Thursday, March 17, 2011

Why is it hard for Filipinos to seek counseling/psychotherapy?


Though there are a lot of emotional needs and struggles with anxiety within the culture, Filipinos tend to be resistant to the idea of seeking professional help for several reasons:
First of all, seeking help from a psychotherapist is more painful than the existing emotional and psychological pain that is privately experienced by the person (or the family caring for someone who is struggling). The stigma attached to seeking professional help by those who are struggling can sometimes cause more pain. Gossip is also very influential within the culture and going to a counselor would make one the focus of that gossip. The Filipino’s cultural values of shame “Hiya” and self-protection “Amor Propio” are two of the biggest factors preventing Filipinos from seeing a counselor or psychotherapist.
Secondly, individuality and individuation are not part of the Filipino psyche. Filipinos are group oriented people. They take their identity from the group and do not want to be seen as different, nor do they want to bring a bad reputation to the group and risk being ostracized. Within the culture the diagnosis of one person might easily be assumed to other members of his or her group. If a child is suffering with schizophrenia, it is not uncommon to hear others called the family a “schizophrenic family”. The diagnosis can also affect other family members, causing discrimination and stereotypes which would mean loss of opportunity. The brother of a lady who was getting married was diagnosed with schizophrenia. When the family of the fiancĂ© knew about it, they decided to cancel the wedding.

Third, the cultural expectation is looking for a magical touch. The vast majority of Filipinos are Roman Catholic and they seek healing through contact with religious relics and expect instantaneous healing. Many impoverished people spend all of their money to make pilgrimages to holy sites to obtain healing. Or they visit an Albularyo who mix some herbs and chant to dispense healing. In the same way, most people do not seek counseling until they are very desperate. Then they come expecting to be magically healed. A client expects to be given advice from the counselor and to come out of the counseling session with their problems solved. Psychotherapy does not really work this way.

The first meeting with a counselor is just intake and getting to know the client so they can set the goal for psychotherapy. It is not until at least the second session that they start to address the problem in a thorough way. When counseling requires more than two sessions, I notice that a number of clients will not follow through with the set appointment and may eventually drop out – unless they are still struggling with the same issue. Most of the time, when clients experience a little relief, they consider themselves healed. So instead of following through with the agreed treatment plan, they stop until problems recur. For example: I was treating a lady for panic disorder for 4 sessions. She stopped coming to counseling because she was no longer experiencing any panic attacks. But the treatment plan was based on Cognitive Behavioral Therapy and was supposed to last for 8 - 12 sessions. A year later she came back and told me that she was having panic attacks again. She asked me to see me for only two sessions, because she did not have time for counseling.