Cultural Perspectives on Trauma
Culture is a double-edged sword. Because of human beings' dependence on it, its loss becomes traumatic. The power of culture as a protector, integrator, and security system is evident in studies where the degree of cultural assimilation is a key variable. In these studies, individuals who were strongly identified with cultural values benefited from increased social support; culture buffered them from the impact, and even the occurrence, of traumatic events However, culture provides protection at a cost. Strong attachments to persons and lifestyles leads to a deeper sense of loss when the life of the culture is disrupted. When people adhere to a system and bond to the other individuals within it, the loss of those persons and the disintegration of the system become traumatic.
_ deVries, M.W., "Trauma in Cultural Perspective," in van der Kolk, B.A., McFarlane, A.C., Weisaeth, L., eds., Traumatic Stress, New York, NY, Guilford Press, 1996.
I. Understanding Cultural Diversity
A. A definition of culture
1. How is culture defined? Many people think as culture in terms of national identity or racial origin. The American Heritage Dictionary of the English Language offers a broader conception.
"The totality of socially transmitted behavior patterns, arts, beliefs, institutions, and all other products of human work and thought characteristic of a community or population."
2. Cultures are a means for sharing wisdom and skills that are necessary to the survival of the community, the individual and the community's view of humanity.
Culture appears to refer to the shared practices of groups that govern their relations to exploiting and defending a territory. Furthermore, cultures are defined by being transmissible not only within a group but across time and generations. Finally, they seem to serve to bond groups in a common purpose thereby providing protection not otherwise available to individuals in response to threats to survival.
_ Chemtob, C.M., "Posttraumatic Stress Disorder, Trauma, and Culture," International Review of Psychiatry, Volume 2, Chapter 11.
B. Our own cultural diversity
1. Today, the typical American has ties to more than one one culture. Our parents may be of different races or ethnicities. Our national heritages come from all over the world. While for some, English is a first language, for others English is a second or even a third learned language. There is a growing recognition that hearing, seeing, mobility, or mental impairments tend to result in different cultural characteristics. Religious affiliation shapes behavior, patterns, arts, beliefs, and attitudes. Sexual orientation creates bonds and distinctions that govern perceptions of the world. And even those who justly claim a narrow cultural heritage in terms of race, ethnicity, language, ability, religion, or gender are also products of shared cultures through the media and our interrelationships with others. So, when we eat out, as we do often, we often choose "ethnic" restaurants. When we listen to popular music, it is likely to be rock `n roll's amalgum of black and white "folk" music.
the fact that culture change through culture contact is now ubiquitous means that we have an opportunity to evaluate the extent to which people who are not embedded in intact and cohesive cultures are affected in respect to their resilience after catastrophic events. It is fast becoming the norm for people today to identify with multiple cultures. Such multiple identifications have the potential to affect the cohesion of the self by increasing the cognitive complexity required to integrate the much larger number of elements that are referenced by multiple cultures. Certainly, the growth of culturally diverse populations requires that one navigate cultural environments that can change rapidly and unpredictably. In itself, this increases life stress and may decrease the capacity of people to screen and moderate the impact of catastrophic events. In contrast to the predictability and continuity that culture imposes on our lives, including the prescription of rules for obtaining and maintaining social support, living within multicultural environments is a challenge.
_ Chemtob, C.M., "Posttraumatic Stress Disorder, Trauma, and Culture," International Review of Psychiatry, Volume 2, Chapter 11.
2. Whatever our cultural backgrounds, one thing seems true: cultural references and identity shape how we identify the threat of traumatic events, interpret them, and manifest our distress at them.
3. It is important for crisis responders to attempt to understand their own cultural identities, to begin to acknowledge beliefs, values and judgments they may have about others, and to recognize where similarities in cultural influences may enhance the ability to communicate with and understand others in the aftermath of trauma.
4. To assist intervenors in identifying their own and others' cultural mix, an exercise in constructing a cultural matrix can be helpful. The purpose of this exercise is to stimulate individuals in their efforts to see the connections between their own cultural backgrounds and beliefs as well as to consider how strongly various cultural influences affect their everyday life and values. The "Matrix" below is designed to help responders think through the development of a similar one for themselves.
a. Issues that help define culture identity include attitudes towards spirituality, birth, dress and other factors such as those listed in the left-hand column of the chart. As you look at the chart create your own questions about each category of attitudes and beliefs. The following questions are some that might arise when thinking about the categories outlined in the chart.
Birth: Is birth order significant? Is creating birth important?
Marriage: Is making a lifelong commitment through marriage important? Are marriages simple a matter of convenience or necessity? Should one consider marriage as an experiment or a commitment?
Death: Should death be consecrated or memorialized? Does it matter if someone remembers the dead? Is death an end to life or is it a beginning?
Gender: Is there a higher value in being male or being female? Are genders equally capable of doing the same tasks in life? Should there be designated roles for each gender?
Language/dialect: Does the ability to speak a language correctly matter? Is there a preferable language or dialect for communication?
Spirituality: Do you believe in God? Do people have everlasting spirits or souls?
Individualism: Do you believe that self-fulfillment is the greatest achievement? Should everyone be guaranteed the right to free speech?
Communitarianism: Is there ever an incident when an individual's needs should be sacrificed to the needs of others? Does the majority of a community have the right to dictate behaviors of individuals?
Ambition: Should people strive to live up to their potential?
Acquisitions: Is personal property important to you? Does the accumulation of property appeal to you?
Power: Is strength equivalent to power? Is power something to be sought after?
Wealth: Is being rich better than being poor? Is wealth based on material possessions?
Children: How many children should one have? Is it necessary to have children?
Elderly: Should old people be allowed to commit suicide if they want to? Are old people disposable?
Homosexuality: Should same sex couples be allowed to be married? Is homosexuality a crime against nature?
Dress: Does dress make a difference to you? Are there ways in which people might dress that would be offensive to you? Do you stereotype people based on their dress?
"Differentness": Are strangers welcome in your home? Are there customs or rituals that others observe that you find offensive?
Each set of questions or thoughts that are stimulated by these categories of attitudes, beliefs, and behaviors arise because of ideas formed through cultural orientations.
b. Sources of cultural orientation include race, ethnicity, nationality and religion, but also include such attributes as age, gender, language, sexual orientation, and other categories listed across the top of the matrix. For instance, a person in their eighties may find it offensive when an adolescent wears a miniskirt or shorts simply because in the elderly person's mind it is inappropriate for someone to show their thighs in public. Someone who had been poor and born into an uneducated family and now is wealthy and has a higher education may have different attitudes towards wealth and language because of their new cultural influences. A person who resides in Toledo may have different attitudes and beliefs about power than a person who resides in Washington, D.C.
c. Crisis intervenors are encouraged to use the matrix to identify important sources of cultural identity in their lives. Address the issues listed or others that may be important to you. Rate on a scale of one to ten the importance of each source of culture and how it has shaped the way you think about an issue. For instance, If your religion has contributed strongly to your belief that it is important to give birth and to have as many children as possible, put a "10" in the boxes connecting religion and children. If you believe that your income level has no affect on your beliefs in God, place a "0" in the box that connects income and spirituality. Finally, notice where you have high numbers in the various boxes. These numbers indicate the strength of certain cultural influences.
d. This matrix can be useful in three ways. First, service providers can use it to identify the key cultural influences in their own lives. Second, service providers can use the matrix to initially assess the cultural backgrounds of individual victims or groups they serve. Third, intervenors can use it as a guide to find significant commonalities between themselves and others in order to establish a basis of communication.
II. Cultural Narcissism as an Inhibitor to Understanding Other Cultures
A. The brain is narcissistic
The brain takes in only sensory perceptions _ what we see, hear, smell, or touch _ without narrative or interpretation until cognitive connections organize the perceptions and give them meaning. They are interpreted by social and environmental circumstances, and then become "reality." Reality is framed in the initial cognitive and emotional senses based on those circumstances. Intrusions in that reality must be approached cautiously _ buffered by social support _ but innocently until those intrusions bring danger.
Culture may in many ways be viewed as a protective and supportive system of values, lifestyles, and knowledge, the disruption of which will have a deleterious effect on its members. During social and cultural upheavals, drastic changes occur in people's expectations, `the meaning of life,' and communal values. Cultures, however, are powerfully resilient to the stresses of the environment and resistant to change. Culture thereby buffers its members from the potentially profound impact of stressful experiences. It does so by means of furnishing social support, providing identities in terms of norms and values, and supplying a shared vision of the future. Cultural stories, rituals, and legends highlighting the mastery of communal trauma, the relationship to the spiritual realm, and religion itself are important mechanisms that allow individuals to reorganize their often catastrophic reactions to losses. Culture, as a source of knowledge and information, locates experience in a historical context and forces continuity on discontinuous events.
_ deVries, M.W., "Trauma in Cultural Perspective," in van der Kolk, B.A., McFarlane, A.C. and Weisaeth, L., eds, Traumatic Stress.
B. Stranger caution
Caution around strangers develops naturally, and stranger aversion develops naturally as certain flora and fauna are identified as dangerous The single most powerful impediment to the study of cultural influences is ethnocentrism. People tend to assume that their experience of the world is the world. In a sense, this assumption confuses the cognitive map with
the world it depicts. This naive realism is reassuring to people as it confers on their world view a solidity that serves to increase their sense of psychological security.
It seems likely that ethnocentrism represents the vestiges of an ancient avoidance of strangers. Brown (1969) described this ancient pattern as it pertains to early Greece:
"In primitive Greece, as in other cultures where the basic unit of society is not the individual but the family or the clan, religious and social institutions were strongly affected by distrust of the stranger, the member of an alien family group. Intercourse with strangers was surrounded with magical safeguards: meetings occasioned magico-religious ceremonies; points of habitual contact were regarded as hallowed ground; natural or artificial boundaries, where the friendly world of one's own kindred ended and the inhospitable world of strangers began, could not be safely passed without the aid of ritual."
It is possible that this stranger avoidance is reflected in the developmental phase of stranger anxiety among children. Emergence from the cocoon of the familiar and safe can be aversive and frightening.
_ Chemtob, C.M., "Posttraumatic Stress Disorder, Trauma, and Culture," International Review of Psychiatry, Volume 2, Chapter 11.
C. Patterns for accommodating difference
1. Pre-exposure to difference may predispose reactions to difference, either negatively or positively, depending upon individual experience with encountering difference and social reaction to that difference.
2. Exposure to difference may either confirm or deny negative or positive responses.
3. Extraordinary responses may provoke zealot defensiveness or zealot conversion _ casual responses may allow for accommodations .
4. Cultures and individuals will eventually integrate responses into a pattern of meaning and a prototype for future actions.
5. Likelihood of defensiveness will be high based on pre-exposure conditioning due to the need for security and social resonance.
III. Culture Affects Philosophies of Life and of Trauma
Several conceptual schemes provide some insight into how different cultures may need different types of intervention or strategies for service delivery. Some are illustrated in the charts of the Axis of Control, the Axis of Conflict, and the Axis of Life. The following is a description of each of these tools of analysis.
A. The axis of control, below, describes the degree to which individuals feel in control of their lives, and the degree to which they may feel personal responsibility for what happens to them or their community. (This chart appears in Parsons' work, cited above.)
B. The axis of conflict, below, describes how people tend to react to conflict in their lives and the goals they seek in resolving it.
C. The axis of life, on the next page, attempts to illustrate different perspectives on life and death issues and whether individuals seek to resolve their concerns about life and death through commune with nature, God or technology.
D. Each perspective illustrated in these charts suggests differences in attitudes, philosophies, and values that one encounters when providing outreach and service to culturally diverse groups.
IV. Trauma and Culture
A. Basic concepts
1. Threats and trauma events are perceived as traumatic based on the individual's capacity to integrate such events into his or her experience _ cognitively and physiologically. This capacity is affected by the cultural context of the affected person. In the United States, most literature on trauma and appropriate intervention strategies is based on theoretical and philosophical paradigms drawn from a white, Anglo-Saxon, Judeo-Christian perspective in the United States. Yet it is clear that people with different cultural backgrounds _ including backgrounds not defined by race, ethnicity, nationality or religion _ may perceive trauma and appropriate treatment differently.
All ethnically focused clinical, sociological, anthropological, and experimental studies converge to one central conclusion regarding ethnic America: Ethnic identification is an irreducible entity, central to how persons organize experience, and to an understanding of the unique "cultural prism" they use in perception and evaluation of reality. Ethnicity is thus central to how the patient or client seeks assistance (help-seeking behavior), what he or she defines as a "problem," what he or she understands as the causes of psychological difficulties, and the unique, subjective experience of traumatic stress symptoms.
Ethnicity also shapes how the client views his or her symptoms, and the degree of hopefulness or pessimism towards recovery. Ethnic identification, additionally, determines the patient's attitudes toward his or her pain, expectations of the treatment, and what the client perceives as the best method of addressing the presenting difficulties.
_ Parsons, E.R., "Ethnicity and Traumatic Stress: The Intersecting Point in Psychotherapy," in Trauma and Its Wake, ed. Figley, C.R., Brunner/Mazel: New York, 1985.
2. The capacity for integration is expanded, developed and maintained in the context of social relations.
Regardless of the relative value a society places on individualism or conformity, there seems to be a universal tendency for people under threat to form very close attachments to other people or communities. Freud observed that the more terrifying the external threat, the stronger the allegiance to the group becomes; under extreme conditions, such as war, people may go so far as to sacrifice their own lives in order to assure survival of the group. Ernest Becker called the resulting deep sense of belonging the "taming of the terror." In analogy to Freud's notion that trauma results in rupture in the "membrane of the mind," Lindy and Titchener have called the social support that surrounds victims "the trauma membrane."
_ McFarlane, A.C. and van der Kolk, B.A., "Trauma and Its Challenge to Society," in Traumatic Stress.
3. Social relations through cultural composites may be defined explicitly or implicitly. Explicit manifestations include ideologies or laws. Implicit understandings are found in rituals, practices, and behaviors.
Cultures also create meaning systems that explain the causes of traumatic events. "Fatalistic" cultures believe that traumatic events have external causes that must be continually faced during life; causes and consequences do not disappear. Rituals and symbolic places are necessary to ratify and support group members during times of inevitable difficulty. Traditional cultures assign causation either to a god or gods, to others (witchcraft), or to ancestors (breaking of rituals or taboos). Such concepts of external causation have the social function of linking an individual's experience of illness and trauma directly to the larger society.
_ deVries, M.W., "Trauma in Cultural Perspective," in van der Kolk, B.A., McFarlane, A.C. and Weisreth, L., Traumatic Stress.
B. Impact of culture on trauma
If the threats to life associated with psychological trauma are universal, then what varies across cultures is the perception of what type of threat is traumatic, the interpretation of the threat's meaning, the nature of the expression (presentation) of symptoms in response to such threats, the cultural context of the responses of traumatized people, as well as the cultural responses by others to those who have been traumatized, and the culturally prescribed paths to recovery from experiencing life-threatening events. Finally, it is also useful to consider the process by which the exposure of individuals and groups to traumatic events is made useful for the entire culture.
_ Chemtob, C.M., "Posttraumatic Stress Disorder, Trauma, and Culture," International Review of Psychiatry, Volume 2, Chapter 11, 1997
1. Culture influences what type of threat is perceived as traumatic. A young woman in a Housing Authority apartment with her mother and five siblings wants a place of her own. Her knowledge and experience tell her the only way out is to have a child and thus qualify for her own apartment. She has derived that experience from a mother and grandmother who have spent their lives in public housing. Her definition of what is traumatic is different from others.
I'm not upset about the rape, if that's what you want to call it. It doesn't matter. All I care about is getting out of here. I thought they would make me pregnant and they didn't. I could kill them for that. If I had a baby, I could leave this place and get an apartment of my own.
_ Thirteen year old victim of a gang rape, NOVA Crisis Notes, Philadelphia, 1993.
Cultural filters on the perception of threat and how it is interpreted show up in many different ways:
For example, Carlson and Rosser-Hagan (1994) described a group of Cambodian refugees, nearly half of whom had been physically assaulted, 60% of whom
had a family member killed, and 86% of whom met the criteria for PTSD. Carlson and Rosser-Hagan were surprised to find that refugees rated food shortage more distressing than the death of a close relative.
2. Culture influences how individuals interpret the meaning of a traumatic event. In some cultures particular kinds of tragedy are a part of mythology and legend as well as daily life. If the potential of a traumatic event is integrated into cultural expectations, the occurrence of it may not be as distressful for survivors as for those who have not planned for the event. On the other hand, the prediction of disaster in the lore of a culture may cause some survivors to despair unless that prediction and their experience of its fulfillment is accompanied by a prediction of hope. Many cultures document reports of individuals who have a gift for "seeing" and reporting coming events of death or disaster. It is legendary among Celts, American Indians, Buddhist monks, Australian Aborigines, and other populations. What might be a trauma under other circumstances, may, in fact, be a comfort to an individual who "understands" the event.
A Maori woman once told me that she was crossing a stream on her return to her village (Waikane), after a short journey, when she saw in front of her a thin, trembling mist. In this midst she beheld the dim face of her father. This was broad daylight. The fog-wraith faded away, and weeping, she hurried home to her kainga, to find that her father _ whom she had left in perfect health only hours previously _ had suddenly died, about the very time the misty apparition had appeared to her.
_ Pomare, M., in collaboration with Cowan, J., Legends of the Maori, Southern Reprints: New Zealand, 1987.
3. Culture influences how individuals and communities express traumatic reactions. While reactions to trauma seem to be common throughout all cultures, having a common base in human physiology, manifestations of responses may differ significantly. It is emphasized that the dominant responses may vary and be labelled somewhat differently than responses in the primary cultural milieu of the United States, but that the symptoms are often similar to posttraumatic stress reactions.
In contrast to the universalistic perspective is the view that trauma responses vary from one ethnocultural group to another. Referred to by Simon and Hughes as "unfamiliar ways of being crazy," the so-called culture-bound syndromes (or "culture-originating affective-behavioral syndromes") are found in many countries. Ness described the "Old Hag" or "Ag Rog" syndromes in descendants of immigrants from the English West Country to Newfoundland: being awake but being unable to move and experiencing great exhaustion and fatigue. Hispanics, especially Mexicans, are known to suffer a condition called susto, or fright, which has been understood in the West as the equivalent of an "anxiety state." The Japanese psychoanalyst Yasuhiko Taketoma reintroduced the concept of Amae, a characterological state of passive-dependency, insecurity, and helplessness. China has itsshenjing shuairuo, a somatopsychic manifestation involving headaches, weakness, irritability, poor appetite, and concentration difficulties.
_ Parsons, E.R., "Post-Traumatic Ethnotherapy (P-TET): Processes in Assessment and Intervention in Aspects of Global Psychic Trauma," in Williams, M.B. and Sommers, J.F., Jr., eds., Handbook of Post-Traumatic Therapy, Greenwood Press: Connecticut, 1994
4. Culture forms a context through which traumatized individuals or communities view and judge their own responses. If people think that their society will not accept them as victims, they tend to withdraw and be silent. Worse, they may accept the group's view that people with those adverse reactions are themselves to blame.
Reason and objectivity are not the primary determinants of society's reactions to traumatized people. Rather society's reactions seem to be primarily conservative impulses in the service of maintaining the beliefs that the world is fundamentally just, that people can be in charge of their lives, and that bad things only happen to people who deserve them. Bearers of bad tidings are generally considered dangerous; thus, societies tend to be suspicious that victims will contaminate the social fabric, undermine self-reliance, consume social resources, and live off the strong. The weak are a liability, and, after an initial period of compassion, are vulnerable to being singled out as parasites and carriers of social malaise. Society can only make a commitment to victims if it accepts these two ideas: (1) that victims are not responsible for the fact that they were traumatized; and (2) that if victims are not helped to deal with the memories of their trauma, they will become violent or anxious people, unreliable and easily distracted workers, inattentive parents, and/or people who use drugs and alcohol to help them cope with unbearable feelings.
_ McFarlane, A.C. and van der Kolk, B.A., "Trauma and its Challenge to Society", in van der Kolk, B.A., McFarlane, A.C. and Weisaeth, L., eds., Traumatic Stress.
5. Culture may affect the response of the immediately traumatized. This is a critical issue for many people who are victims. Their own culture or the culture in which they exist may reject or stigmatize them. Holocaust survivors faced accusations of apathy, compliance, acquiescence, and even blame for their survival. Viet Nam war veterans were cursed for their participation in the war. At times, that social blaming is perceived as an additional injury. At times, for some survivors, it may be a rally call to consolidate their grief and trauma and begin again. It may also reflect the trauma of the "non-traumatized" _ those who wish to deny participation or involvement in the events of the world but realize that their denial is a self-condemnation.
Traumatic events do not exist in a vacuum. Like other social phenomena, they should be understood within the social and cultural context in which they occur. It seems that society reactions toward Vietnam's returning veterans had undoubtedly been affected by the strong objections toward that war. In the same manner, the attitudes of society toward survivors who reached Palestine after the war may be understood in light of historical and cultural process that took place in preceding years. The glue which was to join the Jewish settlers into a cohesive community was a common identity and a common goal: to become New Jews. In the period between the two world wars, the heroic figure of the `New Jew' was portrayed in stark contrast to that of the Diaspora Jew, the identity that they were desperately trying to shed. The Diaspora Jew was seen as a debased, weak, cringing, conniving soul, a despicable character whose personality had been distorted by centuries of persecution, while the New Jews were to be free people living in their own country _ tall, proud, just, and strong. According to the historian and Holocaust survivor, Saul Friedlander, the ethos of the New Jew led to a repudiation of the diaspora which bordered on contempt. This ideology, which preexisted the Holocaust, gave birth to the patronizing and disdainful attitudes toward Holocaust survivors." _ Solomon, Z., "From Denial to Recognition: Attitudes Toward Holocaust Survivors from World War II to the Present," Journal of Traumatic Stress Studies, April, 1995.
6. Cultures may help to define healthy pathways to new lives after trauma. The routines and traditions of the culture may aid survivors of a tragedy in feeling reoriented. This is particularly true when cultures have formalized ways of reentry after a traumatic event, or when cultures have a means of integrating an individual's trauma story with the mythology of the culture. Cultures have a way of rendering life predictable. They set the parameters of action. When they fail due to a traumatic event, then their members are more vulnerable. Yet by the same token, cultures that respond to a particular disaster with a survival ethos are likely to carry with them many members who might otherwise collapse. The defiance or despair of a given culture's reaction to trauma will certainly influence the fate of its most commited members.
When cultural protection and security fail, the individual's problems are proportional to the cultural disintegration. The avenues of vulnerability resulting from trauma follow the routes vacated by culture. Paranoia substitutes for trust; aggression replaces nurturance and support; identity confusion or a negative identity substitutes for a positive identity. Social bonding becomes a regression to nationalism and tribalism, thereby permitting individuals to deny the experienced losses or to defend themselves against expected additional losses. Compounding these problems in most areas of the world is that at times of cultural disintegration, the population is often physically depleted and fatigued as well. For example, the citizens of Bosnia, Somalia, and Rwanda are both physically and psychologically traumatized. These psychological and physical consequences will strongly affect their lifestyles and mental states in the future, even if the norms and values of their given cultures are reinstated. Yet, paradoxically, the members of a culture will always (or most often) rebuild on a templar or remanent of cultural customs and values.
_ deVries, M.W., "Trauma in Cultural Perspective," in van der Kolk, B.A., McFarlane, A.C., and Weisaeth, L., eds., Traumatic Stress.
C. Trauma and culture are particularly complicated today
1. Multiple identifies impose more cognitive complexity for negotiating the environment. Many immigrants to the United States face the demands of negotiating between two cultures, as do people in the United States who have been born in rural cultures and then enter urban cultures. However, in today's world, those cultures are more diverse. An American Catholic Indian raised in an isolated portion of a South Dakota reservation may be exposed through television and radio to experiences that seem unreal, and then may move to New York City to pursue educational or career opportunities. The vastness of possibilities are endless. Gertrude Bonnin (Zitkala-Sa), a Sioux woman who lived from 1876 until 1938, articulated many of these challenges in her efforts to bridge the gap between traditions of her own society and assimilation in other societies.
She spent her life in balance between two worlds, using the language of one to translate the needs of another. She was in a truly liminal position, always on the threshold of two worlds but never fully entering either.
_ Fisher, D., "Foreword," American Indian Stories, Zitkala-Sa, University of Nebraska Press: Lincoln and London, 1985
2. There is an increase in life stress and a decrease in the capacity to screen and moderate the impact of catastrophic event.
It seemed so impossible to live. I needed to help my children, to make sure that they went back to school. I needed to write letters at work. I needed to buy groceries and fix the car. I needed to find a place to live. I needed to be able to communicate with people in another language. I needed to find a private place to bathe. The most important thing was to find someplace warm to gather my family so that we could be together. But, it all seemed impossible. Problems rained down and no answers to go with them.
_ Survivor of the Kobe earthquake, NOVA Crisis Response Report, February, 1995.
3. Cultural traumas are transmissible across time and generations _ as a bond for survival.
The resolution of a traumatic experience requires considerable investment by individuals in the processes of assimilation and accommodation. Similarly,
cultural groups are challenged to make sense of traumatic experiences. Among the most primitive functions of trauma in a cultural context is to provide information about the world through harm to one or many individuals for the benefit of the group. For example, the warrior who survived a battle, at considerable personal cost to himself, can transmit information about the enemy's battle dispositions that may benefit the group in later encounters. Similarly, the cost incurred by a warrior is a potent lesson about the direct costs of war, which can act to regulate the likelihood (probability) of future conflicts. Such information transfer, both latent and explicit, serves to increase the fitness of the group. Furthermore, as societies evolve, the mechanisms of information diffusion may change, the symbolic abstraction may increasingly become detached from direct communication, but the basic nature of the fundamental messages do not change.
V. Action Planning for Working in a Cross-Cultural Perspective
All cross-cultural encounters are potential learning experiences. They may result in the discovery of new information or in an enhanced understanding of something not fully appreciated before. Systematic learning depends on whether the worker-as-health-provider is willing to adopt the role of worker-as-learner.
_ Green, J., Cultural Awareness in the Human Services, Prentice Hall, 1982.
Prior to cross-cultural work, education is needed on differences about a culture's routines, traditions and impact of family relationships. Be prepared to accommodate and integrate such cultural standards into crisis and counseling work. Attention should be paid to the following issues.
1. Geography, climate and environment.
Environment affects interpretations of trauma, individuals' interpretation of their experience, and their pathways to new lives. Someone born and raised in the desert does not find as much comfort in an environment of mountains and trees as someone who was born in the mountains. Someone who is used to seasons of extreme cold and rainy weather may accept the catastrophes related to cold and rain better than someone who has been used to a hot, dry environment. Plant and animal life contribute to cultural interpretations of the world. Beliefs based on nature are apparent in all cultures.
At the beginning of time a buffalo was placed in the west in order to hold back the waters. Every year the buffalo loses one hair, and every age he loses one leg. When all his hair and all his legs are gone, the waters will rush in and the cycle will end. It is believed that the buffalo currently stands on one leg and is very nearly bald.
_ Brown, J.E., The Sacred Pipe, Penguin Books: Baltimore, 1971.
2. History of a culture.
Every culture carries with it a history of trauma. Irish-Catholic-Americans have cultural memories of the Irish potato famine, persecution because of their religion in the late 1800s, and discrimination after immigration because of their religion and poverty. Palestinians have cultural memories of being displaced from their homeland and of persecution and discrimination. African-Americans have cultural memories of slavery and persecution. Refugees from Central America have cultural memories of victimization due to abuses of power. Cambodians have cultural memories of the killing fields. Armenians have cultural memories of genocide. Jewish people have cultural memories of the Holocaust. These memories and histories are important in understanding the traumatic events of today. But histories also bring hope and coping skills. The Maoris inhabited New Zealand before the years of war with European immigrants, but for all their traumas, continue to exhibit cultural strengths.
The culture of every nation, it has been said, must arise out of its background. The Maori life and traditions, the response of the Maori race to its very beautiful and wonderful environment, supply that distinctive background in New Zealand. Here is a people with a culture possessing many features different from those evolved by any other primitive race, a people with remarkably original sense of artistic values in decoration and craftsmanship. A people of keen intellect who had the creative faculty very highly developed and who have given the world a literature rich in poetic fancy.
_ Pomare, M. and Cowan, J., Legends of the Maori, Southern Reprints: New Zealand, 1987.
3. Language of culture.
I have been satisfied that traditional perspectives on justice flow out of traditional understandings that the languages themselves contain if you can only speak of justice in one way, you cannot be expected to do justice in any other way.
_ Ross, R., Return to the Teachings _ Exploring Aboriginal Justice, Penguin Books, Toronto: Canada, 1996.
Language differences and patterns among diverse cultures are common and complicated. One can learn Spanish, French, English or Russian but not understand the synthesis of verbs, nouns, adjectives, adverbs and phrases that result in common understandings among those who are a part of the culture. Some languages have multiple nouns for the designation of the sun. Others have various phrases that signify beauty. Languages dictate how one forms ideas, translates sensory perceptions, and interprets the world. The phrasing, silences, speed of delivery, and pitch or tone of voice, even when using the same word or phrase, mean different things to different people. These nuances assist in constructing language and dialect. Crisis intervenors need to be aware of such differences even if they are not able to speak the language.
Training is needed for speaking through an interpreter. Interpreters or translators contribute to the ambiance of any crisis setting. They become the interpreters not only of the survivor but also of the intervenor. In some cultures it may be appropriate for them to translate with additional flair. In other cultures such interpretation may be offensive. It is wise for crisis intervenors to try to train translators in elementary crisis intervention, if possible. It is also important to work with translators after they have interpreted so that they are not vicariously traumatized.
4. Routines and rituals of culture
Eating and sleeping patterns, spiritual practices and beliefs, dress, and social behaviors are a part of cultural integration. Some cultures care about the hours of awakening or going to sleep. Some focus on types of foods and their preparation, while others care about day-to-day to routines. Some cultures are based upon spiritual beliefs, and designate the type of dress and adornments to wear. Crisis intervenors should try to understand different rituals and routines and to accommodate cultural mandates when they are present in different social environments.
We learned not to visit a center between 12 and 2:00 p.m. because lunch was very important. In fact, for the refugees lunch was dinner. If we came at that time they would think they had to share their food. There was no doubt that they would share it _ they believed in making everyone welcome and at home _ but being there at that time meant that they would not have enough to eat.
_ NOVA Crisis Response Reports, Bosnia, February, 1995.
B. Entrance to a different culture
1. Establish a basis for caregiving through relationships established before a disaster, if possible.
The fact that NOVA had a relationship with people in Japan before the earthquake was important in the arrangements of the crisis response team efforts in the earthquake's aftermath.
2. Respond to tangible needs.
In the 1997 floods in Fargo, North Dakota, the town was most interested in help to reconstruct their homes and businesses, and how they could attend to building dikes. Their concerns in the middle of disaster were focused on everyday needs.
3. Identify a friend or colleague who is a respected insider in the culture and who can help make connections with that culture.
This may be a long time friend or a colleague who recognizes the potential impact of the tragedy. In the aftermath of the Edmond, Oklahoma, tragedy in which 14 people were killed, it was Michael Turpen who called to ask for help. He had been affiliated with the victims' movement and was the Attorney General of the state of Oklahoma at that time _ a recognized leader and "one of us" among the affected victims.
In the aftermath of the serial murders committed by Jeffrey Dahmer in Milwaukee, Wisconsin, the intervention of a gay man was useful in establishing connections with the homosexual community, a number of whose members had been Dahmer's prey.
When NOVA provided services to the Chicago Housing Authority, it was helpful to have preexisting connections with officials and residents of that agency prior to arrival.
C. Convey respect and good will
No matter what the preconditions to introduction to other cultures, caregivers should always convey respect and goodwill. Respect and professional courtesy are particularly important when dealing with people who have negative views of caregivers.
1. Say hello and request the opportunity to talk with people.
2. Acknowledge differences and apologize for discrepancies between your behaviors and those of the people with whom you are talking.
3. Be aware of your own cultural biases and try to be non-judgmental.
4. Always say please and thank-you when appropriate; always request permission to do things.
1. Orientation to caregiving interventions
a. Participate in access rituals, which often involve ceremony, food, and expressions of goodwill.
b. Explain purpose of intervention and the need for reciprocal questions. Many cultures find questions intrusive. Yet for the caregiver, they may be essential in the establishment of understanding. Some cultures resist questions because they protect themselves through a "healthy paranoia" concerning the questioner. However, questions and answers are often the only way to clarify differences in language, customs, and unconscious behaviors.
c. Express an appreciation for the culture's strengths in coping with trauma. Every culture has means to deal with trauma and can explain those means. Their understanding of trauma and its implications is inherent in their eventual integration of tragedy into their lives.
d. Express a willingness to learn about the ethnic group involved. One method to convey this is to ask "If I were a victim of this trauma, how would you expect me to deal with it?" The answer may provide cultural insight and lead to a question about how they might think others in their own culture might deal with the trauma.
e. Acknowledge your limitations and differences. These may include the inability to speak or understand the language, confusion over certain customs or rituals, or spiritual understandings.
f. Establish your competence in understanding trauma's impact whether or not you understand the cultural context of the event.
2. Practical problems
a. Build trust.
b. Deal with immediate environmental problems such as financial loss, secure shelter, family conflict and the like that group members are having difficulty handling.
c. Assist the survivors or victims with financial resources or compensation, if possible.
d. Help the survivors focus on something tangible that they can accomplish in the next few days.
3. Crisis intervention with cultural focus.
a. Be aware of culturally-specific communication techniques, such as the use (or avoidance) of eye contact, the integration of food and drink in discussions, the pace of conversation, body language, and so forth.
b. Ask survivors if their families should be present during discussions or if they would like to have clergy members present.
c. Openly acknowledge your limitations with language or other communication concerns, and ask the survivors to tell you if you say something wrong or do something offensive.
d. Ask survivors to tell their story and talk to them about the crisis reaction.
e. Ask survivors to describe what they would like you to do to help them and then tell them truthfully what you can and cannot do.
f. Search for the meaning of suffering and pain relevant to the cultural group involved.
g. Search for the meaning of death in the culture.
h. Search for the meaning of life.
i. Ask survivors if they would like to go to a place of worship or if there are any ceremonies or rituals that are particularly directed at crisis in their culture.
j. Useful cross-cultural interventions include: reduction of isolation, relaxation techniques, education about crisis and trauma reactions, reframing the crisis in culturally-relevant terms, helping individuals develop control, and increasing self-esteem and self-regulation.
k. Leave information in the primary language of the culture.
VI. Hints for Helping
A. Dress appropriately.
Men should wear suits and women should wear dresses in most cultures. In the aftermath of tragedy, these forms of dress may not be available. Nevertheless, an outside team of crisis responders may convey their respect by dressing appropriately.
B. Establish commonality with survivors through access rituals and mutual interests.
Eat and drink what is offered. Ask about family, friends, pets, plants, and loved ones.
C. Search for linguistic equivalency even if you do not know the language of the culture.
D. Greet and say good-bye to survivors in their own language.
E. Allow survivors to direct you through cultural protocols and follow their direction.
F. Participate in defined rituals, as allowed or requested.
G. Apologize when you do something wrong.
H. Clearly define your objectives and make reference to other situations similar to this in which you were helpful. Remember, this is different than working in a familiar culture.
I. Find out, and use, appropriate body language.
J. Bring a gift of commemoration.
K. Be aware of spiritual beliefs in the culture.
L. Ensure that written communications are either in the appropriate language or are linguistically and structurally correct to facilitate translation.
VII. Different Ethnic and Cultural Contexts
The purpose of this section is to highlight some of the different ethnic and cultural environments that crisis responders may encounter after a disaster. It is not a definitive description of various cultures. It is included to stimulate thought, debate, and learning between participants and instructors. Three things should be noted.
The observations are drawn from NOVA staff and volunteers who have worked with disaster survivors and who live in a multicultural environment. NOVA welcomes additional comments for future editions of the manual.
Crime victimization is often more prevalent within minority populations than between the dominant population group and minorities. Therefore, crime victimization is included as a context for understanding cultural environments. While minority group members suffer victimization, they often also become victims of the system when accused of crimes.
The population characteristics, historical experiences, and values of four major cultural groups _ American Indians, Asian Americans, African Americans, and Hispanic/Latino Americans _ are provided in sketch form. Participants may want to look at the lists and add their own observations.
A. Native Americans/American Indians
(Drawn from "Cultural Aspects of Working with American Indian Youth" in Indian Child Welfare Digest Model Practice Approaches, August-September, 1989, a publication of Three Feathers Associates; and Counseling the Culturally Different, Theory and Practice, 2nd ed., D.W. Sue and D. Sue, John Wiley & Sons: New York, 1990.)
1. Population characteristics:
a. This may be the fastest growing population in the nation.
b. The population is youthful with 50% being 17 years and younger.
c. One fifth of all families have a single parent as head of household.
d. The crime rate is not well measured, but Native Americans serving victims on reservations report that it is very high. Domestic violence, child abuse, and assault are often unreported.
e. Many Native Americans living on reservations live in physical isolation from other cultures. They may also live in rural areas where they are isolated from access to the traditional American justice systems.
f. For many years, there have been limited employment and educational opportunities for Native Americans.
g. There are 530 distinct Native American tribes, of which 478 are recognized by the U.S. Government and 280 have a land base. Value systems are often similar between tribes, but rituals and traditions differ greatly.
h. 50% of Native Americans live on reservations. Some people have suggested that the Native American population living outside a reservation tends to assimilate more than any other minority in the United States.
2. Historical experience in the United States:
a. Racism and extermination. Only 10% of the original number of the American Indian population was alive by the end of the eighteenth century. Certain tribes, such as the Yosemites in California, were completely obliterated. Others, like the Nez Perce, were driven out of the United States (although descendents of that tribe remain).
b. Factors contributing to the population reduction were infectious diseases, government policies of eradication and forced migration, and the establishment of reservations. The Cherokee migration on the "Trail of Tears," from Georgia and the Carolinas to Oklahoma, was one of the most documented.
c. Policies that forced American Indians to be educated in English-speaking boarding schools separated children from their culture.
d. Federal statutes have replaced tribal customs as the primary legal grounds for defining who is identified as an American Indian/Native American.
3. Values of culture:
c. Noninterference with others.
d. Time orientation is toward the present not the future.
e. Extended family relationships have priority over nuclear family.
f. Harmony with nature.
g. Life is inextricably intertwined with other life and the world. God(s) or spirits control destiny but can be appealed to. Therefore, behavior in this world is important.
4. Analysis of "assimilation" in the context of the continuum of cultural influences. (This analysis is drawn from the work of Three Feathers Association cited above. It could be used with any culture by analyzing the variables for the "stages" and noting their manifestations.):
a. Traditional: Individuals maintain language, cultural traditions and perform Indian dances. They are not likely to be influenced by non-Indian forces. Humor and hospitality are valued. Individuals usually marry within the tribe or follow clan or tribal guidelines. They have personal control of emotions and aggression, self-acceptance and acceptance of others. They demonstrate quiet autonomy.
b. Traditional Adaptive: Individuals maintain a strong affiliation with tribe. They follow the Indian life-style. They speak or understand tribal language. Individuals participate in tribal customs and traditions. They may practice non-tribal religious beliefs. They are more likely to accept interracial marriages. They have developed "coping skills" in dealing with non-Indian standards.
c. Contemporary: Individuals have no firm identity with either Indian or non-Indians worlds. They may exhibit "generic" Indian attributes. They probably associate with others who are Contemporaries or Traditional Adaptives. They are more likely to have been educated by non-Indian standards than those who are Traditional or Traditional Adaptive. Individuals may participate in Indian social, political and athletic organizations which are used to further establish their identity. They tend to develop stronger tribal orientations as they grow older.
d. Contemporary Adaptive: Individuals do not usually carry "Indian" identity, but may be recognizable as Indian by non-Indian society. They are usually multicultural and of multiracial hertiage. They may practice Christianity or other religions. They have social contacts with non-Indian communities. They may claim to be Indian when social or other benefits may be obtained, e.g., college schlorships. They often have parents or relatives who are Contemporaries. Extended family relationships are infrequently maintained.
e. Assimilated: These individuals may be found throughout mainstream non-Indian society. They are not usually recognized as Indian. They normally do not live within or associate with Indian communities. Their personal values and beliefs are developed from a non-Indian perspective. They may be considered a "lost Indian" or a "successful Indian" depending on the speaker's point of view.
B. Asian Americans
(The following material is drawn from Color of Justice, by Brian Ogawa, Office for Criminal Justice Planning: Sacramento, California, 1990, and Counseling the Culturally Different, Theory and Practice, 2nd ed., D.W. Sue and D. Sue, John Wiley & Sons: New York, 1990.)
1. Population characteristics:
a. In 1985, there were approximately 5 million Asian Americans in the United States. That figure is expected to double over the next 10-20 years.
b. While Japanese Americans have been the largest group for many years, Chinese Americans are now predominant. Demographers predict that Filipino Americans will be the largest group within the next 30 years. While some communities have experienced the impact of relatively large numbers of people immigrating from Southeast Asia, the effect of that immigration is still to be assessed.
c. Except for Japanese Americans, the Asian populations are now principally foreign born.
d. There are at least 29 distinct subgroups among Asian American population, and these differ in language, religion, and values.
e. There is little data on the rates of crime victimization among Asian Americans. It is expected that much crime goes unreported because of fear of reprisal. The Bureau of Justice Statistics does not break out statistics on victimization of Asian populations in a useful way for crisis responders.
2. Historical experiences in the United States:
a. Racism towards Asian Americans was initially apparent in the indentured servitude among the first Chinese immigrants and the animosity towards their immigration characterized by the media denomination _ "The Yellow Peril."
b. The Japanese bombing of Pearl Harbor and the ensuing war was used as a reason to intern 110,000 Americans who had immigrated from Japan or were born in the United States of Japanese parents.
c. Issues concerning Asian Americans were made more complex by the Vietnam War. Some 700,000 refugees have arrived in the United States since 1975. The majority are Vietnamese (66.6%); the others are Khmer (20.5%), Laotian (13.5%), and Hmong (7.8%).
3. Values of culture:
a. Focus on interdependence and community.
b. Values favor discreetness, and non-imposition of feelings upon others.
c. Harmony with nature.
d. Reference to cosmic forces.
e. May view world situation fatalistically but rely upon God(s) or ancestors for assistance in coping.
C. Black or African Americans
1. Population characteristics:
a. The black/African American population is estimated at over 23 million people; the vast majority are descendents of slaves brought into the U.S., though some are voluntary immigrants from Africa, the Carribean, and Latin America.
b. 86% live in cities or in census tracts that have over 50% or more black/African American populations.
c. Crime victimization rate is highest of all ethnic groups and the majority of crime is perpetrated by other members of the same population. The highest cause of death among young black males is homicide. 42% of the prison population is black/African American males. This population may be overrepresented by such offenders due to the impact of racism.
d. 35% of black families live below the poverty level; 40% are in the middle economic class, and 10% of black families are members of the upper economic class.
2. Historical experiences in the United States:
a. Slavery and racism: This is the unique subpopulation of Americans based on migratory history. For most African Americans, their ancestors were a part of the only population that arrived on this continent as enslaved immigrants. Some whites arrived as indentured servants. Many Native Americans were taken as slaves in their own land. But the impact of the importation of slaves from Africa continues to affect the culture of black America.
b. Disconnection of families: because of slavery, African American families were often torn apart. A marriage could be broken up at the will of the slave owner. Children might be taken from their parents and sold. For many African Americans family unification and values are a priority. To some extent these values have been preserved through matriarchy.
c. Color has been a defining issue. "African American" is only a recent self-description of this specific ethnic population. True, color has been used with others to give demeaning racial labels _ "Red Indians" or "Redskins," and "The Yellow Peril" are examples. But African Americans alone were for centuries officially described by color _ "Negro" _ the Portugese word for black _ while the hateful perjorative "Nigger" was the common term used among the majority population. Beginning in the Civil Rights revolution in the 1960s, many African Americans replaced the "Negro" euphamism with "black," a descriptor they used with pride.
d. By the end of the 1990s, many blacks chose to call themselves African Americans as a neutral descriptor, like German American. As this is written, both "black" and "African American" are deemed terms of respect by the millions who apply them to themselves _ finally being addressed on their own terms, and in their own terms.
3. Values of culture:
a. Time orientation is towards the future.
b. Belief in duty.
c. Religion is a source of strength _ primarily Christian beliefs but these are often supplemented by belief in spiritualism. (See below concerning the "afterlife" beliefs about death.) A growing number are adherents to various Muslim sects.
d. Family connections, with special respect for mother figures, are important.
e. Distrust of system. Other ethnic groups may believe in the justice system, but there is a traditional distrust of the judicial system by many African Americans because of the history of slavery in the United States.
f. Stress between black middle class and black poor. There seems to be a distressed relationship between African Americans who have become successful and those who feel trapped in their circumstances of poverty and hopelessness _ a reflection that the black middle and upper classes have been growing at historic rates, but that the circumstances for the large black underclass have been growing worse.
D. Hispanic/Latino Americans
1. Population characteristics:
a. Population of about 14.6 million.
b. About 9 million are of Mexican descent, 3 million are from Puerto Rico, 1 million are Cuban, and the rest are from other Latin-American countries.
c. Terms of self-identification are not uniformly accepted. Many prefer "Hispanic" to the exclusion of the Spanish "Latino," and many are of the opposite view, while most treat either descriptor as respectful. A minority of those of Mexican descent speak of themselves as "Chicano."
c. The Hispanic/Latino population is greatly underestimated due to the number of undocumented aliens. It is estimated that the Hispanic/Latino population will be the largest minority population in the U.S. by 2030.
d. Hispanic/Latino Americans suffer a higher robbery rate than other population groups, and there is evidence that Hispanic/Latino males suffered the highest rate of violent crime of demographic groups analyzed by the National Crime Survey.
e. The population is very young and most households include more than four people.
f. The population is very religious and most are Roman Catholic.
2. Historical experiences in the United States:
a. Racism complicated by perceptions of migrant farm laborers and illegal immigrants.
b. Mexico and the United States were at war in determining boundaries in the defining stages of both nations. South America and the United States have also had a tense and conflict-related history.
c. Like European immigrants of the 19th century, Hispanic immigrants of this century, both legal and undocumented, have faced extreme poverty and exploitation.
d. Many of the recently migrating populations have experienced abuse in their homelands because of political oppression. Many of the nations from which these populations migrate have experienced long histories of political turmoil.
e. Many immigrating or first generation Hispanics/Latinos speak little or no English. There is often conflict in communities over whether Spanish should be an official second language.
3. Values of culture:
a. Time orientation tends to be present and past.
b. Strong extended family relationships. Family may include "comadres" and "compadres" _ honorary parent figures who may not be biologically related. Family and community is built on a patriarchal structure.
c. Harmony with nature.
d. Fate is determined by God. But one is responsible to God for how one responds to fate.
e. Deeply religious in everyday life but belief in God may coexist with belief in a spirit world.
f. Sacrifice in this life may be perceived to lead to salvation in the next.
g. It is important to adhere to rules defined by culture.
VIII. Cultural Observances Concerning Death
A. Ethnic-specific characteristics
1. African Americans have traditions concerning death that draw from many different ethnic and religious backgrounds. There are many different religious faiths in black America and many diverse races. Hence, like white Americans, any particular family may draw from a number of different cultural backgrounds. Some common patterns include:
a. High involvement of a funeral director in preparations for mourning and for burial.
b. A gathering of friends and members of the family at the home of the deceased to offer support to the living and to share their grief.
c. A wake in which music is played or songs are sung. Some African Americans hold a worship service known as a "Home-Going" service. It usually reflects the personality of the deceased and celebrates the conviction of going home to Jesus and being reunited with relatives and friends.
d. A shared meal among grieving loved ones after the wake and funeral.
e. A funeral service followed by a burial. Cremation is less accepted in the black community than in some other cultures.
f. A deep religious faith and integration of church observances.
g. Memorial services and commemorative gifts.
h. Many in black communities mourn by dressing in white as a sign of resurrection and celebrate with music and hope.
i. African Americans often express grief at death with great emotion.
j. Some African Americans believe in the concept of the "living dead," people who have died but whose spirits live on in the memories and thoughts of those still living. These people are the ones who will help others who die move to the next world.
2. Hispanic populations also have cultural backgrounds as diverse as the many countries from which they come. Most but not all practice the Roman Catholic faith. Common patterns in the aftermath of death are:
a. High involvement of the priest in funeral plans.
b. Family and friends are encouraged to be a part of the commemoration.
c. The rosary is said by surviving loved ones, often at the home of the deceased. Among some Hispanic groups the rosary is said each night for nine nights after death. Some families say the rosary every month for a year after death and then repeat it on each anniversary.
d. Catholic funeral services include a Mass. Loved ones are encouraged to express grief and many are involved in the procession to the grave.
e. Many Hispanic survivors commemorate the loss of their loved ones with promises or commitments. These promises are taken very seriously and those who fail to honor them are considered sinners.
f. Money gifts to help cover the expense of the funeral and burial are not unusual.
3. American Indian observances also vary considerably in their traditions, religions, and rituals. But there is a strong commonality among many tribes that centers on the natural world _ the earth, the animals, the trees, the natural spirit. Even among those who have been converted to Christianity, there is an emphasis on the reunion with nature that occurs with death.
a. The medicine man, shaman, or spiritual leader usually moderates the funeral or death service. It may or may not follow a particular order since each individual is unique. In some tribes or clans burial is not traditional; hence, there may be resistance to laws that require burial or cremation of the body.
b. Some tribes call on their ancestors to come to join the deceased and, in effect, help in his or her transition.
c. Most Indian cultures are not concerned about preserving the body and so embalming is not common. However, dismemberment and mutilation outside the natural deterioration of the body is taboo.
d. There is a belief that the spirit of the person never dies and so sometimes sentimental things and gifts are buried with the deceased as a symbolic gesture that the person still lives. The spirit of the person may be associated with a particular facet of nature _ animal, bird, plant, water, and so forth. Symbols of such spirits may be a part of the ritual in the death ceremony.
e. It is important to ensure that the burial of the person takes place in their native homeland so that they may join their ancestors and inhabit the land to which their loved ones will also return.
f. In some tribal cultures, pipes are smoked at the grave sites.
g. In some, there is significance to burying people with symbolic reference to a circle.
h. In some tribal cultures there is significance in non-burial, allowing the deceased to pass on to the other world in a natural way.
4. Asian Americans may follow Buddhist, Confucian, or Taoist practices regarding death with some elements of Christian traditions. Common practices include:
a. A family gathering at the funeral home to make arrangements with the family elders assuming ultimate responsibility for the ceremony.
b. There is great respect for the body. Warm clothes may be used for burial and watertight caskets are used to keep the elements out.
c. Stoic attitudes are common and depression may result from the internalization of grief.
d. An open casket allows for respect to elders and often poems in calligraphy are left for the deceased. Among Chinese Americans, a cooked chicken may be placed by the casket as a last meal for the deceased and spirits. The chicken will be buried with the body.
e. Music is often used _ a band may wait outside the funeral home and accompany the procession to the cemetery.
f. The funeral route is important.
g. The burial plot's location is very important, as is the choice of the monument. Incense may be burned at the grave. Among some Asian American populations, sacrifices may be made at the funeral.
h. A gathering of family and friends for a meal after the funeral shows respect for the spirit of the deceased and thanks those who came to pay their respect.
i. A picture or plaque is usually kept in the home and displayed with items that create a shrine.
j. Forty-nine days after death is important to more traditional Chinese families. Incense will be burned and other traditions of commemoration observed. Twice a year, either at the grave or at the home shrine, a ceremony is observed.
k. Among some Southeast Asian populations, blue is the color of mourning.
B. Religious observances of death
1. The role of religion is important for most victims/survivors because their answers to religious questions form their view of life, death, and meaning.
2. Many people do not know their position on religion until disaster strikes, and then their religious faith and beliefs are formed.
3. Some religions give individuals more power over life than others. Some religions give collections of individuals power over life. Some religions give spirits more power over life than the living. Some give free will. Some give fatalism. Whatever, all have defined ways of dealing with death.
4. Some religious differences.
a. Jewish observances
i. All customs are designed to treat the body with respect, so autopsies and embalmings are generally prohibited. Viewing the corpse is also considered disrespectful.
ii. The emotional needs of the survivors are very important.
iii. There is variance among Reform, Conservative, and Orthodox Jewish practices.
iv. No funeral is allowed on Saturday (the Sabbath) or on major religious holidays.
v. Music and flowers are not encouraged.
vi. Eulogies are given by rabbis and family and friends. When the deceased person is held in high regard, there are usually several eulogies.
vii. Family members and others accompany the casket to the grave and family members are encouraged to place a shovel of earth on the casket as a sign of the finality of death.
viii. The period of mourning lasts for one year. The mourner's "Kaddish" or declaration of faith is said at the gravesite: "Blessed, praised, glorified and exalted; extolled, honored, magnified and lauded be the name of the Holy One. May abundant peace from the heavens descend upon us, and may life be renewed for us and all Israel, and let us say Amen."
ix. "Sitting shiva" refers to the seven-day mourning period immediately following burial. No food is cooked by the family. A candle or lamp is kept burning in the memory of the deceased. The Kaddish is said every day during this time.
x. Some people observe a period of three days following the burial during which visitors are not received and the time is devoted to lamentation.
xi. After the first seven days, survivors are encouraged to rejoin society but still maintain mourning by reciting the Kaddish twice daily for thirty days.
xii. Many mourners may wear black pin with a torn ribbon is worn during the funeral and for the next week as a symbol of grief. Others may wear a torn garment.
xiii. Newborn babies may be named after the deceased. (This is important to remember since many cultures believe it improper to name people after the dead and, in fact, adults may change their names to avoid being named after someone who has died.)
xiv. The first anniversary is marked by the unveiling of a tombstone at a special ceremony.
b. Roman Catholic observances
i. Since the Second Vatican Council, the terms "last rites" and "extreme unction" are no longer used by the Catholic Church.
ii. The Sacraments of the Sick are prayers that are said as the person is dying, and involve confession and communion. If a person dies before the sacraments are given, the priest will anoint the deceased conditionally within three hours of the time of death.
iii. There is often a wake and, if so, the priest will conduct the service or say the rosary.
iv. There are distinct phases to "The Mass of Christian Burial"
Prayers at the funeral home.
Welcoming the body to the church.
Covering the casket with a white cloth.
Sprinkling the casket with holy water.
The Eucharist is celebrated.
Prayers are said after the Mass.
Casket is escorted to back of church.
At the cemetery, the grave is blessed.
Consecration is a reaffirmation that the person will rise again. Prayers address not only the dead but the survivors _ their faith in eternal life is encouraged.
v. One-month anniversary of the death is often celebrated by a Mass, as are those of other anniversaries.
c. Protestant observances
i. There are a wide range of Protestant observances.
ii. For many, after death, there is a family gathering at the home or funeral home.
iii. Caskets, open or closed, are a part of passage. Memorial items may be placed in the casket.
iv. Cremation is an accepted option for some.
v. Black dress is a part of mourning.
vi. Funeral services include music and testimonials.
vii. Gravesite visits may be made.
viii. Memorial services are common, and sometimes replace funerals and other immediate observances of death.
ix. Flowers and donations are preferred ways to express condolences.
x. There is no formal structure to observe death month after month, year after year.
Responding to a disaster in a community where the traumatized are of a different culture is challenging. If crisis intervenors can focus on similarities instead of differences, and show respect for the people they serve, the challenge becomes manageable. A Chinese Buddhist prayer can guide caregivers in their service to diverse cultural groups:
O, that I might become for all beings the soother of pain! O, that I might be for all of them that ail the remedy, the physician, the nurse, until the disappearance of illness! O, that by raining down food and drink, I might soothe the pangs of hunger and thirst, and that in times of famine I might myself become drink and food! O, that I might be for the poor an inexhaustible treasure! All my incarnations to come, all my goods, all
my merits, past and present and future, I renounce with indifference, so that the end of all beings may be attained.
_ The Asians: Their Heritage and Their Destiny, Rev. ed. Philadelphia: J.B. Lippincott, W.P.T. Welty, 1963.
© 1987, 1994, 1998 by the National Organization for Victim Assistance, Washington, D.C.