No abstract

In an earlier paper (Neki, 1976) an attempt has already been made to compare how dependence as a socio-developmental dynamic emerges and evolves under two disparate cultural influences, namely the Western and the Indian. It is now proposed to examine it as a dynamic of therapeutic relationships in these two cultural settings. 'DEPENDENCE ' IN THE THERAPEUTIC SITUATIONDependence in therapy consists of the following elements: 'a feeling of helplessness, overvaluation of the strength of others, seeking restoration by dependence, blind faith, and desire for constant presence and undivided attention and esteem of the person depended upon ', Maslow & Mittleman (1941). This archaic disturbance of relationships may be perceived either in a general way as the patient's personality pattern constituting the pathogenic base of his symptoms or more specifically, within the therapeutic process as a defence calling for analysis, or even as a need craving for gratification.In fact, the latter is often considered to be merely a re-living inside the therapeutic situation of the style of object-relations learnt by the patient during his early childhood. However, there is something within the therapeutic situation itself also that brings about the occurrence of dependency states. Some observers have even said that 'it is the analyst's attitude toward the patient. . .(that) is responsible for the outbreak of such a state and not the patient's attitude toward the analyst' (Reding, 1963). Dependence states are said to be ubiquitous in all psychoanalyses and 'actually are released by the strict application of classical technique leading to the analysis of characterological defenses' (Reding, 1965). These seem to be released under the stresses of transference and counter-transference. Certain attitudes and behaviour of the therapist in the therapeutic situation often enhance them. These attitudes and behaviour include, in the words of Wolberg (l954), 'overprotecting the patient, making decisions for him and exhibiting directiveness in relationship'. The patient might feel that 'the therapist's efforts are part of a special interest: and the help he was offeringa parental possessiveness/protectivenessis sought more than the understanding of underlying conflict ' or, the therapist himself might be over-zealous 'to produce results in the treatment rather than to help the patient to work something out' (Stein, 1972). However, the patient who is suffering and hopes for relief, who is afraid about the future and expects comfort, who is ill and is grateful to the therapist for allowing him to be ill, who is lonely and finds a shoulder on which to be able to lean and cry is enormously predisposed to unleash needs of dependence and does so as far as his therapist acquiesces or encourages him in doing that.there are many factors in every doctor-patient relationship which push the patient into a dependent childish relationship to his doctor. This is inevitable. The only question is how much dependence is desirable. The obvious answer is that it w...

Sahaja is an Indian ideal of mental and spiritual health that has received special emphasis in the Sikh scriptures--especially, the Adi Granth. Since the concept of sahaja has long been associated with mystical thought and practice, its description has become shrouded in peculiar esoteric terminologies. It is the purpose of this communication to divest sahaja of its esoteric, mystic connotations and to redefine it as a mental health ideal in the context of contemporary conditions.

Therapeutic relationship has been considered an important ingredient of all psychotherapies. In communities in which no familiar conventions of such a relationship are available, the therapeutic encounter poses very different problems from those in the West, where such conventions freely prevail. This study has been carried out by five therapists representing three widely disparate cultures, but all working together in Tanzania. It brings together their perceptions of these problems and the strategies they employed to resolve them while working with African patients. In their view, in spite of great disparity between the world view behind Western psychotherapy and that of African communities, it is not impossible to forge a therapeutic relationship if empathic understanding and cultural sensitivity are added to the attitude of acceptance. After all, the therapist must attract and keep the patient before he can expect anything from him. The authors describe how this can be done with African patients.

Belief in witchcraft, which serves a variety of social functions and personal defences, is bound to emerge in psychotherapy with individuals from a culture that holds such beliefs; endeavouring to understand it can open up new therapeutic possibilities. The nature of witchcraft, the profiles with which it intrudes into therapy, and the socio-psychological functions it fulfills are considered. Referring such patients to witchdoctors is morally unjustifiable, but the witch-doctor's folk-image provides a floating transference, around which the therapeutic relationship can be built. In dealing with witchcraft-ideation, understanding is based as much on cultural as on personal empathy, and to enhance its relevance, therapy may appropriate some of the functional dynamics of the witchcraft system into its own therapeutic manoeuvres.