Argues that the concept of cultural bereavement more meaningfully explains psychiatric disorder in refugees who have experienced traumatic events than does the diagnosis of post-traumatic stress disorder (PTSD). Separated from their homeland, culture, and past, refugees can develop disabling symptoms that mimic PTSD, but that will not be ameliorated by Western therapeutic practices alone. For example, many Cambodian refugees describe themselves as having “the Cambodian sickness,” which refers to a constellation of symptoms including lethargy, headaches, and worrying about the family at home. It would be a mistake, however, to interpret any one of these symptoms only as the clinical indication of PTSD, because the symptom actually may symbolize the whole complex of cultural bereavement. The concept of cultural bereavement can refine clinicians’ understanding of psychiatric disorder among refugees by: (1) minimizing the likelihood of refugees being labeled as having disorders when their symptoms reflect a profound communal suffering; (2) detecting disorder in refugees who exhibit no clinical symptoms in Western terms; and (3) improving the accuracy of diagnosis, where identification of trauma may fail in cases where the refugee faced more subtle trauma (such as loss of self-identity) rather than more obvious traumas (such as rape).
