A dynamic view of culture defines it as the semiotic system that people use to interpret their inner and outer worlds and that shapes their responses to it.

Culture is more than the fixed patterns of behaviour acquired and transmitted through symbols and related to a particular cultural group.

Cross cultural psychiatry makes use of both universalistic and relativistic concepts.

It is important to make use of these concepts as clinician in the diagnostic and therapeutic process with patients.

Attention will be paid to the concept of idioms of distress, how does the patient elaborate his suffering?

Clearly elucidation of the idioms of distress is essential in formulating an accurate diagnosis.

Another factor as emphasised in the Cultural Formulation which is highly relevant to this subject is the therapist patient relationship. Transference and countertransference issues related to the necessity of reconciling the meaning of verbal and nonverbal expressions of the patient along with contextual information about the patient and his environment with diagnostic critieria are relevant here.

Some research particularly related to how symptoms are expressed and carried out in the department in Rotterdam will be discussed in this workshop.