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Large numbers of Caribbean people - Puerto Ricans, Jamaicans, Trinidadians, and other West Indians have migrated to mainland United States, Canada, and England. Migration means culture contact including, for some immigrants, contact with the mental health care system of the host country. Cultural differences between those delivering mental health services and those receiving them may lead to misunderstandings. An enlightened approach to psychiatric care is that cultural considerations have to be a primary focus in interpreting the meaning of behavior and in planning mental health care.
The aims of this article are to clarify certain aspects of Caribbean cultures, in particular, selected folk religions, as they might relate to Western notions of mental health and mental illness; to clarify certain underlying assumptions of Western psychiatry; and to identify ways in which Western psychiatry can improve its practice with people of certain Caribbean cultural groups.
Cross Cultural Look
Western Misinterpretation. Among Puerto Ricans, the belief in spiritism is fairly widespread. Spiritism is the conceptualization of the material world as surrounded by a non-material world populated by spirits, which are either bad or good. These spirits have the power to attach themselves to people and influence human affairs. They may even manifest themselves as reincarnations of other people or things. Psychiatric personnel may view a person holding such beliefs as delusional.
Spirit possession is common to certain folk religions in Haiti, Trinidad, Jamaica, and other Caribbean countries. Spirit possession differs from the Puerto Rican spiritism in that a specific named god enters and "takes over" the body of an individual for a period of time; in spiritism the gods are not such specific entities and the concept focuses on communication with the spirits rather than corporal entry for the spirits.
An individual may become possessed during a religious ceremony or, less frequently, in a variety of secular circumstances. Possession may provide the individual with an opportunity to play positively valued social roles and thus support his/her self-esteem.
The practice of obeah, which exists in many of the Caribbean islands, is a system of beliefs and practices involving manipulation of evil spirits. I provided psychotherapy to a young, schizophrenic, female West Indian, Judith. The therapy took place in the client's home. The client's pastor, who referred her for...