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Listening and weaving language into an effective therapeutic tool is a capacity that every psychoanalyst shares. We listen to our patients and identify with them. We flow into their stories, becoming one in empathy. From their stories we construct a hypothetical model of each patient. This model is shaped by repetitious family patterns, character structure, and life pain. We draw on the narrative tale with a purpose—therapeutic change. The heart of this paper is a description of how a psychotherapist can use identification with a patient to unravel the deeper meaning of that patient's personal tale, particularly when the therapeutic working alliance is cross-cultural.
Every psychotherapy relationship requires a working alliance of therapist and patient. The working alliance is that part of the relationship that is rational and purposeful. There are basic elements considered universal to every working alliance. An alliance is fueled by drive—libidinal and aggressive wishes—and is colored by transference and defense. An alliance gains focus from the motivation of the patient to overcome pathology or to master a problematic situation (Greenson, 1981, p. 192). To achieve cure or mastery, the alliance draws on the observing ego of the patient and the analyzing function of the therapist. I propose to extend the definition of the working alliance to include culture and countertransference.
Clinical literature seldom discusses the impact of culture on the working alliance. A cross-cultural working alliance is, by definition, a therapeutic dyad that incorporates a psychotherapist and patient of dissimilar backgrounds. Each participant enters the alliance with cultural introjects, which are the values, attitudes, and customary ways of behaving that stem from