Therapy, Culture and Spirituality

Developing Therapeutic Practice

G. Nolan,W. West

• Publisher: Palgrave Macmillan
• Year: 2014
• ISBN:
  9781137370433
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

This edited collection addresses how therapy can engage with issues of race, culture, religion and spirituality. It is a response to the need for practitioners to further their understanding and skills base in developing ways of appropriately responding to the interconnectivity of these evolving issues.

1

Multiculturalism, Religion and Counselling: Freedom to Heal

Roy Moodley and Claire Barnes

Introduction

Religion and psychology have not always been comfortable bedfellows. Historically, religion has been marginalised in mainstream psychology (Emmons & Paloutzian, 2003). For example, Sigmund Freud presented religion and spirituality as neuroses and forms of denial that limited, rather than enhanced, insight into one’s inner world (Galanter, 2005). Psychologists emulated Freud’s anti-religious stance through much of the 20th century, regarding religion and spirituality as defence mechanisms used to justify or deny certain maladaptive behaviours and emotions (Aten & Leach, 2009). Even today, psychologists as a group are far less religious than the population as a whole. For example, an American survey found that compared to the rest of the population, psychologists are ‘twice as likely to claim no religion, three times more likely to describe religion as unimportant in their lives and five times more likely to deny belief in “god” ’ (Delaney et al., 2007, p.542). An overwhelming proportion of Americans (95%) believe in ‘god’ and almost half (40%) attend a weekly worship service (Plante, 2009), and 80% of Canadians claimed a religious affiliation on the 2011 census. Meanwhile, psychologists tend to adopt a scientific or naturalistic view of the world (Carone & Barone, 2001).

Indeed, in certain respects religion and psychology fundamentally disagree. The psychological model of health emphasises the client’s right to autonomy and self-determination. In contrast, most world religions emphasise the primacy of the collective good, a position that complicates, if not directly contradicts, the psychological model of individual wellbeing. Psychological perspectives on coping and change also differ greatly from religious models (Carone & Barone, 2001). The medical model, which remains the dominant paradigm in psychology, advocates biological or cognitive interventions as a basis for change, while a religious model or one that is within a multicultural framework allows for the intervention of a greater power in the path towards recovery.

This uncomfortable paradigmatic fit between religion and psychology prevented, for much of the 20th century, acceptance in the psychotherapeutic profession of religion and spirituality as avenues towards healing. In recent decades, however, this longstanding distrust has begun to ease. A renewed interest in the positive role of religion in psychotherapy has been evident since the early 1990s (Aten & Leach, 2009). Religion and spirituality have been given increased attention in the mainstream counselling literature (Hagen et al., 2011), and literature on the psychology of religion has steadily grown, providing a more complex and complete picture of how these two constructs intersect (Miller & Kelley, 2005). Therapists are increasingly embracing the role of religion and spirituality in their client’s lives, viewing it as integral to their clients’ identity, worldview, health and wellbeing. Anecdotal evidence suggests that most mental health practitioners are more tolerant of a client’s narrative of struggle and recovery if it is infused with religious ideas. Dual interventions are increasingly common, with clients visiting a Western psychotherapist and traditional healer concurrently (Moodley et al., 2008). This promising direction of treatment provides clients with access to both spiritual and scientific wisdom regarding psychological wellbeing, mitigating possible value conflicts with mental health providers (Moodley et al., 2008). Clinicians are increasingly recognising the points of compatibility between religion and psychology: the two domains share a focus on growth, inner experience and human flourishing. Tellingly, a recent study (Lawrence et al., 2013) suggests that, nowadays, physicians and psychiatrists are not in fact biased against religion. The authors found no evidence that psychiatrists are less likely than physicians to recommend religious involvement to their clients. Furthermore, primary care physicians are more likely to recommend that patients get involved in their religious communities when the physician or the patient is religiously observant, indicating that physicians and psychiatrists alike generally view religion as a positive force in their patients’ lives.

One reason behind this recent rapprochement of religion and psychology is the publication of numerous research studies revealing empirically validated associations between religion/spirituality and positive outcomes (Miller & Kelley, 2005). Some have questioned the conclusiveness of these studies (King et al., 1995). Indeed, a closer examination of the studies suggests that many have only examined the absence or presence of religious practice in relation to illness (Pressman et al., 1990), or the religiosity of terminally ill patients (e.g., Nelson et al., 2002), or the effects of prayer on depression and anxiety (e.g., Boelens et al., 2012); and some studies demonstrate negative as well as positive effects of religion and spirituality (Ano & Vasconcelles, 2005; Green & Elliott, 2010). These caveats notwithstanding, the association between religiosity and positive outcomes seems well-established: people who identify as religious, in particular those who hold liberal rather than fundamentalist religious orientations (Green & Elliott, 2010), tend to report greater health and happiness, even when controlling for religious affiliation, work, family, social support or financial status (see, for example, Brown et al., 2013; Ferriss, 2002; McCullough et al., 2000; Shafranske, 2005). Research on religiosity, illness, healing and life satisfaction has tended to report outcomes that are generally positive and acceptable to the current ideological and moral trends prevalent in post-modern societies, particularly in North America, and especially grounded in a Judeo-Christian set of beliefs and ethics.

Another reason for psychologists’ recent warming to religion/spirituality is the growth of multicultural counselling practices in professional psychology. Most training programmes now emphasise the importance of mental health practitioners’ awareness and sensitivity when working with clients from a range of social and cultural backgrounds, including diverse religious backgrounds. The old negative view of religion in psychology is increasingly seen to be equivalent to, and as unacceptable as, racism, sexism, queerophobia, classism, disableism and ageism. However, in the West, under the rubric of multiculturalism the picture has been somewhat complicated, in the sense that religion is also a site for ideological and political enactments within which the individual’s health and wellbeing can be compromised. Counselling and psychotherapy are places where such enactments are deciphered and analysed.

Indeed, to bring religion into psychology is necessarily to bring multiculturalism in as well. Religion is not a monolithic construct but a wide diversity of traditions, institutions, beliefs and practices, and therefore necessarily implicates issues of diversity, cross-cultural (mis)understanding and culture. According to Miller and Kelley (2005), culture lies at the root of any exploration of religion and spirituality, leading researchers to consider in more detail the intersections of religion, spirituality and multiculturalism. Given that religion and spiritual issues have had at least half a century of research and scholarship in multicultural counselling, clearly there are conceptual, theoretical and practice-based strategies from this scholarship that may benefit mainstream counselling and psychotherapy in its search for the value or healing potential of including religion and spirituality in therapy. Indeed, mainstream psychologists have begun to question the Western, individualistic values embedded within popular counselling approaches, calling for practitioners to develop greater multicultural counselling competence (Vogel et al., 2013).

In this chapter, we explore what these multicultural paradigms are and discuss how they can be incorporated into mainstream counselling, psychology and psychotherapy. We begin with a brief overview of how religion and spirituality have been incorporated into multicultural counselling.

Multicultural counselling and its quest for the spirit(ual)

Since the 1960s there has been a growing interest in integrating multicultural and diversity issues into counselling and psychotherapy. This infusion of multicultural ideas and ideologies, especially race, ethnicity and culture, into psychology, counselling and psychotherapy was prompted by socio-political and cultural changes that took place in the West, particularly the civil rights campaigns of the 1960s. Historically, psychology has been complicit in projects of oppression by positing fundamental psychological differences among groups. The pseudo-scientific racist theories that evolved and flourished in the late 19th century resulted in misconceptions about race, culture and ethnicity which in turn led to inappropriate assessments, misdiagnosis and over-representation of black and minority ethnicities in mental health. This resulted in misinformed and inadequate psychological and mental health services for racialised communities (see Fernando, 1988; Turner & Kramer, 1995). Lack of appropriate mental healthcare practices meant that black and minority ethnic clients did not seek counselling and psychotherapy and had low rates of participation (Sue, 1998; Vessey & Howard, 1993) and high levels of premature termination compared with majority culture clients. These inequalities prompted the multicultural counselling movement to critique mainstream psychology and counselling for being eurocentric, individualistic and focusing on psychopathology (Moodley, 2011). Initially, multiculturalism and diversity scholars were preoccupied with immigration, acculturation, adaptation, integration and culture-bound syndromes. However, over the ensuing decades, through evidence-based randomised control trials, the focus shifted to more complex and clinically related matters, such as racial identity theories (Helms, 1990, 1994), cultural competencies (Sue et al., 1992), intersectionality, cultural competency, Group of Seven stigmatised identities (Moodley, 2011; Moodley & Lubin, 2008) and integrating traditional healing into counselling and psychotherapy (Moodley & West, 2005). As a result of this rapid evolution and development, multicultural counselling, especially in North America, was widely considered to be the ‘fourth force’ in psychology after psychodynamic, cognitive-behavioural and humanistic psychology (Pedersen, 1991). Even without this ‘fourth force’ identity, multicultural and diversity counselling has been at the forefront of integrating religion and spirituality into psychotherapy.

Multicultural counselling finds its roots in part in the civil rights movement (see Funderburk & Fukuyama, 2001), which was profoundly connected to religion and spirituality: Dr Martin Luther King was a Baptist minister and the liberation songs used by his movement were adapted versions of spiritual hymns. Since culture and race were at the foundation of multicultural counselling, it could be argued that religion and spirituality have been incorporated into the movement from the very beginning. For example, Vontress, one of the founding fathers of multicultural counselling (e.g., Vontress, 1962), first highlighted issues of intergenerational trauma, black masculinities and black rage, and emphasised that culture, religion and spirituality were an integral and fundamental aspect of the black or African-American experience (see, for example, Vontress, 1979, 1986, 2001, 2002, 2010; see also, Moodley et al., 2012).

The 2000s were a period of increased growth of multicultural counselling and psychotherapy, particularly in North America. This period also saw an increasing tension within the diversity movement, most of it related to the Group of Seven identities (Moodley, 2007) and their place in what was fast becoming the new multicultural counselling movement, later reframed as critical multicultural counselling or diversity counselling and psychotherapy (Moodley, 2011). Some multiculturalists have been troubled by the inclusion of sexual orientations and disability as part of multicultural counselling, arguing that issues of race, ethnicity and culture have become marginalised and that a focus on homophobia, disableism and ageism has displaced racism. However, in terms of religion (one of the Big 7 social identities) there has not been too much concern, since it has always been a part of multiculturalism, although in certain contexts there has been an uneasy relationship between religion and multiculturalism; for example, while multiculturalism in general hinges on notions of plurality, some faith groups hold intolerant views and strong beliefs against LGBTQ (lesbian, gay, bi-sexual, transgender, queer) communities. Concurrently, another shift appeared to be taking place: the inclusion of ideas and healing practices from indigenous, Aboriginal and First Nation communities; for example, healing circles, storytelling circles, sweat lodge ceremonies and the medicine wheel (McCabe, 2007; McCormick, 2005, Poonwassie & Charter, 2005; Smith, 2005). The research into the integration of healing methods into counselling and psychotherapy has not been confined to Aboriginal or indigenous groups but has spawned a great deal of research on traditional healing methods across all cultures and communities in the diaspora and globally (see, for example, Moodley & Oulanova, 2011; Moodley & West, 2005; Moodley et al., 2008; Sutherland et al., 2014). At the core of this work is the concept of the spirit, which frames spirituality and spiritual experiences as central to the healing process; this is achieved with or without institutional religion as the site for metaphysical enactments.

Religion, spirituality and multiculturalism: Overlaps and tensions

Deep tensions often exist between institutional religion and multiculturalism. Historically, institutional religion and its ideologies have been most enduring and most persuasive in informing an individual’s subjectivity, group identity and national sense of belonging (Whitehead et al., 2013). Therefore, throughout the centuries religion, spirituality and culture have been interconnected in many ways, informing (and indoctrinating) people through language, literature and the arts. The rise of multiculturalism in the West reinforces this ideology of dominance within which multiple cultural groups that constitute a multicultural society make claims to belonging in a particular place through the enactments of religious ideologies; the iconicity of these cultural artefacts produces in effect a tension and fragmentation that multiculturalism itself was created to prevent in the first place. Some religious and spiritual traditions require their followers to adhere to a particular interpretation of the sacred text which is considered to represent the absolute truth, while multiculturalism assumes a post-structuralist understanding of ‘truth’, in which openness and acceptance of difference are paramount and all truths are acceptable with their inherent contradictions, ambivalences and ambiguities in a post-modern society. In North America, the power and privilege of Christianity has allowed some churches to impose oppressive values such as anti-homosexuality and restrictions on women’s freedom. Individuals interested in forwarding the philosophy of multiculturalism have been sceptical of religion’s place within this more liberal framework. The ‘multiculturalism’ within religions – for instance, the diversity of Christian denominations, or the differences between Sunni and Shia Islam – has clearly created its own conflicts and traumas, far from the image of harmony and tolerance hoped for by proponents of multiculturalism.

One way that scholars have attempted to reconcile these tensions between religion and multiculturalism is to distinguish between religion and spirituality as separate constructs, with religion referring to traditional, institutionalised systems of worship and spirituality referring to a more personal and dynamic experience of the sacred (Paloutzian & Park, 2005). Spirituality is often assumed to be positive and growthpromoting, while religion is negative and restrictive (Aten & Leach, 2009). Moreover, spirituality is often embraced by those interested in diversity issues as embodying the values of multiculturalism, while religion is viewed as conservative, dogmatic and ideological. While this representation may appear to be overly simplistic in its configuration, it nevertheless attempts to offer a set of definitions or boundaries within which meanings can be constructed towards a possible engagement of the spiritual within cultural norms that are not dictated by institutional religion. The separation of spirituality and religion has been criticised by Zinnbauer and Pargament (2005), who state that framing religion and spirituality as contrasting concepts is unnecessarily limiting ...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• List of Figures and Tables
• Acknowledgements
• Foreword
• Notes on Contributors
• Introduction
• 1. Multiculturalism, Religion and Counselling: Freedom to Heal
• 2. Asking for Help Is a Sign of Weakness
• 3. Synchronicity
• 4. The Concept of Honour and Shame for South Asian British Muslim Men and Women
• 5. One Western Size Fits All: Counsellor Training in Different Countries and Cultures
• 6. Listening to the Grandmother Spirit: The Chance for Prophetic Change in Contemporary Healing
• 7. Embracing the Rainbow: Race and Therapy
• 8. Managing Therapeutic, Spiritual and Faith-Based Pastoral Programmes in an International Multi-Faith Higher Education Community
• 9. Witnessing: From Passer-by to Attuned Other
• 10. Perspectives at the Edge of Experiencing in Clinical Supervision
• 11. The Spiritual in Counselling Training
• 12. Counselling and Spiritual Accompaniment
• 13. Acculturation, Spirituality and Counselling Sikh Men Living in Britain
• 14. Cultural Challenges When Working with People from Refugee Backgrounds
• 15. Researching Therapy, Culture and Spirituality
• 16. Conclusion
• Index