心理-“Both Gods & Dr. are Needed"

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“Both Gods & Doctors are Needed":Strategies in Psychotherapy for Psychiatric Patients with Chinese Popular Religion


“Both Gods & Doctors are Needed”:

Strategies in Psychotherapy for Psychiatric Patients with Chinese Popular Religion

文榮光院長

        Chinese popular religion (or folk religion) is defined here as the blend of Daoism, Confucianism, Buddhism, and the primal religion: shamanism. Around 44% of the general population in Taiwan belong to this category, which is the most popular one. A majority (61.7%) of community dwellers in Southern Taiwan believed in spirit possession phenomenon, and about 1.7% had spirit possession experience.

         A survey on the utilization of various healing modalities among psychiatric patients with a variety of mental disorders e.g. schizophrenia v.s. neurotic disorders found up to 81% v.s. 25% utilized shamanism as folk psychotherapy. There was 25% of schizophrenia experienced spirit possession.

       Belief in possession by spirits, evil or benevolent, is common in Chinese societies. The belief is most often associated with mental disorders. It has been described in almost all categones of psychiatric diagnosis, especially if a patient’s symptoms are biggare and he or she acts like “someone else”. Prayers and offerings at temples or calling of Daoist priests or shamans to perform rites for healing psychiatric patients are common practices seen in Chinese families. Shamanistic meditation, trouce, and possession, either by self practice in the family or group practice at temples on shrines are even more popular in these two decades.

       Both somatization and dissociation, instead of psychologization and repression, are two major coping mechanisms in societies where mental illness id heavily stigmatized, and modern western-style psychotherapy is poorly sanctioned and not popular in general population.

        Hence, psychotherapy for psychiatric patients with Chinese folk beliefs should be practiced in an appropriate manner that takes traditional religiosity and spirituality into account, and within the Chinese context.

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The following strategies that might be good for the conduct of psychotherapy in this regard are:

Therapist’s conceptual reorientation and establishment of cultural competence in health care, which means the ability to work effectively with patients from culturally diverse groups and communities. Therapists need to have a culturally and religion spirituality sensitive attitude, appropriate cultural knowledge, and flexible enough skills. This cultural re-orientation and the adoption of the “Bio-Psycho-Social-and Spiritual” theoretical model would be essential & useful for the psychotherapy.
Relationship-oriented approach from the outset, which pays prior attention to the patient’s “relational self” and his family as the most significant others and their dynamic interactions, regarding the help-seeking & illness behaviors. The therapist’s open-minded, respectful attitude and comfortable addressing their experiences would be helpful for the making of good therapentic relationship.
It need to be more directive, supportive, and less analytic and insight-oriented. Patients tend to externalized the illness problems as well as relationship(gunxi) oriented in their world views.
“Both the visible and the invisible need to be treated. Integration of psychotherapy and psychopharmaco-therapy.
“Both gods and doctors are needed”. Collaboration of folk psycho-therapy and psychiatric treatment.