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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Trauma and Culture, One Treatment Does Not Fit All.

Allan N. Schwartz, LCSW, Ph.D. Updated: Aug 13th 2007

The magazine section of the New York Times, Sunday, August 12 edition, ran an interesting article about post traumatic stress disorder. The article noted the fact that the way people suffer after a major disaster occurs, depends a lot on their culture, values and norms. Consequently, the way in which people are to be helped must vary according to that culture. In other words the way in which American and Western psychology describes PTSD does not fit the symptoms of people from Non Western cultures.

According to the article:

1. For people in Sri Lanka, PTSD symptoms do not include flashbacks and nightmares as described in the DSM IV. Instead, for Sri Lankans, symptoms after a disaster included worries and fears about the loss of their role in their group.

2. Got people in Afghanistan survivors of disasters and war described symptoms that did not match the DSM and for which there are no English words. They described a "nervous anger" for which they have a vocabulary word that we do not have.

3. In El Salvador, where there has been a lot of civil war, people describe a type of internal heat that is very intense.

4. In Cambodia, survivors described night time visits by angry spirits.

Beliefs about how to heal form trauma vary from one culture to the next. In Sri Lanka, individual therapy can complicate the problems experienced by the PTSD patient because it caused them to feel isolated. Instead, people do not split off from the group to speak to a therapist but stay within their group. Among East Africans a sign of maturity is the ability to not speak about distressing and traumatic events.

The title of this article is "Suffering Differently," is written by Ethan Watters, and can be found on page 15.

The major point that can be gleaned from this article is that it is wrong to assume that everyone experiences life in the same way. If we do not recognize the importance of "difference" in our diverse nation and diverse world then our attempts to "help" will back fire and this seems to happen frequently.

What are your comments?

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

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