99
problems
but
migration
ain´t
one
Why do I make the aspect of culture/race explicit?
1. BIPoC, ethnic minorities, expats, and people with migration backgrounds make significantly less use of psychotherapy and counseling than members of the local cultural majority — even though they are often particularly burdened by minority stress and discrimination. This is due in part to limited knowledge about the available healthcare options, a lack of culturally specific services, or fear of discrimination which — let’s face it — also occurs within the healthcare system.
​
2. So that clients know that I intend to take their experiences seriously.
It is not uncommon for BIPoC, ethnic minorities, expats, or people with migration backgrounds to feel hesitant about approaching a white and/or German therapist. They may wonder whether they will be safe from discrimination, whether their lived experiences are known, taken seriously, and understood. Whether they can openly talk about discrimination, racism, and marginalization. Whether they can articulate their perceptions freely without causing offense or facing consequences. Whether differences in identity and privilege might complicate the therapeutic relationship.
I cannot exclude the possibility of negative experiences with me. I have not lived your life, I do not know your circumstances as well as you do, my cultural knowledge is limited, I have unconscious biases, and I make mistakes.
However, my intention is to take you seriously, to build professional knowledge, to continue developing myself, and to apologize if I act insensitively. It is important to me that you feel able to speak openly about your experiences. I value cultural diversity and want to support you in feeling safe, confident, and comfortable with your sense of identity.
​
3. To clearly acknowledge that (inter-/trans)cultural factors can play a significant role in the development, maintenance, and interaction with psychological difficulties.
Antisemitism, (cultural) racism, discrimination, and marginalization are not fictions — they are structural, institutional, and interpersonal forms of injustice and violence. They may be interpreted and processed differently on an individual level, but they are not perceptual distortions or misinterpretations of reality. I consider it an ethical, factual, and professional responsibility to address this openly.
​
4. Because psychotherapy itself is structured in an ethnocentric way.
Historically, most psychological models were developed by and for white, wealthy people in the Global North. Yet the values and norms of other cultures often differ substantially — and thankfully so. Diagnostic methods rarely include culturally specific comparison samples, which makes interpreting test results more difficult. There can be communication challenges not only on the linguistic level but also on the level of meaning (e.g., metaphors, “organ idioms”).
A lack of cultural knowledge and the presence of stereotypes can have serious consequences. Misdiagnoses, inadequate treatment, and harm can occur if cultural aspects are not properly considered.
How do I envision culturally sensitive therapy?
1. How you wish to engage with cultural aspects will always remain your decision.
This is a personal choice that falls under the therapeutic principle of patient autonomy. My role can only be to outline different perspectives and their possible implications. As someone who is culturally privileged (white, German), it is not my place to expect a particular stance from you. Within the framework of my professional responsibility, your well-being is my priority, and the only relevant question is which way of engaging with cultural aspects is most supportive for you.
​
2. Do we have to emphasize these aspects?
No, of course not. My intention is not to force this topic, but to be prepared for it if you wish to address it or if it becomes relevant. A categorizing or dividing mindset in terms of “me vs. others” (ingroup vs. outgroup) can lead to feelings of isolation, alienation or lack of connection / belonging. Some people experience that highlighting issues such as discrimination and racism increases their sensitivity and can intensify their distress. Others do not consider the cultural aspect personally relevant — which I regard as equally legitimate.
​
3. What is my professional perspective on cultural aspects?
Cultural identity always emerges in relation to certain marked groups that are perceived as similar or different with regard to particular characteristics. It is therefore formed through differentiating (assumed) commonalities and differences between oneself and (groups of) others. The criteria used in these comparisons are socially constructed and, in principle, arbitrary — yet historically shaped and highly meaningful in everyday life. For example, a person may be perceived as a Person of Color in Germany, but as white or light-skinned in parts of Africa or South America, leading to very different experiences of privilege.
I understand cultural identity aspects as cognitive categories shaped by social experience, which can become relevant within interpersonal and societal dynamics. Certain features (e.g., skin color, nationality, language) can entail similar experiences and privileges, for example in relation to power and access to resources.
​
A central contemporary theory in analyzing cultural aspects is intersectionality. It examines and describes the interactions between different identity attributes and their consequences (e.g., in terms of privilege and discrimination) for individuals.
Thus, a person may be privileged in some respects (e.g., cis and heterosexual) while being disadvantaged in others (e.g., nationality, skin color). Even people who share one identity characteristic (e.g., homosexuality) may have very different experiences depending on other attributes — for example, coming from a secular upper-class background vs. a traditionally religious working-class background.
Another important theory informing my work is poststructuralism. It holds that knowledge cannot be entirely objective, but is shaped by discourses, power relations, and social conventions. It emphasizes the virtually endless diversity of interpretations and perspectives.