The Family's Coping with Problems and Difficulties
Culturally competent family therapists must realize that families of different cultural backgrounds do not conceive of their problems and difficulties and do not attempt to solve them in the same ways. Families differ in what they identify as symptoms or problems, in how they define and explain the difficulties and in their modes of coping and help-seeking. Psychopathological phenomena, personal and interpersonal crises and other difficulties are culturally relative both in their root causes and in their outward manifestations. People of different cultures do not suffer from the same things. Different combinations of factors cause distress in different social groups.
Lebra ( 1982) discusses sources of psychological pain and well-being in Japanese culture.
The Japanese in general are socialized to reflect upon themselves (hansei) instead of accusing someone else suspected to be the source of frustration . . . one's suffering is to be understood as a consequence of the sufferer's negligence of her duty as a daughter, wife, mother, descendant or believer. (P. 272)
Bilu and Witztum ( 1993) in a study of psychopathology in an ultraOrthodox Jewish community in Jerusalem cite culture-bound psychological risk factors peculiar to growing up in a strictly religious ambiance. They note overindulgence in the spiritual while neglecting pressing real-life issues. They also discuss factors that counterbalance these real-life issues, that is, the structural, benign environment of the Yeshiva. The authors also describe culture-specific external manifestations of psychopathology in this commu-