Roberto Lewis-Fernández — Columbia psychiatrist and lead developer of the DSM-5 Cultural Formulation Interview — argues that Western psychiatry isn't the universal default; it's a cultural product like any other. In this conversation, Lewis-Fernández walks through what the Cultural Formulation Interview actually does, why somatization is the global norm rather than the exception, and why the field's tendency to treat its own framework as 'knowledge' while treating patients' frameworks as 'beliefs' is a 19th century idea that should be discarded.
Topics: the Cultural Formulation Interview (CFI) and how to use it clinically, why psychiatry itself is a cultural product, somatization across cultures, the knowledge/beliefs asymmetry in clinical practice, working with patients across language and cultural difference, structural determinants of mental health, and the limits of imposing biomedical frameworks on patients who see the world differently.
Roberto Lewis-Fernández, MD is Professor of Clinical Psychiatry at Columbia University, Director of the NYS Center of Excellence for Cultural Competence, and President of the World Association of Cultural Psychiatry