For Cross-cultural psychology, listening is more important than a list of symptoms
The western body of psychotherapy takes little consideration of how culture is a part of the human psyche. The DSM IV has been rightly charged with being culturally unconscious of the fact that psychological suffering is unique to the individual’s cultural identity.
This fact was driven home to me during this fall’s five day residential conference at Saybrook University, where I had the chance to participate in an intensive workshop on “Deep knowing of the Other: Culture, Empathy, and Creativity.”
The third portion of this five day series was presented by Dr. Stanley Krippner and Dr. Jurgen Kremer and focused on the obvious and hidden cross-cultural issues that arise in how we see, understand and diagnose psychological suffering.
Krippner’s and Kremer presentation this past week illustrated how the experience of what we in western society may define as psychological suffering may not be the same in another part of the world; they may not use the same words or even see something like depression as psychological suffering. Psychological distress transcends easy western diagnosis and tends to manifest along culturally specific fault lines: it is related to a person’s identity, and their identity is related to their culture.
Without understanding a patient’s culture, a misdiagnosis is often inevitable.
But with the experience of taking the time to open ourselves up to knowing ourselves and others, we can learn how to be with them and how to be supportive.
We can know the stories of others by inquiry and most importantly, listening with openness. Even if their story digs into your sense of what is right and wrong or if you feel compelled to question or judge, listening deeply is always the first step.
As Carl Rogers described it in A Way of Being: "An empathic way of being with another person has several facets. It means entering the private perceptual world of the other and becoming thoroughly at home in it."
That’s the beginning of a therapeutic bond. When we listen with empathy we can discover ways in which we are related to the other. The stories that others tell us can reveal ideas and values that we may share, as well as points of distress that we may not.
A therapist who takes the time to know their clients is entering their private world. In doing so, we can work to see what the true source of their internal struggles and pain may stem from.
Deep knowing allows the therapist to see that a “psychological distress” could be related to their client’s cultural experience in the world. Since we cannot separate people from their cultural identity, the work of “deep knowing” and empathy can only aid in understanding them and begin the work of helping them move through their personal pain.
The work of this series was meant to open us to the power of knowing the other in a way that goes past the superficial layers. Without this understanding we cannot do the work of helping others – and psychology in non-western cultures will bear an uncomfortable resemblance to imperialism.
-- Makenna Berry