Cross Cultural Issues in Psychotherapy
In recent decades, as the world becomes a smaller, more interactive place, professionals in all disciplines are becoming aware of the importance of taking into account cultural differences. The Western World, having been psychologically ethnocentric for centuries, has finally come to realize that cultural variations affect all fields of investigation, including psychotherapy.
It has become increasingly apparent that therapists in Western Europe and the United States — due to several factors, including economic mobility and the influx of immigrants from all parts of the world — are treating a more varied international community. Clearly, these therapists have to be trained to understand and take into account differences in cultural perceptions. Such differences may be based on ethnicity, religious background, race, country or origin, socioeconomic status, or even language.
Pinpointing Cultural Differences
People in different cultures have different views of the world, including:
Definitions of “normal” behavior
Perceptions of gender roles
Expectations of maturation, success, aging
Appropriate ways of expressing emotions
Means of communication, such as body language
Attitudes towards seeking help
Methods of managing marital and parenting issues
Attitudes towards education
It is essential that psychotherapists be trained in such variations if they are to help individuals with diverse backgrounds.
Examples of Cultural Differences
Even among integrated groups, cultural differences may apply. Most of us are aware, for example, that in the United States, men are allowed, or even expected, to be more aggressive than women, and that women are expected to be more open about expressing their feelings. For this reason, depression may manifest more as irritability or anger in men and as sadness in women.
More far-reaching differences have to be taken into account, too, if psychotherapists are to avoid making misdiagnoses or using treatment methods that may be ineffective, or even intimidating, to some patients.
Examples of cultural differences are:
In some cultures, hallucinations are not considered to be a form of illness, but rather a form of spiritual communication.
In a study in which Westerners and East Asian were presented with a postulated situation of conflict, the Westerners chose sides, whereas the East Asians tended to come up with a compromise solution.
In some ethnic or national groups, asking for help with psychological problems is considered shameful and stigmatizing.
Languages vary. In some languages there are no words for emotions that speakers of other languages use and understand. An example is the Mexican word “Pena ajena” which means the embarrassment of watching someone else’s humiliation.
Clearly, psychotherapists have to be trained to be sensitive to the perspectives of their patients in order to help them. It is essential that such training be inclusive and comparative, rather than prejudicial. The point of understanding cultural differences is to increase the therapist’s ability to build bridges with flexible healing techniques, never to perpetuate stereotypes.
It is important that the therapist explore his or her own cultural background to become aware of any inherent bias that must be overcome in order to be of psychological assistance.