Working Inter-Culturally in Counselling Settings

Aisha Dupont-Joshua

• Publisher: Routledge
• Year: 2003
• Print ISBN: 9780415227483
• eBook ISBN: 9781134587759
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

What does it mean to work inter-culturally?
Our multi-cultural society is changing the parameters of counselling. Working Inter-Culturally in Counselling Settings explores how racial issues can be recognised and worked within a practical, clinical setting. The book looks at how the counselling setting can influence practice, and the book includes chapters in a range of settings, including:
* counselling training and supervision
* social work
* the probation service and prisons
* setting up counselling services in culturally diverse communities.
Aisha Dupont-Joshua, together with contributors of diverse cultural heritage, moves away from exclusive white models of thought, and adopts more of a world view, inclusive of cultural difference. Working Inter-Culturally in Counselling Settings will be invaluable for counsellors, trainers, supervisors and other mental health professionals.

Chapter 1
Introduction

Aisha Dupont-Joshua

What does it actually mean to work inter-culturally? This is a very big question and by way of an introduction into this, I will begin by talking about myself and my involvement in the inter-cultural movement, and why becoming involved with this way of thinking has had so much impact on my life and work. In 1990, I had the privilege of training with the late Jafar Kareem, the founder of the Nafsiyat Inter-Cultural Therapy Centre in London. This training in intercultural therapy included anthropology, sociology, and challenged both eurocentric assumptions in counselling (eurocentric being based on European thought and concepts) and psychotherapeutic models of thought. It was revolutionary in counselling training in Britain and was very significant to me in my development, and self-concept as a black woman of mixed race, an immigrant, living and having been brought up in Britain, and as a counsellor. Issues of race and culture had never been on the agenda before in my experience of the counselling world, and this different way of thinking opened up new avenues of understanding for me and has become an essential part of my perception of how I relate to the world. It has also given me an understanding and a willingness to work with the emotional problems facing black and other ethnic minorities, living in a white host society. My training and subsequent friendship with Jafar Kareem gave me tools and a vocation to work with the problems of living in a multi-cultural society.

Jafar Kareem, who was originally from India, founded the Nafsiyat Inter-Cultural Therapy Centre in 1983 to provide a special psychotherapy service for black and other ethnic and cultural minorities, as a result of his experience of working as a psychotherapist in the National Health Service in Britain. Kareem (1992) says that his experience showed him that non-European clients were not responding to the type of psychotherapy being offered and appeared to be rejecting it, as it was practised at that time. This led him to question whether something was wrong with the way it was being practised (rather than taking the point of view of many faltering white practitioners, who came to the conclusion that black people were psychologically unsuitable for psychotherapy) and consequently lead him to explore new ideas that could be relevant to non-European clients.

Kareem (in Kareem and Littlewood 1992) says that a psychotherapeutic process that does not take into account a person’s whole life experience, including their race, culture, gender and social values, could lead to a fragmentation of that person. He found that there were huge differences in the concept and expression of mental distress in European and non-European people, that fundamental concepts of personhood were radically different, and this needed to be acknowledged and understood for therapy to be practicable; this included family structures, child-rearing and education, obligations to the community and social hierarchy, morality and spiritual concepts—that people were social beings, woven into traditional structures, rather than isolated individuals. A vivid example was used by Kareem, who described an experience with a Nigerian client of noble birth. The client became stuck when asked to describe his relationship with his mother. After a missed appointment, he came back and declared that he was unable to do this, as he had been fed by nine pairs of breasts. He felt that an understanding of these aspects of people were fundamental to any therapeutic practice; leading him to challenge the assumption that there can be any kind of universal model of the self, as portrayed by the leaders of psychotherapeutic thinking. He felt therefore that cultural patterns needed to be integrated into any therapeutic models.

Kareem (1992) found that there were fundamental differences between individual human beings, physically and/or in their ways of being, and that inner and outer events can deeply affect a person’s psyche and become part of their unconscious life. Social and political events in the external world, such as prejudice, racism, sexism, poverty and social disadvantage can shape the lives of individuals, in relation to different societies, and these powerful forces may well become internalised, causing profound distress—these issues, along with inner conflicts, must be addressed as clinical issues. Our work therefore must encompass the inner experiences of the client, together with their total life experience, including their communal life experience before arriving on western soil. Dupont-Joshua (1994) gives the example of Mr J. who had been a respected member of his community, before he immigrated to England, so that his family could escape the degradation of being black in the apartheid system of South Africa. Forced to work a day and an evening job to cover the high costs of living in London with a large family, Mr J. eventually sought help for depression and chronic ill health.

Kareem (1978) defined intercultural therapy as:

A form of dynamic psychotherapy that takes into account the whole being of the patient—not only the individual concepts and constructs as presented to the therapist, but also the patient’s communal life experience in the world—both past and present. The very fact of being from another culture involves both conscious and unconscious assumptions, both in the patient and in the therapist. I believe that for the successful outcome of therapy it is essential to address these conscious and unconscious assumptions from the beginning.

So began the ideas of an inter-cultural therapy that could be used as a bridge to communicate across cultures, so that therapists of totally different life experiences could begin to relate to their culturally different client.

Thinking inter-culturally, it is important to consider what, unconsciously, the white therapist may represent for the black or ethnic minority client, in a historical or social transference—bringing up associations with slavery, colonisation, the Holocaust and other oppressions. It is also important to consider the white therapist’s negative counter-transference, for they are part of a society that projects negative images of black people and this might be around feeling their black client to be ‘primitive’, or being latently violent. Working inter-culturally, it becomes the therapist’s responsibility to facilitate the black or ethnic minority client’s negative transference, because the client would most probably be in too weak, vulnerable or needy a position to initiate this part of the working relationship. The relationship of mistrust between black and white people in our society can be mirrored in the therapeutic relationship, and black and ethnic minority clients often feel once again in a powerless and vulnerable position.

Working with the emotionally damaging effects of racism forms an important part of inter-cultural work—traditionally, therapy did not work with the effects of racism, as it was felt to be a political or external issue, and that therapy was for working primarily with the inner world. An example could be that racism could be perceived as a state of victimhood in the client, rather than a living reality that many black people have to face on a daily basis. The effects of racism can become internalised, damaging both the victim and the perpetrator, and working and dealing with the very primal and painful emotions evoked for all, by racism, is a very important aspect of our work. It must be understood by the white therapist that for many people of black and minority cultures, the most traumatic feature in their lives is to be black in a white society. Lennox Thomas (1992, p. 133) asks the question ‘what makes the dealings in a consulting room between a white therapist and black patient “different”? What are the processes which the therapist needs to go through to disentangle themselves from the structural racism of the society in which they live and were raised?’

Kareem (1992) cites the example of Victoria, a young black woman, who when consulting a white woman therapist because she had become depressed and feared she was going mad, was made to feel that issues of race were essentially her problem. Whenever she tried to bring up anything about her feelings about being black, the therapist always interpreted that as a projection of her inner chaos on to the outside world. Consequently Victoria felt misunderstood and angry that her pain about being in a black/white situation, where she was made to feel powerless, was unacknowledged. She finally sought help from the Nafsiyat Inter-Cultural Therapy Centre because she needed a therapist who could immediately recognise her pain in being powerless and black in a society which is racist. The problem with the first therapist was not that she was white, but that she was unable to look at (or had never been taught to look at) the interrelated themes of race and powerlessness as problems of reality.

Working with the sense of loss is often an important issue when working inter-culturally with black and ethnic minority clients; loss in many aspects: roots, family, environment and social status. For many people of African-Caribbean origin, separation from their parents, especially their mothers, when their parents came to Britain as migrant workers in the 1950s and they were left behind in the Caribbean, has become an important area of work in damaged attachments. Difficulty in forming close and trusting relationships can often be related to this original loss. Elaine Arnold (1998) says that because the reunification of families occurred without social support and counselling, parent-child difficulties often remained unaddressed, leading to behavioural and social difficulties and a disproportionate number of children going into the care of local authorities. The attempts to address these issues with traditional methods of therapy were sadly inappropriate, due to the lack of understanding of the family dynamics of West Indian immigrant parents.

Training in counselling and psychotherapy, where practice begins, has been sadly lacking in racial and cultural components, and this has double-edged consequences. Firstly, white therapists are completely unequipped to work with culturally different clients, and secondly, people of minority cultures often feel reluctant to join traditional training, finding the material unrelated to their experience of life and that they are unable to bring up issues of race, culture and racism, thus perpetuating the cycle of a white-dominated profession. Kareem (1992, p. 31) when talking of his psychotherapeutic training said:

Such intense training can sometimes be compared to a kind of colonisation of the mind and I constantly had to battle within myself to keep my head above water, to remind myself at every point who I was and what I was. It was a painful battle not to think what I had been told to think, not to be what I had been told to be and not to challenge what I had been told could not be challenged and at the same time not to become alienated from my basic roots and my basic self

Inter-cultural counselling and psychotherapy training and training components positively take on board these processes and work with validating diverse cultural traditions and expanding therapeutic models to include worldview models.

From 1995 to 2000 I was Editor of the BAC’s RACE (Racial and Cultural Education in Counselling) multi-cultural journal. This became an important way of communicating inter-cultural ideas and publishing writers of diverse cultures. The experience was a very rich one for me and brought me into contact with so many diverse and interesting writers that the idea of editing this book came as a natural progression of this. The relevance of many of the writers whom I was working with was begging a larger readership, so I took on the challenge of presenting a body of work that would reach a wide range of people working and studying within the caring professions who wish to widen their perimeters and integrate working with issues of race and culture into their work. I am very glad also to be able to include chapters by two of the founder members of the Nafsiyat Inter-Cultural Therapy Centre, Lennox Thomas and Elaine Arnold, who, together with Jafar Kareem, have led the way in inter-cultural thinking. I have tried to present the work in a practical and accessible way, so that people can use the ideas presented in their work setting—I have found that so much of counselling and psychotherapy literature is presented in such a dry, academic way that it is actually quite intimidating and hard to relate to, thus defeating the purpose of communicating with people. In a sense this could relate to a western academic approach, which in some ways perpetuates the exclusive thread which has run through this profession.

The healing properties of the talking therapies are now reaching a much broader spectrum of clientele and are being used in such settings as prisons, social services, the probation service and with disenfranchised groups around the world—I am very pleased to present chapters of working within these areas and others. Here counselling and psychotherapy is no longer adhered to as a religion, with an allpowerful belief system, but as a practical tool that can be adapted to the setting in which it is used and to the culture in which it finds itself. Our multi-cultural society is increasingly demanding that we look at power and spiritual disenfranchisement and that we look at our premises and assumptions. Rather than seeing this as threatening, we can choose to see it as widening our vision and enhancing our practice. As we know as counsellors and psychotherapists, any change requires inner questioning and self-reflection, as well as outer knowledge and action.

Included in this book are nine very varied and original chapters, by people of different races and cultures and working backgrounds. We lost a few contributors on the way due to births, illness and displacement, and the book has changed form in the process, but I hope you will find something stimulating that will be useful in your work and of interest to you. As a way of introduction, I have written a brief synopsis of each chapter. I would like to thank our multicultural group of contributors, Isha Mckenzie-Mavinga, Samuel Ochieng, Piers Vitebsky and Sally Wolfe, Wajiha Mohammad, Duncan Lawrence, Pam Williamson, Lennox Thomas, Elaine Arnold and Angus Igwe, for their hard work and cooperation in compiling this book. Isha Mckenzie-Mavinga, a Black British woman of African-Caribbean and European and Jewish heritage, uses the medium of writing as a mirror in her therapeutic work with black women. She runs therapeutic support groups for women affected by domestic violence, has contributed to the provision of alternative therapies for African Caribbean Mental Health and has also worked as an artist in education. She says that she feels that black women have a soul injury caused by patriarchy, slavery and colonialism. Having no therapeutic models to work with in their quest for healing, she feels that black women need to work together in the therapeutic relationship, linked by a common experience and the acknowledgement of common wounds. Through a long process, Mckenzie-Mavinga describes how the difficult work leads to building a positive identity and sense of self, through listening to each other lovingly, turning away from the negative gaze installed by racist images and responding to the eye of the beholder.

The liberation from fear is an important component in MckenzieMavinga’s work, and she describes how she uses metaphor as a useful way of locating fear hidden within the texts, and the women are playfully encouraged to face and express their fears in the context of their lives, using their cultural experience and language. MckenzieMavinga says that writing as a therapeutic tool pre-dates psychoanalysis and is a way of understanding the mind, in the same way that writing makes conscious a dialogue with the self and is a way of understanding the internalised self and relationship with others. She feels that it is an opportunity for black women’s subjectivity to transfer from the sole attention of her family, to her own self-discovery.

Samuel Ochieng is originally from Kenya, where he trained as a psychologist, and has also lived, worked and trained in counselling in the USA and England. Moving between these cultures, he has found that attempting to apply western psychological concepts to an African setting did not fit and that African cultures and ways of thinking and being needed to be understood in their own right and not be interpreted and translated through western psychological thought. He says that to attempt to mould a person without knowledge of their cultural make-up is to dismiss their heritage—he refers to this as the same mentality as colonisation, where the coloniser brought in his ideas as ‘better’ and ‘more powerful’ than those that were inherent in the cultures they colonised.

Ochieng explores important aspects of the African approach to life, including the concept of the group identity, as opposed to the western striving for individuality—how the individual gives meaning to the group and the group gives meaning to the individual—the individual becoming the representation of a clan and carrying with them a tribal and ancestral bonding within them from before birth. He likens African forms of communication with people dead or far away to the western use of the internet, and says that it is essential to understand this natural process of communication that is inherent in a people in touch with nature and who use natural forces for cures and protection as part of the African psychological make-up.

Ochieng gives an overview to the understanding of why witchcraft is a central part of the African psyche. He says that he feels that he is not alone on his journey; his family spirits and clansmen walk with him, to protect him and make themselves known to him on occasion in diverse shapes or forms. To him, it is a deep-rooted energy force outside of the self that may be called on occasionally as a part of natural existence. He likens the merging of the African psychological perspective to stepping into worlds of dualities and has evolved a model that he calls ‘Skiatism’, which incorporates both western and African thought. Here, symbols are used, just as with Jung, and understood in the ‘language’ that it is being presented in, so that when an individual appears in the counselling room they bring with them their entire family, both alive and dead. He feels that when working from an African framework a counsellor must acknowledge different realities as a way of life and understand problems in this perspective.

Piers Vitebsky and Sally Wolfe are a husband and wife team, with a Jewish and white British/Scottish/Irish background, respectively—working in Cambridge. Vitesbsky is an anthropologist and Wolfe is a counsellor and inter-cultural therapist, and they have been working together for several years, establishing a counselling service in Yakutsk, Siberia. There they have been working with the Sakha and Even, indigenous peoples who have become psychologically disenfranchised by the engulfing Russian Soviet Union. Vitebsky’s experience as an anthropologist and Wolfe’s experience as an intercultural therapist have been pooled to gain an understanding of the politics, the different cultures, the languages and how to work with the particular problems facing these people.

They have found that some of the standard western procedures, such as assessment, referral and supervision, were largely unknown and they have worked on presenting these procedures for possible adaptation to their setting. Vitebsky and Wolfe discuss at length the impact of the setting in which the counselling is done on the actual therapeutic work, so that the activity is not seen in a void, but rather organically moulded by its setting. Though not many, if any, practitioners reading this piece will be setting up counselling practices in Siberia, some may be attempting to set up counselling practices in diverse communities in Britain or around the world, and I feel a lot can be learned from their work in examining our assumptions and expectations when adapting to counselling in diverse cultural settings.

Having gone through the painful experience of divorce as an Asian woman, Wajiha Mohammad describes at first hand the experience, the stigma, the alienation from her community, the loss of status and poverty she experienced as a single parent. Now a counselling tutor and Ph.D. candidate, studying and working with the effects of divorce on Asian women has become her life’s work. The project was her way of resolving her feelings around her divorce, but also to explore the needs of other divorced Asian women and how counselling could be helpful to them.

Mohammad looks at the whole institution of divorce, its implications and relation to societal changes in the western world, and focuses on looking into the attitudes and influences of...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• List of illustrations
• Notes on contributors
• Chapter 1: Introduction
• Chapter 2: Creative writing as healing in black women’s groups
• Chapter 3: Working with an African perspective in counselling practice
• Chapter 4: Assumptions and expectations: Adapting to diverse cultural settings
• Chapter 5: Working with the effects of divorce on Asian women in Northampton
• Chapter 6: Racial and cultural issues in counseling training
• Chapter 7: Counselling and cultural diversity in prison
• Chapter 8: Working inter-culturally with probation and forensic clients
• Chapter 9: Inter-cultural counselling in a social services setting
• Chapter 10: The impact of multicultural issues on the supervision process