Reclaiming Inner Being : Esssays On The Individual In Todays Cultural Setting

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This is why atheists, agnostics and believers can all — and often do — identify as spiritual.

One need not believe in God in order to have questions that scientific materialism cannot answer. Most of my study participants think contemporary Western culture is far too outward focused, glorifying material success and procurement at the expense of the things that really matter. They would agree with the famous cultural critic Erich Fromm, who in the s argued modern societies emphasize having things as opposed to just being. Spirituality stresses the importance of attuning to our inner life — both as a way of resisting the constant pressure our culture exerts to value what lies outside of us, as well as a means of finding a place of refuge.

This is one reason why, for instance, environmentalists have often endorsed spirituality.

Questions about meaning and value in the world

One of the major causes of climate change and environmental destruction, these environmentalists argue, is the never-ending quest for economic growth, fuelled by a capitalist logic of acquisition and expansion. The Dalai Lama once quipped, while the West was busy exploring outer space, the East was busy exploring inner space.

Regardless of the veracity of this generalization, he was getting at something that many of my study participants feel: When millennials say they are seeking to become more spiritual, they are often saying that they are trying to resist this trend. For many millennials looking inward is an ethical endeavour. For many, becoming more contemplative or aware of their inner life allows them to interact with others in a way that is less reactive, less harmful and more authentic to who they think themselves to be.

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Thus, there are certain virtues which have come to be associated with spirituality: These virtues naturally flow out of the introspection inherent to spirituality because they ultimately require a high level of self-knowledge. That is, knowledge of why we hold the beliefs we do, knowledge of why we act in certain ways, and most importantly, knowledge of our interdependence. For others, it entails attuning themselves to the immaterial dimensions of life. Nor am I suggesting that all individuals who fit the above description are necessarily spiritual.

I only mean to propose that these three characteristics cover a lot of what millennials mean when they call themselves spiritual. The Process Perspective II. The Call of Character. The End of Our Exploring. Stages in the Ritualization of Experience. Handbook of process theology. The Predicament of Belief. Suffering and the Search for Meaning. God's Reign in the Natural Sciences. God, Freedom and Human Dignity. Knowing Right from Wrong. The Life of the Mind RenewedMinds. Problems of Evil and the Power of God. The Evidence for God.

Navigating the Sea of Talmud. Genuine Dialogue and Real Partnership. Job, Jonah, and the Unconscious. The Wisdom to Doubt. Rediscovering the Wonder of Judaism. Informed by Science-Involved by Christ. Beyond the Postmodern Mind. Abingdon Old Testament Commentaries: Christian Moral Theology in the Emerging Technoculture.

Man and Nature in God.

Moving Toward Spiritual Maturity. The Rain in Spain. For example, lower education levels seem to relate to heavy drinking independently of socioeconomic status Kuntsche et al. Culture has an effect on an individual's attitudes toward education; for instance, a lack of cultural understanding on the part of educational institutions affects student goals and achievements Sue A number of factors besides more The desperation associated with poverty and a lack of opportunity—as well as the increased exposure to illicit drugs that comes from living in a more impoverished environment—can also increase drug use Bourgois Lower SES and the concurrent lack of either money or insurance to pay for treatment are associated with less access to substance abuse treatment and mental health services Chow et al.

For example, compared with Medicare coverage, private insurance coverage increases the odds twofold that someone who has a substance use disorder will enter treatment Schmidt and Weisner Thus, lower SES can have a dramatic effect on recovery. Often, they encounter a difficult process of acculturation as discussed throughout this chapter.

They can also share concerns surrounding the renewal of visas, obtainment of citizenship, or fears of possible deportation depending on their legal status. Immigration itself is stressful for immigrants, though the reasons for migrating and the legal status of the immigrant affect the degree of stress.

Western culture too focused on material success

For documented residents, the process of adaptation tends to be smoother than for those who are undocumented. Undocumented persons may be wary of deportation, are less likely to seek social services, and frequently encounter hostility Padilla and Salgado de Snyder Nonetheless, there are numerous variables that contribute to or influence well-being, quality of life, cultural adaptation, and the development of resilience e. Research suggests that immigrants may not experience higher rates of mental illness than nonimmigrants Alegria et al. Department of State's Bureau of Population, Refugees, and Migration, is a useful resource for clinicians to gain information about topics including culture , resettlement experiences, and historical and refugee background information.

This site is also quite useful for refugees. It provides refugee orientation materials and guidance in establishing housing, language , transportation, education, and community services, among other pressing refugee concerns. Immigrants who are refugees from war, famine, oppression, and other dangerous environments are more vulnerable to psychological distress APA They are likely to have left behind painful and often life-threatening situations in their countries of origin and can still bear the scars of these experiences.

Some refugees come to the United States with high expectations for improved living conditions, only to find significant barriers to their full participation in American society e. Behavioral health services must assess the needs of refugee populations, as the clinical issues for these populations may be considerably different than for immigrant groups Kaczorowski et al. For immigrant families, disruption of roles and norms often occurs upon arrival in the United States for review, see Falicov Generally, youth adopt American customs, values, and behaviors much more easily and at higher rates than their parents or older members of the extended family.

Parental frustration may occur if traditional standards of behavior conflict with mainstream norms acquired by their children. The differences in parents' values and expectations and adolescents' behavior can lead to distress in close-knit immigrant families. This disruption, known as the acculturation gap, can result in increased parent-child conflicts APA ; Falicov ; Telzer Research shows that family cohesion and adaptability decrease with time spent in the United States, regardless of the amount of involvement in mainstream culture.

This suggests that other factors may confound the relationship between family conflict and increased exposure to American culture Smokowski et al. When working with clients who are recent immigrants or have immigrated to United States during their lifetime, the APA recommends exploring:.

Clients who are migrants e. In the United States, migrant workers are considered one of most marginalized and underserved populations Bail et al. Migrants face many logistical obstacles to treatment-seeking, such as lack of childcare, insurance, access to regular health care, and transportation Hovey ; Rosenbaum and Shin Current data are limited but suggest high rates of alcohol use, alcohol use disorders, and binge drinking, often occurring as a response to stress or boredom associated with the migrant lifestyle Hovey ; Worby and Organista In addition, limited data on migrant mental health reflect mixed findings regarding increased risk for mental illness or psychological distress Alderete et al.

One factor associated with mental health status is the set of circumstances leading up to the migrant worker's decision to migrate for employment Grzywacz et al. Many factors contribute to an individual's cultural identity, and that identity is not a static attribute. As a result, people may feel conflicted about their identities—wanting to fit in with the mainstream culture while also wanting to retain the values of their culture of origin. For clients, sorting through these conflicting cultural expectations and forging a comfortable identity can be an important part of the recovery process.

Some of the more commonly used terms related to cultural identity are defined in Exhibit Cultural Identification and Cultural Change Terminology. Acculturation is the process whereby an individual from one cultural group learns and adopts elements of another cultural group, integrating them into his or her original culture. Although it can more All immigrants undergo some acculturation over time, but the rate of change varies from group to group, among individuals, and across different periods of history.

Earlier theories suggested that immigrants generally assimilated within three generations from the time of immigration and that assimilation was associated with socioeconomic gains. More recent scholarship suggests that this is changing among some cultural groups who may lack the financial or human capital necessary to succeed in mainstream society or who may find that continued involvement in their native or traditional culture has benefits that outweigh those associated with acculturation Portes et al.

Acculturation typically occurs at varying speeds for different generations, even within the same family. Acculturation can thus be a source of conflict within families, especially when parents and children have different levels of acculturation Exhibit Castro and Murray ; Farver et al. Five Levels of Acculturation.

Numerous models have been developed to explain the process of acculturation. Many studies have found that increased acculturation or factors related to acculturation are associated with increased alcohol and drug use and with higher rates of substance use disorders among White, Asian, and Latino immigrants Alegria et al. Place of birth is most strongly associated with higher rates of substance use and disorders thereof. For example, research suggests a rate of substance use disorders about three times higher for Mexican Americans born in the United States than for those born in Mexico Alegria et al.

Asian adolescents born in the United States present a higher rate of past-month alcohol use than Asian adolescents not born in the United States 8. Mora asserts that the stress associated with acculturation has a significant effect on increasing substance use and abuse among Latinas; this can be observed most clearly in the increases in substance use associated with being a second- or third-generation Latina from an immigrant family. The stress associated with acculturation could also contribute to rates of mental disorders and co-occurring disorders CODs , which are higher among more acculturated groups of immigrants Cherpitel et al.

In fact, American-born Latinos who have used substances are three times more likely to have CODs than foreign-born Latinos who have used substances Vega et al. Research also suggests that acculturation could interact with factors such as culture or stress in increasing mental disorders. As an example, Marin found that, compared with Whites, Mexican Americans expected significantly more negative consequences and fewer positive ones from drinking, but Marin also found that the more acculturated the Mexican American participants were, the more closely their expectations resembled those of Whites.

Other factors that can contribute to increased substance use among more acculturated clients include changes in traditional gender roles, exposure to socially and physically challenging inner-city environments Amaro and Aguiar , and employment outside the home often a role-transforming change that can contribute to increased risk of alcohol dependence. Multiple studies using international samples have found that the greater the amount of gender equality in a society, the more similar alcohol consumption patterns are for men and women Bloomfield et al.

Many immigrants to the United States where gender equality is relatively strong come from societies with less gender equality and thus with greater prohibitions against alcohol use for women. Karriker-Jaffe and Zemore found that higher levels of acculturation are associated with increased alcohol consumption only when combined with above-average SES and not with lower SES , suggesting that income is another factor to consider when evaluating the effect of acculturation on alcohol use. Most notably, immigrants coming from countries with unusually high levels of drinking do not necessarily experience a change in their use, and they may even consume less alcohol and fewer drugs that they did in their native countries.

Even among those born in the United States, however, data suggest that greater identification with one's traditional culture has a protective function. For example, in the National Latino and Asian American Study, the largest national survey specifically targeting these population groups to date, greater ethnic identification was associated with significantly lower rates of alcohol use disorders among Asian Americans Chae et al. Less research is available on the relationship of acculturation to substance use and substance use disorders among nonimmigrants, but some data suggest that a lower level of identification with one's native culture is linked with heavier, lengthier substance use among American Indians living on reservations Herman-Stahl et al.

For some American Indians, more involvement in Tribal culture and traditional spiritual activities is associated with better posttreatment outcomes for alcohol use disorders Stone et al. American Indians who drink heavily but live a traditional lifestyle have better recovery outcomes than those who do not live a traditional lifestyle Kunitz et al. Likewise, African Americans may have greater motivation for treatment if they recognize that they have a drug problem and also have a strong Afrocentric identity Longshore et al.

Overall, acculturation and cultural identification have tremendous implications for behavioral health services. Research has shown an association between low levels of acculturation and low usage rates of mainstream healthcare services. Individuals can feel conflicted about their identities—wanting to both fit in with the mainstream culture and retain the traditions and beliefs of their cultures of origin. For such clients, sorting through these conflicting cultural expectations and forging a comfortable identity can be an important part of the recovery process. Familiarity with cultural identity formation models and theories of acculturation including acculturation measurement methods; see Exhibit can help behavioral health workers provide services with greater flexibility and sensitivity see Appendix B for instruments that measure aspects of cultural identity and acculturation.

Acculturation is a construct that includes factors relating to behavior, knowledge, values, self-identification, and language use Zea et al. One of the biggest problems in analyzing the effects of acculturation is determining more A culture 's history and heritage explain the culture's development through the actions of members of that culture and also through the actions of others toward the specific culture.

Providers should be knowledgeable about the many positive aspects of each culture's history and heritage and resourceful in learning how to integrate these into clinical practice. Their eagerness to assimilate or remain separate depends greatly on the circumstances of their immigration Castro and Murray The depths of suffering that some clients have endured can result in multiple or confusing symptoms. For example, a traumatized Congolese woman could speak of hearing voices, and it could be unclear whether these voices suggest an issue requiring spiritual healing within a cultural framework, a traumatic stress reaction, or a mental disorder involving the onset of auditory hallucinations.

Within the United States, cultural groups such as African Americans and Native Americans have long histories of traumatic events, which have had lasting effects on the descendants of those who experienced the original trauma. Consequently, past as well as present discrimination and racism are related to a number of negative consequences across diverse populations, including lower SES, health disparities, and fewer employment and educational opportunities see review in Williams and Williams-Morris According to theories of historical trauma, the traumas of the past continue to affect later generations of a group of people.

This concept was first developed to explain how the trauma of the Holocaust continued to affect the descendants of survivors Duran et al.

In the United States, it has perhaps been best explored in relation to the traumas endured by Native American peoples during the colonization and expansion of the United States. One can extend this concept to other groups e.

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Some research indicates that thinking about historical loss or displaying symptoms associated with historical trauma plays into increases in alcohol use disorders, other substance use, and lower family cohesion Whitbeck et al. Brave Heart theorizes that historical traumas perpetuate their effects among Native Americans by harming parenting skills and increasing abuse of children, which creates a cyclical pattern—greater levels of mental and substance use disorders in the next generation along with continued poor parenting skills.

Specifically, Libby et al. Additional research highlights a relationship between elevated chronic trauma exposure and prevalence of both mental and substance use disorders among large samples of American Indian adults living on reservations Beals et al. Sotero reviews research on historical trauma across diverse populations and proposes a similar explanation of how deliberately perpetrated, large-scale traumatic events continue affecting communities years after they occur. She argues that the generation that directly experiences the trauma suffers material e.

These lasting sequelae of trauma then affect the next generation, who can suffer in many similar ways, resulting in poorer coping skills or in attempts to self-medicate distress through substance abuse. Attitudes toward sexuality in general and toward sexual identity or orientation are culturally defined. Each culture determines how to conceptualize specific sexual behaviors, the degree to which they accept same-sex relationships, and the types of sexual behaviors considered acceptable or not Ahmad and Bhugra In any cultural group, diverse views and attitudes about appropriate gender norms and behavior can exist.

For example, in some Latino cultural groups, homosexual behavior, especially among men, is not seen as an identity but as a curable illness or immoral behavior Kusnir In some Latino cultural groups, self-identifying as other than heterosexual may provoke a more negative response than engaging in some homosexual behaviors de Korin and Petry ; Greene ; Kusnir For some individuals, gay culture provides an alternative to their culture of origin, but unfortunately, cultural pressures can make the individual feel like he or she has to select which identity is most important Greene However, a person can be, for example, both gay and Latino without experiencing any conflicts about claiming both identities at the same time.

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Heterosexual behaviors are carefully prescribed by a culture. Typically, these prescriptions are determined based on gender; behaviors considered acceptable for men can be considered unacceptable for women and vice versa. In addition, cultures define the role of alcohol or other substances in courtship, sexual behaviors, and relationships Room Other factors that can vary across cultural groups include the appropriate age for sexual activity, the rituals and actions surrounding sexual activity, the use of birth control, the level of secrecy or openness related to sexual acts, the role of sex workers, attitudes toward sexual dysfunction, and the level of sexual freedom in choosing partners.

Beliefs, attitudes, and behaviors related to health, illness, and healing vary across racial, ethnic, and cultural groups. Many cultural groups hold views that differ significantly from those of Western medical practice and thus can affect treatment Sussman The field of medical anthropology was developed, in part, to analyze these differences, and much has been written about the range of cultural beliefs concerning health and healing. In general, cultural groups differ in how they define and determine health and illness; who is able to diagnosis and treat an illness; their beliefs about the causes of illness; and their remedies including the use of Western medicines , treatments, and healing practices for illness Bhugra and Gupta ; Comas-Diaz In addition, there are complex rules about which members of a community or family can make decisions about health care across cultural groups Sussman In mainstream American society, healthcare professionals are typically viewed as the only ones who have real expertise about health and illness.

However, other societies have different views. For instance, among the Subanun people of the Philippines, all members of the community learn about healing and diagnosis; when an individual is sick, the diagnosis of his or her problem is an activity that involves the whole community Frake Cultural groups also differ in their understanding of the causes of illness, and many cultural groups recognize a spiritual element in physical illness. The Hmong, for example, believe that illness has a spiritual cause and that healing may require shamans who communicate with spirits to diagnose and treat an illness Fadiman ; Gensheimer With respect to mental health, providers should be aware that any mental disorder or symptom is only considered a disorder or problem by comparison with a socially defined norm.

For instance, in some societies, someone who hears voices can be considered to have greater access to the spirit world and to be blessed in some way.

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Furthermore, there are mental disorders that only present in a specific cultural group or locality; these are called cultural concepts of distress. Appendix E describes cultural concepts of distress recognized by the DSM Other specific examples of cultural differences relating to the use of health care and alternative approaches to medical diagnosis and treatment are also presented in Chapter 5.

Religious traditions or spiritual beliefs are often very important factors for defining an individual's cultural background. In turn, attention to religion and spirituality during the course of treatment is one facet of culturally competent services Whitley Christians, Muslims, Jews, and Buddhists among others can be members of any racial or ethnic group; in the same vein, people of the same ethnicity who belong to different religions sometimes have less in common than people of the same religion but different ethnicities.

In some cases, religious affiliation is an especially important factor in defining a person's culture. For instance, the American Religious Identification Survey reported that 47 percent of the respondents who identified culturally as Jewish were not practicing Jews Kosmin et al.

According to the American Religious Identification Survey Kosmin and Keysar , only 15 percent of Americans identified as not having a religion; of those, less than 2 percent identified as atheist or agnostic. Many religions are practiced in the United States today. This TIP cannot cover them all in detail in. However, this TIP does briefly describe the four most common by size of self-identified membership religious traditions.

For people in treatment and recovery, it can be especially important to distinguish between spirituality and religion. For example, some clients are willing to think of themselves as spiritual but not necessarily religious. Religion is organized, with each religion having its own set of beliefs and practices designed to organize and further its members' spirituality. Spirituality, on the other hand, is typically conceived of as a personal matter involving an individual's search for meaning; it does not require an affiliation with any religious group Cook People can have spiritual experiences or develop their own spirituality outside of the context of an organized religion.

Spirituality often plays an important role in recovery from mental illness and substance abuse, and higher ratings of spirituality using a variety of scales have been associated with increased rates of abstinence Laudet et al. If substance abuse represents a lack of personal control, discipline, and order, then spirituality and religion can help counter this by providing a sense of purpose, order, self-discipline, humility, serenity, and acceptance.

In addition, spirituality can help a person with mental illness gain a sense of meaning or purpose, develop inner strength, and learn acceptance and tolerance. Chappel maintains that the development of spirituality requires a concerted and consistent effort through such activities as prayer, meditation, discussion with others, reading, and participation in other spiritual activities. Counselors, he says, have an obligation to understand the role that spirituality can play in promoting and supporting recovery. The first step in this process is for counselors to learn about and respect clients' beliefs; understanding the roles of religion and spirituality is one form of cultural competence Whitley Christianity, in its various forms, remains the predominant religion in the United States today.

According to Kosmin and Keysar , 76 percent of the population in identified as Christian, with the largest denomination being Catholics Most mainstream Christian religions support behavioral health treatment, and many churches serve as sites for self-help groups or for Christian recovery programs. Some Christian sects, however, are not as amenable to substance abuse and mental health treatment as others. Judaism is the second most common religion in the United States 1. Most Jews believe that they share a common ancient background.

However, the population has dispersed over time and now exists in various geographic regions. In , approximately 5 percent of people who identified as adherents to Judaism the religion, as opposed to people who identify as culturally Jewish were Latinos, and approximately 1 percent were African Americans Kosmin et al. Regarding beliefs about and practices surrounding substance use, there are no prohibitions against alcohol use or other substance use in Judaism, but rates of alcohol abuse and dependence are significantly lower for Jews than for other populations Bainwol and Gressard ; Straussner This could be partially attributable to genetics, yet there is also a definite cultural component Hasin et al.

Conversely, rates of use and abuse of other substances are about the same or slightly higher for Jews in the United States compared with other populations Straussner Because some Jewish people will feel uncomfortable in Step groups that meet in churches and are largely Christian in composition, mutual-help groups designed specifically for Jewish people have been developed. Other Jewish people in recovery may prefer participating in secular self-help programs Straussner Most Jewish people support behavioral health treatment.

In , roughly 1. Many Americans assume that all Arabs are Muslim, but the majority of Arab Americans are Christian; Muslims can come from any ethnic background Abudabbeh and Hamid Islam is the most ethnically diverse religion in America, with a membership that is 15 percent White, 27 percent Black, 34 percent Asian, and 10 percent Latino Kosmin et al.

Attitudes of Muslims toward mental illness and seeking formal mental health services are likely to be affected by cultural and religious beliefs about mental health problems, knowledge and familiarity with formal services, perceived societal prejudice, and the use of informal indigenous resources Aloud Attitudes toward substance use, abuse, and treatment will likely be shaped by Islam's prohibition of the use of alcohol and other intoxicants. Many Muslim countries have harsh penalties for the use of alcohol and other drugs. For these reasons, Muslims appear to have low rates of substance use disorders.

Despite there being no current data regarding levels of alcohol and other substance use among Muslim immigrants in the United States, Cochrane and Bal found that, in a comparison of Sikh, Hindu, Muslim, and White probably Christian men in a British community, Muslims by far drank the least, yet those Muslims who consumed the most alcohol experienced a greater number of alcohol-related problems on average. High levels of alcohol consumption among Muslims who do drink could be related to feelings of guilt and shame about their behavior, thus potentially leading to further abuse and avoidance of seeking substance abuse treatment when problems arise Abudabbeh and Hamid In , about 1.

In , according to Kosmin et al , the majority of Buddhists were Asian Americans 61 percent , but a significant number of White Americans have embraced the religion they make up 32 percent of Buddhists in the United States , as have African Americans 4 percent and Latinos 2 percent.

In China and Japan, Buddhism is often combined with other religious traditions, such as Taoism or Shintoism, and some immigrants from those countries combine the beliefs and practices of those religions with Buddhism. Buddhists believe that the choices made in each life create karma that influences the next life and can affect behavior McLaughlin and Braun The Fifth Precept of Buddhism is not to use intoxicating substances, and thus, the expectation for devout believers is that they will not use alcohol or other substances of abuse Assanangkornchai et al.

In the United States, no specific substance abuse treatment programs specialize in treating Buddhist clients. Buddhist substance abuse and mental health treatment programs do exist in other countries e. This chapter has established the foundation and rationale of this TIP; reviewed the core concepts, models, and terminology of cultural competence ; and provided an overview of factors that are common among diverse racial, ethnic, and cultural groups. As you proceed, be aware that diversity occurs not only across racially and ethnically diverse groups, but within each group as well—there are cultures within cultures.

As you read this TIP, remember that many cross-cutting factors influence the counselor—client relationship, the client's presentation and identification of problems, the selection and interpretation of screening and assessment tools, the client's responsiveness to specific clinical services, and the effectiveness of program delivery and organizational structure and planning.

Turn recording back on. National Center for Biotechnology Information , U. Purpose and Objectives of the TIP This TIP is intended to help counselors and behavioral health organizations make progress toward cultural competence. The key objectives of this TIP are helping readers understand: Why it is important for behavioral health organizations and counselors who provide prevention and treatment services to consider culture. The role culture plays in the treatment process, both generally and with reference to specific cultural groups.

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