Background
The rise of migration to Europe and North America (mainly from Asia and Africa) since the end of the second world war (WW2) especially during the past three decades, is resulting in growing interconnectedness between people around the world, while globalization of lifestyles, media, technology, as well as social and political systems (including health care and cultural pursuits) is resulting in conflict as well as collaboration across the world in many fields, including those around mental health and wellbeing—for example around the Movement for Global Mental Health (MGMH) (Summerfield 2012; Bemme and D’souza 2012; Das and Rao 2012; Shukla et al. 2012a, b). In some instances, geo-political power dynamics results in ‘globalization’ often meaning ‘Westernization’ (Petras and Veltmeyer 2001) rather than true sociocultural interchange between the West and the Rest (for discussion of what is meant by ‘the West’ and ‘the Rest’ see Hall 1996)—something evident in the field of mental health and wellbeing. Consequently Western ideologies and systems of ‘mental health care’ underpinned by (Western) psychology and psychiatry are being imposed and/or taken up in the Third World demonstrating a form of coloniality (Fernando 2014; Mills 2014). Meanwhile, in the West, diasporic communities of non-Western cultural origin are increasingly dissatisfied with psychiatry and clinical psychology encounter when they access—or are forced into—mental health services in the West (Fernando 2010; Littlewood and Lipsedge 1997). For instance, clients argue that psychologists and psychiatrists fail to understand individual cultural healing contexts (Bhugra and Bhui 1998); and that therapy has no benefit (Garfield 1986). This results in very low intake of psychology or psychotherapy services among clients from a non-Western cultural backgrounds. And if they do engage with these processes they tend to show significantly poorer outcomes from therapy, or drop out of therapy much earlier than the norm. It seems that the clinical psychology and psychotherapy models and approaches to understanding the human being is individualistic, Eurocentric and ethnocentric in nature (Moodley and Palmer 2006). Since the 1960s, there has been a concerted effort to address this issue in clinical and counselling psychology, psychotherapy and psychiatry (see Laungani 2005; Fernando 2010, 2014; Vontress 1991, 1999).
Laungani (2005) noted that psychologists and mental health practitioners are always influenced by the dominant epistemologies of the cultures within which they live and work, and hence, they will certainly have a bearing on their clinical practice. Working cross-culturally can result in tensions and conflicts when competing and, sometimes contradictory cultural values and healing practices are at odds with each other. He argued that, ‘if one were to construct a solid counselling bridge across Eastern and Western cultures, it would be necessary to examine not only the cultural factors but also the epistemologies, which guide the professional work of counsellors and therapists’ (p. 254). The need to examine the dominant epistemological frames will offer the opportunity to not only look critically at Western Eurocentric discourses in mental health but will also make room for creative thinking about alternatives within Western healthcare practices. Indeed, there are several programmes and movements that are working to integrate ways of thinking about the human condition and traditional healing practices in the Global South into current Western psychiatric, psychological and counselling services (e.g., Moodley and West 2005). The rationale for these endeavours is often to develop culturally sensitive and culturally competent practices in the Global South, but still within the parameters of the Western scientific tradition as represented by (Western) psychiatry and clinical psychology.
The reason for the domination of Western psychology and psychiatry is, of course, historical—largely the result of geopolitical power dynamics that have resulted in Western economic and cultural dominance. There is a growing literature exploring this topic under the umbrella of indigenous psychology (Kim and Berry 1993; Ho 1998; Allwood and Berry 2006; Kim et al. 2006; Pandey 2011), although this process is not approved by some traditional Western academics (e.g., see Jahoda 2016). Also, it should be noted that innovative approaches to the study of (what amounts to) ‘psychology’ continue to arise in various settings and sometimes associated with particular individuals, such as Fanon, Gandhi and Martín-Baró (Watkins and Shulman 2008)—a matter considered later when chapters in Part III of the book are described.
The majority of people in the world today live in what is now called the Global South, mainly the regions of the World formerly referred to as the ‘developing world’ or ‘Third World’ (Tomlinson 2003)—a concept that arose post WW2 to encompass countries that, generally speaking, have a non-Western cultural backgrounds and suffered from underdevelopment and exploitation during the colonial era (Pomeranz 2000)—but ‘Global South’ also encompasses the cultures of indigenous people in regions of the world that were once (before Western colonization) dominated by their ancestors, for example, in Australasia and America. Although many aspects of their cultural traditions have been dismantled and others corrupted and hybridized, many people in the Global South are still informed for their day-to-day lives by ideologies and ways of thinking about the ‘mind’—psychologies—that are different to that embodied in traditional Western psychology that stems from post-Enlightenment thinking in Europe (Fernando 2014; Foucault 2006). Some of the ideologies—such as the Cartesian mind–body dichotomy and the rejection of spirituality—underpinning the nature of ‘mental illness’ that inform Western psychology and psychiatry are in many ways at odds with cultural traditions that influence the lives of most people of the Global South and, to some extent, diasporic communities of non-Western heritage living in the Global North.
The Cartesian mind–body dichotomy which has been the bedrock for the evolution of psychology and psychiatry is still the mainstay of knowledge production in these disciplines. From its earliest origins when Plato contemplated and cogitated about the psyche and soma, the focus in theory, research and practice has been on either the body or the mind, never the two as a whole, and certainly not including the spirit. The notion of the spirit has been marginalized and reduced to the periphery of psychological and psychiatric research. However, in recent decades, there has been a slow but intensive engagement by scholars investigating issues of spirituality, wellbeing, counselling and psychotherapy. They are calling for an inclusion of religion and spirituality in psychology and psychotherapy, and emphasizing that culture and race needs to be part of this conversation (see Nolan and West 2015; West 2011). For example, Nolan and West (2015) argue that, ‘a careful consideration of spirituality and religion in a therapeutic context requires that culture and race or ethnicity be also kept in mind and that cultural differences are nuanced in the context of spirituality and religion’ (pp. 1–2). Even Carl Jung who was regarded a racist (see Dalal 1988), in his later life said: ‘our new psychology is in no way advanced enough to present a theory of the mind that would have universal application’ (Jung 1931, para. 1298; cited in Stephenso...