APORTES PARAFISCALES

Race, culture, and ethnicity are very hard to separate in reality. When we use the term multiculturalism, we agree with Pedersen (1990) that it includes factors such as demography (age, gender, place of residence), ethnography (ethnicity, nationality, religion, language usage), status (social, economic, and educational factors), and affiliations (formal memberships, informal networks). The primary emphasis in multicultural counseling for many years has

been to manage and eliminate the fact that most psychotherapy has developed from a Western perspective and that it has a tendency to judge non-Western perspectives as dysfunctional or bad (Sue, Ivey, & Pedersen, 1996). The work to eliminate this bias is much needed. Psychotherapists consistently need to be aware of how their differences—be these racial, ethnic, religious, or sexual orientation— not only are a factual dimension that affects the helping relationship but also are factual inputs that have dramatically shaped patients. Although there are many practical concerns in this area, we choose to focus on two issues in particular that many contextual psychotherapists manage with only great difficulty. These are issues of power differential and of historical multicultural issues of exploitation. The power differential that exists between many multicultural groups is obvious. It may stem from the fact that one is from a higher socioeconomic group, has more education, or is in the majority ethnic class. These differences are obvious but are especially complicating to the therapeutic relationship when the psychotherapist is in the more powerful position. This is further complicated by the fact that many patients, when they come to therapy, see themselves as “sick” and in need of being “cured.” Because the psychotherapist is the helper, this gives him or her a more powerful position. Any time there is a power differential between psychotherapist and patient, a power struggle will ensue. Most of the time this struggle is covert, but it is nonetheless complicating to therapeutic relationships. The heart of the struggle is at the metacommunication of the patient improving. Whenever there are problems with improvement, patients are likely to feel less power in relation to the psychotherapist and they are likely to feel that the helper does not understand their problems. Patients will most often express this in the form of anger toward the psychotherapist or hopelessness toward their situation and their inability to make changes. The psychotherapist, on the other hand, is likely to feel this power differential in not being able to understand why patients cannot make improvements. “I have given the patient directives and support. What else does this individual need to make the necessary changes?” The psychotherapist will most often express these feelings through frustration or a desire to give up.

In power struggles concerning the progression of therapy, the key is not to eliminate them but rather to neutralize the effects that already exist. This is most effectively done through admission of the differential, by opening oneself to being taught from the other’s perspective, and by the psychotherapist maintaining a one-down position in the therapeutic relationship. Observe how the following

female therapist skillfully accomplishes this in working with a middle- aged black man who was struggling with controlling his anger. Therapist: Now that I know a bit about what brings you to therapy,

I would like to spend a short time talking about our relationship.

Man: What do you mean?

Therapist: We come from a very different perspective. I am female and you are male. I am white and you are black. We come from different family backgrounds, and I’m the counselor, wheras you are the client.

Man: I don’t suppose you can understand what it’s like to be a

black man in this society, any more than I can understand what it’s like to be a woman.

Therapist: You are right. We can never really fully understand one another. But I do want to learn more. I also want to be aware of any time I’m asking you to do something that feels demanding or insensitive.

Man: (Laughs) That may be most of the time.

Therapist: Did I already say something that made you feel angry or hopeless?

Man: (Long pause) Many white people say they want to

understand and want to be sensitive. But when it gets down to it, they just give lip service to it.

Therapist: How can you help me avoid that position?

Man: (Looks at the therapist a long time in silence.) I will tell

you when I feel that “white” coming out of you at me. Because the therapist acknowledges the fact of the power differential, she exposes the man’s feeling about her as a person and about the therapy in general. After the therapist puts herself in a one-down position, the man decides that he will be honest with her when he feels that she is taking the power position.

The second issue involves multicultural exploitation, and it grows out of generations of certain races having exploitive power over other. Examples of this type of exploitation are, unfortunately, not hard to find. It is of historical significance because the exploitation has not only served to form part of the identity of people who have suffered, it has also severely damaged the trustworthiness that exists in dimension four between different groups. When this type of

exploitation exists between psychotherapist and patient, it is not enough for the helping professional to give admission. The psychotherapist must also acknowledge his or her responsibility in the exploitation.

As contextual therapists, we believe that trustworthiness does not simply exist in current relationships, but, rather, trustworthiness has either been built throught or has damaged previous generations of relationships. As a white man living in the 21st century, I may say that I have no responsibility for the persecution of blacks through the slavery of the 18th and 19th centuries. But the fact is, my white predecessors stole black people’s freedom, heritage, and identity and passed the benefits they received from that exploitation down to the next generation. Even if those direct benefits diminished over the years, each generation in my lineage gained at least some advantages in life at the expense of the blacks who were exploited. In the same way, blacks in the 21st century have inherited the disadvantage of this exploitation throughout their generations. Is there any real way that whites can believe that the effects of slavery have not worked as a disadvantage to blacks living today? We do not think so. In the same vein, there is little alternative to the fact that whites living today have benefited from and have advantages over the black race that has been exploited.

The exploitation that exists between whites and blacks is only one example of the multicultural damage that has taken place in history. When this fact of past or current exploitation exists in a therapeutic relationship, the psychotherapist should admit not only that damage has been done but that he or she has some responsibility for the insults that have been delivered on behalf of previous generations. Sometimes this acknowledgment of responsibility will come in the form of an apology. Sometimes it may come in the form of an offer of reduced fees or of community service. The acknowledgment, however, is a trustworthy effort that affects the fourth dimension of relational ethics, which in turn has the potential of neutralizing the facts of the damaging past in the current therapeutic relationship.

FACTUAL ECONOMIC CONCERNS