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Counseling across the “sham of culture”

Last night I finally finished reading the brilliant novel, The Siege of Krishnapur by JG Farrell. It’s one of those can’t-put-it-down-and-go-to-sleep-like-a-sensible-person books. So, as the minutes past midnight ticked by, I reached the conclusion of the book, and as it happened, the end of the rule of the East India Company. In the denouement, the hero is heard to say, “Culture is a sham. It’s a cosmetic painted on life by rich people to conceal its ugliness”.

Well, hell. I had believed that I was going to shortly be released by Farrell’s novel so I could finally join Will in blissful slumber. That line kept me up until my eyelids finally flatly refused to stay open. I woke up this morning still wrestling with the idea of culture as a cosmetic for the wealthy. Certainly money allows the more privileged people in the world to buy their way into far more comfort than others can afford, but what about the rebuttal given in the novel by the callow young romantic poet, “Ideas, too, are a part of culture. No one can say ideas are a sham. Our progress depends on them”. Given that he meant “progress” in the best British colonial sense, it’s a highly charged term (Farrell has his British overlords starving and rotting in the marble-columned banqueting hall their predecessors in the Company built in happier days to underline the whole “progress” conceit.)

As I mentioned yesterday, I’m getting ready to go back to India next week. I’m taking grad students, and we’re co-hosting a conference on art and play therapies for trauma at a college in Mumbai. There are a *lot* of ideas going on there, and many of them are about “progress”.

All of which leads back to the starting point of the circle: how much of what we call “culture” is cosmetic? How much of what we generally call “multicultural” or “cross-cultural” counseling is then also cosmetic?

Because I am truly a pedant some days, I’m going to begin my response (certainly not an answer) with a definition. Mr. Merriam and Mr. Webster say, “the beliefs, customs, arts, etc., of a particular society, group, place, or time: a particular society that has its own beliefs, ways of life, art, etc.: a way of thinking, behaving, or working that exists in a place or organization (such as a business).”

In therapy, the key bit of the definition is the middle, the “way of life” bit.That’s where we tend to get hung up- how differently people from various cultures view constructs such as the “right” way to conduct male/female relationships, the “right” way to behave in public, to work, to/if worship, etc. We’ve seen a far too vivid example of clashing ideas of what’s “right” in terms of the behavior and role of the police in Ferguson recently.

So, right, back to the therapy room with us.

How much, if any, of the typical “cultural” considerations we tend to consider when working with people are cosmetics designed to paint over (white wash?) the ugliness of life? When counseling students write up case reports, we always expect them to talk about the client’s gender, race, ethnicity, sexual orientation, marital status, and social class. This is intended to help the reader better understand the issues presented and the relevance of the treatment plan.

I do think including cultural/demographic data is important to designing effective treatment: the inner world view of the client is central to the likelihood that treatment will be helpful. Knowing your client is generally considered to be key to helping him/her.

But what if  it’s not?

If Farrell’s hero is on the right track, maybe culture matters less than we’ve been taught? I think working with play and art as healing media certainly flattens out a lot of the usual demographics, especially with young children. What I mean is, children can decide that a car is a car, or it’s a bed, or it’s a spaceship. Since I don’t use any of the classic psychoanalytic or psychodynamic theories where the therapist interprets the symbols in the play or art for the client, which is very judgement-laden and very seriously culturally created, it is what the client says it is.

Even so, when working with clients or students from cultures very different from my own, such as the students I’ll be teaching in India later this month, how much of what I’m saying is “progress” is a cosmetic to make the ugliness look better?

I’m going to talk a good deal about brains while I’m there. Brains are pretty much the same in all humans, anatomically. We’ve learned a tremendous amount about how our brains work; how they’re hurt by traumas and how they can heal, in the last few years. It’s wonderful to know more about all of that. We should be able to extrapolate some of this into new formulas for medication that are more effective and targeted. We should be able to devise more effective therapies. We certainly have a huge quantity of new evidence that play does, in fact, heal.

But how relevant is that in a country with nearly zero mental health care?

I don’t want to be the Avon Lady of mental health in the developing world. I think in order to avoid that sad outcome, I’m going to have to be on my toes to be sure I can tell if I’m carrying a suitcase full of make-up around with me. And I’d better be careful not to open it up and start make-overs on a bunch of unsuspecting Indian folks. I think they’ve seen that act before.

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