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4. Communication skills
( See Part II and Introduction.)
Communication cannot be discussed without also talking about culture because, as discussed in Section 3 of Part III, culture affects the way we see each other and how we interpret the messages we send. As a result, conversations between people from different cultural backgrounds may take unexpected directions and may easily generate misunderstanding.
PART III: THEORY
People who are familiar with two cultures can play a vital role. They can act as go-betweens, translating and explaining not only what is said but the ways in which people communicate. For example, some cultures move quickly to the point, while others wait until a relationship has been created. Cultural brokers can facilitate the pace of a conversation, and moderate statements that are considered appropriate in one culture but offensive in another. Gifted cultural mediators can also help to identify and define problems in a manner that both sides understand, and identify solutions and ways of going forward.
If you need to use a translator for your meetings with a survivor, she should respect certain rules of professional conduct. She should introduce herself and give information about her role before you start. She should understand that everything said is confidential. She should translate only what is said and all that is said, and should not try to explain and interpret. If you( or the survivor) do not understand, ask for clarification and the interpreter should translate the clarification. She should speak in the‘ first person’ and should not take on a supporting role.
Culturally significant phrases and expressions were introduced into DSM – IV in an attempt to make diagnostic practice more culturally appropriate, relevant and representative. While this marked a first step towards exploring values in diagnostic criteria, it does not replace a thorough exploration of the values of patient and professional during the clinical process. The American Psychiatric Association( 2002) recommends that five cultural elements should be considered( See Cultural aspects, Part 1, page 9). The second of these relates to the patient’ s explanatory model of the illness, and explores cultural factors beyond race and ethnicity. However, in isolation from the other elements, awareness of explanatory models is unlikely to influence the quality of the consultation, the assessment, or management of the patient’ s distress.
Empathy and confirmation
Communicating with survivors of GBV cannot be done without empathy. A common understanding of empathy is that it means‘ to put yourself in someone else’ s shoes’, to imagine the experience of another and understand and feel what he or she understands and feels. Empathy facilitates communication. At the same time, it is difficult to pretend empathy, and communication is likely to fail if false assumptions are made about a survivor’ s state of mind or feelings. Communication between a helper and a survivor therefore requires empathy of a sophisticated kind. To communicate, helpers need to be skilled in understanding a survivor’ s mental and physical state of mind.
Sometimes it may be too painful or embarrassing for a survivor to talk about her feelings or thoughts, for example, of her anger or hatred. She may feel too ashamed to do so, or fear rejection, if these feelings are not culturally acceptable. To overcome this fear, the helper can assist by saying,“ I understand that you feel and think this way, it is natural, anyone would feel that way”, etc. By going beyond mere understanding, confirmation of this kind provides a more robust form of support than empathy. This said, words of confirmation legitimise only the expression of feelings and thoughts, not possible( re-) actions that might be undertaken as a result of them.