Dr Shahieda Jansen
Right from the start of my career as a psychologist, I struggled with a sense of alienation, with feelings of resistance to the very idea of “being a psychologist”. After qualifying as a psychologist I self-identified as a researcher in health program development for many years. I finally surrendered and ventured into a brief spell of private practice but I apparently never carried myself like a therapist. “You do not behave like other psychologists” was the casual observation of the receptionist at the private practice where I rented room space.
Concerns with fitting in and an awareness of genuine feelings of being “part of” evading me, fuelled exploration of myself. What kind of self was I? Self-analysis laid bare my narcissistically injured self, self-esteem issues, chronic self-doubt and fears of my own competence (to name a few!). What personal self-analysis failed to answer though was why feelings of alienation tended to escalate in certain social contexts. Were there irreconcilable differences between my collectivist upbringing and the individualistically organised culture of the profession of psychology?
Self vs. non-self
Grappling with alienation in social settings gradually led to me reading compulsively on ‘the configuration of self’. The configuration of the self refers to the degree to which we conceive of a person as separate and self-determined (Kitayama, Markus, Matsumoto, & Norasakkunkit, 1997). It seems that all cultures draw a distinction between the self and the non-self (Heelas & Lock, 1981). Societies differ at what point the line is drawn and the porousness of the boundary, resulting in a continuum of individualisms and collectivisms, or diverse configurations of self.
A major influence in foregrounding the self against its backdrop is the assumption of reality as meaningful. The majority of the world’s citizens subscribe to a two-tiered worldview, a level of meaning alongside ordinary living. In two-tiered societies, collectivist formulations of the self are the more common approach to personhood (Christopher & Hickinbottom, 2008). This is in contrast to the empty self of one-tiered modern western industrialized societies, empty because the self is estranged from community and tradition (Cushman, 1990).
Psychology as I was taught is an off-shoot of modern western industrialized societies. Modern psychology’s deep, subjective, independent and private self is detached from its structural-cultural context (Christopher & Hickinbottom, 2008). This locus of self on the individualism-collectivism spectrum, has ramifications for the whole therapeutic chain of events. Alliance formation and contracting, interpretation of problems, diagnosis, considered solutions, as well as treatment and recovery, are all responsive to self-construal.
We are familiar with conventional psychology’s construction of emotional experiences as strictly internal affairs, even though scholarship on emotions suggests the contrary (Barbalet, 2001; Zorn & Boler, 2007). Our personal emotional injuries may be but one layer of dysfunction that sabotages our wellbeing. Socio-economic access, our neighbourhoods and the institutions we frequent may all form part of emotional geographies that shape and colour our subjective experiences (Barbalet, 2001). Hence, a personal narcissistic wound may be a necessary but insufficient explanation for the experience of invisibility in certain cultural contexts, a vital caveat worth inserting in postcolonial post-apartheid South Africa. Personal, cultural, professional, political, racial and societal forms of narcissisms may co-exist. Institutional and cultural expressions of narcissism can activate the same feelings of invalidation, alienation and invisibility as its personal form.
Little me vs. Big me
A Chinese framework of self to which I have been drawn because of the synergies between Eastern and African collectivist conception of the self (Kitayama, Markus, Matsumoto, & Norasakkunkit, 1997), conceive of individual level psychological injuries as “Little me” insecurities (Dien, 1983). Within the Chinese model of self “Little me” constitutes the individual or personal dimensions of the self. “Little me” is distinguished from “Big me”: cultural, group and existential dimensions of the person (Dien, 1983).
My narcissistic injuries are personal (Brown, 2008). I have a “hole” in myself. Notwithstanding my personal insecurities, when I am surrounded by those who reflect both “Big me” and “Little me” dimensions of myself, in other words, when my whole self is welcomed, and I am individually and culturally embraced, my confidence level soars. Even in tough and strife torn environments, I am able to access and express creative aspects of myself because of a more holistic experience of belonging (Fernando, 2018). I then feel seen and validated at interconnected, multiple levels of my being. I am an individual, and simultaneously an expression of my acquired primary discourses. Or as I sometimes say out loud, I come from dysfunction, but I do not come from emptiness. Some western trained mental health professionals may be unaware of their existential emptiness (Frager, 1999). They may have a “hole in their universe”, and unwittingly subscribe to a “punctured view of reality” (Fernando, 2018). Such a “Big me” affliction is not as perceptible, and is less amenable to cure, at least with conventional therapeutic methods, according to Cushman (1990).
Obsessed with pathology?
The problem of modern western psychology is not essentially intellectual; though conceptual confusion abounds. We routinely assume as psychological what many cultures perceive as spiritual (Heelas & Lock, 1981). Our concept of health may be limited to the absence of symptoms. Hence clients’ approach to sickness, health, and even the good life may not overlap with ours (Christopher & Hickinbottom, 2008).
Cultural associations of the continuity of mind and body, may be at variance with professional psychology’s dualism of mind and body (Fernando, 2018). We may not have been trained to theorise the subjectivity of our clients (Teo, 2017). We are unfamiliar with their socio-spiritual traditions because we were mostly rewarded for expert problem cataloguing (Schultz-Ross & Gutheil, 1997). The detection of problems is an important skill, but in the absence of a more holistic grasp of personhood we remain blind to obvious human capabilities, socio-cultural resources and self-healing capacities (Schultz-Ross & Gutheil, 1997). When pressed we may not be able to respond with a vision of a well person (Efran, 1991). In our obsession with pathology, we miss flashes of quantum healing during moments of openness to the “whole of the client’s being”.
Furthermore, when we embolden the self as more self-sufficient than it really is, we neglect to connect clients to their bodies, other people, spirit and culture or animals and nature (Jasanoff, 2018). And we ignore the proposal from affective neuroscience that the basis of the primordial self is emotion, the self is primarily constituted by affect, not cognition (Alcaro, Carta, & Panksepp, 2017) .
Even so-called “uneducated” clients are rightfully wary of the risks of consulting with modern mental health professionals. They are perplexed by our overzealous psychic excavations – for “demons”, without pausing to celebrate their street wisdom and survivalist grit. They appreciate that our exclusive “pedalling in pejorative labels” poses a threat to their survival.
Toward a psychology of who we are
So how do we move forward? How can individualistic psychology plug that “hole in its universe?” We begin to bridge the credibility gap in mental health care when we judiciously integrate client meaning frames into our psychological formulations (Patel, 2014). A good place to start is to mourn the loss of ontological density of psychology’s individualistic, separate and private self, as we elaborate on the socio-historical and political contexts that gave rise to the empty self of the modern industrialized west (Cushman, 1990).
Students in psychology will then learn about Freud but also about a psychology sensitive to its location in Africa (Ratele, 2017). The time has come to learn, teach and practice psychologies that manifest the layers of realities of its learners, teachers and users. We seize the moment to re-articulate Africa’s heritage of modernist psychology towards a psychology of who we are (Yazdi, 1992).
Transformed assumptions of the self may translate into small steps forward in the project to decolonize psychology. At the heart of many local cultural and religious traditions is a social view of the self. The cross-cultural therapeutic encounter has a greater chance of success with enhanced sensitivity to the values of persons socialized in collectivist traditions (McCormick, 1996). Even when people from collective traditions refer to their individual selves, it may still be with reference to their group selves (Kitayama, Markus, Matsumoto, & Norasakkunkit, 1997).
Lastly, openness to engage with the stigma that modern mental health care routinely attracts may increase awareness of epistemological violence in psychotherapy, expressed as alienating miss-attunements, micro-ruptures and subtle aggressions. We can remain psychodynamic, cognitive behaviourist or eco-systemic, and assimilate the right degree of client meaning frames, while being more radically ethical about psychotherapy as an encounter laced with the “holes” of its practitioners.
Dr Shahieda Jansen is a registered clinical psychologist and a certified group therapist. She is Deputy Director: Academic Support and ICT at UNISA, Western Cape. Previously she was the Manager of Student Counselling at the University of the Western Cape (UWC) where she coordinated the psychological and broader developmental needs of the students and supervised and trained Masters-level psychology interns. Her PhD thesis was entitled “Emotional experiences of participants of all-male psychotherapy groups”. She writes this article in her personal capacity.
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