one size doesn't fit all... the need for culturally tailored recovery services.
What comes to mind when you think about culture?
We often consider culture as observable characteristics such as food, dance, music and art. However, these are merely an external display of more profound and broader cultural components - the complex ideas, deeply held preferences, attitudes and values.
The culture iceberg illustrates that a culture's core components may not be visible. These components shape our beliefs, values, behaviours, and perceptions. Culture refers to a particular group's shared customs, traditions, language, arts, and social institutions. At the same time, identity encompasses the self-perception and sense of belonging an individual derives from their cultural background. In many cases, different cultural groups share similar core values (such as "honesty", "respect", or "family"). Still, these are often interpreted differently and incorporated into specific daily attitudes. Ultimately, these internal forces become visible in the form of observable behaviours, such as the words we use, act, and communicate.
Cultural identity is formed through multiple sources such as family, community, education, and exposure to different cultural influences. For children of migrants, these different sources may conflict with each other. New definitions of "normal" that oppose the home and community definitions may be perceived in schools and on television. Our early experiences within these contexts lay the groundwork for our cultural identity as we internalise the values, norms, and practices of the culture we are raised in. Language, rituals, and traditions become significant markers of our cultural identity, fostering a sense of belonging and group affiliation.
Identity gives us a location in the world and presents the link between us and the society we live in. We use identity to understand how we are the same as those who share our identity and different from those who don’t. Identity is most clearly defined by difference. We frame who we are by contrast, in opposition to another identity.
Growing up in a small Punjabi community in Bradford I struggled to establish a cultural identity. I never fully felt part of the Punjabi community and could never completely identify with my British nationality. Using the acculturation model, I sat in the marginalised area on the cultural sidelines, feeling different from everyone around me. It was not until later in recovery that I could define my identity comfortably as a combination of my Punjabi heritage and British nationality.
Cultural identity is formed through multiple sources such as family, community, education, and exposure to different cultural influences. For children of migrants, these different sources may conflict with each other. New definitions of "normal" that oppose the home and community definitions may be perceived in schools and on television. Our early experiences within these contexts lay the groundwork for our cultural identity as we internalise the values, norms, and practices of the culture we are raised in. Language, rituals, and traditions become significant markers of our cultural identity, fostering a sense of belonging and group affiliation.
Identity gives us a location in the world and presents the link between us and the society we live in. We use identity to understand how we are the same as those who share our identity and different from those who don’t. Identity is most clearly defined by difference. We frame who we are by contrast, in opposition to another identity.
Growing up in a small Punjabi community in Bradford I struggled to establish a cultural identity. I never fully felt part of the Punjabi community and could never completely identify with my British nationality. Using the acculturation model, I sat in the marginalised area on the cultural sidelines, feeling different from everyone around me. It was not until later in recovery that I could define my identity comfortably as a combination of my Punjabi heritage and British nationality.
When I came into recovery, as the only Asian in the room, at first all I could see were the differences. Although I could completely relate to their experiences and they had an interesting take on alcoholism, a part of me whispered that I was different because of my culture and background. For anyone in recovery, you will know this is a perilous position to feel unique and different from your recovery peers. What I was experiencing was something called 'false polarisation.' False polarisation refers to a situation where a complex issue such as alcoholism is simplified into two opposing sides, often resulting in an oversimplification and distortion of the actual range of opinions or perspectives. For me, I oversimplified it into a 'me' and 'them' disregarding the nuances and diverse viewpoints around me.
In time I got sober and stuck around recovery, but these ideas of cultural difference remained with me. I could see that I had more in common with the people in recovery than I had initially thought. What I once thought were binary options of 'me' and 'them' separated by a gulf of difference was not a gulf at all.
Although our cultural differences may not be as large as we initially think, the differences are there, and we can't trivialise their impact on a person's journey in recovery. We have a mature understanding of the physical and psychological domains in recovery, we now need to start developing our understanding of the lived experience domain. Over the years I have seen many people from a South Asian background come into recovery and not stay. The numbers speak for themselves, if we look at the ethnic makeup of recovery services and compare it to the census data, it illustrates that migrant communities are under-represented across all recovery modalities.
I believe that in improving access to services for migrant communities, we need to understand these cultural nuances and adapt existing services to take them into account. In doing so, we can remove the unseen hurdles members of migrant communities have in accessing recovery services. This is not to say that only people from the same community can help each other, this is about improving the cultural literacy of existing services.
The impact of culture is more than just a barrier to entering recovery services. After many years in recovery, I began attending a culturally focused Punjabi recovery meeting. As I attended this meeting, I could share a side of myself I had never shared before in recovery. Only then did I realise that there was a part of me I had never really shared about in recovery. This was not because I was told not to share it, but I held it back as I wanted to share about my culture and not have to explain it. Having a space I could share my journey and recovery within the context of culture opened a whole new dimension of my recovery. Existing services need to be redeveloped to incorporate cultural context to meet the needs of migrant communities. The lack of this has resulted in the under-representation of these communities.