This paper is an analysis of the position that cultural constructivism is significant to the well-being of psychiatric and mental health discourse and practice. It focusses particularly on the nature of the ‘self’ as it is perceived from a Western ethnopsychological perspective. Differentiation is made between types of self which can be found in other cultural systems, both within and without Western society. A relationship is explored between the particular definition of the ‘self’ and discourses on therapeutic relationships, both fundamental tenets of modern mental health nursing practice. This analysis suggests that nurses should endeavour to move beyond the rhetorical, and thus constraining, ideology of individual responsibility, with which mental health practice is now engaged, and move to a basis for practice which depends on understanding clients' lived experiences.