Monday, February 22, 2010

Western Bias in Psychology and Psychotherapy

There is a very distinct bias in Western psychology and psychotherapy in terms of language, class, and values. The whole developmental foundation of psychology is based on a Western European / American concept of the self.

If I learn nothing else from this class in multicultural theory, it's that as therapists we need to stop assuming that the people we see are just like us - as we start our careers in social service agencies and other forms on experiential internships, most of our clients won't be anything like us, especially in class and values.
In the United States and in many other countries as well, psychotherapy and counseling are used mainly with middle- and upper-class segments of the population. As a result, culturally diverse clients do not share many of the values and characteristics seen in both the goals and the processes of therapy. Schofield (1964) has noted that therapists tend to prefer clients who exhibit the YAVIS syndrome: young, attractive, verbal, intelligent, and successful. This preference tends to discriminate against people from different minority groups or those from lower socioeconomic classes. This led Sundberg (1981) to sarcastically point out that therapy is not for QUOID people (quiet, ugly, old, indigent, and dissimilar culturally). Three major characteristics of counseling and psychotherapy may act as impediments to effective counseling.

1. Culture-bound values: individual centered, verbal/emotional/behavioral expressiveness, communication patterns from client to counselor, openness and intimacy, analytic/linear/verbal (cause-effect) approach, and clear distinctions between mental and physical well-being.

2. Class-bound values: strict adherence to time schedules (50-minute, once or twice a week meetings), ambiguous or unstructured approach to problems, and seeking long-range goals or solutions.

3. Language variables: use of Standard English and emphasis on verbal communication.

While an attempt has been made to clearly delineate three major variables that influence effective therapy, these variables are often inseparable from one another. For example, use of Standard English in counseling and therapy definitely places those individuals who do not speak English fluently at a disadvantage. However, cultural and class values that govern conventions of conversation can also operate via language to cause serious misunderstandings. Furthermore, the fact that many African Americans, Latino/Hispanic Americans, and American Indians come from predominantly lower class backgrounds often compounds class and culture variables. Thus, it is often difficult to tell which variables are the sole impediments in therapy. Nevertheless, this distinction is valuable in conceptualizing barriers to effective multicultural counseling/therapy. (p. 137-140)
These are some important issues - and many of them will come into play for me in Tucson, which is more culturally diverse than it looks on the surface.

But there is a bigger issue at work here, too, one that I won't see as much but one that I think has biased ALL of Western psychology - the focus on the individual. All of the major developmental models are based on Western European and American ideas of development, emphasizing the individual and his/her autonomy. The rest of the world doesn't necessarily see things that way - even here in Tucson, the Pascua Yaqui are more collectivist than individualist, which is probably true to some extent in Hispanic culture as well.
Focus on the Individual

Most forms of counseling and psychotherapy tend to be individual centered (i.e., they emphasize the “I-thou” relationship). Pedersen (2000) notes that U.S. culture and society are based on the concept of individualism and that competition between individuals for status, recognition, achievement, and so forth, forms the basis for Western tradition. Individualism, autonomy, and the ability to become your own person are perceived as healthy and desirable goals. If we look at most Euro-American theories of human development (Piaget, Erickson, etc.), we are struck by how they emphasize individuation as normal and healthy development (Ivey, D’Andrea, Ivey, & Simek-Morgan, 2002). Pedersen notes that not all cultures view individualism as a positive orientation; rather, it may be perceived in some cultures as a handicap to attaining enlightenment, one that may divert us from important spiritual goals. In many non-Western cultures, identity is not seen apart from the group orientation (collectivism). The Japanese language does not seem to have a distinct personal pronoun I. The notion of atman in India defines itself as participating in unity with all things and not being limited by the temporal world.

Many societies do not define the psychosocial unit of operation as the individual. In many cultures and subgroups, the psychosocial unit of operation tends to be the family, group, or collective society. In traditional Asian American culture, one’s identity is defined within the family constellation. The greatest punitive measure to be taken out on an individual by the family is to be disowned. What this means, in essence, is that the person no longer has an identity. While being disowned by a family in Western European culture is equally negative and punitive, it does not have the same connotations as in traditional Asian society. Although they may be disowned by a family, Westerners are always told that they have an individual identity as well. Likewise, many Hispanic individuals tend to see the unit of operation as residing within the family. African American psychologists (Parham et al., 1999) also point out how the African view of the world encompasses the concept of “groupness.”

Our contention is that racial/ethnic minorities often use a different psychosocial unit of operation, in that collectivism is valued over individualism. This worldview is reflected in all aspects of behavior. For example, many traditional Asian American and Hispanic elders tend to greet one another with the question, “How is your family today?” Contrast this with how most Americans tend to greet each other: “How are you today?” One emphasizes the family (group) perspective, while the other emphasizes the individual perspective.

Affective expressions in therapy can also be strongly influenced by the particular orientation one takes. When individuals engage in wrongful behaviors in the United States, they are most likely to experience feelings of guilt. In societies that emphasize collectivism, however, the most dominant affective element to follow a wrongful behavior is shame, not guilt. Guilt is an individual affect, while shame appears to be a group one (it reflects on the family or group).

Counselors and therapists who fail to recognize the importance of defining this difference between individualism and collectivism will create difficulties in therapy. Often we are impressed by the number of our colleagues who describe traditional Asian clients as being “dependent,” “unable to make decisions on their own,” and “lacking in maturity.” Many of these judgments are based on the fact that many Asian clients do not see a decision-making process as an individual one. When an Asian client states to a counselor or therapist, “I can’t make that decision on my own; I need to consult with my parents or family,” he or she is seen as being quite immature. After all, therapy is aimed at helping individuals make decisions on their own in a “mature” and “responsible” manner. (p.141-142)
We need a whole other developmental psychology that accounts for this fundamental difference in how people are encultured and how that impacts and defines development. It's interesting to me that Integral Psychology has not even touched on this as far as I can tell.

All quotes taken from:
Counseling the Culturally Diverse: Theory and Practice. (2008). Sue, D. W. & Sue, D. 5th Edition. Wiley: NY.


BBS said...

Thank you. It is refreshing to read that others are taking this into consideration.

Diane D'Angelo said...

Excellent piece. That psychotherapy replaced community for an entire generation plays into this as well.