Almost every profession that interacts with individuals as members of a societal context, is required to attend some kind of cultural competence training. Psychology, counseling, and social work are only some of the disciplines that ethically require knowledge and continuing education in looking at what makes us diverse. The limitation to this approach of looking at diversity exclusively as culture is that the clinician gets blindsided from the vast possibilities of differences. We more often look at race, sometimes at ethnicity, and almost never really ponder and asses the meaning of culture from the eyes of our clients. Hence, the human mind, the thoughts, the rational, and the irrational tends to be overlooked.
The human mind contains and processes what turns our behaviors in reality: our thoughts. In many occasions, the professional has been taught how some “cultures” think. Therefore, even before the therapeutic process begins, the clinician has a stereotyped conceptualization of the client’s cognitions in his or her head. However, even though race, ethnicity, and culture (as well as gender and other characteristics) modify our world view and perception of reality, it does not solely define our thoughts.
In order to ponder the similarity of our thoughts despite what could be different due to culture, one can use Cognitive-Behavioral Theory (CBT) as a framework. One of the main concepts of CBT are automatic thoughts and schemas. Automatic thoughts refer to the thoughts that “pop on our head” (consciously and subconsciously) right after an event happens. If we follow the complicated trail of automatic thoughts, we would be able to find a schema. A schema is an ingrained idea that someone holds as true. For example, a male is laid off from work and thinks “I am always unable to keep a job”, among other automatic thoughts. Moreover, after furthering assessing this thought, a clinician could possibly lead the client to identifying the schema “I always fail no matter how hard I try”. One could see this as irrational thinking. However, for someone believing this schema, this sounds like the truth. Now, what do you think a woman would think? An Asian? An African American? Probably something similar or even the same.
The idea of similarity of thoughts is not to overgeneralize or avoid the inevitable fact of social constructivism in different cultures. The idea is to see that in some way or another different cultures have similar thoughts and schemas. A street child from Costa Rica that has experienced physical abuse may think similar to a girl from Thailand being submitted as a sexual worker. “I am worthless” or “It is all my fault” may be schemas developing in both scenarios despite the culture of the children. Opening this door we could then look at others under the same light. Is it possible that others from a culture different from mine think the same way I do? Inevitably this is the key question that links the gap between the clinician’s culture and the client’s culture.
Falicov (1998) under her model Multidimensional Ecosystemic Comparative Approach (MECA) calls it “maps”. Falicov believed that at a certain point the “clinician’s map” and the “client’s map” would converge. For example, by both experiencing divorce, or immigration, or being parents, etc. Therefore, if a Middle Eastern clinician mother of five was working with a Dominican man who was suffering depression for not being able to see his children in Dominican Republic, she could identify with the patenting role. We are not talking of assumptions, we are talking of a chance for genuine empathy. Moreover, this clinician would probably be able to identify with the man’s irrational thought of “If I don’t give the best to my children I am a failure.”
Thoughts and beliefs transcend country of origin, color of the skin, and language. A therapist should look beyond culture (without undermining its important significance) and look into thoughts that could foster a better therapeutic alliance. Diversity goes beyond what we can see and many times beyond what we can hear. Thoughts are what define our behaviors and reflect back on what we understand of our environment. Thoughts are colorless and genderless. Thoughts are the key to understanding diversity in a healthy and therapeutic relationship with our clients.