Therapy and Culture
4 Warning Signs of a Therapist Who Doesn't Understand Culture
Have you ever had someone tell you that they thought you were [insert stereotype here] because you were of a particular culture or ethnicity? Unfortunately, therapists and mental health professionals may also do the same thing. Pretty wild, right? And this is no joke. I have clients who told me their previous therapists have said these things to them. So that’s why I want to dedicate this post to discuss this. So, if you’re looking for a therapist, be on the look out for the things on this list!
For simplicity’s sake, I’ll use my cultural identity as an example for some of the following four points. But I encourage you to think about your identity, as you read this. I think it might help provide some insight into your experiences, and why you might feel that your therapist may not understand you…and heck, why most people around you might not understand you.
1. They assume you’re a cultural zombie
What I mean is that the therapist attributes everything to your culture. They assume that your culture is the reason for everything that we do, think, and feel. It may be something innocent, like saying “your feelings of shame is cultural.” Which sounds like they may have taken a crash course on Asian cultures, and is now applying that knowledge in the session with you. Or it may be something a little bit more racist, like saying “you must be good at math, because you’re Asian.” Or they might try to connect with you by saying something awkward about how much they love your ethnic cuisine, assuming that you also love it and want to talk about it.
Regardless of which it is, it makes you feel that your therapist doesn’t understand you. And this really affects the work that you do with your therapist.
2. They assume they know everything about your culture
Ok, let’s be super real here. I’m Han Chinese, who was born in Hong Kong, and immigrated to Toronto when I was six. Am I culturally competent? Do I know everything about my culture? Well, it depends on who you ask. If you ask my parents, they would say that my Cantonese sucks, and I know very little about the culture. But if you ask some of my Chinese friends, they would say my Cantonese is fluent, and I know a lot about my culture.
So what’s going on here?
The point I’m trying to make is that cultural competency is a façade. Culture is complicated and always shifting. And on the ground level, everyone understands and practices their culture differently. That’s why I am very careful to check myself, when I work with clients with very similar cultural backgrounds.
It is important for the therapist to take the time to know how you experience and practice your culture, to make sure they aren’t making any unfounded assumptions.
But this doesn’t mean that we don’t have similarities. Therapists just shouldn’t assume where those similarities are at. And this leads into the next point…
3. They assume that you experience the world in the same way as someone else from the same culture (also known as stereotyping)
So, what the heck, right? So let’s use myself as an example, and go back to my identity as a Han Chinese kid…things are already looking a little dicey here. Because within the national boundaries of China, there are many, many different cultures and ethnicities. And to make things even more complicated, ethnic groups such as Tibetans and Uyghurs have been subjected to colonization by the Chinese government. This means that their lived experience in China is vastly different from a Han Chinese who grew up in Beijing. And this is within one nation. So, as we can see, culture is a very complicated concept, and everyone’s experience of it is different.
And being from Hong Kong, I actually experience language barriers when I travel to mainland China, because the national language is Mandarin, while people from Hong Kong speaks Cantonese. And Hong Kong was colonized by the British for over 150 years. This is another added complexity to culture, as shaped by world histories via colonizers stealing from, and pillaging the rest of the world (yes, I’m throwing shade here).
So a therapist needs to have much more than a basic crash course around cultural competency. What you want from a therapist is someone who lives and breathes the understanding of culture, and is able to bridge that into your therapy sessions. Because you’re your culture, but you’re also not your culture, if that makes sense (it just means you subscribe to parts of it, and not subscribe to other parts of it).
4. They assume your problem stems from your culture
There’s a lot of “cultural deficit” going on. What I mean by that is that some therapists understand culture as mostly a negative, and as something bad. The prime example of this is the belief that mental health is stigmatized in Asian cultures.
And true story…in a mental health agency that I used to work for, a client wrote on his intake form that his parents don’t understand mental health. And a colleague immediately ask, “is he Asian?” So what’s up with the assumption?
Yes, there’s mental health stigma in Asian families and communities. But which community doesn’t? And when we look at the discipline of Western psychology and psychiatry, there’s a long history of mental health stigma – institutionalization, locking people up, tying people down, shock therapy, gender identity disorder – the list goes on and on.
Which is why I personally dislike the “cultural deficit” approach. It is part of the racist structure that we live in, which really tries to emphasize on the negatives of our culture. And the messed up thing about it? It then blames us for our own struggles, without ever acknowledging that racism and structural oppressions has huge impacts to our mental health.
This is why therapists MUST have the skill to connect larger structural forces to individual experiences of clients. By not doing so, they will not be able to help you recognize the racism that you have experienced, and the ongoing impact that it has on you.