Difference and Diversity in Counselling

Contemporary Psychodynamic Approaches

Sue Wheeler

• Publisher: Bloomsbury Academic
• Year: 2006
• ISBN:
  9781350305915
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

All counsellors are compelled to take account of the diverse society in which they practice and to inform themselves of best practice with all client groups. This book provides a contemporary psychodynamic perspective on difference and diversity to bring practitioners up to date with current thinking when faced with a client who is in some way 'different'. References to race, culture or disability in classical psychoanalytic literature are few. In a society that embraces diversity and seeks to afford equality for all, theories of male and female identity development need revisiting. Older people make up a large proportion of the population and religious beliefs make headline news, but psychodynamic perspectives on clinical work with such groups are limited. Indeed, the social context of the 21st century, that provides the backdrop for the hopes, fears and aspirations of our clients, warrants attention, as people and organisations are shaped by the social systems that prevail. In the past decade equal opportunities legislation and the need to be proactive in thinking about diversity has begun to make its mark. Complacency is no longer tolerated. This book is essential reading for counsellors and psychotherapists in training and for experienced practitioners whose continuous professional development will be enhanced by re-evaluating how diversity affects their practice.

PART

I

Social Context and Society

CHAPTER

1

Thinking Psychodynamically about Diversity

Sue Wheeler

Counsellors and psychotherapists are usually liberal minded people. Such a career is chosen because we care about people, embrace altruism, and strive to make some contribution towards righting the ills of this world. At the same time we are powerfully and often unconsciously influenced by the culture and society in which we live. While wanting to help others, we also need to look after ourselves and fit in with the families, communities and organisations in which we live and work, and that can create conflicts in our value and belief systems. Diversity in society can be considered at many levels. Signing up to an equal opportunities policy is easily done; understanding some of the more complex implications and implementing it is not so simple. Engaging with difference and diversity at a deep level is challenging and leaves no assumptions undisturbed, no values and beliefs unchanged. It can be profoundly disturbing.

Some years ago while visiting Egypt I took a felucca across the Nile. Our sailor was a handsome young man called Abdul, aged about 20 years. His boat was the first in a line of feluccas on the shore offering their services for the short crossing. He spoke excellent English and was clearly articulate and intelligent. We chatted happily about numerous topics and then I asked Abdul what he was going to do with his life. He replied, ‘I am going to sail a felucca.’ Somewhat surprised I asked what he did during the summer months when there were fewer tourists around. He replied, ‘I will swim and wait for the winter.’ I have pondered on that conversation for many years, trying to reconcile my expectations of life, education, good job, promotion, pension, nice home, social status, with his experience and expectations. He was satisfied with his life and was in no hurry to change anything. He radiated a peace and tranquillity that was most attractive. As a psychotherapist, it made me question whether my cultural norms and expectations inhibit my clients exploring theirs or whether I collude in a blinkered way with the status quo.

Affluent Western societies may be advanced in many ways, but pressures to achieve and consume lead to stress and mental health problems abound. Such societies produce contradictions that echo personal moral dilemmas. The planet is being rapidly destroyed by carbon emissions and depletion of resources but it is hard to give up cars or foreign travel. Religion is encouraged as long as it does not lead to fundamentalist fanaticism. Gay relationships can be tolerated but not legalised in marriage. Intolerance and oppression are rife throughout the world and the counselling room is one place in which individuals should be able to explore their values and beliefs, but how open can the therapist be to the client when their own value system is challenged?

Counselling and psychotherapy is a strange activity, often presented as concerned with intrapsychic and interpersonal processes. Some psychoanalytic theories metaphorically place the mother and child in a bubble and map human development as if nothing outside the bubble matters, or influences that intimate relationship and the growth that ensues. The therapist works in the rarefied atmosphere of the consulting room devoid of personal accoutrements in order to preserve the power of the transference. However, there is turbulence everywhere, not just related to the psychic equilibrium of the client, but also in the therapist and most powerfully in the world outside that room. World events, whether it be the invasion of a country, terrorist attacks, natural disasters or the continued erosion of the ozone layer and the ensuing climate change permeate the therapy room one way or another. Therapists and clients, including those who are black, disabled, Muslim, lesbian or gay, rich or poor, old or young, carry not just their personal family history but also their social and political history. In the words of Juliet Mitchell (1974), ‘the personal is political and the political is personal’; therapists take a political stance as an integral part of their role.

The Western world in the 21st century hosts a diverse society; many countries have legislation written and enforced to foster inclusive societies, covering topics such as equal opportunities, discrimination with respect to religious beliefs, age, sexual orientation, gender or disability. There is often other legislation that is not so generous; immigration, particularly for asylum seekers for example, is ever more tightly monitored and controlled. Counselling and psychotherapy services proliferate in English speaking countries, but are not widely used by some sections of society. Indeed, assessment for psychotherapy will render some disadvantaged groups unsuitable because of a lack of psychological mindedness (being able to construe some of life’s difficulties as being related to the self and not all externally driven) (Coltart, 1988) or an inability to articulate needs clearly and make appropriate demands. The individualistic worldview that counselling promotes will serve to alienate cultural groups that value family and community above individual responsibility. If older people, particularly those in institutions have access to counselling, they are in a minority; Freud’s assertion that psychotherapy has little to offer those over the age of 50 has not helped the development of services in this sector.

Training to be a psychodynamic counsellor or therapist is challenging for both student and teacher; the curriculum always demands more time than is available. A multitude of theories have evolved from the work of Freud that warrant attention: human growth and development must be understood, psychoanalytic technique must be practised, the interface with psychiatry needs to be appreciated, and the numerous ways in which therapy can be practised, briefly, in groups, families, over the internet, studied. While various client groups and presenting problems are a legitimate focus for study, the role and function of society as a powerful influence on individuals and groups, particularly minorities or other overtly disadvantaged groups, tends to be relegated to the study of sociology that does not quite make the tight agenda of a training course. The stretched curriculum promotes tokenism. A seminar on cross-cultural counselling focuses on the client who is in some cultural sense different, in the protected space of the consulting room rather than the less tangible context of wider society. The educational background of counsellors and therapists is wide ranging. Ideally, a suitable foundation for psychotherapy training would be the social sciences: history, politics, economics, sociology, anthropology and philosophy, that would provide a matrix of background knowledge to aid understanding of the client in his/her social, economic and political context. Regrettably the pull towards psychotherapy training is an urgent need to make sense of self and others through the fascinating and all consuming study of intra and interpersonal processes. Such a process is adequately supported by a rich fund of psychoanalytic literature to fuel the intellect on such a quest, and a dearth of psychoanalytic literature that makes the social, historical and political context of the therapeutic relationship a priority. Young (1994) describes his quest to find psychoanalytic literature on racism: ‘Never, never before have I come up with so little, and much of what I have found isn’t much use … it’s pathetic’ (p. 100).

This book aims to fill in some of the gaps traditionally found in psychoanalytic literature by bringing world history, sociology, politics and religion into the consulting room in the service of understanding clients who might be labelled as ‘different’, recognising that we are all involved in the labelling process and the alienation it creates. It aims to bring the political in its broadest sense into the frame of therapy, in order to give all involved in the therapeutic endeavour a broader view of the emotional stresses and strains of civilisation and their impact on humanity as well as on the individual.

Elliot (2002) analyses the links ‘between the psyche and the contemporary social world’ (p. 11) to conclude that the development of self is inevitably and inextricably influenced not just by current culture and society but also by historical events that have shaped that society. ‘The cultural and institutional processes of modernisation which have launched the West upon a dazzling path of global expansion are said to have reached into the heart of selfhood and created new forms of personal identity’ (p. 11). Particularly pertinent to this argument is the concept of transference in its widest sense. Often understood as a response to a person that is rooted and shaped by early life experiences with significant others, usually authority figures and parents, a broader interpretation evident in the work of Freud is a transference response to social relationships and the cultural realm beyond the family. The development of self is a complex process that can be explained by numerous psychoanalytic theories, but introjection is acknowledged to play its part, whether the introjection of the mother’s smiles and love symbolised by the breast in Kleinian theory or self objects as defined by Kohut (Siegel, 1996). If we acknowledge the transference relationship with culture and society, the implications for the development of self and identify in a hostile or prejudicial society are frightening. For members of an oppressed minority group, whether black, disabled, without good language or communication ability, internalising the negative reaction of the external world will inevitably have a damaging impact on their identity and sense of self. The elderly, while not a minority group in any sense, will have absorbed the impact of challenging world events, as well as a rapidly changing culture that, added to the anxiety created by physical decline in later years, gives them good cause for psychotherapeutic attention.

The social context of the 20th century within which psychoanalysis, psychotherapy and counselling have developed since Freud’s day has been marked by conflict and cooperation, differentiation and integration, often in dialectical movements. The ambivalence inherent in personal relationships is apparent on a global stage. Political and economic events affect the everyday lives of ordinary people, their work, lifestyle, relationships, habits and consciousness as well as spawning theories about the nature of society and human nature. Freud (2001) recognised three sources of human suffering: ‘the superior power of nature, the feebleness of our own bodies and the inadequacy of the regulations which adjust the mutual relationships of human beings in the family, the state and society’ (p. 86). About the first two there is a limit to what can be done, although pollution and global warming are making strides towards the deterioration of the environment and medical science continues to make advances in prolonging life, but such progress is not without an impact on the organisation of society. Given that human beings organise their social systems and institutions to support their way of life for their own comfort and satisfaction, we have been spectacularly successful in creating wealth in the Western world but less successful in promoting health, well being and the relief of suffering. Given these man-made systems, the conclusion must be that ‘a piece of unconquerable nature may lie behind – this time a piece of our own psychical constitution’ (Freud 2001, p. 86), not least human aggression.

Unbridled human aggression is evident throughout the Western world even in the early years of the 21st century. Some groups of people bond with some common sense of identity and then proceed to persecute and slaughter another group that may be identified as being different because of their race, culture, language or religion. ‘Anyone who calls to mind the atrocities committed during the racial migrations (Greeks and Turks) or the invasions of the Huns … or at the capture of Jerusalem by the pious Crusaders or even indeed the horrors of the recent world war [First World War] … anyone who calls these things to mind will have to bow humbly before the truth of this view’ (Freud 2001, p. 112). Certainly the slaughter of the First World War (1914–18) had a profound effect on Freud’s writing, influencing his works Beyond the Pleasure Principle and Civilisation and its Discontents (both in Freud 2001). The recrudescence of anti-Semitism and the rise of the Nazis prompted Freud’s flight to England. At the time of his death, the extent of the massacre of millions of Jews, gays, communists and gypsies in concentration camps was unknown, but such events fit with his predictions and his pessimistic analysis of the human psyche. Freud (2001) states, ‘It is always possible to bind together a considerable number of people in love so long as there are other people left over to receive the manifestations of their aggressiveness’ (p. 114).

Other events of the 20th century have had a powerful impact on the organisation of society, such as the economic slump of the inter war years and the Second World War, which have weakened beliefs in notions of progress and liberal democracy. The collapse of the Austro-Hungarian, Ottoman and Russian empires after the First World War and of the British Empire after the Second World War, as well as of the Soviet Union and Communism in Eastern Europe (1988 to 1992), marked the replacement of multi-ethnic empires ruled by metropolitan authoritarian governments from London, Paris, Berlin, Istanbul or Moscow, by nation states based in large measure on ethnic identity.

Wars and revolutions have changed the political map of the world. World Wars I and II, the Cold War, Korean War, anti-colonial, materialist and socialist revolutions in China, Vietnam, Algeria and Cuba claimed many lives and changed cultures. For a time, at the end of the Cold War, there was a sense of triumphalism and a boost to the notion of the liberal capitalist market and democracy, but this was short-lived. The relatively peaceful revolutions that led to the overthrow of Soviet Communist power in Russia and Eastern Europe (East Germany, Poland, Czechoslovakia, Romania and Bulgaria) are set in contrast with the violent conflict in the former Yugoslavia. Ethnic cleansing provides a horrible illustration of the intolerance of difference and the barbaric way in which aggression against men, women and children, including sexual violence, was unleashed when the institutions that governed and ordered society broke down. States have been established according to religious and ethnic identity (such as Israel, Serbia, Croatia, Pakistan), which has led to the expulsion, torture or death of others who were identified as different, for whom there was no place and no mercy.

In South and Central America – Chile, Argentina, Brazil, Venezuela and Nicaragua – conflicts raged between a variety of popular/radical/socialist revolutionary movements and authoritarian military rule, often backed by multi-national corporations and the US government. At the same time these conflicts have testified to the potential for cooperation and solidarity across different groups and nations; workers, peasants and intellectuals have found common cause, as in the case of Zapatistas from Mexico linking in dialogue with French farmers.

There have also been some triumphs for civilisation in the 20th century, shaping people’s behaviour and consciousness, that are relevant to this book: the emancipation of women and the growth of feminism in the Western world and the abolition of Apartheid in South Africa, to name just two. Starting with their achievement of the vote, women have united to challenge institutional and familial oppression, to create opportunities for choice of role in the home, organisations and society as a whole. The process and progress of liberation continues, but much has already been achieved. In South Africa, the pressure from within the country and outside, not least the anti-Apartheid movement, finally yielded a liberation that was long overdue. In the words of Nelson Mandela (1995), it was a ‘Long walk to freedom’. That society still struggles to empower, support and protect all its citizens, but it is work in progress.

For a generation reaching maturity in the 1950s and 60s there was an ever present threat of nuclear war. This sometimes reached a climax: as during the time of the Russian suppression of the Hungarian uprising in 1956, the Anglo–French–Israeli Suez crisis in 1956 and the Cuban missile crisis in 1962. In 1968, besides the uprising in Prague, there were democratic demonstrations on North American university campuses and in European cities (London, Paris, Rome and Berlin), with students and sometimes workers revolting against US government involvement in the Vietnam war as well as more generally against the alienation and exploitation of consumer capitalism. The effects of these events led to changes in consciousness and involvement in political activity spread into a wide range of movements. Feminism, ecology, human rights and identity politics fuelled political activity and political engagement changed personal identities.

One of features of the world sc...

Table of contents

• Cover
• Title page
• Copyright
• Contents
• List of Figures and Tables
• Notes on the Contributors
• Acknowledgements
• Introduction
• Part I: Social Context and Society
• Part II: Gender and Sexuality
• Part III: Disability and Old Age
• Part IV: Race and Culture
• Index