In context


When I began studying anthropology, a subject matter which I now think of as at the core of  my identity on a professional and personal level, it was presented to me as a discipline understanding society through the study of ‘other’, ‘exotic’ cultures. Culture in this sense, always took place somewhere else, which assumed that our everyday reality was just ‘normal’. The irony during that first year of living in London and studying for a masters in social anthropology at the LSE was that everyday life and culture in a British urban context, which apparently was not considered worth studying from an anthropological point of view, was extremely alien and ‘other’ to me, as though my world had been turned upside down.

 I had travelled extensively and lived in Europe before, so I did not expect the degree of culture shock I was experiencing. Everything seemed so difficult, disabling and at its worst, possibly life threatening. Figure for example, trying to cross a busy road near Rotherhithe tunnel, where my hall of residence was. During those initial weeks of living in London, it proved almost impossible to look first right and then, left before crossing the road, and not the other way round, which meant invariably not registering the cars approaching at considerable speed. Everything was placed the wrong way, the doors, the taps in the bathroom, the cooker which was gas operated and not electric. The concept of a café in the Docklands in 1993 was unheard of, if not laughable, and that first morning coffee which I had considered a basic ritual of starting the day since I had turned eighteen tasted plainly wrong despite my best efforts to adjust to the British context of a kettle and a cafetiere. My context was lost and that left me deeply disorientated.

            This week I received a long email from somebody who had also tried to reach me over the phone and which I found incredibly irritating. It was clearly addressed to me, but the context was totally wrong from suggesting a talk over the bank holiday weekend for ‘business’ to assuming I would be interested in quantitative research in psychology (I am not!). Despite my common sense telling me to treat the email as spam and not to reply, I ended up writing to the person and asking them not to contact me again. It took me a while to realise what it was that I found so annoying, but I think it was clearly the lack of being tuned in to my context. The email was coming from America and it was taking for granted a different cultural context such as the predominance of evidence based practice and working over the weekend, even when it is an extended bank holiday weekend.

This grating incident brought home to me how much psychotherapy can only be practised within a particular cultural context, how it is deeply rooted in locality and cultural specificity. This is almost paradoxical at a time, where the world of psychotherapy is considering a significant paradigm shift through the crisis of the pandemic, i.e. the possibility of working online with people living in other places in the world. As much as this is exciting, is there a danger there of cultural dominance, i.e., of assuming that our specific context is shared by another with significantly different life experiences, like the person who sent me the email did? And what about being lost in translation, interpreting what we hear according to our particular context and what is considered ‘normal’ or ‘acceptable’ within it? I have noticed repeatedly in recent years, while working with patients who live in other parts of the world, how much they try to inform me subtly about the specificity of their context. But could it also be that they sense that I am interested in understanding where they are coming from? It seems to me that any theory (and especially any theory that informs clinical practice) operating outside context runs the risk of becoming reductionist and pathologising, in other words, doing more harm than good.

            Yet, one of the creative gifts of the pandemic for me, which admittedly had also started on a smaller scale before (see above), was the possibility of reaching out across cultures and working with people living in significantly different cultural contexts. My practice in any case, as well as my everyday life in London, has been hugely cross cultural and after the initial culture shock, I began thinking that London was a great place to live for those who, like me, did not feel like they could belong in a straightforward way, for those who preferred to be misfits. What has been a real eye opener for me this week though is to what degree I have unwittingly integrated cultural context in my work and social life. When I meet somebody, whether a new patient or a potential new friend, I look out for their context. This is in my mind diametrically opposed to stereotyping, such as determining whether this person is for example, French, gay, middle aged, middle class and so on. In truth, context always entails stories and the uniqueness of each encounter. It is about who we are at a particular moment in the encounter with an-Other and how we have integrated all the places we have been connected to and all the narratives which have marked us and have become part of our identities.

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