Mind-Body Dualism and the Holistic Approach to Mental Health in Eastern Perspectives

I first encountered the concept of mind-body dualism while studying a paper on cognitive behaviour. Descartes famously articulated this idea, which differentiates between the mind as an immaterial, thinking substance and the body as a material, extended substance. This dualistic view has significantly influenced Western philosophy and scientific perspectives on the mind-brain relationship.

In contrast, Eastern worldviews offer a different perspective on wellbeing. Concepts such as Yin and Yang from Taoism, the interconnectedness of body and mind in Chinese Traditional Medicine, and Tai Chi practices highlight a more holistic approach. Additionally, practices like Yoga from India are integral to this perspective. These ideas have been part of my lectures on recovery from an Asian lived experience perspective for the Mental Health and Addictions — Postgraduate Diploma in Health Science.

The Western psychological model of mental health is unique in its separation of mind and body when considering wellbeing. However, the last decade has seen a shift towards acknowledging a more integrated model, the bio-medical social psychological mental health dualism model (BPS-PMHDM), which recognises the interconnectedness of various factors.

Eastern practices, such as meditation, yoga, tai chi, and martial arts, have long emphasised cultivating wellbeing through practices like breathing exercises. Mindfulness, for example, originated from Buddhist practices and has been adapted by Western society, stripping away its religious elements. However, the challenge remains that in most of the Eastern world, mental health is often associated with “mental ill health” rather than “wellbeing.” This is because the state of wellbeing is often closely related to one’s connection with their immediate family, lifestyle, harmony in their immediate environment, social status, and at times, wealth, instead of focusing solely on the individual mind.

Secondly, the problem also partly stems from the translation of mental health terms from English to Eastern languages. Words like psychology, counselling, and mental illness were first developed by the Western clinical setting, which was not commonly understood in daily conversation before the influence of Western psychology. Consequently, all these terms were directly translated from Western medical terminology. Additionally, translations could be either transliterations or translations that lack context, leading to misuse or misinterpretation. For example, “Psychologist” might be transliterated as “心理学家” (xīnlǐ xuéjiā), where “心理” (xīnlǐ) means “psychology,” and “学家” (xuéjiā) means “scholar” or “expert.” Translation aims to convey the meaning of the English word in Chinese. In this case, “Psychologist” might be translated as “心理医生” (xīnlǐ yīshēng), where “心理” (xīnlǐ) still means “psychology,” and “医生” (yīshēng) means “doctor” or “physician.” These translations often lack the context, which can easily lead to misuse or misinterpretation. In each of the Eastern societies, those words have never been heard of and used, and sometimes they do not truly represent the meaning of the role or terminology that is used in medical terms. On the other hand, each culture and language has its own words and interpretation of the elements of describing certain conditions. Take a look at the Chinese character, such as “heart.” In the old days, the Chinese word “心” (xīn) means “heart” or “mind.” Many of the illnesses or psychological issues were believed to stem from our hearts as the centre of life force, consequently, there are many words that use the concept. A few more examples are as below:

- 心情 (xīnqíng): Mood or emotional state.
- 心理 (xīnlǐ): Psychology or mental state.
- 心态 (xīntài): Attitude or mindset.
- 心愿 (xīnyuàn): Wish or heartfelt desire.
- 心痛 (xīntòng): Heartache or emotional pain.
- 心情好 (xīnqíng hǎo): Feeling good or in a good mood.
- 心疼 (xīnténg): To feel distressed or heartbroken.
- 心有余悸 (xīn yǒu yú jì): To still feel anxious or uneasy.
- 心慌 (xīnhuāng): Nervous or flustered.
- 心平气和 (xīn píng qì hé): Calm and composed.
- 心事 (xīnshì): A matter of concern or something weighing on the mind.
- 心甘情愿 (xīn gān qíng yuàn): Willing or wholehearted.
- 心神不宁 (xīnshén bùníng): Restless or anxious.

Moreover, the modern emphasis on recovery in mental health can create further complications. The individualistic culture of recovery, with its focus on self-determination and autonomy, fails to address the collective nature of Eastern cultures, where decisions are made in a group setting, and hierarchy and familial roles are important. Self-advocacy and self-determination can be perceived as selfish, especially when decisions, including health, education, and careers, are typically consulted with parents.

To address these issues, I encourage professionals to explore the concept of wellbeing with Asians with lived experience from a collective cultural viewpoint and at the same time, ask what their understanding of the concept of mental health and mental illness is, what they believe about people with diagnoses, and spend some time explaining how mental health and wellbeing are viewed in Western societies, especially in New Zealand. This can help individuals examine their own biases and reduce stigma attached to labels.

I also encourage professionals to explore with individuals with lived experience from an Asian background to get a better understanding of their views and beliefs about Western bio-medication. For example, many Chinese believe in prevention and replenishing the body through herbal medication, viewing Western medication as “toxic.” Understanding what they are taking and its purpose is crucial. This can help to avoid situations where individuals might be taking herbal medication that can counteract the Western medication prescribed by a doctor.

Understanding the collective cultural view of being “unwell” and its impact on family dynamics is essential. Identifying key decision-makers and understanding the importance of relationships in collective cultures are crucial steps. When I was working as a peer support worker in a pilot-funded programme from Auckland Te Whatu Ora in around 2005, I adopted a different approach from the Western model, which typically only serves individuals with lived experience who are seeking peer support. Instead, I met with the whole family during the first meeting with the young adult who requested the peer support service. Rather than focusing solely on their son, I shared my own journey of recovery and allowed his parents to ask any questions. This approach is important because, in many collective cultures, building relationships is paramount, and tasks come second. This means I might need to share a bit more about myself before they are fully supportive of their adult son seeing me and able to provide their full support. At times, the father or the mother might call me, and I give equal attention to the questions they ask (not about their son, due to privacy concerns) but rather providing psychoeducation and sharing any concepts they might want to learn more about. This includes consistently introducing the Western biomedical model of mental health, treatment, and recovery concepts. An individualistic peer support worker might see this approach as intrusive or even codependent. However, as an Asian, I understand that our culture emphasises roles and responsibilities, and I am providing respect to them as parents who care deeply about their son’s mental distress.

Unfortunately, despite giving presentations at AUT for approximately 18 years, there is still minimal discussion regarding the impact of Eastern cultural nuances on mental health in New Zealand. Additionally, there is a lack of workforce development that specialises in Asian collective culture. The responsibility for incorporating cultural perspectives often falls to the individual facilitating the training. AUT is among the institutions that consider diverse cultures, which is why I have had the opportunity to deliver guest lectures to postgraduate students each year, thanks to a wonderful lecturer who values diversity.

A significant gap remains: we have yet to bring Asian individuals together to explore the concept of “wellbeing” from their own cultural perspectives through a collective worldview. How do they know when they have reached a state of wellbeing that truly reflects their identity, collective culture, and close-knit family and community ties? Unpacking the concept of mental health and wellbeing in this context is a journey we are still embarking on.

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