It was the great master therapist Irving Yalom who once recommended to new therapists: “create a new therapy for each patient”. His idea was that working with his patients required an appreciation for their unique inner world and language, and the development of a new “therapeutic language” (as he called it) for each person who came to therapy. Dr. Yalom´s advise goes very much against those who want to “standardize” the methods and techniques used in psychotherapy, and supports spontaneity and the creation of a unique form of therapy for each patient. His advice was given in a book published in 2002, but in this time and day of globalization, I think that it is more relevant than ever.
Psychotherapy is a very unique kind of relationship, where “clients” open up and dare to talk about very private parts of their lives, telling their therapists things that, in many cases, would not share even with those who are closer to them, be it family or friends; thus, having this kind of experience can be very new –and sometimes scary- for many people.
Therapists are aware of this challenge, and, of course, have trained in skills aimed at easing the development of this relationship. Part of a therapist´s work is to create conditions that make a client feel fully accepted and supported. What we do is offer empathy and “unconditional positive regard”, a wonderful notion inherited to us by Carl Rogers, which basically means that the client is accepted and supported because of who she is, regardless of what she says and does. This positive environment is part of every therapy; however, as Dr. Yalom pointed out, good psychotherapy also takes into account the inner worldview of the client and the possibility of creating a new language, almost a new therapeutic culture that would be another expression of acceptance of who the client is.
Here is where, in my view, culturally sensitive psychotherapy comes in!
I wonder, and I guess that we all can just imagine the differences that emerge in the way a psychological help is co-constructed when the client is a Venezuelan woman; or a Nepali young man; or a German PhD student… As a therapist, I have had clients with very different cultural backgrounds, and I know that these clients unique personal stories have been shaped as much by their own personal experiences, as well as by their communities, their language, their local discourses and the values that shape what matters to them. I cannot imagine that my understanding of the importance of their culture would not be part of the skills and competencies that I should bring to help them as a therapist.
As we are seeing unprecedented movements of people across national and cultural borders seeking to study, find employment and develop relationships; it is only natural that the conversation around cultural behaviors in therapy is increasing. But how is this relevant to a good psychotherapy? And how do you know if you can benefit from working with a culturally sensitive therapist?
My answer follows some ideas of Columbia Professor D.W. Sue (father of cross-cultural counseling) and it goes as follows:
- If you identify with a culture or sub-culture that is different from “mainstream” (general) culture, you will benefit from working with a “culturally sensitive” therapist who is interested in learning more about your culture and how it shapes your values and your perceptions of what therapy is about. You may also appreciate working with a therapist who is culturally aware and knows her own personal values and how these also shape the therapeutic relationship
- If you find cultural transitions difficult and overwhelming, or if you and your family are migrating or relocating, you will benefit from working with a therapist familiarized with the impact that migration and cultural transition has in one´s sense of self and identity, and who might have also a deeper theoretical (and practical!) experiences with migration.
- If you would like to use the resources and tools that your culture has given you to express your values, feelings or personal history, you will benefit from working with a therapist who will want to learn about your culture, your language and will work jointly with you in supporting alternative ways of expression, that fit more how you express yourself.