any suggestion that he should seek therapy. Further-
more, his lack of motivation for therapy would
probably make it an unprofitable venture.
Advantages of This Definition. Defining abnor-
mal behavior in terms of subjective distress has some
appeal. It seems reasonable to expect that adults
and some children can assess whether they are
experiencing emotional or behavioral problems
and can share this information when asked to do
so. Indeed, many methods of clinical assessment
(e.g., self-report inventories, clinical interviews)
assume that the respondent is aware of his or her
internal state and will respond to inquiries about
personal distress in an honest manner. In some
ways, this relieves the clinician of the burden of
making an absolute judgment as to the respondent’s
degree of maladjustment. Of course, younger chil-
dren are often incapable of reflecting upon or
reporting their subjective distress, rendering this
index of maladjustment moot.Problems with This Definition. The question is
whether Cynthia, Kwame, or both are maladjusted.
The judgment will depend on one’s criteria or
values. From a strict standpoint of subjective report,
Cynthia qualifies but Kwame does not. This exam-
ple suggests that labeling someone maladjusted is not
very meaningful unless the basis for the judgment is
specified and the behavioral manifestations are stated.BOX5-2 Focus on Professional Issues: Culture and DiagnosisCulture has a significant impact on our thoughts
and the way we view ourselves and the world
around us, our experience and expression of emo-
tions, and our behavior. Therefore, culture should
be taken into account when a person is being eval-
uated for psychological problems, and mental
health professionals should be aware of their own
cultural biases as they evaluate those from other
cultures. What may be labeled as unusual or deviant
in one culture may not be considered as such in
another culture.
Consider the following case of Gusti A., a
34-year-old Indonesian man:
As a student he was often sick and he pondered
on life and why one suffered sickness and death.
He was puzzled as to the meaning of life and
death. He spent a lot of his time alone in his room
trying to solve these problems. Then he found he
could not sleep and his condition got worse, to
the point that he rarely went to classes or tried to
study or even bothered to look after himself
properly. His friends became concerned about his
condition and wondered if he was going mad.
Then one of his friends found him talking to
himself and thought he had finally gone crazy. His
friend took him home because he was frightened
something would happen to him if he were left
alone. His condition continued for over six
months, until he felt he really was mad. Then he
began to have strange experiences. One day hewas walking with a friend who suddenly collapsed
unconscious in front of him. Feeling a strong
desire to help his friend, Gusti A. reached out his
hand and placed it on the unconscious man’s head
and tried to transfer his energy to him. He then
instructed his friend to wake up, and he did.
Although he was not sure if his friend had recov-
ered as a result of his action or not, he tried to
test his ability to heal others. He also had various
premonitions which proved accurate, such as see-
ing in his mind an accident in front of the univer-
sity before it happened, and feeling worried
about his grandmother and shortly afterwards
discovering that she was seriously ill. As a result of
several such experiences he was finally convinced
that he did in fact possess special powers; fur-
thermore he knew that his grandfather, father
and his cousin had similar abilities. He began to
learn from books...about spiritual healing and
then began to use his inner power...to heal
people. (Stephen & Suryani, 2000, p. 19).
To those of us from other cultures, Gusti A.’s
beliefs and behaviors may seem quite unusual or even
evidence of a serious mental disorder like schizophre-
nia. However, individuals like Gusti A. are viewed as
traditional healers (thebalian) in Bali, Indonesia.
Many anthropologists and cross-cultural psychiatrists
and psychologists argue that the states of conscious-
ness, beliefs, and behaviors of these traditional hea-
lers are distinct from those that characterize mental136 CHAPTER 5