Culture Shock

Simon Trepel, MD, 4 th Year Psychiatry Resident

University of Manitoba, Faculty of Medicine

Learning Objectives

•  To become familiar with concepts of culture

•  To Understand Culture Shock

•  To recognize possible symptoms of culture shock

Introduction

  People generally assume that the experience of travel will be an enjoyable and memorable one. With proper planning and realistic appraisals of potential problems, a majority of our vacations and extended trips will in fact live up to our positive expectations. There are many sources of stress related to travel, however, if we consider time zone changes, vast cultural differences, logistics of travelling- like companions, mode of transport and accommodations, new strange environments, and various other variables. An often overlooked potential source of stress and difficulty is the transition in our thinking, feelings and behaviour that takes place when we are immersed in a foreign culture. This transition represents the changes that must inevitably take place when we travel, or re-locate, from one culture to another. Sometimes the transition is fraught with many physical and mental symptoms that actually preclude enjoying the trip itself. Adverse symptoms while attempting to adjust to a new culture has been described as "Culture Shock"

Culture

  Culture is an amorphous process that shapes everything about our understanding of ourselves, others, and the world around us. We take our own culture with us wherever we go. Culture has been described as the "software of the mind" because it is a type of information that is learned in a collective context distinct from human nature and personality. One's own culture may be hard for one to describe or conceptualize, until one is immersed in another culture, and able to appreciate the differences. Trying to observe and understand another culture has been described as "watching chess without knowing the rules". The moves people make will appear random or be difficult to understand without becoming familiar with the behavioural rules. The stress of attempting to modify our own thoughts and behaviours while in another society has been defined as Culture Shock.

Culture Shock

  Oberg first described Culture Shock in 1959 as a "shock of the new". It is understood as a consequence of strain and anxiety resulting from contact with a new culture and the feelings of loss, confusion, and impotence resulting from the loss of accustomed cultural cues and social rules. Taft defined Culture Shock as a "feeling of impotence from the inability to deal with the environment because of an unfamiliarity with the cognitive aspects and role-playing skills". Culture Shock is a normal multifaceted experience resulting from the numerous stressors that occur in the context of contact with a different culture. Culture Shock has been associated with tourists, business-people on extended assignments, refugees, and international students.

Stages of Culture Shock

  There have been many models proposed to describe the various symptoms seen in culture shock. Most authors conclude that there exists a pattern of stages that are experienced in a specific order. While the order does not change, one may regress to an earlier stage based upon the severity and type of stress one encounters. Typical stages of Culture Shock are:

Contact-Fascination-Honeymoon Stage

Interest, excitement, euphoria, insomnia, positive expectations and idealization of host culture, any anxiety and stress is interpreted positively.

Disintegration-Hostility-Crises-Culture Shock Stage

   Emerges within weeks-months. Characterized by irritability, pre-occupations with cleanliness, safety, devaluation of host culture, multiple physical/psychological problems related to cortisol-mediated stress responses. Symptoms include anxiety, agitation, panic, conversion-hysteria, anger, aggression, poor concentration/sleep/energy/appetite, loneliness, and even suicidal ideation. One wants to go home!

Reintegration-Acceptance-Reorientation-Gradual Recovery Stage

In order to be able to function effectively, there must be some adaptation to the new cultural environment. Without adaptation, one attempts "flight or isolation". Resolution of the Culture Shock stage entails making acceptable adaptations to the new rules, roles and behaviours of the host country. Adaptations will require problem solving, and gaining new perspectives on one's own culture and the new host culture. Central to this process are concepts of empathy and non-judgement. Problems and stressors do not end in this stage, but rather preparations are made to enhance functioning.

Adaptation-Resolution-Acculturation-Autonomy Stage

One is able to develop stable adaptations that are successful at resolving new and current problems. One gains an awareness of cultural similarities and differences with their own, as existing on a continuum of adaptive human behaviour. One accepts the new culture without idealization or devaluation.

Conclusions

  There has been little systematic research to address the mechanism and manifestations of Culture Shock, despite its first description over 40 years ago. Culture Shock is a phenomenon that occurs in specific individuals placed in foreign cultures for varying lengths of time. It is an important area of concern for immigrants, travellers, tourists, international business people, as well as international students. Culture Shock is a well-described process that occurs via predictable stages. Preventing difficulties and symptoms may be difficult, but clinicians should use an educational approach, stressing intercultural education, empathy, non-judgment, and the utilization of appropriate problem solving approaches to ensure that Culture Shock does not affect one's ability to enjoy and function in the new society, or hinder a return to one's own culture.

References

•  Winkleman M, Cultural Shock and Adaptation , Journal of Counselling and Development, 1994 (73) 121-126.

•  Stewart L, Culture shock and Travellers , Journal of Travel Medicine, 1998, 5(2): 84-88.

•  Mumford DB, The measurement of Culture Shock , Social Psychiatry, 1998 (33): 149-154.

•  Lockie C, Travel Medicine and Migrant Health , 2000.