1

Applied Theory Paper

Student’s Name
Course
Tutor’s Name
Date
 2

Applied Theory Paper

Introduction
Anne Fadiman's narrative, "The Spirit Catches You and You Fall Down," explores two

significant cultural disputes that took place in American society throughout the 1980s in great

detail. The author introduces a variety of challenges throughout the book, all of which will be

addressed in this paper. With regard to healthcare and welfare in western America, this report

shows that the Lee family had several challenges. Many interpreters may see this dramatic

occurrence as a shift into the domain of cultural relativism because of the Hmong language's

grammatical restrictions. If anything, this book's events could even have been required for the

Lee family's long-term success. Despite the fact that others have seen the injustices committed

against this family, it serves as a reminder of the need of social workers maintaining a keen

awareness of their work and the individuals they serve. A Hmong girl with epilepsy, Lia Lee, is

the basis for Anne Fadiman's work. What happened to the Lee family has triggered a discussion

about how best to connect between spiritual healing and modern, logical medicine. As a

consequence of the Western era's "superior" understanding of enlightenment, doctors and social

workers have been allowed institutional biopower over Lia's parents, who have been granted

institutional biopower over their own children. This philosophy, on the other hand, is more of a

dogma than an expression of growth.

The goal of this research is to determine which two theoretical viewpoints are more often

accepted by social workers. The Hutchinson textbook devotes considerable space to the conflict

viewpoint, and this will be the first theoretical angle to be discussed. The second school of

thought we'll look at is the social constructionist perspective. Each theoretical viewpoint will

feature key concepts, issues, and well-known academics associated with the book to show how

this relates to social work to a larger or lesser degree than the preceding approach. Our
 3

discussion will include both a micro and macro-level evaluation, as well as how the novel's

viewpoint on treatment may change as a result. To help Lia Lee's client and her family, we will

also explore any theoretical viewpoints that Lia Lee's social work uses.

Part I: Identifying and Defining Theoretical Perspectives

Social Constructionist Perspective 

The social constructionist perspective is comprehensive and complicated in that it

explains how people build meaning, a sense of self, and a social environment as a consequence

of their interactions with one another (Kung, 2018). This perspective stresses how people learn

their relationships through engaging with one another and interacting with the environment in

accordance with their intended understandings of the world, as well as by interacting with one

another and the environment (Kung, 2018). It is this point of view that is depicted in the novel

The Spirit Catches You and You Fall Down, which provides insight into the Hmong culture, as

well as their thoughts about western medicine and doctors, among other topics. Over time, the

Hmong culture has developed into a society that is primarily dependent on herbal medicines and

rituals for the treatment and maintenance of its members' medical conditions (Fadiman, 2012).

Most of the time, rather than biological reasons, spiritual or physical factors are recognized as

contributing factors to sickness. According to the philosopher David Hume, the social

constructionist perspective proposes that human knowledge is the driving force of the cosmos

(Morris, & Brown, 2001). Knowledge, according to social constructionists, emerges through

human interactions and interactions with others. As a consequence, what we consider to be true

and objective is the outcome of social processes that take place within historical and cultural

settings. According to this principle, while the truth may be established within the constraints of

a certain subject, there is no overarching truth that is more valid than any other in the scientific
 4

community. The information generated by a community has ramifications on a social, cultural,

and political level. It is the knowledge of certain facts, values, and realities held by a community

that is accepted and sustained by the community. When new members of a community adopt

such information, the reach of the knowledge becomes even wider. Ideas concerning power and

privilege in a community become formalized when a community's accepted knowledge is turned

into legislation.

For his contribution to the social constructionist perspective of society and community,

Charles Cooley, a sociologist, is the most well-known academic of his generation. It is Cooley

who introduced the notion of the "looking-glass self," which is described as the process through

which we learn to see ourselves through the eyes of others (Yeung & Martin, 2003). We are

impacted by those who we consider being in control over us and by one whom we think to be of

consequence, Cooley believed, and we have a proclivity to engage into and accept his evaluation

of ourselves by way of sympathy. As Cooley explains, this is prevalent in the book because the

Hmong place their faith in their elders and clan leaders to make choices on their behalf; as a

consequence, these people are seen as having a larger amount of power based on their image as

produced by the Hmong community.

Standpoint theory is a social constructionist perspective that is centered around the idea

that what people know and believe is shaped by where they stand in society, their geographies,

cultures, race, gender, and so on. It is centered around the idea that what people know and

believe is shaped by where they stand in society, their geographies, cultures, race, gender, and so

on (Nelson, & Constantinidis, 2017). A central tenet of the movement is "the notion that what

individuals know and think is molded by where they are in society, their geographical locations

and cultures, their race and gender, and so on" (Nelson, & Constantinidis, 2017). Given their
 5

limited access to other geographical regions in the Hmong culture, it is plausible for researchers

to assume that individuals in this society, whose resources are limited, have turned to spirituality

for therapeutic purposes. This concept is important and may be used in all aspects of the book, as

well as presenting rationales for the decisions made in each section. Because the Hmong people

are very proud of their cultural past, this is a valid reason.

Therefore, the social constructionist approach was chosen for this research because it

focuses on how cultures and environmental surroundings have the ability to alter one's

perspective, ideas, beliefs, and understanding of the world and how it operates. The social

constructionist approach is described as follows: In addition to how American doctors, Social

constructionists are all around us and include diverse features as racism such as marriages,

government policies, child abuse, crime disease, and psychology, many of the decisions that

shaped Lia's life were influenced by his parents' upbringing and cultural beliefs, as well as how

the American doctors viewed Lia (Bates, 2017). The Enlightenment had an impact on physicians'

thinking. The Enlightenment was an intellectual movement that flourished in the eighteenth

century and emphasized scientific ways of reasoning above religious ones. It was considered to

be an era of "reason," with Immanuel Kant's appeal to "Dare to Know" being widely recognized

(Tu, 1996)). This movement resulted in significant advancements in "Western" medicine and

technology, but religion and spirituality were largely downplayed or ignored entirely. The United

States was also a part of this movement and, as a result, is considered to be a product of the

Enlightenment.

Conflict Perspective

The conflict perspective sheds light on the conflict that occurs as a result of inequalities

in the allocation of resources. "Conflict arises from the deliberate interaction of two or more
 6

parties in a competitive environment," (Oberschall, 1978). Consideration should be given to

issues such as dominance, oppression, and inequality from the standpoint of the conflict.

Researchers and academics have been able to better grasp conflict detection and determination in

social environments using these concepts. Among other things, these ideas are at the center of

the clash between politics and culture (Oberschall, 1978). The Hmong have lived in Laos'

mountains for centuries, raising cattle and cultivating their land. They believe that conventional

healing procedures may alleviate the symptoms of the majority of illnesses, which they attribute

to a spiritual cause. Taboos against medical operations, beliefs about illness causation, and power

systems within families and clans are only some of the aspects of Hmong culture that are at odds

with western medicine. As a consequence, cultural differences can lead to misunderstandings

between physicians and their patients. Shamanic rituals, such as animal sacrifice, have caused

problems between the Hmong and their American neighbors. For one thing, some Americans

suspect the Hmong of kidnapping and killing their neighbors' dogs. The sad tale of Lia Lee

highlights the need for a new paradigm of cross-cultural understanding and cooperation when the

two cultures meet.

A number of academics have made a profession out of studying conflict. Karl Marx and

Max Weber's contributions have been utilized for centuries in a variety of disciplines. In the

context of social work, these contributions have had a lasting influence on the way the idea is

conceived and used. When it comes to the creation of postcolonial thought, Joseph-Earnest

Renan is the most important figure. Since his philosophical background, Renan has made

substantial contributions to the social work profession and this viewpoint by aiding in making

sense of race and ethnicity as well as showing how dominance may have an adverse effect on

those who are less fortunate. Colonialism is analyzed in this theory as a factor in the cultural and
 7

political evolution of colonizing and colonized nations (Hutchinson, 2017). All of these themes

permeate the story of the Hmong exodus from Laos to the United States. It is the focus of

postcolonial theory that global disparities and power imbalances between the international

community and the domestic population are examined (Huchinson, 2017). Postcolonial theory

also explains why the powerful want to control and limit the movement of people via a range of

legal mechanisms and policies (George,2009). The Hmong people have lived in China for a long

time. As a result of China's intention to limit their freedom, many Tibetans fled to Thailand. An

in-depth grasp of Hmong culture provided by Fadiman helps to differentiate between the

oppressor and the oppressed populations, making it simpler to identify the perpetrators and the

victims. Consequently, the oppressed population may be identified more easily.

Using a conflict perspective, I was able to analyze how many of the stories inside the

book show how dominance, oppression and the clash between two cultures are plainly obvious

multiple times. Through these stories, Fadiman hoped readers would see how American culture

has a grasp on many social aspects. Because of their contacts with colonized people in the

Western world, western cultures have built an image that fosters and perpetuates their privilege

and power over those who have been colonized (Hutchinson, 2017).

Part II: Micro and Macro-Level Analysis

Micro-Level Analysis

Lia's health and the relationship between physicians and parents are the focus of micro

level practice. A social constructivist examination of Foua and Kao Lee and doctors at MCMC

will be conducted. We'll be looking at everything from our own biology to our own culture to

our own little groups to our own social structures to our own institutions at a micro level of

comprehension. From a micro-level perspective, many tales in The Spirit Catches You and You
 8

Fall Down may support this approach. In Lia's instance, there are several micro-levels that might

be relevant: Her parents were Hmong, uneducated, and neglected to provide her with enough

medication. Lia's parents were unable to give her medication because of language and

communication difficulties, and interpreters were unable to tell her what to give her.

It is one of the concepts and themes that are used to the micro level dimension of goal -

biological. Epilepsy is a neurological illness that cannot be cured, but it may be controlled with

medication by a doctor at MCMC. In the end, Foua and Kao concluded that the drugs prescribed

by physicians were to blame for Lia's seizures and personality shifts. Their lack of interest was a

result of this (Fadiman). In addition, the physicians saw this condition as one that required strict

management due to the potential for consequences. This is a story the doctor put up to keep them

from considering any other possibilities.

One of the other concepts of aim is that of the individual, which is to say, spiritual. They

thought that Lia's condition was one of "quag dab peg," which translates to "The Spirit That

Catches You and You Fall Down" in Mandarin. At three months old, Lia's sister banged the door

so hard that Lia's spirit left her body and was gone. This started the issue (Fadiman). It was

impossible to discourage these parents from this story that they had crafted (Dimaano, &

Spigner, 2017). In the Hmong culture, the belief that the patient has a link to the otherworld or

the divine during a seizure is considered to be a significant aspect of the sickness, and Foua and

Nao Kao agreed. So, although they want to keep Lia safe, they don't want to completely manage

the condition. The community sees Quag dab peg as a candidate for shamanic work.

Lastly, the aim is the environment, which includes families and small groups. Using the

examples above, we can see how the relevance of symbol to Foua and Nao Kao is influenced by

the society they live in and how the symbol (and the importance) may vary from the medical
 9

community, which has its own culture. These symbols, which might include words, norms, and

roles, assist us to comprehend how individuals interact with their surroundings. Rather of acting

based on what they know to be true, they act on what they think to be true. Due to their minimal

exposure with the medical community before to Lia's illness, Foua and Nao Kao were suspicious

of it. People at Ban Vinai (a refugee camp in Thailand) crowded around a Hmong woman who

had returned from the United States and questioned her about why American physicians took so

much blood - Hmong belief that blood cannot be replenished and you may use it all. Because

humans require their bodies and organs to be reborn, surgery is not acceptable. Alternatively,

physicians might eat Hmong patients' brains, kidneys, and livers. They may have been affected

by tales like these. The physicians, on the other hand, were suspicious of the Nao Kao family

after discovering that Lia's medicine was not being administered correctly. They initially

assumed it was a result of the language barrier, but as time passed, they came to understand that

it was a deliberate act. In other Hmong patients who were brought to Neil and Peggy with

quarter-sized circular markings, they phoned Child Protective Services only to learn that these

marks were part of traditional therapeutic practice in many Asian countries.

The idea helps me grasp the dimensions in a variety of ways. There is no one objective

reality, according to social constructivism. Each person's reality will be shaped by their

interactions with the social and interpersonal environment around them. ' A similar cultural and

mental development among the Hmong people has occurred among the medical professionals at

MCMC, causing them to see Lia's diagnosis and treatment in ways that are incompatible with the

Hmong way of thinking. As a result, these two realities come to a head. Hmong people have

never tried to fit in with the mainstream culture throughout their history, the author explains.
 10

Because several nations have attempted to compel them to, including China, they have fled. An

understanding of how Foua and Nao Kao were able to challenge the American medical system

because of their common Hmong heritage may be gained via social constructivism (Betancourt,

& Maina, 2004). An emphasis on the individual and social development is highlighted at this

level. Finally, Foua and Nao Kao's worldviews are highly different, and it is impossible to cross

the cultural divide. This section's unaddressed issue is that the social constructionist approach

does not let us see the wider picture from a macro perspective. Even if you don't agree with this

idea, it does an excellent job of explaining why there are cultural variances.

Part III

Macro-Level Analysis

As a social worker, macro-level practice is essential. There would be no laws, rules, or

regulations without them. There are several ways in which the research, program-creation-and-

intervention process may have a beneficial impact on public policy, administrative structure, and

leadership when applied to communities throughout the country. Macro social work's focus on

systemic disparities and other forms of oppression is shown by the advocacy of structural

remedies that go beyond the individual's ability to adapt and cope (Johnson, 2017). One of the

stories in the "spirit that catches you, and you fall down" collection explains how the Hmong

refused to negotiate or accept violence against them. They were able to maintain a self-sufficient

lifestyle in the highlands due to their acquisition of property. In his ethnographic research,

Fadiman outlines how crops were useful to the Hmong and other ethnic groups. In her tribe, "no

one was more important than the other" everyone worked in same capacity (Fadiman 2012). Due

to their farming lifestyle and lack of social hierarchy, the Hmong did not have a leader or feeling

of deprivation or inferiority (Fadiman,2012). Only a small portion of their most valuable

 11

commodity, opium, was utilized to pay taxes and a little portion was used for medical and

ceremonial purposes. In contrast, things changed swiftly once the route between Vietnam and the

United States was shifted. As nations with greater might gained influence over the Hmong,

various countries began to compete for control of the Hmong people and their territory. It was

thought that Laos will be taken over by communism by the United States. The United States was

prohibited from sending troops over the border after a conference at which both countries agreed

to work together. They created a strategy to send the CIA to train and recruit Hmong men for the

military.

In order to save their territory, the Hmong were steadfast, and the hidden army put

together by the US was unconventional but efficient. When compared to other American forces,

the United States was paid very little for fighting in the conflict. Having nothing to work with

after the bombing, there was no other option. Hmong were seen as only safe provided they

continued their opium trafficking, according to US policy. Even at the age of 10, the United

States of America is still recruiting Hmong youngsters for service. As a consequence of the

terrible conflict, many of them were killed and their towns were destroyed. The Hmong culture

has experienced a major shift as a result of its close relations to the United States. A deal

between the United States and Vietnam about the withdrawal of American forces from Vietnam

marked the end of the combat. (Johnson, 2017). Rice bags were dumped on fields that had

burned, one of the most serious mishaps. As a result of the United States withdrawing support,

communists penetrated Hmong land, leaving them with little choice but to accept defeat. While

some were airlifted out of the country, others had to risk their lives by hiking.

Part IV
 12

How Micro- and Macro-level dimensions help to decide who and how to target the

intervention

This chapter makes it apparent that the inquiry is focused on the Hmong people, and the

remainder of the book demonstrates this. In order to better understand the plight of the Hmong

people before they go to Thailand, conflict theory has been used. For this audience, the

macroeconomic level is particularly helpful since it helps them to better understand economic

issues and policies. The conflict perspective sees society as a way of accomplishing a task with

limited resources. Working at the macro level of social work, which includes practice with large

populations such as entire towns or states or non-place populations such as the cultures of

people, it is appropriate to examine interactions and power dynamics between two cultures in the

context of Merced in the United States. With the conflict viewpoint, the Hmong's repression,

manipulation and deprivation of their land and resources may be better understood. They didn't

have a lot of money to work with, and Vietnam was the most powerful country in the region.

When the United States left many Hmong to fend for themselves in the face of resistance, they

let their privilege to get the better of them and seized control. In the end, the United States and its

prosperity fooled the Hmong people.

It is because of the cultural disparities between the Hmong and Americans that this book

employs a competing perspective to explore cultural issues. The book discusses the notion of

oppression. Since of this, the Lee family found themselves in a position Fadiman, (2012) as well

as feeling inferior to others because doctors and medical experts make decisions for the family

on a regular basis. This control was mostly based on the Lee family's lack of awareness of

American healthcare systems. This leads in the doctors, nurses, and other staff people assigned to

Lia's care running over and controlling them. Although the medical team inspired by Western
 13

Enlightenment thought and Lia's parents' distinctive Hmong worldviews, among other factors. A

Thai refugee camp had been used by Lia's parents for sanctuary throughout the Vietnam War and

the covert war in Laos and Vietnam. In 1980, they moved to Merced, California, with their little

daughter. Prior to the family's move to the United States, both Lia's parents had never been

outside of Southeast Asia. Farmer from the Laotian highlands, neither of them cosmopolitan nor

prosperous in the classic sense, they were also both ignorant farmers. To put it another way, none

of them were literate in their own tongues, much alone English. Their traditional understanding

of the human body and medicine helped them deal with Lia's epileptic convulsions, which was a

godsend in disguise.

Lia's parents put a heavy premium on the healing powers of shaman healers, as well as

medicines and animal sacrifices, because of their traditional understanding of medicine

(Fadiman, 2012). A lengthy history of anti-assimilation sentiment in the United States goes back

to the Lee family. To avoid genocide or assimilation into dominant cultures, the Hmong people

stayed in mountain settlements or nomadic groups, according to Fadiman. As a result, the

Hmong people in Laos' highlands have formed self-sustaining communities to keep them apart

from the lowland Lao (Fadiman, 2012). There is a great deal of conflict in terms of power and

cultural hierarchy because of this lengthy tradition of cultural resistance to assimilation. As a

result, the health care system also failed this family, making a series of assumptions that signaled

that they were unable to satisfy the family's needs.

Conclusion

The conflict between Western medicine and Hmong culture, made worse by a scarcity of

interpreters, cultural understanding, and education on both sides of the border. Anne Fadiman

explains how a scenario with a critically ill kid went awry and offers recommendations for more
 14

efficient methods to communicate and give care in similar situations. This book has a plethora of

beneficial information. The field of social work may not seem to focus much emphasis on the

theory since it is a practice-intensive discipline; yet, theory should guide every choice that social

workers make. Viewpoints for practice include well-known theories such as psychodynamic and

systems theory, as well as less well-known perspectives such as existential theory and

existentialism. In spite of the fact that some theoretical perspectives are more appropriate in a

micro or macro setting than others, social workers should have a diverse and readily available

knowledge of theories to aid their work in any setting. This increased repertory (including many,

but not all, theories) provides social workers with the capacity to apply at least one theory to

almost every circumstance in any context with any number of participants, allowing them to be

more effective.
 15

References

Bates, J. (2017). Themes of Biopower in The Spirit Catches You and You Fall Down. Relics,

Remnants, and Religion: An Undergraduate Journal in Religious Studies, 2(2), 5.

Betancourt, J. R., & Maina, A. W. (2004). The Institute of Medicine report" Unequal

Treatment": implications for academic health centers. The Mount Sinai Journal of

Medicine, New York, 71(5), 314-321.

Dimaano, C., & Spigner, C. (2017). Teaching from The Immortal Life of Henrietta Lacks:

Student perspectives on health disparities and medical ethics. Health Education

Journal, 76(3), 259-270.

Fadiman, A. (2012). The spirit catches you and you fall down: A Hmong child, her American

doctors, and the collision of two cultures. Macmillan.

George, M. (2010). A theoretical understanding of refugee trauma. Clinical Social Work

Journal, 38(4), 379-387.

Hutchinson, C. A. (2017). Darfur Conflict: A Phenomenological Study of Female Victims'

Perception of Justice. Nova Southeastern University.

Johnson, R. (2017). Embodied social justice. Routledge.

Kung, F. Y., Chao, M. M., Yao, D. J., Adair, W. L., Fu, J. H., & Tasa, K. (2018). Bridging racial

divides: Social constructionist (vs. essentialist) beliefs facilitate trust in intergroup

contexts. Journal of Experimental Social Psychology, 74, 121-134.

Morris, W. E., & Brown, C. R. (2001). David Hume.

Nelson, T., & Constantinidis, C. (2017). Sex and gender in family business succession research:

A review and forward agenda from a social construction perspective. Family Business

Review, 30(3), 219-241.

 16

Oberschall, A. (1978). Theories of social conflict. Annual review of sociology, 4(1), 291-315.

Tu, W. (1996). Beyond the enlightenment mentality: a Confucian perspective on ethics,

migration, and global stewardship. International Migration Review, 30(1), 58-75.