Mental Health and Polynesian Clients

Originally published in The GM Resource & Referral Directory 2000, 258-259.
By Cabrini Makasiale, with Philip Culbertson

People indigenous to Oceania and the South Pacific are either Melanesians (Fiji, Vanuatu, Solomon Islands, Papua New Guinea) or Polynesians (Samoa, Tonga, Rarotonga, Niue, Aotearoa). There is a great similarity when we talk about doing counselling and psychotherapy with people of these various cultures, and yet each culture has its unique history, traditions, and values. In order to be responsible, since no Melanesian therapist contributed to this article, the remarks herein are limited to the stressors and needs of Polynesian clients.


Five major issues define Polynesian identity: hierarchy, obedience, family, land, and spirituality. Polynesian cultures are all hierarchical, though there is some difference among them in the way that power is distributed and moderated. All Polynesian cultures require obedience from inferior to superior in a complicated vertical structure of authority. “Family” is a large category in Polynesian societies, and most often resembles what Pakeha would call “a widely-extended” family. Land, too, is a primary source of identity: all Polynesians can recite easily the name of the village or geographical area to which their family belongs and something of the family’s history there. Personal names often relate to family history, or geography of origin, or the achievements of an outstanding ancestor, or the family’s hopes for the bearer. Names, like traditions of greeting and welcoming, are a critical factor in establishing a therapeutic alliance with Polynesian clients. Conversely, incorrectly pronouncing a client’s name or dismissing the expectations of cultural protocols, can quickly damage that alliance.

Culture Specific Stresses

It is very difficult for Polynesians to separate culture from self, or family from self. A child is born into “a group belonging.” From day one, the child goes to the group – on the mother’s lap, the sister’s lap, the auntie’s lap – and sleeps with a group when the group sleeps, and is carried everywhere and participates in everything. For this reason, many Polynesians are unskilled at making decisions independently, without seeking family advice and consensus. Therefore, an “externally-referenced” personality emerges. Pakeha culture presumes an independent core identity of separation, individuation, and individualism; Polynesian culture presumes a situational identity, dictated most often by cultural expectations, family desires, and tradition as interpreted by elders. Exposure to Pakeha ways of being and thinking undermines this identity structure, and can create significant stress and even nnd so the counselor working cross-culturally must exercise patience with the client.

With Polynesians, the family is always present, even when it is invisible (the family within). At times, it may be appropriate to have other family members present in the treatment rooms. At other times, the “internal family” needs to be made visible through externalization. Only then can choices be made about when to be connected and when to be separate. Polynesian clients may be reluctant to make decisions or behavioral changes without checking with the extended family first. I say to my client, “Yes, you may go check with your family, and there’s something else I would like to put before you to have a look at and see whether you would be interested in another way of looking at it – after you have come back from your family.” Eventually they will tire of functioning as a go-between between the therapist and the family, and begin to find a sense of self, to make decisions on their own.

The mental health worker’s knowledge of the client’s culture, effective observation of expected protocols, and a secure therapeutic alliance of trust all serve as doorways to allow new ideas to be introduced. Among the most productive counseling techniques is re-framing, in which the content or intent of traditional ways of doing things is honored, but the outward expression of the tradition is altered to accommodate the client’s new situation, or needs for personal expression toward future goals.

For Further Reading:

  • Becker, Anne. 1995. Body, Self and Society: The View from Fiji. Philadelphia: University of Pennsylvania Press. >
  • Culbertson, Philip. 1997. Counselling Issues in South Pacific Communities. Auckland: Accent Books.
  • Culbertson, Philip. 1999. “Listening Differently to Maori and Polynesian Clients,” Forum: The Journal of the New Zealand Association of Psychotherapists 5, 64-82.
  • Epati, A’e’au Semi. 1998. “Multi-Cultural Issues in Everyday Practice: Samoan Culture.” Auckland: Auckland District Law Society.
  • Finnegan, Ruth and Margaret Orbell (eds). 1995. South Pacific Oral Traditions. Bloomington: Indiana University Press.
  • Foster, RoseMarie Perez, Michael Moskowitz, and Rafael Art. Javier (eds). 1996. Reading Across Boundaries of Culture and Class: Widening the Scope of Psychotherapy. Northvale: Jason Aronson.
  • Ihimaera, Witi, ed. 1998. Growing Up Maori. Auckland: Tandem.
  • Mageo, Jeannette Marie. 1998. Theorizing Self in Samoa: Emotions, Genders, and Sexualities. Ann Arbor: University of Michigan.
  • Morton, Helen. 1996. Becoming Tongan: An Ethnography of Childhood. Honolulu: University of Hawaii Press.
  • Tuilotolava, Mary. 1998. “Multi-Cultural Issues in Everyday Practice: Tongan Culture.” Auckland: Auckland District Law Society.


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