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Dr. Carl-Ivar Dahl raises the challenging question as to whether psychoanalytic forms of therapy can be helpful to patients coming from a culture quite divergent from that which gave rise to and continues to form the context for psychoanalytic theory and practice. He points out that this question is taking on more urgency as practitioners in all western countries, even those with a relatively homogeneous population like Norway, find themselves confronted with refugee patients from all over the world.
Dr. Dahl briefly discusses differing assumptions about the role of culture in shaping values, the symbolization of subjective experience, and personality development. Commenting on the implications these might have for the cross-cultural applicability of psychoanalytic forms of psychotherapy, Dr. Dahl suggests that consciously held values such as “finding reticence a more desirable communicative style than wearing (your) heart on your sleeves” could change, if in the context of a therapeutic alliance the patient can come to see verbal communication of thought and feeling as meaningful. Dahl proposes that when culture specific language and symbols are used to express psychological issues, this language can serve as a “system of reference” to the patient's psychological conflicts, once the therapist has come to understand it.
Dahl concludes that, provided the patient's personality structure and psychopathology fall within the range considered accessible to an analytic form of therapy in accord with western criteria, cultural differences need not be a barrier to the use of psychoanalytic therapeutic approaches. However, technical modifications involving “support, holding and structuring” may be called for in order to develop and maintain a therapeutic alliance in the face of specific