Bilu Y, Witztum E
Department of Psychology, Department of Sociology and Anthropology, The Hebrew University of Jerusalem.
Sci Context. 1995 Spring;8(1):159-73. doi: 10.1017/s0269889700001939.
One disconcerting aspect of the role of culture in shaping human suffering is the gap between the explanatory models of therapists and patients in multicultural settings. This gap is particularly noted in working with Jewish ultra-orthodox psychiatric patients whose idioms of distress are often derived from a sacred reality not easily reconcilable with psychomedical reality. To meet the challenge to therapeutic efficacy that this incompatibility may pose, we propose a culturally sensitive therapy based on strategic principles that focus on the patient's mythic world and religious idioms of distress as the kernel of therapeutic interventions. Using one case of post-traumatic stress disorder (PTSD) as illustration, we seek to show how the religious symbols through which the patient's distress was articulated may be manipulated to effect cure. The case highlights the narrative quality of both illness construction and self-reconstruction.
文化在塑造人类痛苦方面所起作用的一个令人不安的方面是，在多元文化背景下，治疗师与患者的解释模型之间存在差距。在与犹太极端正统派精神病患者打交道时，这种差距尤为明显，他们表达痛苦的习语往往源自一个神圣的现实，而这个现实很难与心理医学现实相协调。为应对这种不相容可能对治疗效果构成的挑战，我们提出一种基于策略原则的文化敏感疗法，该疗法将重点放在患者的神话世界和痛苦的宗教习语上，将其作为治疗干预的核心。我们以一个创伤后应激障碍（PTSD）病例为例，试图展示如何通过操控患者用来表达痛苦的宗教符号来实现治愈。该病例突出了疾病建构和自我重建的叙事性质。
