Learning Cloud International

(v1)

ASSESSMENT 7
Name: Georgeta Tufis
Score: 100%
Passmark: 100%
Attempted: Monday, February 20, 2017
Attempt Number: 1
Time Taken: 00:24:12
Locked: No
Marking Required: No

1: Correct 1. What are some ways that people from different cultures deal with conflict?
Introduction.

Etymologically, the word conflict comes from Latina and means collision or clash. A very usual word
nowadays, but trying to define it in all its complexity it reveals a lot of ramification and multiple facets.
Looking at the definitions of the word, conflict is usually related to struggle, opposition, incompatibility,
interference, tension, competition, interaction, incompatibility, scarcity, goals, interests, power. Conflict
is usually defined as A disagreement through which the parties involved perceive a threat to their
needs, interests or concerns.

Conflict is also defined as an interaction between actors (individuals, groups, organisations, etc.)
where at least one actor senses incompatibilities between their thinking, imagination, perception,
and/or feeling, and those of the others( Glasl (1994))
Is a process in which two or more parties attempt to frustrate the attainment of the others goals. The
factors underlying conflict are threefold: interdependence, differences in goals, and differences in
perceptions. ( Wall (1985))

Or, according to Coser (1956) , conflict is a struggle between opponents over values and claims to
scarce status, power and resources.
There are many classifications and theories about conflicts and according to disciplines, we find tons
of literature. Conflict can be approached from intrapersonal, interpersonal, intergroup, intra-society
and international/global perspectives with psychological, sociological, geopolitical, philosophical
dominants etc.
The origin and the nature of conflicts are also discussed under the sign of culture-nature (biological)
dichotomy; psychological factors; social, organizational, environmental, politics or cultural dynamics.

The anthropological approach relates conflicts to the systems of meanings, rituals and symbolism,
language and communication, ethnicity and identity, gender, environmental and sense of place, values
and ideologies.

Conflicts assume the existence of aggressiveness as an innate attribute of human nature. There are
controversial theories and debates about the duality nature/culture in this regards. In anthropology, for
instance, according to Ferguson (2006), there is no firm evidence of war for thousands of years during
Palaeolithic times (following the analyses of human skeletons for signs of lethal wounds, and studies
of human settlements for indicators of warfare).

There are numerous regions in the world where good archaeological data are available for centuries
or even millennia before any suggestion of war appearsAlthough episodes of war are possible any
time in human prehistory, there is no convincing evidence of collective intergroup violence any time
before 10,000 years agoand in many parts of the world much more recently than that.

Following different theories, apparently the shift from nomadic to sedentary life represented the first
step in defending the land and against the potential aggressors.
Other conditions were the emergence of social ranking, increased population and resource
degradation, state formation, and the spread of war from states to non - state people.

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 There are many other example that explain under different perspectives the aggressiveness, conflict
or violence. Religious reasons, rituals and different forms of symbolisms are among the main
justifications and legitimizations of this.

Aztecs, for instance, is an example. They believed that the gods give fertility to humans only if they are
nourished by human beings. With human sacrifice, the Aztecs expected to tip the battle of
supernatural forces between evil and good in their favour. This way, the major reason for war was to
capture enemy soldiers for ritual sacrifice.

Humans are capable of empathy, kindness, even love and they can achieve astounding mastery of
the challenges posed by their environment. But they are also capable of
maintaining beliefs and values and social institutions that result in senseless cruelty, needless
suffering, and monumental folly in their relations among themselves, as well as with other
societies.

Violent colonial domination movements; rebellions against oppressive regimes; genocides and mass
purges are forms of manifestation of human conflict and aggressiveness.

After this short introduction on conflict, I will focus now my attention on analysing two extremes under
an anthropological perspective:

The Yanomami society one of the most famous anthropological case of a violent society and one
opposite example Amish or Semai one of the most peaceful societies.

I will conclude my presentation with an analysis on different conflict reaction styles practiced in
different cultures.

The Yanomami community is a famous example of one of the most prone to conflicts, violence and
aggressiveness tribes studied by anthropologists. They are presented as the quintessence of chronic
and endemic primitive instincts of violence and conflicts, as exemplars of primitive fierce (Chagnon).

Following the description of Chagnon, the anthropologist that studied the indigenous society for more
than three decades, Yanomami illustrates the icon of the Hobbesian Bellum omnium contra omnes, a
laboratory of human conflict.

They seem to have a passion for conflicts, aggression, violence, practising all forms of brutality and
aggressiveness; the duels for instance are institutionalised, conventionalized, and ritualised forms of
interpersonal aggression. The Yanomami are portrayed as savages, primitive and fierce people and
their reasons for this combative lifestyle are not restricted to self-defence or defence of their land or
people but it is a way of enjoying life.

The typical Yanomami male is often covered with wounds and scars of innumerable quarrels, duels
and combats and as a sign of his place in community. According to Harris (1974) all Yanomamo men
physically abuse their wives. Kind husbands merely bruise and mutilate them; fierce ones wound and
kill.

Combative sports, violence as a means of solving problems, infanticide, wife-beating, rape, anger,
blood feuding, physical punishment, painful adolescent initiation rites, internal warfare, torturing the
enemies, genital mutilation, human sacrifice, cannibalism are all expressions of human brutality and
violence associated usually with the primitive tribal condition.

Nowadays, the recent conflicts in Rwanda, Somalia, and Afghanistan etc have been characterised as
a return to the Hobbesian tribalization condition.

This group is one extreme example of how conflict is faced, managed and dealt with at collective level
and the propensity of its members to embrace all forms of violence as a natural condition of living.

At the opposite side, we can find peaceful societies that rarely engage in physical aggression or forms
of violence. Usually, their propensity towards harmony and non-violent interpersonal relationship are
rooted in different forms of spirituality and religious principles. Among the main characteristics of the
low-conflict societies are: a peaceful spirituality/ religious; a strong linkage between individuals; high
identification with the collectively; low social stratification; low social discrepancies between its
members; devaluation of competition, of social-self, of personal ego; promotion of values like
simplicity, humility, modesty, obedience, internalisation of negative emotions. One notable example is
the Amish`s way of expressing anger - just by being silent for several days.

The non-cultivation of the sense of self has a huge impact on how people build up the relationships
dynamic. They are highly conscious of the danger of pride, the manifestation of individualism, and are
trying not to impose their views, opinions on others. This kind of general behaviour is highly oriented
towards the well-being of others, towards the community and all form of pursuit of individual interest is
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 discouraged. Their peaceful attitude is founded on religious beliefs and they believe that, by Christ,
are forbidden to become involved in any warfare or form of violence. They do not defend themselves if
attacked, and when faced with hostile neighbors or governments they simply abandon their farms and
move. Military service is an absolute contradiction to the spirit of Amish. Their approch towards conflict
is of an absolute avoidance, passivity and quiteness.

We can find the main traits to the Semai community in Malaysia where as themselves say "There is no
authority here but embarrassment and "there are more reasons to fear a dispute than a tiger.

Aware of the potential destructive power of negative emotions, Semai`s psychological mindset is to
refrain from expressing the impulses or the aggressive reactions. From childhood, children are taught
to fear their own negative impulsive and to preserve the harmony, the solidarity and the equilibrium in
the village. They seem to have more an avoiding-resolving approach to conflict, through informal
strategies in order to restore the peace.

According to some authors, Semai people have as main values avoiding violence and sharing food.
This sense of sharing food as a primary moral value can be find in other peaceful communities, such
as Lepchas, for instance that lives in Sikkim (North India), Kalimpong, Buthan or Nepal. There are a
lot of similarities in values among all the so-called peaceful communities and we can easily identify
common patterns such as a sense of self integrated into the collective self, rituals to control the evil
spirits responsible for negative propensities aggressiveness, jealousy, competition, conflicts.

The conflicts, obviously exist in all communities, there are nowhere angels on the earth, but the
prevalence belongs entirely to the promotion and conservation of the sense of community, of
cooperation. Inuit people live coherently with two contradictory and opposites values killing and non-
violence. As hunting people, killing is unescapable for surviving; but non-violence is a must for
maintaining the society as a whole. They can practice a form of benevolent aggression in the
education of their children for instance.

Having no tolerance or very low tolerance for discord, the general approach of the so-called peaceful
communities has an avoiding, accommodating, even ignoring approach towards conflict.

That peaceful version of human beings, may entitle us to to embrace the credo of Q.Wright, 1942 - "No
general golden age of peace existed at any stage of human history nor did any general iron age of
war. Neither the Rousseauian nor the Hobbesian concept of natural man is adequate"

Excellent evaluation and discussion well done

2: Correct 2. What are some ways that people from different cultures deal with depression?
Have you ever suffered from Hwa-byung?
Have you ever been sad?
Have you ever had Ataque de nervious?
Have you ever proved shin-byungs symptoms?
Do you feel like feeling a Litost?
Have you ever felt depressed?
Have you ever had pena ajena?
Did you happen to feel apathetic? What about Tocka, Dor, Saudade? Have you ever felt like
experiencing them? Please describe what do you feel when you feel like depressed? And when
having proved Litost?

Let`s try to answer to all these questions! Maybe some of them are very meaningful to us and we can
answer giving even specific details; for others, we may be in need of more precise information about
the meaning of the word in order to be able to answer the question.

Once clarified, one may be able to see if he had ever experienced shin-byungs, pena ajena, Hwa-
byung, depression etc
Have we ever felt embarrassed?

Most of us, chances are, will answer affirmatively. Maybe it happened, at least once in our life to feel
embarrassed or uncomfortable at the thought of embarrassing others by our smell, our gaze, our
defaults. Maybe we have never heard about this possibility and never experienced it. Maybe we are
obsessed with this or heard about what it is known under the name of Taijin Kyofusho (TKS).

This term, for instance, was introduced as a Japanese- or Korean-culture-bound form of social anxiety
in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1996, 2000) and as
anthropophobia under social phobia in the tenth version of the International Classification of Mental
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 and Behavioral Disorders.

The essential feature of TKS is the fear of social contact, extreme self-consciousness (concern about
physical appearance, body odor, bushing), and the fear of contracting diseases.
TKS is one oexample of a culture-bound syndrome.

Hwabyeong or Hwabyung is another example of a culture-bound syndrome among many others.

Symptoms related to Hwabyeong are "eok-ul" - feeling of unfairness) and "bun" eruption of anger).
The main symptoms experienced by people suffering from this so called "depression anger illness"-
ulhwabyeong are external anger, heat sensation, pushing-up in the chest, respiratory stuffiness,
going-out, epigastric mass, palpitations, insomnia, headache/pain, dry mouth, anorexia, frightening
easily, sighing, sad mood, "hahn" (a Korean sad-sentiment), many negative thoughts, hate, anxiety
with agitation, guilty feeling.

Our Western paradigm is more likely to diagnose it as a kind of stress or depression which for Korean
people is a misinterpretation and misdiagnosis as it is typically associated with a disorder experienced
by older women.

There are several risk factors contributing to the development of Hwa-Byung. Kim and Park (2004)
suggested that psychosocial stress caused by marial conflicts, family conflicts, financial loss, or
poverty can lead Korean women to develop the symptoms of Hwa-Byung.

Do people in different cultures experience similar emotions, or are the emotions of people in other
cultures different from one`s own?
Do Western and non-Western mental health professionals understand the same thing when analysing
the symptoms and diagnose?

Are conceptions of mental illness only understandable within the linguistic and cultural framework
within which they are expressed?

Are people reacting differently to sadness, distress, unhappiness, shame according to the cultural
environment they are coming from?

There are a lot of theories, Universalist or relativist and depending on perspective we have different
even opposite answers.
Would it be pertinent to gather the different culture-bound syndrome under the same Western concept
of Depression?
I have already discussed in the first point how certain members understand to react to a common
emotin like anger: by silence. In this particular example, does it anger become less anger just because
the reaction is different from our culturally expected way of reacting to it?

Kleinman argue that even fundamental emotions (anger, sadness) cannot be assumed to be the same
in different cultures.
Are all women from all cultures over time supposed to experience Postpartum depression? The
physiology of women pregnancy and childbirth is the same all over the world, but the event is
conceptualized and experienced by the mother and by her social group very differently (Kumar, 1994).

Women from different cultures may think that only white or rich or lucky women can experience
postnatal depression, as a sign of their weakness or as a sign of their chance of affording this privilege.

Stern and Kruckman (1983) draw attention to the fact that the defining criteria for depression may vary
greatly across different cultural settings, so the problem cannot simply be resolved by applying a
Western concept of depression to other cultures.

One has to have nowadays strong evidence to defend one single position without running the risk of
not being taken seriously.

Despite our commonalities we are so different, and despite our differences we are so similar.
A truism that helps us to keep us on the safe side when trying to draw definite conclusions on human
nature.

excellent research and discussion well done

3: Correct 3. What are some cultural attitudes towards mental health, and seeking assistance
with mental health issues?

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 Attitudes toward mental illness vary among individuals, families, ethnicities, cultures, and countries.

People from diverse cultural backgrounds might display different constructions of mental health illness
and, therefore, various ways of handling and coping with it.

Getting treatment for a mental illness can be a sensitive issue for anyone, but members of ethnic
groups and racial minorities, apart from the administrative, financial problems may face cultural
obstacles in approaching the health professionals.

Cultural and religious teachings often influence beliefs about the origins and nature of mental illness,
and shape attitudes towards the mentally ill.

Acculturation and enculturation, family, collectivism and individualism, stigma, cultural mistrust in
health system and treatment, religion and spirituality, interpretation of distress are key cultural
variables that have a huge impact on how people from different cultures approach the health issue.

In many cultures, psychiatric disorders are stigmatized, and people may be reluctant to seek help from
health professionals, preferring to try and manage the illness with no outside help or approaching to
traditional professionals

Among the most common barriers, I can mention the access to health services, the knowledge of
services provided, health insurance, the status of people (immigration, temporal stay, rights etc),
language skills, proximity of services, trust in the health systems and their professionals.

Physical barriers to seeking mental health services may be related more to social class than to culture.
Mental health services may be unaffordable for individuals with a low socioeconomic status, for
instance.

The cultural barriers and the informal way of dealing with mental issues is one of the major differences
in the way people approach mental health.

How do people from different cultures deal with their emotional problems? Who seeks help when, why,
and under what circumstances?

Peoples conceptions of the nature, causes, and cures of mental illness are culturally influenced.

In some Asian cultures, for example, there may be no distinction between physical and psychological
problems because the psyche and soma are seen as a whole. There is a holistic approach and the
western approach is incompatible and, as a consequence, underutilised.

The way people think about cure is also influenced by culture. Among Asian, Hispanic, and African
Americans, it is often believed that a mental illness can be treated or overcome through willpower,
heroic stoicism, and avoidance of morbid thoughts rather than by seeking external, professional
psychological help. The avoidance of negative thoughts, for instance, is in contrast with the traditional
perspective in psychoanalysis, perceived more as a repressive harmful mechanism to the individuals
mental health.

Another attitude in approaching mental health is related to traditional cures and healers, tribal
ceremonies or rituals; the spiritual mentor , guide or wise of the village/community.
In general, the attitudes can be from total ignorance, avoidance, to intermittent approach when other
options have been already tried.

The core problem, despite all the cultural differences, is the Trust in the medical health systems, their
professionals and their technology and the cure usually prescribed.

Even among cultures more similar we can find mistrust and different perceptions on the efficacy or
performance of health systems or share different attitudes about the cures provided.

People in general perceive, for instance, the German system health differently than they perceive the
Slovenian one, even if they never tried them and the prejudice here speaks volumes.
When it comes to different cultures, imagine a scenario when you may be in an African city and having
prescribed different herbs, ointments, and exotic rituals in order to be cured.

One Western mind may be shocked, scared and totally insecure and worried about his life and health.
The same happens when that people coming in our cultures and are facing all our medical
prescriptions, methods, therapies etc and told they suffer from depression, a term that has no meaning
for them.

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 Excellent work you have researched and understood this well

4: Correct 4. What do you think you and society can do to overcome the resistance within some
cultural groups to mental health support?

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 Now let`s see what can we do in order to overcome the resistance within some cultural groups to
mental health support?

We can continue thinking on the same scenario and imagine ourselves somewhere, in a foreign
culture, substantially different from ours, with different health practices and treatment. We can more or
less communicate, as usually people everywhere are expecting to have a conversational command of
English (!) and the question is:

Will we be willing to approach their system and seek cure, support or treatment?

Will we be willing to overcome all our prejudices, fears, doubts, preconceptions and step inside?

What may someone else from that culture do for me in order to convince me they could heal me?
What their society can do for me in order to overcome the resistance to their mental health support?

Trying to reflect on the question for this assignment and before launching me in wonderful discourses,
I was thinking to invert the question and to become more aware of my own reactions and attitudes.

When you are ill, sick or facing a health problem usually you are not in a good mental state in order to
reflect properly about the right choices. You are simply desperate; you feel bad and are willing to do
everything, or almost, in order to recover.
A first step in our process of healing would be to gather information as much and pertinent as possible
about the health system, our accessibility, administrative procedures, different cures, treatment
practised locally.

We can continue to ask around advice and information about potential beneficial options. The process
encompasses many steps such as finding the right place or one that you may a priori trust, a
competent professional that would give you a good diagnostic, and prescribe a good treatment.

Many traditional methods of treatment may heavily rely on religious or spiritual beliefs and the process
of curing is accordingly. In traditional African medicine often the psycho-spiritual aspects should be
addressed before medical aspects. In African culture, it is believed that "nobody becomes sick without
sufficient reason. Sickness is sometimes attributed to other causes than organic ones such as guilt for
a sin or moral infringement. The illness, therefore, would stem from the displeasure of the gods or
God, due to an infraction of universal moral law. Usually according to the type of imbalance, plants,
ointments, rituals, incantations are prescribe,depending on the gravity even sacrifices.

Acupuncture, herbals, yoga, qigong, cupping are among the possible tratements one can be
prescribed.

When facing the options presented we may be willing to give a try or, on the contrary, to search for
health centres and professionals we are used to.
What can someone make for us in order to make change our mind and give it a try and trust the
practitioner and healing process? It would be difficult to give a general answer as it depends on each
individual- his openness, the level of education, the exposure to multicultural environments, his level of
knowledge of other ways of doing things, his curiosity or desperation because no other choice
available on the spot.

What can the society or the community try to do for different cultures in order to overcome their
resistance to mental health support?

Depending on their material and human resources, of how big is the ethnic community living within
their culture, it would be welcome the initiative of integrating in the medical services traditional
therapies, methods, approaches as an alternative for the patient.

It is a mark of sensitiveness and multicultural awareness to offer alternatives in tune with different
cultural values and beliefs.

Realistically speaking, no society can afford to encompass all therapies or cultures in their internal
systems but when big ethnic groups or minorities are already present on the territory a good way of
integrating them in society and even of preventing health problem due to the psychological challenges
faced by integration into a new culture.

Holistic approaches, along with traditional healing, referral to different services, social and
psychological support, specific programs, promotion into community of services available

One of the main obstructions is the mistrust and our self-centration on our culture. The fear of being
misdiagnosed or of experimenting a cure or treatment without anticipating good results to happen are
major obstacles for all people from all cultures.

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 The resistance to mental health support may be overcome through knowledge, information, personal
experience, and exposure to different practices, trust in the health system and its support. The mental
health professional really need to integrate in their work good multicultural practices, multicultural
awareness dimensions and sensitiveness; the benefits would be not only for their patients but also for
their own professional development and their profession.

*************

SET TASK

Research attitudes to mental health and treatment for mental health problems, such as depression,
anxiety, aggression, stress related illnesses in three different cultural groups.

Introduction

I shall try to discuss some aspects of depression in three different cultural groups Chinese, Indian
and Japanese.

I will analyse different aspects of the topic in reference to two broad sets of cultural scripts, namely
normative cultural scripts (distress is perceived differently depending on the cultural context) and
deviant cultural scripts (culture shapes the ways in which lines are drawn between normal and deviant;
whereas some forms of distress may be understood as a diagnosable medical problem in some
cultural contexts, are recognized as a normal manifestation under particular conditions in others).

Thus the translation of an illness in all its complexity (definition, pathology, diagnosis, symptoms, cure,
treatment etc ) from a cultural context to another is inappropriate.

Fully aware of the danger of falling under the relativism, I shall assume in support of my position that,
despite all universals of human beings, of all commonalities the experience, understanding,
manifestation on psychological level of our inner life has its distinctive differences intrinsically related
to cultural environment.

Cultural-bound syndrome is an example of patterns of abnormal behaviours that occurs meaningfully

within certain cultural groups and which might defy the Western categorization. Before jumping to
conclusions and diagnosis, professionals are under the ethical obligation of their profession to take
into account the individual`s ethnic and cultural context in evaluation the socalled metal disorder.

The issue of how mental disorder should be defined is still controversial. Despite all potential
universals, we cannot ignore the weight of particular explanations or interpretations of symptoms of
distress that do not fit into Western psychiatric theory.

In regards to depression, if the Western paradigm relates the symptoms to effects of chemical
imbalances and genetic factors, the key symptom of low energy is explicable in Chinese contexts with
a low qi (life force or energy), that fits with traditional Chinese medicine.

In line with Kleinman A. interpretation, I will try to show how some anxiety disorders may in fact occur
universally but their expression and experience have to be related to cultural factors. This position has
a long history and we can find it in the words of Boas that wrote If it is our serious purpose to
understand the thoughts of a people the whole analysis of experience must be based on their
concepts not ours (Boas 1943).

As a consequence, this patient is more likely to seek spiritual and traditional treatments rather than
medical care, as we will see later on. If professionals ignore the appreciation of the sociocultural
context of traumas and of responses to traumas all the therapeutic process fails its scope.

Depressive feelings are experienced by a lot of people from a lot of cultures and times and are a
normal component of disappointment and grief. Depression may be a symptom of a mental disorder
(such as bipolar disorder, an anxiety disorder,) or of other medical diseases, ranging from diabetes
and thyroid disorders to postviral syndromes.

Depression can be defined as a disorder of intercorporeality and interaffectivity.

According to current opinion in western psychopathology, depression is regarded as a disorder of

mood and affect on the one hand, and as a distortion of cognition on the other. Disturbances of bodily
experience and of social relations are regarded as secondary to the primarily innerand individual
disorder.

According to current psychiatric opinion, deprssion is a disturbance of mood and affect, typically
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 connected to negative cognitions, and emotions such as anxiety, shame, and guilt. Optional symptoms
may include bodily or vegetative disturbances such as loss of appetite, weight, or libido, insomnia, and
psychomotor inhibition; then the diagnosis receives the supplement with somatic syndrome

Depressed patients exhibit a wide range of affective, cognitive, behavioral and

physiological symptoms. They experience sadness, anxiety, feelings of worthlessness and guilt; they
engage in self-denigration and rumination; they experience anhedonia, tearfulness, psychological
retardation and undefined pain; they stop practicing personal hygiene and they exhibit changes in
appetite, sleep, and libido. In the worst-case scenario, depression can even lead to suicide

Western medicine describes the etiology of depression in terms of biological, psychological, social and
sociocultural factors.

Biologists attribute depressive symptoms to genetic factors, disturbances in circadian rhythm,

high cortisol levels, defective negative feedback in the hypothalamic-pituitary-adrenal (HPA) axis, and
abnormalities in neurotransmission and brain structure. Specifically, it is believed that deficient
serotonergic signalling has pathological implications in depression

Despite these predominant views, however, affective or cognitive symptoms are by no means found in
all patients suffering from depression. Instead theymay complain of constant fatigue, sickness,
numbness, various kinds of pain or dysaesthesias.

Transcultural studies have found that somatic symptoms and psychomotor inhibition were found to be
prevailing in countries in Africa, Asia and other cultural groups. Thus, in various cultures the somatic
and the psychosocial experience of the illness constitute an integraln and holistic unity, and the lived
body functions as a particular medium for the expression of interpersonal states and conflicts.

The split between somatic or external and mental or internal symptoms turns out to be the result of a
specifically western cultural development.

While antidepressant medications in Western medicine have been proven to be clinically effective,
their use has been limited by potentially serious side effects.
Moreover, currently used antidepressants provide only temporary relief of symptoms but are not
curative.

It may well be that the dichotomy between us and them in regard to discussions of culture-bound
syndromes has been too quickly drawn; between, that is, the non-western peoples, the
underdeveloped peoples, the primitives (who have the exotic and the culture-bound
syndromes) and the western world, the developed world, the civilized world.
Hughes (1985, p. 11)

Depression Chinese perspective

Depression is called yi-yu-zheng in Chinese. Transliterally, yi-yu means clogged or stagnant status
of qi. Yu describes a collection of syndromes that are characterized by the obstruction of qi circulation.

Many disorders including depression are attributable to qi stagnation, of which the treatment involves
the prescription of herbs that promote qi decongestion. Generally referred to as vital energy in the
Western world, qi can be viewed as the functional manifestation of organs in the body. Qi can also be
regarded as a substance partially derived from dietary nutrients, which nourishes every organ in the
body. Qi can be manifested
in visible forms such as blood, mucous and serous fluids.

The liver plays an indispensable role in qi circulation. Through regulating the flow and activity of qi, the
liver promotes optimal circulation of blood as well as digestion and metabolism in the spleen and
stomach
Hence, the proper flow and function of liver qi is crucial to ones health.

Causes of depression: Two factors can contribute to the aggravation of liver qi stagnation: phlegm and
anger. Qi interacts intimately with blood, mucous fluid and serous fluid. When qi becomes clogged,
other fluids also lose the driving force allowing them flowing smoothly Dampness then accumulates
and eventually transforms into phlegm, which
is sticky and can further inhibit the flow of qi. If phlegm invades body regions above the chest, it can
cause mental confusion. On the other hand, the seven emotions, namely, pleasure, anger, anxiety,
grief, fear, shock, and melancholy, are also related to the functioning of specific organs. Anger can
impair liver function, and when it acts in concert with stress, the optimal circulation of liver qi will be
impaired.
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 According to the five-element theory, wood (the liver) generates fire (the heart or brain), which is
indicative of the supportive role of liver in brain function. Liver qi stagnation can therefore manifest
itself in the malfunctioning of the central nervous system.

Chinese treatment of depression:

The most representative prescription is Chaihu-Shugan-San, which contains seven constituent herbs:
Bupleuri Radix, Aurantii Nobilis Pericarpium (Citrus reticulata), Cnidii Rhizoma (Ligusticum striatum),
Cyperi Rhizoma (Cyperus rotundus), Paeoniae Alba Radix (Paeonia lactiflora), Aurantii Fructus
(Poncirus trifoliata) and Glycyrrhizae Radix (Glycyrrhiza uralensis).

Other treatments contain acupuncture, cupping, meditation, moxibustion (burning an herb above the
skin to apply heat to acupuncture points), tui na (Chinese therapeutic massage), dietary therapy, and
tai chi and qi gong (practices that combine specific movements or postures, coordinate breathing, and
mental focus).

Numerous studies of psychiatrists in Chinese cultural areas highlight the tendency of Chinese patients
with mental disorders to present somatic complaints in place of psychological suffering. Based on this
differences in interpreting the illness all approach has to be done under the exigence of this paradigm
if wish to be meaningful.

Depression Punjabis cultural group Indian perspective

Punjabi is an ethno-linguistic group living in India and Pakistan, and the subsequent partition of
Punjab. Today Punjabi Hindus are mostly found in Indian Punjab and in neighboring states. I shall
discuss some main points following the research`s results of Currer, 1986 according to which Punjabis
people tend to somatise mental illness. The focus on somatisation is a process with big impact on the
whole way of approaching the illness and seeking treatment. The somatisation usually may imply: a
non-recognition of mental illness, so that the ailments are always presented as somatic; a non-
recognition of the relationship between physical ailments and emotions; a negation of mental symtoms
and refusal to consult a psychiatrist.

The way of expressing the symtoms are also charged with cultural meanings; the heart falls;
thinking too much; sinking heart; the life goes out of the heart; something heavy rests on my
heart; the blood becomes wicker with worry; I have the illness of sorrows; too much thinking in
the heart. Thinking in the heart is the core expression and the source of the illness and in contrast
with the Western approach it is not the brain or the mind that is affected but the source of emotions.
When one attribute of the mind, such as thinking is displaced and migrates towards the heart the
disequilibrium installs. Thinking too much becomes an illness and now the focus will be on alleviating
the heart from the intruding.

Even if the patient may have a clear recognition of the mental illness the true meaning it is far away
from being that we commonly are used to. This kind of illness it is not understood as susceptible to be
treated by doctors or by tablets, as thinking-in-the-heart-illness describes a state of mind, of heart, of
the emotions; we can see how the expression takes shapes as a culturally related illness. The
treatment and the source of heling will be directed towards the spiritual guide, the prayer, the herbs,
the communion with nature and the universe. The difference from the Western perspective may stem
also from the fact that seeking support outside would cause disruptions of the group harmony, lose
face place the family under the public judgement. Apart from the social consequences, of major
importance are those related to how pain and suffering are viewed in the religious and cultural context.

In Hindu tradition, suffering, both mental and physical, is an integral part of life and of karma and is the
consequence of past inappropriate action that occurred in either ones current life or in a past life.

Hindu traditions promote acceptance of pain and suffering as a means to a greater end and as a way
to become less attached to this illusory world. Prayer, the spiritual search and liberation, the empty
mind, the focus on the right path are the ways of attaining the spiritual liberation and achieving
moksha, complete release.

The depression may not seem to make part of the main concerns of Hindu people and when happens
it may be approached just as an opportune experience towards meditation and awareness.

Depression in Japan

Japan is an interesting case in regards to depression illness as there are many controversial debates
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 and contradictory positions on if Japanese people are affected by depression, if depression ever
existed or exists in the Japanese cultural context. According to some studies, some authors mention
argue depression was not widely recognised in Japan until the late 1990s until the cold of the soul
started to be recognised as the illness of Japanese people.

My reference book will be Depression in Japan: Psychiatric Cures for a Society in Distress by Junko
Kitanaka that contradicts many researches claimimg that depression is a new phenomenon for
Japanese culture and that hardly existed in premodern Japan. The authors invites us through a
linguistical voyage showing the words and concepts through which Japanese expressed their low
moods and emotions.

The term utsubyo the new word for depression existed in premodern Japan under the name of
utsusho and ki-utsubyo illustrating an illness characterised by gloomy moods, lack of energy and
social withdrawal. Etymologically, Utsu has dual meanings: as the character utsu is graphically made
up of trees densely growing together, the term signifies a physiological state where things are
rampant, densely owergrown, or stagnant. Utsu has been used from early times as an expression for
gloominess, sorrow and pensiveness.

The concept of utsusho when transferred from China at the turn of sixteenth century by Tashiro Sanki,
had six meanings, depending on what was stagnating: stagnation of ki, moisture, heat, phlegm, blood,
and food. Ki-utsu would produce sharp, stinging pain in the chest (ki= the Chinease term for life
energy), dizziness, headaches. Utsusho means then a state in which ki lose its normalcy, becoming
stagnated and blocked, unable to dissipate. From this perspective, the path for a good health is to
preserve a smooth circulation of ki and when blocked usually patients are guided towards treatment
with herbal medication, acupuncture, moxibustion, massage or hot springs.

The remedies for ki-utsu take often shapes of recommendations like Go out as you would like and
nurture your ki (Ekima). The lack of physical movement, an excess of desires are most of the time
among the main sources of utsusho.

The author shows us as the term falls in disuse and with the influence of Western medical concepts
was replaced by melancholia, depression etc. Reclaimed by modern neuropsychiatry, utsubyo
became an illness that was so stigmatising that the Japanese could no longer conceive of suffering
from it.

To different concepts, different therapies and cures are developed.

According to the Japanese psychiatrist Shoma Morita, for instance, influenced by the principle of Zen
Buddhism, the cure is not defined by the alleviation of discomfort of the attainment of some ideal
feeling state but by taking constructive action for a meaningful existence and not ruled by the
emotional state. The principles of his therapy are contrary to the common Western practices. We are
used to think that the way we think has a huge influence on how we feel and it suffice to work on our
mind in order to control our emotions and state of heart.

Paradoxically, believe Morita, when our attention is focused on escaping the unwanted thoughts the
results are an increase of the frequency and intensity of the experiences we are trying to avoid. This
effect happens because we are fighting against the natural way of get rid of our thoughts and
emotions.

All feelings are natural. The goal of Morita Therapy is arugamama (acceptance of life as it is) and in
order to attain this state we have to accept our own emotions. When we feel angry, depressed, sad,
fearful, lonely, guilty we have to accept these feelings and not to focus on changing them, to convert
sadness in joy, loneliness in sociability, depression in good mood. The natural way is to accept and
integrate the negative state of the heart and not to negate it, to accept it as being part of an important
register of your life until it disappears or becomes evanescent naturally. When we become overly
preoccupied with ourselves, our attention no longer flows freely, but becomes fixated on a self-
centered focus.
The more we pay attention to our symptoms (our anxiety, depression for example) the more we
become trapped.
The human condition seems to be the pursuit of chimera. We may never really experience a deep
satisfaction with the way things are in this moment, and the idealized future never arrives. Our life can
become like the pursuit of an idealized mirage that grows ever more distant the more we pursue it.
Another problem is that our mind is capable of imagining and wishing for things that have nothing to
do with how life is. For example, people want to adopt lifestyles without experiencing the natural
outcome of those lifestyles. People imagine that they can live fully and not experience the
uncomfortable thoughts and feelings that are naturally a part of that kind of life. Morita described this
as a kind of contradictoriness of thinking.

In line with this paradigm, a number of Acceptance and Commitment Therapy (ACT) and Mindfulness-
Based Cognitive Behavioral Therapy have been developed to approach depression, anxiety or other
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 forms of mental distress.

They may work or not depending on a vast array of cultural and social preconditions, depending on
the therapist, on the the patient, on the mental illness and its severity and on the way the therapy
vibrates and integrates into the general paradigm.

So far, psychiatry has not discovered the recipe to approach mental distress in an integrative way.

Maybe it is really a difficult task and maybe even impossible as volens-nolens, despite our awareness
and multicultural openess, we are still remaing trapped between the limits of our cultural identity or our
multicultural experiences.

Thank you!

A very good submission. You have thought about and answered all the questions well showing a solid
understanding of the unit. Keep up the great effort! As always if you have any course related questions
or need to submit any additional work, you can use my direct email at
deanna@learningcloudgroup.com

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