Cultural Values and Self-Harm

Abstract

We are all born into a broad culture strongly influenced by kinship, upbringing, development, and peer exposure. We carry the basic characteristics of that culture with us wherever we go. Cultures mould both our personalities and our attitudes. Yet some core aspects of culture may change because of acculturation following exposure to broader, newer, and stronger cultural influences, whereas other aspects of cultural identity remain unchanged and still others change depending upon the degree of exposure and the degree of influence. An individual’s cultural and ethnic identity always remains important to the individual. Cultures also dictate attitudes to psychiatric conditions, explanatory models, and ways of perceiving things as well as interpreting these experiences. Suicide and self-harm as well as attitudes toward suicidal behavior are very strongly influenced by cultural values. Cultures also affect legal aspects in society. In addition, defining what is normal and what is abnormal is a cultural act, and healthcare delivery is directed accordingly. Hofstede (2001), using aspects of cultures of multinational business companies, suggested that cultures can be understood according to five dimensions. These include collectivism–individualism, power distance, masculine–feminine, uncertainty avoidance, and longversus short-term orientation. These dimensions do not mean that all individuals from the specific cultures have similar behaviors, but they certainly have attitudes that may affect their functioning. The collectivist–individualistic or sociocentric–egocentric dimension indicates that individuals may see their own identity as kinship-based, with a responsibility toward a larger group: The notions of the self would differ. In certain settings, individualism relates to societies where ties between individuals are comparatively loose and members are expected to look after themselves and their immediate (nuclear) family, whereas collectivist societies provide strong and cohesive ingroups that protect individuals in exchange for unquestioning loyalty. Studies have indicated that the prevalence of psychiatric disorders, especially common mental disorders, varies according to type of culture (Maercker, 2001). Cultural identity has at its core a sense of attachment or commitment to a cultural group and is thus both a cultural and a psychological phenomenon (Berry, 2007). Embedded within the cultural identity are identities related to gender, sexual orientation, religion, and cultural beliefs, which also dictate dietary and other taboos and practices. It is clear that some individuals from egocentric cultures (especially the more egocentric ones) are good at entering and leaving new social groups and are able to form new ingroups; they also disregard the needs of their communities and are focused on pleasure-seeking and their need for specific friendships. Sociocentric individuals, on the other hand, rely on emotional interdependence, group solidarity, and sharing of duties and obligations (see Hofstede, 2001, for further details). Similarly, differences exist according to the masculine–feminine nature of cultures. In masculine cultures, individuals focus more on status, earnings, and training; in low masculine index cultures, individuals have an orientation toward relationships and higher quality of life. When looking at the distance from the source of power or longterm orientation, differences in attitudes can be identified that influence cultural values. Culture conflict can arise between members of one culture and another culture, or even between members of the same culture. The latter is more likely especially if they are at different levels of acculturation, for example, between children born in the new culture and their parents. This has been shown to be a potential cause for self-harm (Bhugra, 2004; Bhugra, Baldwin, Desai, & Jacob, 1999; Bhugra, Desai, & Baldwin, 1999). This conflict deals with the situation where both sides feel trapped and stuck, and the younger, vulnerable individual may take time out by harming themselves. Another possibility is that, in sociocentric cultures, the self is embedded in the kinship, which aims the nature of self-harm at the larger family or kinship and not at the individual per se. As Morris (1994) highlighted, the concepts of self vary across cultures. Eastern cultures have different perceptions of the individual, and these values and perceptions will likely change as a consequence of globalization. The worldview of individuals is influenced by their culture and their cultural values, and these worldviews in