Psychiatrists assessing Native children and adolescents often find them passive, difficult to assess and not forthcoming. This behaviour, which actually reflects the influence of Native culture, is often misinterpreted by clinicians unfamiliar with that culture as evidence of psychopathology. Patterns of conflict suppression, conflict projection and the humiliating superego are described and placed in their historical and cultural perspective, where they originated as techniques of ensuring the group unity and cohesion essential for survival in a hostile environment. Failure to recognize and understand such cultural influences can lead to errors in diagnosis and treatment that can turn what was intended as a helpful encounter into a destructive one.