The impact of 'cultural difference' in the therapeutic space : a self psychology perspective on the finding of understanding

Master Thesis


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University of Cape Town

This study explored the influence of cultural difference in psychotherapy. This is an issue of particular relevance in South Africa where cross-cultural work is commonly practised. Yet there appears to be a silence surrounding the experiences of therapists who are working cross-culturally. The aim of the study was to explore, from the perspective of the therapist, how a psychoanalytic self psychology approach, allows us to engage and work with difference in the therapeutic space. The method used was a case study analysis of a psychotherapeutic relationship between the researcher, a white therapist-in-training, and a black client. The analysis drew on process notes written after the therapy sessions, and focused on the first year of the therapeutic relationship. The material was analysed using a hermeneutic-psychoanalytic theoretical framework.. Two aspects of the psychoanalytic self psychology approach were identified as potentially useful ways of working with difference: 1) the significance of the role of empathy in therapy and 2) the intersubjective stance which is inherent in self psychology. The case study analysis suggested that by paying attention to empathic processes, it becomes possible for us to track the way in which real and perceived differences between therapist and client can lead to empathic ruptures. The adoption of an intersubjective stance highlights how the therapist-client interaction constitutes the meeting of two subjective worlds which are socio-historically defined, multi-dimensional and fluid. The study suggests that in South Africa, where acknowledging racial difference runs the risk of creating divisions between people, there may be a tendency in therapy, to reframe racial difference as some other kind of difference which is less threatening such as language and/or gender difference. One of the fears behind naming and working with difference which was identified, was the fear of being part of a process that uses racial difference to oppress people. A second fear was that by naming difference, divisions would be created between therapist and client which could threaten a potential connection and jeopardise the therapeutic relationship. The study suggests that only after those unconscious threats and fears have been made conscious, does it become possible to authentically connect cross-culturally and thereafter, to begin to locate the similarities in our experiences.

Bibliography: leaves 73-77.