Knowledge is a tree, not a conclusion, and it has been a tree for all of time. Sometime, however, it verboten in the Bible with a didactic “tale” apparently by oligarchs telling the average religious person to view the tree of knowledge and its information as verboten. This is the beginning of the limits and control of information necessary for oligarchic dominance, as opposed to capital-type control which is more commodity-based --though information is now a commodity as “intellectual property.” (With “intellectual” being a strong word for the slurry capital pumps into the population.)

The most important extension of this type of information control currently exists as academia with its early revival of control as the dialectic and didactic by academy founders Socrates and Plato in ancient Athens, and recently by Hegel to fit current capital. Important is that these instructors specifically used sexual abuse to control, which survived to our time as, for instance, the Aboriginal residence schools openly, and covertly elsewhere.

Causality is a rational reduction of the complexity of life saying that “if something happens in relation to something else, that something else caused the first thing.” As a rational reduction, it is a “dumbing-down” of all the highly sophisticade life-system that affect us. Knowledge is naturally structured both in society and in our minds in tree structures, also called “complex data structures” Personally, I have never been “causal” (I believe) because I have been influenced by aboriginal knowledge organization, and also abstract art and music early on as a child with access to all of New York’s museums and libraries (access has since been restricted to children.)

If I something is unavoidably causal, I say “simple math” --this causes that, w/o making a bid deal about it.

Empiricism is the scientific method (and system) built from causality and is considered the only (measurement) science, even by scientist who should know better. It suffers from being highly-fractured, as it is built from independent causal conclusions that also tend to be ego-vehicles from empiricist scientists. Another widely-misused term is “objective” as a synomym for “cruel” such that normal human thinking, such as the recollection of experiences, is excluded from empiricist conclusions; only empiricist numbers are used, often as an output of highly-purposed statistical systems. Dependance on statistics is such that statistics now often produce hypothesis and theory, that is validated by the same statistical systems. Information from other sources such as experience and observation, no matter how detailed, cannot test well against conclusive information produced specifically to test well by statistical systems. This statistical reality is most true for current control of the mind (both human and animal) in cognitive-behavioral strategies of CBT. Interestingly, in CBT, the dialectic method as the socratic method is also key for (as they say) “thought control.”

Objectivism, such as Ayn Rand’s and (current-capital’s) Adam Smith’s objectivism simply “objectify’s” people to make then inanimate numbers rather than feeling people to allow for capital exploitation. As it happens, capital-supporting empiricism, as info-oligarchic, also leverages this, and fills its capital-supportive role by defining and maintaining it as its own from of exploitation, originally sexual abuse.

Friday, December 14, 2012

Cultural counselling services

Multicultural barriers for the therapeutic alliance exist on two levels: social barriers that can be thought of as misunderstandings or biases, and medical mismatches where the symptomatic descriptions and expectations of non-mainstream clients result in a conflict with basic clinical values and procedures. These mismatches result in misdiagnoses and wrong treatments such that client reflections can be mistaken for psychosis, somaticism, disassociation, personality disorders, and malingering. Kirmayer and his associates (2003) sought to show the value of recruiting mediators who are expert in translating the languages and explaining cultural values of non-mainstream clients, such as immigrants and refugees; these specialists provide cultural consultation services (CCS), and the cultural experts are called “culture brokers.”

Cultural formulation

The core of the study was a cultural formulation of the clients exceptional traits and states. There is no reason not to include clinical cultural traits as well (which was psychiatric and thus medical), as, in the end, clinicians benefited in much the same ways clients did. The components of the multicultural formulation where drawn from personal histories (that included the traumatic results of war for at least 40% of the participating clients), and current issues (which for the war-traumatized includes the anxiety of waiting for official decisions). Current factors for the clients were the effects of immigration on family structure and supports, friction between generations, personal identity issues with respect to society and gender, and spiritual losses. On the clinical side, biases were mediated not just by differing cultural values, but by the clinicians views of clients’ poverty, unemployment, politics, and even race. Both clients and clinicians felt the mismatch of differing approaches to medicine such that clinicians were frustrated by their inability to match clients’ descriptions of symptoms with DSM-provided data, and clients were disappointed by the clinicians’ inability to provide what they have come to expect from medicine.

How CSS works

When clinicians contacted the study team for CSS assistance, a signal was sent to the clients of the clinicians’ concern that instantly benefited the alliance. As the CSS helpers provided symptomatic translations and understandings, previously puzzling symptoms were put in contexts that could be related to the DSM. Clinicians also immediately benefited personally as their frustrations and biases gave way to appreciation for the sophistication of their clients' cultures. In the cases where only clinicians met with the CSS helpers, clinical alliances were built around the issues and thus motivated action.

How CSS can be applied

The core value of the CSS study is the “formulation” that seeks to model a relationship between both the cultural values clinicians and clients by embracing both. The client can then benefit along parallel tracks of care: traditional cultural approaches (which may have a social dimension) and current mainstream clinical that may better treat symptoms. A first step is for the clinician to signal the client of interest in client’s cultural approach by attempting to fully comprehend it. The clinician might note each component of the client's view of problems so that a holistic model can be constructed such that correlations can be identified to link the clients’ approach to mainstream diagnosis and treatment structure.

Conclusions and after-effects

The study had interesting after-results including the recruitment of the researchers as therapists, as some of the participating clinicians chose to "dump" their clients on them. This brought added attention to the transitional needs of multicultural clients as newly-provided understandings resulted in new diagnosis and treatments. Another need stressed by the study was for the clients' self-determination in determining the duality of treatments; many who might have benefited from CSS had likely left therapy or never attempted it because of the cultural rifts, both social and medical.

The service is not cheap because, to be successful, the consultants have to be well-trained; the study showed that low-cost substitutes, such using menial-level hospital workers as translators provided poor returns, and is thus not cost-effective. Further, clients may reject CSS support from community members as they are concerned that their privacy will not be protected. A similar concern is that many clients “dropped out” or never sought help because of the problems caused by multicultural rifts. An issue of concern for the refugees was their fear that a poor diagnosis would affect their status-seeking efforts. Beyond cultural and clinical support through cultural services is the need to promote the guarantee of ethical protections to the immigrant sub-cultures.

Complimenting cultural values benefits all

When components are found to be different, the approach should be complimentary; a holistic value is matched with a clinical procedure such that clinical does not replace the cultural, but confirms and enhances it. According to the study, a complimentary and mutually embracing approach benefitted clinicians as well as clients. It also opens the possibility that the cultural connection can benefit mainstream medicine with the dissemination other-culture knowledge.


Kirmayer, L., Groleau, D., Guzder, J., Blake, C., & Jarvis, E. (2003). Cultural Consultation: A Model of Mental Health Service for Multicultural Societies. Canadian Journal Of Psychiatry, 48(3), 145.

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