As many people are now transplanted to a new cultural setting due to immigration, marriage into other cultures, being refugees, students living away from their families or many other causes, multicultural and cross-cultural counseling demands that therapists demonstrate cultural competence and understanding of their patients and their struggles with cultural issues, racism, religious prejudice, changed gender roles, language, social and economic set backs, discrimination, and other related experiences.
Therapists must be equipped with ethnocultural knowledge and apply multiculturally responsive therapeutic framework and strategies when treating trauma with diverse populations.
They must posses a humble posture of learning, empathy and respect, to be able to better understand how different cultural groups handle stress, may have alternative coping strategies, their values of honor, pride, their beliefs, differences on how they express grief, their different communication customs, their resilience and motivations, their cultural stigmas on mental health, their needs, desires, abilities and must be open and enquire about their feelings, views, emotions gently, with care and sensitivity when treating trauma
Online therapy is especially important when you wish to find professionals with cultural competency, to save time previously lost in traffic, time lost in waiting rooms, when you live far from urban centers, or when the patients are in more than one location, as well as greater flexibility of schedules.
Many busy professionals are embracing technologies that empower patients and tele health therapists eliminating barriers of access for mental health. Such discriminations have a detrimental psychological impact and can have symptoms like those of post traumatic stress disorder (PTSD), such as anger, depression, anxiety, low self esteem, hopelessness, insomnia, chest, and head aches, among others. Such trauma is often exacerbated by other trauma such as family violence and collective traumas suffered by their extended family and social network, as well as vicarious and indirect trauma when exposed, for example, to news coverage of police brutality as with George Floyd and many others. Many Indigenous North Americans are traumatized by the disproportionate number of suicides as well as incarceration, which is also the case for other minorities. In addition to the above such stress is aggravated by other health and social disparities.
Millions of people with disability suffer trauma caused by social, workplace, medical or public discrimination. It is estimated that in the United States 19% of the population has disability and this does not include chronic illnesses such as 11% suffering from chronic pain and another 17.6% from severe chronic pain,
nor those suffering from long term autoimmune diseases, metabolic disorders, Lyme disease, fibromyalgia, chronic fatigue, diabetes, depression, anxiety or bipolar mental health challenges and other progressive disorders.
In addition to the above, many suffer from internalized ableism that makes them feel unworthy, not able to overcome their challenges, not loved and understood by family, friends, co workers and thus have difficulty with their life’s purpose. This type of trauma can benefit from therapy to manage the stress of the discrimination, or its effect on relationships and how to advocate for their needs.
Trauma associated with religion and/or spiritual abuse takes many forms, and it is unfortunately much more prevalent than reported. For example, we all know of the holocaust of the Jewish people, we know of the Islamophobia after 9/11, the conflicts between Moslems and Jews in the Middle East,
the persecution of Bahais in Iran, of the traumas suffered by Indigenous people who were victims of child sexual abuse by priests, the slavery and rape of Yazidi girls by ISIS, the conflicts between Hindus and Sikhs in India, the persecution of the Rohingya Muslims by the Buddhist majority in Myanmar, the long-time conflicts between Sunni and Shia Moslems.
In addition to the above, millions also suffer religious trauma: wanting to change their religion or leave a cult-like community and being in a family and/or community environment where they are subjected to physical, mental, spiritual, and emotional abuse for not conforming to the religious understanding and values of a spouse, their extended family, or their community.
The traumas suffered in all these situations can be compared to Post Traumatic Stress Disorder (PTSD). Individuals exhibit symptoms like nightmares, anger, confusing thoughts, anxiety, loss of self-esteem, depression, grief, feeling isolated from family, friends and community, and many other symptoms usually associated with PTSD. These mental health challenges not only affect the original victims of the religious trauma but it can have inter-generational consequences.
Many who suffer these types of traumas may be culturally reluctant to seek mental health counseling. Such therapy could be misunderstood, regarded as only necessary for people who have lost their minds. This affects all the members of an extended family. Unfortunately, in such cases they may refer the matter to the same people who are the original cause of the trauma. As a result, many go without help and try to hide what is happening to them.
We live in a new age where international resettlement is common. People accept a career opportunity or to study abroad. Many marry a person of a different culture and settle in a new country. They have to cope with many challenges: a different set of values, way of life, family structure and religious beliefs. All of this while experiencing separation from the familiar: the food,
health services, the role of women, expected traditions and behaviors. All prior support systems are removed. When changes happen by choice, as when studying abroad, it is possible to get help for the transition. The same is true for career changes when the employer will help with the challenges of cross-cultural transitions.
Counselling can help manage such challenges and bring back the emotional equilibrium needed. Different people and circumstances result in many different symptoms resulting in a variety of symptoms. These can include physical, mental, or emotional signs of distress such as headaches, changes in sleep patterns or appetite. Symptoms can also include extreme feelings of sadness and worthlessness, irritability, anxiety, isolation, frustration, disorientation, helplessness, powerlessness, vulnerability, and confusion. These are related to the loss of social rules and accustomed cultural cues. Depression, confusion, anger or extreme levels of homesickness which can precipitate many symptoms including panic attacks, extreme sweating, irregular heartbeats, high blood pressure, substance abuse and gastrointestinal disturbance.
We spend more time at our workplace than in any other activity. Over 40% of all people consider their work as stressful. Organizations and employers must be prepared to help prevent such stress or to support their employees. If they bring pre-existing traumas into the workplace, it can not only affect their work performance and productivity, but also affect those of their colleagues and the whole organization. Currently we can see the stressful effects of the health pandemic. All activities worldwide have been affected. Many families are dealing with death, grief, suicide, accident, or injury. While at work, people can be exposed to a variety of pressures such as sexual harassment or various types of discrimination (racial, religious, sexual or cultural, including language proficiency).
Bullying, threats, harassment, betrayal, maliciousness, extreme isolation, chronic pressure, unresolved conflict or a toxic work environment can cause uncertainty. This could include fear for the future, downsizing, or fear of unemployment. Many such situations can affect physical, emotional, or mental health, all of which are intertwined.
Work related trauma can also result from feeling victimized by having too many responsibilities or unrealistic expectations from the employer. Poor communication, gossip, bullying, tension, harassment, discrimination, low job satisfaction, or personality conflicts at work can all contribute to poor health.
The symptoms can manifest in multiple ways. These can include insomnia, irritability, mood swings, anger, or feelings of disappointment and disillusion about their career choice and/or employer. People can become filled with confusion about why they are unable to meet the demands placed on them. Hopelessness can set in. The inability to cope can result in anxiety and fear, fatigue, muscle tension, family problems, depression, feelings of isolation and substance abuse. Certain professions will also have special stressors. For example, the police force, the military, firefighters, health care workers, clergy, teachers, those who work in mining or overnight shift workers, airline crews, among others. Organizations and employers can seek help from mental health counselors to offer confidential online support. Such help would prevent employees who are suffering from such conditions from losing their jobs, as many will not share their traumas with the organization for fear of stigma.