Abnormal Psychology

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One cannot divorce the human psyche from the cultural norms of society or community. In Bongani’s case, ethnicity, and culture are factors to be considered, in coming to an all embracing understanding of his condition. Bongani is a Zulu man; hence an understanding of Zulu culture is necessary. He lived with his very traditional grandmother. Bongani may feel that the reason he is experiencing bad luck in the form of losing his job and the breakup of his relationship. As well as hearing voices may be tied to his cultural beliefs. [o]“Traditional Zulu people also perform a purification ritual (inhlambuluko) a month after the burial of the diseased.” (Edwards, 2011, p. 338) it is known that if inhlambuluko is not done it may cause bad luck as well as spirits trying to communicate with the parties involved. “Some illnesses are believed to be related to ancestral displeasure (abaphansi basifulathele).” (Edwards, 2011, p. 342). In this case Bongani may feel that it is best to complete the rituals so that his luck may change. According to (Barlow & Durand, 2014, pp. 223-224) funerals and burial ceremonies help us work through our grieving process, Bongani shows symptoms of acute grief and may be directly linked to the fact that he did not complete all the ceremonies involved in dealing with grief and this prolonged experience could have led to his MDD. If Bongani is to complete the ceremony he will still suffer from MDD because he will still have to come back and face the reality[p] of his losses as they are stressful life events that have already affected him so in removing his ‘bad luck’ he is still faced with the effects of it. Thus treatment will be required. If he were to see a traditional healer for treatment, the healer will not see his symptoms as a mental illness but rather as stress or thinking too much Sorsdahl, Flisher, & Stein (2010, pp. 287-288). If it is considered to be an illness the illness would be seen as stress. Sorsdahl et al (2010, pp.288). In consideration of (Edwards[q], 2011) treatment may be directly linked to the ritual so once the ritual is complete Bongani may be healed from his psychosis[r]. The problem with this is that his psychosis [s]is directly linked to environmental stress that he will still have to face on his return to university.

In dealing with Bongani’s MDD the treatment required to bring Bongani into remission would be an antipsychotic medication, to alleviate his auditory symptoms. A mood stabilizer should be a mild one considering that his symptoms for MDD are mild in severity with the exception of his psychotic features. Once he is stable psychotherapy may begin, psychological treatment for depression may begin Barlow & Durand (2014, p. 251) but here Bongani has to still deal with his past feelings towards his father as well as his guilt. Cognitive therapy may be used to deal with his negative thought process. And Interpersonal psychotherapy will help him resolve environmental and circumstantial stresses he encounters.

The legal and ethical issues surrounding the suggested treatment must be considered, according to Barlow & Durand (2014, chapter 16) Bongani must want treatment, he has the right to refuse treatment therefore it cannot be forced upon him. If he prefers to see a traditional healer that is his choice and he has a right to it. His mental illness does not make him dangerous (Barlow & Durand, 2014, p. 537) therefore he is not a harm to society, only to himself, he has not expressed any thoughts of suicide or self-mutilation, only an unstable psychosis which has affected his social environment, cognitive abilities and his health with his increased weight loss. Within his right to medication treatment (Barlow & Durand, 2014, p. 582) the person treating him has an obligation to choose the most effective medication, medication that has been clinically proven to alleviate his symptoms he also needs to be aware of the side effects of these medications. Upon hearing the side effects of the treatments he has a right to refuse such treatment (Barlow & Durand, 2014, p. 583) “…even if doing so is not in their own best interest.” With regard to psychological treatment, ethically, it is important to consider Bongani’s culture and his own thoughts and ideas surrounding society. One can only guide him through the stages of gaining resolution. If he is to go home and complete his rituals the auditory hallucinations may also be alleviated and the strong feeling of guilt may subside.

In conclusion when looking at Bongani’s history, current situation and symptoms it is clear that due to environmental and circumstantial stresses, as well not dealing with his grief in a health normal manner he has developed Major Depressive Disorder with psychotic features. By involving his cultural background and allowing him to deal with his grief, some of his symptoms may be alleviated. However psychotherapy is very much needed to see him through his stresses so that he may come to a sort of resolution for his current circumstances, as well as any that he might face in the future. This all-embracing treatment would lead to holistic healing.

Reference list

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5th Edition ). Washington, D.C: American Psychiatric Association.

Barlow , D. H., & Durand, V. M. (2014). Abnormal psychology (Vol. 7th Edititon ). Boston: Personal Education Inc.

Edwards, S. (2011). A Psychology of Indigenous Healing in South Africa . Journal of Psychology in Africa, 21[t] (3), 3335-348.

Sorsdahl, K. R., Flisher, A. J., & Stein, D. J. (2010). Explanatory models of mental disorders and treatment practices among traditional healers in Mpumalanga South Africa. African Journal of Psychiatry, 13[u], 284-290.

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