Cultural Sensitivity in Grief: What Mental Health Providers Need to Know

As the leaves turn color and fall to the ground, here in the Northern Hemisphere, we enter the season of dying. Cultural views of death and dying vary widely across different societies and can significantly differ from Western perspectives. This is an area that is so important for mental health professionals to recognize and respect these cultural differences, to avoid pathologizing them inadvertently. This article lists various practices and views of death and dying, from across Ethnicities. Keep in mind this doesn’t include variations across religions and faiths, which in itself have their own views and practices. 

Please note there is my own bias in this article specifically, that I’ve made an effort to include various ethnicities within Asian American and Pacific Islanders, out of my own personal desire to help counter the myth that we are this homogenous group. Lastly, this is of course not an exhaustive list and if you have feedback, I’d love to know. Enough said, let’s take a look. Here are some examples of diverse cultural views of death and how Western psychology can sometimes misinterpret or pathologize them: 

Indigenous Beliefs: 

Cultural Perspective: In many indigenous cultures, death is seen as a natural part of the life cycle, and it often involves a strong spiritual and communal connection. Rituals, such as honoring ancestors, are an integral part of the grieving process. 

Potential Misinterpretation: Western psychology might pathologize indigenous grief practices as "complicated grief" or "prolonged mourning." It may overlook the cultural significance of these practices. 

Eastern Philosophies (e.g., Buddhism and Hinduism): 

Cultural Perspective: Reincarnation is a fundamental belief in many Eastern philosophies. Death is viewed as a transition to another life, and the process is seen as part of the soul's journey toward spiritual enlightenment. 

Potential Misinterpretation: Western psychology may view beliefs in reincarnation as a form of denial or as a symptom of an adjustment disorder rather than a culturally significant belief system. 

Mexican Dia de los Muertos (Day of the Dead):

Cultural Perspective: In Mexican culture, the Day of the Dead is a celebration that honors deceased loved ones. Families create altars and offer favorite foods, drinks, and mementos to honor and remember the departed. 

Potential Misinterpretation: Western psychology may mistakenly interpret these celebrations as a form of pathological grief, especially if they involve activities that are unconventional in Western practices. 

African and African-American Traditions: 

Cultural Perspective: In African and African-American cultures, death is often viewed as a part of a larger community or ancestral context. Rituals and ceremonies play a crucial role in connecting with ancestors and ensuring their continued presence.

Potential Misinterpretation: Western psychology might pathologize these rituals, viewing them as "maladaptive" or "disorganized" grief responses rather than recognizing their cultural significance. 

Japanese Cultural Beliefs: 

Cultural Perspective: In Japan, the concept of "amadoi" refers to the belief that spirits of the deceased coexist with the living. This belief underlies various customs and rituals for remembering and paying respect to the deceased. 

Potential Misinterpretation: Western psychology might pathologize these beliefs as indicative of delusional thinking or complicated grief rather than acknowledging their cultural context. 

Ancestor Veneration (East Asian Cultures, e.g., China, Japan, Korea): 

Cultural Perspective: Ancestor worship is common in East Asian cultures. Families may have ancestral altars, conduct rituals, and celebrate Qingming or Chuseok to honor and connect with deceased ancestors. 

Potential Misinterpretation: Western psychology may misinterpret these practices as symptoms of grief-related disorders or obsessive-compulsive tendencies rather than recognizing their cultural significance. 

Reincarnation (Hinduism and Buddhism, e.g., India, Nepal, Tibet): 

Cultural Perspective: In Hindu and Buddhist traditions, death is seen as a transition, and reincarnation is a fundamental belief. Rituals, like Pind Daan in Hinduism, aim to assist the deceased's soul on its journey. 

Potential Misinterpretation: Western psychology may view discussions of reincarnation as a form of denial or as a symptom of complicated grief, rather than respecting the cultural and spiritual significance. 

Filial Piety (Chinese Culture): 

Cultural Perspective: In Chinese culture, filial piety emphasizes respect for one's ancestors. Ancestral tablets and rituals are maintained to fulfill these obligations. 

Potential Misinterpretation: Western psychology might pathologize these practices as "prolonged grief" or "complicated mourning" rather than recognizing their cultural context. 

Ritual Pollution (Balinese Culture, Indonesia): 

Cultural Perspective: In Bali, death is believed to bring ritual pollution, and elaborate purification rituals are performed to cleanse the living. Cremations are grand celebrations involving complex rituals. 

Potential Misinterpretation: Western psychology may see these rituals as distressing or harmful, potentially diagnosing clients with post-traumatic stress or complicated grief. 

Ritual pollution, also known as ritual impurity, is a concept found in various cultures and religions. It refers to a state in which an individual or object is considered spiritually or ceremonially unclean or impure due to their involvement in specific activities or events. Ritual pollution is often related to religious or cultural beliefs and is distinct from physical or biological cleanliness. The specific beliefs and practices associated with ritual pollution can vary widely from one culture or religion to another. Some common examples of activities or events that can lead to ritual pollution in different cultural contexts include: 

Death and Mourning: In many cultures, contact with a deceased body or involvement in mourning rituals can lead to ritual pollution. The belief is that death is a spiritually significant event, and those who come into contact with it require purification.

Bayanihan and Community Support: 

Cultural Perspective: Bayanihan is a Filipino cultural value that emphasizes community support and cooperation. In times of death, communities come together to provide emotional and practical support to grieving families. 

Potential Misinterpretation: Western psychology might misunderstand the extensive involvement of the community as intrusive or as enmeshment, potentially diagnosing individuals with attachment issues or a lack of autonomy.

Bardo Beliefs (Tibetan Buddhism): 

Cultural Perspective: In Tibetan Buddhism, there is a belief in the transitional state called the Bardo, where the soul undergoes various experiences before rebirth. Death is seen as a continuation of the soul's journey. 

Potential Misinterpretation: Western psychology may misinterpret these beliefs as delusional or dissociative experiences, rather than understanding their cultural and spiritual significance.

To avoid pathologizing cultural views of death and dying, mental health professionals should engage in culturally informed and respectful practices. This includes actively listening to clients' perspectives, understanding the cultural context, and recognizing the value and meaning of cultural practices related to death and grieving. It's essential to approach each individual's experiences with cultural humility, allowing space for diverse beliefs and practices in the context of mental health care.