Years ago I got branded as a racist for refusing to treat a client whose primary language was Russian. Apparently this was a woman who was depressed and could have benefited from therapy, but her command of the English language was considered only descent at best. The physician who wanted the woman to get treatment from me was also Russian and had little tolerance for being told 'no.' I later learned that she had been discriminated against by American doctors upon her arrival in the states and was therefore very sensitive to the needs of the Russian community.
"You hate Russians!" the doctor yelled into the phone before I could explain why I refused to see her patient for treatment.
I immediately considered all the things Russian that I enjoy: Black Russians, Ivan Drago, Beef Stronganoff, even Communism, at least in theory. Therefore I rejected her nefarious claims about me.
So why would I not take on a client who could clearly use help but not speak English well?
Back in the day when I was still considering being a religious person, I was walking out of church after service with a friend. The pastor was at the end of the line of exiting people, waiting to say good-bye, and I stood near the end of the queue for my turn to shake his hand and bid farewell for the week. As we slowly approached him I noticed my sneakers, which I had thrown on my feet in haste after having overslept for probably the 30th Sunday in a row. The shoes were blue suede, almost like boating shoes that would normally be seen at some yuppy regatta. Given that my friend worked in the field of fashion, I decided to ask for her take on my footwear.
"Hey, do these shoes make me look like a jerk off?" I said.
She looked somewhat horrified. "What?"
"The shoes," I repeated, as we got to within about 10 feet of the pastor. "Do they make me look like a jerk off?"
A look of relief came over her and then a huge giggle that she needed to stifle. "Oh! I thought you said, 'these shoes make me want to jerk off.'"
I laughed. "Oh. No. I mean, I didn't say that. And also, I mean, they don't make me want...you know..."
"Right, I know," she said, probably creating a mental list of my potential fetishes. "And yes, they look pretty stupid, especially with plaid shorts. Just wear normal sneakers like everyone else. Perv."
How does this anecdote of sartorial idiocy relate to therapy? Notice in the exchange with my friend how a change of just a few words completely altered the meaning of the sentence. In the first, I'm asking her if I am engaging in a fashion faux-pas. In the latter I'm sharing masturbation fantasies just before saying farewell to a man of the cloth. Subtle changes in language drastically change meaning. This issue actually handicaps a patient, because providing her services in a fairly unfamiliar language will invariably lead to missed nuances.
Both self-talk and open conversation can strongly impact emotions. When a client who has been curt with a co-worker tells himself, "I'm such an asshole to people, no one likes me!" he's likely to feel a strong depression. Contrast that with the client who says, "I acted like an asshole, but that doesn't mean that no one likes me." This second person is likely to feel remorse or regret or guilt, but is unlikely to get depressed. In fact, this client, simply by changing a few choice words, is more likely to apologize to the co-worker and be done with it, whereas the former is inclined to withdraw and perpetuate the problem.
In couples' work, most therapists discourage the use of extreme terms. For example, a wife would be challenged when she says, "he never spends time with the kids," unless she can prove that the term never is factually accurate. More often than not such a term isn't entirely on target and, moreover, it often generates defensiveness on the person toward it is directed. If the wife makes a slight change and says, "he doesn't spend nearly as much time with the kids as I would like him to," not only is she conveying a likely more accurate statement, but she's setting up a productive, problem-solving dialogue with the husband.
Many say that English is one of the hardest languages to learn. Is it fair to ask a woman who has only a marginal understanding of the subtle nuances of the language to engage in therapy with someone who can't translate to her native tongue? Hell, I've spent multiple sessions teaching monolingual Americans the difference between "assertive" and "aggressive." How can someone who may not even have heard either of those terms be expected to grasp their subtle differences?
So a small medical office in New York City thinks that I now hate everyone who is of Russian decent. I can deal with that, especially since the office was able to find a therapist who speaks her language, and I was told that the woman is doing quite well. So all's well that ends well, I suppose.
The morals of the story:
1) Don't hate Russian people
2) Only conduct or engage in therapy in your strongest language
3) Wear normal shoes
3) Do not have sexual discussions of any sort in church.
I know, I know. What pearls of wisdom will I come up with next?
Years ago I got branded as a racist for refusing to treat a client whose primary language was Russian. Apparently this was a woman who was depressed and could have benefited from therapy, but her command of the English language was considered only descent at best. The physician who wanted the woman to get treatment from me was also Russian and had little tolerance for being told 'no.' I later learned that she had been discriminated against by American doctors upon her arrival in the states and was therefore very sensitive to the needs of the Russian community.
"You hate Russians!" the doctor yelled into the phone before I could explain why I refused to see her patient for treatment.
I immediately considered all the things Russian that I enjoy: Black Russians, Ivan Drago, Beef Stronganoff, even Communism, at least in theory. Therefore I rejected her nefarious claims about me.
So why would I not take on a client who could clearly use help but not speak English well?
Back in the day when I was still considering being a religious person, I was walking out of church after service with a friend. The pastor was at the end of the line of exiting people, waiting to say good-bye, and I stood near the end of the queue for my turn to shake his hand and bid farewell for the week. As we slowly approached him I noticed my sneakers, which I had thrown on my feet in haste after having overslept for probably the 30th Sunday in a row. The shoes were blue suede, almost like boating shoes that would normally be seen at some yuppy regatta. Given that my friend worked in the field of fashion, I decided to ask for her take on my footwear.
"Hey, do these shoes make me look like a jerk off?" I said.
She looked somewhat horrified. "What?"
"The shoes," I repeated, as we got to within about 10 feet of the pastor. "Do they make me look like a jerk off?"
A look of relief came over her and then a huge giggle that she needed to stifle. "Oh! I thought you said, 'these shoes make me want to jerk off.'"
I laughed. "Oh. No. I mean, I didn't say that. And also, I mean, they don't make me want...you know..."
"Right, I know," she said, probably creating a mental list of my potential fetishes. "And yes, they look pretty stupid, especially with plaid shorts. Just wear normal sneakers like everyone else. Perv."
How does this anecdote of sartorial idiocy relate to therapy? Notice in the exchange with my friend how a change of just a few words completely altered the meaning of the sentence. In the first, I'm asking her if I am engaging in a fashion faux-pas. In the latter I'm sharing masturbation fantasies just before saying farewell to a man of the cloth. Subtle changes in language drastically change meaning. This issue actually handicaps a patient, because providing her services in a fairly unfamiliar language will invariably lead to missed nuances.
Both self-talk and open conversation can strongly impact emotions. When a client who has been curt with a co-worker tells himself, "I'm such an asshole to people, no one likes me!" he's likely to feel a strong depression. Contrast that with the client who says, "I acted like an asshole, but that doesn't mean that no one likes me." This second person is likely to feel remorse or regret or guilt, but is unlikely to get depressed. In fact, this client, simply by changing a few choice words, is more likely to apologize to the co-worker and be done with it, whereas the former is inclined to withdraw and perpetuate the problem.
In couples' work, most therapists discourage the use of extreme terms. For example, a wife would be challenged when she says, "he never spends time with the kids," unless she can prove that the term never is factually accurate. More often than not such a term isn't entirely on target and, moreover, it often generates defensiveness on the person toward it is directed. If the wife makes a slight change and says, "he doesn't spend nearly as much time with the kids as I would like him to," not only is she conveying a likely more accurate statement, but she's setting up a productive, problem-solving dialogue with the husband.
Many say that English is one of the hardest languages to learn. Is it fair to ask a woman who has only a marginal understanding of the subtle nuances of the language to engage in therapy with someone who can't translate to her native tongue? Hell, I've spent multiple sessions teaching monolingual Americans the difference between "assertive" and "aggressive." How can someone who may not even have heard either of those terms be expected to grasp their subtle differences?
So a small medical office in New York City thinks that I now hate everyone who is of Russian decent. I can deal with that, especially since the office was able to find a therapist who speaks her language, and I was told that the woman is doing quite well. So all's well that ends well, I suppose.
The morals of the story:
1) Don't hate Russian people
2) Only conduct or engage in therapy in your strongest language
3) Wear normal shoes
3) Do not have sexual discussions of any sort in church.
I know, I know. What pearls of wisdom will I come up with next?