experiences. Over time, it became clear that many of the psychiatrists’ conceptions of what was occurring for these families were radically different from the conceptions of the families themselves. It was apparent that these families’ perspectives of life, in particular their Samoan cultural beliefs, were in no way fitting with the beliefs of the psychiatric system. It was also clear that these families were being routinely traumatised by the process. In response to this, we started wondering about how we could bring to light these families’ own beliefs around mental health, how these knowledges and skills could inform the psychiatric services, and how they could contribute to a policy of different service provision. (p.184)
The following video by Tamailieutu Kiwi Tamasese explains a groundbreaking research project that was conducted in order to honour Samoan ways and understandings.
Photo credit: Kasia Waldegrave
Further reading about the Samoan mental health project:
A story of practice from Māori therapist, Flora Tuhaka
The following story of Flora Tuhaka’s practice is entitled Pura Pura Tuku Iho (the seed that has been passed down). It eloquently conveys her culturally informed family therapy approach.
- Pura Pura Tuku Iho (the seed that has been passed down) by Flora Tuhaka
Therapy as metaphoric reflection
The story you have just read, Pura Pura Tuku Iho, includes a moving example of Flora Tuhaka’s use of metaphoric reflection. This approach to family therapy is further described in this interview with Charles Waldegrave.
The invitations and challenges of culture
In the following classic paper, Charles Waldegrave subjects some of the assumptions that underpin the social sciences to a cultural analysis. In doing so, he describes a unique opportunity for psychologists and other helping professionals to recognise and honour other (non-Western) cultural ways of describing events and how this can lead to creative practices and enable the health and welfare resources to get to those who most need them, on their own terms. He describes the significant of enabling (and resourcing) workers from other cultures, to develop new paradigms, and new shifts in the field. As he writes: “This will not lead to the abandonment of social science, but it will enable that body of knowledge, to sit appropriately along side other realms of knowledge, such as gender knowledge, and cultural knowledge, without dominating. A new experience for the social scientists, but I suspect a liberating one!” (p.157)
- The challenges of culture to psychology and postmodern thinking by Charles Waldegrave
This paper was originally published in M. McGoldrick ed. (1998) Re-visioning Family Therapy: Race, Culture and Gender in Clinical Practice. New York: Guilford Press. Republished here with permission. Copyright remains with Guilford Press
Chapter 6 references
Tamasese, T. K. (2003). Honouring Samoan ways and understandings: Towards culturally appropriate mental health services. In C. Waldegrave, T. K. Tamasese, F. Tuhaka & W. Campbell (Eds.), Just Therapy – a journey. A collection of papers from the Just Therapy Team, New Zealand (pp. 183-195). Dulwich Centre Publications.
Tamasese, T. K. (2003). Multiple sites of healing: Developing culturally appropriate responses. In C. Waldegrave, T. K. Tamasese, F. Tuhaka & W. Campbell (Eds.), Just Therapy – a journey. A collection of papers from the Just Therapy Team, New Zealand (pp. 197-200). Dulwich Centre Publications.
Tuhaka, F. (2003). Pura Pura Tuku Iho (the seed that has been passed down). In C. Waldegrave, T. K. Tamasese, F. Tuhaka & W. Campbell (Eds.), Just Therapy – a journey. A collection of papers from the Just Therapy Team, New Zealand (pp. 175-179). Dulwich Centre Publications.
Waldegrave, C. (2003). The challenges of culture to psychology and postmodern thinking. In C. Waldegrave, T. K. Tamasese, F. Tuhaka & W. Campbell (Eds.), Just Therapy – a journey. A collection of papers from the Just Therapy Team, New Zealand (pp. 147-158). Dulwich Centre Publications.
Waldegrave, C. & Denborough, D. (2003). Therapy as metaphorical reflection. In C. Waldegrave, T. K. Tamasese, F. Tuhaka & W. Campbell (Eds.), Just Therapy – a journey. A collection of papers from the Just Therapy Team, New Zealand (pp. 121-130). Dulwich Centre Publications.
