We, as counsellors, hope that we can ‘meet’most clients empathically; and it causes us toreflect when we can’t. Whilst our difficultiesmay be about a number of factors, it is worthappreciating that sometimes culture and faithmay impact on our ability to be empathic.Western models of psychotherapy – the lensthrough which therapeutic process is oftenunderstood, and on whose ways of ‘being’ and‘doing’ therapy is often based – are not alwayshelpful, particularly when cultural and faithmatters are more overtly significant to thecontext of our client’s life.
It is generally accepted that the relationshipbetween the therapist and the client is a vitalpart of the therapeutic experience. If the clientperceives the relationship to be good, andparticipates in the therapy, then the outcomeis often a positive one1. To achieve the mosteffective working alliance, considerationshould be given to the compatibility of thetherapist and client, which suggests thatfactors such as class, background, culture andethnicity need to be considered. But does thatmean that Peter (a white, liberally Christianman) couldn’t work effectively with Jasbinder(an Asian, Sikh woman)? No, but there may bea need for greater awareness of cultural andspiritual aspects to the relationship. In writingthis article, we are aware of the difficulties of expressing concepts in a way that recogniseand embrace the uniqueness of eachindividual. Yet, we appreciate that commonexperience and context can only be writtenabout in a shared sense, which can be accusedof being stereotypical. We honour the fact thatnot all Sikh clients (nor counsellors) will sharewhat we are expressing, but many will – andheightening awareness of potential issuesthat may impact on therapeutic process isour intention.
Although multiculturalism has become moreaccepted by host cultures, there is still a level ofmisunderstanding, ignorance, preconception,and sometimes mistrust of other cultures.Morris Jackson2 points out that even insocieties where different cultures live alongsideeach other, and there is an apparent sharedunderstanding of one another’s cultures, theystill appear not to be able to relate to each othereffectively. Therapists and clients are part ofthis society. Counsellors and psychotherapistshave to be aware of their own beliefs,assumptions and attitudes towards peoplewho are culturally or racially different3.
In Jasbinder’s experience, often clients fromminority ethnic groups have had to overcomebarriers such as racism, and as a result of this, make drasticchanges to their own beliefs, moral code and values, inorder to survive in the host country and to develop theirown coping strategies. The client may have expectationsof the therapeutic process and outcome, which are farbeyond that which are actually achievable. There maybe a temptation for the therapist to perceive a client fromanother culture in a particular way which mightunintentionally lead to bias, eg common misconceptionsheld by the therapist may be that everyone from a particularculture is perceived as sharing the same beliefs, customs,language, and morals or value system (indeed this articlemay read as if they do!). Yet without some prior knowledgeof an individual’s culture, it is very difficult for the therapistto be able to offer the core conditions for therapeuticgrowth, or build any kind of positive therapeuticrelationship with the client.
Unconscious judgmental and discriminatory attitudes maywell lead to negative therapeutic outcomes. Counsellors needto be willing to explore their own culture and racial origins inorder to better understand their own cultural identity, beliefsand values. Any assumptions that the counsellor mayunconsciously have, may be received by a client of a differentculture from their own as racism – not an aggressive racism,but racism in the form of the ‘assumption’ that it is the cultureof the client that is the cause of the problem; because it doesnot fit a Westernised understanding of self-actualisation orprocess. The difficulties faced by culturally diverse clientsmay be quite different to those experienced by clients fromthe host culture.
Even with some prior knowledge of a client’s culture andbeliefs, there is still a danger that the counsellor mayassume that two clients, who appear to be from the samecultural background or geographical location, will hold thesame values and beliefs. Simple things, such as seating andpersonal space, may be something to be considered, ascertain body posture, eye contact and other gestures maybe interpreted incorrectly by the client.
Also the support systems that exist within other culturesmay have an impact on the therapeutic relationship andprocess. Support systems such as the family, community,religious and spiritual institutions, and religious leaders, areall areas of support that clients from South Asian cultures,from which many Sikhs come, may turn to. Many SouthAsian people are not willing to talk about their emotions,nor are they accustomed to self-analysis4 and would expecttherapists to be authoritative and directive in theirapproach; this may compromise some therapeutic models.Some knowledge of the client’s culture may be useful to thecounsellor; for example, the client’s role within the family orcommunity and how this impacts on the client and theissues that are affecting the client. It has been asserted thatthere has been a tendency by the host nation to try andassimilate immigrants by expecting them to forget abouttheir own culture and adopt the culture of the host nation5.In our opinion these are completely unreasonableexpectations, as the roots of a person’s culture run far toodeep for them to be severed so easily; nor should they beexpected to in an attempt at integration. Their cultural andreligious beliefs, values, rituals, family structure and dietarypractices are all part of their upbringing and of what makesthem who they are5. From a psychological perspective, thefamily structures, kinship patterns, and rules that governtheir daily lives, are important. This includes the role ofwomen, what constitutes abuse in their culture, howchildren are raised, ways of grieving and mourning, andthe role that ritual and religion play in their daily lives.
One of the oldest healing traditions in the world is theIndian healing tradition. As far back as 1300BC, healers andphysicians in India had a holistic concept of health; andmental and spiritual health was given significantimportance. Even today, many South Asian people whosuffer from stress (or other more serious mental illnesses)will often go to their religious place of worship to try to findsome inner peace, sometimes turning to the religiousleaders within these institutions for guidance. One of thepsychotherapy models for use in India was proposed byNeki6. This is the Guru–Chela model of the therapeuticrelationship and was seen to be ideal for Sikh clients. ‘Guru’essentially means teacher and or spiritual guide or leader,and ‘Chela’ means disciple. This form of therapeuticrelationship sits well with some people of South Asianorigin as the relationship puts the Guru in charge of themind and soul, and the disciple is happy for the Guru totake them on a therapeutic journey which will alleviatetheir suffering. This is tenable where self-discipline isto be inculcated into clients, and where direct guidanceand advice is sought from the therapist in order to createharmony between the client and society6.
The Sikh culture shares certain traditions with the widerSouth Asian community. It is distinct however in itsreligious beliefs, spiritual traditions, customs and culturalbehavioural patterns. The Guru-Chela model fits well withSikhism as the teachings of the 10 Gurus are at the core ofthe religion. The word, ‘Sikh’ means, ‘to learn’, or ‘learner’.The 10 Sikh Gurus taught a philosophy which was farremoved from the religious codes and teaching of the otherreligions that were prominent at the time. These teachingsare all within the Sikh Holy Scripture, ‘the Guru GranthSahib’, which was pronounced as the present day Guru bythe 10th living Guru, Guru Gobind Singh. The Guru GranthSahib (GGS) is the central focus for Sikh worship. The keyconcepts in Sikhism are: God is one; equality; voluntaryservice; meditating on the name of God and spiritualliberation; earning by honest means; and sharing withothers. In Sikhism, religion and ethics go together. Living avirtuous life in accordance with the five virtues written inthe Guru Granth Sahib is vital if spiritual development is tobe achieved7. The five virtues are: honesty; compassion;generosity; patience; and humility. However, alongsidethese virtues, the Gurus recognised that the humancondition is such that we are open to living a less virtuouslife and drawn towards the five sins described in the GGSas: kam (lust); krodh (anger); lobh (greed); moh(attachment); and ahnkar (ego). A worthy and virtuous lifecan only be achieved through self-discipline which isthree-fold: physical, moral and spiritual. The physicaldiscipline includes acts of service and charity, and sharingwith others whilst continuing to fulfil family duties. Moraldiscipline includes righteous living, earning honestly, andrising above selfish desires. Spiritual discipline is abouthaving belief in only one God7.
In Sikhism, the ego does not have the same conceptualmeaning as it does in the psychoanalytic world. Accordingto the Sikh worldview, the ego is the major cause of life’ssuffering as it is experienced as the ‘I’, and as being separatefrom, or different, to others4. The tendency is for humans togravitate towards an ego-centred world, whereas the Sikhreligious goal is to experience unity with one cosmologicalessence that unifies all. This results in a struggle forpermanence and existence. Essentially, suffering is a resultof the human existence, and a result of the ego’s desire tofulfil four core human needs: security, love, respect, andfreedom. In Sikhism, the way to spiritual liberation is toliberate oneself from the ego. In achieving this, onebecomes ‘God-centred’, as opposed to being ‘self-centred’.Dr Kala Singh8 developed the ‘Sikh spiritual model ofcounselling’ which outlines the six steps necessary toachieve spiritual liberation. These consist of:
- Understanding what ego is and how it affects us
- Self-realisation: realising that the ego is the root of theproblem and therefore needs to be extinguished
- Five vices: recognising the five vices, ascertaining whichis at the root of the problem and learning how to controlthese vices
- Humility: recognising that humility is necessary tocounteract the ego
- Five virtues: whilst the five vices need to be controlled,the five virtues need to be developed
- Meditation and spiritual liberation: on completion of thefive previous steps, true humility has been achieved andone is spiritually liberated. It is this spirituality andmeditation that brings peace of mind in allcirc*mstances8.
In Sikhism, the ego is said to be at the centre of all lifestresses as it is the ego’s desire to meet a person’s core needsof security, love, freedom and respect, and it is the pursuitof the fulfilment of these core needs that prevents spiritualliberation.
Sikhs, like many other South Asian cultures, do notnormally see talking therapies as a way of resolving issuesand problems in their lives8. There is still some stigmaattached to mental illness, and counselling would be seenas a last resort, when all else fails. Sikhs would probablyprefer to use psychology based on Sikhism, which statesthat human attachment to the temporal world leads to aperson being drawn into the five vices. However, it ispossible to live in the temporal world where these five vicesexist, without being affected by them. The GGS suggeststhat Sikhs should keep these vices under control by living asa lotus flower does – taking nutrition from a pond withoutgetting dirty and wet. Practising the five virtues helps toimprove and maintain a person’s mental health. Spiritualmeditation allows the mind to alleviate stress, which isbelieved to be the primary cause of disease.
How then does all of this impact on the therapeuticrelationship and process? The therapeutic relationshipbetween the counsellor and a Sikh client may be identifiedby the client as a Guru-Chela relationship. This immediatelyputs the counsellor in a position of power as the client maybe expecting the counsellor to work in a directive andprescriptive manner. The client will probably haveexhausted all other avenues such as family, community,friends, and the Granthi (teachers) at the temple, beforecontacting a counsellor, all of whom will have given adviceand direction, a major part of which will have been to directthe person to look within the Sikh religion, and teachings,for the answers. The GGS does encourage talking aboutproblems and issues. However, many Sikhs may not want toopenly discuss problems because of shame and stigma9.Sikhs tend to discuss problems in an impersonal andcollective context, quite often in a philosophical manner.Discussing the human condition allows it to be normalised,and therefore receiving support from others whilst livingamid suffering (such as bereavement) allows a person toreceive the knowledge required to alleviate suffering4. Anunderstanding of the Sikh concept of living a meaningfullife whilst fulfilling the core needs, would enable thecounsellor to gain some understanding of the Sikh client’sinner world. This would then allow the counsellor to enterthe Sikh client’s frame of reference and walk alongside themon their therapeutic journey. Non-verbal communication isan important way of communicating empathy to a Sikhclient, as people of South Asian origin tend to respondprimarily to non-verbal communication. Verbalcommunication of emotions across cultures may bedifficult and be open to distortion. Therefore, non-verbalcommunication may be more appropriate10. For exampleSikhs originate from Punjab which is in the north of India,and, in Punjabi culture, frequent use of hand gestures is thenorm. Non-verbal gestures may also be more credible tothe client as verbal communication may at times contradictnon-verbal communication.
For Sikhs, religion and spirituality are at the core of who they are. We hope that by writing on these issues,counsellors will feel more informed. We also trust that wehave been sensitive enough to have honoured Sikhism,and its followers, who may be our clients at some time.
Jasbinder Singh has a BA(Hons) incounselling and psychotherapy studiesfrom the University of Central Lancashireand is training to become a person-centredcounsellor.
Dr Peter Madsen Gubi, PhD, MBACP (SnrAccred) is a senior lecturer in counsellingin the School of Health at the University ofCentral Lancashire. His research interestsare in counselling and spirituality.
References
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4. Sandhu JS. A Sikh perspective on life-stress: implications forcounseling. Canadian Journal of Counselling. 2005; 39(1):40-51.
5. Luangani P. Asian perspectives in counselling and psychotherapy.New York: Brunner-Routledge; 2004.
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