Cultural competence as a core emphasis of psychoanalytic psychotherapy.

Abstract

Psychoanalytic theory has been criticized for decontextualizing individual development. While recognizing the historical neglect of sociocultural context in psychoanalytic theory, this article raises attention to psychoanalytic contributions to the exploration of sociocultural issues in psychotherapy and calls for a systematic inclusion of cultural competence as a core area of emphasis of psychoanalytic psychotherapy. The article includes a brief review of cultural competence in professional psychology, and both a critique of psychoanalysis regarding the neglect of sociocultural context in psychotherapy and a discussion of psychoanalytic contributions to a complex understanding of sociocultural issues in psychotherapy. Specific approaches to cultural competence that extend existing psychoanalytic theory concerning sociocultural context are presented. These include the recognition of historical trauma and neglect of sociocultural issues, indigenous cultural narratives, role of context in the use of language and expression of affect, influence of experiences of social oppression and stereotypes on therapeutic process and outcome, and the dynamic nature of cultural identifications.

Power Dynamics in the Clinical Situation: A Confluence of Perspectives

“…Relational theorists thus continue to appreciate unconscious aspects of the patient-therapist relationship, but they have emphasized more mutual, interactive processes. According to Slochower, therapists in the interpersonal tradition were the first to move the paradigm of transference beyond the notion of the regressive patient: "They formulated a model in which the patient is an adult and the analyst a participant observer (Sullivan, 1954(Sullivan, )" (2017. To sum up: The relational perspective appreciates transference phenomena but construes power as issuing from unconscious shared dynamics and the emotional interdependency of patient and therapist.…”

The impact of emergency aid work on personal relationships: a psychodynamic study

“…Although neither of the above-mentioned studies drew on psychodynamic theory, they signalled a curiosity about the unconscious forces that may be at work in aid workers' lives. This has been accompanied in more recent research by more nuanced examinations of deeper emotional reactions to exposure to conflict, including self-doubt, shame and isolation (McCormack and Joseph 2013), along with more focussed attention on the role of interpersonal networks in supporting the resilience of humanitarian workers (Thomas 2016). It is also only in recent years that studies have begun to consider not just the impact of the work on field staff, but pre-existing factors and traits, such as childhood trauma (Eriksson et al 2013), a need for self-reliance and a reluctance to seek help from others (Skeoch et al 2017).…”

“…On the one hand, they are privileged cosmopolitan professionals whose "transnational lives" (Fechter 2007) afford them a "world right to circulate unhindered" (Croucher 2012). In stark contrast to "disadvantaged travellers" (Redfield 2012b) such as migrants, refugees and asylum seekers, the people who undertake to provide assistance to these populations stand to accrue a range of personal and financial benefits from their work, including frequent travel, an interesting lifestyle, the opportunity to save money (Fechter 2012a) or the cultivation of personal meaning (Thomas 2016). They are, of course, also potentially sustained by altruistic motives, even if those are inevitably mixed with self-interest (Tassell and Flett 2011;Vaux 2001).…”

“…If the adrenalin provides energy to give people a boost, Van der Kolk (1989) has demonstrated that repeated exposure to inescapable stress releases endogenous opioids in the human body that provide soothing relief from anxiety. Naparstek (as cited by Thomas 2016Thomas , 2005 has also argued that individuals can become addicted to their own biochemical responses to trauma, setting up a self-perpetuating cycle of behavioural re-enactment. Taken together then, it can be concluded that emergency contexts have the capacity to help people manage and regulate their moods, either upwards or downwards, in ways that can, like any other chemical addiction, become compulsive.…”

Mentoring Students in Clinical Training: Exploring the Culture-Centred Model and Critical Consciousness Development

“…This means that in order to become culturally competent individuals should hone it and live it. Tummala-Narra [5] defined cultural competence as a process or an orientation that is not committed to any specific technique but rather "…involves a way of construing the therapeutic process" (pp.2-3). Psychologists should by education, training, experience, respectful curiosity, consultation, supervision, interaction with other cultures, and research, attempt to become aware of their own biases and knowledgeable of other cultures [6][7][8].…”