February 1979

Psychotherapy in the Goldfish BowlThe Role of the Indigenous Therapist

Author Affiliations

From the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School (Dr Borus), and the North End Community Health Center Mental Health Program, Boston.

Arch Gen Psychiatry. 1979;36(2):187-190. doi:10.1001/archpsyc.1979.01780020077008

• The therapeutic advantages and liabilities that accrue to the indigenous therapist (be he professional or paraprofessional) because of the indigenous state were explored, utilizing the five-year experience of ten indigenous therapists in Boston's North End. The current and historical proximity of therapists who live in the same neighborhood as their patients do provides both with increased access to, longitudinal knowledge about, and a blurred role concept of the other that may help or hinder the therapeutic process. Similarities in culture and values can foster alliance formation, differentiation of psychopathology, and therapeutic interventions, but also may interfere when therapy abuts culturally shared blind spots. These data are relevant to the private general psychiatrist as an indigenous therapist in nonmetropolitan America.