The following was written by an older woman using the pseudonym Schoonmaker (1993):
I became 18 years old at the close of World War II. It was a time when men came back from the war to reclaim their "rightful"
place in society, i.e., one of dominance. A new wave of homophobia swept the nation as men sought the jobs held by women during the war, expecting the women to return to their previous subservient roles. College deans expelled students for lesbian attachments; my college was no exception.... I isolated myself from fellow students and was terrified that discovery of my sexual orientation would end my hopes for a medical career.
If even the word homosexual was used in my presence my mouth got dry and my heart pounded. I carefully wiped out any traces of a personal life in my conversations with co-workers, and refused all social invitations. I continued to be alone with my shame. (Schoonmaker, 1993, p. 27)
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In mental health assessments, a client's personal history is commonly organized into a developmental and social history that includes informa- tion regarding the individual's education, family upbringing, significant relationships, work experience, medical and psychiatric history includ- ing substance use, and psychiatric or psychological treatment. Questions aimed at eliciting information in these categories typically assume a pas- sive stance toward clients' cultural histories. But as Schoonmaker's (1993) experience illustrates, understanding the cultural events during the his- torical periods of a client's life adds to the therapist's understanding of a person (Rogler, 2002). It can be helpful to think of the historical cultural context as a sort of template into which the individual's personal history fits—a template that deepens one's understanding of the individual.
Consider another case of a college-educated, married 72-year-old Japanese American man during an assessment conducted in 2007. Cal- culating the client's date of birth immediately leads to questions about the client's personal history in relation to historical events. A general knowledge of the dominant cultural attitudes toward Japanese Ameri- cans during World War II, the probable internment of the client's fam- ily, and the socioeconomic losses of Japanese Americans after the war would lead the therapist to make hypotheses about the impact of the war on the client that are different from those the therapist might make about an older European American man.
Furthermore, the greater a therapist's knowledge of historical events that are significant in the client's culture, the more relevant his or her questions will be. For example, this Japanese American client turned 18 years old a few months before the Korean War armistice was signed.
Did he serve in the military, and if so, what was his experience as a visi- bly Asian American man? How did the assimilationist attitudes of the late 1940s and 1950s affect him? He was a young adult when the Civil Rights Act became law in 1964; did this event have an impact on his employ- ment opportunities? As an Asian American, what was his experience of the Vietnam War? Recognizing the illegality of interracial marriage in many states until 1967 (Root, 1996), did he marry a Japanese American woman or not? What did the women's movement in the dominant cul- ture mean for his marriage? These questions are similar to those sug- gested for therapists in their own cultural self-assessments. Although it may not be appropriate to ask the client all of these questions, the ther- apist's consideration of them can open up a wider range of hypotheses about the client.
The answers to such questions depend to a great extent on the client's immigration history, including where he, his parents, and his grandparents were born and grew up. This particular client's history raises the following questions: Does he identify as issei (the first gener- ation of Japanese American immigrants) or nisei (the second generation, and the first born in the United States)? Or might he identify as kibei, a
subset of the nisei who were born in the United States, were sent back to Japan for their education, and then returned to the United States (Matsui, 1996; Takaki, 1993)? If he grew up in Hawaii, did his parents work in the sugar cane fields, as did many Japanese people living in Hawaii in the 1930s? Or were they immigrants to the mainland United States during a time when anti-Japanese sentiment was building in the form of the San Francisco School Board Segregation Order of 1906, the California Alien Land Law prohibiting Japanese immigrants from buy- ing land, and the Immigration Act of 1924, which essentially halted Japanese immigration to the United States (Matsui, 1996)? Finally, the therapist should think about and possibly ask the client how it was for him to move into the identity of an older man within his own fam- ily, keeping in mind the variety of attitudes toward aging in Japanese, Japanese American, and European American cultures.
Although the therapist might not know about all the specific events mentioned in the preceding paragraph, all it takes is a few minutes after an assessment to look up a particular era in a history book to get a feel- ing for cultural events of the times. Takaki's (1993) and Zinn's (2005) books on the history of ethnic minority groups in the United States are excellent resources. For Canadians, I recommend Unequal Relations: An Introduction to Race and Ethnic Dynamics in Canada by Elliott and Fleras (1992). With regard to people who grew up in other countries, the annu- ally updated World Almanac (World Almanac Education Group, 2007) is a convenient resource with information on the languages, religions, eco- nomic conditions, ethnic identifications, and political events of every country in the world. A good resource for practical descriptions of dif- ferent religions is The World's Religions by H. Smith (1991).
One way to call attention to the historical influences on a client's life is to construct a timeline that notes sociocultural events in addition to personal events. Figure 6.1 provides an example. As with any time- line, intersecting marks on a horizontal line denote significant dates.
F I G U R E 6 . 1
Example of Timeline for Older Japanese American Man
Interment WW II Assimilationist period
19 b. 1935
enc
42 19 s Korean
armist
45 19
r
53 196
Women's Vietnam Strong Multiculturalism Rising health Social Security u, A » moverr
jhts Act
Interracial marriage illegal until 4 1965 19
1967 i6 19
lent V e
Var U ids ecor
1970s 1975 19 S.
omy
)0s I I
i8 19
Interned Family Military Married Son Daughter moved service
to city
born born
Kids go 88 19
care costs and pensions Affirmative action— ™f overturned in states changes
1990s 2000s 89
Retired Depression
to college diagnosis Depressed again
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However, with this timeline, personal events are written beneath the line and historical cultural events above the line. Some clients may like drawing the timeline with the therapist, and longer legal-size paper or flip charts are convenient for this work. It is important to note that most of the questions concerning the client's cultural history (i.e., the top side of the timeline) should not be asked directly; it is the therapist's respon- sibility to learn such information outside assessment sessions.