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When the patient and the therapist belong to different religious traditions, the therapy is in essence cross-cultural. Religion is significant in identity transitions such as naming ceremonies, membership in social groups, marriage, and parenthood. Religion may even prescribe autonomy or dependence. As a result, the analyst needs to be aware of the role that religion has in any given therapy.
A patient from a culture with an associated religion such as India and Hinduism, Israel and Judaism, or Pakistan and Islam is likely to assume that his religion is different from that of her American therapist. Even before the initial meeting, both the patient and the therapist have assumptions about the influence that the difference in religion may have on the therapy. The opportunities, as well as the pitfalls, that appear when the patient and therapist are of different religions transcend the initial meeting. In the case presented in this article, religion provided an important treatment focus for a Hindu patient with a Christian therapist.
There was the risk that I, raised Christian with extensive time in a Hindu village, might have shown excessive interest on the emphasis Hinduism places on ritual and on the personal adaptations of my patient's religion to life within the United States. During my initial visit to India I noted that the Hindu religion has ritual rules regulating behavior. The following seven visits provided occasions to observe ritual. These ritual rules provide certainty about appropriate behavior and insurance against uncertainty. Although the extensive ritual present in Hinduism serves to provide a child with security, adults often develop flexibility in observing rituals. With maturity, most Hindu adults have determined the ritual in