On the last track we discussed three common counseling microskills. These three common counseling microskills were attending behaviors, clarification, and reflection. We also discussed the ethical concerns raised by using these microskills in an unmodified manner with clients of a different culture.
On this track we will discuss transference and countertransference and the different dynamics these two aspects of counseling have in treating culturally different clients. Later on the track, we will also consider the case of a culturally different client experiencing transference.
Obviously transference and countertransference have a number of ethical implications in treating clients in general. I have found that the ethical dangers of transference and countertransference, however, can be magnified when they are applied to a cross-cultural counseling experience. Have you noticed this yourself in your cross-cultural counseling experiences?
As you are well aware, transference is a manifestation of what a client has learned about human relationships in contacts with significant figures. Thus if a culturally different client brings transference to his or her relationship with his or her therapist, he or she will often play out, or transfer, to the therapist significant issues regarding interpersonal relationships. Clearly, to qualify as transferential reactions, the client’s reactions should meet the criteria of being intense, inappropriate, persistent, impulsive, and ambivalent.
Obviously if you properly recognize your client’s transferential reactions, you will not personalize them, nor, if you are a new therapist, be frightened or overwhelmed by them. Do you have a culturally different client that is transferring to you? How have you handled this transference? Let’s look briefly at the case of Akashi (ah-kah’-she) to see how transference exhibited itself in his therapy sessions.
Akashi, a 22-year-old Asian American, began therapy sessions to cope with the guilt he felt following his father’s death. Three weeks before his father died, Akashi had argued with his father over his involvement with a political group at his university. His father had died without the argument being resolved. When Akashi was paired with a white counselor, he responded with distrust. Throughout preliminary sessions, Akashi maintained his openly suspicious attitude.
In one session, the therapist explained that one important aspect of therapy was the adjustment of individuals to society. Akashi then angrily responded, "Well, do you want to adjust people to your sick white society?" The therapist then realized that not only was Akashi aware of the oppression Asians had historically experienced in America at the hands of white Americans, but as a result Akashi was still distrustful of all whites. The therapist was now dealing with transference as well as Akashi’s grief issues, as Akashi was transferring his blame of the white society at large to his therapist.
Regarding countertransference, I have found that it tends to be less common than transference. However, it can still create ethical problems in the counseling relationship. Obviously therapists tend to be much more astute at understanding the acted-out parts of their clients, but are generally less understanding of their own acted-out behaviors. As you probably know, countertransferential reactions generally meet the same criteria as those listed for transferential reactions. To reiterate, therapists experiencing countertransference will often react intensely, inappropriately, persistently, impulsively, and ambivalently. Make sense?
These concepts of transference and countertransference apply to the counseling of a culturally different client in that they serve to frame strong and irrational reactions by both the client and the therapist in terms of cultural conflict and cultural identity development. As such, an understanding of transference will likely be more useful if it is interpreted in a different manner than it would be with a typical American client.
As you know, transference generally implies the traditional analytical framework of the therapist as a representative of the primary caretaker. Ethically, the therapist needs to be aware, when transference is applied to a cross-cultural therapy experience, the therapist becomes a representative of a culture instead of the primary caretaker. According to Sciarra, in his book "Multiculturalism in Counseling", a culturally different client in the conformity stage may easily idealize a therapist from a dominant culture.
How would you interpret this idealization? For a therapist less experienced in multicultural counseling, it may appear that the culturally different client has childhood dependency issues. However, it goes without saying that in reality this idealization is a function of how the culturally different client sees him or herself in relation to the dominant culture.
Thus when working with clients from nondominant cultures, transference issues based on race or ethnicity may have more to do with the culturally different client’s level of cultural identity development than with the primary caretakers of the traditional analytical framework. As such, cross-cultural counseling in which transference becomes apparent may need to adopt a cultural framework instead.
For therapists who work with clients from nondominant cultures... frequently the therapist’s reaction to the client will have more to do with his or her own level of cultural identity development. As you are well aware, even though codes of ethics exist for your profession, therapists are not exempt from racial or ethnic stereotypes. According to Sciarra, the more highly developed a therapist’s cultural identity is, the greater the therapist’s capacity for openness to and an enrichment by clients from different cultures.
In my experience, to maintain professional ethical standards, multicultural therapists need to be courageously honest with themselves in admitting racist attitudes or ethnic stereotypes that might result in negative reactions to culturally diverse clients. Ethically to be a sensitive multicultural therapist you may constantly scrutinize how two diverse cultures, your own culture and your client’s culture, impact the counseling relationship. Do you agree?
Do you have a culturally different client like Akashi who has been having transference issues in your counseling relationship? Does he or she react intensely, inappropriately, persistently, impulsively, or ambivalently toward you regardless of your therapy techniques? What are the ethical implications of approaching transference from the traditional framework of the primary caretaker as opposed to the more appropriate cultural framework?
On this track we have discussed transference and countertransference as they relate to cross-cultural counseling. Regarding transference, we have discussed the traditional analytical framework of the primary caretaker as used in traditional counseling experiences, and compared it to the more appropriate cultural framework that may be necessary in cross-cultural counseling experiences. Regarding countertransference, we have discussed the importance of the therapist’s ability to recognize countertransference as well as the importance of admitting one’s own racist attitudes and ethnic stereotypes.
On the next track we will discuss topics that relate to multicultural group counseling, including three important issues in multicultural group counseling. The three issues that we will discuss are, 1. Heterogeneous Versus Homogeneous Groups, 2. Projective Identification in Multicultural Groups, and 3. Racial/Cultural Identity Development in Groups
Peer-Reviewed Journal Article References:
La Roche, M. J. (1999). Culture, transference, and countertransference among Latinos. Psychotherapy: Theory, Research, Practice, Training, 36(4), 389–397.
Yi, K. (1995).
Psychoanalytic psychotherapy with Asian clients: Transference and therapeutic considerations. Psychotherapy: Theory, Research, Practice, Training, 32
Yi, K. Y. (1998).
Transference and race: An intersubjective conceptualization. Psychoanalytic Psychology, 15
What are five ways that culturally different clients experiencing transference may react to a therapist?
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