Psychogenic Seizures in an Espiritismo Context: The Role of Culturally Sensitive Psychotherapy.

Abstract

A case of a Puerto Rican woman with a complex clinical presentation of psychogenic seizures (PS) is discussed to illustrate how cultural practices and beliefs transform such dissociative somatoform disorders. In this case, the PS revolved around some deeply ingrained spiritist beliefs and possession experiences, which permitted the externalization of the client's guilt feelings for not having averted the suicide of her grandmother. It also shows how a psychotherapist can integrate the client's cultural beliefs in spiritism (or espiritismo) with some well-known traditional therapeutic techniques. Also, it illustrates the benefits of using a cultural conceptualization that takes into account the client's religious attribution of her illness and describes how the effectiveness of traditional therapeutic modalities can be enhanced by reframing them according to the phenomenological framework of the client.

Towards an integrative theory of psychogenic non-epileptic seizures (PNES)

“…In others, inherent components (i.e., 'hard-wired' behavioural patterns) are likely to be more relevant, such as actions and cognitive biases typically associated with emotions such as fear, anger and/or disgust (cf. Kretschmer, 1923;Baslet, 2011); this is consistent with the apparently universal existence of PNES-like phenomena across cultures (Brown & Lewis-Fernández, 2011;Martinez-Taboas, 2005) and the stereotyping of symtoms often seen. Rather than being cognitively impenetrable reflexes, we assume that these are general action tendencies that can be modified by other information, beliefs and goals within the system, consistent with the apparent variability of PNES between and within cultures and individuals (cf.…”

Evidence‐Based Practice and Its Implications for Culturally Sensitive Treatment

“…Thus, these therapists challenge the accuracy of espiritismo beliefs, guilt, and other dysfunctional beliefs. However, a purist cognitive-behavioral approach runs the risk of undermining the therapeutic alliance: agreement on tasks, agreement on goals, and empathic attunement (Martinez-Taboas, 2005).…”

Cross-Cultural Assessment of Psychological Trauma and PTSD

“…Two case studies (Martínez-Taboas, 1995b suggest that in Puerto Rico the phenomenology of dissociative disorders is influenced by beliefs in espiritismo (spiritism). Espiritismo is a philosophical and folk healing practice widespread in Latin America that espouses the immortality of the soul and the ongoing relationship and contact between the living and the spirits of the dead.…”