What Western Psychology Misses About Spiritual Experience in African and Diaspora Communities

If a culture pathologizes your prayer, the problem is not your prayer.

For centuries, African and diaspora communities have practiced possession, prophetic dreaming, trance states, and ancestor communication as sacred — not as symptoms. These are not the relics of a pre-scientific past. They are sophisticated spiritual technologies for healing, for truth-telling, for community alignment, developed across millennia and carried forward through the Middle Passage, through colonialism, through every system designed to erase them.

And then Western psychiatry arrived with its clipboard.

The Diagnostic and Statistical Manual of Mental Disorders — the DSM — is the primary framework through which mental health is diagnosed in the United States and much of the Western world. It determines who receives treatment and what kind. It shapes what clinicians see when they look at a patient. And it was built, almost entirely, on the psychological experiences of Western, white, secular populations — a fact the field itself has been slow to reckon with.

For African and diaspora communities whose spiritual lives are rich, communal, embodied, and ancestrally rooted, the consequences have been severe. The DSM has not simply misunderstood these communities. It has, in many cases, punished them for being whole.

This is not a coincidence. It is a pattern with a history. When a clinician encounters a Black patient who describes hearing the voice of an ancestor, seeing visions during prayer, or entering a trance state during communal worship, the clinical framework most of them were trained in offers a narrow set of interpretations — and many of those interpretations end in a diagnosis of psychosis or dissociative disorder.

The patient knows what they experienced. The community knows what they experienced. But the clipboard has a different answer.

What the DSM was built to measure — and what it wasn’t

The DSM was first published in 1952, shaped by mid-twentieth-century American psychiatry — a field dominated by white, male, largely secular practitioners whose primary patient populations were institutionalized white Americans. Over its revisions, it has expanded and improved. But its foundational assumption — that there is a universal standard of psychological “normal” against which deviation signals disorder — has never been fully dismantled.

Psychologists Joseph Henrich, Steven Heine, and Ara Norenzayan gave this problem a name in 2010: they called it the WEIRD problem. Most psychological research, they found, is conducted on populations that are Western, Educated, Industrialized, Rich, and Democratic — a group that represents roughly 12% of the world’s population but generates the majority of the world’s psychological data. The behaviors, beliefs, and experiences of the other 88% are regularly treated as variations of a WEIRD norm, or as pathology when they diverge from it.

For African and diaspora communities, divergence has always been costly.

What they called symptoms

Let us be specific. These are not theoretical misreadings. These are documented, recurring mislabelings of sacred practice:

Spirit possession — the sacred mounting of a practitioner by an Orisha in Yoruba tradition, or by a Lwa in Haitian Vodou — has been classified as dissociative identity disorder, psychotic break, and conversion disorder. The clinical eye sees fragmentation. The community sees communion.

Prophetic dreaming — the receiving of ancestral guidance, warning, or mission through the dream state, a practice recognized and valued across West and East African traditions — has been flagged as grandiose delusion. The elder who dreams her community’s direction and rises to lead from it is not delusional. She is precisely what her tradition prepared her to be.

Trance states — entered during communal worship, drumming ceremony, or spiritual practice — have been coded as dissociation or altered mental status requiring clinical intervention. The body that surrenders to sacred rhythm in a Candomblé ceremony is not malfunctioning. It is doing exactly what the tradition asks of it: becoming a vessel.

Ancestor communication — hearing the voice, feeling the presence, or receiving the guidance of those who have crossed over — has been recorded in clinical notes as auditory or visual hallucination. For communities across the African continent and the diaspora, the ancestors are not symptoms. They are the original peer support system.

Communal grief rituals — including keening, prolonged communal mourning, and active ritual engagement with death — have been pathologized under extended grief disorder frameworks designed around privatized, individualized Western bereavement. A community that grieves loudly, collectively, and for as long as grief requires is not disordered. It is doing what the living owe the dead.

Frantz Fanon, the Martinican psychiatrist and anticolonial theorist, saw this dynamic with devastating clarity. In his landmark work, he documented how colonial psychiatry did not simply misunderstand African mental life — it used diagnosis as an instrument of control, a way of delegitimizing the inner worlds of colonized people so that their resistance, their spirituality, and their refusal to assimilate could be treated as madness rather than wisdom.

What the Yoruba tradition knows about the mind and the spirit

In the Yoruba tradition, the relationship between the inner life and the spiritual world is not a problem to be solved — it is the foundational premise of what it means to be human. The ori — the personal spiritual intuition and inner head — is understood as the seat of individual consciousness and destiny, in constant relationship with the divine. Mental and spiritual wellbeing are not separate domains. They are one.

When a member of a Yoruba community is suffering — from grief, confusion, spiritual disruption, or what Western frameworks might call mental illness — the community does not isolate the individual and hand them to a specialist. It gathers. Ifá divination — the sacred oracle overseen by Orunmila, the keeper of wisdom and destiny — provides a framework for diagnosis that is at once spiritual, psychological, relational, and communal. The babalawo (divination priest) does not simply name what is wrong. He reads the web of relationships, ancestral influences, and spiritual debts that have shaped the condition. The treatment is always relational, always communal, always rooted in restoring right relationship between the person, the community, and the divine.

The Egungun masquerades — the embodied presence of the collective ancestors in Yoruba ceremony — are not theatrical performances. They are the community’s way of keeping the ancestors present and active in the life of the living. When the Egungun dances through the village, grief is held communally. Wisdom is transmitted. The boundary between living and ancestral is made permeable in a way that heals rather than harms.

None of this maps onto the DSM. And that is the DSM’s limitation, not the tradition’s.

As scholar and Ifá practitioner Wande Abimbola documented in his foundational work, the Ifá literary corpus contains sophisticated understandings of human psychological states — states for which Western psychiatry is still, in many cases, developing adequate frameworks. Our ancestors were not waiting for the DSM to understand the human mind. They built their own systems. And those systems worked — and still work — for millions of people across the African world.

What culturally grounded mental health actually looks like

The DSM-5, published in 2013, made a partial concession to this critique. It introduced the Cultural Formulation Interview — a structured tool for clinicians to explore a patient’s cultural context, spiritual beliefs, and community understanding of their distress before applying a diagnosis. It is a step. But studies of clinical implementation suggest that most practitioners either are unaware of it or do not use it consistently. A tool that exists but is not used is not a solution. It is an alibi.

Culturally grounded mental health is not a diversity initiative. It is a clinical imperative — and a justice imperative. It requires clinicians to ask not only “what is wrong with this person” but “what framework does this person use to understand what is happening in them, and how does their community hold that understanding?” It requires the humility to recognize that the practitioner’s framework is not the only framework — and may not be the most useful one.

It looks like a therapist who knows that when a Black woman says her grandmother visited her in a dream and told her to leave that relationship, this is not psychosis. It is sacred communication that deserves to be honored, not suppressed.

It looks like mental health programs that integrate community elders, spiritual practitioners, and traditional healers as co-facilitators rather than obstacles to be worked around.

It looks like assessment tools that do not pathologize communal grief, extended family structures, or embodied spiritual experience as inherently disordered.

At Ubuntu Village, we hold this understanding in everything we do. We do not ask our community to choose between their spiritual inheritance and their mental health. We know those are not opposites. They never were. The healers of our ancestral traditions understood that a person’s inner life — their dreams, their visions, their relationship to the unseen — is not separate from their physical health or their capacity to show up for community. It is the foundation of all of it.

What Western psychology misses is not a minor methodological gap. It is a fundamental misunderstanding of what human beings are — and what holds us together. Our communities have always known something the DSM is still trying to learn: that the spirit is not a symptom. It is the source.

What spiritual experience in your own life has been questioned, dismissed, or mislabeled — and what did you know to be true in spite of that? Share your journey with the village.

References + Related Reading

References

• Gara, M. A., et al. (2019). A Naturalistic Study of Racial Disparities in Diagnoses at an Outpatient Behavioral Health Clinic. Psychiatric Services, 70(2), 130–134.
• Fanon, Frantz. (1961). The Wretched of the Earth. Grove Press.
• Henrich, J., Heine, S. J., & Norenzayan, A. (2010). The weirdest people in the world. Behavioral and Brain Sciences, 33(2–3), 61–83.
• Lewis-Fernández, R., & Aggarwal, N. K. (2013). Culture and psychiatric diagnosis. Advances in Psychosomatic Medicine, 33, 15–30.
• Abimbola, Wande. (1976). Ifá: An Exposition of Ifá Literary Corpus. Oxford University Press Nigeria.
• American Psychological Association. (2017). Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality.

Related Reading

• Epigenetics and Ancestral Memory: What Your Body Remembers
• Music, Ritual, and the Science of Belonging
• Mirror Neurons and Communal Healing
• Angels Across Cultures: Introducing Our Angelology Series

About the author

Michele Mitchell

Founder, President & CEO — Ubuntu Village Inc.

Michele Mitchell is the Founder, President, and CEO of Ubuntu Village Inc., a 501(c)(3) nonprofit empowering communities across the African diaspora through ancestral wisdom, public health advocacy, and digital innovation — with active programs across East Harlem, Kenya, Uganda, and Nigeria.

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