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The importance of the cultural context can be seen in the psychoanalytic psychotherapy of Kimiko, a young Japanese woman who came to therapy to “discover herself.” Born into a prominent family of the Japanese upper middle class, she had married an American intellectual in Tokyo at age 23 and had accompanied him to the United States two years later. By the time she came for treatment, at age 26, Kimiko had been in America for a year, but she was still struggling to acclimatize herself to the new social and cultural world of New York. She was seen once a week for a three-year period, which ended with her 100th session.
One may wonder why someone who wanted something as fundamental as discovering herself came only once a week. But this very question suggests a cultural difference, for psychoanalytic practice is far more accepted in the United States than in Japan. Before Kimiko, I had never met a Japanese client with such a sophisticated motive for therapy. More often, Japanese patients experience a strong sense of shame in coming for the psychiatric healing of “mental afflictions.” Even for Kimiko, there was a certain cultural “risk” in committing herself to a course of psychoanalytic psychotherapy. Moreover, her limited income made once weekly treatment the only realistic possibility.
I should note here that I will be reviewing this case with a particular goal in mind. I wish to demonstrate the relevance of the cultural context of adolescent and postadolescent growth to a transcultural understanding of patients like Kimiko. What do I mean by “transcultural”