Distinguishing Between Effective Help for Psychosis, and the Oppression of Individual and Cultural Differences

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Length: 1 hour 1 minute

Ron Unger, LCSW

While simplistic approaches contrast an imagined “normality” with “psychopathology,” more realistic approaches acknowledge that different cultures have different ways of being healthy, and individuals within those cultures commonly find even more diverse ways to interpret experience and to live successfully. And when major problems do occur, it may be unclear whether the person truly needs to become more “normal” to be healthy, or whether the person may simply need access to people who can affirm their differences and help them discover ways to live successfully with them.

The Hearing Voices Network has been a pioneer in suggesting an “emancipatory approach,” proposing that hearing voices may be understood as a human difference like being gay, one that people may struggle with but also something people can accept and integrate into a successful life, especially if given appropriate assistance in overcoming any difficulties. Other apparently “psychotic” experiences may also be understood as, to some extent at least, just human differences that can be accepted and integrated rather than suppressed.  

The process of becoming “psychotic” may itself be understood as one of breaking away from what is “normal” within a given culture, but it does not follow that whatever then emerges is pathology. Rather, new states of mind may be a mix of unhelpful “mistakes” in being organized that exist alongside possible individual, family, and even cultural innovations, the stuff of prophecy and shamanism.

What would it look like to have a less arrogant “treatment” approach for psychosis, one that appreciated cultural nuance and the wide range of individual variation that can be part of a successful lives, rather than attempting to “colonize” divergent individuals by imposing on them dogmatic paradigms about “mental health”? What would it look like to instead collaborate with people in discovering unique possibilities that might work for them?

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