Beliefs in causes of illness

Harmony and balance/imbalance

Traditionally East and Southeast Asians regard health as a holistic matter. Health is viewed as a state of harmony within an integral body and between the individual and his/her environment and nature. Local pathological changes are considered in conjunction with the rest of the body, and not in isolation. Disharmony in any one area results in systemic imbalances that can lead to illness:

In Buddhism disharmony can emerge as a consequence of previous wrongful actions, or because of an imprudent lifestyle.

In Taoism disharmony results because of an imbalance within the individual or between the individual and nature, or because of discord with the ancestors.

In Confucianism disharmony results when the five basic relationships of society are disrupted.
More specifically, an imbalance of yin and yang, a blocked or weak chi, or imbalances in particular organs lead to ill health, and if unchecked eventually to disease. Diseases themselves are categorised according to yin and yang. For example, interior, vacuity and cold disorders are classified as yin, and exterior, repletion and heat disorders as yang (Shih, 1996).

Supernatural causes

People who subscribe to Folk Religion, or to aspects of it, may attribute ill health to supernatural causes and employ ritual and talismans to manage it. Some clients (more likely elderly clients) may believe that once dates of bad luck have passed, the health problem will recover spontaneously (Shih, 1996).

Biomedical causes

There are many East Asian clients whose preference is biomedical medicine and explanations provided by this system will be readily embraced.

Implications for practice

It is important when working with clients from East Asian backgrounds to understand the meaning the health problem has for them, or their perceptions of the cause of the illness. This serves not only to develop a trusting and mutually communicative relationship between the client and health providers, but also to develop appropriate interventions for the client and family.

Traditional approaches to the health issue may need to be incorporated in treatment (see Traditional Treatments below). Where these are contra-indicated, the issue will require working through in order to facilitate the client remaining in health services.