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If I were asked which group of patients seemed to be given the least support by the culture, and at the same time were at great odds with their environment, I would point to the group of adolescent boys. The fact that they had no choice in the majority of cases, but to regress back to mother, was, in my opinion, tragic. ft is an indictment of the culture in its failure to provide healthier alternatives for the adolescent boy who is struggling to emancipate himself from his attachment to mother.
Adolescence is, of course, a confluence of events. The appearance of an almost entirely new biologic and metabolic makeup brings rapid growth, new sensations, and new powers. The intensified psychological drives serve as a means to adapt to the overwhelmingly new situation and are an integral part of the growing-up process itself. His social and cultural world suddenly changes as he leaves behind the situations and symbols of his childhood and attempts to bridge the gap between childhood and maturity.
In the face of these events, the usual phrase describing the adolescent is “nothing fits.” He appears to take a stand against everything, except the symbols and values of his own peer group. Rebellion against society is one of his preferred enthusiasms. One does not have to read the volumes documenting the protests of youth everywhere; one has only to be awake, alive, and alert to events happening all over the world today. More and more, this rebellion has taken the form of active movements, in large groups, registering loud protest against society and the establishment. From the Hippie movement to the seizure of University offices, they have never been as organized before as they are today.
One has to look for causes, more diverse and global than simply adolescent turmoil, to encompass the forces behind widespread agitation. At the same time, one has to look for specific factors within each culture which aggravate the discontent and unrest in adolescents. With the Filipino male adolescent, the principal psychological difficulty is in overcoming the effects of having been protected and controlled for a prolonged period of time.
Filipino culture emphasizes certain attitudes which impede the male adolescent’s movement towards emotional growth and maturity. It is perhaps no coincidence that these very attitudes embody in themselves much of what is “adolescent.” These cultural elements are at once idiosyncratically Filipino and also adolescent. For example, the cultural themes -of amor propio and pakikisama feed very well into the adolescent’s heightened narcissism and well- known peer-group dependence.
The overload of anxiety from rapid biological events and intensification of psychological drives mobilizes the adolescent’s sexual and aggressive impulses. He then turns to his social and cultural surroundings looking for accepted practices to help him pattern his anxiety over these new-found powers.
An outline of the interplay of psychological and cultural factors in the Filipino adolescent is given below.
A. INTERDEPENDENCE CONFLICT
1.Filipino parents believe that their children remain their children regardless of chronological age. They and their children seldom achieve the level of “man-to-man” relationships. This is succinctly expressed in the parental injunction, usually following an argument disobeying rules, that so long as he is staying under parental roof (meaning still dependent on them) he must listen to and obey parental wishes even if he were already an adult.
2. Should the adolescent want to take on a job to asset independence, most parents will not allow him. Reasons: What will neighbors say; it will interfere with their plans for him (college, diploma); he is too young to work. Contrast this with other cultures where adolescents take summer jobs, work for their college tuition, etc.
3. And even if parents allow him to work, what jobs are there available for him? At most, only families with business enterprises have job opportunities for their adolescent children. This, however, is not real independence.
4. Dependence on the peer group, which is typically an adolescent step away from parents towards an identity of his own, creates much parental anxiety. There is some reason for this. Filipinos set such a store by pakikisama (going with the wishes of the other person or of the group) that on the adolescent, the “barkada” (gang) exerts great influence. He may take long, solitary walks like all adolescents do, but he is more likely to be at the beck and call of his friends.
B. AUTONOMY AND MASTERY; ASSERTION AND AGGRESSION; CONFLICT WITH AUTHORITY
1. Parents tend to make big and small decisions for their children regardless of age. Although the situation is not as rigid as in some oriental countries where, for example, parents arrange marriages for their children, Filipino parents do nearly as much.
2. Filipinos get little privacy and the adolescent to whom this is a crucial issue has an extremely difficult time whenever he is moody or wants to be alone.
3. The hallowed authority of parents which is a cultural institution brings strong repressive measures when challenged. Physical punishment for the disobedient adolescent is still regarded as within the bounds of parental prerogative.
4. The cultural habit of shaming, especially by teasing not only by the parents and siblings, but also by the peer group, discourages efforts at self-assertion and increases self-doubt. Decision making becomes perilous; fear of blame for untoward events promotes phobic attitudes.
5. The cultural habit of “ningas kugon” excuses the adolescent’s unpredictability and short-lived perseverance in a project, particularly if it is an intellectual endeavor or is rather challenging. The permissiveness, protectiveness and indulgence provided by— parents in the early years before adolescence, bounded, only by limits which protect parental authority, are conductive to the development of a pleasure oriented or instinct-prone individual who brooks little frustration or delay in gratification.
C. IDENTITY CRISIS
In addition to all the above-mentioned factors which encumber the resolution of the identity crisis, the following have to be taken into consideration:
1. The cultural standard for manliness is sexual activity and potency. On one hand, threatened by parental authority, guilt if he gratifies himself, shame from society should he fail; on the other hand, confronted with the cultural definition of manliness, the adolescent finds few cultural alternatives. Either he postpones his maturity, which is difficult, or he seeks direct sexual release. The cultural role of the father in relation to his children gives him and his sons little opportunity to develop a strong relationship which would facilitate positive identification. The children are closer to the mother. Communication between a wing son and his father becomes limited and inadequate. The boy then picks up cues in his identification process from the general cultural surroundings which lack the personalized, meaningful emotional element potentially present in a father-son relationship.
2. College, which is the adolescent’s healthiest available outlet for harnessing his energies (and as Erikson  puts it, “probably the greatest organized artificial postponement of adulthood, emotionally speaking”), is heavily laden with family pressure and cultural standards for success. His age for entering college is younger than most college freshmen elsewhere. There is also a marked discontinuity between college life and everything else which preceded it.
3. The prospect of economic prosperity is attractive to majority of Filipinos. After years of being always in the begging position, secretly envious of the foreigner who exploited him, he now can dream and plan about raising his economic status. The adolescents are no exception. However, the pressure to make the grade, the vicious competition, and the knowledge that there are far too few opportunities to go around have a dampening effect on his motivation. Young girls of his age seem to be better motivated to join the competition. There is much less pressure on her and she does nor have as turbulent a time as he has negotiating the adolescent transition. The model of the successful man is one who makes a lot of money and the majority of young people dream about it. The number of adolescents who have the needed potential even in a vague way or who actually aspire and plan towards the achievement of the goal, is something else.
4. One noted talent of the people in this culture is a propensity to imitate. This has been described and documented by authors and is frequently remarked upon by Filipinos themselves. Unfortunately, however, his imitative abilities are enlisted in the service of adopting those tendencies or patterns from foreigners which he can utilize to serve his needs for show, power, and prestige. It does not seem to extend to work or economic patterns.
The adolescent who has a need for symbols to proclaim his identity will adopt those pertaining to the values of the day, be it a Banlon shirt, a sports car, long hair, sit-ins, demonstrations, etc. For the adolescent in this culture, this can be an advantage as he needs all the outlets of expression he can get without hurting anyone. On the other hand, the imitativeness, as in the adult Filipino, may involve only a copying of external features, a duplication of form but without the substance.
5. Traditionalism in choice of occupation has gradually been diminishing. In a survey of medical students in 1962 (Bowers 1962), 20-25 per cent mentioned that they were in medicine due to the influence of their parents and the high status accorded this profession in the culture. The traditional professions like medicine, law, and engineering are urged upon the youngsters by parents. Many take commerce, not necessarily to become businessmen later on, but to find ready employment. Furthermore, this course does not appear as formidable as the others. More parents now realize the harm of imposing their ambitions upon their children and so are giving the latter more room to decide for themselves. This is a distinct advantage for the adolescent to whom the experience of discovering by himself what he is and what he would like to be, is of the utmost importance. However, after years of being told what to do and what to be, he will not find it easy to answer this question by himself. Even if the process is painful, the trend is towards this healthier direction. Perhaps the world-wide awareness, problems, and rebellions of today’s youth have to be thanked for this development.
6. What the culture tolerates and condones and what it punishes, in a person’s manner and extent of release of aggression, is of great concern to the adolescent. At this age aggressive energy is not only readily available but also likely to leave permanent psychological scars if uncontrolled. The general inconsistency in discipline in childhood has to be compensated for by a more consistent, predictable, and fair enforcement of the law. Where an adolescent sees inconsistencies perpetuated, his own system of controls will vary accordingly. Family and powerful friends sometimes wreak havoc with the court’s good intentions. Sometimes, they are unable to do so. The adolescent therefore assumes that a person takes a chance and the consistency of his own system of controls depends on his willingness or reluctance to take that chance.
One wonders therefore what lies in store for the Filipino adolescent who will inherit the society and the culture. Of all the segments of the population caught in the cross-currents of change, he bears the greatest brunt. His quest for identity is without the guidelines his parents had. The order of the day has changed. Patterns of personal relationship have become flexible; choices for life-styles have become more varied. Suddenly his voice of protest is now being heard. Responsibility for his actions is now being shifted to his shoulders and, to be fair, credit for any success should also belong to him.
Perhaps he will learn the lessons of this painful period and do better by his sons. He may create a culture that will offer something more concrete to an adolescent trying to be a man, than the nebulous symbolic value of being circumcised or an occasional visit to a house of pleasure or the vicarious thrill of seeing others get away with wanton aggression.
From all indications, it looks like the tides of economic progress will sweep him closer to the realization of his dream for a better life, in the material sense. More and more of the things money can buy will be within his reach; but part of the price he will pay will be the loss of the dependable interpersonal relation- ships of the past. “Pakikisama, utang na loob, hiya, awa, ‘amor propio” will then be ugaling maganda, incompatible with contemporary values.
Will he be like the citizen of an industrialized society, who is lonely, isolated, and alienated; who gears his life toward success, achievement, material comforts, economic prosperity, in fact, toward everything which results from doing?
To be lonely is to feel alone in the emotional waters of life, with no one to really share one’s joys and pains; to be isolated is to be completely incapable of being really affected by another, in an emotional sense; to be alienated is to be removed from one’ real self, when one merely exists or is driven to do what he does, not from any real motivation but only because he has to do it. The italics are meant to emphasize situations wherein the individual performs with seeming involvement in his relationship with other people and in what he is doing. The frenzy of activity is to conceal the very lack of involvement.
In my experience with American patients in psychotherapy both in the United States and in the Philippines admittedly limited, I have heard quite often the lament of the patient: “I feel like a phony” or “I feel like such a fake!” This seems to stem from his constant struggle to fit into a certain mold, to be something else better than what he is and, of course, from the dismay when his “real” self announces itself in other ways. Autonomous and free, he is nevertheless driven and compelled by some force to achieve, to succeed, to be strong, to be self-sufficient. Somewhere along the way to gain mastery of himself and of his environment, he suspects he may have lost the joy and essence of living.
In this study, I did not - encounter one patient who felt lonely, isolated, or alienated except in transient situations. However, it was a threat which hung over many of them. Instead of this kind of complaint, the Filipino patient’s lament is apt to be: “I am not loved!” or “They have rejected me; I am not in.”
As the Filipino moves towards a modern, technological, and industrialized society, will he be trading a headache for an upset stomach?