Making Contact with Culture: A Psychotherapist’s View

Kubik’s (2014) paper, Culture Contact: cognitive and psychodynamic aspects deals with interesting facets of the discourse of the concept of culture, that one would tend to overlook. It starts off simply, describing a scenario of two individuals holding passports from different continents. How do these persons view each other’s culture? How do they communicate their differences in culture? How much of the culture that represents each person’s heritage do each individual actually possess? How much do these individuals have in common?

Culture is learned.

In gestalt therapy terms, the learning is actually introjected (Clarkson, 2014, S. 58). Introjection is often also described as the act of swallowing information and influences without chewing it first. The difference between learning and introjection, is that learning is cognitive and introjection goes deeper— introjected material becomes the self. The resultant terminology is aptly called the cultural identity. Once it becomes integrated into the self, the self does not notice it any longer as material that is merely learnt. This could be a way of explaining why we tend to be blind to our cultural learnings.

The process of introjecting learned material in the cultural context can be described as enculturation.  Enculturation is a life-long process of introjections. This process serves the purpose of enabling the individual to integrate and function in the social sphere.

Society provides as much security as it traps the individual. This is how we also understand the concept of introjection – what we learn in this way is difficult to escape from if it doesn’t serve us positively. Hence throughout phases of life, we find ourselves having to deal with our cultural biases and adapting to other people’s culture.

The self as many voices.

I like to think of a learning of cultural elements as a way of obtain a new “voice” in our heads. Each introject is like introducing a new character or “face” (Satir, 1978/2009) in an intra-psychic theatre. As a child develops into adult these form the polyphonic voices similar to the ones we encounter in Dostojevskij’s novels (Bakhtin, 1984).  As the article mentions, these become our unique cultural profiles, which change dynamically with the influences we encounter in our lives.

Cognitive and Psychodynamic Levels of Learning

Learning involves being in contact with material. I guess that this is what the article alludes to with the term, cognitive level. We perceive and learn the material, but for the material to be internalized, it trickles thorough the psychodynamic aspects of our consciousness, the psychodynamic level.  What I am imagining is, that the perception of the learned material can be shared by separate individuals at the cognitive level, but each person makes meaning and introjects this material differently at the psychodynamic level.

An example is the symbolism of crows in Japanese culture as mentioned in the article, citing Akira Kurosawa’s (1990) film. Most persons at the cognitive level see the same crows— which are black birds— but the meaning different cultures make of crows are different. The Japanese culture, for example, sees the crows to be more injurious than perhaps other cultures. There are also explanations for it: the crows in Japan are bigger and more likely to attack people and property. Incidentally, in western media, the Raven, also a black bird is often depicted as a messenger of menace in literature—like in Edgar Allen Poe’s The Raven— and Hollywood films.

How Cultural Objects are Dealt with in Gestalt Therapy

Throughout my gestalt therapy training, we are constantly trained to be aware of the fact that we, as individuals, put different attributes onto tangible and intangible objects. These are also sometimes termed as cultural objects (Owen, 2015).  As gestalt therapist, we need to ask the client what the objects mean to them individually, so as to avoid assuming that we share the same meaning of the said object with our clients.

The content of the article is very relevant to our work as therapists. If we are able to be aware of our cultural biases, we will be better able to make contact with the client in therapy, thereby being more effective in understanding the client and his/her psychological issues.


Bakhtin, M. (1984). Problems of Dostojevskij’s poetics: Theory and history of literature. (Bd. 8). Manchester, UK: Manchester University Press.

Clarkson, P. (2014). Gestalt Counselling in Action (4th Kindle Ausg.). London: SAGE Publications.

Kubik, G. (2014). Culture Contact: Cognitive and psychodynamic aspects. Lecture at the University of Rome Tor Vergata Feb 25 2014.

Kurosawa, A. (Produzent). (1990). Dreams. [Kinofilm].

Owen, I. R. (2015). Phenomenology in Action in Psychotherapy.

Satir, V. (1978/2009). Your many faces: The first step to being loved. (Kindle Ausg.). Celestial Arts.

“Worst Problem” faced by Domestic Maids: Study

Extract from recent paper by Wessels (2017).

“Overall, a perceived distress as a result of coercive employer behaviour is evident. Abusive employer behaviour was indicated most commonly as the worst problem by the women in this study while working as a FDW in Singapore, while only 15% of FDWs mentioned excessive work to be the worst problem personally experienced, despite 93% of surveyed women facing excessive working days
or hours.

Findings suggest a tolerance towards exploitation, which is further perpetuated by the ease at which employers, particularly in Singapore, are able to deport migrant workers like FDWs back home. This might make it less likely that a FDW would raise any issues she may have with her employment conditions for fear of being sent home.(p. 104)”

My Interest on the matter

The article is concise and gives us a good experiential view of the nature of exploitation of these workers. My interest actually lies in the Singaporean psyche. Yes, the government (Singapore and the countries where the maids come from) and businesses have created a situation conducive for exploiting the maids. Arguably, we as citizens, have very little influence on this. Why is it then, do we have to add to the pain by behaving in abusive way towards the workers? What is the psychodynamic forces underlying the Singaporean culture that lead to “tolerance towards exploitation”? How is this hurting the Singaporean?

The problem with studies surrounding FDWs points the spotlight on the workers’ plight. This direction of attention has proven to backfire, especially with the Singaporean society.  Read this article of rebuttal published in Singapore’s most read english newspaper , and one can see the vehement denial, not of responsibility, but of acknowledgment that practices carried out by the Singaporean employer is a source of confinement and isolation, which are cause of psychological distress.

“Scenarios such as not giving the maid the house keys, needing permission to leave the house or other similar situations should not be considered as “isolation” or “confinement”, said MOM. (Straits Times) ”

I salute this study by Wessels It is food for discourse and hopefully awareness and change.  I find, however, we are in danger, with good intent to focus almost unilaterally on the plight of the FDWs. We have not not brought adequate attention to the pathological attitudes of the Singaporean society towards the maids, and how this way of thinking and the introjects that lay hidden actually compromise the lives of the average Singaporean themselves.

Certainly, the limitation of the already long paper does not permit this. However, in my opinion, it is a way forward, and needs to be done. Too much focus on the plight of the FDWs set this group deeper into the victim position in the eyes of the Singaporean public /and government.

As is stated in the article, there is a gross power disparity between the two groups: as in Hegel’s master-slave dialectic. The problem with focussing of the slave’s victimhood, one gives more power to the perpetrator. The way out of this is to empower the slave is to help him help himself, and to show the master that he is also a victim of the dialectic.

The same group of researchers have written a paper on part of this process that empowers the FDWs to support themselves: How to implement peer-based mental health services for foreign domestic workers in Singapore? 

It is probably time for someone to come forward with the next study, on what this phenomenon can tell us about the Singaporean psyche, and how it is affecting the average Singaporean life today.


Wessels, A., Ong, M., Daniel, D. (2017). Bonded to the system. Labour exploitation in the foreign domestic work sector in Singapore.

Peer-Based Mental Health Services for Domestic Workers

Sudev (2017), How to implement peer-based mental health services for foreign domestic workers in Singapore?, sets a positive way forward for Singapore in coping with the lack of mental health options available for this group of individuals.  As a Singaporean I support this idea, and am open to help in any way possible.

Foreign domestic workers (FDW) are a group vulnerable to severe mental stressors due to the nature of their employment. The article cites previously published studies, many by researchers from Singaporean institutions.

Risk factors identified regarding the mental health problems amongst FDWs are:

  • homesickness,
  • a lack of social support,
  • communication-related barriers, marginalization,
  • isolation,
  • lack of personal control and privacy,
  • employer restrictions and abuse.

Due to lack of support, the FDWs do not have an avenue to speak out, due to fear of deportation, and losing savings that they have invested in, in order to  get the jobs. Many regard approaching someone for help regarding a mental health issue as compromising their jobs.

“Despite this vulnerability, FDWs face substantial barriers to seeking help when experiencing mental health problems. This is due to their marginalized status in Singapore, an inadequate legal protection with a resulting fear of deportation due to ill health (including mental illness) and the lack of available formal psychosocial support services for migrants (Huang & Yeoh, 2003; Ueno, 2009).”

Delivery of psychological therapies by peers

Paraprofessionals are peers belonging to the community of concern are trained by professionals to provide necessary interventions to members of the group. In the field of mental health, psychological therapies are made available to a wider population through this system.
This allows the necessary services and treatment to be available efficiently and cost effectively to those who really need them. These paraprofessionals may, in some cases, also be better suited to work with the group, because of their relatedness to the culture of the  group.
This practice also provides the group with self-empowerment.

Encouraging Results from Study

The paper illustrates the steps in detail on how the first paraprofessionals were trained, and the results of the training. The result shows a positive step forward, and this is encouraging.



Sudev, S.  Wessels, A.,  Wong, H.M. & Keng, S-L. (2017). How to implement peer-based mental health services for foreign domestic workers in Singapore?. Retrieved from:

Nationalism and National Identity: Liberating and Destructive Aspects

Kelman explains to us the liberating and destructive aspects of Nationalism and National Identity. As a Holocaust survivor, he experienced the persecution of of nationalism of the National Socialists in Germany in WWII, and at the same time it is the Israeli nationalism that helped the Jews regain their self dignity and identity as a people.

Kelman spent decades working through the Palestine-Israeli crisis, negotiating peace and preventing death and destruction.


Kelman, H. C. (2016). Resolving Deep-rooted Conflicts: Essays on the Theory and Practice of Interactive Problem-solving. Routledge.

Conformity and Obedience: Slippery Slope to Dehumanization of the Other

The social consequences of conformity and obedience of a group to it’s authority figures. Conformity and obedience to a group (be it a nation, an ethnic or religious group, a company or a family etc.) are acts of loyalty, which, when acted out of consciousness is a slippery slope to the dehumanization of other people who are not part of the group, e.g ethnic minorities, foreign workers, etc.

What must we learn the extreme example of dehumanization? Kelman, a survivor of the Holocaust writes the steps that has led to atrocities:


Kelman, H. C. (2016). Resolving Deep-rooted Conflicts: Essays on the Theory and Practice of Interactive Problem-solving. Routledge.

The Function of Religion in Mental Health Today

Religion is in the modern “westernized” world today a topic of contention, that sparked off ever since the era of the Radical Enlightenment that began in the 18th Century in Europe. The situation is somewhat reversed in Asia because the religion of Asia was not Christianity till after this era. Since the theme of this website is not focussed on Religion or History, we cannot completely separate these aspects of cultural anthropology from modern life.

Religion founds the value system of the person. In Psychotherapy, we view the person’s wholeness. This includes the patient’s cultural background and religion. Religion is an important factor of life regardless of whether the person admits it to him/herself or not.

This is the focus of this article: to connect religion in mental health, and to mention the similarities and dis-similarities between the mindset of the two institutions– Religion (Christianity, in particular) and Psychotherapy.

Religion and Metaphors

Religion is transmitted by spoken and written word. Some are also depicted through art. There is hardly any religion in this world that is not transmitted through texts. Literature and art are language of metaphors. It is because of the use of metaphors that the meanings and wisdom of the texts can transcend through time.

Metaphors are poetic. These poetry contain truths about human nature and relationships, truth about our existence, our humanness as part of nature, and wisdom (Carveth, 2017). These are valuable messages that we learn through our culture and hand down to our children.

Much of this poetry is also transmitted through art. Visual art and music. This is how we attain the feelings and the essence of the religious influence.

As part of being human, we gain much from being able to absorb the images, poetry and music and make meaning out of them.

Some of these metaphors are considered myths. Myths are the stings that connect people in a group (Bion on Groups).

This is also known in Cultural anthropology as symbolism.

When we use symbols, we are able to grasp profound meanings through the symbols. We do not just look at the symbol as an object for what it is.

For example, a dove may symbolize peace. When taken literally a dove is just a white bird.


Religion against Pathological Narcissism

Narcissism is a word that very much belongs to the world of mental health. To the psychotherapist, narcissism is the root of mental and relationship issues. Religion, in its roots, and psychotherapy share, in a way a common goal of weaning man out of narcissism. There is a differentiation between healthy narcissism and unhealthy narcissism. Healthy narcissism is a self-preserving instinct that help us excel and survive in life. In this context, unhealthy narcissism is being referred to. Unhealthy narcissism is a borderline-operated personality structure as defined by Kernberg.

Read also: Kernberg’s Model of Narcissistic Personality Disorder

The intrinsic value system most religions is one of denouncing self grandiosity, entitlement and the exploitation of others. In the beatitudes recited by Jesus, it is written in Matthew 5:1-12:

“Blessed are the poor in spirit,
    for theirs is the kingdom of heaven.
Blessed are those who mourn,
    for they will be comforted.
Blessed are the meek,
    for they will inherit the earth.
Blessed are those who hunger and thirst for righteousness,
    for they will be filled.
Blessed are the merciful,
    for they will be shown mercy.
Blessed are the pure in heart,
    for they will see God.
Blessed are the peacemakers,
    for they will be called children of God.
10 Blessed are those who are persecuted because of righteousness,
    for theirs is the kingdom of heaven.”

In the beatitudes, Jesus lists out the qualities in a person’s character, and this aligns with Kleinian thought: that healing comes with the ability to mourn, accept one’s weakness, reconciliation (accepting others’ guilt and hence one’s own). Read also: The Manic Need to Control : Kleinian Theory

Religion against Idolatory

The grandiose self-image, and all the objects associate with this image (i.e. wealth, intelligence, looks…etc.) are the worshipped idols. The person is fixated on them, and has no time for anyone else. Idolatry is a projection of value on to external objects. It is a means of being a creator of something/someone greater than oneself. Underlying is the need to feel omnipotent, avoiding the shame of being small.

Religion against Self-Omnipotence, Pride and Oppression of Others

The narcissist lives in a state of constant need for omnipotence. No man is omnipotent, because we are vulnerable to the forces of nature. Eventually we get weak and die. The narcissist cannot deal with that and works against this dreadful thought by creating mental scenarios, idealization, demolishing others, envy, ambitions etc. Victimization of other persons by devaluing, discriminating against, bullying, alienating… is a means for the narcissist to deny his or her own vulnerabilities. He/she gets a taste of overcoming these vulnerabilities by annihilating the spirit of other people who he/she perceives to have these qualities.

Religious literature and art do teach us to overcome our self pride and grandiosity, and be kind and empathic to other beings.

Religion against Envy

Also a part of gaining omnipotence is the need to grab what is seen as good in other people. Read more about envy here. Religions tell us to “be thankful”. In many religions there is a kind of celebration of thanksgiving. Psychoanalysis mention too that gratefulness is an antidote for Envy.

Religion for Guilt and Reparation

Most religions have concepts of guilt and making reparations. Read about Guilt here. As human beings we often are tempted to do deeds that interfere with the wellbeing of others, and that our conscience tell us is not right. We feel guilt. Sometimes we feel guilt if we cannot fulfill our duties because we are human. Guilt is hence felt when we have humanity and compassion in us.

In pathological narcissism, guilt feelings cannot be felt by the individual. The pathologic narcissist has a mental issue that blocks out guilt feelings and empathy. When no guilt is felt, no reparation can be made.

Reparation is practiced in many religions. We are sorry and make up for it. According to psychoanalysis, reparation is the route to empowerment of the self. When we fall, we repair. We know then that we can overcome our failure and live stronger.

Read also: Making Reparation & Mourning as the Road to Mental Healing

The narcissist who cannot feel guilt and cannot repair becomes more paranoid.

Religion is our source for ethics, aesthetics, anthropology and should ideally be a cure for narcissism.

Religion and Magical Thinking

Religions also include what many may call “magical thinking”. Belief in “facts” we cannot rationalize. These are things that we will never be able to prove exist or doesn’t exists, and things that we leave to faith, because they are ungraspable.

While the wisdom and insights to human existence correlate overall in different religions, it is the content of this magical thinking that differ in different religions. This content that differs sometimes cause conflict between groups of people of different religions.

Julien Offray de la Mettrie

When Abuse of Religion cause Suffering

In today’s world, as it was in the days of the Enlightenment, people suffered because of abuse of religion by religious institutions. The ways people suffer because of religion:

  • Being oppressed by religion.
  • Being persecuted due to religion.
  • Being shamed by religion.
  • Being judged by religion.
  • Restriction of freedom /rights by religion. etc.

When this happens, we see the narcissistic side of religious institutions. The very act of omnipotence, grandiosity, pride and envy is enacted by religious institutions, and this causes immense suffering.

Psychoanalytic theory explains this as a phenomenon of the loss of ability of religions to separate the metaphors from the objects. The taking of metaphors literally. Seeing the white bird instead of peace in a dove.

In narcissist, this inability to symbolize is well documented. There is splitting of the psyche in the paranoid-schizoid position, and the person (in this case the institution) sees things in black and white. This split person is devoid of empathy and a sense of being one with humanity. Like a narcissistic person, a narcissistic institution idolizes and is concerned about its grandiose self image. It is against everything the religion it represents is about.

Put under the microscope, no religion is free from narcissism. Not even the so-called New Age or the Atheists!


Psychotherapists would often say that it is highly unlikely for a narcissist, especially a malignant narcissist or psychopath would ever show up for in their practice. It is usually the victims of these narcissists that seek help because of abuse. Pathological narcissism is a cause for suffering and environmental damage. It has been mentioned, that we live in a culture so terrified of tenderness, that we are drawn to pick up narcissistic traits ourselves. This too is the root of much of our mental pain.

Freud was quoted as saying that the cure for mental illness is the cure for narcissism, and in order for that to happen, one must learn to love. Melanie Klein says the antidote to envy is gratitude.

That said, I am not subscribing to adopting an attitude of accepting powerlessness, uselessness or total abandonment one’s rights. This kind of new-age mentality reflects also black-white thinking of the paranoid-schizoid position, and describes masochism, which harms more than it serves. There is, after all a concept of healthy narcissism and healthy use of envy, which serves to preserve the organism (self) and serve the environment (others).

Rather than deciding to be for or against religion, we could figure out for ourselves what works for us as individuals in the realm of spirituality and religion. We may also choose to look around us with unbiased eyes so that we can see what serves the world that we have and what destroys. This is probably our best guide.



Carveth, D. (2017). F&B 2017F Religion. Retrieved from

Privacy as Personal Control

“Personal control” was identified as the psychological concept central to privacy.

Definition of Privacy

Wolfe &Laufer (1974) write: “The need and ability to exert control over self, objects, spaces, information and behavior is a critical element in any concept of privacy” (p. 3).

Three aspects of privacy, all of which are concerned with control:

  1. freedom to choose or control of choice,
  2. control over how much access others have to one’s thoughts and behaviors,
  3. control over how much the environment can affect one, i.e. the ability to shield oneself from the effects of the environment if necessary.

Altman (1974) defines privacy as “the selective control over access to the self or to one’s group” (p. 6).

Definition of Personal Control

The term “personal control” is related to terms like “autonomy,” “freedom,” and “power”.

Personal Control as a Psychological Concept

Byrne and Clore (1967) : Situations that threaten a person’s perception of personal control are noxious to the person. This motivates the person with the need to attempt at restoring effective control over him/herself in the situation. The person adapts to the situation by reacting in a way to maintain personal control.

When personal control is greatly compromised, and if the situation is not improved, the individual adapts to this situation through behavioral responses, and/or psycho and somatic responses, which are part of the creative adjustment to the adverse environmental situation.

This is not different from the response of a person to traumatic situations. What are the symptoms of trauma? What are the adaptations to traumatic experiences?

Privacy may be described as two-way information control. For Altman, “Privacy is an interpersonal boundary control process, designed to pace
and regulate interactions with others” (p. 3, emphasis added).

Wolfe and Laufer (1974) suggest that privacy has three aspects:

  1. control over choice,
  2. control over access, and
  3. control over stimulation.

Westin (1967) : Privacy is the “claim of individuals, groups or institutions to determine for themselves when, how, and to what extent information about them is communicated to others” (p. 7)

“…the most serious threats to an individual’s autonomy is the possibility that someone may penetrate the inner zone and learn his secrets … [which] would have him naked to ridicule and shame and would put him under the control of those who know his secrets” (p. 36, emphasis added).

Interesting point. What is the intention of the other to deprive the individual of privacy? Control? What is behind this behavior? Fear? misstrust? Insecurity? How does projective identification does this.

Kelvin (1973) views privacy as a kind of counterpower that one can exercise to modify or nullify the perceived power of others. “Thus privacy is not simply freedom of action due to the absence of intervention or constraint, but freedom in a context of potential power which might inhibit it” (p. 11).

In sum, privacy as control is behavior selection control. As such it is particularly immune to consistency validation. As a result, privacy concerns are more likely than many other control concerns to create conditions for stress. Research suggests that disease may be a consequence of uncertain outcome control (i.e., low behavior-selection control, Weiss, 1972). Other data suggest that suddenly losing control–as when behav- iors which previously had been adequate, fail to work in a new situation– is also highly predictive of disease (Stroebel, in Luce, 1971).

Holmes and Rahe (1967) found that chronic disease correlated highly with
the magnitude of social readjustments required of people in a given duration. The authors argue that uncertainty, especially about how to act in new situations, produces stress that contributes to disease. Certain aspects
of privacy as well (i.e., uncertainty about privacy requirements) may prove contribute significantly to disease. Some concern about this relationship has been expressed recently in the medical literature (Kornfeld, 1972). In view of these possibilities, imaginative and well-designed research into

the relationship between privacy and disease, especially between privacy and recovery from disease in hospitals and other treatment facilities, is called for.


Johnson, C. A. (1974). Privacy as personal control. Man-environment interactions: evaluations and applications: part2, 83-100.

Altman, I. Privacy: A Conceptual Analysis. In S. T. Margulis (Chm.), Privacy as a Behavioral Phenomenon, Symposium presented at the meeting of the Environmental Design Research Association, Milwaukee, Hay, 1974.

HOLMES, T. H., &RAHE, R. H. The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 1967, 11, 213-218.

KELVIN, P. A Social-Psychological Examination of Privacy. British Journal of Social and Clinical Psychology, 1973, 12, 248-261.

WOLFE, M., &LAUFER, R. S. The Concept of Privacy in Childhood and Adolescence. In S. T. Margulis (Chm.), Privacy as a Behavioral Phenomenon, Symposium presented at the meeting of the Environmental Design Research
A ssociation, Milwaukee, Hay, 1974.

WESTIN, A. F. Privacy and Freedom. New York: Antheneum, 1967.