When I first moved to Singapore, I was excited to meet and work with people from all over the world. I have visited Singapore before on vacation and I immediately liked the diverse culture of the local population. In addition, there is a huge expat community bringing in even more diversity. In 2020 more than a quarter of the population in Singapore were expats (Population in Brief 2020 report). Thus, it is unavoidable to meet someone from a different cultural background than your own. In my work some clients request for me to be their therapist because we have a similar cultural background. Some do the exact opposite: they request for me because I have a different cultural background. What both of these groups of clients have in common is that they have a particular image in mind what it means to have a specific cultural background. They assume that my cultural background influences me in my role as a therapist. They are right. But how are culture and the individual related? And how does it matter in psychotherapy?
What is culture?
It is hard to find a complete definition of what culture is. There are a lot of things that culture consists of like shared experiences, history, values, places, language, interests, traditions or behavioural patterns. Let’s not forget the ethnic and religious heritage part of it. Culture defines what rules people live by, along with how they understand the world and what they perceive as conventional or “normal”. It provides a framework, thus people from the same cultural background have a shared idea of e. g. what is considered taboo, how verbal and nonverbal communication works or how respect is expressed. These rules have an impact on how we perceive our self and our role within society.
Culture shapes our perception of the world
From a psychological perspective individual development takes place in a cultural context. Hence culture shapes our memories, how we think and feel and how we express ourselves. For example, people from North America complete a sentence beginning with “I am…” rather with naming their profession or a personality trait, whereas people from Africa rather state their role in relation to others like which tribe or family they belong to. There are also differences in our facial expressions. Anger or grief can be expressed differently in different parts of the world. So, even how feelings are experienced and interpreted can differ between cultures.
The influence of culture or society on the individual is mediated mainly during childhood. Parental ideas about how a child should be brought up, what is considered an ideal development and how a child should be like is broadly influenced by culture. Also, research shows that while Japanese teenagers interpret parental demands for obedience as a sign of devotion and warmth, German teenagers perceive it as the parents rejecting their behaviour. This example shows us how important it is to keep in mind that our individual experience is strongly connected to the society and culture we grew up in. Consequently, it can lead to confusion in immigrant children who are confronted with the culture of their parents and the one of the society they live in. Or partners from different cultural backgrounds can easily get into conflict by simply misinterpreting the meaning of what the other person does or says. At the same time, we need to keep in mind that depending on experience there can still be differences within the same culture or society. Therefore, the individual experience can still be unique and differ from what is expected in relation to the cultural background.
The impact of culture on therapy
In order for psychotherapy in a cross-cultural setting to work successfully it is important for the therapist to acknowledge the similarities and differences between their own and the foreign culture. Part of the job as a therapist is to engage in the individual needs and perceptions of the world of each client respectively. Regardless of the cultural background therapists will always notice some differences to their own needs and perceptions to some extent. In cross-cultural contexts it is important to keep in mind how the cultural background of a client affects the therapy process. Depending on our culture there can be different ideas about how illnesses are developed or if and how you are supposed to deal with it. There may also be different rules as to how symptoms are displayed or talked about or what is generally perceived as suffering or distress. The therapist does not necessarily need to know everything about the client’s cultural background. More importantly, the therapist needs to stay mindful of the differences in their culture. If the therapist stays curious and asks the client openly about their culture the differences will be no obstacle for a successful therapy journey.
In my experience working with clients and colleagues from different cultures is possible and enriching. Since therapy is a personal process that includes communication and exploration of the client’s unique experience it gives us a space to understand and learn more about ourselves and the world. As a therapist I am grateful for all clients who put their trust in my work and through whom I can also learn more about their culture and world. In this spirit I want to end this article on a quote from the screenwriter and director Robert Alan Aurthur: