HOW DO ASSUMPTIONS OF DIFFERENCE AND POWER AFFECT WHAT AND HOW WE TEACH?

Roxana Llerena-Quinn, Ph.D.

This article offers a description of six teaching stances regarding difference organized around the meaning of difference and power, with a particular reference to family therapy training. The six constructions of difference are examined in relation to individuals, families and the larger systems. They are embedded with special reference to the meaning made of these differences.

For the purpose of this paper, culture is understood as the set of implicit or explicit guidelines transmitted to individuals from a particular society, group or subgroup, which tells them how to view and experience the world. These guidelines are often learned, and then dropped out of awareness. The resulting "cultural lenses" that are acquired through this process are important in determining how we see ourselves and others, what we value and how we behave. Our lenses also influence the structures we construct for dividing people into social categories (rich/poor, men/women ROLES, upper class/lower class, normal/abnormal, etc.) and the elaborate ways for moving them from one social category into another, with or against their will (Helman, 1994). The following assumptions of difference illustrate not only how our lenses influence how we view and respond to the "Other," but also how implicitly or explicitly we teach these assumptions to others. It is important to note at the outset that any individual or institution may use different assumptions with respect to different categories of difference. That is, one may be at the same time blind to assumptions about race and highly enlightened to assumptions about gender.

CONSTRUCTION 1: DIFFERENCE AS INFERIORITY

Belief that dominant groups are superior and non-dominant groups are inferior is the underlying assumption of this construction of difference. The construction assumes the existence of a normal culture and family, generally reflecting the values of the dominant group in a society, which is held as an ideal. The dominant group defines value, truth, beauty, morality, and allocates social resources accordingly. Deviation from the norm is assumed to be either dysfunctional, of lesser value, or inferior. The belief in the superiority of traditional HETEROSEXUAL family structures provides an example: two-parent families are "normal" and "better" than single parent families or alternative family structures. The resulting loss in social status or other negative consequence to the lesser group is seen as deserved. Thus, whenever possible, difference is to be avoided at the risk of stigma, punishment or intervention. Cultural superiority can result in a range of paternalistic postures, where services are applied disproportionately (too much, too little, not at all) to the lesser groups.

Power Effects: Patterns of dominance/subordination emerge based on the presumed superiority or entitlement of some groups over others. The potentially most serious power effect is the destruction of the non-dominant group, an extreme example being found in the holocaust of World War II. Intentionally or not, destructive policies and practices threaten non-dominant group's survival (Cross, Bazron, and Isaacs, 1989). Images of the lesser group as not quite human facilitate the process. The impact of these assumptions can be felt at personal, clinical, and institutional levels. For example, the Tuskegee experiment, a government sponsored research project that withheld needed treatment from African Americans without their consent and at the expense of their lives, was conducted for the sake of science. Other examples include discriminatory lending and renting practices, treating a non English-speaking patient without a trained interpreter, the criminalization of mental illness, and punitive policies towards the poor who are seen and publicly defined as lazy. A tragic and costly corollary of this stance is that society does not fully profit from the strengths of the targeted communities because their contributions are not integrated into the fabric of society.

Effect on What we Teach: Information about the real lives and strengths of non-dominant groups is pervasively absent from the curriculum. Whenever non-dominant groups are mentioned, it is to justify their inferiority. The critique focuses on individual or family outcomes without an equally important critical analysis of the role of an oppressive social system in creating those outcomes. For example, in the genetic justification of IQ differences, minority children are seen as culturally deprived, rather than as being denied an education equivalent to the dominant group. Gay and lesbian relationships are seen as transient when laws prohibiting their marriage are ignored. The curriculum is also silent about the personal and social effects on people who are continuously told that they don't measure up to an imposed standard. The "science" from which the curriculum is derived perpetuates the problem not only through sampling bias, but also through de-contextual definition and analysis of problems. The science of mental health thus reproduces the values and standards of the dominant group. Linear and reductionistic thinking dominate the discourse.

Effect on How we Teach: Education takes place in segregated schools. Access to academic institutions is not equal for all students regardless of merit. The dominant discourse tends to be taught by and for the dominant group by an expert teacher. Students have little input into the learning. An apparent homogenous "truth" is taught.

CONSTRUCTION 2: DENIAL OR MINIMIZATION OF DIFFERENCE. "WE ARE ALL THE SAME"

The assumption of sameness and the minimization of differences assume that whatever differences exist are both unimportant and insignificant. Sameness is equated to fairness. Noticing differences is not permitted because it would not be fair. The beliefs in equal opportunity and equal treatment are based on this assumption. This position disguises the fact that everyone starts at a different place and with different opportunities and privileges. Dominant values continue to prevail but they are assumed to be universal.

Power Effect: The main effect of this stance is "color-class-gender-privilege blindness." Assimilation is encouraged in all spheres and practices. Access to society's benefits requires that people must blend in and minimize their differences. Because this construction is based on the assumption that we all start at the same place with the same opportunities, only those who can assimilate "benefit." Those who can't assimilate encounter not only a lack of access but also blame for not thriving in a world of equal opportunity. Inequities resulting from "privilege-disadvantage" dynamics remain hidden and unmarked behind a façade of "fairness." Blindness to the strengths and identities of non-dominant groups prevents society from profiting from those differences. Inaction is the main response to the needs of diverse individuals.

Effect on What We Teach: The theoretical "myth of sameness" dominates both the

discourse and the curriculum (Hardy, 1989). This myth neglects the importance of context as a shaper of intra- and interfamilial dynamics. Conventional social science falsely teaches a universalized family, rather than pointing to "the normal family" as one of many family forms produced by hierarchical social and economic patterns of development. We teach students not to notice different or discriminatory contexts. Clinical interventions therefore tend to be one size fits all. -Regardless of need, families must fit themselves to the dominant method as taught and practiced. The lives of non-dominant groups remain invisible and the costs of assimilation remain hidden. Initiatives to include cultural competence or contextual issues into the curriculum do not exist.

Effects on How We Teach: We teach in desegregated schools where opportunity is equal, but access is limited. Students are left to fend for themselves in addressing the contextual issues ignored by this world-view. Diverse faculty or diverse students' perspectives are not incorporated into the universal curriculum. The exclusionary manner of how we teach is hidden under the guise of equity and sameness.

CONSTRUCTION 3: DIFFERENCE MATTERS: IT IS SOMETHING "OTHERS" HAVE

While difference is recognized as real, at the core of this construction lies the central assumption that difference is something that matters only to the different others. Differences are accepted, but they are believed to lie outside the centrality of the dominant group's life. The dominant culture adopts an anthropological stance about those differences. Differences between groups are generalized and amplified.

Power Effects: This assumption results in powerful stereotyping. Gross generalizations are usually made about families and individuals in one targeted dimension of difference. With altruism as a central motive, activities are undertaken to learn more about the different other through ethnic food days, ethnic festivals, and an occasional lecture. Individuals from diverse groups are hired to work with diverse populations without attention to the context in which services will be delivered. These altruistic initiatives are largely initiated at the individual level and are not central to the mission of the organization. Individuals of dominant groups, working on these initiatives, often experience confusion when non-dominant groups do not appreciate their efforts. The failure to integrate the diverse perspectives into the central mission of the organization limits the benefits and longevity of these initiatives. The voices of non-dominant groups remain unheard because they are inaccurately "spoken for" by inside or outside group informers whose voices accommodate the dominant discourse but fail to transform it (Sampson, 1993).

Effects on What We Teach: The curriculum continues to teach the myth of theoretical sameness. Differences within each group are overlooked and seen as uniform while differences between groups are over-generalized (Hardy, 1989). We teach stereotypes that ignore important within-group differences, such as religious, linguistic, generational, socio-economic, racial or gender differences. Contextual variables such as poverty, neo-colonialism, racism, classism, and sexism are not addressed.

Effects on How We Teach: Diversity themes are added-on to the curriculum in a patchy, unsystematic manner. A few interested individuals may develop curricular activities without much organizational support. These curricular activities may take the form of a lecture, an elective class, a reading group or an occasional receptive supervisor. Due to the "newness" of these activities, few faculty are trained and there are few faculty from non-dominant groups. Curriculum content presents stereotypical representations of diverse groups. Often, members from non-dominant groups are placed in the position of experts who are asked to speak for whole groups. For dominant groups, there is much talk about the "other" with little examination of self in relation to the other. Dominant group faculty, supervisors and students are not held accountable for developing the competencies necessary to work with diverse populations. Participation in these courses or activities is seen as elective and voluntary, separate from one's ethical obligation to all families.

CONSTRUCTION 4: DIFFERENCE IS GOOD FOR BUSINESS. THE PROFIT MOTIVE

In the current climate of managed care, the dominant group has realized that difference has profit potential in the marketplace. The ever-growing numbers of diverse patients and health system economic pressures have given birth to the "business of diversity." Access to different population markets offers a business advantage. Difference becomes a marketing issue. The economic motive brings new levels of the organization and management to the table and initiatives to reach out to diverse communities become more formally organized. Competition brings an air of recognition to the issue. Training initiatives are seen at more levels of the organization. However, difference is still something that "other" groups have. Differences are not yet valued for their learning potential nor are they integrated into the core of the organization.

Power Effect: On the positive side, there is increased access to services for diverse families. Separate units of diverse staff are established to serve diverse families. Initially, non-dominant groups welcome these opportunities at developing parallel structures that can respond to clients' needs. On the negative side, marginality continues. The parallel structures usually function independently without integration into the mainstream. The separate program is expected to meet all the service needs of diverse populations while mainstream clients have access to a wide range of services and specialties. The separate program becomes the minority version of one size fits all minorities' needs. Before long, the diverse workers realize that their clients don't have access to the same services as mainstream clients and that they themselves don't have the power to influence the way business is done. The social conditions that give rise to "symptoms" remain largely unchanged. The risk of tokenism continues for the minority provider. These programs at times are used as show pieces and a spokesman for all minorities. The struggle for funding is exhaustive. Accomplishments can be short-lived due to market fluctuations, since the parallel programs are usually the last to be funded and first to be downsized with economic fluctuations. Since there is no formal accountability to the non-dominant communities served, the dominant organization never attempts to learn from these separate programs, and any unique skills and services created during the process are lost.

Effect on What We Teach: Schools develop some courses that address the needs of diverse communities, but these are separate, not integrated into the general curriculum. Content is derived primarily from academic sources without community input or culturally competent research. As the curriculum begins to broaden, there are discussions about "access," and "best practices," but there is little discussion about the dominant individual or organization in relation to those with less power. Power issues are addressed from a mainstream perspective.

Effect on How We Teach: There is an increased flux of resources into teaching diversity or courses on multiculturalism. Some states may even require these courses for licensure. The classrooms become more integrated, but not representative of the client populations. The number of minority faculty is outrageously small. Activities are seen as mandated (affirmative action, licenser requirements, and economic motive) but not as needed or desired. Unspoken conflict may divide groups on different sides of the curriculum. The curriculum aims at expanding minds, but not the hearts of the students. The knowledge acquired is seen as lying outside oneself, only needed to stay competitive in the field.

CONSTRUCTION 4: DIFFERENCE AS VALUE FOR BETTER KNOWLEDGE. MULTIPLE PERSPECTIVES ENHANCE THE LEARNING OF A LARGER TRUTH

Differences are elicited because they are valued and needed to co-create their own reality, own learning and knowledge. Knowledge that is constructed from multiple perspectives has greater value and relevance. Belief in the underlying vitality of difference does not confuse diversity per se with differences that stem from oppression. There is a growing awareness of the limitations of language and the lack of frameworks for explaining relationships. Efforts are made to understand what is invisible, unspoken. This is particularly important because language is an instrument of power and people have power in a society in direct proportion to their ability to participate in the various discourses that shape that society (Foucault, 1980).

Power Effect: All voices are valued, invited and must be heard. Instead of ending dialogue, differences deepen the conversation and promote self-reflection and self-awareness. People feel increasingly understood in the ways they understand themselves. Difference is understood as existing in and between all of us.

Effect on What We Teach: There is a strong commitment to include the voices of all families in the curriculum, the well known and less well known, the confident and the tentative with an active search for the forgotten. Frameworks and assumptions that inform our work and ways of being explicitly take into account how communities are shaped by both painful histories of expropriation, conquest, slavery, and discrimination as well as rich legacies of culture, ancestry, and heritage (Krieger, 1966). We learn from one another as we share about our families, our communities, and ourselves. We teach that each one of us is author and authority of our experiences and perspectives, and that knowledge grows through contact with the other.

Effect on How We Teach: Because of the belief that knowledge is generated by a community of knowers who bring multiple perspectives, the faculty is a diverse team that purposely seeks its own diversity and full participation in the co-creation of new narratives. Students are seen as valued resources that add voice, diversity and perspective to the teaching and learning. Community voices are considered fundamental to the shaping of the curriculum. Knowledge is generated by integrating written narratives of others together with the narratives of the lived experiences of students, teachers and families. Diversity expands the explicit and hidden curriculum. The curriculum is both didactic and experiential, taught and learned by all.

CONSTRUCTION 6: DIFFERENCE AS AN ECOLOGICAL RELATIONSHIP, CONNECTED TO SURVIVAL

Consonant with current understandings of biology and global ecology, difference comes to be understood as fundamental to the survival of both us and of all living systems. A successful and sustainable occupation of the biosphere depends fundamentally on our interdependence with each other, with all other life and on the vitality of our differences. We gain an appreciation of the inherent self-interest in considering the interest of others and the awareness of our collective responsibility in the face of inequity. Difference is understood to be a relationship between self and others that can expand, nurture and fulfill through connection—or that can destroy or marginalize through oppression. While differences are good and necessary for survival, they are optimal when they exist in a context of justice.

Power Effect: Difference is valued and power is shared. All meanings have a transformational potential. There is a growing understanding that unacknowledged power disguises accountability. Discovery of our interdependence makes us realize that we are accountable to one another. The health of society ultimately depends on the health of all families, as the health of the biosphere depends on the health of all species. All of us are accountable for that health for all families. Each of us has the power to transform our hearts and the social structures we construct. We can think of the whole society and act in our local contexts.

Effect on What We Teach: The curriculum reflects a fluid relationship between what is taught and the realities of all families and communities. It seeks both a clearer language and methods to understand how power, inequality and social justice affect all families. The clinical interventions taught are relevant to the biological, psychological, social, economic, cultural and spiritual needs of families. The health of the provider and the environment in which services are delivered are also protected. The empathy extended to families must also be extended to oneself, fellow students, and colleagues. Culture is not seen as a trait that individuals or families possess, but as a dynamic relationship between the individual and the context from which justice emerges. Competence is not a "place" where one arrives but a life-long process characterized by openness to learning. We learn how to learn from each other.

Effect on How We Teach: We teach in an integrated, sustainable environment transformed by our similarities and differences as we face our common humanity. Analyses of power and privilege include the realization that we depend on each other for survival and to the extent that we disregard one aspect of our ecology, we diminish our possibility for survival in another. This understanding is contained not only in one course or lecture, but in everything we do through the curriculum. Teaching is more dialogical and experiential and less didactic but immensely insightful and respectful of diverse learning preferences that may include a variety of approaches. There is recognition that different forms of understanding/teaching may be needed in the learning of different skills throughout the learner's development.

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Roxana Llerena-Quinn is a psychologist in the Latino Program at Children's Hospital in Boston. She facilitates with others, a cultural self-awareness course for first and second year medical students at Harvard Medical School. At the Center of Multicultural Training in Psychology (CMTP), she is one of the faculties of the family therapy seminar. She is a current member of the NMTP Board.