Impact of cultural beliefs and practices on mental health

Sajida Shah 

At the age of 13, she was worried due to the recently started bleeding from her vaginal area without any manifested injury. She ran to her mother and asked what is happening to her. Her mother scolded her, and asked her to put some piece of cloth over it, so that nobody could notice the bleeding as it would be a source of embarrassment for the family and for the girl herself. Her mother then sent her to a special house which was full of menstruating girls and pregnant women.

This is the story of 13 years old Huran Bibi from Kalash valley of Chitral, who was one of the members of Bashalani (The house built specially for the menstruating and pregnant women.) The cultural view of Kalash people is based on the concept of purity, thus menstruating and pregnant women are considered to be impure as per their cultural beliefs. Being a part of a primitive culture, I always thought to explore the strength as well as the weakness of our cultural believes and practices, that may have a healthy or unhealthy impact on people. The aim of focusing the “Cultural practices” is a trial to understand its impact on our mental well being especially the vulnerable (Women) beings.

Numerous studies have been conducted on relationship between Culture and mental health. Mostly, the concept of being well or sick is well-defined according to the cultural background, cultural beliefs and cultural practices used by a specific group. Koneru, Mamani, Flynn, & Betancourt (2007) defined culture in relations of objective components (houses and tools) and subjective components such as societal norms, roles, dogmas, and principles. Further, argued that culture is a dynamic practice designed by an individual’s commitment within their social set-up. Pumariega, Rogers, and Rothe (2005) define culture as a way of life which includes traditions and customs. These customs transmitted through learning and play a vital role in molding the beliefs and behaviors of the people exposed to them. Generally, people in social groupings who share same religion, children and adolescents who play together and adults who work in same professions have their own cultural beliefs and practices. Culture is largely defined as a collective tradition or fixed dogmas, standards, and ethics. Culture frequently changes and is influenced both by the views of people and the burdens of their surroundings (Lopez & Guarnaccia, 2000). People are bound to their customs and traditions because they think that their ancestors have transferred these practices to them so these practices are to be preserved for their future generations.

Different cultures have different practices and beliefs regarding mental illnesses. In some cultures mental illness is thought to be the result of bad deeds and going against almighty Allah. In addition to that, a concept of bad evil entrance into the body is also found in few cultures. For the treatment of those mentally ill patients people incorporate religious/spiritual treatment. Sometimes religious treatment enhances coping mechanism of mentally ill patients but sometimes its themes may incorporate into religious delusions.

Mirza and Jenkins (2004) studied that the prevalence of anxiety and depressive disorders in Pakistan was 34% out of which 29-66% women were affected and 10-33% men were affected. Furthermore, the study also highlights the prevalence of pediatric mental disorders which was found to be 15.8% in Pakistan.Khan, Mahmood, Badshah, Ali, & Jamal, (2006) studied the prevalence of anxiety, depression and their associated factors on medical students in different institutions of Karachi (Jinnah Postgraduate Medical Center, Karachi, Departments of Medicine and Medical Students, Aga Khan University).Approximately 70% of students were suffering from anxiety and depression. Among 70% about 59% of the students were female and 43% students were Urdu speaking.

Now let’s talk about some causes and their outcomes in relation to culture and mental illness. It is obvious that cultural beliefs and traditional practices are the root cause of mental illnesses and mental disorders. Referring to the scenario, the cultural practices and beliefs of purity made the little girl isolated from the society. Living away from family once in a month makes the girl feel guilty and being an alien to her. Not having a bath till the menstruation period ends make the young girl to think of being untouchable and lowers self-esteem. Such kinds of practices can lead to social isolation or depression with many other mental health problems. Similarly many other traditional practices are found in our culture which influences our mental health such as gender based violence that can lead to depression, suicidal ideation, severe anxiety, low self esteem and stress. In addition, divorce, forced and early marriages, domestic violence, son preferences, concept of being virgin, duty to be obedient, polygamy and honor killing also impact our mental health. These cultural believes and practices are not bound to women only but had destroyed men’s mental well being too. The society expects men not to cry, not to hit against girls, or overreliance on others in solving personal problems (Encyclopedia of Domestic Violence, 2007). Furthermore, boys are taught that a real adult man must be strong, responsible to support his family and exhibits masculine characteristics such as audacious, daring, and willingness to face danger. Moreover, they are also taught towards whom, when and why they should use physical force and he is not supposed to fight women rather he is to come to her defense. Fulfilling societal expectation suppresses the biological responses of the body to any stimulus which ultimately creates psychological pressure in men. They may end up with psychological disorders such as aggression, anxiety, fear, stress, depression etc. It has been declared that aggression perpetrated towards women reflects extreme manifestations of dominant cultural values. Different scholars agree that beliefs about the masculinity roles of men are culturally constructed from birth. They learn from their traditional societal norms what they are expected to be (e.g., dominant, tough and violent) as well as what they are not expected to be (e.g., submissive, weak, calm) (Kite, 2001). These all socially constructed roles overwhelm the naturally constructed men and prohibit them not to go against the assigned roles which have restricted them to be brave and strong even if they had a great loss in their lives.“There are two major psychological responses by individuals when adjusting to loss: (1) the use of coping mechanisms; and (2) emotional reactions” (Herbert G. Lingren). Coping mechanisms operate to psychologically protect individuals and are used to reduce the level of anxiety they feel at a given moment. This allows them to better adjust to the loss and begin the grieving and healing process. Similarly, fear and anxiety are also emotional responses of loss. Unfortunately, our society has ban on the expression of these emotions for men. If un-intentionally these feelings are expressed by them, they are being bullied and stereotyped by the society.

In short, traditional beliefs and practices may lead to severe mental illnesses in both men and women. It is our responsibility to understand the reality and make others able to understand the situation clearly. We need to aware society about the harmful impacts of such responsibilities and together we can redefine societal values based on their healthy and unhealthy impacts. The awareness can be through media in the form of plays, documentaries, theatres, writings, poems and text books as a syllabus in schools, colleges and universities as well as in the holy places where people can be gathered easily.