Does psychology as an import from Western culture adequately explain Eastern behavior? Are all human brains and thus, development, cognition, and behavioral patterns essentially alike? Are its methods of therapy appropriate or displaced? Are the goals for outcome similar regardless of geography, or must they be modified to reflect the values of the dominant culture? And perhaps most of all: is the overlay of a Western model of the mind effecting change on the cultural psyche of the East?
Psychology as a scientific study has the pathology-driven Western medical model at its foundation, overlaid by the values of ancient Greece, such as individuation, self-control, and self-efficacy. The cultures of Asia have at their core the values of ancient China, such as hierarchy, moral development, achievement, and social responsibility, and a non-dualistic medical system that is based on principles of balance and harmony. Some, such as Richard Nisbett in The Geography of Thought,argue that these phenomenally diverse core systems result in very different processes of cognition. In the West, cognitive process is one of logic, critical analysis, and direct, rational thought, in which the universe is conceptualized as the sum of its parts which can further be categorized, and is generally termed Analytic Cognition. In the East, cognition is abstract, paradoxical, circular and indirect, the universe a web of infinite connections; this is known as Holistic Cognition. If cognition and constructs of illness are phenomenally different, how can the same model for human behavior and development adequately apply to both?
One’s sense of self is also quite differently defined in these two disparate regions of the world: either sociocentric or egocentric. In the former, which describes the cultures in Asia, one’s concept of self is formed within the social context, and defined by it at any given moment; a sense of selfhood requires social connectedness. In the Western world, the egocentric model is dominant; each person’s sense of self is considered autonomous and unique, individuated, and largely consistent regardless of context. Thus, while a primary goal of psychology in Western society is one of self-development, in an Asian setting it would be one of self-transcendence toward enlightenment.
The process of psychotherapy depends upon the orientation of the individual. In Western societies, this is one of dispositionism, in which the internal disposition of the person is the primary consideration. In the East, however, the orientation is one of interactionism, in which the presence of complex causalities is assumed and the focus is on relationships and reactions between persons or the person and the surrounding environment. Of course, neither of these orientations stands alone, but both are present in each setting; however, one takes clear precedent over the other. In each, the approach of psychotherapy would be rather obviously different, in focusing either on internal processes such as self-esteem or internal locus of control, or on relationships, methods and patterns of relating, and one’s place in the grand scheme of society.
Creativity is another area in which these regions of the world differ greatly. While novelty isn’t well suited to Eastern cultures, and can feel threatening to the overall social cohesiveness, it’s inherent in Western modes of thinking and behavior, and deemed crucial to problem-solving. In the West, time and one’s developmental processes are conceived of as linear and finite with a beginning and an end; thus, innovation and breaking with tradition are required to effect change, and to grow. In the East, however, development consists of successive reconfigurations and is dynamic, involving reinterpretation and new uses of tradition rather than a break with it. The spiral, not the line, is a more accurate image of progress, whether personal or societal. Creativity is both a by-product and a necessary component of the former model, while of minimal use in the latter.
It’s often said that psychology with its concepts of mental illness and health is, or was until recently, taboo in Asian cultures, and the mentally ill stigmatized and marginalized as a source of family shame. While the latter has been true at one time or another in all societies, East and West, it’s an oversimplification of the Eastern conception of health. In classical Chinese medicine, which springs primarily from Taoism with influences of Buddhism and Confucianism, health is inclusive of all aspects – physical, mental, emotional, spiritual, and social – and conceived of as a state of harmony and balance, illnesses termed as ‘patterns of disharmony’. These patterns include symptoms from all aspects of the person. Never having adopted a Cartesian duality of mind and body, Asian cultures thus never conceived of mental illness as a distinction. This too represents a profound dissonance in the Eastern and Western conceptions of and treatment approaches for mental health. Further, various Asian philosophies view the universe, and the person as a microcosm of same, as being in a continual process of change and impermanence, while Western psychology deems the self and the personality to be largely fixed at an early age, with a sense of continuity throughout one’s life.
As the Western, largely American, model of mental health and illness has made its way to Asia, scholars have begun questioning its universal applicability. Geoffrey Blowers, an assistant dean of psychology at Hong Kong University, is one who has written and presented on this subject. Some Asian models of psychology have emerged, based upon the philosophical constructs which have strongly influenced Asian societies and individual psyches. One such example is Buddhist psychology, developed primarily in Japan and other parts of Asia. It differs profoundly from that of the West in several ways, notably in lacking a fixed concept of self but rather one in a constant state of flux; the path to enlightenment is transpersonal, one of moving beyond a sense of personhood and of the self. Some aspects of Buddhism, in particular the concept and practice of “mindfulness”, have been widely adopted within Western psychotherapeutic practices as well. Hybrid models of psychology are also being attempted, and one promising model is Chinese Taoist Cognitive Psychology. Mental health as viewed from a Taoist perspective, another of the pillars of Asian mentality, include a transcendence from self and secularity, the dynamic revertism of nature, integration with the law of nature, and ultimately a high level of transformation and transcendence.
In contrast, a recent article in the New York Times, “The Americanization of Mental Illness” [08 January 2010], identified growing trends in Asia toward not only the Western model of conceptualizing, diagnosing, and treating mental illnesses, but in the incidence of the disease patterns themselves. As an example, eating disorders were unheard of in Asia until recently, and are now fast on the rise, as are schizophrenia and several personality disorders. The concepts behind these disorders are very much a product of Western cultural values and beliefs, yet are appearing now throughout Asia. While mental disorders as conceived of in the West were largely somatized in Asian cultures, this is changing rapidly. And, with increased exposure not only to Western ideals but conceptualizations of mental illness, the manifestation of such illnesses is undergoing substantial change. Along with this, an increasing dependence not only on a pathological model but on pharmacological treatment is widely seen. A growing body of scholars protests this trend, arguing that mental health and illness have never been conceived of in the same way throughout cultures, and that this represents profound cultural alteration.
The argument can be made that science, in the form of western psychology just as in western forms of medicine before it, has made great progress in understanding human illness and treatment. Thus, a conclusion might be drawn that Asian societies would do well to adopt these methods. But a simple adoption of a system which is in many ways antithetical to that of the culture is inadequate at best. It can equally be said that Eastern philosophical systems have contributed greatly to the understanding of human behavior and, in particular, to that of consciousness. More consideration, and more care in its application, is needed, with great cultural sensitivity, and an integration of models is an obvious outcome.
Dr Anne Hilty is an health psychologist with a transpersonal orientation; she has a clinical practice in integrative psychotherapy which is additionally influenced by classical Chinese medicine, somatic psychology, and Asian shamanic traditions. Located in the Central district of Hong Kong, she can be contacted at: annehilty at gmail dot com.