AFFECTIVE ACCEPTANCE:

5
EMBRACING INCLUSION AND
DEVELOPING EMPATHY

In this chapter, we complete coverage of the eight assumptions involved

in developing affective acceptance. First, we discuss the importance of real-
izing counselors' vulnerability to cultural encapsulation, followed by the
importance of embracing inclusion in the developing of empathy. We then
focus on the importance of internal spiritual resources and conclude with the
importance of embracing ambiguity in the process of developing inclusive
cultural empathy (ICE).

ASSUMPTION 5: COUNSELORS ARE ALL VULNERABLE

TO CULTURAL ENCAPSULATION

As therapists, we are vulnerable to the experience of cultural encapsu-

lation as well as its negative effects on our ability to become empathic with
our clients. The concept of cultural encapsulation was introduced by Wrenn

Parts of chapter 5 are from Culture-Centered Counseling and Interviewing Skills, by P. Pedersen and A. E.
Ivey, 1993, Westport, CT: Praeger/Greenwood Press. Copyright 1993 by Praeger/Greenwood Press.
Adapted with permission.

93
(1962) in a discussion about the problematic manner in which many school
counselors approach their students. Since this introduction, the concept has
been broadened to use with all counselors, psychologists, social workers, and
other mental health workers. A culturally encapsulated counselor sees the
world through a cultural lens without recognizing that many of her or his per-
ceptions may in fact be biased and thus damaging to clients. Cultural encap-
sulation is built on five basic identifying features.
First, a culturally encapsulated person defines reality and truth on one
rigidly maintained set of cultural assumptions. This set of assumptions is pre-
sumed to be constant and unchanging. Although truth and reality are seen as
constant for many people, the truths each person perceives tend to be very
different. These differences are based on the cultural patterns of thinking and
acting that were prepared for each individual before he or she was born. Peo-
ple who use their own value systems and experiences as the solitary reference
point from which to interpret and judge behavior, thoughts, and emotions are
commonly referred to as ethnocentric. Ethnocentrism is the tendency to use
one's own group's standards as the standard when looking at other groups, to
position these standards at the top of a hierarchy in which all others are
ranked lower in comparison (Berry, Poortinga, Segall, & Dasen, 1992).
Second, the culturally encapsulated individual assumes that her or his
perspective is correct and is thus not sensitive to cultural variations among
individuals. In this way, the encapsulated individual is trapped into one par-
ticular way of thinking that resists adaptation and rejects alternatives. A key
issue in the maintenance of cultural encapsulation is the fact that most peo-
ple are somewhat ensnared in our ways of perceiving the world by the com-
fort of believing that we have resolved the significant issues in life (or that
they have already been resolved for us). When we believe that we know what
is true, regardless of the actual veracity of our convictions, we tend to become
comfortable, as if in an emotional homeostasis. Within this emotional homeo-
stasis, most people are unlikely to seek out or pay heed to any information
that might contradict their beliefs. This emotional homeostasis is upset with
a form of cognitive dissonance when we are confronted with new information
contrary to our assumed "truths." The portion of the section on the value of
ambiguity (see Assumption 8) in developing ICE will focus more on this issue.
Third, maintenance of perspective is based on unreasoned assumptions
without proof and regard to empirical reality. When confronted with evi-
dence contrary to the encapsulated assumptions, the culturally encapsulated
individual ignores or otherwise invalidates the information presented. Encap-
sulated people have a tendency to be surprised or even unbelieving when con-
fronted with evidence of changes in truth or new truths. An example given
by Wrenn (1962) was the "truth" of the shape of the world. At one point in
time the truth was that the world was flat. Obviously, now this "truth" has
been refuted with new "truth" about the shape of the world. When faced with

94 INCLUSIVE CULTURAL EMPATHY

the viewpoints of others, the culturally encapsulated individual will put
between little and no effort into evaluating them as presented. In this way,
he or she will make very little attempt to accommodate the needs of others.
The exhibit accompanying this section is designed to present a current
"truth" with new information that presents a new "truth" (see Exhibit 5.1).
It is intended to help readers come to understand how vulnerable people all
are to cultural encapsulation and how constant vigilance is necessary to over-
come it and remain outside of it.
Fourth, the culturally encapsulated individual will not put in the effort
to carefully evaluate the viewpoints of others when those viewpoints are not
similar to her or his own and instead will seek technique-oriented short-term
solutions. This individual will also make little effort to accommodate the
needs of others who are different. The encapsulated presumption made is that
everyone was born with the same opportunities and realities and thus only
minimal accommodations are needed. Such encapsulated individuals will
often see that accommodations are needed for others when someone close
enough to them newly requires them. For example, it is common for people
not to be very aware of the way much of the world does not cater to differen-
tial needs of people with physical disabilities until a family member becomes

EXHIBIT 5.1
Testing the Underlying Truth

Objective
To see how people from different cultures experience a different "truth" from the
perspective of their cultural values.
Procedure
1. Ask each member of the class to write down a statement they believe to be true.
(As an alternative, the whole group might identify a statement that all members
believe to be true.)
2. Ask each member to write a sentence explaining why the statement is true.
3. Next ask each member to write a second statement explaining why her or his
first explanation is true.
4. Next ask each member to write a third statement explaining why her or his
second explanation is true.
5. You may go on to asking members to write a fourth, fifth, and more statements,
but usually by this time the class has become hostile and refuses to continue the
exercise saying "I don't know or care why it's true! It's just true!'
6. Ask the members to present their chain of linked explanations leading back to the
statement of truth and look for similarities and differences among the chain of
explanations among class members.
7. When we are pushed back to the "reasons behind the reasons" of how we define
truth (as in arguments on religion or politics or emotional topics), we typically
become quickly upset and anxious.
Note. From 110 Experiences for Multicultural Learning (pp. 74-75), by P. B. Pedersen, 2004, Washington, DC:
American Psychological Association. Copyright 2004 by Paul B. Pedersen. Adapted with permission.

EMBRACING INCLUSION AND DEVELOPING EMPATHY 95

disabled. This form of selective accommodation also occurs with different
viewpoints. For example, it is often the case that individuals adamantly
opposed to the rights of nonheterosexual people will only soften their views
when they discover that a close relative or friend is not and has long not been
heterosexual. Even when a new viewpoint is integrated into the perspective
of a culturally encapsulated individual, it is not uncommon for this person to
choose not to see that such accommodations are likely due to many other
people in many other contexts. In a therapeutic setting, the culturally encap-
sulated counselor will be less likely to recognize when her or his client is hav-
ing distress because of oppression or lack of societal privilege.
As with the identifying features we mentioned previously, the fifth fea-
ture behaviorally overlaps with the others. The culturally encapsulated indi-
vidual judges everyone from the viewpoint of her or his own self-reference
criterion without regard for the cultural context of the other person. A chal-
lenge we all have in confronting our vulnerability to cultural encapsulation
is the fact that many of the things we do on a daily basis inherently reinforce
its ongoing existence. Pedersen (2003a) clarified that the criteria we use in
referring to ourselves can serve as a danger in fostering ongoing cultural
encapsulation. This is to say that the terms and culturally prescribed defini-
tions thereof serve as a tool to maintain our stance within a given cultural
perspective. Most terms we use in self-description are culturally laden and not
value free. Even if we do not say anything directly negative about another per-
son or culture, our self-descriptions automatically place priorities on certain
values, actions, thoughts, and attitudes.
For example, a man who consistently refers to himself as "self-made" and
"independent" is choosing to define himself in terms that highlight specific
culturally encapsulated values. The value-given preference in such a self-
reference is a preference for individualism over collectivism. Using such self-
labels highlights a cultural perspective while simultaneously deemphasizing
or even denigrating other cultural perspectives. This man may consider his
self-description as stating he is competent, hardworking, and accomplished.
His perceived ability to do what he has done in his life "on his own" is what
he sees as a personal strength, and thus a positive self-reference. To another
person, coming from another cultural perspective, this self-description may
have a very different meaning. The man may instead be seen as self-centered,
selfish, not family oriented, not community oriented, and thus without honor.
This man's example conveys that it is ultimately best if a person learns how
to care for her- or himself over caring for the community or system within
which she or he exists.
In this particular example, even if the listener comes from a cultural per-
spective that values independence and self-promotion, such a self-description
can still be problematic. The man describing himself as independent and self-
made may be overlooking societal advantages he has had from birth. The fact

96 INCLUSIVE CULTURAL EMPATHY

that he is a man already means that he has had advantages over women in
"making himself." He may also be overlooking overempowerment coming
from having been born White, heterosexual, in a family with both parents
intact, without any physical or mental impairments, in a safe and comfortable
home, raised as a member of the dominant religion of his area, having been
able to go to better funded schools than others, and so forth. Others not born
with such relative advantages may experience frustration, envy, or lower self-
esteem when talking with this self-made and independent man who has had
a good deal of the advantages given by society as a sort of birthright.
As we discuss these issues with counselors and therapists in training, we
commonly have students posit that cultural encapsulation is really more a
thing of the past and nowhere near as present today as it was when Wrenn
(1962) first discussed it. To the contrary, we feel that cultural encapsulation
may be more common today than it has ever been in the past.

Ten Ways That Cultural Encapsulation Is Common Today

The following is a list of ways that cultural encapsulation manifests itself
on a regular basis today:
1. The portraying of diversity with hostile stereotypes.
2. The dominant culture's overemphasis of universal issues while
ignoring cultural issues.
3. A preference for exclusion and exclusivity rather than inclu-
sion and inclusivity.
4. The common portrayal of diversity and universalist alterna-
tives as polar opposites.
5. A preference for competition over cooperation.
6. A propensity to define reality according to monocultural
assumptions.
7. An insensitivity to, if not complete ignorance of, the exis-
tence and validity of cultural variations.
8. A tendency for those in power to protect unreasoned assump-
tions against perceived challenge.
9. A general preference for technique-oriented, simple solutions.
10. A reluctance to evaluate alternative viewpoints fairly and
openly.
Many, if not all, of the previously discussed tendencies are built on fear
of the unknown. This fear is fed by lack of experience with varying cultures
and peoples as well as the worldviews, traditions, beliefs, and values that
accompany them. As we come to realize the ongoing challenge of combating
our vulnerability to cultural encapsulation, a game plan to confront this chal-
lenge becomes useful.

EMBRACING INCLUSION AND DEVELOPING EMPATHY 97

Eight Ways to Combat Vulnerability to Cultural Encapsulation

The following are eight actions counselors can take to avoid maintain-
ing and developing encapsulated perspectives and responses to the experi-
ences and behaviors of others:
1. Develop an awareness of our own culture and worldview. To
avoid approaching others with cultural encapsulation, individ-
uals need a clear awareness of stereotypes and assumptions we
make or have traditionally made of others. People are often
guilty of oversimplifying the cultures and experiences of others
with biases based on values we have developed as part of our
worldviews. It is not uncommon for people who have majority
status to perceive themselves as devoid of culture, when in fact
it is their culture that determines the way that they respond and
interact to others around them.
2. Develop an understanding of how our life experiences, atti-
tudes, values, biases, and culture influence the way we respond
to others. As our awareness of these issues becomes clarified, we
need to take time to evaluate how they shape our feelings,
thoughts, and reactions to others around us. Such evaluation
will begin to clarify why we might respond negatively to situa-
tions that might have a neutral effect on others. Talking with
others from different cultures and who have different values
about similar situations might help to highlight attitudes, values,
and biases that shape our emotional and behavioral responses
to others.
3. Get to know people who come from different cultural and con-
textual backgrounds than you. For example, if the majority of the
people you know well grew up in a similar environment to yours
(say, suburban or inner city), then you will be well served to get
to know people from quite disparate experiences than yourself.
4. Get to know more about the content of hearts and minds of
people who grew up in very different environments. On top of
meeting and getting to know people from different cultures and
contexts individually, we have found that reading the writings
of people from different backgrounds can dispel a great deal of
myths, biases, and stereotypes. When made to read and respond
to writings by people with different life experiences and per-
spectives, our students have commonly reported that the exer-
cise was powerful and even life altering. Of course, after reading
such a strong statement, some readers will presume that this is
overstated. Keep in mind that that majority of fiction and essay

98 INCLUSIVE CULTURAL EMPATHY

 that the average person reads is written by others coming from
very similar cultures and contexts. Examples of books that have
had a powerful effect on people from disparate backgrounds
include The Bluest Eye, by Toni Morrison; Bone: A Novel, by Fae
M. Ng; There Are No Children Here: The Story of Two Boys Grow-
ing Up in the Other America, by Alex Kotlowitz; and The Circuit:
Stories From the Life of a Migrant Child, by Francisco Jimenez.
5. Seek for understanding on ways that diverse cultures share com-
mon ground. As we have mentioned before, a focus only on dif-
ferences will not foster a productive relationship or the needed
collaborative set that makes therapeutic relationships thera-
peutic. As we learn of the different experiences, values, and cul-
tures of others, a key to the development of empathy is the
development of an ability to connect with others in the cultural
borderlands we share.
6. Persevere in a routine of unlearning something every day. This
suggestion was made by Wrenn (1962) when he first introduced
the concept of the culturally encapsulated counselor. This is
based on the fact that truth is not static but instead evolves as
new information is introduced. We can combat our vulnerabil-
ity to cultural encapsulation with an ongoing regime focused on
replacing outdated things we have learned with new things we
learn. As we discard that which is no longer true, we make way
for new truths. We need to remember that the very things we
hold most important in our beliefs may be the very things that
others have every reason to not believe.
7. Learn to trust others to have solutions to problems to which we
see no solutions. Our inability to generate effective solutions is
often based on the limited viewpoints from which we study our
challenges. As we learn to trust others who come from different
perspectives and contexts, we learn the true meaning of cele-
brating the power of diversity. We learn that differences are not
best when tolerated, but instead best when seen as something
akin to a broad platform on which we can stand with confidence.
8. Develop new standards for assessing "appropriate" behavior aside
from our own reference groups. The fatal flaw of cultural encap-
sulation is our tendency to compare all others with what we are
most familiar. The integrations of diverse definitions of propri-
ety allow us to alter ourselves mentally and emotionally on the
basis of the various contexts and cultures of people with whom
we come in contact. We should take time to ask others what they
see as appropriate and follow up with garnering information on
why they see things the way they do. This process is not so much

EMBRACING INCLUSION AND DEVELOPING EMPATHY 99

 about augmenting our own values as it is about developing com-
fort with values that are not the same as our own.

Further Discussion on Cultural Encapsulation

A common culturally based perspective on human sexuality is that sex-
ual intimacy occurs in one of three categories. Sexual intimacy occurs
between opposite sexes (male and female), which is defined as heterosexual;
between same sexes (male and male or female and female), which is defined
as homosexual; or with people of either the same or the opposite sex, which
is defined as bisexual.
This culturally based perspective is founded on the assumption that all
people are born either male or female. This is actually not accurate. A large
number of individuals throughout the world are born with ambiguous sexual
reproduction systems. These people, once known as hermaphrodites, among
other labels, now prefer to call themselves intersex. Although the term inter-
sex is most commonly used to refer to developmental anomalies that result in
ambiguous differentiation of external genitalia, it may be used to describe the
lack of concordance in the chromosomal, gonadal, hormonal, or genital char-
acteristics of an individual. Thus a person with an intersex condition is born
with sex chromosomes, external genitalia, or an internal reproductive system
that is not considered "standard" for either male or female.
The instance of intersex anomalies has been estimated to be between 1 in
every 100 to 1 in every 4,500 (1 in 2,000 is cited most often). This means that
it is likely that more babies are bom intersexed than those born with cystic fibro-
sis, the incidence of which is 1 in 2,500 (Blackless et al, 2000; Dreger, 1998).
In the United States, the current response of choice (or correct treat-
ment) for intersex individuals is to "normalize" the abnormal genitals using
cosmetic surgical technologies, cosmetic hormone technologies, and so on.
Doing so is thought to eliminate the potential for psychological distress. In
the past several years, numbers of people born intersexed have joined together
to advocate for the "normalization" processes to be stopped with intersex chil-
dren until they are old enough to consent to the treatment.
A brother of one of the authors was born intersex. After the doctors and
his parents chose his gender to be male, he was medically treated to appear more
masculine. On top of other medical treatments, he was treated with a powerful
regime of male hormones. He has been happily married for over 16 years to a
heterosexual woman. In the past several years, Hale has become an advocate
for the rights of unborn intersex people, appearing on a documentary with the
Discovery Channel and in interviews with the online magazine, Salon.
Given the previous information, consider the following questions to
help explore your level of encapsulation:

100 INCLUSIVE C LJLTURAL EMPATHY

 1. What does the information about intersex say to you about the
construct of gender?
2. If gender can be assigned to people at birth, despite the reality
of their biology, is gender an appropriate factor to use in decid-
ing who may marry whom in society?
3. In the case of Hale and his wife, what type of relationship do
they have? (heterosexual, homosexual?)
4. If you consider it a heterosexual relationship, what criterion are
you using to make that distinction?
5. What if, at birth, the doctors had decided to make Hale into a
female? How would that affect your views about his relationship
with his wife?
6. In several cultures throughout the world, children who are born
intersex are not treated like they were bom with birth defects
but instead are revered as special. How do you see cultural
encapsulation playing a role in the Western approach to the
response to intersex newboms?

ASSUMPTION 6: INCLUSION IS MORE LIKELY TO DEFINE

A CULTURAL CONTEXT THAN EXCLUSION

Historically, most of the research on therapeutic process and out-

comes has focused almost uniformly on either individuals or families (Ivey,
Ivey, & Simek-Morgan, 1993). This approach to thinking about psycho-
therapeutic relationships has overlooked broader social units such as orga-
nizations and social systems and thus falls short of comprehending the
entirety of the human experience (D. W. Sue, 1995). This research is
reflective of a cultural bias historically inherent in the approaches of coun-
selors and psychologists. Many counselors continue to focus therapeutic
work on the individual and her or his perceived needs while overlooking
how that person is an interactive component of a cluster of many other sys-
tems. As the family systems approach introduced the concept of the self-
in-system over 4 decades ago, a systemic perspective is beginning to take hold
in the work of many therapists. Although this movement is in the right direc-
tion to allow for a much more inclusive approach to the perspectives and
approaches used in counseling relationships, the field still needs to become
even more inclusive. Many therapists using a systemic approach have a ten-
dency to define the client's system as her or his immediate family and little
more. This approach still falls short of the reality of the experience of a great
deal of our clientele. A more culturally aware approach to counseling will
include self-in-relation and family-system-in-relation to broader systems within
varied contexts. D. W. Sue, Ivey, and Pedersen (1996) summed up the issue

EMBRACING INCLUSION AND DEVELOPING EMPATHY 101

well when they emphasized that "a part of every counseling session needs to
attend to significant others and contextual issues" (p. 37).
The key to inclusivity within cultural context is an awareness of the fact
that a therapeutic focus on individual or narrowly defined systemic problems
is very likely overlooking many key factors related to the client's needs.
Arguably, a portion of every single counseling session should focus on issues
of context and the client's existence as a person-in-relation to others as well
as context. Therefore, homosexual people experiencing symptoms of anxiety,
women with depressive symptomatology, and differently abled people expe-
riencing issues of self-esteem should be helped from a perspective that
includes not only their individual challenges but also issues of homophobia,
sexism, and ableism, respectively. Ultimately, the culturally aware counselor
will use a culture- and context-centered approach to counseling instead of the
more simplistic client-centered approach.

Inclusion Activity: The Intrapersonal Cultural Grid

The intrapersonal cultural grid (ICG) provides a means to describe and

understand specific behaviors in the context of the expectations and values
behind that behavior (see Figure 5.1). The ICG defines cultural context
broadly to include all salient social system variables. The interaction of the
personal variables and cultural teachers in the ICG assumes that culture is so
dynamic and complex that the cultural context changes across individuals
and across situations. Rather than describe a person's "culture" as a static or
unchanging label, this grid describes how each behavior is controlled by
salient expectations and culturally learned values. This broad definition of
culture makes the following three assumptions.
1. Each person's multicultural identity is complex, incorporating
a combination of salient social system variables.
2. Each person's multicultural identity is orthogonal, including a
multiplicity of salient social system roles simultaneously.
3. Each person's multicultural identity is dynamic, changing from
time to time and place to place as different social system roles
become salient.
Rather than describe a person's culture in the abstract, the ICG seeks to
identify a specific individual's personal cultural orientation in a particular sit-
uation through understanding each specified behavior in the appropriate cul-
tural context. The grid combines personal (behavior, expectation, and value)
with social system variables (cultural teachers).
The ICG is based on the notion that culture is "within the person," pro-
viding a framework for linking intrapersonal with interpersonal variables. Each
person's behavior by itself does not communicate a clear message or intention.

102 INCLUSIVE CULTURAL EMPATHY

 PERSONAL VARIABLES

Where you learned Why you did it What you did

to do it

CULTURAL TEACHERS

1. Family relations
Relatives
Fellow countrypersons
Ancestors
Shared beliefs

2. Power relationships
Social friends
Sponsors and mentors
Subordinates
Supervisors and
superiors

3. Memberships
Coworkers
Organizations
Gender and age groups
Workplace colleagues

4. Nonfamily relationships
Friendships
Classmates
Neighbors
People like me

Figure 5.1. The intrapersonal cultural grid. From A Handbook for Developing
Multicultural Awareness, Third Edition (p. 96), by P. B. Pedersen, 2000, Alexandria,
VA: American Counseling Association. Copyright 2000 by the American Counseling
Association. Reprinted with permission.

Only when that behavior is analyzed within the context of the person's salient
social system variables does the person's intended message become clear. The
context is best described by what is called expectations. Expectations are cogni-
tive variables that include behavior-outcome and stimulus-outcome expectan-
cies that guide individual choices. "If I do this ... (insert behavior), then that
... (insert expectation) is likely to occur." The social system variables are essen-

EMBRACING INCLUSION AND DEVELOPING EMPATHY 103

tial to both persons in a relationship for understanding one another's anticipated
outcomes. The skill of extrapolating expectations from social system variables
and linking specific behaviors with expectations improves with practice. The
ICG is designed to help you analyze your behavior by first matching it with rel-
evant expectations, then identifying the values behind each expectation, and
finally identifying the social system variables that taught those values.
Use the following steps to analyze your behavior with the ICG:
Step I: Identify a particular behavior in yourself or someone else. Let's
look at your behavior in deciding to read this chapter.
Step 2: Evaluate the expectation behind the behavior. What do you
expect to happen as a result of your reading this chapter? Let's assume you
expect to learn something you do not already know, although there are
actually many different and sometimes conflicting expectations attached
to a single behavior.
Step 3: Identify the values on which each expectation is based. If we
assume you are reading this chapter to learn something, then perhaps
learning is an important value for you. Again, there are many different
values behind each expectation, some more conscious than others.
Step 4: Find out from where those values came. Who taught you the val-
ues that shape your expectations and direct your behavior? We may well
search for the source of your values by looking at social system variables.
Each value, such as learning, may well come from many sources, such as
family, religion, educational group, socioeconomic group, ethnic or
nationality group, affectional orientation, and gender group, to name but
a few of the likely candidates. In any case, you know for certain that those
values were taught to you by someone and did not "simply happen."

By identifying each social system variable for a person's specific behav-

iors, the ICG helps to deconstruct the context of the expectations and val-
ues behind each behavior and highlights the importance of defining cultural
context broadly.

ASSUMPTION 7: INTERNAL SPIRITUAL RESOURCES

ARE IMPORTANT

It is helpful to be aware of the clients' spirituality and religiosity and of

the roles that religion and spirituality play in their lives. Religion and spiritu-
ality play large roles in the lives of most U.S. citizens. According to a poll, 88%
of Americans describe themselves as religious or spiritual, although a larger
percentage of Americans see themselves as spiritual rather than as religious
(L. Miller, 2005). This same poll reported that 81% of Americans practice
Christian religions, whereas 4% practice non-Christian religions and 15%

104 INCLUSIVE CULTURAL EMPATHY

practice no religion. A very high percentage of Americans believe in a God
(96%), and three quarters of the U.S. population see religion as a very impor-
tant part of their lives (Corey, Corey, & Callanan, 2003). The predominant
religions in the United States are Roman Catholic, Baptist, Methodist, and
Lutheran, with Roman Catholic and Baptist coming in as the two most com-
monly identified religions by state. From the data, it becomes clear that the
overwhelming majority of Americans see themselves as Christian, whereas
those who practice any non-Christian religion are in a very small minority.
Although people throughout the world have known it for centuries,
social scientists are increasingly finding empirical evidence that religious and
spiritual values and associated behaviors can promote wellness (Richards &
Bergin, 1997; Richards, Rector, & Tjeltveit, 1999). Numerous studies have
found evidence of a relationship between spirituality and perceived ability to
cope with chronic illness, disabilities, and other stressful life events (e.g.,
Brooks & Matson, 1982; Carson & Green, 1992; Crigger, 1996; Kilpatrick &
McCullough, 1999; Tix & Frasier, 1998). A common thread across these
studies was the fact that when faced with crises, people have a tendency to
turn to their religious and spiritual beliefs and customs for comfort. Ironically,
merely one third of psychologists appear to view religious faith as important
in their own lives (Plante, 1999). Thus, there appears to be a lack of con-
nection between the perspectives of clients and the perspectives of psychol-
ogists when it comes to religion and spirituality.
If religion and spirituality are important to our clients' worldviews, then
they should also be important to us as culturally inclusive counselors. Stanard,
Sandhu, and Painter (2000) argued that because of the growing body of empir-
ical evidence of the importance of spirituality and religion in clients' percep-
tions and wellness, spirituality should be considered the "fifth force" in
counseling and psychology. Although up to 95% of professionals see a con-
nection between spirituality and mental health, coursework on spirituality in
therapy is relatively rare in training programs (Carlson, Kirkpatrick, Hecker,
& Kilmer, 2002). Religion and spirituality may have been historically
excluded from the field of psychology because of its origins as an empirical dis-
cipline (Wolf & Stevens, 2001). The field of psychology seems to have long
avoided the area of study despite Jung's (1933) teaching that healing is not
possible without a spiritual awakening or at minimum a focus on the issues rel-
evant to spiritual distress. It is our view that competent mental health profes-
sionals will take extra effort to study religion and spirituality as they pertain
to wellness and apply this learning in their therapeutic relationships. If we
continue to relate to our clients ignoring spiritual and religious issues, we may
miss crucial variables that would be of the utmost help to them. For example,
Rodriguez (2004) argued that in Latino cultures, spirituality and religion are
so integrated that a focus on the client's culture separated from spirituality cre-
ates a false dichotomy and thus does a disservice to Latino clients.

EMBRACING INCLUSION AND DEVELOPING EMPATHY 105

 An important component to effective awareness of religion and spiritu-
ality as key factors in the therapeutic relationship is the therapist's recogni-
tion of her or his own religiosity and spirituality. Various authors have argued
that personal religious and value clarity is key to effectively relating to clients
on spiritual grounds (e.g., Faiver, Ingersoll, O'Brienn, & McNally, 2001; Grif-
fith & Brian, 1999). Similar to other forms of cultural awareness, relating
effectively with another person on issues of spirituality becomes very difficult
if not impossible if the therapist has not developed clarity and comfort with
her or his own spirituality. Faiver and colleagues described awareness with
regard to religion and spirituality as an awareness of one's own beliefs com-
bined with open-mindedness to other beliefs. To this definition we would add
that it is helpful if the therapist can develop a genuine interest in the beliefs
of her or his clients as well as a comfort in exploring the overlap of religious
and spiritual values with other cultural and contextual variables.
Religious and spiritual perspectives vary from orthodoxies of major inter-
national religions, such as Catholicism, Islam, Hindu, and Buddhism, to much
less structured perspectives including those of various indigenous peoples, such
as the Navajo peoples, to nonreligious-based approaches to spirituality, such
as the humanist and moralist approaches. Affective acceptance of religious and
spiritual diversity requires the counselor to be, at minimum, versed in her or
his own views and beliefs in religion and spirituality while simultaneously open
to learning new views and beliefs. It is also quite common to find that the
clients' use and focus on spirituality and religiosity will vary because of other
cultural variables. For example, Fumham and Forey (1994) found that women
are more likely than men to seek alternative therapeutic help.
Zinnbauer and Pargament (2000) presented four helping orientations
that counselors use with regard to religious and spiritual issues in psychother-
apy. These approaches are rejectionism, exclusivism, constructivism, and plu-
ralism. An overt focus on how we approach others' religiosity and spirituality
is necessary because no therapeutic relationship is value free regardless of the
counselor's efforts to maintain a value-free stance and because counseling has
been found to be inherently value laden (Bergin, 1980; T. A. Kelly, 1990).
Rejectionism is an approach that is focused on denial of the importance
of religious and spiritual realities commonly fundamental to the majority of
our clients. Belief in the existence of a god, spirits, heaven, reincarnation, res-
urrection, and holy land are examples of the types of spiritual realities that
rejectionists deny. From this perspective, expressions of spirituality and reli-
giosity are interpreted as evidence of underlying mental illness instead of
taken simply as expressions of spirituality and religiosity. These counselors
focus on helping their clients to work beyond the supposed defenses, delu-
sions, and magical thinking of such to a more rational and ego-oriented man-
ner of living. As examples of this approach, Zinnbauer and Pargament (2000)
included the psychoanalytic concept that religion is little more than a defen-

106 INCLUSIVE CULTURAL EMPATHY

sive primitive idealization, the cognitive-behavioral approach that equates
religious thinking with irrationality and disturbed mental and emotional
functioning, and the existential description of religious beliefs as ways to
avoid responsibility and decision making and defenses against anxiety about
death and dying. Zinnbauer and Pargament criticized this approach to reli-
giosity and spirituality as (a) deterring a counselor's ability to develop an
effective therapeutic alliance with religious clients, (b) creating a general
wariness of therapists because of expectations that the clients' values and reli-
gious beliefs will be altered and demeaned in counseling, (c) misrepresenting
religiosity and spirituality as counterproductive to mental wellness, and ulti-
mately (d) disrespectful to cultural variance in clients.
In direct contrast to the rejectionist approach is the exclusivist approach
to religious and spiritual issues. Exclusivism is based on a fundamental belief in
the reality of a religious or spiritual dimension of existence for all peoples.
Exclusivists tend to have strong beliefs that they do not readily reconcile with
beliefs of others that are different. They believe that there is a set of absolute
realities that are true and applicable to themselves as well as all people. These
realities are generally based on orthodox translations of religious texts. Ema-
nating from this belief set is the assumption that one set of values and world-
views is ultimately correct and thus most conducive to mental and emotional
health. Exclusivism can function much like religious zealotry in that the exclu-
sivist is resolute to help the client also believe in a specified solitary "true" reli-
gious or spiritual worldview. The exclusivist sees the counselor's role with
clients who believe differently as one of responsibility to bring the client
to also believe in the same religious values and percepts as the counselor.
Zinnbauer and Pargament (2000) criticized this approach as being (a) ethi-
cally unsound in its overt rejection of different values and beliefs as well as
proselytizing of the counselor's values and beliefs, (b) judgmental and reject-
ing of others from different religious backgrounds and different denominations
in the same religious vein (e.g., Catholic and Baptist), and (c) ignorant of the
fact that both religious and nonreligious varieties of coping play a role in men-
tal health and in coping successfully with challenges.
The constructivist approach refutes the existence of an absolute reality
while recognizing that individuals have the ability to create their own per-
sonal realities and meanings out of life. Constructivism is based on the assump-
tion that all belief systems are ultimately constructed by individuals and
collectives on the basis of their varying social contexts. The focus of con-
structivists is primarily on the quality of the client's constructions as evalu-
ated by its internal consistency and coherency as well as its functionality in
helping the client adapt to her or his context. Constructivists intentionally
work within the belief systems of their clients, intentionally incorporating the
worldviews of each client. Zinnbauer and Pargament (2000) highlighted a
few concerns about use of the constructivist approach: (a) Authenticity may

EMBRACING INCLUSION AND DEVELOPING EMPATHY 107

become a concern when the beliefs of the constructivist counselor vary sig-
nificantly from those of the client, thus harming the quality of therapeutic
alliance; and (b) clarity of definition of wellness and pathology may become
tenuous, as definitions of propriety are sometimes based on religious values
that run contrary to commonly accepted cultural norms (e.g., the view of
children having rights independent of their parents).
The pluralist approach allows for multiple interpretations of reality
based on various religious and spiritual perspectives. Pluralism is based on
recognition of the existence of an absolute reality but affords numerous and
even conflicting belief systems as appropriate in defining it. The pluralist
believes that many spiritual paths can be valid in the human striving for spir-
itual fulfillment and that the same spiritual reality can be expressed within
different cultures and by different people in diverse ways. Pluralistic perspec-
tive clarifies that no single religious system is able to fit all religious or spiri-
tual reality as each different system has a limited slant on the truth. In this
way, the pluralistic counselor may maintain personal religious beliefs while
simultaneously appreciating the different beliefs of her or his clients. These
differences are not seen as detrimental to the therapeutic alliance as they each
play a role in defining the same ultimate reality. The pluralistic approach
requires both the counselor and client to be cognizant of her or his own indi-
vidual spiritual and religious history, worldview, and values. Therapeutic
goals are codefined from a shared belief in an absolute reality with flexibility
for differing cultural interpretations and perspectives.
Similar to the advice of Zinnbauer and Pargament (2000), we recommend
that counselors develop the ability to use either the constructivist or pluralist
approach to client spirituality and religiosity. The approach that fits you best
will depend largely on your own spiritual and religious stance. Those who have
no specific religious or spiritual leanings will likely be most comfortable with
the constructivist approach, whereas those maintaining a set of religious beliefs
and values will likely be more comfortable working from the pluralist approach.
Either approach requires the counselor to be aware of her or his own spiritual
and religious beliefs and values and maintain openness to those of the client.
A culture-centered perspective enhances a person's spiritual complete-
ness by linking culturally different spiritual perspectives of the same Ultimate
Reality. Spiritual dimensions are partially defined by each different perspec-
tive of many different cultural groups. The goal should be to acknowledge
each group's limited and imperfect attempt to describe the Spiritual Infinite
rather than being the exclusive captive of any one limited perspective. Clients
define themselves and their realities on the basis of spirituality and religiosity
from any number of sources. We need to become aware that for many cultures,
the healing process is infinitely intertwined with spiritual wellness. To many
people, psychological distress is basically related to a sense of spiritual entan-
glement that requires "straightening." Empathic counselors and therapists

J 08 INCLUSIVE CULTURAL EMPATHY

will select approaches to counseling from a ground of flexibility and broad
awareness of the varying importance of spirituality in the process. The coun-
selor with ICE will also be able to work with creativity and flexibility that
allows for a blending of conventional and more alternative methods of helping
(D. [Link]., 1996).
The following are a few questions that might be used in exploration of
the role of religion and spirituality in your clients' identity, as paraphrased
and adapted from Archer and Waterman (1993, pp. 327-329):
• Do you have a religious preference?
• On a 7-point scale, with 7 being extremely important and 1 being
not important, how important are your religious beliefs to you?
• Do your parents have a religious preference, and if so, how
important is it to them?
• Does your spouse have a religious preference? How does your
spouse feel about your religious beliefs?
• Are there any differences between your beliefs and those of your
spouse or parents?
• Do you currently attend religious services? If so, how often?
Have you in the past?
• What are your reasons for attending the services?
• How do you feel while you are engaged in activities related to
your religion?
• Do you find yourself getting into religious discussions? If so,
what point of view do you take?
Exhibit 5.1 is designed to highlight how people of different cultures
experience a different truth from the perspective of their cultural values.

ASSUMPTION 8: AMBIGUITY, ALTHOUGH INCONVENIENT,

HAS POTENTIALLY POSITIVE VALUE

Social scientists have increasingly come to the realization that ambigu-

ity is not necessarily an enemy to mental health. Many have hypothesized
that knowledge itself is much more integrative and interactive than it is
static. Kitchener and Brenner (1990) defined wisdom as a synthesis of knowl-
edge from divergent points of view. Meacham (1990) hypothesized that a key
aspect of wisdom is a consciousness of one's own unreliability and an aware-
ness of what one does and does not know. Labouvie-Vief (1990) highlighted
the importance of an efficient and evenhanded dialogue between logical
forms of thinking and more illogical forms of processing. In response to 25 years
of science, life, and practice, Gelatt (1989, 1991) changed his theoretical
perspective from a fully rational approach to decision making (Gelatt, 1962)
to an embracing of ambiguity he called positive uncertainty. This approach

EMBRACING INCLUSION AND DEVELOPING EMPATHY 109

focused on the value of maintaining an open mind accepting and even
embracing inconsistency and uncertainty and using the nonrational thought
and intuition in the process of making decisions. The focal rationale for this
perspective is based on the postmodern philosophy that reality is not objec-
tively measurable but instead the subjective creation of each individual from
her or his given frame of reference.
The following three guidelines of this approach are useful for high-
lighting the manner in which therapists may begin to embrace ambiguity en
route to developing ICE. These guidelines focus on information, process, and
choice. The value of embracing uncertainty is emphasized throughout.
1. "Treat your facts with imagination, but do not imagine your
facts" (Gelatt, 1989, p. 254). The basic premise behind this
guideline is that decision processes would be completely unnec-
essary if we had constant and consistent access to all the infor-
mation. The process of decision making is based on the need to
collect, evaluate, and respond to information. The problem with
a solely rational approach to doing this is based on three issues.
First, the reliability of facts is limited as they become obsolete
quickly. Society is going through such a rapid amount of change
that knowledge on any issue has a short tenure. What we leam
today can become obsolete tomorrow and then be seen as little
more than misinformation. Second, increased information often
brings increased uncertainty. Information can be garnered at
such great speed today that it inherently outpaces our ability to
fully process it. It is not uncommon for the most learned schol-
ars to state that the greatest thing they have learned is that they
really do not know anything. Third, as information is sent and
received by people with subjective perspectives and varying
worldviews, it becomes modified at both ends of the transaction.
Thus, no information is truly objective and devoid of bias. As
therapists, we will benefit from the knowledge that what we
actually know is ultimately ambiguous and the tip of the iceberg
of what is actually truth. As we become comfortable with our
uncertainty about that which we know, we can develop an atti-
tude of enthusiasm for collecting other new and different infor-
mation and opinions. Such an approach affords us with the
ability to embrace the fact that there is always more to learn and
respond with creativity and imagination.
2. "Know what you want and believe but do not be sure" (Gelatt,
1989, p. 254). If we become too fixed on what we want, we can
miss out on the opportunity to discover new and better things to
want. Evidence to this end includes the fact that many of the

110 INCLUSIVE CULTURAL EMPATHY

 greatest inventions were discovered by accident. Examples of
this include the accidental inventions of the microwave oven,
Silly Putty, Velcro, the Slinky, Vaseline, and the yo-yo. In the
case of the microwave oven, in 1942, Percy Le Baron Spencer
was working with radar equipment at Raytheon when he noticed
that a candy bar had melted in his pocket. The story follows that
the second thing Spencer held in front of the equipment was a
bag of unpopped popcorn. It is clear that Spencer, and ultimately
the world, was served by his creative responding to unexplained
happenstance. The process of making decisions should not only
be a process for achieving goals but also be one for discovering
them. An approach to life as it unfolds around us devoid of a
rigid holding to a set of beliefs can lead to creative responding
and powerful discovery. Our beliefs have a tendency to function
as glasses through which we look at the world. On this metaphor,
rigid holding to beliefs can leave us living a life with blinders on,
blocking our ability to see fantastic new opportunities. Our cre-
ativity, imagination, and positive coping are best served when
we have embraced the ongoing process of including new infor-
mation and arranging and rearranging it in our mind's eye.
3. "Be rational, unless there is a good reason not to be" (Gelatt,
1989, p. 255). This guideline emphasizes a holistic approach to
science in which a balance is created between what is consid-
ered to be rational and what is intuitive. Knowledge and logic
function most effectively when counterbalanced with creativity
and flexibility. A natural result of this combination is inconsis-
tency in choice. It is likely impossible to be flexible and inven-
tive without demonstrating a certain amount of inconsistency.
When balancing our environs in this manner, flexibility calls
for a capability to respond to change as well as a capability to fos-
ter change. The future is much less predictable than it is created.
Embracing dichotomies affords us the ability to invent the future
instead of allowing someone else to invent it for us.
The debate activity in Exhibit 5.2 is designed to help bring affective
acceptance and develop skills relative to positive uncertainty.

Vignette for Debate Activity

Martha, a 21-year-old high school dropout, was kicked out of her father's
home at age 16. She survived the first 3 of the past 5 years by living with friends
and working odd jobs. In the past couple of years, she found herself becoming
increasingly dependent on others, as she has developed an addiction to crack

EMBRACING INCLUSION AND DEVELOPING EMPATHY 111

 EXHIBIT 5.2
Dichotomous Thinking Versus Positive Uncertainty Debate
Directions: Divide the class into four groups. The groups are all presented the
debate scenario listed in the text and are then asked to prepare different arguments
from the perspective of their group affiliation.
1. Dichotomous Thinking Group A: Responsibility of the Individual
This group is to prepare an argument on why all responsibility falls on the
individual in the vignette.
2. Dichotomous Thinking Group B: Responsibility of Society
This group is to prepare an argument on why all responsibility falls on society,
based on the vignette.
3. Positive Uncertainty Group
This group is to prepare an argument on how responsibility is not inherently an
"either/or" issue, on the basis of the vignette.
4. Debate Evaluation Group
This group will prepare to evaluate the merits of the debate of each group. Part of
this group's preparatory discussion should include how they will evaluate the
debaters' arguments without allowing bias to enter into the process.

cocaine. Over the past 2 years, her living environment has varied from home-
lessness to living with friends to living in a crack house. Martha has turned to
using her sexuality to support her addiction in the past year. Martha recently
had a baby boy from an unknown father who was bom addicted to crack.

Question for the Debate

On whom does the responsibility for the care of the baby boy stand?

Discussion Questions for the Debate Activity

1. How did you feel when you were put in the position of taking a
particular stand on this issue?
2. Did anyone develop a new perspective through this activity? If
so, what is it, and how did you develop it?
3. What other types of issues might be well served by a "positive
uncertainty" perspective?
4. How might positive uncertainty help counselors develop better
ICE?

FINAL THOUGHTS ON AFFECTIVE ACCEPTANCE

Each of the eight assumptions presented in this and the previous chap-
ter is important to the development of the kind of awareness necessary to

112 INCLUSIVE CULTURAL EMPATHY

develop ICE. We would like to add that as counselors seeking to become cul-
turally aware, one should also do the following. First, one needs to become
familiar with cultural and language differences and how these differences cre-
ate contexts for others that are different than for themselves. As discussed in
this and the previous chapter, many variables come into play in the quality
of experience of each person with whom therapists come in contact. Aware-
ness of the relevant biases, prejudices, and the systemic responses built out of
them allow counselors opportunity to become effective and empathic.
Second, counselors and therapists who are culturally aware are also con-
cerned for the welfare of culturally different clients. There are many issues
and situations that our culturally different clients confront and are confronted
with on a regular basis that may be very different from our own experiences
and contexts. In chapters 6 and 7, we cover applications of ICE that demon-
strate that culturally inclusive professionals respond to the welfare needs of
clients through empowerment, prevention, and advocacy efforts.
Third, an awareness of multicultural issues is directly related to an ongo-
ing desire to learn about, understand, and become sensitive to the experiences
and perspectives of people of different cultures and contexts. This requires
ongoing efforts to learn, flexibility regarding personal beliefs and expectations,
and a passion to connect with clients where they are. Although many thera-
pists have historically strived to meet their clients in the middle on these vari-
ables, this has not always worked in the clients' favor. Such expectations can
too easily become culturally impositional, as many therapists define wellness
on the basis of their own cultural background and biases. The section in this
chapter on the importance of internal spiritual resources (Assumption 7)
focused on four different types of approaches used in responding to the cultural
differences of religion and spirituality (rejectionism, exclusivism, construc-
tivism, and pluralism). These four approaches somewhat parallel those offered
in the section focused on exploring cultural similarities and differences.
Fourth, as we become increasingly aware of the perspectives of our
clients, it is important that we are also able to articulate our own cultural
backgrounds effectively. Such articulation should only be carried out in a
manner that avoids any perception of imposition of values on our clients. The
ability to articulate our own backgrounds is important because we need to
navigate the territory of both similarities and differences we have in common
with our clients.
As we develop increasing multicultural competence, we must recognize
that there will always be limits to our cultural expertise. When one observes
the multitude of cultures and intersections of cultures, it is easy to see that it
is not possible for any one person to know everything. Multicultural compe-
tence is more of a journey than a destination. Cultures are constantly evolv-
ing as they interact and adjust to changes in a complex world.

EMBRACING INCLUSION AND DEVELOPING EMPATHY 113