Advanced Psychopathology

Monday, May 08, 2006


The final one...finally

It seems evident that when working with clients from ethnically diverse backgrounds, the role of the therapist, how one is perceived, and interventions the therapist may make in turn can run counter to more traditional modes of psychodynamic therapy. As a therapist, it is key to remain consciously aware of how constructs within different cultures,such as how respect is conveyed, appropriate physical contact/distance, and issues of time and humor are perceived. For example, Arab, Latin American and southern European cultures tend to prefer less physical distance when interacting with others and so if a client from one of these backgrounds was engaged with a therapist who was from a different (perhaps Euro-American Caucasian) background, the therapist would be required to reevaluate his/her role in the therapy room and engage with this client in a manner that would require more conscious awareness on the part of the therapist. The therapist would have to determine what effect his/her own culture may have on his/her ability to adapt to the client’s method of interaction and to acknowledge that he/she is not a blank slate who brings an entirely objective stance to the therapeutic interaction.

In many cultures across the globe, the notion of separation/individuation and the importance of the mother-infant interaction seem to be at odds with what is deemed as successful development by classic psychodynamic theories. For example, in more collectivistic societies, such as various Asian cultures, childcare duties may be dispersed among several generations of family members, including extended kin networks who form primary bonds with infants and appear to safeguard against possible negative interactions experienced with “mother.” In addition, complete separation from primary caregivers and the ability to see oneself as a fully-functioning whole individual who is separate from those they have had the closest interpersonal experiences with is often not seen as a positive developmental outcome. In contrast, the ability to see oneself within the context of others and to attempt to strengthen the concept of cohesion instead of separation is often a goal of childrearing practices. Due to this notion, it would be important for therapists working with these clients to acknowledge what is valued in their society and show a sense of empathy and respect for how cultural differences oftentimes help define the course of therapy and to meet the client where they are in terms of the idiosyncrasies that constitute their psychological past.

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