Psychogenic seizures in an Espiritismo context:: The role of culturally sensitive psychotherapy

A case of a Puerto Rican woman with a complex clinical presentation of psychogenic seizures (PS) is discussed to illustrate how cultural practices and beliefs transform such dissociative somatoform disorders. In this case, the PS revolved around some deeply ingrained spiritist beliefs and possession experiences, which permitted the externalization of the client's guilt feelings for not having averted the suicide of her grandmother. It also shows how a psychotherapist can integrate the client's cultural beliefs in spiritism (or espiritismo) with some well-known traditional therapeutic techniques. Also, it illustrates the benefits of using a cultural conceptualization that takes into account the client's religious attribution of her illness and describes how the effectiveness of traditional therapeutic modalities can be enhanced by reframing them according to the phenomenological framework of the client.