One of the most pressing but subtle demand of our growing population on the mental health services is the desire for professional services that can make minds function effectively. I want to believe that it is not just peculiar to us in Nigeria but a universal need. Human beings are higher animals because we possess a mind rather than instincts. The operations of the mind are very complex and require management by every individual. However when this effort proves ineffective; it is not out of place to seek professional help but Nigerians would rather go to pastors, diviners, and spiritualists. Medications have greatly contributed to the management of mental illness but there is also a wide range of psychologically based treatment modalities available for certain mental disorders or a compliment for those who are already taking medications.
The mind and the brain as 2 sides of the same coin unequivocally make a demand on the mental health experts to always explore the psychological underpinnings of abnormal behavior. No matter the reasons our experts give; there remains a very huge need for psychologically based interventions in the population apart from drug treatment. However, culture remains a very crucial resource or impediment in accessing psychotherapeutic interventions. Every society possesses certain attitudes, values, beliefs and health behavioral patterns communicated from one generation to the next. In the African society; mental illness is believed to occur as a result of distortions in the harmony between an individual and the cosmos, which may mean his family, society, peers, ancestors or a deity. According to Lambo; the African way of thinking does not draw a line between the living and non-living, natural and supernatural, material and immaterial, conscious and unconscious. These sets of phenomena are considered as opposites in the western societies but are understood as unities in Africa.
The seen and unseen exists in a dynamic interrelationship with the past, present and future harmoniously woven into another. The dream world and the daylight have equal reality. Africans perceive ill health to have material, moral, supernatural and pre-natural causes which can only be determined by physical intervention and divination. Exclusive research efforts have shown that Africans generally believe that disruptive behavior and breaking of taboos are punishable through misfortunes and mental illness. There are numerous traditional classifications of mental disorders and explanatory models for mental illness using spiritual and religious idioms totally different from the basic biomedical model.
The challenge exists therefore for the mental health practitioners in Africa to creatively adapt orthodox psychotherapeutic methods in the light of our cultural peculiarities. Psychotherapeutic interventions are highly sophisticated methods of treatment that derive their principles from varying postulations of how the mind functions. These principles also by inference explain mental distress and recommend methods of intervention. Psychotherapies are more sophisticated than mere counseling which can be given by ordinary untrained persons in a process of helping the client to solve problems.
In developed cultures; extensive, dedicated training is required to be certified as a psychotherapist. I am afraid this model may not appropriately fit into our situation as it may be difficult getting an African on a Freudian couch to freely associate in psychoanalysis. Our concept of causation of mental illness oftentimes supernatural is usually shrouded in secrecy expected to be unraveled by divination. Irrespective of the level of education; Nigerians open up more to someone adjudged to possesses supernatural powers to solve their problems using symbolism, divination, and incantations to appease the gods. This may explain the relative proliferation of spiritism based religious movements in Nigeria.
The practice of psychotherapy must be reviewed in Nigeria in the light of our cultural peculiarities. Psychotherapy strives to alter behavior with verbal interchange. This interchange takes place in the context of explanations proffered over time to explain how the mind functions. Beyond rigid adherence to methodological procedures; there are universal concepts embedded in those theories serving as a premise for those psychotherapeutic techniques that could be culturally adapted.
Cognitive behavior therapy is becoming popular in treating some mental disorders like post-traumatic stress disorder, OCD, phobias and other forms of anxieties. This model, for instance, grew from the concept that it is not events per se but rather people’s interpretations of events that are responsible for the production of negative emotions such as anxiety, anger, guilt, or sadness. Aaron Beck argues that in mental disorders, patients systematically overestimate the danger inherent in certain situations, bodily sensations or mental processes. Once a stimulus is interpreted as a source of danger an anxiety programme is activated. CBT, therefore, attempts to help patients identify their negative danger related thoughts and modify the thought processes that maintain them.
There are enormous culturally based resources within our environment that can make use of these models in our environment with results.
Dr Adeoye Oyewole
adeoyewole2000@yahoo.com
+234 803 490 5808 (WhatsApp Only)
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