As we continue to strive for cultural competence in mental health, it's important to recognize the potential clashes between therapeutic practices and cultural norms. In his lectures, Dr. Derald Wing Sue identifies five "don'ts" in therapy, the third of which is making eye contact.
While eye contact is generally encouraged in Western cultures, it may be seen as disrespectful in others, particularly when interacting with elders or authority figures.
As mental health clinicians, it's crucial to understand that non-verbal communication carries significant weight in many cultures. Lack of eye contact does not necessarily indicate avoidance or disinterest or timidness. Rather than making assumptions, it's important to seek consent and inquire about the meaning of eye contact in the client's culture. This can be a delicate conversation, but taking the time to educate ourselves and approach with sensitivity can greatly benefit the therapeutic relationship.
In my work, I practice and teach consent for conversation. We often think about consent for touch or activities, though consent for conversation can be overlooked. Sometimes people can just unload on us without checking to see if we are ready, willing, and able to listen. Likewise, as clinician, we can sometimes ask questions that may seem intrusive if the client is not prepared.
I might approach this situation something like: "As we are talking, I am noticing something about our interactions, and I would like to explore that with you." Provided I get a yes, I might say, "I am noticing that you don't make eye contact often and I want to check in with you about it. I understand a little about your culture though I also know that a little knowledge can be a dangerous thing so I don't want to assumptions. Can we talk about that a little?"
Asking for consent for conversation gives the client some agency in saying yes or no and can help remove what may seem like a requirement or obligation from an authority figure, the therapist.
Let's continue to prioritize cultural competence in mental health and strive to provide inclusive and respectful care for all.
First posted on LinkedIn