Case Report

iMedPub Journals 2017

ACTA PSYCHOPATHOLOGICA
www.imedpub.com ISSN 2469-6676 Vol. 3 No. 4: 49

DOI: 10.4172/2469-6676.100121

The African Belief System and the Patient’s Mavis Asare1* and
Samuel A Danquah2
Choice of Treatment from Existing Health
Models: The Case of Ghana 1 Methodist University College Ghana,
Progressive Life Center, Ghana
2 Psychology Department, Legon/
Methodist University College Ghana,
Ghana
Abstract
This paper presents a narrative review including a case study of the African Belief
System. A strong belief in supernatural powers is deeply rooted in the African *Corresponding author:
culture. In Ghana, there is a spiritual involvement in the treatment of illness Mavis Asare
and healthcare. The new health model in the African culture therefore can be
considered to be the Biopsychosocial(s) model-with the s representing spiritual  masare@mucg.edu.gh
practice-compared to the biopsychosocial model in Western culture. The case
study on dissociative amnesia illustrates that Africans consider spiritual causes of Methodist University College Ghana/
illness when a diagnosis of an illness is very challenging. The causes of mental Progressive Life Center, P.O. Box AN 5628,
health conditions in particular seem challenging to Africans, and therefore are Accra-North, Ghana.
easily attributed to spiritual powers. The spiritual belief in African clients should
not be rejected but should be used by caregivers to guide and facilitate clients’
Tel: +233 263344272
recovery from illness. The spiritual belief provides hope. Therefore when combined
with Western treatment, this belief can quicken illness recovery.
Keywords: Spiritual belief; Spiritual; African; Traditional culture; Biopsychosocial;
Citation: Asare M, Danquah SA (2017) The
Treatment methods; Mental health
African Belief System and the Patient’s
Choice of Treatment from Existing
Health Models: The Case of Ghana. Acta
Received: July 05, 2017; Accepted: July 29, 2017; Published: August 10, 2017 Psychopathol. Vol. 3 No. 4:49

Introduction across generations, spiritual belief in Africa can be described as

behaviour genetics. There are different kinds of beliefs-the belief
By way of free will, humans choose among various options based in the Almighty God and belief in other spirits [4-8]. In Ghana,
on many factors. Some of these factors include their spiritual most herbalists prepare their herbs on the basis of spiritual
beliefs, preferences, knowledge and perceptions [1]. Choosing belief. The elite African who has adequate knowledge about
treatment modalities are also influenced by our free will. In Africa, the scientific cause of illness also incorporates spiritual factors
the spiritual belief is a major determinant of choice of treatment when dealing with illnesses [9]. The current Western model, the
[2]. The African Belief System seems to originate from the Creation biopsychosocial model, is used to explain health and illness. It
history where the Almighty God created the universe and the considers health as including physical, mental, emotional and
first man [3]. This belief is strongly held by indigenous Africans social factors [10]. For the African, however, wellbeing is not just
[4,5] and it has been passed from generation to generation. The about the healthy functioning of the body system through proper
spiritual belief is therefore part of an African. You cannot stop
healthcare and lifestyle, but well-being goes beyond scientific
the African from believing in supernatural powers. The continued
causes to include spiritual involvement [4,8]. The modification of
existence of spiritual belief among Africans suggests heritability
the biopsychosocial model to include spiritual factors [11] is best
of this belief. The explanation, however, for this continuous
suited in the African culture.
spiritual belief among Africans is the fact that it is transferred from
one generation to another through parenting and upbringing
of children. Therefore, a young person in Africa grows up with
What is the African Belief System?
belief in a Supreme God. A popular local proverb in Ghanaian The African Belief is the strong hope in Spiritual powers. The
Akan language “Obi nkyere akwadaa Nyame” which means word “Spiritual” as seen in the aspects of the Biopsychosocial
nobody teaches the child the existence of God’ [6] confirms the (s) approach to healthcare and illness [11] is based on beliefs
continuation of beliefs across generations”. As children in Africa which can be connected to the history and culture of Africa [4].
grow to exhibit this spiritual belief and the belief continues to run The behaviour of Africans is motivated by what they believe, and

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ACTA PSYCHOPATHOLOGICA
ISSN 2469-6676 Vol. 3 No. 4: 49

what they believe is based on what they experience. Although A typical case study on dissociative amnesia in
western medicine and health care systems have been introduced Ghana
in Africa, many African countries still rely on traditional health
care [2,12-14]. The data was obtained with consent from a client at a psychological
clinic [9]. A client loses her memory as a result of shock from a
Healthcare Consultations in Ghana broken relationship. From assessment, it was revealed that client
has dissociative amnesia.
Africans decide on the kind of treatment they want in accordance
with the illness and cause associated with the illness. A patient What then is dissociative amnesia and how can it be explained
in Ghana has various existing treatment models to choose from as a mental health condition other than a spiritual attack?
at his/her disposal. A few of the current health models with their Dissociative amnesia is a psychological disorder characterised by
practitioners include the following: abnormal memory functioning whereas there is no structural brain
a. Physical health hospitals and clinics-services provided by damage or a known neurological cause. It results from the effect
of stress or psychological trauma on the brain, but no indication
physicians;
of any physiological cause. It is often considered to be similar to
b. Mental health hospitals and clinics-services provided by the clinical condition known as repressed memory syndrome.
mental health professionals including psychiatrists, clinical Dissociative amnesia is described as an act of self-preservation
psychologists. Clinical counsellors and social workers; resulting from severe anxiety or shock. With this condition,
unpleasant or unwanted or psychologically dangerous memories
c. Psychological clinics-services provided by clinical psychologists, are repressed or blocked from entering the consciousness [16].
clinical counsellors and social workers; Normal autobiographical memory processing is blocked by
d. Herbal Clinics-provides treatment with tested local herbs an imbalance of stress hormones such as glucocorticoid in the
processed into herbal medicines; brain, particularly in the region of the limbic system involved with
memory processing [16,17].
e. Traditional herbal centres-herbalists provide treatment with
local herbs and spiritual guidance; A Case Study of a Client
f. Spiritual centres- services provided by priests and spiritual Informed consent was obtained from the client before including
healers. this case study in the paper.

Within the Spiritual consultations, there are three components Initial assessment
in practice in Ghana. These include: (a) Orthodox churches, (b)
The client was in acute dissociative amnesia state and could not
Charismatic churches, (c). Shrines including Spiritual Herbalists. respond to psychological test. Therefore, the standard clinical
Orthodox Church practices usually include solemn prayers to interview was conducted to take information from the family
the Almighty God with less emphasis on warding off evil spirits who accompanied the client to the clinic.
whereas Charismatic Church practices utilises a harsh approach of
loud prayers to Almighty God and more emphasis on deliverance A 36-year old woman who is highly educated and from elite
family, experienced dissociative amnesia as a result of shock
and warding off evil spirits. The Charismatic church practices
from a break-up of a love relationship. Two weeks before
also involve frequent fasting (going without food) and all-night
wedding, the client learned that her fiancée had gotten married
prayers (staying through the night to pray). It appears that almost
to another person. Upon hearing this at the office, she fainted.
all Africans believe in the Almighty God and worship through the
Within the week she showed the following symptoms: She could
Churches-either Orthodox or Charismatic. Shrines and Spiritual not remember her name, the name of her fiancée; could not
Centres usually focus on warding off evil spirits through the remember family members and co-workers. She experienced
powers of lessor spirits. complete loss of self-identity information and deterioration in
her work commitment.
Criteria for Choosing Treatment Modalities
Parents of this client believed in Western medical treatment
The choice of the treatment modalities by the patient is not but as they did not understand the condition, they attributed
associated with the proximity nor with the cost of treatment, this to spiritual attack, saying that the condition is due to the
but, rather it seems to be related to the patient’s or the family’s co-workers’ envy of the client’s success. The Parents of the
concept of the aetiology of the illness which is based on the client, however, first visited the medical center for treatment. A
spiritual belief [2,15]. If the patient believes that his/her mental Magnetic Resonance Imaging (MRI) examination was conducted
health disorder is due to sin against God, the choice of treatment and the results proved that there was no physical damage to
would be Orthodox Church practices; if the cause of illness is the brain. The medical examination which showed negative
due to demonic influence (satanic) then the choice would be results consolidated the strong belief of the client’s family, that
the Charismatic Church practices; and if he/she believes that her condition was spiritual attack. Based on the medical results
the cause is witches, a curse from the “juju/voodoo”, the wrong indicating no physical cause, parents of the client consulted the
doing against the ancestral spirits, etc. the Shrine is consulted. Charismatic church for treatment. The spiritual intervention,

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however, did not alleviate the symptoms of the client and they [2]. People consult mental health hospitals and clinics when
decided to visit the medical center again. The medical center also spiritual and herbal treatments do not eradicate symptoms.
could not help until finally there was a referral to see a Clinical The least preferred treatment choice in mental health is the
Health Psychologist. She was finally diagnosed and successfully Western medical practice including psychiatry and psychological
treated with a psychological intervention. Consultation with the treatment [9].
Clinical Health Psychologist provided scientific and psychological
The belief, however, has an advantage in illness treatment. In
causes of the condition. This was helpful in the psychological
Ghana, spirituality has been found to help people cope with a
treatment because the initial consultation at the medical center
wide range of illnesses and stressful situations [17]. In over
did not provide any diagnosis when the MRI results showed no
45 studies examining relationships between spirituality and
physical damage to the brain.
meaning and purpose in people with illness, 42 of the studies
Choice of treatment in mental health (93%) reported significantly positive relationships [17].
In the area of mental health, it has been noted that in Ghana Spiritual beliefs help in illness management, in that this belief
the health seeking behaviours of clients are mostly focused provides hope. It is therefore likely that cognitive stressors of
on the Charismatic and Orthodox churches, followed by the negative thoughts associated with the illness condition can
Shrine consultation, including the traditional herbal treatments be eradicated. Plante [18] studies have shown that worries
where some of the practitioners combine shrine and herbal generated by chronic illness can slow the illness recovery process.
treatment approaches [2,15]. The Western medical practices For example, some patients with chronic medical conditions do
including psychiatry and psychology seem to be less patronized not adhere to treatment as a result of a lack of hope [9]. The
by Ghanaian clients [9]. Mental health issues are less understood belief can provide hope in medical treatment, and help the client
by Ghanaians and Africans, and therefore very often their causes to adhere to the medical or psychological therapies until these
are associated with spiritual factors. treatments achieve their effects.

Discussion Recommendations for Clinicians in Ghana

The above client’s case illustrates the effect of the African Belief The belief is very strong in Africa. Health education on scientific
System on the choice of treatment in Ghana. In the case study causes of illness cannot eliminate spiritual belief in Africans,
examined, the lack of an explanation for the client’s illness especially about the Belief in the Creator, Almighty God. The
prompted the family to seek spiritual care, based on their Spiritual Belief in Africans should be embraced by Clinicians
existing spiritual beliefs. Though the family had strong spiritual in Africa. Clinicians utilising the Western medical practice in
beliefs, if the medical center had identified a physical cause of hospitals and clinics, should accept the belief of African clients and
the condition, the family would have complied with Western utilise these beliefs to increase their compliance and adherence
treatment. In Ghana, situations that are challenging to explain are to scientific medical treatment. Clinicians should strengthen
generally attributed to spiritual causes [15]. Spiritual beliefs seem spiritual beliefs of clients who already exhibit these spiritual
to influence Ghanaians and Africans when choosing treatment beliefs and direct them to use the belief positively to improve
modalities for their illnesses. Based on the spiritual belief in their illness and healthcare. Also, the belief can be guided by
Ghana, the treatment choices in order of preference include: 1. clinicians to help in illness recovery; for example, a client can be
Herbal treatment followed by 2. Spiritual treatment: The least directed to modify spiritual practices (such as fasting) until he/she
preferred treatment choice is the Western medical practice. Even recovers from illness. Spiritual healers should be acknowledged
when Africans utilise the services of Western hospitals and clinics, in the healthcare practice in Africa. The Spiritual healers should
they do the spiritual consultations concurrently. Therefore, many be trained to understand basic medical conditions in order for
Ghanaians combine Spiritual treatment (through prayers and them to modify spiritual practices to the needs of the client; for
meditation to God, or lesser gods including juju/vodoo) with the example suspending clients’ fasting when they are ill.
Western medical treatment.
Conclusion
The belief in spiritual involvement in illness and healthcare is
independent of educational level [9]. In the case study presented, There is increased knowledge on scientific causes of illness.
caregivers of elite family attributed dissociative amnesia to Majority of Ghanaians therefore consult medical care for their
physical health conditions. However, despite the consultation of
spiritual causes. Massive health education on scientific causes
Western hospitals and clinics, Ghanaians seem to also rely on
of illness has not eradicated the spiritual health beliefs in Africa. supernatural beliefs for healthcare and illness recovery. From
The belief is even more prominent with mental health conditions the case study, the lack of explanation for the client’s illness
[2,9]. A plausible explanation for this strong belief about spiritual prompted the family to seek spiritual care, based on their existing
causes of mental illness is that research into mental illness is quite beliefs. In Ghana, situations that are challenging to explain are
recent in Africa. As there is a strong spiritual belief in Africans attributed to spiritual causes and that is their belief system [7,15].
[4], any situation or event which is not clearly understood is Spiritual belief, therefore, should be explored during assessment
attributed to spiritual explanations [7,15]. In Ghana, the first and diagnosis of a client in order to reduce the delays in
treatment of choice in seeking treatment for mental illness is seeking medical treatment. These delays result from the doubts
the Spiritual practice, followed by the Traditional Herbal practice associated with whether the condition is spiritual or medical.

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ISSN 2469-6676 Vol. 3 No. 4: 49

Consent Acknowledgements
Written informed consent was obtained from the client in the We acknowledge Staff and Interns at PLC-Ghana.
case study.

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