Cultural incommensurability in psychodynamic psychotherapy in Western and Japanese traditions.
OBJECTIVE
To examine cultural incommensurability between clients of Japanese ancestry and Western therapists.


METHODS
Aggregated case-study method was used to analyze psychotherapy cases of Japanese individuals seen by Western therapists. Eight cases were selected for this study from a private practice client pool.


RESULTS
Themes were: (a) only observable data were valued for diagnosis and treatment; (b) cultural stereotypes hampered treatment; (c) individuation and separation occurred within a social web of norms in Japanese culture; (d) key concepts in mental health such as "death and dying" and "rape" were interpreted by clients within a Japanese cultural framework, resulting in unique psychological reactions and behaviors, which had not been recognized by Western therapists; (e) psychological effects of immigration were minimized or ignored by Western therapists; (f) culturally unfamiliar behaviors were "pathologized" by Western therapists; and (g) Western therapists showed ethnocentric biases regarding the effects of immigration.


CONCLUSIONS
Various forms of misunderstanding and culturally ignorant practices were found in the treatment of eight Japanese clients by these Western therapists. These ineffective and often harmful practices were unrecognized by the Western therapists.
Kozuki
Yoriko
Y
Department of Psychosocial & Community Health, University of Washington School of Nursing, Box 357263, Seattle, WA 98195-7263, USA. ykozuki@u.washington.edu
Kennedy
Michael G
MG
D000293:Adolescent; D000328:Adult; D000368:Aged; D001213:Asian / Q000208:ethnology*; D001291:Attitude of Health Personnel / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D003144:Communication Barriers; D003220:Conflict, Psychological; D018864:Cultural Diversity; D004641:Emigration and Immigration; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000628:therapy; D008875:Middle Aged; D015205:Northwestern United States; D010686:Philosophy, Medical; D010817:Physician-Patient Relations; D011287:Prejudice; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D019366:Western World