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A view on talking therapy from beyond 'the west'

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Shlink

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From a Rwandan man (just happens to be mentioned in the abstract summary of Cognitive Evolutionary Therapy for Depression a speculative research chapter by a Romanian psychologist)

“You know, we had a lot of trouble with Western mental health workers, especially the ones who came here right after the genocide. They came and their practice did not involve being outside in the sunshine… which is, after all, where you begin to feel better. There was no drumming or music to get your blood flowing again – when you’re depressed and low you need to have your blood flowing. There was no sense that everyone had taken the day off so that the entire community could come together to lift you up and bring you back to joy. There was no acknowledgement of the depression as something invasive and external that could actually be cast out of you again. Instead, they would take people one at a time into these dingy little rooms and have them sit around for an hour or so to talk about bad things that had happened to them. We had to ask them to leave the country.”
 
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I agree to some extent about the drumming
and getting outside, involving the community where possible

I dont agree with the idea
of not talking about the bad things that had happened
or the casting out of spirits

I did enjoy a book called The Woman who Glows in the Dark
about curanderismo in Mexico
where they make a sound proof hut for their therapies
so that the client can shout and wail about their pain
 
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Shlink

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I agree to some extent about the drumming
and getting outside, involving the community where possible

I dont agree with the idea
of not talking about the bad things that had happened
or the casting out of spirits

I did enjoy a book called The Woman who Glows in the Dark
about curanderismo in Mexico
where they make a sound proof hut for their therapies
so that the client can shout and wail about their pain
I don't imagine the guy is saying never talk about what's happened, but when and how. There has been a known problem of crisis counsellors etc going into conflict/disaster zones to do 'interventions' inappropriately, for example.

I can relate to that soundproofing example because that's come up as an issue for me in therapy, just talking with the therapist let alone if shouting, and getting distracted by others too due to social anxieties. Does it for anyone else?

I don't quote the guy because I believe that activities and locations are necessarily therapeutic in themselves for anyone. Or specific cultural/spiritual beliefs, even though acceptability and placebo effect are important.

I just think it's getting at a deeper problem with individualised western talking therapy culture. Which I think is also why the evolutionary psychologist is quoting him.
 
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Shlink

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Some talking therapies do a bit of activity, beyond just talking in the office, but it's very limited isn't it. Which limits things both ways - limits what the therapist can directly learn and verify about the person.

Meanwhile some organisations try to promote physical and social activities to mental health patients, but it's never really done in a specialist therapeutic way.

There's a huge gap inbetween.
 
Bizzarebitrary

Bizzarebitrary

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"Where is our culture and our community found in your healing practice?" I wonder if that's the essence of the problem this individual had with the therapeutic approach. I would imagine that cultural competency training would've been emphasized in preparation for counseling abroad. Maybe not.
 
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Shlink

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"Where is our culture and our community found in your healing practice?" I wonder if that's the essence of the problem this individual had with the therapeutic approach. I would imagine that cultural competency training would've been emphasized in preparation for counseling abroad. Maybe not.
I expect that's a good way to put it, from that perspective.

But is there still an assumption here that the current western model is fundamentally correct, within the west? That the best way to facilitate deep change is for the individual to occasionally go off to an office space to sit and talk for an hour or so at a time? There is a suggestion that is inadequate for many people. Even if the therapist is able to observe and learn exactly what the problematic pattern is, just through having those isolated sessions, can deep problematic instinctual patterns necessarily be changed by just talking about the pattern, with maybe a bit of relatively superficial behavioural/social work, and expecting the person to change themselves back within their life.
 
Bizzarebitrary

Bizzarebitrary

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But is there still an assumption here that the current western model is fundamentally correct, within the west? That the best way to facilitate deep change is for the individual to occasionally go off to an office space to sit and talk for an hour or so at a time?
I wouldn't say this describes my recovery experience. Talk therapies definitely do contribute, so does medication. In addition to those, my array of supports include: mental health communities such as this one and other support groups. My family and my friends. Self-directed wellness activities - exercise and mediation. Volunteer service in alignment with my values, lifelong learning to fight stagnation...the list goes on and on and I will keep adding to it for so long as I live.

My point is, I don't subscribe to a durable recovery which is centered on the medical model alone. Or any model alone. I acknowledge how medication plus therapy has helped so many of my peers, but I need quite a bit more than that. I need to be an active partner with my doctors in directing my recovery plan. They understand and welcome this. It took decades for me to realize the importance of my own engagement.
 
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