As I travel with my family through Italy, this trip abroad continues to highlight the importance of being sensitive to cultural differences. It’s amazing (and a little embarrassing) how we automatically assume the values, norms, and traditions we’ve been raised with should be universally understood and applied, even though we are in a foreign country with people who speak their own language and have their own system of money. Of course the truth is every culture has a unique way of relating to others and it’s subjective understanding of what is acceptable and unacceptable behavior. As a guest in another country I continue to have experiences that serve as important and humbling reminders that there are very real cultural differences that need to be understood and respected. What matters here is how they do things- not my core sense of what is or is not appropriate or familiar.
While traveling in Italy it’s important to understand that a raised voice and dramatic hand gestures does not translate to mean “angry” or threatening, just animated. After our first cab ride in Rome, we gave the driver a large tip. After all, he had successfully navigated an obstacle course of speeding Vespas, mini-cars that looked like go carts seemingly coming out of nowhere, and an endless stream of pedestrians. He looked at the tip, became clearly upset, and handed it back to us. We thought he was insulted because we didn’t give him enough. We learned that he was upset because we gave him too much! The same was true after we left a large tip for a waiter who misinterpreted it to mean that we were unhappy with the service!
Although initially confusing, it was a great learning experience. We need to be clear about how any given culture will interpret our intentions as they are looked at through the lens of their cultural point of reference. It’s a reminder that my words, gestures, and actions might mean something quite different to clients who come into treatment with different core values and experiences. As therapists we need to check in with our clients to be certain that our interventions and intentions are both understood and in sync with their understanding of the therapy process and their “problems.” We have to ask more often about their point of reference and the familial, cultural, and religious values and traditions they follow. We can’t make assumptions or pretend to know, we need to admit our lack of knowledge and invite our clients to teach us. When a client makes sustained eye contact is that a sign of respect or intimidation? If the client makes no eye contact is that indicative of depression or deference? Is therapy perceived as a gift or does it reinforce the notion that the person must be “seriously troubled?” It depends upon their culture!
Perhaps if we took more time to weave this into the establishment of the therapeutic relationship as well as our understanding of the client’s “symptoms” and struggles, it might increase the efficacy of our interventions. We might be misinterpreting what we see and hear when we don’t take those differences into account. And unless we think about the ways in which our clients’ cultures have influenced their thoughts, expression of feelings, ways of interpersonally relating, and their behavioral choices, we might be missing both internal and cultural resources and roadblocks that will impact our clients’ healing journeys.