Abstract
Issues of gender, ethnicity, power and position not only influence the identity and social suffering of the patient, but shape the clinical encounter influencing therapeutic alliance, transference, countertransference and the process of assessment and treatment. This chapter uses case material from the work of South Asian cultural consultants to illustrate how the identity of the consultant influences clinical encounters with patients from the Indian subcontinent, with particular attention to gender and power issues. The cultural or racial similarities or differences in the identity of consultant and patient, or referring clinicians, raise complex issues encompassing institutional, familial, and individual dynamics. These issues may have positive effects on the clinical alliance, or create excessive ambivalence and negative responses that undermine therapeutic work. Mirroring of gender and power attributes can position the therapist as someone who shares vulnerabilities and strengths with minority patients. This can cause impediments to clinical work, with resistance, scotomas or excessive identifications. The intrapsychic, intra-familial and socio-political implications are explored using a case examples as well as reference to current literature on gender, migration and identity. As the cultural consultation strives to promote cultural safety as the primary basis of engagement, therapist and patient identity issues must be acknowledged and conflicting agendas of gender, power, ethnicity, as well as cultural dissonance and prejudice must be negotiated by consultants and clinical teams.
The young women with amber skin, hair and brows of black
as crows’ wings, eyes of lionesses in heat,
dressed in silks of delirious hues…
they wander through foreign rooms in the last daylight of the century
painting their eyes…
somewhere out of them, alive or dead I have sprung
yet no one seems to recognize me.
From: “Ancestors” by Rishma Dunlop (2004, p. 31)
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Guzder, J., Santhanam-Martin, R., Rousseau, C. (2014). Gender, Power and Ethnicity in Cultural Consultation. In: Kirmayer, L., Guzder, J., Rousseau, C. (eds) Cultural Consultation. International and Cultural Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7615-3_8
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