PATIENTS, CHAPERONES AND HEALERS - ENLARGING THE THERAPEUTIC ENCOUNTER

The common assumption in most therapy is that the process is initiated by a need in the patient and managed or directed by the therapist. If there are other people involved, except for the case of group or fami ly therapy, they are at best marginal to the ongoing process as conduc ted in the therapy room. This paper, jointly written by a social anthr opologist and psychiatrist, presents a model of therapy in an ultra-Or thodox Jewish community in which chaperons accompanying the patient (a common feature in the setting) may fulfil important functions as cult ural bridges, sometimes even going so far as serving as active co-ther apists. Ethnographic data is offered to demonstrate how chaperons may assist in enabling the healers to overcome feelings of cultural distre ss' and discomfiture on the part of the patients and how they assist t he therapists to be 'culturally sensitive' in their use of psychiatric methods in a population which has deep misgivings about such procedur es. The paper concludes with an argument for increased openness and fl exibility in the practice of psycho-therapy, particularly in cross-cul tural encounters, which would allow for greater use of chaperons.