The convergence between family experience and political/societal dynamics brings culture, cross-culturalism, and multi-culturalism into psychotherapy room. Rather than considering cultural issues or multi-cultural perspectives and knowledge as occasionally relevant or "added value" in therapy, they become intrinsic to all clinical work based on the following two assertions. The survival culture of growing up and living in a totalitarian society without civil rights and with vulnerability to arbitrary and abusive treatment by more powerful individuals is essentially the same as the survival attitudes, beliefs, values, and behavior of an individual who has grown up in a dysfunctional or abusive family. The relationship between the survival and flourishing culture in a democratic society with civil rights and protections against arbitrary and unfair treatment and of survival and flourishing attitudes, beliefs, values, and behaviors of an individual who has grown up in a functional and supportive family are also essentially the same. These two perspectives transcend and unify ethnicity, race, class, gender, religion, and other categorical definitions.
Assessment and eventual treatment will be benefited by recognition that individuals, couples, or families and cohorts of people have shared experiences and subsequent dynamics of neglect, abuse, humiliation, trauma, marginalization, objectification, oppression, and so forth. While excessive stressful experiences may occur in communities (a ghetto) or countries (Arab Spring in Libya or war-torn Vietnam) from historical dynamics such as genocide, warfare, famine, and oppression, Hannah or Petey may be scarred from family abuse and dysfunction. Understanding of individual's healthy versus toxic life experiences and their resultant emotional, psychological, and cognitive reactions and responses will then amplify and illuminate understanding of individuals from historically or socially functional versus dysfunctional circumstances, that is totalitarian (feudal) versus democratic environments. Understanding a group's (ethnicity, class, race, tribe, nation, etc.) historical or socially functional versus dysfunctional circumstances and how they promote distinctive survival patterns of attitudes, values, beliefs, and behaviors will then clarify individual responses in smaller units of community- the couple, the family or relationships in the school or workplace. These conceptualizations allow for respect, understanding, empathy, connection, and translation, which are essential to successful cross-cultural relationships as a psychotherapist working with individual clients, couples, and families from diverse backgrounds. Respect and understanding can occur because of the conceptual clarity that the choices of behaviors were driven by survival needs in the individuals' life contexts, rather than strange illogical choices. Empathy and connection is facilitated as the therapist identifies with the feelings, needs, and choices that he or she would have made him or herself if he or she had experienced the same life context. And, the therapist can translate to the clients that the behavior and choices were necessary survival choices. It is especially important to translate each individual's behavior as consequential from his or her cultural (life and/or societal experiences) rather than from disrespect or disregard of the other person's needs or feelings.