The Role of Culture, Values and Trauma in Shaping Abnormal Bodily Experience in Migrants

The way somatization is expressed—including the actual somatoform symptoms experienced—varies in different persons and in different cultures. Traumatic experiences are intertwined with cultural and social values in shaping the resulting psychopathological phenomena, including bodily experiences. Four ideal-typical cases are presented to show the different levels involved. The effects of trauma, culture and values may be pathofacilitating (creating a social context which is necessary for the experience to take place), pathogenetic (taking a causal role in the onset of the psychopathological reaction), pathoplastic (shaping the form such a psychopathological reaction takes) or pathointerpretive (different interpretation of the same symptoms depending on the patient’s beliefs). While the roles of trauma and culture were already well recognized in previous accounts, this chapter adds an exploration of the importance of values, including cultural values, in the aetiology, presentation and management of somatization disorders. As a consequence, the therapeutic approach has to be adjusted depending on the way these factors intervene in the patient’s construction of mental distress.