Samoan and Psychiatrists' Perspectives on the Self: Qualitative Comparison

Abstract

To compare psychiatrists' perspectives on the meaning of self, in general adult public practice psychiatry in the Wellington region of New Zealand, with a Samoan view of self and to discuss the implications for the practice of psychiatry with Samoan people in New Zealand. A focus group of psychiatrists was convened for three sessions. A Samoan view of self was presented to the participants. Transcripts of the focus groups were analysed using inductive content analysis and a process of cultural accountability was included in the research design. Individual and secular notions of self dominated the psychiatrists' perspectives and contrasted with the primacy of relational and spiritual notions of self in Samoan culture. Psychiatrists experienced a sense of cultural 'dissonance' on first exposure to the Samoan views. The Samoan notion of self was considered to challenge the universalist assumptions of Western psychiatric theories as understood by the participants. The Samoan relational notion of self had implications for clinical interviewing, understanding of phenomenology, formulation and treatment planning with Samoan patients and their families. Dedicated Samoan or Pacific Island mental health services would allow culture-specific concepts central to an understanding of mental health to be embedded in service delivery. The process used in this study and the notion of dialectical tension could be used in the cultural education of mental health clinicians. The cultural accountability process models an important aspect of such training.