• The UK is a very multi-cultural place 

  • Cultural difference is an important consideration when choosing a therapist says Christina Moutsou

  • You can find therapists and counsellors who offer languages other than English here


What is culture? Some people think that cultural difference is about coming from a faraway country or belonging to an ethnic minority group.

In reality, culture is so ubiquitous that even therapy has its own culture; in fact one that, for many people new to it, is shocking to start with. For example, sitting in a room with a stranger, sometimes in silence, sometimes talking about some very difficult feelings, is an alien culture for somebody who has been told as a child to ‘get on with things’ or to ‘pull themselves together.’ In fact, therapy, when it is working, should always be about cultural difference. Effective therapy helps us reconsider what we have taken for granted in our lives before, the ways to be in the world that our parents or teachers have assumed to be right for us, but that did not always agree with us.


On the other hand, many Greek people, who come to see me to have psychotherapy in Greek, or sometimes surprisingly in English, assume that we are just the same 


In a place like London though, cultural difference comes into play quite literally in the consulting room, where the therapist and the client may be from different parts of the world, have a different mother tongue, skin colour and assumed ethnic or religious or sexual identity. ‘How can you ever understand me, if you don’t even understand my language?’ a client told me angrily once when I started practising as a therapist. She was not only referring to my ‘foreign’ accented English, I think, but also to the class difference between us. She came from a particularly narrowly defined small English town working class background. She stayed in therapy with me for six years and a lot of the work we did was about how, in her mother’s eyes, to be different and separate from her was equivalent to being bad and unworthy. On the other hand, many Greek people, who come to see me to have psychotherapy in Greek, or sometimes surprisingly in English, assume that we are just the same because I am Greek and that the therapy will be about talking to somebody who just gets where they are coming from. Of course, it would be easy to identify cultural patterns when working with Greek clients, such as domineering families and difficulties with boundaries in relationships and separating from one’s family.


My work as a therapist in London is teaching me much about difference and how we can use our differences 


However, it seems that difference is not on the agenda when choosing a culturally compatible therapist. Greece is the second most class driven society in Europe after Great Britain, a Guardian article claimed some years ago. I was never aware of class differences when growing up as a child in Greece, at least not consciously so, assuming like some of my Greek clients that we are all the same. However, my work as a therapist in London is teaching me much about difference and how we can use our differences to question the sometimes limiting assumptions we grew up with and to develop a sense of genuine self in relation to the people we care about. 


Further reading

Working with gender identity in the therapy room

How does our culture affect our sex lives?

The psychology of grief: cultural differences in death and dying

Identity and character work in therapy