CH. 3 Cultural Approaches to Health

Question 1

Cultural Approaches to Health

Answer 1

CULTURAL APPROACHES TO HEALTH:

• An effective health psychologist has to be ready to deal with diverse beliefs, TJB– No matter how stupid they are.

CULTURALLY COMPETENT – We all need to be knowledgeable about different cultures.

• As all good psychologists know, if someone believes something strongly enough, no matter how stupid it is then those beliefs can influence that person’s behavior and reactions.

Question 2

World Medicine

Answer 2

WORLD MEDICINE – Different cultures have different definitions of health.

• Health beliefs and practices are closely tied to religion and nationality, which are components of culture not given much attention in Western medicine.

WESTERN BIOMEDICINE – Most common approach to medicine, derived from the work of Greek physicians, such as Hippocrates and Galen.

• Hallmarks of this approach are an increasing reliance on technology and the use of complex scientific procedures for the diagnosis and treatment of illness.
• Western biomedicine views the body as a biochemical machine with distinct parts.

REDUCTIONIST – Western biomedicine searches for the single smallest unit responsible for the illness. Western doctors try to localize the cause of an illness to the parts directly surrounding the original point of the problem.

Question 3

Greek Roots

Answer 3

GREEK ROOTS:

• Western biomedicine often claims the 4th-century b.c. Greek, HIPPOCRATES, as its father, primarily because he was the first to separate medicine from religion and myth and to bring scientific and analytical reasoning to health care.

GALEN – So-called emperor of medicine during the Roman Empire.

LEONARDO DA VINCI – Italian artist

ANDREA VESALIUS – Greatly advanced Western biomedicine with their studies of human anatomy.

WILLIAM HARVEY – First described the circulation of blood and the functioning of the heart to the Western world in 1628.

ANTONIUS VAN LEEUWENHOEK – Gound lenses to magnify objects 300 times.

Question 4

Technological Innovations

Answer 4

TECHNOLOGICAL INNOVATIONS – Western biomedicine has strong ties to technology. Once the microscope became widely used, blood, saliva, and other bodily fluids were closely examined, leading to a better understanding of the structures and functions of a wide variety of cells.

LOUIS PASTEUR – Pasteur proved that viruses and bacteria could cause disease. In 1878 Pasteur presented his germ theory to the French Academy of Medicine

WILHELM ROENTGEN – In 1885 the German scientist discovered X-rays.

• Advances such as MIR and CAT scans, led to closer examinations of the body and bodily functions.
• Technology, by introducing the study of the cellular level, fueled the drive of Western medicine to find the answers to the causes of illnesses and death.
• The other main element of Western biomedicine is surgery.
• The reliance on technology and the evolution of pharmacology and surgery signal the main approach of Western biomedicine to healing.

HEALTH – According to this model, is the absence of disease.

Question 5

Traditional Chinese Medicine

Answer 5

TRADITIONAL CHINESE MEDICINE (TCM):

TCM – The body is treated as a whole.

• Each part of the body is intrinsically connected to other parts of the body and to what is happening around the person (Hsu, 2010). Critical elements of a healthy life include a person’s food choices, relationships, and emotional life.
• In TCM, everyone is a part of a larger creation and lives and flourishes in unison with it. In stark contrast to reductionist Western biomedicine that focuses on a cellular microscopic level of diagnosis, TCM is macroscopic.

Question 6

Chinese Medicine Sources of Illness

Answer 6

CHINESE MEDICINE SOURCES OF ILLNESS:

​YING and YANG, and THE FIVE PHASES – The Two main systems categorize the forces identified in TCM that influence health and well-being.

• According to one Chinese philosophy, all life and the entire universe originated from a single unified source called Tao.
• The Tao is an integrated and undifferentiated whole with two opposing forces—the yin and the yang—that combine to create everything in the universe.
• Each yin and yang contains the seed of the other.
• The circle represents the supreme source, or Tao. Yin translates to “shady side of a hill” whereas yang translates to “sunny side of the hill.
• A healthy individual has a balanced amount of yin and yang.

THE FIVE PHASES – Refer to specific active forces and illustrate the intricate associations that the ancient Chinese saw between human beings and nature.

ENERGY, or Qi(pronounced Chee) – Another critical aspect of TCM, moves within the body in the same pattern as it does in nature with each season and with different foods helping to optimize energy flow within the body.

FIVE ELEMENTS:

1. WOOD
2. FIRE
3. EARTH
4. METAL
5. WATER

• Each link to a season of the year, a specific organ, and a specific food

Question 7

Traditional Chinese Medicine Treatment

Answer 7

TRADITIONAL CHINESE MEDICINE TREATMENT – In TCM, optimal health consists of balancing yin and yang and optimizing the smooth flow of qi through the body by the coordination of the five elements.

• Qi flows through the body in 12 precise, orderly patterns called meridians.
• The trained TCM physician focuses on both the physiology and the psychology of the individual.
• Instead of asking what is causing what, the doctor asks what is related to what.
• Not only do many doctors in China provide patients with a prescription for pharmacological drugs as they would receive here in America, but they also provide a prescription for TCM cures (e.g., herbs or ointments). In many Chinese hospitals, the two dispensaries sit side by side.
• Western medicine is used more often for acute problems (by Chinese and Chinese Americans), and TCM is used more often for chronic problems.

Question 8

Ayurveda: Traditional Indian Medicine

Answer 8

AYURVEDA: TRADITIONAL INDIAN MEDICINE:

• Yoga is a part of Ayurvedic practices.
• Approximately 2,000 years ago, Charaka, an Indian sage, developed Ayurveda, a traditional Indian holistic system of medicine.

Described Four Causative Factors in Mental Illness:

1. Diet (incompatible or unclean food).
2. Disrespect to gods, elders, and teachers.
3. Mental shock due to emotions such as excessive fear and joy.
4. Faulty bodily activity.

• Thus, Ayurveda considers a biopsychosocial approach in formulating causative factors in mental disorders.
• The basic core of Ayurvedic medicine parallels the way members of most Asian American cultures view life. A healthy system is made up of healthy units working together in a symbiotic relationship with the well-being of the individual being indivisible from the well-being of the community, the land, the supernatural world, or the universe.

Question 9

Ayurveda Sources of Illness

Answer 9

AYURVEDA SOURCES OF ILLNESS:

• TCM and Ayurveda share many similarities. Ayurvedic science also uses the notion of basic elements: five great elements form the basis of the universe.
• Achieving the right balance of these elements in the body is critical to maintaining a healthy state.
• These three doshas are also referred to as humors or bodily fluids and correspond to the Greek humors of phlegm (Kapha) and choler (Pitta).
• Similar to the meridians in TCM, the existence of these forces is demonstrated more by inference and results of their hypothesized effects than by physical observation.

In addition to diseases caused by the imbalances of the doshas, Ayurveda identifies diseases as having six other key causes.

• Due to natural changes in the body, genetic predispositions, trauma, gods or demons, season, deformities present at birth.
• Ayurvedic practitioners believe that health is a natural state maintained by keeping the body clear of toxins and the mind relaxed and stress-free.
• The accumulation of toxins can occur when we are stressed and when waste is not effectively eliminated from the body. Consequently, some of the major Ayurvedic treatments involve detoxification and effective waste removal.

Question 10

Treatment

Answer 10

TREATMENT:

• Because imbalance is a source of illness, Ayurvedic medicine employs a number of techniques to reestablish balance. These include purification, surgery, drugs, diet, herbs, minerals, massage, color and gem therapy, homeopathy, acupressure, music, yoga, aromatherapy, and meditation.

DIVIDED INTO THERAPIES INVOLVING – Dietary changes and changes of activities at the level of the physical body and in tune with the seasons and climate, clear the mind, spiritual rituals.

Ayurvedic medicine recommends five ways that the body should be purged of toxins – Vomiting, laxatives, enemas, nasal medication, and bloodletting.

• About 600 different medicinal plants are mentioned in the core Ayurvedic texts.

Question 11

Curanderismo and Spiritualism

Answer 11

CURANDERISMO AND SPIRITUALISM:

CURANDERISMO – Is the Mexican American folk healing system.

Surveys of Mexican Americans show that even among highly assimilated Mexican Americans, traditional and indigenous practices persist

Question 12

CURANDEROS Sources of Illness

Answer 12

SOURCES OF ILLNESS – Acknowledges the existence of two sources of illness, one natural and one supernatural. When the natural and supernatural worlds are in harmony, optimal health is achieved.

• Beyond this supernatural balance component, the curandero’s concept of the cause of illness parallels that of Western biomedicine.
• Like biomedical practitioners, curanderos believe that germs and other natural factors can cause illness.
• However, curanderos also believe that there are supernatural causes to illness in addition to natural factors. If an evil spirit, a witch, or a sorcerer causes an illness, then only a supernatural solution will be sufficient for a cure. Illness can also be caused if a person’s energy field is weakened or disrupted. Whether diabetes, alcoholism, or cancer, if a spirit caused it, supernatural intervention is the only thing that can cure it.
• Unlike Western biomedicine and TCM, the practices of curanderismo are based on Judeo-Christian beliefs and customs.

Question 13

Curanderos Treatment

Answer 13

CURANDEROS TREATMENT – Curanderos use three levels of treatment depending on the source of the illness: material, spiritual, and mental.

• Working on the material level, curanderos use things found in any house (eggs, lemons, garlic, and ribbons) and religious symbols (a crucifix, water, oils, and incense). These material things often are designed to either emit or absorb vibrating energy that repairs the energy field around a person.
• The spiritual level of treatment often includes the curandero entering a trance, leaving his or her body, and playing the role of a medium. This spiritual treatment allows a spirit to commandeer the curandero’s body, facilitating a cure in the patient.
• The mental level of treatment relies on the power held by the individual curandero rather than on spirits or materials.
• Curanderos each have his or her own set of specializations. For example, midwives (parteras) help with births, masseuses (sobaderos) treat muscle sprains, and herbalists (yerberos) prescribe different plants.
• The uses of curanderismo have been associated with negative health outcomes that are more often seen in the news.

Question 14

American Indian Medicine

Answer 14

ANERICAN INDIAN MEDICINE:

• Four practices are common to most:

1. Use of herbal remedies.
2. Use of symbolic rituals/ ceremonies.
3. Involvement of healers.
4. Medicine men, medicine women.

SHAMAN – Medicine men, medicine women.

Question 15

American Indian Sources of Illness

Answer 15

AMERICAN INDIAN SOURCES OF ILLNESS – American Indians believed that human beings and the natural world are closely intertwined. The fate of humankind and the fate of the trees, the mountains, the sky, and the oceans are all linked.

• Everything in life is connected and influences everything else.
• Shamans treat spirits as real entities, respecting them as they would any other intelligent being or living person.

Question 16

American Indian Medicine Treatment

Answer 16

American Indian Medicine Treatment – Ritual and ceremony play a major role in American Indian medicine.

• One of the most potent and frequent ceremonies is the sweat lodge.
  
  • A sweat purifies the people present.
  • Before each sweat, attendees tie prayer strings and pouches, which are little bags of red, black, yellow, or white cloth (Cohen 2003). Each color represents a direction and type of spirit, and the choice of color depends on the ceremony to be performed.
• The sequence of prayers, chants, and singing following the addition of hot rocks continues until all the rocks are brought in
• The hot stones raise the temperature inside the lodge, leading to profuse perspiration, which is thought to detoxify the body. Because of the darkness and the heat, participants often experience hallucinations that connect to spirit guides or provide insight into personal conditions.
• Many healers also employ dancing, sand painting, chanting, drumming (which places a person’s spirit into alignment with the heartbeat of Mother Earth), and feathers and rattles to remove blockages and stagnations of energy that may be contributing to ill health.
  
  • Healers burn herbs such as sage, sweet grass, or cedar (called a smudge) in almost every ceremony and let the restorative smoke drift over the patient.
• Today most American Indians use a blend of Western biomedicine and American Indian spiritualism. Most reservations usually have both spiritual healers and Western doctors, but traditional American Indians are often wary of the doctors and first seek out medicine men.

Question 17

African American Beliefs

Answer 17

AFRICAN AMERICAN BELIEFS:

• African Americans who use complementary and alternative medicine (CAM) in general are more likely to use folk medicine in particular.

Question 18

Are Complementary and Alternative Approaches Valid?

Answer 18

Are Complementary and Alternative Approaches Valid?:

COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) – Most of the non-Western approaches to medicine described in this chapter are commonly referred to as complementary and alternative medicine (CAM).

Voodoo and shamanistic rites do not fall under the CAM umbrella – Describes any healing philosophies and therapies that mainstream Western (conventional) medicine does not commonly use.

• From the sections above, many of these alternatives to Western science have different levels of scientific testing; it cannot be denied that many who practice CAMs feel better. Based on rigorous scientific testing CAMs are not always distinguishable from placebos in randomized control trials.
  
  • But many practitioners do not need scientific proof.
• Non-Western treatments is that the methods were discovered by trial and error and also superstition and religion.
• The ancient Chinese text, The Yellow Emperor’s Classic of Internal Medicine, which is the basis for Traditional Chinese Medicine, suggests that communications with the heavens account for traditional medical practices.
• U.S. health-care workers use CAMs significantly more than the general public.

Other commonly used are:

• Deep-breathing exercises, mindfulness-based stress reduction, and mindfulness-based cognitive therapy), chiropractic care.
• In 1998 Congress established the National Center for Complementary and Alternative Medicine (NCCAM)
  
  • Studies the effectiveness of other CAMs such as aromatherapy, meditation, acupuncture/acupressure, hypnosis, dance, music and art therapy, and even prayer.
• The critical point to realize about these varying beliefs is that health psychologists must be aware of a person’s beliefs in order to treat the person comprehensively.
• What people believe influences what they do to remedy the situation. Giving antibiotics to someone who believes her cold is due to evil eyes may not yield the same effects as giving antibiotics to someone who believes her cold is due to a germ.
• Belief is a strong tool in the arsenal of the healer and an important element for the health psychologist to consider when attempting to maintain health and prevent illness.
• Acupuncture is one of the most scientifically validated forms of alternative medicine and is gaining popularity in hospitals nationwide, although portions of Western biomedicine heavily mistrust it.

Question 19

Summary

Answer 19

SUMMARY:

• Curanderos treat patients on material, spiritual, and mental levels, depending on where the illness is thought to have begun. Spiritual treatments may involve the healer going into a trance and playing the role of a medium. Material treatments involve household items and religious symbols, and mental treatments rely on the power held by the healer.
• Traditional Chinese medicine (TCM) treats the body as a whole in which every single part is intrinsically linked to other parts and to what is happening around the person. According to TCM, food, relationships, and spiritual harmony are all conducive to health. Diseases are thought to be caused by imbalances in yin and yang.
• Yin and yang are mutually interdependent, interchangeable forces that make up the entire universe. The Tao, or energy force, of the universe is influenced by the balance of yin and yang and needs to be fostered for optimal health. Main treatments include acupuncture and herbal therapy.
• American Indian medicine also focuses on spiritual balance and living in harmony with nature. The most common practices involve the use of herbal remedies, ritual purification or purging, symbolic rituals and ceremonies, and the involvement of shamans.
• Acupuncture could be useful by itself or in combination with other therapies to treat a number of issues such as addiction, headaches, menstrual cramps, pain, carpal tunnel syndrome, and asthma.