East versus West
Living in a global era, many clinicians who use songwriting in their practices will encounter songwriters from diverse cultures. Typically, Western and Eastern cultures differ substantially with respect to their values and traditions. Laungani (2007) emphasizes that even within specific countries several cultural practices may be present. For clinicians practicing songwriting in facilities where they may create songs with diverse cultural groups, understanding how concepts of the Individualism (Western) versus Communalism (Eastern) continuum operate is imperative. According to Laungani (2007), Individualism respects that individuals are entitled to have control over their lives, to have responsibility for addressing their own problems, and to respect the need for the physical and psychological space of others. Conversely, in Eastern Communalism (Hindu and Islamic societies), family and community are at the center of all activity; so when one member of the family or community experiences difficulties, it affects the entire family and community. As will be outlined later in this chapter, this affects how therapeutic songwriting might be viewed as an individual or communal interest.
Another West-East difference that impacts the songwriting process is the perception of emotional expression. Within Western cultures, people have been socially conditioned to avoid expressing emotion and to function at a cognitive level. Tov and Diener (2007) understand this as a cultural belief that expressing strong emotions is a sign of weakness within a person. This contrasts with Eastern values that encourage emotional expression to allow people to experience catharsis. Within Eastern cultures, however, permission to express emotions is dependent upon the person's place within the family hierarchy. As Laungani (2007) states, people who are at the lower levels of the hierarchy are vigilant about 'who can say what to whom, how, and with what effect' (p. 141).
As emotions are socially and culturally determined, different emotions are more readily accepted in some cultures when compared with others. In Western cultures, pride is recognized as a desired emotion that encompasses autonomy and independence. In contrast, Eastern cultures celebrate sympathy and humility as socially acceptable emotions (Tov & Diener, 2007). When linking this with a therapeutic songwriting process, clinicians can therefore predict that accomplishment, pride, and autonomy are emotions that are culturally desirable and therefore relevant for Western songwriters to experience, but may be regarded as inappropriate for those in Eastern cultures. Similarly, some Indian communities discourage the expression of anger, viewing it as socially destructive. And unlike in Western cultures, in some Indian communities shame is regarded as a positive emotion when experienced by women because it reinforces their membership in a patriarchal society (Tov & Diener, 2007). Therefore, when songwriters express different emotions within their song creations, the clinician needs to consider carefully what these emotions mean within the songwriter's cultural community.
Culture is a determinant of perceptions and understanding of health, wellbeing, and treatment. People from Eastern cultures are more likely to seek out traditional remedies (Gurung, 2010), which may positively or negatively impact on their receptivity to songwriting. Indian traditional healers focus their healing practices on returning balance to the body-mind-soul state, while Chinese medicine focuses treatment on promoting flow through the body (Gurung, 2010). Consequently, Hays (2008) suggests that many 'Eurocentric' approaches to therapy may be inappropriate to use with people from non-European cultures. Examples of inappropriate behaviors relevant to songwriting practice may be the use of verbal skills such as paraphrasing, probing and asking questions, tone of voice, and non-verbal skills such as eye contact. In some cultures, the clinician may be perceived as a person of authority, and it is therefore inappropriate for the songwriter to make eye contact with the clinician.