Ethnography as Metaphor in Psychotherapy Training
Hocoy, Dan, American Journal of Psychotherapy
Harry Stack Sullivan (1940) described the psychotherapist as most essentially a "participant-observer." This term is typically used to characterize the dual roles of the ethnographic researcher. The myriad of similarities that exist between the anthropological method of ethnography and psychotherapy afford a distinctive pedagogical opportunity. A model of psychotherapy instruction in which ethnography is used as conceptual framework and experiential metaphor is presented here. An overview of the model, as well as its potential advantages and limitations, is discussed. In the absence of any established pedagogy in psychotherapy and given current pressures in graduate training programs to condense curricula and integrate research and clinical instruction, ethnography provides a valuable teaching alternative or supplement to current psychotherapy training methods.
Harry Stack Sullivan (1940) described the essential nature of the psychotherapist as being that of a "participant-observer" (p. 207). This description provides an illuminating characterization of the dual nature of the psychotherapist's role. The therapist is a "participant," actively engaged in the dynamic relationship s/he co-creates with the client, and a detached "observer," critically evaluating the client's manifestations. The syntactic joining of these words also speaks to the intractable entwinement of the two activities in psychotherapy. It is the therapist's very participation that allows for an elicitation of revealing information about the client. The therapist's relational engagement evokes the client's inner psychological dynamics for observation.
The term "participant-observer" (Agar, 1996, p. 33) is typically used to describe the role of a researcher engaged in the primary research technique of cultural anthropology, namely, ethnography. Interestingly, the work of the ethnographer has many parallels to that of a psychotherapist. The role of the ethnographer is to understand another person's way of life from the point of view of the other (Malinowski, 1922, 1944) through immersion in the other's culture and "en counter (ing) it firsthand" (Packer, 1995, pp. 3-4). Similarly, for the psychotherapist, it is only through experiencing the client's reality (i.e.,' transferences, dynamics) firsthand in the therapeutic relationship that she or he understands the other. The observations of the ethnographer are drawn from the unique, co-created field of researcher and cultural subject(s), while the observations of the psychotherapist are similarly drawn from the unique interpsychic space of the therapeutic dyad. Both ethnographer and psychotherapist are required to have an awareness of their own perceptual filter or transferential lens to be able to distinguish the dynamics of the other from their own projections.
Apart from Sullivan (1940), these two fields have been linked by other theorists; these associations include: employing psychotherapeutic concepts in ethnographic investigations (Horowitz, Stinson, & Milbrath, 1996), ethnographically inspired investigations of the use of language in psychotherapy (Pea & Russell, 1987), adopting an ethnographic attitude in psychotherapy with clients of different cultural backgrounds (Zhang, 2003), and a more comprehensive understanding of the nature of psychopathology through ethnography (Kleinman, 1988; Kleinman & Kleinman, 1991). However, there is no precedent for utilizing the method of ethnography for the instruction of psychotherapy. Yet, the multiple similarities between the ethnographic and psychotherapeutic relationship provide an interesting pedagogical opportunity for those teaching the complex art of psychotherapy. Given the inherent parallels, it is not surprising that the acquisition of ethnography enhances one's understanding of psychotherapeutic work. Certain nuanced aspects of psychotherapy that might escape the direct deductive focus of the trainee, can be grasped peripherally through the analogous practice of ethnography. …