Psychotherapy and Training Collective of New York

Cross Cultural Competence Revisited

by Susan Pinco, PhD, LCSW-R, CCR

When looking for a therapist most of us hope to find someone who "speaks" our language; who understands our frame of reference and who feels a bit like the good family we had hoped we had.

The profession has recognized the importance of this by requiring that therapists, at least those who are licensed as Clinical Social Workers, have a minimum number of Continuing Education Credits (CEUs) focused on the topic of cross cultural competence, each year. Imagine my surprise, as a seasoned clinician of more than twenty years who has attended numerous training sessions and who has literally traveled around the world in an effort to better understand people, at finding myself sitting in NYC, listening to a program on of all topics, cybersex, and realizing how little I really knew about other cultures.

As I listened, enrapt, to a presentation by Weston Edwards from the Pride Institute, I came to see, once again, how culture creates the lens through which we see all things. While generally aware of the pervasiveness of culture's impact related to concepts of beauty, justice, even ethics, it has rarely been so clear to me how it quite simply impacts all that we think, see, feel. Sadly, we are generally quite blind to the nature of our "lens". Even if we are infinity curious and nonjudgmental we miss out on so much simply because we don't consider the possibility that there could be another way of interpreting what we are seeing.

For example; a Japanese woman may accept a "marriage proposal by lowering her head and being silent; an Ibo woman (in Nigeria) declines by being silent, unless she runs away, which means acceptance" (Schmitz 1994 quoting Saville-Troike 1985) And, if this proposal occurred in NYC we would assume that neither bride was in the least bit interested and perhaps be outraged when someone questioned our assumption.

Looking to the world of cyber space, "ParTy" is not a simple invitation to a gathering, it is an announcement that crystal meth or "Tina" will be offered. And, 4:20 doesn't refer to the time but rather to the availability of marijuana. My hair curled to think of how little I understand of all the abbreviations and acronyms the twitters, Craigslist browsers, and Face book aficionados utilize to circumscribe their world. Not only do I have to brush up on my French and Spanish but I have to actively assimilate this new language that is the purview of the linked in generation, as well as introduce myself more fully to the language of the numerous other communities who honor me with their trust. Only by doing this will I be able to help my clients identify the disparate cultures that make up the melting pots of their being so as to help them make peace between competing and conflicting values and norms.

To make this a bit less poetic, we here in the US spring from and live in multiple cultures (there are over 147 different languages spoken in NYC alone). We're not from a single tribe where there has been no intermarriage and where there has been little influence from other cultures. This multicultural experience extends to most other areas of the world where, while there may be multiple distinct social groups the lines between them are blurring significantly. This means that we, as individuals and as a global community, are often faced with competing demands, values and beliefs which we must reconcile as internal discord leads to confusion, irritability, anxiety and depression or suppression.

Taken more simply; imagine that you are a man who grew up in a family where problems were settled using violence, where to be a man meant that you had to shut off your emotions, have a stiff upper lip and just "do it". Imagine that you had fallen in love with a woman who valued intimacy and feelings. How would you navigate these cultural divides?

Or.. imagine that you are "queer". That at the tender age of 5 you realized that you were different but couldn't quite figure out how. That you grew up in the south and were Christian or Muslim. How do you find a cultural setting that nourishes and supports you so that you can begin to reconcile the competing values of the different cultures from which you have sprung.

Or.. you are a Orthodox girl from a family that values education, independence and success in business. Imagine that you find yourself pregnant and two years from completing your PhD. How do you move through the minefield of options to reach a decision?

In each of these scenarios, culture plays a pivotal role in both defining the "problems/conflicts" and in leading us to a solution. It is the language that we speak, it is the very fabric of our being. Sometimes the numerous threads that are woven into us are in harmony; creating a sense of connectedness and coherence and at other times, they clash, leading to disharmony, discomfort, and distress. It is only by looking closely, in a nonjudgmental and compassionate way, that we can begin to relax into a state where the inherent anomalies of our cultures can be reconciled.

Susan Pinco, PhD, LCSW-R, CCR