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In this paper Maduro describes how he uses ethnic assumptions about sickness and health held by patients of Hispanic background in connection with dream analysis so as to facilitate the self-healing faculties of the psyche. In order to provide a facilitating environment, the therapist should not divorce culture and personality systems, should not stress psycho-pathology at the expense of the creative functions of the unconscious, and should work in a lively interactive manner with the patient.
Maduro finds that dream analysis is enhanced if the dream is related to sociocultural issues. In this way, associations become truly personal, and concrete ways of thinking are validated rather than regarded as inferior. In addition, living, as many Latino patients do, in a hostile culture, valuing of background and ethnic origins has an impact on the level of self-esteem. As a therapist Maduro feels he should fit in with Latino expectations that the healer's behaviour be warm and personal; he adopts an open systems approach to the treatment setting.
In the British context Maduro's ideas would resonate to the experience of many workers in child guidance clinics where it has been found necessary to respect and adapt to the patient's ethnic background and to vary orthodox technique. One difference is that few therapists in Britain have an immigrant background (or only had one in the rather distant past). Maduro, being a Latino himself, can share the cultural assumptions he is describing. Nevertheless, his flexibility is exemplary and it is good to see such work described as analysis and published in a psychoanalytic journal; this offers encouragement to many workers outside the private practice system.