Toye, J., 2003. Cultural Diversity and CAT. Reformulation, Autumn, pp.25-29.
The social and political dimension of people’s experience has always been an important aspect of CAT theory and practice. It has been given even greater emphasis in the latest textbook on CAT, in which Ryle and Kerr (2002) describe CAT as having a commitment shared with others in society to ‘offer conditions in which humans can flourish’. They also state that ‘any model of psychotherapy should be able to generate some meaningful acccount of cultural and ethnic diversity as manifest in the range of individuals and their problems’. In this context they believe that CAT may have something to offer. They consider as an example of diversity the way an individual from a traditional, closed culture might experience relationships as compared with someone from a Western individualistic culture. They refer to the meaning attached to gender as another example of ‘how culture is manifest in terms of self-identity’. One can see that many aspects of personal identity are influenced by society beyond the immediate family circle. Ethnic identity, sexual orientation, class and economic status, and disability, are other categories that come to mind. Members of groups identifiable in such ways can be said to share a culture.
In a recent review of how ideas about the nature of self are influenced by history and culture Rachel Pollard (2001) observes that theories about the self tend to be associated with competing ideologies about the nature of society. She concludes that ‘the search is still on for forms of subjectivity that are non-prescriptive, inclusive of difference’.
Post September 11 we cannot be unaware of the deep political, economic and religious differences that divide our world, nor of the fact that our society is fully caught up in them. Analysis of social messages in reciprocal role terms is, in my experience, helpful for understanding the tensions in therapy when a client with a specific religious commitment sees it, and the therapist, as representing a system of values different from their own (Toye, 2002). Ros King (2002) illumines how recognition and acceptance of difference in intellectual and physical ability between a (competent) therapist and a learning disabled client can help defuse feelings potentially destructive to the relationship between them. However, the range of situations in which social and cultural differences could be destructive seems limitless, and their social and cultural origins correspondingly complex. It also seems unlikely that any approach on cultural and social issues developed within CAT can satisfy the wider world that it is adequately ‘inclusive of difference’. Nonetheless it seems worthwhile to explore relevant social and psychological theories outside CAT about these problems. In addition I ask whether such theory gives support to the interpretation of social, cultural and political differences in reciprocal role terms.
On the basis of the literature reported on below there are three universal aspects of social and cultural differences, particularly relevant for the therapist-client relationship:
In practice these aspects are likely to be interrelated. How such differences affect the therapeutic relationship will of course vary by case. The therapist's role as 'expert' is likely to have a bearing most of the time. In addition, if the therapist is white and middle-class and the client comes from a different background, in many cases there will be a risk that the social reciprocal role of superior to inferior will come into play. Unless this is challenged, it will undermine the therapeutic task by biasing difficulties arising from differences under (1) in favour of the therapist’s understanding, and in (2) that the therapist’s beliefs and values are 'normal'. The therapist may remain unaware of such issues and the client may have difficulty unaided in identifying and articulating them. In the context of one area of difference - being black or white -Thomas (1992) provides good illustrations of the kind of difficulties which can arise.
The CAT Understanding of Culture and Society
CAT theory about culture and society to date has concentrated on the ideas of Vygotsky as explored, for instance, by Ryle (1991) and Leiman (1992 and 1994b). They describe a process by which interactions between child and adult allow the child to absorb meanings ascribed by the adult and thus to function meaningfully within that environment. Tools and language are the means through which meaning is mediated between adult and child. The concept of the Zone of Proximal Development, based on this situation, has been used within CAT to inform a positive model of behaviour for the therapist who is sensitive to the outer limits of what the client is ready to learn.
Ryle explains the connection between Vygotsky’s ideas about the intellectual development of the child and their implications for culture in terms of Vygotsky’s commitment to ‘non-dogmatic Marxism’ (Ryle's phrase, 1991). The editors of a key Vygotskian text translated into English (1981) describe Vygotsky as subscribing to Marx’s belief that ‘historical changes in society and material life produce changes in human consciousness and behaviour’. In more everyday language I take this to mean that, for example, at the personal and inter-personal level, changes in the kind of work people do, the tools and techniques they use, how much they get paid and by whom, and the kind of working relationships they have with their workmates/colleagues, affect how they behave and what they believe - as do many other aspects of their daily life. Vygotsky’s work, as far as we know, concerned only the way a child communicates with an adult in the course of a practical activity. He characterised it as being both an external, interpersonal process and an internal and intrapsychological process, which of course is consistent with the key CAT concept of reciprocal roles.
Cultural Psychology/Activity Theory
Cole (1996), a theorist in the Vygotskian tradition, gives the historical origins and brings up to date what he defines as ‘the study of the culture’s role in the mental life of human beings.’ His study of 19th and early 20th century psychologists leads him to conclude that Russian psychologists always differed from their western counterparts in their approach to the discipline. Whereas the latter for the most part modelled psychology on the natural sciences, the Russians saw this as likely to lead to a split in psychology between those pursuing that route and those concerned with cultural explanations. They saw psychology instead as combining the study of culture, biology and social interaction, and all three as aspects of human development. For Cole the key elements of the Russian cultural-historical school are the beliefs that 1) meaning and ideas are transmitted through the mediation of artifacts: 2) historical development consists in the transmission of culture from one generation to another, and 3) practical and everyday activities should be the focus of analysis. Because of this last emphasis this type of theory is sometimes called ‘activity theory’.
Drawing on both Russian and American work on cultural psychology Cole arrives at a more complex account than that of Vygotsky and his colleagues. He believes that ‘mediated activity’ - that is activity between persons involving objects, ideas and language - has ‘multi-directional consequences’. In other words, change takes place among people in relation to each other, in connection with the situation they find themselves in, and in the language or other means through which interaction occurs. He argues that the nature of a given activity influences the type of thinking which takes place, and sees cultural differences as being cognitive in nature arising from differences in the forms of activities within different societies. Examples of cross-cultural investigations include how memory tasks are conducted and children’s speech acquisition. The consequences for adult ways of communicating are not, however, considered. Cole states that predictions can be made about a child on the strength of the culture it is entering before it is born. He describes human beings as ‘reach(ing) into the cultural past’ for their memories of what was appropriate for them, and carrying the same ideas into the future to create a sociocultural environment for the newcomer. Thus immediately on birth a child encounters gender expectations, eg ‘won’t play rugby’ if it’s a girl, on baby’s emergence from the womb in the USA of the 1970s.
Although examples of the effects in adult life for communication between people from different cultures are not given, there is a very strong implication from this theory that there will be cognitive differences arising from social activity and correspondingly different cultural expectations. In the context of cultural differences this is the most significant aspect of Cole’s theory for CAT.
In a sympathetic critique of activity theory Gauvain (2001) says that it lacks detail about the range of social partners, social arrangements and processes which contribute to cognitive development. As a means of extending the enterprise she looks at the roles of parents, siblings and peers, and reports on observational studies of mothers with babies in different parts of the world. When such examples are given, from a CAT perspective one can begin to appreciate in principle the process through which differences come about in respect of social assumptions and behaviour. For instance, by the time a child is four and a half months old a mother from the Marquesas Islands in the Pacific directs its attention much more to other people than an American mother of a similarly aged child. Gauvain sees this as ‘supportive of development in (a) community where children from early on in life have regular care-givers others than their mothers’. One can imagine how the experience of being cared for by a wide range of people would encourage a greater degree of trust in the wider community than in the American case, and how values and beliefs similarly would be influenced.
Gauvain also criticises classical activity theory for neglecting the role of emotion. She makes the point, which is certainly congruent with CAT theory, that the adult’s focus on an object or event is emotional as well as instrumental; many studies show that the adult’s emotional response influences the child’s actions and that infants actively seek out emotional messages.The role of emotion certainly is crucial in order to account for the fact that ‘difference’ between groups very often arouses strong negative feelings, in reaction to ethnic group, cultural practice, sexual orientation etc. The reciprocal roles which typically apply are rejecting to rejected, contemptuous to contemptible, and abusing to abused. It is easy to envisage how such reactions can be learned by a child from the adults around it, though this is not the kind of issue with which cultural psychology apparently has concerned itself to date.
Constructionism and Identity Politics
The work of social psychologist Kenneth Gergen over the past thirty years approaches the question of cultural difference from another angle. It began with a highly theoretical critique of social psychology, and he now sees his ideas as having had a role in the emergence of ‘identity politics’ in the late 1960s and 1970s when women, blacks and gays started to question the status quo.
In a recent article (2001a) he summarises his original critique of the scientific and empirical credentials of social psychology. Specifically he questions the idea that the world is objectively given and can be understood as such by the individual mind. He argues instead that to speak as a rational agent is ‘to participate in a system that is already constituted’, involving language and conventions about what is deemed rational. People can use language and partake in this activity only because they are interdependent and relational beings. What counts as an observation or finding depends on pre-existing conventions and traditions of understanding. Thus the natural sciences have their own criteria of intelligibility as do, for instance, spiritual practices. Some ideas are so culturally specific, eg the Hindu concept of the Atman, that they may not be intelligible within another culture. While Gergen’s approach, which is called social constructionism, has a different starting point from cultural psychology, in many respects it is consistent with it.
Elsewhere ( 2001b ) Gergen writes about a profusion of value-based sub-cultures in conflict with each other within society. By questioning the intellectual supremacy of the empirical/positivist stance and its claims to define what is rational and ‘really’ the case, constructionism found itself involved in a ‘love affair’ with groups who felt themselves excluded from the mainstream and marked out by virtue of being women, black or gay. They were given a means of challenging prevailing majority assumptions, felt liberated to develop and characterise their own sense of identity, and able to make claims for their interests and point of view as being of equal validity with others’.
In time, however, he says this way of thinking appeared to generate as many problems as it solved. The belief that opposing groups each inhabited different ‘discourse worlds’ further polarised debate, increased hostility and led to mutual blaming. Divisiveness increased within groups as sub-groups focussed on what they saw as their own interests - for instance in the drive for gender equality white women were accused of silencing black women - and causes lost their effectiveness as rhetoric flourished for every conceivable group which saw itself as suffering. Most fundamentally, the argument that the assumptions of the dominant discourse are socially constructed applies equally to the basis on which any group constructs its sense of identity. The categories in which people are placed are generated by the culture in which they live. Irrespective of whether the categorisation is intended to be negative or positive, it has the undesirable effect of reducing the individual’s potential outside that category.
Relevance to CAT and ‘Difference’
In their comments about cultural and ethnic diversity Ryle and Kerr (ibid., p. 47) suggest that therapists should ‘aim to be free of normative cultural values’. Both cultural psychology and Gergen’s ideas lead one to question whether in principle this is possible. However, they also throw light on the nature of the challenge we face if we are to be able to carry out any form of ‘culture mapping’ relevant to CAT, as Ryle and Kerr also suggest is desirable.
If one’s cultural and social background influences one’s way of thinking, assumptions and values, there is the possibility that when client and therapist have very different backgrounds, these could be detrimental to the development of a working alliance and agreement about the aims of therapy. On the other hand a therapist’s awareness of how much one’s way of thinking, values and beliefs are the product of social and cultural experience may encourage an appropriate humility and cautiousness when meeting a person whose life and formative experience seem very foreign to one’s own. Constructionist theory is both useful and at the same time frustrating in its ideas about identity. It is helpful in drawing attention to one’s taken for granted assumptions, to how one may be perceived by others in terms of class, ethnicity, and professional status, and how one may be perceiving the other person in turn. Yet if all these perceptions and attitudes are constructed and in some sense ‘unreal’, what are we to do about them when in practice they are often associated with intense distrust and antagonism?
Gergen recognises the nature of the impasse his theory can lead to (2001a). If all points of view are culturally created can one take any point of view seriously? The objection of course applies to social constructionism itself. A consequence is that the individual, both personally and professionally, is left without any sense of security about the validity of any point of view. The position one adopts, it seems, is basically a matter of choice. However, I do not think that the choice is necessarily arbitrary. There can still be reasons for one's choice. Both social constructionism and cultural psychology, despite their limitations, offer interpretations of the world which are congruent, in my opinion, with the difficulties we have in accommodating difference. And the way in which Gergen deals with the theoretical problem constructionism poses is,in my view, persuasive.
He argues (2001a) that highlighting the cultural origins and context of ideas is not to deny their significance or value, but to give a different perspective on them. What he wishes to avoid is an ‘unstinting commitment to a particular way of defining the real’ because the result is to close down all opportunities for dialogue between those holding different positions. His alternative is to ask psychologists to consider the cultural implications of a particular approach: ‘An effective empiricism requires a posture of culturally, ethically, and politically informed pragmatism’. The belief that no form of enquiry or activity is value free becomes a stimulus to self-reflection and criticism on the implications of one’s work. He argues (2001b) that the work of the psychotherapist unavoidably has social and political implications and, if the constructionist position is adopted, involves 'a posture of self-reflexivity and a curiosity about those who differ'.
Gergen’s further line of argument (2001b) is to suggest a move from identity into 'relational politics - a politics in which the self/other, we/them binaries are replaced by a realisation and appreciation of the significance of relational process'. Thus, whenever there is antagonism between 'us and them' -or I vs you - we work together to try and understand how 'we together' created this situation and what we might do to find new and creative ways out of it. The question of how this might happen, if at all, when the parties are very unequal in terms of power and money is not addressed. Gergen's description, however, applies precisely to what CAT therapists try to do in therapy by working collaboratively and by discussing difficulties in their relationship with the client in terms of reciprocal roles. Moreover, the concept of 'relational politics' suggests the relevance of reciprocal roles.
At the level of detail, however, Gergen's account is neither supportive of the concept of reciprocal roles, nor any advance upon it - rather the reverse. In his awareness of the many different social contexts in which people function and his emphasis on 'relational being', he expresses doubts about the relevance of the 'private self'. In an article (1994) about relationships he is concerned to avoid dualism, and denies the possibility of the subjective experience of emotions or of an individual’s point of view. His account of how in practice people relate to each other makes no sense in terms of everyday understanding and usage.
The value of Gergen's work is to highlight the philosophical and ethical implications of recognising 'difference' and trying to deal with it. In practical terms he is concerned like others to further opportunities for intercultural communication.
Gudykunst (1988) is concerned mainly with communication between those from very different cultures, eg American and Japanese. He summarises empirical research on how culture affects interpersonal communication, and how group membership and culture have different types of impact at different levels of intimacy. It seems that once relationships reach the friendship stage group membership no longer has much effect, and this is promising for the possibility of intercultural therapy. Considering also different sub-groups within American society, he argues (1998) that processes involved in communication at the face to face level are similar regardless of whether it takes place between those from the same culture or between two individuals from different cultures. In both cases we use stereotypes - equivalent to Gergen’s categories of identity politics - especially when on ‘automatic pilot’. But stereotypes for our own culture or group tend to be more favourable and more accurate than those for other cultures and groups. Thus it is helpful, and in the case of therapists vital, that we become aware of how stereotypes affect the way we communicate, both negatively and positively.
Relevance of Reciprocal Roles
When starting on this reading I had hoped to find a correspondence between the ideas of theorists interested in the relational nature of the self or experience and reciprocal roles. But outside Vygotskian thinkers I have been disappointed. Burkitt (1997), for instance, who is interested in the relational nature of emotions, insists that they exist only between people and are 'not expressions of something contained inside a single person'. Like Gergen, therefore, he denies by implication the possibility of an individual carrying their reciprocal roles with them and relating to themselves in particular ways. A book with a promising title - ‘Communicating Prejudice ‘(Hecht, 1998) - actually says little about the process of communication. In one contribution, however, Moon and Rollinson describe relations between middle-class and working-class people as normally involving a one way dialogue, with commands, diagnoses, instructions, judgments and definitions being delivered by the middle-class and no channels for the ‘upward flow of thoughts ‘ from the working class. We can extrapolate into judging to judged, diagnosing to diagnosed, plus ignoring to ignored etc.
At this stage in the search, therefore, it seems as if the Vygotskian analysis of child/adult relating, with an acknowledgment of the role of emotion, remains the best paradigm in psychology for CAT reciprocal roles. CAT theory and practice transcend philosophical (one might say pedantic) concerns about dualism, to provide an idea which people can understand in terms of the way they relate to others and how they relate to themselves. It may seem a big leap to move from seeing my mother as rejecting of me to feeling that ‘society’ is rejecting of me, but both may be strongly felt. If, through what is essentially a metaphor in the case of society's influence, I can find alternative more constructive ways of dealing with my sense of rejection on both counts, then the concept has made a useful contribution.
What can we learn from this limited survey of literature on cultural difference?
The implications of these findings for practice require much more thought and exploration. Certainly relevant is the suggestion made by Ryle and Kerr (ibid.) that the reformulation could include understanding of the patient’s cultural assumptions and formation. However, in cases where this is appropriate, the reformulation might also need to make explicit the therapist’s assumptions and values, and how reciprocal roles apply. In order for the latter to be possible, the therapist would need to be aware of their own ‘cultural and social reciprocal roles’ similarly to how they should be aware of their personal ones. Ryle and Kerr have used the term ‘culture mapping’. Maybe this would be one necessary form of it.
I hope that ACAT members will respond to this article with comments, and with their knowledge of other relevant reading. I wonder whether anyone would be interested in joining with me in a project to explore how we might identify our cultural and social reciprocal roles. Clearly it would be good if we had participants who, among them, had a wide range of cultural and social backgrounds.
Burkitt, I (1997) Social relationships and emotions. Sociology 31,1,37-55
Cole, M (1996) Cultural Psychology: A Once and Future Discipline Cambridge MA: Harvard UP
Gauvain, M (2001) The Social Context of Cognitive Development New York: Guilford
Gergen, K J (1994) Realities and Relationships: Soundings in Social Construction. Cambridge MA: Harvard UP
Gergen, K J (2001a) Psychological Science in a Postmodern Context American Psychologist 56, 803-812
Gergen, K J (2001b) Social Construction in Context London: Sage
Gudykunst, W B (1988) Culture and Interpersonal Communication Newbury Park CA: Sage
Gudykunst, W B (1998) 3rd edition: Bridging Differences - Effective Intergroup Communication Thousand Oaks CA: Sage
King, R (2002) An exploration of the practice of CAT with people who have learning disability from the perspective of the therapeutic relationship Unpublished dissertation
Leiman, M (1992) The concept of sign in Vygotsky, Winnicott & Bakhtin: further integration of object relations theory and activity theory. British Journal of Medical Psychology 65, 209-221
Leiman, M (1994b) Projective identification as early joint action sequences: A Vygotskian addendum to the Procedural Sequence Object Relations Model British Journal of Medical Psychology 67, 97-106
Moon, G M & Rollinson, GL (1998) Communication of Classism. In Hecht, M L, Ed Communicating Prejudice London: Sage
Pollard, R(2001) Some of the Historical and Cultural Background to the Self ACAT News, 15, 5-8
Ryle, A (1991) Object Relations Theory and Activity Theory: A proposed link by way of the Procedural Sequence Model. British Journal of Medical Psychology 64,307-316
Ryle, A and Kerr, I (2002) Introducing Cognitive Analytic Therapy Principles and Practice Chichester: Wiley
Thomas, L (1992) Racism and Psychotherapy; Working with Racism in the Consulting Room: An Analytical View. In Kareem and Littlewood: Intercultural Therapy: Themes, Interpretations and Practice Oxford: Blackwell
Toye, J (2002) Psychotherapy and religion: rivals or allies? The implications of religious commitment for Reciprocal Roles in Cognitive Analytic Therapy Unpublished dissertation
Vygotsky (Eds. Cole, Steiner, Scribner& Souberman ) (1978) Mind in Society: The Development of Higher Psychological Processes Cambridge MA: Harvard
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