Intro: Inherently Cross-Cult/Multi-Cult - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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Intro: Inherently Cross-Cult/Multi-Cult

Therapist Resources > Therapy Books > All Relationships MultiCult

All Relationships and Therapy are Multi-Cultural- Family and Cross-Cultural Complications
by Ronald Mah

**Author's Note: Other than public figures or people identified in the media, all other persons in this book are either composites of individuals the author has worked with and/or have been given different names and had their personal identifying information altered to protect and respect their confidentiality.  

One is… and the other is something else.  Perhaps, one or the other is urban, rural, Jewish, Turkish, British, immigrant, migrant, gay, Mexican, black, Greek Orthodox, straight, Catholic, Moslem, Saudi, Ukrainian, devoutly religious, casually religious, professional, aristocratic, white, Japanese, American, Protestant, secular humanist, Christian, refugee, immigrant, Native-American, Californian, New Yorker, Jew, Israeli, male, female, Hispanic, Cambodian, San Franciscan, Turkish, or is two or more of these.  Sometimes, there are obviously differences between two individuals.  For example there is Adit and Helena, one individual is male, Saudi, a casual Moslem, and from aristocratic money, while other is female Ukrainian, Catholic, and from a professional family.  There seems to be an obvious need to consider multi-cultural and cross-cultural perspectives in their therapy.  How do they talk?  What do they expect?  How do they communicate?  How do they play?  Will a pair such as Adit and Helena end up with major cross-cultural problems as their rules and expectations in an intimate relationship are out of sync?  Metaphorically, might one of them be playing by the values and rules of tetherball with the other playing with the expectations and behavior of Pictionary!?  That seems to imply that the "game" or the relationship is inherently unplayable or doomed to failure.  Yet, the game of relationship or of relating can have universalities among different cultures and between two demographically mismatched individuals.  Successful, productive, and/or intimate dynamics have quite often resulted from ethically, racially, religiously, economically, and other mismatched couples or relationships.  Much like gin and mahjong or water polo and soccer or the board games of Western chess and Japanese go or other culturally different games, there can be numerous similarities and commonalities between or among two or more individuals from various cultures.  While two individuals may have different playing styles and levels of skill, the rules of chess remain the same.  Invested individuals often can figure out how to make the relationship work, and develop a new mutually honored and shared set of values, attitudes, beliefs, and behavior.  Might the rules of relationship also hold major similarities- virtually universal requirements that form the foundation for the new relating culture?  

On the other hand, there are two individuals to the naked eye that appear to be essentially from the same background and practically speaking with negative dynamic resulting in major relationship problems.  For example there is Hannah and Petey, who are both white middle-class Anglo-Saxon Protestant.  While sharing major commonalities, there are also major distinctions in each of their make-ups beyond male-female values and behaviors not obviously apparent to someone else.  Their relationship "game" may have major stylistic conflicts and the mutual goals of intimacy and harmony may not be achieved.  Beyond their shared demographic experiences, where did they learn their respective relationship game rules?  They ostensively appear to claim and share the same expectations but somehow their collaborative intimacy game goes awry.  Rather than partnered teammates striving for mutual goals against common obstacles and enemies in some video game or a three-legged race challenge, they end up frustrating each other!  There may be two others, who while sharing the same sex, they operate from mismatched gender models.  That could be two men in a work or team sports situation, one of which abhors showing sensitivity or vulnerability working with another man much more willing to be emotionally open and available.  Or, women in academic, vocational, or social communities manifesting leadership with contrasting styles: one more extroverted and assertive and the other more collaborative and supportive in the background.  It could be two gay men or two lesbians with models of same-sex intimacy that are out of sync.  Multi-cultural and cross-cultural assessment and strategies may prove highly advantageous to therapy despite apparent demographic matches.  One is an individual and the other is the person he or she is in a relationship with as a colleague at work, school, or athletics, or in a couple, or family.  Or, perhaps one of the people in the relationship is a client and the other is the therapist.  What is the "therapy game" of the therapist?  Multi-cultural and cross-cultural issues, match, and mismatch may be as important between the therapist and clients- perhaps, more vital as between or among individuals seeking help.  Therefore, all relationship and therapy may be inherently multi-cultural and cross-cultural.

When individuals, couples, or families come to therapy, they may present a single presenting issue or a single situation, task, or problem to address.  However, often what appears to be a single difficult decision issue is often entangled in much more.  "Entangled in the overtly expressed decision issue may be the fact that the individual, one or both partners, or family member is fighting to maintain self-esteem.  Or it may be that the issue at the focus is linked to broad power battles in a relationship, the couple, or family.  There are battles that are present on many different issues.  It may be that the individual or the couple differs culturally, and the one issue of disagreement is linked to broad cultural differences, for example, what is appropriate for women and men in their two cultures, or differing cultural understandings of loyalty to family of origin" (page 203, Rosenblatt and Rieks, 2009).  One individual, partners, or family members may present a problem and seek the therapist to sit in judgment and pick out the wisdom (and stupidity!) between them.  When the therapist works with couples or families, they take care to not choose one individual's perspective over the others.  The therapist may be well advised in individual therapy to be appropriately skeptical of the individual's rendition of relationship woes as well.  The other individual or persons not physically present in session being described may have diametrically opposed interpretations of relationship experiences and dynamics.  The therapist nevertheless tries to find validity from the existential reality of each individual.  It is assumed that each individual, both partners, and different family members' perspectives have validity.   That while they have differences, they also often have similar underlying needs.  Accepting the two or more ways of interpreting the same life, experiences, and communications eventually lead to third or alternative and potentially more functional ways interpretations.  

"Couples… sought to strike a balance between individual, couple, nuclear family, extended family, and faith community subsystem needs.  In instances where a skewed emphasis was placed on one subsystem's needs, this tended to have a negative systemic impact… Learning how to balance subsystem needs was indispensable to individual, couple, and family well-being" (Joanides, et al, page 80, 2002).  If an individual (especially, if confirmed by a side-choosing therapist in therapy) asserts his or her needs over the others, then the skewed balance of the relationship harms overall well-being.  Balancing to fulfill the needs of the individual in his or her important relationship or both partners and all family members creates a new culture- that of functional relationships.  Within this process moreover is the therapist as a second perspective (conceptually, a different cultural orientation) to an individual client, or a third perspective to two partners much less a third, fourth, fifth, or additional perspective to several family members' views.  In facilitating functional relationships for individual, couple, or family clients, the therapist must first establish a functional relationship with the client or clients.  This relationship is inherently d cross-cultural since therapy is tasked to explore, discover, and develop processes alternate to what has already failed or found inadequate for the individual, couple, or family.  It becomes incumbent on the therapist to not only assess the potential cross-cultural conflicts between the individual and others, between partners, and among family members, but his or her own cultural foundations for personal, couple, or family relationship health as they may.  Cross-cultural differences or conflicts may be not only an important root of relationship dysfunction but also of therapeutic failure or success.  If the therapist were to dismiss client's models and values however dysfunctional currently, it will create disconnection rather than build rapport.  The individual, partners, or family members are likely to already to be intolerant and rejecting of others.  Recognizing and honoring behavioral foundations embedded in cultural training of all types (including from the family-of-origin) is an important step to offering and facilitating change to more adaptive processes in new contexts such as the new relationship.

In extending the concept of two perspectives into larger societal contexts finds Biever, et al in "Therapy with intercultural couples: A postmodern approach" making virtually the same recommendations for intercultural couples therapy.  They recommend therapists, "…adopt a both/and stance.  The both/and stance flows from the postmodern idea of multiple, socially constructed realities and the valuing of diversity.  Both sides of a dichotomy are prized.  For example, one distinction frequently made by therapists is that of intercultural differences and intracultural similarities.  From a postmodern perspective, it may be more useful to assume that all cultures are both similar and different.  This both/and perspective helps the therapist focus on two useful ideas.  One is that there are both similarities and differences between cultural groups.  Secondly, and invariably, there are both similarities and differences within a particular culture" (Biever, et al, 1998).  All therapy is inherently cross-cultural and multi-cultural therapy.  Bhurga and De Silva in "Couple therapy across cultures" (2000) state that, "It can be argued that psychotherapy, or indeed therapy of any kind, is culture-specific… within each model of psychotherapy, there exist key elements which can be classed as universal."  These elements include identifying problems, naming problems, and prescribing/implementing a remedy.  Therapy attempts a remedy that includes a period of orientation, establishing a therapeutic relationship, and finally the therapy process of change management.  The causes of the problem are discovered though discussion and thoroughly examined.  The cultural context of the interaction, that is, therapy is of major importance.  "This context also brings with it societal factors and complexities, including inherent power relationships.  Recognition and understanding of these are important for the work of a therapist, in both assessment and intervention" (page 183-84).  Each member in a relationship and the therapist bring in unique experiences from societal factors and complexities not limited to the contexts of ethnicity, race, religion, and nationality.  From separate family of origins and other experiences individuals in a relationship work through contextual challenges to form a functional (or dysfunctional) operational couples culture.  The therapist needs to be aware of multiple combinations of cross-cultural and multi-cultural principles and theories with multiple couple assessments for treatment with not only more obvious cross-cultural, relationships but also seemingly mono-cultural relationships.  The relationship between historically oppressed peoples and survivors of family dysfunction will form the foundation for a broader cross-cultural approach to all therapy.  

The therapist is more apt to consider cross-cultural or multi-cultural perspectives relevant only in obvious situations such as immigration.  The therapist would likely seek and find benefit from the following advice articles such as by Ishiyama and Westwood in "Enhancing Client-Validating Communication: Helping Discouraged Clients in Cross-Cultural Adjustment" (1992).  "There are many hurdles to jump for persons leaving their familiar homeland and entering a new sociocultural environment.  For example, limited language and cultural competencies become obstacles to achieving personal and career goals.  This process can be discouraging.  Also, leaving a supportive social network behind and living among strangers can create intense feelings of loneliness and uprootedness... The following statements reflect the hardship of the discouraged ethnic clients with whom we have worked:

No one seems to understand what I'm going through.

I miss home, but I can't go back. I feel trapped here.

I'm not good enough to be successful in this country.

People think I'm dumb and incompetent. I resent that.

No one seems to need me or care about me. I feel insignificant and abandoned.

I was "somebody" back home but nobody here.

I feel different and isolated. I don't belong here.

With these feelings, clients come for personal, vocational, and academic counseling. They wish to be understood and validated by the counselor, to ease their inner pain, and to find better ways of dealing with their problems"

Careful examination of the writings of Ishiyama and Westwood shows that their recommendations for immigrants have relevance for all clients and especially those working on relationship issues.  The "immigration" or migration, rather than from another country can be conceptualized to be similar to leaving a family-of-origin and entering into the new community of couplehood or the family.  Not being understood, missing home, fear of failure, incompetence, abandonment, identity, and isolation also may occur in the "foreign" world of the new relationship.  In every relationship there at least three cultures interacting: the culture of each individual and the culture that has developed between the two individuals.  These cultures may be very similar to highly dissimilar… compatible or incompatible, as English and Scottish cultures are more similar while Swiss and Haitian are more dissimiliar.  Culture can be defined as the set of attitudes, values, beliefs, and behaviors that individuals or groups of people develop to survive in a particular context.  Thus, distinctive cultures will develop for Americans, Italians or Koreans based on American, Italian, or Korean environmental demands for survival.  In addition, there would be sub-sets of attitudes, values, beliefs, and behaviors for handling sub-contexts faced by groups within the larger group.  That context or environment can be determined by geography (desert, river, valley, sea side, fertile or barren, etc.), by economics (poverty, affluence), history (the Depression, westward expansion, the 60's) and other issues including experiences from the family of origin.   For example, American culture of the early 1800's prior to the development of the telegraph (which provided immediate cross-continental communication) and railroads (efficient movement of people and goods) became profoundly different with the changes in technology.  Current cultural patterns for girls and young women have evolved from patterns from earlier American society that did not support gender equality.  Each individual, male or female develops patterns from their personal contextual challenges from earlier life experiences.  

Any two individuals: Adit and Helena or Hannah and Petey for example, who come together to enter into a relationship or form a couple come from two different families.  One pair from a Saudi family and a Ukrainian family, and the other pair from two different WASP (white Anglo-Saxon Protestant) families.  Relationship challenge may be from somewhat to extremely distinctive sets of attitudes, values, beliefs, and behaviors from the two families-of-origin.  Every family (a context or environment) exists within and is influenced by other multiple contexts or environments (including ethnic traditions or communities, financial circumstances, natural, rural, urban, or suburban settings, and the current social-political world).  Every family also exists with and is influenced by the emotional and physical health and stability of its individual members.  All relationships have inherent cross-cultural issues and multi-cultural dynamics – often involving significant conflicts.   "Couples may be anywhere on a spectrum from destructively emphasizing their difference in background to being unaware that difference is playing a role in their problems… Partners who have maximized their differences may lead distant, parallel lives.  Each partner may pursue his own religion and relationships with extended family and friends.  They may also be polarized in culturally influenced areas such as boundaries and hierarchies," (Eaton, 1994).  At the point the relationship becomes intolerable, painful, or the polarization unfulfilling, an individual, the couple, or family may come for therapy.  Thus all therapy is inherently cross-cultural and multi-cultural therapy.  An individual or each member of the couple or family and the therapist bring in many unique experiences including but not just limited to the contexts of ethnicity, race, religion, and nationality.  The individual, partners, or members need to work through contextual challenges to form a functional (or dysfunctional) operational relationship culture; this is the third culture.  
When Baltas, et al describes the acculturation of a migrant to a different culture, it is comparable to individuals acculturating to either the culture of his or her partner or to a new relationship culture.  "A critical concept in understanding psychological well-being and adaptation among migrants is acculturation.  Although acculturation is neutral in principle, it has typically come to mean the degree to which continuous first-hand contact with a different culture leads to changes in the beliefs and behaviours of a group.  Moghaddam et al have argued that fully acculturated people come to hold as their own the attitudes, beliefs and values of the new culture.  At the psychological level, acculturation involves learning a new behavioural repertoire and shedding some prior behaviours and attitudes. Cultural conflict may arise when individuals or groups have incompatible behaviours and attitudes" (page 174, Baltas, et al   2000).  The principle of acculturation relative to two or more individuals however often places an implicit higher value of one culture over another.  An immigrant often needs to acculturate to the dominant mainstream culture in order to successfully navigate social, academic, and vocational demands of the new society.  However, whether one individual's culture is inherently ill-suited to the new context of the relationship and thus, is supposed to convert to the other person's supposedly superior models and values is questionable.  Whereas the immigrant has to adapt to the new countries demands, two individuals may make equally egocentric adamant demands for the other to submit to ones "superior" process.  Neither Adit nor Helena automatically defer to the other's preferences, nor do Hannah and Petey.

A goal of therapy then becomes to see if an individual or each member can function and hold as his or her own the attitudes, beliefs, and values of the new relationship culture versus becoming immersed in culture conflict in the relationship.  Historically oppressed peoples and survivors of family dysfunction share significant similarities.  This perspective forms the foundation for a broader cross-cultural approach to all relationship-oriented therapy.  The richness of cross-cultural and multi-cultural theories will offer insight for assessment and practice with not only more obvious cross-cultural relationships (for example, couples of different ethnicity, race, religion, and nationality), but also seemingly mono-cultural relationships.  Without using culture-based terminology, various approaches to therapy may reflect these cross-cultural and multi-cultural principles.  In some seemingly mono-cultural relationships (for example, both members such as Hannah and Petey being 30ish white, Protestant, middle-class), recognizing the relationship between historically oppressed and disenfranchised peoples and survivors of family trauma and dysfunction may be useful.  The attitudes, values, beliefs, and behaviors of members of oppressed communities often are reflected in the patterns exhibited by individuals from abusive or dysfunctional families.  This perspective asserts a culture of survival for oppressed individuals either of a family or of society.  Therapy therefore can use cross-cultural survival paradigms for facilitating healthier relationships between two individuals.

3056 Castro Valley Blvd., #82
Castro Valley, CA 94546
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
office: (510) 582-5788
fax: (510) 889-6553
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