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Culture and Reflexivity in Systemic Psychotherapy: Mutual Perspectives

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The therapeutic relationship is increasingly becoming a central topic in systemic psychotherapy and cross-cultural thinking. Here, experienced systemic psychotherapists offer their reflections and thoughts on the issues of race, culture, and ethnicity in the therapeutic relationship. The aim is to develop this area of systemic practice, to place culture squarely at the centre of all systemic psychotherapy practice as a model for all psychotherapy practice, to encourage both trainees and experienced systemic psychotherapists to pay attention to race, culture, and ethnicity as central issues in their own and their clients' identities, and to inform researchers who use qualitative research techniques such as ethnography.This book moves the issues of culture, race and equity into the centre of psychotherapeutic practice, including that which involves therapeutic encounters across culture, racial and ethnic divides. It develops an approach to cultural transference and demonstrates that thinking about culture, race and ethnicity does not belong at the margin.

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CHAPTER ONE: Culture and the reflexive subject in systemic psychotherapy

ePub

Any history or genealogy must remain incomplete, because it depends on the starting point of the author and how much context he or she includes. History and genealogy are themselves contingent, and I do not pretend to be able to offer a comprehensive account of the life of reflexivity in systemic psychotherapy. I do offer punctuations, which I hope will give food for thought. Much hinges on what we consider a system to be. Do we consider a system to be like a mechanical or a physical body, or a language structure with attributes, which wholly or partially exists outside the consciousness of the persons who engage in it? Or do we consider a system to be a series of transactions with attributes which are wholly accessible and transparent to those who consciously are engaged or choose to be engaged in it? Or a bit of both? And what are the implications for reflexivity of these two positions?1

An incomplete history of reflexivity in systemic psychotherapy

A historical account of reflexivity in relation to cultural differences in systemic psychotherapy must begin with Bateson and particularly with his two postscripts (1936 and 1958) to his ethnographic study Naven (Bateson, 1958; Krause, 2007). This starting point also allows us to draw parallels between systemic psychotherapy and anthropology. I think that we want to do so not only because Bateson was an anthropologist, but also because there are similarities in what systemic psychotherapists and ethnographers do. For me this also articulates two feelings of bewilderment. The first relates to my discovery (as an anthropologist) that Bateson’s ethnographic work among the Iatmul people, despite yielding extraordinary insights (Bateson, 1972a; Berger, 1978; Nuckolls, 1996; Strathern, 1988; Wilder-Mott & Weakland, 1981), held no interest for trainers and teachers of systemic psychotherapy during my own training twenty years ago. The second relates to the more recent disappearance of the concept or the idea of a “system” from much teaching and writing in systemic psychotherapy. This is a subversion, because one way or another, and whichever particular school of systemic psychotherapy one follows, the notion of “system” is still a central assumption, theory, or concept in the discipline. It is what distinguishes us from other psychotherapies.

 

CHAPTER TWO: Can we tolerate the relationships that race compels?

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David Campbell

“The fact remains that getting people right is not what living is all about anyway. It’s getting them wrong that is living, getting them wrong and wrong and wrong and then, after careful consideration, getting them wrong again. That’s how we know we’re alive: we’re wrong. Maybe the best thing would be to forget being right or wrong about people and just go along for the ride. But if you can do that—well, lucky you”

(Roth, 1997, p. 35)

A personal statement

In the summer of 1962, I had just graduated from high school in Kansas City, and was preparing to go to university at a small men’s liberal arts college in Ohio. One hot day in July, I received a letter from the college informing me that “amongst the 280 men in the incoming class were two Negroes …” (I will never forget the way this word, with its capital “N” stood out on the page.) The letter continued to ask if I would have any objections if one of these men were assigned to share a room with me. Partly I was shocked by this and partly I was very curious, so I wrote back saying, “on the contrary I would be very interested to share a room with one of these men” … and so it happened.

 

CHAPTER THREE: What would (or can) I know? Reflections on the conditions of knowing and understanding in intercultural therapy

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Carmel Flaskas

I wrote the abstract for this chapter in the week in which the Prime Minister of the newly elected Labour government of Australia made an apology to indigenous peoples for the wrongs of the past. “Sorry day”, with all the talking and the memories and the associations that surrounded it, with all the acknowledgments and the witnessing, had a poignant mix of sorrow, pain, hope, and undeserved tenuous trust. Not for the first time, as a non-indigenous and white Australian, I experienced the generosity in the involvement of Aboriginal and Islander peoples, and felt unworthy and grateful in the face of it. It was a moment of connection and a move toward reconciliation. It was also a time for comprehending the chasm of difference between indigenous and non-indigenous Australia, and the chasm of difference between the tears of indigenous and non-indigenous Australians with respect to our shared past and our shared present.

I feel a kind of fraud writing in this book, for I belong to that group of therapists who are socially and contextually the most illiterate in their personal capacities for intercultural work. I felt nothing but unselfconsciously “at home” culturally and racially in my childhood, growing up in a local milieu of a largely homogeneous culture in the 1960s. With three of my four grandparents coming from different cultures (Irish, Greek, Danish), this would have to stand as a kind of achievement (for better and worse) of assimilation within an immigrant nation, and an achievement of my grandparents and parents. I am still bemused when people ask if I have “gone back” to my heri-tage—which one, I wonder, and why? I am unaware of any cultural yearnings, and just think of myself as coming from Brisbane. But, although I admit I would be hard-pushed to yearn for Brisbane, I would yearn for Australia if I could not live here, for it is my homeland. And while unconsciously I might have inherited intergenera-tional orientations to surviving the experience of alienation and cultural bereftness, I have had to learn as an adult, consciously and bit by bit, some literacy in the intimate experience of foreignness and otherness, and some fluency in relating to, through, and across culture and race.

 

CHAPTER FOUR: Objectification, recognition, and the intersubjective continuum

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David Pocock

I will begin with a poor question: what is culture? The idea that culture can be something (some “thing”) without a reflexive concern for definition led, during the period of my family therapy training in the late 1980s, to “culture” becoming a corrective to ethnocentric assumptions of universality implicit in the theories of family structure and process that had proliferated in the preceding two decades. The predominant message to trainees was that cultural differences were to be respected, honouring culture being a good thing. Simultaneously, late 1980s UK family therapy was preoccupied with gender. However, here the message was strikingly different. Skewed gender roles were not to be respected but challenged, patriarchy being a bad thing. It is a testament to the feasibility of Foucault’s (1975) notion of the disciplinary power of discourse that I do not recall the obvious question being framed by any of us trainees: given that most cultures could be judged to be patriarchal, and notions of equality imply a mostly Euro-American ethnocentricity, which message should predominate—do we honour and respect patriarchy or challenge it? Since the denigration of otherness (to consolidate a comfortingly superior togetherness) is also a feature of most dominant cultures, the same dilemma becomes even more acute for racism; surely we should not honour that? With the linguistic turn in family therapy of the 1990s, one way of managing the discomfort of moral relativism that these issues raise was to allow in marginalized discourses—to give the other a voice. But, as Burr (1999) argues, this mostly sidesteps the issue; would we wish to further legitimize the voices of paedophiles and holocaust deniers, are these not also cultural groups?

 

CHAPTER FIVE: With an exile’s eye: developing positions of cultural reflexivity (with a bit of help from feminism)

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Gwyn Daniel

“What seems to you

so nimble and fine,

like a fawn,

and flees

every which way,

like a partridge,

isn’t happiness.

Trust me:

my happiness bears

no relation to happiness”

(Taha Muhammad Ali, 2006)

Cross-cultural work most starkly reminds therapists not to be too ready to attribute meaning to the utterances of others, a tendency which probably constitutes one of our profession’s “occupational hazards”. The tightrope we walk between connecting with the meaning systems of others and staying aware of the all the nuances that constitute difference is a never ending one. It involves making the imaginative leap into others’ worlds to search for meaning and coherence, especially in what may seem strange and inaccessible (Krause, 2002b), as well as acknowledging that difference is inevitable, and requires respecting “the other as other with whom one has connections but whose inner space cannot be colonized” (Frosh, 2009, p. 189). The ability to communicate across difference involves risk taking and extending ourselves beyond our own cultural comfort zone; in fact, these very processes bring forth information about what are “taken-for-granted” comfort zones. Thus, we are required to be aware both of our current prejudices (Cecchin, Lane, & Ray, 1994) and to recognize constraints in our thinking that might be indicative of prejudices we have yet to recognize or articulate. This can be defined as being self-reflexive, but self-reflexivity in a context of cultural diversity does not seem to be an adequate concept. I prefer to think about cultural reflex-ivity.

 

CHAPTER SIX:Cultural and family ethos in systemic therapy

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Paolo Bertrando

“The aspects of things that are most important for us are hidden because of their simplicity and familiarity. (One is unable to notice something—because it is always before one’s eyes.) The real foundations of his enquiry do not strike a man at all. Unless that fact has at some time struck him.—And this means: we fail to be struck by what, once seen, is most striking and most powerful”

(Wittgenstein, 1953, p. 29)

In this chapter, I will outline the evolution of my own practice in the light of my experience with other cultures, both in supervision of cases around the world, and in my everyday work— however limited—with minority or ethnic groups. Such experiences have made me slightly suspicious of my own attitude toward “simple” or “taken-for-granted” cases—cases where I think I know everything about clients because I have the (erroneous) feeling they are “just like me”. In order to deal with this phenomenon, we have to reflect on the nature of families, on the one hand, and of culture, on the other.

 

CHAPTER SEVEN: Developments in Social GRRRAAACCEEESSS: visible–invisible and voiced–unvoiced

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John Burnham2

The importance of being aware of, sensitive to, and competent in working with issues of social difference has a rich history in the systemic and narrative approaches to therapy and training and is specified in the AFT learning outcomes in the training for therapists and supervisors. (AFT website). The “Social GGRRAAACCEEESSS” is a mnemonic developed jointly with Alison Roper-Hall (Burnham, 1992, 1993; Roper-Hall, 1998) and has, in its various forms, been making a practical contribution to this movement, in the systemic field, since 1990. This chapter describes its history, presentations, applications, and exercises. It introduces the distinction between Personal and Social GGRRAAACCEEESSS, and explores the differences within SG, along the dimensions of visible–invisible and voiced–unvoiced.

History

In 1990, I was, as a therapist, supervisor/trainer, and director of systemic training programmes, struggling along with many others to manage the complexity that was involved in engaging and working with those aspects of experience and practice that were, at that time, referred to as the “isms” (e.g., racism, sexism, ageism). As a personal prompt, I created a mnemonic called DISGRRACCE to remind me of these important aspects of difference. It stood for Disability, I, Sexuality, Gender, Race, Religion, Age, Class, Culture, and Ethnicity. I used it as a personal reminder, a teaching tool, and I included it in student handbooks as a guideline for writing case summaries. In a teaching session, I might put the mnemonic across the top of the board as a visual context/guideword for myself and the participants. I used to say, “It’s a DISGRRACCE if we do not include these issues in our therapy/training, etc.” The “I” was inserted to make up the mnemonic, but when I asked audiences to guess what the I stood for, many people said “identity”, and proposed that identity was created from and within these different aspects of lived experience. This idea of identity was “lost” when the mnemonic was later altered. It might be said that these aspects of difference are constitutive of a person’s identities and, recursively, the communities in which they live and where and with whom they story their experiences.

 

CHAPTER EIGHT: The personal and the professional: core beliefs and the construction of bridges across difference

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Barry Mason

Introduction

This is a chapter that has evolved out of practice, theory, and personal experience. It arises from a long-standing focus on the relationship between the development of my own personal core beliefs and the influence of those beliefs on my clinical work as a family and systemic psychotherapist working with individuals, couples, and families from different cultures and religions. A central question for me has become not only how I can help clients find a systemic both–and position, and how the therapeutic relationship can encompass a both–and position, but also, to what extent I can find such a position in relation to my personal beliefs and my professional task. Some of the content herein comes from a certain disillusionment with some of the more recent developments in family therapy, and could be said to be a continuation of the work that contributed to the publication of the book, Exploring the Unsaid (Mason & Sawyerr, 2002), which sought to encourage practitioners to take more risks in working cross-culturally. This was based on the view that interpretations of the developments in theory and practice were hindering, as well as aiding, us in creating effective clinical work. As Alice Sawyerr and I wrote in our introduction to that book, “to develop intimacy, to develop closeness of whatever kind, one has to be prepared to take chances and risk vulnerability” (p. xix). This chapter is written with that in mind.

 

CHAPTER NINE: Hewing out hope from mountains of despair

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Archie Smith

“With this faith, we will be able to hew out of the mountain of despair a stone of hope”

(from Martin Luther King Jr’s speech
“I have a dream …”, Washington, 1986, p. 219)

Introduction

In 1963, on the steps of the Lincoln Memorial in Washington, DC, Martin Luther King Jr, a Baptist minister and civil rights activist, shared his dream with a racially diverse cross-section of USA society. Would his speech resonate with almost everyone present? Tension and hope were in the air. National Guard troops were poised to quell a riot. It did not happen. Near the end of his “I have a dream” speech, Martin Luther King Jr said, “With this faith we will be able to hew out of the mountain of despair a stone of hope.” With these words, he conjured hope for a whole nation. He pointed a way for everyone facing a seemingly intractable economic, social, and political problem (Washington, 1986).

In this chapter, I use “mountains of despair” as a metaphor for major depressive episodes. I am an African-American male, a pastoral theologian who teaches at the Graduate Theological Union in Berkeley, California, and a family therapist. A part of my task is to widen the lens for an assessment of human difficulties in the light of faith traditions and to identify grounds for hope. Sometimes, this assessment of human difficulties means crossing over into unfamiliar territory where one is a stranger and cultural outsider. I am an insider to African-American male culture, although I can only represent a small part of it, and, therefore, I might experience unfamiliar parts of my own culture as “strange”. I am an outsider to the Korean Confucian–Christian culture I am about to discuss.

 

CHAPTER TEN: Engaging within and across culture

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Rabia Malik and Philippe Mandin

Our plan for this chapter is to describe and reflect upon clinical work with Pakistani families in the context of court mandated parenting assessments in childcare proceedings. Although court work represents only a small proportion of the family work that we have done together over the past ten years, we have chosen it as the focus in this chapter as it seems to bring to the fore some of the complex processes of working across culture and of joint working, which are more difficult to identify in purely therapeutic interventions. For example, the limitations of the “not knowing approach” often used in family therapy to access cultural themes become more visible when the process is adversarial, stakes are high, and clear recommendations are expected. The clinical example will illustrate how the court context pushes towards essentializing diversity and drawing rigid lines, which are often present in cross-cultural therapy, but which can remain unacknowledged. All cultural systems operate with assumptions and constraints that organize people’s behaviour, beliefs, and emotions. Working across culture means remaining open and respectful to difference, while remembering that culture is an interactive process, not a static fixed system. As the case example will also demonstrate, cultural concepts are deeply meaningful, but also fluid, illusionary (Krause, 1998) and difficult to access. We will describe and reflect on our attempts to engage with such polarized systems in order to create a thinking space to allow alternative explanations to emerge.

 

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