Cultural Humility in Patient Care and International Conflict
Key Takeaways
- Cultural humility operationalizes cross-cultural care by eliciting patients’ salient cultural and religious values and integrating them into treatment plans to improve therapeutic alliance and outcomes.
- Civilizational frameworks posit that modern conflicts are increasingly propelled by cultural-religious identities rather than territorial disputes, complicating Western assumptions about governance and individualism.
How cultural humility in psychiatry reframes global conflict, urging respect, diversity, and shared values amid escalating tensions.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
In my last column, I mentioned a book I started to read in the late 1990s but did not finish.1 I had always been interested in the cultural aspects of psychiatry, leading to developing the first national model in cultural psychiatry education for psychiatric residents.2 From that time in the late 1970s, cultural psychiatry evolved from interest to competence to cultural humility, all to help improve treatment outcomes in cross-cultural clinical matches.3 That evolution seemed to fit my clinical stance on culture, which was to ask patients what cultural, including religious, values were important to them, and then I would try to incorporate them in our treatment plans.
Therefore, hearing about a book that emphasized the increasing “Clash of Civilizations” in international conflicts due to cultural and religious values rather than geography, I was intrigued. It was a hard and dense book to read at a busy time of work. Now seems to be the right time to pick up the book again and finish it, because the essence of its predictions seems to have come true in the war against Iran after the attack of the United States and Israel.
The book’s author, who died in 2008, predicted that Islamic civilization would become the greatest adversary of the so-called Western world. He identified several major civilizations:Western, Latin America, Chinese, Japanese, African, Orthodox, Islamic, Hindu, and Buddhist. Iran has a long and proud Persian culture of language and values, recently led and infused with an Orthodox Shiite Islam. It is not at all clear that the West understands and appreciates these values. Right now, Iran has defiantly elected a new leader that seems to be a doubling down on their values and structure. The sophisticated technical destruction and growing list of casualties must be distressing to anyone with the health care values of healing and health.
At the end of the book, Huntington recommends that these new civilization conflicts will unlikely be resolved with war or conquering. Rather, each civilization needs to respect the domains of the other. Then we could see and share what is in common, coming together to create one Civilization. For “the West,” separation of church and state, social pluralism, and individuality are generally thought to be of high value, but not for the East, however that is defined.
At this time of war, that hope for unity and simultaneous diversity seems like an impossible dream or fantasy, doesn’t it? Perhaps the world at least needs more of what we have in psychiatry: cultural humility.
Dr Moffic is an award-winning psychiatrist who specializes in the social, cultural, ethical, spiritual, and religious aspects of psychiatry, and since 2012 is in retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekdays column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He has been an advocate and activist for mental health issues related to climate instability, physical burnout, and xenophobia, among other social justice causes, serving on many related local and national community and professional Boards. He serves on the Editorial Board of Psychiatric Times.
References
1. Huntington S. The Clash of Civilizations and the Remaking of World Order. Simon & Shuster; 1996.
2. Moffic HS, Kendrick E, Reid K, Lomax J.
3. Leaks HM, Pahl K, Lewis CF.
