Cultural Incommensurability in Psychodynamic Psychotherapy in Western and Japanese Traditions

PURPOSE: To examine cultural incommensurability between clients of Japanese ancestry and Western therapists. DESIGN: 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. FINDINGS: 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.