Discusses how health care practitioners can accommodate traditional Southeast Asian healing beliefs and practices when diagnosing and treating refugee clients. Many Southeast Asian refugees have retained their traditional healing remedies despite having settled for a time in the United States. Traditional practices such as cupping and coining are believed to release excessive air associated with certain physical illnesses; the resulting bruises and skin abrasions need to be differentiated from evidence of abuse and, in particularly, of child abuse. Severe emotional disturbances, attributed to spirits of malicious intent, are commonly feared and denied. Consequently, Southeast Asians suffering emotional problems tend to present themselves for care with physical symptoms, such as complaints about being hot or having a weak heart or kidney, and they often avoid mental health referrals. Health care practitioners need to be alert to twin risks: on the one hand, pursuing an intractable physical symptom with progressively intrusive measures, when the physical complaint is a metaphor for emotional disturbance; and, on the other hand, misdiagnosing signs of a chronic disease as delayed somatic response to refugee trauma. Health care practitioners need to pay close attention to the refugee patient’s point of view and enlist the services of a bilingual interpreter.
