Hi everyone, I’d like to ask a somewhat delicate question. I hope I can frame it properly, without offending anyone.

As therapists, how do you handle situations where a patient’s behaviors, values, or relational style clash with your own values or with what you consider “healthy” or “appropriate”?

I’m not referring to clear cases of abuse, human rights violations or illegal behavior, but to more subtle, culturally rooted differences.

For example:

• A patient who has a very direct, blunt, or even crude communication style that feels normal and respectful to them, but can come across as aggressive or invalidating to you.

• Very close and interdependent family relationships (by choice, not coercion), which in your framework might be interpreted as “enmeshment”, codipendency or poor boundaries.

• Values related to family loyalty, respect for elders, or more traditional gender roles that conflict with the strong emphasis on individual autonomy and rigid boundaries often taught in therapy.

In these cases, how do you distinguish between: What is objectively problematic or harmful, and what is simply different from your own culture or personal values?

And how do you manage the risk of unintentionally imposing your own cultural and therapeutic framework on the patient?

Thanks to anyone willing to share their experience or way of thinking about these situations.

Originally posted by u/That-Pineapple3866 on Reddit.

Top comment by u/WingsOfTin

What helps me the most is maintaining a sense of humility.

I’m not the client, I’m not living their life, they are a wholly independent being who gets to decide how they are living out their time here on earth.

You can always query and point out potential limitations or costs to them of these patterns, but the client themselves needs to actually have a desire for these patterns/outcomes to be different.