INTRODUCTION: Cultural congruence is the idea that to the extent a belief or experience is culturally shared it is not to
feature in a diagnostic judgement, irrespective of its resemblance to psychiatric pathology. This rests on the argument
that since deviation from norms is central to diagnosis, and since what counts as deviation is relative to context, assessing
the degree of fit between mental states and cultural norms is crucial. Various problems beset the cultural congruence
construct including impoverished definitions of culture as religious, national or ethnic group and of congruence as
validation by that group. This article attempts to address these shortcomings to arrive at a cogent construct.
RESULTS: The article distinguishes symbolic from phenomenological conceptions of culture, the latter expanded upon
through two sources: Husserl’s phenomenological analysis of background intentionality and neuropsychological
literature on salience. It is argued that culture is not limited to symbolic presuppositions and shapes subjects’
experiential dispositions. This conception is deployed to re-examine the meaning of (in)congruence. The main
argument is that a significant, since foundational, deviation from culture is not from a value or belief but from
culturally-instilled experiential dispositions, in what is salient to an individual in a particular context.
CONCLUSION: Applying the concept of cultural congruence must not be limited to assessing violations of the symbolic
order and must consider alignment with or deviations from culturally-instilled experiential dispositions. By virtue of
being foundational to a shared experience of the world, such dispositions are more accurate indicators of potential
vulnerability. Notwithstanding problems of access and expertise, clinical practice should aim to accommodate this
richer meaning of cultural congruence.
This paper emerged from a workshop on cultural congruence presented with Professor Derek Bolton at the 15th Conference of the International Network of Philosophy and Psychiatry, Dunedin, New Zealand (July 2012).