Understanding Race, Ethnicity and Power: The Key to Efficacy on Clinical Practice

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9780029253410: Understanding Race, Ethnicity and Power: The Key to Efficacy on Clinical Practice

While practitioners in the social services and mental health professions work with people from a variety of ethnic, racial, social, and economic backgrounds, they often do not understand or feel comfortable with those whose cultural backgrounds are different from their own. Several books have addressed this problem by examining the ethnic diversity of clients, surveying the behaviors and values of various groups. Elaine Pinderhughes moves far beyond this limited client-oriented approach to reveal the pervasive influence of race, ethnicity, and power on the practitioner's own identity and in interactions with others -- peers, subordinates, and superiors, as well as clients.

Experiences related to cultural difference can cause individuals to develop negative, ambivalent, or confused perceptions, attitudes, and beliefs about themselves and others. In a cross-cultural treatment encounter, these internalizations can compromise the ability of the practitioner to provide effective assistance to the client; at the same time, they may cause the client to misperceive or distort the intentions of the practitioner. To overcome these obstacles, practitioners must transcend the cultural blindness of the "melting-pot" perspective in which the white middle class is assumed to be the norm and develop a greater understanding and appreciation of differing needs and values. Pinderhughes emphasizes that the development of this cross-cultural sensitivity requires that practitioners first attain an awareness and comprehension of their own cultural background and its meaning and significance for their interactions with others. Practitioners who understand and value their own ethnicity are in a better position to value that of their clients, and to help them overcome psychological conflict and feelings of alienation resulting from experiences related to their cultural identity.

Understanding Race, Ethnicity, and Power enhances cross-cultural awareness by examining the influence of racial and ethnic identity upon the psychological and social dynamics of interactions among individuals from diverse backgrounds. Pinderhughes emphasizes the primary role of power in the dynamics of cross-cultural communication and examines how power and lack of power, which are inherent in the roles of clinician and client and in their cultural group statuses, can affect clinical processes and outcome. Through examples drawn from her clinical practice and the numerous cultural sensitivity training workshops she has conducted at universities, health facilities, agencies, and professional meetings nationwide, as well as through her review of the most current professional thinking and empirical data, Pinderhughes helps individual practitioners clarify the meaning and values implicit in their own attitudes, feelings, and behaviors, and shows how to incorporate these insights in daily clinical practice to better control, and even change, their own biases.

Elaine Pinderhughes offers a comprehensive, judicious, and insightful approach to issues that have been too long ignored. Understanding Race, Ethnicity, and Power is a vital new resource for all practitioners and students seeking to deepen cultural sensitivity in clinical practice and a lasting contribution to improved understanding in our pluralistic society.

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About the Author:

Elaine Pinderhughes, M.S.W., is Professor and Chairperson of the Clinical Sequence at the Boston College School of Social Work.

Excerpt. Reprinted by permission. All rights reserved.:

Chapter 1

Introduction

I bring to the therapeutic interface a growing and at times painful acceptance of the sorrowful part of my Irish ethnicity and an appreciation of the value placed on giving, humor, hard work, religious faith, family independence, and an increasing expression of feeling. I also bring a working-middle-class orientation to my work; an orientation that tries to fight against my father's bigoted message that people-of-color were not to be trusted or liked. To feel powerful, he needed to ridicule, a response defined by his Irishness and his fear. I am still grappling with the ways in which this has affected me in my work, whether I do have power and feel powerful, and how I can use this to help my clients.

So wrote a social work student as she struggled to complete a written assignment on the significance of her cultural background to her effectiveness in cross-cultural practice.

Experiences related to cultural differences can cause people to develop negative, ambivalent, or confused perceptions, feelings, and attitudes about themselves and others. Such internalizations can prompt one to behave in unhelpful ways toward others and thus can compromise the ability of the practitioner to demonstrate the competencies that are necessary for effective assistance to the client. At the same time, these internalizations can also cause clients to misperceive or distort the intentions and interventions of practitioners. This book addresses the need for attention to these issues in its focus on what professionals as well as clients bring to the cross-cultural treatment encounter. It examines how cultural perceptions and experiences related to ethnicity, race, and power affect people's sense of themselves as well as others, their feelings and attitudes, and the behavior they manifest in ways that show up in service delivery.

For generations in America diverse, often opposing, values and beliefs have interacted dynamically. Democratic principles supporting the equality of people before the law and tolerance for diversity and pluralism have found expression in religious, philosophical, and political writings and in the Constitution. However, in the competitive sociopolitical and economic process that also influences behavior and culture, power and resources determine which persons, ideas, values, and traditions prevail. Forces pressing for equality and for discrimination, for rights and privileges for all and for men only, for democracy and for slavery have interacted dynamically with the superior resources and power of the most influential--middle-class White Anglo-Saxon Protestants--often determining the outcome. Rewards and positive value came to diverse people who adopted the behaviors, customs, and language of this influential cultural group. The blending process and "melting pot" ethic at times prevailed over forces favoring separate though equal cultural and ethnic identities.

Native Americans, descendants of slaves, and immigrants all learned in countless ways that the individuals viewed as having the most value and power in the United States were those who embraced the homogenization of the melting pot. From the time of the Civil War through the era of the expansion of the West, and subsequently during the growth of urbanization and industrialization, this thrust toward homogenization urged would-be adherents to give up their ethnicities and abandon their pre-American cultures. To belong and to be embraced, people were encouraged to change their names; disavow old-country values, beliefs, and language; relinquish familiar cultural practices; and become generally ashamed of any identity that was less than "100 percent red-blooded American." "The proponents of the melting pot theory could be terribly cruel to ethnics who would not melt" (Solomon 1976, p. 176).

The pressures to adopt this sameness existed on every level of the American social system, remaining strong until the 1960s. In the field of education as in all other areas of American life this ideology reigned supreme, for the task of the public school system was conceptualized as teaching American democracy and English to the children of immigrants (Cafferty and Chestang 1976, xii). History, literature, art, music, as well as the sciences endorsed the value of cultural assimilation and provided no reference point for the culturally different except in depicting their culture as inferior and inadequate. Contributions of the unmelted were largely ignored.

In human services, the cultural blindness of the melting pot perspective was also the guiding ethic. In the fields of health, mental health, and social services, the needs and problems identified as significant to White middle-class persons were assumed to be the appropriate yardsticks for understanding and delivering services to everyone. The definition of problems, i.e., what is pathological and deviant, the theoretical constructs that determine assessment and intervention methods, the strategies devised, the programming of services, and even the evaluation of outcomes had been developed in terms of what seemed appropriate for the White American middle class.

For generations Blacks along with other people-of-color sought acceptance into this melting pot. Their hopes, brightened by the civil rights movement, were dashed when the White backlash showed them that they would continue to be excluded because they could not change their skin color. Realizing that the role and acceptance of a people are related to the resources, influence, and advocacy of its members, Blacks launched a determined effort to change the negative identity that Americans had forced upon them which had been used as a basis for their exclusion. In this undertaking, they struggled to develop pride, power, and a positive sense of identity based on their present attributes. That effort sparked the desire of other people-of-color and other excluded people to do the same.

Responding to the demands of Blacks and other people-of-color that they be viewed in terms of their strengths, coping efforts, and cultural adaptations rather than via projections and stereotypes, White ethnics also insisted on such recognition. Their claim to power and their movement toward reaffirmation of cultural identity was more than simply the cry of oppressed or minority groups; it became for many a method to achieve political aspirations (Fieldstein and Giordano, 1976). Now recognized as a significant source of group identification and an important factor in the values, family patterns, life-styles, and behaviors that have persisted over generations, ethnicity has become identified as a vital force in America.

There is increasing evidence that ethnic values and identification are retained for many generations after immigration...and play a significant role in family life and personal development throughout the life cycle....Second, third and even fourth generation Americans, as well as immigrants, differ from the dominant culture in values, lifestyles and behavior. (McGoldrick 1983, p. 4)

Such awareness has signaled to many that America is at last set on the course of pluralism, the original intention of the Founding Fathers (Papajohn and Spiegel 1976; Cafferty and Chestang 1976, p. xi). Its rediscovery is hailed as a sign that the country is at last beginning "to come to terms with the religious, racial, ethnic and geographic diversity that exists within its boundaries" (Greeley 1976, p. 6). Pluralism has also brought recognition of the high psychological costs exacted by the melting pot ethic. For many-- including those who chose to melt, those who did not, as well as those who could not--the price has been too high. Cut off from cultural roots and reference groups, they experience political powerlessness and a personal sense of isolation and become vulnerable to cultural ambiguity, negative identity, and psychological conflict. Many have sought relief from confusion, depression, alienation, and self-hatred in alcohol and drugs. Such consequences of cultural ambiguity have been dramatized by several novelists including Ralph Ellison (Invisible Man), Theodore Dreiser (Sister Carrie), and Abraham Cahan (Rise of David Levinsky).

Pluralism is now recognized as a welcome antidote for the sense of powerlessness, impotence, and rootlessness that pervaded American life for those who tried to melt (Fieldstein and Giordano 1976). Its validation of a group connectedness and positive cultural identity for everyone can bestow meaning and identity in a society grown complex and impersonal (Sanders 1975). An appreciation of pluralism nourishes attributes urgently needed in people today: psychological security, capacity for understanding, and appreciation of difference.

Recently the significance of pluralism and the importance of appreciating cultural difference have been further reinforced by the influx of immigrants and refugees from Southeast Asia, Central America, South America, and the Caribbean. In fact, the United States is now rapidly becoming "the most ethnically diverse society in the world" (Comas-Diaz and Griffith 1988, p. 2).

In the human service professions of health, mental health, social services, and education, the thrust toward pluralism in America has led to profound changes. Hospitals, health and mental health settings, and social agencies are now attempting to structure services that are sensitive to the cultural preferences of patients and clients. In the field of education, schools are now pressed to offer multicultural education and to include in the curriculum content on a variety of ethnic and racial groups.

Preparing teachers and practitioners to meet these challenges has involved the acquisition of knowledge about specific cultural groups and of skills for working with them. The ability to become comfortable with culturally different others and to recognize the relativity of one's own values are critical elements in professional training but are extremely difficult to develop. The development of cultural sensitivity requires first an awareness and understanding of one's own cultural background and its meaning and significance for one's interactions with others.

This book seeks to develop such an awareness by examining individual, racial, and ethnic identification and the psychological and social dynamics of interactions among individuals from diverse backgrounds. It will draw upon the experiences of people engaged in the search for cultural self-awareness and consider the implications for what happens and what should happen at the cross-cultural helping interface. Using this data the following chapters will examine the dynamics of ethnicity, race, and power, and show how they emerge in practice. It will demonstrate that the work involved in helping people may require changes on a variety of levels: in social structures, in people's definition of others and/or themselves, as well as changes in their behavior on different levels. And most importantly, it will demonstrate that the changes which are needed may well need to occur in the practitioner as well as in the client.

Culture and Human Functioning

The concept of culture is a complex one. The province of anthropologists, sociologists, psychologists, and other social scientists, it has been a topic of disagreement among scholars who have gotten entangled in the intricacies of the systemic processes characterizing it. One approach to understanding is the perspective of open systems, which emphasizes the interdependence of the many areas of human functioning that affect and are affected by culture. Thus, in order to understand individual behavior or emotion one must consider the relationships among the individual, the family, and the social system; the value orientations of the individual, family, subgroup, and social system; the geographical setting; and the interpenetration of all these systems and processes that operate in a reverberating and reciprocal manner. All of these factors influence and are influenced by each other, and they must all be taken into account in any understanding of culture (Papajohn and Spiegel 1976).

Culture may be defined as the sum total of ways of living developed by a group of human beings to meet biological and psychosocial needs. It refers to elements such as values, norms, beliefs, attitudes, folkways, behavior styles, and traditions that are linked together to form an integrated whole that functions to preserve the society (Leighton 1982). Ethnicity refers to connectedness based on commonalities (such as religion, nationality, region, etc.) where specific aspects of cultural patterns are shared and where transmission over time creates a common history. Race, while a biological term, takes on ethnic meaning when and if members of that biological group have evolved specific ways of living. An illustration of its having acquired a cultural meaning is seen in the use of the term White Anglo-Saxon Protestant. Ethnic values and practices foster the survival of the group and of the individuals within. They also contribute to the formation and cohesiveness of the group and to both group and individual identity.

The survival of the group and its members is best assured when the environment (defined as all that is external to the individual and family including the neighborhood, peer group affiliations, church, school or employment, governmental and economic institutions) provides appropriate resources at the appropriate time in an appropriate way (Germain 1979). Necessary resources, defined as protection, security, support, and supplies, ensure biological, cognitive, emotional, and social development. Lack, distortion, or excess in these environmental nutrients cause stress and conflict resulting in disorganization and malfunctioning on individual, group, and societal levels (Germain 1979). The interaction of the environment, whether depriving or nourishing, with the group, family, and individual is mediated by culture. On each of these levels culture contributes to the existence of environmental lacks and sufficiencies and to people's responses to these conditions.

The mediation function of culture is best understood through the concept of social role, which links the individual with family, group, and society via the culturally patterned behaviors that transact these various levels of functioning. Roles program individuals to adopt behavior that is complementary to that of other persons in these systems, while also satisfying inner needs and drives. Personality and ego functioning develop--the self evolves--through the unfolding of internal processes as stimulated by the environment. Key among environmental stimuli for a given individual are surrounding persons who enact these culturally programmed roles. The degree of reciprocity and complementarity in these roles helps determine the degree of conflict within the family, the group, and other parts of the social system. On these various levels of human functioning, culture via social roles acts as a mediator, determining life-cycle tasks and the criteria for appropriate mastery of them. These tasks include the development of trust; the acquisition of language; the management of psychological aspects of puberty;...

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