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At Berlin's Charite hospital, specialized therapists cross cultural barriers to gain a better understanding of immigrants' unique problems.
Depression can have many origins, and it's important to understand the cultural context
Diagnosing and treating mental illnesses is a challenge in itself. In Germany, where around 20 percent of all residents have an immigrant background, many psychiatric patients also come from others cultures.
They, however, are much less likely to seek professional help than native Germans are. Due to language barriers or cultural differences, they may feel inhibited, or not even be aware of the treatment options available to them.
At the Charite hospital in Berlin, the Center for Intercultural Psychiatry, Psychotherapy and Supervision (ZIPP) aims to overcome these hurdles. It employs a team of psychologists, social workers and ethnologists, many of whom have a migrant background themselves.
Putting things into perspective
This provides an alternative to therapists who may have little experience with non-German patients, explains Ernestine Wohlfart, the Intercultural Center's director. She also sees deficiencies in the foundations of psychiatry, whose diagnostic systems are based on Euro-American culture and are hard to apply to other nationalities.
Some patients have escaped violent situations
"Someone can have a different cultural context for things like ghosts, for example," said Wohlfart. "In the western world, if someone starts talking about ghosts, it means that they probably have a psychosis. But when this person can communicate this information in their own social context, it's easier to determine if they have really crossed their own border of reality perception."
At a consultation session for African women, 35-year-old Sonia Sidibe sits rigidly in her chair; her expression friendly but distanced. With increasing animation in her voice, she explains that she came to Germany one and a half years ago because her husband constantly beat and mistreated her.
"Every time I tried to escape from him, my family brought me back," said Sidibe. "So I fled, and all the stress has made me sick. I have heart problems and I feel like I'm suffocating. I take cold showers and open all the windows even in mid-winter because I'm scared that I might die."
Adjusting to a new environment
Sonia Sidibe is being treated for posttraumatic stress disorder at the Intercultural Center. According to Wohlfart, coming to Germany has become a psychological burden for some of the patients.
"Migration always involves an aspect of progression, meaning that people want to experience something new and decide to live in a different environment," said Wohlfart. "But, at the same time, it's a form of regression, because arriving in a new country means starting from scratch."
This was the case with 34-year-old Shinaz Makampe, who came to Germany three years ago. In her home village in Cameroon, she was thought to be cursed because she had had a miscarriage shortly before her wedding and became infertile. As a result, the village community evicted her. She is now safe in Germany, but feels displaced and does not know how long she can stay. She would like to work, but has not received a work permit.
Finding new friends is also not easy, and she is struggling with depression.
The Charite hospital was founded in 1710
"I got here through my social worker at my home for asylum seekers, because I have some psychological problems," said Makampe. "I have to talk to a specialist about them so that I can feel normal in society again and feel good again."
Culture of understanding
Feeling accepted in society is something that many of the patients at the Intercultural Center strive for. Even second- and third-generation immigrants often come here for therapy. They struggle with the divide between German culture and the culture of their parents and grandparents.
The therapists at the Intercultural Center aim to understand their own cultural bias and that of their patients'. This method seems to bring results, as the Center has treated over 600 people from around 90 different countries since it was opened in 2002.
It has gained a positive reputation among immigrant communities as a place where talking to a doctor about mental problems is a less complicated and intimidating experience. This, of course, means a good chance of being understood.
Author: Anna Corves (ew)
Editor: Kate Bowen