How Does A 2 Year Old Boy Has Hiv Aids Exploration of Cognition in Ugandans for Psychotherapy

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Exploration of Cognition in Ugandans for Psychotherapy


Cultural psychology attempts to understand the way of thinking of local indigenous people for the purpose of successful psychotherapy. If the counselor does not understand the background of the traditions, customs and culture of the people he serves, then he cannot understand the subtleties of their cognition in solving life’s questions and problems. In this paper we will explore the background between Ugandan traditional belief systems and post-colonial religious faith. How this contrast and conflict in the Ugandan mind creates a dual cognitive approach to life.


The modern Ugandan for the purposes of psychotherapy is a complex cognition produced by the recent history of emancipation from colonialism (1962) to the years of violent dictators like Obote and Amin who both created an atmosphere of terror in the country. (1. See Social Origins of Violence, Kasozi 1994) Along with these periods of violence comes the conversion to a religious Western faith that includes mostly Protestant churches, but with minorities of Muslim and Catholic influence. Religion dominates television and radio programming with nearly 50% of all programs on fanatical worship and faith healing. Almost the entire population goes to one type of church or another, creating on the one hand a deep religious faith, and on the other a constant fear of hellfire and damnation. Mixed into this melting pot is the modernization of young people who listen to rap music, black soul and other ethnic sounds. Most are accompanied by a video showing girls in miniskirts gyrating sexually to the masculine licentiousness of the lyrics. At the same time the government of the day is trying to impose a new moral order and is banning miniskirts from the streets and placing warning messages in front of music videos saying it is not suitable for under 18s. The government is also trying to introduce a marriage law through parliament to continue male dominance in society and unequal rights for women as the norm. The same government of President Museveni (2nd 27 years in power after the coup de grace) openly talks about anti-gay legislation to suppress and eradicate homosexuals in Uganda. A constant debate among people is the corruption of officials and politicians; this includes land grabbing by illegal means with the support of local authorities, Western aid money used for personal enrichment and bribery from the lowest transport official to the highest government ministers. While it is of course almost impossible to prove corruption when it becomes a daily accepted practice, this does not prevent people from having a negative view of their lives in terms of control and prospects for a better future. A final note is that Ugandans are not a consolidated people, but in fact a country, throughout history, populated from many different regions of Africa, in the west from Ethiopia, Kenya and Tanzania, in the east from Somalia, Congo and Rwanda and in the north, Sudan and the Central African Republic. This mix of cultures and traditions has caused much of the internal fighting since the 1960s when British colonialists liberated the country.

Traditions, customs and culture:

There is an interesting dichotomy between the tribal traditions of the Ugandan people, with their 150-year-old introduction to Western religion, mainly Christianity, and traditional pagan beliefs. This is caused by the practice of witch doctors in all parts of society, from the advisors of the king (3rd Kabaka) to political influences and the general population who want to consult witch doctors about many areas of life. Witch doctors provide a service that surpasses believers, especially for emotional needs in love and relationships. When you ask the local people around the poor area of ​​Lake Victoria, they say that the witch doctor is godless, (not without gods, but without the Christian God) he can bewitch people to do his bidding, solve problems in the economy and business, curse you, provide love potions, poisons to kill, predict the time and the power of prophecy. Recently, a young girl whose husband had wandered off with another woman (very common) tried to lure him back with a love potion given to her by a local witch, but the liquid she secretly put in her husband’s drink actually poisoned him and he died. She is now facing murder charges for her husband’s death. (2. News about the new vision in 2013). Many news reports tell of love potions gone wrong or being cursed and therefore having no control over their actions. All mitigating circumstances that a person can state in court, as justification for a criminal offense or misdemeanor.

Some of Uganda’s social problems are those that many African countries suffer from, such as alcohol abuse, illegal drugs, HIV and AIDS (the only country in Africa still experiencing an increase in HIV infection rates), plus high youth unemployment and lack of opportunity in the workplace. These social problems naturally bring numerous consequences to the mental health of the community. Sexuality is by far the worst problem when it is seen as the hypocrisy of faith and religion. As stated earlier, many Ugandans go to church every week (including the youth) pray and uphold the faith in a very fanatical way, praising the Lord aloud and all his blessings, and at the same time many men practice traditional polygamy and the practice of bride prices. Although bigamy is an offense under the law, it is not prosecuted unless extreme pressure is applied to the case. Many men who marry in the church have girlfriends (also other women) and have children with those women. While still going to church every week and praying for faith. Divorce has become common, which for many first wives means abandonment. Many early deaths from HIV infection are directly attributable to the practice of polygamy and men’s refusal to use condoms as a protective device. The second most difficult area for Ugandans is health, not as you might think because of poverty or malnutrition, but actually obesity among the middle class. Binge eating can be seen as a reaction to the hard times past when food was scarce and you had to eat what you could get, but now binge eating is a thing of the past, many fill their plates to the brim and consume huge amounts of high fat foods. Cancer, heart attack and diabetes are very common and highly prevalent compared to other nations.


It is very interesting when we talk to many Ugandans about their outlook on life and approach to the future how negative they are about most things. They have a possessive attitude towards material objects including women. Men see a woman as an object or property whose purpose is to serve and produce offspring. When he asked a young man (18 years old) about his view of how Ugandans see the world, he said that 60% of what most people talk about is always from a negative point of view. They are looking for someone else to blame for their misfortunes and misfortunes. In speaking with many other Ugandans and expressing this sentiment, many agreed that this is generally true. There is also a general lack of trust between people, they are constantly checking on each other for fear of being cheated, swindled or cheated.

What does all this mean for cognition as a mindset for dealing with problem solving, constructing the reality of everyday life, and the cognitive dichotomy of belief? That most will approach life with a negative attitude, a divide between faith and superstition, a gender bias that creates decision-making that leads to high-risk relationship and sexual behavior, and ultimately a general fear response to life from a history of violence and corruption.


Now our therapist has a broad background of the typical Ugandan mindset, their recent historical events, their dichotomy of beliefs, he can begin to understand the position the client may be starting from. Keep in mind that just because a person recognizes the division of thought and may even realize that it does not agree with reality, it does not mean that the subconscious does not have a profound effect on the person. In Freudian terms, insight should bring relief, but cognitive dissonance shows that many people can hold conflicting points of view and still present them as rational. The super-ego of Ugandans is imbued with traditions inherited from previous generations and shaped by recent historical violence. This guiding influence of religious faith and superstition can create a division in the super-ego allowing a person to hold opposing views of morality and social mores that are easily reconciled. The highly pleasure-driven ID allows overeating due to fear of an uncertain future. Sexuality is governed by the custom of polygamy even as the super-ego is clearly offended by this practice in its devotion to religion. High-risk sexual encounters, driven by ID, including lack of condom use, and despite continued super-ego education from mass communication media and AIDS, have little or no effect on decision-making about high-risk sexual relationships. The ego is clearly weak in its effort to decide between the high-risk id and the morally clear super-ego. The normal defense of the super-ego is to use guilt as a way of suppressing ID activity, but in the case of the Ugandans the guilt is repressed and allows the main pleasure to win over the reality of the situation concluding that the Ugandans have a weak Ego state where they are cognitively protecting their own long-term interests. This also involves cognitive dissonance that has little emotional effect, especially on men with sex and women on overeating that the super-ego is overshadowed by the dominant id.

In the therapy room:

The presenting client is of course an individual within society who has decided that their behavior does not agree with his own outlook on life and has therefore decided to seek support and change through counselling. A therapist trained in therapy techniques but now experienced in cultural psychology is in a good place to begin the healing process. It is always a good idea to assess your client’s cultural background during the ongoing process of psychotherapy to understand their mindset. Because from their life position in tradition, customs and culture, they solve their own life problems. This mindset can be seen from a transactional analysis perspective as the child’s ego-state of child-like values ​​that interact with the parent’s ego-state to prevent the client from making a rational adult decision, which is mixed with a cognitive mindset that has a dichotic belief view. The adult ego state is inhibited from functioning and could almost be eliminated from the tug and pull of parent and child ego states in constant discord. The universality of Freud’s psychoanalysis and Berne’s transactional analysis allows the therapist to understand how Freud’s model of the mind in ego positions and Berne’s ego-states can help educate their clients in their inner thought processes leading to insightful introspection that would reduce harmful social behavior to a more settled healthy life position driven by ego. It is not easy to change long-standing traditions and customs because they do not have direct experience with the client, but they drive a changing culture influenced by historical values.


In conclusion, this article is intended to enlighten both therapists and lay people about the value of cultural-psychological research into the history, attitudes and beliefs of the local population. You cannot successfully treat a patient for mental health problems without a good understanding of how the person developed their super-ego or parent ego-state based on tradition, custom and cultural influences. It is this ability to hold dichotic states within the same reality that creates both the confusion and habitual behavior that exists in one mind. A therapist cannot hope to help change behavior without a full understanding of a person’s belief system shaped by history and tradition.


  1. Kasozi, ABK (1994) A Social History of Violence in Uganda. Fountain Press
  2. New Vision News Paper, April 2013. Ed.
  3. Kabaka = Barundian language meaning – King or Ruler

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