FIG1 Not long ago, Kerry Sulkowicz, M.D., a New York City psychoanalyst who consults to businesses, received a request for help from a business executive in another country. Sulkowicz told the executive that he was open to helping him, but admitted that he had never been to the country in question. "No problem," the executive replied. "In fact, it's good that you've never been to my country because you can bring some fresh perspective with you."

This interplay, which Sulkowicz cited at a recent meeting of the American Psychoanalytic Association in New York City, illustrates the fact that when a therapist and a patient do not share the same culture, it does not invariably lead to disappointing results.

In fact, other examples of cultural mismatches between therapist and patient leading to successful outcomes were cited at a session on culture and psychotherapy at the meeting. For example, S. Kalman Kolansky, M.D., an Alexandria, Va., psychiatrist, reported that over the years a number of non-Jewish patients have sought him out because of his" Jewishness," his "otherness."

And along the same lines, when therapist and patient come from the same culture, it does not invariably lead to a positive outcome, session participants revealed. For instance, some Hassidic Jewish patients have made it clear to Kolansky that they consider their Jewish-ness superior to his. Carmela Perez, Ph.D., a New York City psychologist pointed out that although there is "a widely prevalent idea among clinicians that an apparent match between a patient's ethnicity and a therapist's ethnicity--say, both of them being Hispanic--gives the therapist an advantage in being able to understand the patient, . . . it is [nonetheless] important to pay attention to subtle cultural aspects and their manifestations in the transference-countertransference dynamics of the therapeutic encounter."

So, to optimize the therapist-patient relationship from a cultural vantage, session participants offered some suggestions. Among them:FIG2