Musings
I continue to be amazed by the way that cultural differences impact how a person's statements and behavior are understood. Yes, as human beings we have similar nervous systems, physiological makeup, and general ways we form relationships. But beyond that, we can be so different. Take for instance recent technological leaps in ways human beings in the west communicate. Western cultures are changing so fast with the introduction of new technologies that we have only guesses as to how these forms of communication are impacting and will impact our relationships, society, even physiology.
When working with newly arrived refugees from societies without cell phones, easy computer access, etc., I realize that I communicate differently with them than I do with westerners. I take more time to be with these clients. I take longer to get to the point, honoring the niceties and sometimes more circular ways to discuss a given issue. I share more personal information about myself than I do with western clients, knowing from experience that most of the world will not share their problems with someone they feel is a stranger. I need to build a relationship that is a mix of helper, cultural translator, "child expert," student, and friend. I know this is tricky territory. To even write "friend"in the context of a therapeutic relationship feels dangerous. But there is no way to do effective therapy work with nonwestern people without some openness to being a human being in the therapy session. Like many ethical issues this is a balancing act. I don't ever see clients on weekends unless there is a special event like World Refugee Day. My clients only know general parts of my personal history (e.g. where I come from, how many siblings I have, my marital status, etc.). They do not know about the relationship dynamics in my life or my feelings about controversial political issues. But they may know my favorite foods. In one instance I worked with a Liberian girl who had experienced a lot of early trauma. We were making a lifeline, depicting the major events in her life. She was struggling to share some of these. I knew her father had been killed. So I told her that I, for instance, lost my father when I was four, and that I would write that if I was doing a lifeline. She shyly responded by saying that her father died when she was three. We added it to the lifeline, and immediately we had more to talk about.
It's about being comfortable as a human being and a therapist at the same time. We most definitely bring our person into sessions with us as therapists, and denying that or hiding it doesn't model authenticity and openness for our clients. What if we work on using our person in a way that maintains ethical boundaries and encourages authenticity? If done wisely, I believe that we as therapists can even out to some extent the power differential in the therapeutic relationship, which is so often the trigger of unethical behavior.
When working with newly arrived refugees from societies without cell phones, easy computer access, etc., I realize that I communicate differently with them than I do with westerners. I take more time to be with these clients. I take longer to get to the point, honoring the niceties and sometimes more circular ways to discuss a given issue. I share more personal information about myself than I do with western clients, knowing from experience that most of the world will not share their problems with someone they feel is a stranger. I need to build a relationship that is a mix of helper, cultural translator, "child expert," student, and friend. I know this is tricky territory. To even write "friend"in the context of a therapeutic relationship feels dangerous. But there is no way to do effective therapy work with nonwestern people without some openness to being a human being in the therapy session. Like many ethical issues this is a balancing act. I don't ever see clients on weekends unless there is a special event like World Refugee Day. My clients only know general parts of my personal history (e.g. where I come from, how many siblings I have, my marital status, etc.). They do not know about the relationship dynamics in my life or my feelings about controversial political issues. But they may know my favorite foods. In one instance I worked with a Liberian girl who had experienced a lot of early trauma. We were making a lifeline, depicting the major events in her life. She was struggling to share some of these. I knew her father had been killed. So I told her that I, for instance, lost my father when I was four, and that I would write that if I was doing a lifeline. She shyly responded by saying that her father died when she was three. We added it to the lifeline, and immediately we had more to talk about.
It's about being comfortable as a human being and a therapist at the same time. We most definitely bring our person into sessions with us as therapists, and denying that or hiding it doesn't model authenticity and openness for our clients. What if we work on using our person in a way that maintains ethical boundaries and encourages authenticity? If done wisely, I believe that we as therapists can even out to some extent the power differential in the therapeutic relationship, which is so often the trigger of unethical behavior.
This is so beautifully written, Jesse, and so important to explore and explain. One of the biggest mistakes we make as human beings is assuming that others are as we are. As therapists we are trained to acknowledge differences and this article goes one step further into recognizing that the differences can be so great that it becomes an ethical imperative to create bridges through sharing similar experiences. When we are so removed as therapists that we can not guide through example, then we fail to access our shared humanity. I love your depth and authenticity. Thank you for sharing in this way. I am richer for it.
ReplyDeleteThanks Val! I really appreciate what you say about we as therapists "failing to access our shared humanity." Even having been trained as I was in a holistic model for counseling and art therapy, I still sensed a fear of getting too close to mental illness in my educators. How can we really build rapport if we fear our client's very issues we are there to help shift? I think part of the solution lies in standing firm in our humanity and its many potentialities, including the capacity for mental illness in all of us given the wrong set of circumstances. I know I stand strong in the part of my human-ness that is resilient and healthy as well, and I if I feel that I can't trust my reactions or judgments I seek supervision. This work was not meant to be done alone as far as I'm concerned. I worry for my colleagues that don't seek regular consultation or supervision -- I think that's where we as therapists are the most vulnerable.
ReplyDeleteOh, the vulnerability of standing alone. Two thoughts come to mind, one I am so grateful I do not have to stand alone (and I am so grateful to know amazing, incredible women like you, I can call on when needed) and second thought, we are never alone. I am in a practice of continually affirming my permanent, unalterable, and expansive relationship to all that is. This is the piece I find so critical. Knowing that place inside of me that is connected, solid core knowing that I have access to infinite support, guidance, and love. The key for me, here is listening and taking action. And just to be perfectly clear, I would never do this work without continual supervision. I totally agree with you that this work is not meant to be done alone, it is just to easy to get lost in it. My vision of this work is a deep and complex journey, hang your compass around your neck and refer to it often, and never go into the wilderness alone. Thanks for being a partner in this adventure.
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