Western Psychiatry and Difficulty: Understanding and Treating Hmong Refugees

Abstract

Westermeyer and Her present an account and history of their professional work with Hmong refugees. They begin their chapter with background information about the Hmong people, known as the "Montash" people in Laos, Vietnam, Thailand, and China, indigenous to the Annamite mountain region of Southeast Asia. After the end of the Vietnam War, Hmong refugees sought asylum in the US as they aided American military forces during the war. In presenting a discussion of obstacles to assessment and care, the authors discuss critical issues that include (1) language and the differential semantic meaning of words; (2) interpretation, as there are two major dialects in Hmong language which can post significant problems when using interpreters for psychological assessment and clinical treatment approaches; (3) suspicion and mistrust are features of some Hmong patients; (4) belief system differences can impede proper diagnosis and evoke countertransference reactions due to inaccurate understanding of culturally based differences in beliefs; (5) history of traumatic experiences, rooted in the Hmong history with many foreign countries and groups (North Vietnam, Pathet Lao, etc.) are extensive. The authors make an analogy to the experience of Native Americans in terms of genocidal warfare and ethnic cleansing. Further, they note that PTSD is not the only expectable psychological sequela, as other anxiety, depression, and phobic disorders are prevalent. In the next section of this chapter, the authors discuss the need to understand Hmong social organization, i.e., how families and communities are organized and can be mobilized to provide needed social support. The chapter concludes with an examination of childbirth, child rearing, and childhood development as it pertains to how cognitive structures and ideological systems of belief are formed within the Hmong Society. To conclude the chapter, the authors discuss the application of psychotherapies to Hmong patients: behavior modification, interpersonal therapy, combined therapy and network therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)