Psychotherapy is done in developing countries on the western model. What are the myths and realities

1. ِ‫يم‬ ِ‫ح‬َّ‫الر‬ ِ‫ن‬َ‫مـ‬ْ‫ح‬َّ‫الر‬ ِ ‫ه‬‫اّلل‬ ِ‫م‬ْ‫س‬ِ‫ب‬
َ‫ين‬ِ‫م‬َ‫ل‬‫ا‬َ‫ع‬ْ‫ال‬ ِ‫ه‬‫ب‬َ‫ر‬ ِ ‫ه‬‫ّلل‬ ُ‫د‬ْ‫م‬َ‫ح‬ْ‫ال‬
ِ‫يم‬ ِ‫ح‬َّ‫الر‬ ِ‫مـن‬ْ‫ح‬َّ‫الر‬
ِ‫ين‬ِ‫ه‬‫د‬‫ال‬ ِ‫م‬ ْ‫و‬َ‫ي‬ ِ‫ك‬ِ‫ل‬‫ـا‬َ‫م‬
ُ‫ن‬‫ي‬ِ‫ع‬َ‫ت‬ْ‫س‬َ‫ن‬ َ‫اك‬َّ‫ي‬ِ‫إ‬‫و‬ ُ‫د‬ُ‫ب‬ْ‫ع‬َ‫ن‬ َ‫اك‬َّ‫ي‬ِ‫إ‬
َ‫يم‬ِ‫ق‬َ‫ت‬‫س‬ُ‫م‬‫ال‬ َ‫ط‬‫ا‬َ‫ر‬ ِ‫ه‬‫ص‬‫ال‬ ‫َــــا‬‫ن‬ِ‫د‬‫اه‬
ِ‫ب‬‫و‬ُ‫ض‬‫غ‬َ‫م‬‫ال‬ ِ‫َير‬‫غ‬ ْ‫م‬ِ‫ه‬‫ي‬َ‫ل‬َ‫ع‬ َ‫مت‬َ‫ع‬‫ن‬َ‫أ‬ َ‫ين‬ِ‫ذ‬َّ‫ل‬‫ا‬ َ‫ط‬‫ا‬َ‫ر‬ ِ‫ص‬َ‫ين‬ِ‫ه‬‫ل‬‫ا‬َّ‫ض‬‫ال‬ َ‫ا‬ َ‫و‬ ْ‫م‬ِ‫ه‬‫ي‬َ‫ل‬َ‫ع‬

2. The Past and futurein Pakistan; Mythsand
realities
Dr. M. Nasar Sayeed Khan
Professor of Psychiatry,
President (Elect) Pakistan Psychiatric
Society

4. I was stuck.
 I had been exploring unexplored territory.
 I had found very little to guide me on this journey.

5. “Psychology” then and now:
 At the time of Socrates and Aristotle, there was no word for
psychology and no need for it.
 Most people did not think of themselves as having any
questions which the culture did not answer.
 There was an undercurrent: the collective unconscious,
which carried human capacities in symbolic form. This
accounts for similarities in the myths of different parts of
the ancient world.
 As we will see, “psychology” came to mean first the study of
the soul, and then the scientific study of human thinking
and behavior.

6. When was the word “psychology” first used in
English? What did it mean?
 The term “psychologia” was first used by a Serbo-
Croatian writer named Marulic in 1520. The same term
was used by the German writer Rudolf Goeckel in
1590.
 The word “psychology” was first used in English in
1653. According to the Oxford English Dictionary (2006)
it originally meant “the study or consideration of the
soul or spirit.”
 It was at that time a part of philosophy.

7.  “The scientific study of the nature, functioning, and
development of the human mind, including the
faculties of reason, emotion, perception,
communication, etc.; the branch of science that deals
with the human or animal mind as an entity and in its
relationship to the body and to the environment or
social context, based on observation of the behavior of
individuals or groups of individuals in particular,
ordinary, or experimentally controlled circumstances.”
What does “psychology” mean now, according
to the Oxford English Dictionary?

8.  Sigmund Freud and all we have studied him. The best
part he was a neurologist. He wrote millions of pages
and all without an evidence.
 Then what made him think of Psychotherapy?
 I think from a different perspective:
Who was the first psychotherapist? Why
there was a need for psychotherapy:

10.  We all know that psychology practice in Pakistan is
founded on the Western model: U.S. and European-
trained psychologists brought it to the universities in
the 1960s, and many Pakistani psychologists continue
to be trained in the West. But over the past 10 years,
Pakistani psychology practice and research have been
increasingly interested in, and shaped by, indigenous
culture--one that is largely collectivist, family-oriented
and male-led, and one that is 97 percent Islamic.
Psychotherapy in Pakistan

11. Legends in Psychology of Pakistan as per
PPA
Dr. Prof Dr. Azhar Ali Rizvi
PROF. ABDUL HAYY ALVI
Prof. Muhammad Ajmal

12.  Individuals Vs Group
 Foreground Vs Background
 Culture Vs Creative Spirits
 Difference in teachings
 Living in past (9/11) Vs Present
 Live it up Vs Reincarnation
 Instant Vs Patience
 Now Vs Etenity
 Breaking the barriers
Shift from Westernized psychology to
Easternized psychology!!!!!

13. Stigma in Psychotherapy
 Problem of knowledge = Ignorance
 Problem of attitudes = Prejudice
 Problem of behaviour = Discrimination

14. Stigma in Psychotherapy
 Focus on violence & media
 Mostly only address schizophrenia
 Little attention to emotions
 Little information on actual discrimination
 Few reports from service users
 Few intervention studies

15. Religion, Spirituality and Psychotherapy
 Religion usually refers to “beliefs, practices, and rituals related to the
sacred” (Koenig, 2009, p.284). The term “sacred” often refers to
objects or beings (i.e. God, Allah) considered to be supernatural, holy,
or transcendent (Paragament, 1990).
 Religion can be organized and practiced within a community
that follows certain traditions and holds certain beliefs
(Koenig, 2009).
 Spirituality is viewed as more personal and defined by the individual. It
is considered to be “largely free of the rules, regulations, and
responsibilities associated with religion” (Koenig, 2009, p.284) and
focuses on aspects of life that are “transcendent” or larger than the
individual without necessarily having religious overtones (Pargament,
1990).

16. • Later research has demonstrated how individuals who draw on a more
deeply established system of religious beliefs, practices, feelings, and
relationships are in a good position to find compelling religious solutions
to various problems and cope with everyday living (Pargament, 1997;
Schaefer & Gorsuch, 1991).
• At the same time, others have demonstrated how religion can negatively
impact coping during times of crises and can be associated with poor
mental health and event-related outcomes (Pargament, 1997;
Pargament, Zinnbauer, et al., 1998).
• Given that research has shown that religion/spirituality can positively or
negatively impact coping during times of crises, it is important to
understand the role of religion/spirituality on mental health outcomes.
Religion, Spirituality and Psychotherapy

17.  Religious attributions (Pargament, 1990)
 Religious problem-solving styles (Pargament, Kennell,
Hathaway, Grevengoed, Newman, & Jones, 1988).
 Self-directive
 Deferring
 Collaborative
 Positive and negative religious coping (Pargament, Smith, et al.
(1998)
Application of Faith in therapy….

18. Complicated issues of Psychotherapy: Clinical Issues
in Which Faith becomes Salient: PTSD
 PTSD and Religious Faith
 “One of the most pervasive effects of traumatic exposure is the challenge that
people experience to their existential beliefs concerning the meaning and purpose
of life.” (Fontana & Rosenheck, 2004).
 Traumatic exposure often has a weakening effect on religious faith (e.g. Calhoun
and Tedeschi, 1999; Decker, 1993; Janoff-Bulman, 1992; Liefton, 1988).
 Traumatic exposure also has a strengthening effect on religious faith (Calhoun et
al., 2000; Drescher and Foy, 1995; Lawson et al., 1998; Racklin, 1998)
 Strength of religious faith has an inverse association to severity of PTSD
symptoms (e.g. Astin et al., 1993; Davis et al., 1998; Klingler, 1999; Murad, 1991;
Phan and Kingree, 2001; Saunders, 1999)

19. • Mainline Protestant, Catholic, Islamic, Judaism prohibit
homosexuality
• Social implications for negative attitudes:
• Implications for GLB individuals
– Struggle in integrating sexual identity with religious faith
• LGB individuals can abandon their faith in securing a LGB identity
• LGB individuals also feel their faith has abandoned them
– Development of internalized homo-negativity
• Associated with shame, depression, suicidal ideation, psychological distress,
low self-esteem, lack of perceived social support, and difficulty accepting LGB
identity,
(review Lease, Horne, Noffsinger-Frazier, 2005)
Conflict between religion and non-
heterosexual orientations

20. Islam and Psychotherapy
• Muslims believe in an afterlife
• Illnesses are part of life and not punishment for sins
– Cures should be sought, but only God grants cures
– Those who endure illness with patience will be rewarded at time of
judgment
– It is okay to complain of pain as long as the person does not blame
God
• Euthanasia or attempts to shorten life are prohibited
• If person done wrong to someone, forgiveness should be
sought as the rights of man are more important than the
rights of God
• Islamic creed should be recited at moment of death

22.  Its just a talk therapy?
 How can it change the behaviour?
 It is expensive?
 Therapist is too polite and not assertive?
 How can a women help in OCD by talking?
 Why we need psychotherapy on long term basis?
 Is it to impress others? Elite class chochalay??
 What more?
Points to ponder ????

23.  If I change family remains same?
 If I change , can it change my work and financial status?
 Why I have to do all?
 If I have to do all why therapy then?
 Therapy is common sense?
 How can unmarried understand the marital issues?
 There is inherent power differential?
Points to ponder??

24.  Psychotherapy is a structured form of treatment and
there is evidence that it helps the patients and brings a
definite change.
 The best of the options for this is the
 “ AWARENESS”
 We need to find out reasons why the huge number
produced is not practicing.
 All stakeholders have to sit and collaborate with each
other.
Answers in my opinion…..

25. Inter-sectoral collaborations:

26.  Btreaking the barriers of the domains and work
togather.
Inter-sectoral collaborations:

27. 27
Mujtaba Nasar