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Copyright © 2006 by Teachers College, Columbia University
All rights reserved. No part of this publication may be reproduced or transmitted in any form or
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trieval system, without permission from the publisher.
Library of Congress Cataloging-in-Publication Data
Dwairy, Marwan Adeeb.
Counseling and psychotherapy with Arabs and Muslims : a culturally sensitive approach
/ Marwan Dwairy ; foreword by Paul B. Pedersen.
p. cm. — (Multicultural foundations of psychology and counseling)
Includes bibliographical references and index.
ISBN-13: 978-0-8077-4701-8 (cloth)
ISBN-10: 0-8077-4701-7 (cloth)
ISBN-13: 978-0-8077-4700-1 (pbk. : alk. paper)
ISBN-10: 0-8077-4700-9 (pbk. : alk. paper)
1. Cross-cultural counseling. 2. Psychotherapy. 3. Palestinian Arabs—Counseling of. 4.
Palestinian Arabs—Psychology. 5. Muslims—Counseling of. 6. Muslims—Psychology.
BF637.C6D84 2006
158′.3089927—dc22 2005055972
ISBN 13: 978-0-8077-4700-1 (paper) ISBN 10: 0-8077-4700-9 (paper)
ISBN 13: 978-0-8077-4701-8 (cloth) ISBN 10: 0-8077-4701-7 (cloth)
Printed on acid-free paper
Manufactured in the United States of America
1312111009080706 87654321
Contents
Foreword Paul B. Pedersen vii
Preface ix
PART I U
NDERSTANDING THE
P
SYCHOCULTURAL
H
ERITAGE
1. The Arab People and Islam Religion 3
2. The Arab/Muslim Culture 12
3. Arab/Muslim Families in the United States Khawla Abu-Baker 29
PART II R
EVISING
W
ESTERN
T
HEORIES OF
D
EVELOPMENT AND
P
ERSONALITY
4. Individuation Among Arabs/Muslims 47
5. Collective Personality of Arabs/Muslims 57
6. Assessment Issues Among Arabs/Muslims 71
7. Diagnosis and Psychopathology of Arabs/Muslims 82
PART III W
ORKING WITH
A
RAB AND
M
USLIM
C
LIENTS
IN THE
U
NITED
S
TATES AND
A
BROAD
8. Limitations of Psychotherapeutic Approaches 97
9. Toward Culturally Sensitive Counseling and Psychotherapy 107
10. Family Therapy with Arab/Muslim Women Khawla Abu-Baker 120
11. Indirect Therapy: Metaphor Therapy 138
Conclusion 147
References 151
Index 165
About the Author 175
v
Foreword
When I finished reading Marwan Dwairy’s 1998 book Cross-Cultural Counsel-
ing, I immediately sent an order for five copies to the publishers for me to give
away. This new book, which promises to have an equally powerful effect, is
important for several reasons. First, it brings a message that you will not read
in any of the current textbooks about specific cultural bias in the counseling
profession. Second, it provides a plan for reframing the counseling process to
fit the needs of a collectivistic society, which describes the majority of the
world’s people, and demonstrates the dangers of imposed individualism. Third,
it provides practical suggestions and advice for “low context” counselors com-
municating with “high context” clients building on historical traditions. Fourth,
it deals directly with the consequences of simplistic stereotyping of Arabic and
Muslim people following the September 11 events and the threat of terrorism.
Fifth, it introduces a new methodology in counseling of a “biopsychosocial”
model and the use of metaphors in counseling.
The book is divided into three sections, making it easier for the reader to
make a transition from one topic to the next. The first section looks at heritage
and historical context so that the reader can better understand the development
of ideas from their source. The second section is about development and person-
ality patterns that again help the reader better understand both the similarities
and differences between the Arab/Muslim people and others. The third section
is focused on working with Arab and Muslim clients and practical suggestions
for “indirect” rather than direct approaches. Dwairy talks about the frustrations
he experienced trying to apply the Western methods of his own training to his
Arab/Muslim clients with their more collectivistic and authoritarian values that
contrast with the more internalized and personal issues addressed by Western
methods.
This book is not about indigenous Arab/Muslim alternative therapies but
rather a bridge between Western and non-Western cultures, as Dwairy describes
the task in the conclusion to his book: “A culturally sensitive approach in psy-
chology is very important in this era of globalization, when Western culture is
often offered as the ultimate choice for all peoples, regardless of their heritage
or culture. Mental health professionals have much knowledge to share; their
input can help develop greater understanding of and empathy for the cultures
vii
viii Foreword
of others and promote pluralism within globalization.” His focus is on shared
characteristics and against simplistic stereotypes. Sometimes Western methods
treat the abstract test profile as more real than the actual client.
This book provides not only a journey, an adventure, a metaphor to life
itself, and a series of stories to help the reader understand the Arab/Muslim
client, but also a better understanding of how clients from that cultural context
are likely to perceive the Western counselor. There is an urgent need to reframe
the counseling process in a global context. Without that larger and more inclu-
sive perspective counseling is in danger of becoming the tool of a majority
culture elite defined by a tendency to impose, without justification, a narrowly
defined monocultural perspective favorable to the social/economic/political/mil-
itary special interest group sometimes labeled as “Western.”
Paul B. Pedersen
Preface
The reader of this book will find within it ideas and models based on my 25
years of experience in clinical, educational, developmental, and medical psy-
chology among Arabs, Muslims, Jews, and Americans, but mainly among Pales-
tinian Arabs. I studied for my master’s degree in clinical psychology at Haifa
University in Israel, during which time I received some practical training at
Jewish psychological centers in Israel. Thus both my theoretical study and prac-
tical training were based on the Western-oriented theories of psychology. Imme-
diately after graduation I opened the first psychological center in my native city,
Nazareth, which is the largest Palestinian Arab city in Israel.
The main experience I remember from my first year of work in Nazareth
is that my clients seemed to be different from those described in the context of
psychological theories. They reacted differently to my diagnostic and thera-
peutic interventions. They tended to focus on their external circumstances and
were unable to address internal and personal issues. Terms such as self, self-
actualization, ego, and personal feelings were alien to them. They emphasized
duty, the expectations of others, the approval of others, and family issues. In
conversation with my clients, the task of distinguishing between the client’s
personal needs, opinions, or attitudes and those of the family was almost impos-
sible. This experience was very disappointing, even threatening, to a new and
enthusiastic psychologist who believed that the psychology he had learned was
universal and should therefore work as well among Palestinian Arabs as among
any other people. Using the premise “If I did it, they can do it,” during the first
years in Nazareth I tried to fit the clients to the “Western-oriented psychology,”
using a variety of educational community projects to mold them. Only after
several years did I realize that it was I who should be fitting my theories to the
community. Since then I have been trying to adjust Western theories to fit our
social and cultural reality.
My writings are therefore not of one whose orientation is solely Western
and who looks at and judges the Arabic culture only from a Western perspective.
Rather, they are based both on my personal experience with the Arabic culture
in which I was raised and which I have studied for many years, and on my
formal learning and professional training in Western psychology. I have tried to
discover where Western approaches to psychology do or do not fit the Arab or
ix
x Preface
Muslim culture and how counselors may employ the Arab/Muslim values, cus-
toms, and norms in counseling and therapy. This book does not address tradi-
tional Arabic and Muslim healing practices that are common in these societies.
In this book I extend the scope and deepen and enrich some of the ideas
presented in my previous book Cross-Cultural Counseling: The Arab-Palestin-
ian Case, published in 1998. I extend the Palestinian case and present a more
coherent conceptualization of the personality of all Arab/Muslims, as well as
intervention therapy among them. In the first part of this book the history, demo-
graphics, and culture of Arabs and Muslims in the world and in the United
States are introduced. In the second and third parts a culturally sensitive revision
is made of the theories of development, personality, assessment, psychopathol-
ogy, counseling, and psychotherapy. My spouse, Khawla Abu-Baker, who is a
family therapist and an expert on Arab and Muslim women’s issues, has contrib-
uted two chapters, sharing with the readers her valuable experience among Arab/
Muslim families in the United States, Palestine, and Israel.
While this book highlights some basic psycho-cultural features of Arabs
and Muslims, I urge readers to avoid two main biases that Hare-Mustin and
Marecek (1988) discuss in respect to gender differences: alpha and beta biases.
If I borrow these biases and apply them to cultural rather than gender differ-
ences, then alpha bias indicates the exaggeration of differences existing between
cultures. The existence of psychocultural features in one culture does not ex-
clude these features in some way or degree from another culture and does not
deny many shared universal features. Cultural features are always relative and
not absolute; therefore, if we claim that Arabs/Muslims live in a collective/
authoritarian culture, this does not mean that no other nation shares the same
culture in one way or another. On the other hand, beta bias involves a denial of
the differences that do exist between cultures. This bias may be called “color
blindness” toward cultures; its proponents claim that all people are the same.
When we compare cultures, we need to remember that similarities should not
make us blind to diversity, and vice versa. In addition, I suggest that readers
also avoid a third bias, namely, generalization within the culture, which looks
at cultures from a stereotypic perspective, denying individual differences and
variations within the same culture.
The September 11 attacks have distorted the real image of Arab and Muslim
cultures. Since then, Arab and Muslim citizens in the West have become victims
of misunderstanding or accusations. I hope this book will enable the Western
reader to know these people better and will contribute both to the development
of cultural sensitivity among practitioners who work with Arabs and Muslims
and to the world effort to develop cross-cultural psychology.
P
ART
I
U
NDERSTANDING THE
P
SYCHOCULTURAL
H
ERITAGE
Chapters 1, 2, and 3 introduce Arab/Muslim history and culture to Western
practitioners. The main intent here is to describe the collective and authoritar-
ian features of Arab/Muslim societal behavioral norms. Readers will notice
that, for Arabs/Muslims, history is not only a matter of a past background and
heritage but also a significant component of their daily experience in the pres-
ent. Similarly, culture is also not only a collective matter but also an insepara-
ble component of the individual’s self.
The presence of history and culture in the lives of Arab/Muslim immi-
grants in the West is very noticeable. These components become distinct and
influential when immigrants are exposed to a different culture. Practitioners
who are aware of these components are better able to understand their clients
and the contribution of the Arab/Muslim history and culture to their behavior,
emotions, and attitudes. Chapter 3 gives a more precise description of the
Arab/Muslim immigrant. Generally speaking, these immigrants lead their lives
against two cultural backgrounds: the Arab/Muslim one that is described in
this part of the book and the Western individualistic one. The amount of influ-
ence exerted by each culture may vary from one client to another, depending
on the client’s level of acculturation and assimilation into Western life. Simply
put, some clients are more “Arab/Muslim” while others are more “Western.”
This book may help clinicians understand the Arab/Muslim portion of the cli-
ent’s personality.
Clinicians who work with Arab/Muslim immigrants may wonder whether
the psychocultural characteristics described in this book refer more to Arabs/
Muslims in the United States or to those in Arab/Muslim countries. Clinicians
need first to evaluate the level of acculturation and decide the extent to which
each client is “Arab/Muslim” or “Western.” Based on this evaluation, clini-
cians can adjust their attitudes and interventions regardless of the client’s resi-
dency.
1
Chapter 1
The Arab People and Islam Religion
Western counselors and therapists who work with Arab and/or Muslim clients
usually realize immediately that they are not dealing with an independent indi-
vidual, and discover the tremendous impact of the family, culture, and heritage
on the client’s thoughts, attitudes, feelings, and behavior. The first part of this
book is therefore devoted to describing the cultural heritage with which these
clients come to therapy.
Islam is considered the third and most recent of the world’s great monothe-
istic religions, the other two being Judaism and Christianity, to which it is
closely related. All three religions are products of the Semitic spiritual life. In
contemporary terms, Semitism or anti-Semitism is associated with Jews; but, in
fact, both Arabs and Jews are Semitic peoples.
A BRIEF HISTORY
Long before the appearance of Christianity and Islam, Arabs lived in Najd (Ara-
bia) and the Syrian deserts. To survive the toughness of the desert, they lived
in a tribal nomadic system, moving with their families, camels, sheep, and
horses to places where oases and grass could be found. Because they lived in a
geographic location that links Asia, Africa, and Europe, Arabs worked in trade
and transportation of goods between the three continents. At this time Arabs
were pagan (although later on some became Jewish or Christian). This pre-
Islamic period is called the Jahiliyah (period of ignorance), because Arabic
tribes were then excessive in their violence, tribal revenge and retaliations, hedo-
nistic lifestyle, alcohol abuse, polygamy, and abusive attitude to women.
Islam had its beginnings in the early seventh century (
AD
610) in Mecca, a
town in the western Arabian Peninsula. The prophet Mohammad began to exhort
men and women to reform themselves morally and to submit to the will of God,
as expressed in revelations to him from God. These revelations were accepted
as divine messages by Mohammad and his adherents and were later collected
in a book, the Quran. Islam not only brought moral and social reform that put
3
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