Cultural standards, power and subversion in cross-cultural psychotherapy

In a creolizing world, psychotherapy is challenged by the growing influence of cultural standards, systems of meaning and idioms of distress supported by new groups who play a major role in public health policies. While these elements were originally introduced in psychotherapy with ethnic minorities both to improve the patient-doctor relationship and to bring relevant material from patients' cultural background, they also became a way to empower nonwestern patients in western health care systems. When in the 1980s it became possible to readdress the issue of power in psychiatric practice, something had already changed in the social regulation that psychiatry should endorse. In this article, the author focuses on the new legitimated social and cultural values that underpin the therapeutic process. While obviously these new values should be taken into account, the aim for psychotherapy remains to find a path for a 'subversive' practice that could be something more than just following social guidelines.