Cultural Explanation of the Individuals Illness

To be included here are (a) idioms of distress used by the individual to communicate symptoms (e.g., "nerves," "spirits"), (b) the meaning of the severity of the symptoms as perceived by the client in relation to the cultural reference groups, (c) the client's perception of the cause of the problem, (d) and names applied to symptoms within the client's culture. For example, a Hispanic client would report that he or she feels "depressed" after being exposed to a susto (see Table I). Similarly, among many Hispanics a mental disorder (enfermedad mental) is less severe than being insane (estar loco). In the first case, the client is suffering from a crisis nerviosa or ataque de nervios (i.e., a nervous crisis). In the second case, the client shows a complete loss of control or withdrawal or both, requiring hospitalization (Paniagua, 1998).

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