Western Psychotherapy and the Yoruba:
Problems of Insight and Nondirective Techniques
McGill University, Montreal, Canada
This chapter was originally written in 1962, when transcultural psychiatry was in its infancy. Shortly after completing my psychiatric training, I had the good fortune to work for three years within the Yoruba culture of Nigeria. Between 1957 and 1959, I practiced as government psychiatrist for the British Colonial Service at Aro Hospital, Abeokuta. During this clinical period, I became aware of the expertise of Yoruba traditional healers in treating a wide spectrum of psychiatric disorders, and during 1961 to 1963, I returned to research their treatment methods in detail.
When I first entered psychiatry in the early 1950s, I was trained in psychoanalytically based psychotherapy, which was then regarded as the most effective and highly valued form of treatment for the neuroses. Later, I would learn the advantages of the nondirective interviewing method. During my work as a clinician in Nigeria, however, I rapidly discovered the culture-bound nature of the psychotherapeutic techniques I practiced in Canada. This chapter briefly describes my discovery of the cultural limitations of insight and nondirective techniques—as seen in the year 1962. Today, with flawless hindsight, we may smile at a discovery that nowadays can seem obvious. It was not, however, at all obvious to me, and at the time it would certainly have come as a surprise to my Canadian teachers and colleagues.
Let me begin with an anecdote. I first came to Nigeria in 1957 and worked as a government psychiatrist at Aro Hospital, Abeokuta. One of my first patients was a young schoolteacher with a walking disorder. When she walked forward, her right leg was stiff and she moved with a severe limp; however, if she ran forward, or walked backward, no stiffness occurred and her movements were normal. Her illness was obviously functional (i.e., the pathology was not in muscles or nerves but in feelings and ideas), and I decided that the best treatment would be intensive psychotherapy aimed at exploring and resolving the fears, hostilities, or guilts that were theoretically behind____________________