Nobody Calls It Therapy

Before high school, I went to public schools, so when I started going to a Catholic high school, one of the biggest differences I noticed was how much community was built into the school day.

It was not just classes, sports, clubs, and homework, there were retreats, prayer services, advisory moments, reflection days, Masses, and all these small traditions that made people stop and think about their lives in a way that felt different from a normal school assembly. At first, I mostly saw them as religious events because technically that is what they were, however over time, I started to notice that they were also doing something else.

They were giving students a structured way to process things, not therapy exactly, but something that could feel therapeutic.

That made me start thinking about how different cultures understand mental health. In some places, therapy means sitting in a room with one person and talking openly about your feelings, your childhood, your anxiety, your family, or whatever is going on beneath the surface, and that is probably the version of therapy I hear about the most, especially in American culture now, where people say, "my therapist said…" or "I talked about that in therapy," and it has become much more normal to speak that way.

However not every culture handles sadness, stress, anxiety, conflict, or grief through direct conversation. Some families do not sit down and say, "let's discuss our emotions," they show care instead by making food, giving advice, checking whether you are sleeping, telling you to work harder, praying for you, staying nearby, or pretending not to notice too much, because noticing too directly would make the person feel exposed.

I used to think that not talking about feelings meant people were avoiding them, and sometimes that is true, silence can be damaging when it means no one is allowed to say what hurts. However from an anthropological point of view, silence can also mean different things depending on the culture, privacy in one family, respect in another, protection in a third, or sometimes just the only language people were ever taught.

That is what makes mental health so interesting to me, the feeling might be human, but the way people explain it is cultural.

One person might say, "I am anxious." Another might say, "my stomach hurts," or "I am tired," or "I need to pray," and someone else might not say anything at all, but suddenly start cleaning the kitchen, cooking for everyone, or disappearing into their room. The distress is still there, it just comes out through the body, through duty, through faith, or through behavior instead of a direct emotional sentence.

There's actually a term anthropologists use for this: idioms of distress, the culturally specific ways people express psychological pain when the culture doesn't hand them the vocabulary of "I'm anxious" or "I'm depressed."

In parts of Latin America, there's susto, a sickness caused by a frightening shock that's said to knock the soul loose from the body. In Korea, there's hwa-byung, sometimes translated as "anger illness," where years of suppressed frustration show up as physical chest pain. None of that means the feeling is imaginary, it means the culture already built a language for it, just not the one American therapy uses.

At my Catholic school, I started noticing how retreats work almost like a cultural form of emotional processing. You leave your normal routine, you are put in a different space, and there are talks, reflection questions, group conversations, quiet moments, sometimes music, sometimes prayer, and somehow the setting gives people permission to say things they might not say in the hallway between classes. It is like the structure makes vulnerability less random, you are not just suddenly confessing something in the middle of lunch, you are in a space where reflection is expected.

That does not mean everyone experiences it the same way, some people connect deeply with the religious part, some are more skeptical, and some probably just like missing a day of regular classes, however even then, the ritual matters. Everyone is participating in a shared pause, and in a school environment where people are usually rushing from one thing to the next, that pause can be powerful.

I think this is where anthropology helps me understand therapy in a broader way, since healing is not only one person talking to one professional in one room, even though that can be incredibly important, it can also happen through ritual, prayer, music, friendship, movement, nature, storytelling, family meals, elders, service, or just being part of a community that keeps showing up.

Of course, not all cultural approaches to mental health are healthy. Some traditions make people feel ashamed for needing help, some families dismiss pain because they do not have the words for it, and some communities expect people to "be strong" in a way that actually makes them lonely, so I do not think every cultural response to suffering should be romanticized.

However I also do not think Western talk therapy is the only form of care that matters.

Maybe the real question is not "does this culture have therapy?" but "where does this culture put pain?" In words, in the body, in prayer, in family obligations, in food, in silence, in community, in private, or out in the open?

The more I think about it, the more I realize that every culture has some way of dealing with being human, some ways formal, like therapy, some quiet, like a grandmother making soup without asking too many questions, and some communal, like a retreat where people sit in a circle and say things they did not know they needed to say.

At first, I thought therapy was a specific thing, however now I think it is also a cultural question.

How do people learn to hurt, how do they learn to heal, and who teaches them whether they're even allowed to say it out loud?