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Davidson, L. (1987). Supervision of Psychotherapy East and West. Am. J. Psychoanal., 47(3):230-236.
(1987). American Journal of Psychoanalysis, 47(3):230-236
Supervision of Psychotherapy East and West
Leah Davidson, M.D.
In the area of transcultural psychiatry and psychoanalysis, learning to understand the application of our therapeutic skills in cultural contexts other than our own is currently bringing us closer to what Harry Stack Sullivan termed “a psychiatry of peoples” (Sullivan, 1953, p. 367). These new applications necessarily involve an increase in the frequency of contacts with therapists from other countries both here and abroad, by those of us involved in the teaching and supervision of psychotherapy and psychoanalysis.
This trend has always been present. Many analysts who themselves originally came from Europe in the initial phase of American psychoanalytic history returned to lecture or teach elsewhere and to develop knowledge of skills not available locally. Erich Fromm's last years, for example, were spent both in Mexico and Switzerland, where he was active as analyst, supervisor, and teacher.
In the United States, the influx of foreign psychiatric residents in the 1960s sharpened the focus on the interchange of psychodynamic and psychoanalytic knowledge between Eastern, mostly Asiatic, students and American supervisors (Chen, 1981).
Major cognitive cultural differences in approaches to mental illness and human development became apparent to supervisors and residents at this time. At first, these seemed unsurmountable.
Unfamiliarity with these differences or failure to take them into consideration in favor of a standard teaching approach (e.g., over investment in one particular theoretical position) often led in such contexts to stalemates in the transmission of knowledge, with disappointments on both sides. Eager expectations were then abandoned, and often the patients were the greatest sufferers, since their therapists then turned to somatic therapies with minimal or no psychotherapeutic care. In this position, they were also supported by the return to the “medical model” in the middle 1970s on the part of the American psychiatric establishment (Davidson, 1982).
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