Dilemmas of Psychotherapy in Israel

The impact of sociocultural context on therapeutic process is a neglected topic in the literature of psychotherapy. Many books and papers are written with the implicit assumption that what transpires in the therapist's office is rather isolated from the outside world; that the development of transference will be identical no matter whether the therapy takes place within a private practice, an outpatient clinic, or a mental hospital; that the forms of resistance are the same in the United States, in Japan, or in Italy. I believe that by making such implicit assumptions, we pretend that psychotherapy is an ahistorical, asocial phenomenon, and we are drawn toward an over-abstract view of universal human nature as unfolding in therapy. If, on the other hand, we acknowledge psychotherapy to be a process of interaction between concrete human beings living in a specific institutional, societal, and cultural context, we must expect to find that process highly influenced by its broader context. Such influence may be manifest or latent, conscious or unconscious.

National entities are a major determinant in most people's lives. In comparing the process of psychotherapy in various countries, we are confronted with the difficulties of defining national character. This is a dangerous, yet exciting, terrain. It is all too easy to slip into stereotyped descriptions, violating the uniqueness of the individual. Clearly, not all Englishmen are alike; neither are all Israelis. But this realization should not deter us from seeking common trends or, at least, common issues. Two siblings who develop opposing character styles may be offering two alternative answers to the same question posed by their common family matrix. Apparent contradictions and opposing trends in the psychological characteristics of a single nation may represent a parallel process.

These issues have particular personal relevance for me. I grew up in Israel since age 4, when my family emigrated from Poland. I started my