Cultural Humility

A new study claims that cultural humility leads to better therapy outcomes. It’s defined “as having an interpersonal stance that is other-oriented rather than self-focused, characterized by respect and lack of superiority toward an individual’s cultural background and experience.” I’m all for other-oriented therapists, and I don’t know what the word “respect” means, so I have no quibble with it. [I think it usually means “obedience,” as in, “my boyfriend disrespected me,” but it also means “avoidance,” as in, “I respect your opinion.” But I don’t know what it means in the context of a background or experience as opposed to a belief or a right. I respect your rights by not infringing on them; I respect your belief by adopting it as my own or by citing evidence against it. But what does it mean to respect an experience? I suspect it means something like, if it’s important to you, then let’s talk about it, in which case I’m for it, but if it means something like, if it’s important to you then we shouldn’t change your orientation to it, then I’m against it, especially in therapy, which is supposed to change people’s narratives about their experiences.]

The heart of the matter is in the word “superiority.” Of course my cultural values are superior to those of other cultures! If they weren’t I would switch my cultural values.

Before going on, let’s dispense with the study. What these researchers measured was not cultural humility but the ability to disguise your cultural superiority from the client. Just as a physician doesn’t tell the Latina that her cultural belief in rubbing onions on a burn is stupid, and instead teaches her how to treat a burn without making her defend her culture, we do the same thing with all the distorted ideas that clients have that cause them pain or impede their happiness. My other criticism of the study is that the authors seem not to recognize that cultural humility is a cultural value, and it’s one that they think is superior to other cultural values.

Before getting all humble about other people’s cultures, I need to ask a few questions about that culture’s treatment of people with less power than the rule-makers. Parenthetically, there is no such thing as American or Irish or Muslim culture, because no rule of conduct is preferred in groups by all Americans, Irish people, or Muslims; so I’m talking about what are often called subcultures. (Subcultures are cultures that don’t have enough publicity to make it to the A-list.) Also because cultural values are implemented by humans, no culture lives up to its values, so I’m talking about whether repressive behavior is celebrated or questioned.

Back to my questions about a culture before adopting a stance of humility before it: How are women treated? Are pleasure centers cut off their bodies? Can they testify in court and own property? Can they pursue love and work and hobbies? Is rape condoned or criminalized? Can their families murder them with impunity if they are suspected of having sex? How are people treated who look different from the normative person, especially with respect to skin color? Are they derogated? Enslaved? Deprived? Scared? How are gay people treated? How are atheists, apostates, and infidels treated? If you can tell me your culture—your implicit and explicit rules of conduct—treats these people well, then I will express humility towards it (or adopt it as my own—and if it’s a culture that an outsider is not welcome to adopt, then my own culture remains superior, because in science, everyone’s welcome). Otherwise, I am merely hiding my contempt, which it is important to do sometimes, especially if you have to work with the person.

How is my cultural absolutism different from absolutist cultures that kill, enslave, condemn, or despise people like me under the banner of their absolute sense of superiority? The difference is that my culture (call it enlightenment values or science, with an emphasis on civil liberties, critical thinking, pleasure, humor, and social justice) condones force only in response to force or the threat of force, and otherwise promotes free speech in the marketplace of ideas for resolving differences between cultures. A culture advocates hurting me (now or in the hereafter) or controlling my wife, and I’m supposed to honor it?