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Clinical Paradigm Clashes: Ethnocentric and Political Barriers to Native American Efforts at Self-Healing



Abstract Euro-American theories of psychotherapeutic intervention focus on therapist behavior or the therapeutic relationship, conceived in dyadic terms. The cultural prototype is individualistic and rationalistic: a one-to-one conversation in which the patient discloses and discusses innermost feelings in regular office visits. This may be appropriate for modern Euro-Americans. However, anthropological research finds that in many traditional healing systems, intervention is communal, it utilizes dramatic ritual ordeals and altered states of consciousness rather than rational conversations, and the healer–patient relationship may be less central. This article argues that the latter approach is not ignorant of psychotherapeutic principles; it has its own (however opposed to Euro-American assumptions they may be). Understanding this paradigm clash broadens our understanding of what psychotherapeutic intervention is. It also allows clinicians and policy makers to support traditional peoples in their own efforts at self-healing. Examples will be drawn from the author's work on the healing ceremonies of the Native American Church among contemporary Navajos. [cultural psychiatry, psychotherapeutic intervention, clinical paradigm clash, healing, Native American Church]