Lucia is a clinical psychologist, constructivist psychotherapist, and co-teacher at the Institute of Constructivist Psychology in Padua. She works in private practice in London, where she provides cross-cultural therapy to European clients living in the city. She is passionate about people’s life stories and potential for change.
Mary: Lucia, a couple of years ago, we worked together on the theme of ‘stories’ – I wonder where you would like to start this story?
Lucia: I do tend to see my life as a story, and also in chapters. The start of this chapter was in 2009 when I came to live and work in England. I developed a new professional self. I call it my ‘Nordic self’.
Mary: What were your first impressions?
Lucia: Many aspects of my personality felt quickly at home here. For example, there was more emphasis on organising things, on timing and planning, and on social relationships which had some boundaries. I really value these things, but sometimes in Italy I am seen to be a control freak! It’s not the way things are done there, it’s a much more improvisational culture. In England, there is a start and an end to meeting up with people. When I take my son Emilio to a birthday party it is two hours, a start time and a finish time. I love this!
Mary: I recognise that difference between working in northern and southern Europe. It’s apparent in many small differences, and I’m aware that it can lead to tensions sometimes.
Lucia: For me it is something about clarity I think, and when you come to live in another country, this is helpful.
Mary: I think you worked at first in a hospital? That’s a complex system to join.
Lucia: Yes, it was an NHS mental health hospital. My English was not as confident, especially with so many different accents, and I found it hard to understand everything that was being said. I spent a lot of time observing. There was a huge amount of jargon – professional jargon, much of it particular to the NHS. Some time passed before I first started to work with an English client.
Mary: A big step.
Lucia: Very big. All the patients had severe mental health issues and my anxiety was very high. But it was interesting in practice. The patients arrived with huge emotional content, much of which was not articulated, and so the approach of PCP was very helpful to me. The work we did was beyond the meaning of words – the word as sole trader of meaning disappeared. Some things are hard to articulate in any language.
It was not just about the emotional content, but also it was a feature of working in a very multicultural city with people of many different languages and from many kinds of background which I had no idea about. It makes you more curious, and much more aware of non-verbal aspects. I watched very intently, because in Italy we look people in the eye, and also perhaps to compensate for language difference. In fact, I was told I looked people in the eyes too much and so I had to learn about these differences. Then when I went back to Italy to visit, people kept asking why I looked away in the middle of conversations!
Ways of shaking hands was another example, and also the distance people sat away from the client – it seemed to me very far away. But in spite of the difficulties, I was very passionate about the work. And we were all working as if with foreigners – the differences in nationality, customs and expectations in a multicultural and multilingual city were a challenge for others too.
Mary: Were there ways in which it helped perhaps that you were a ‘foreigner’ too?
Lucia: Yes, I think so. Sometimes it felt like a levelling of power, that I was not so confident in English either, similar to the patients. There was a slight sense of a shared struggle in communication sometimes, especially when I was with the most disadvantaged families. Assumptions became questions for all of us. It made me more aware of the relativity in any culture, and the relationships of power and advantage.
Also, I think that emotion is encoded differently in different languages. Pre- 2009, my emotional experience was entirely ‘in Italian’. Since then, it is encoded in English and Italian, and it’s an interesting process.
Mary: More choices?
Lucia: Yes, not just for me, but also the people I have worked with here, including now in my own practice. My practice now is with European citizens living in London, mostly Italian, but also French, Dutch, Romanian, Portuguese, Spanish and Norwegian.
I notice that intense emotions and experiences from the early years are often encoded in the mother tongue. Italian clients, whom I talk with in Italian, sometimes switch out of Italian and talk in English about these experiences. It is as if English allowed some protective distance and a way to escape social taboos encoded in the mother tongue.
Other European clients, whom I talk with in English, sometimes switch out of English and talk in their own language when they want to express an emotion. And then they come back to English and try to explain. It’s very important to acknowledge and work with clients’ choice of language in therapy.
For me, working in English has opened up new opportunities for different kinds of communication. In English, you can say a lot in very few words. It’s concise. It can help you order your thoughts.
Mary: Italian seems to me to lend itself to elaboration, and is perhaps richer in expressing emotion?
Lucia: Yes, Italian is not concise, a lot of what’s said and written is redundant.
Mary: How lovely, our different constructs in play there – me ‘it’s elaborative’, and you ‘its’ redundant’!
Lucia: My Nordic self! Having more languages certainly opens more choices and gives you more options to explore. But I think the limitations of ‘emotional’ talk in English culture have advantages too in creating a kind of safety. Relationships are kept more compact, and a distance is observed. Intensity can be good of course, but some distance can be a haven. You can tell I have become obsessed with codes!
Mary: That sensitivity is like a kind of radar that’s become very finely-tuned. It’s interesting to me that when you first came over here to live, your husband was working in an Oxford college. That’s a world with a very particular and elaborated code – dining in halls and so on. I remember you telling me when you first arrived that your main point of reference was Harry Potter, and Hogwarts!
Lucia: Yes, I can hardly imagine it now. Living there, having dinner at high table and going to work in the hospital with such disempowered patients was really like moving between two worlds, knowing that they would never, ever meet. There were many intricate points, for example, in dining at Oxford. Things had to be done in the right order, in very specific ways. Rituals were very important. But I think that because I was a foreigner these expectations didn’t really apply. I wasn’t expected to know these invisible rules and I was bound to make mistakes. It wasn’t so important because I would never really be part of that system, so there is also a freedom. You remain a kind of exotic parrot!
Mary: That’s wonderfully put! I think that class is an enormous divide in England. I know that I am personally aware of it almost all the time.
Lucia: Really, Mary? I agree that class is an enormous divide here, but I am not so aware of it when in conversation with people, probably because I cannot tell different accents so clearly.
Mary: Well, sometimes accent is apparent, but I am thinking more of visible lifestyle, of expectations of others and felt entitlements, and of levels of social confidence.
Lucia: It is an issue in Italy too, and perhaps in many other countries, but not in the same way.
Mary: No, I guess partly it stems from being a monarchy and having an institutionalised aristocracy. One of the many and various reasons I feel bereft about Brexit is losing citizenship of Europe. It’s been a strangely precious thing, to be a citizen. We are not citizens here, we are subjects of the queen. It feels very different, an archaically structured society.
What other codes have you noticed?
Lucia: There are differences in gender codes, definitely. Here there are different expectations of men, and of equality in roles and tasks and relationships between men and women. This is not the same in Italy, where gender roles are still very different.
There are differences also in what people are willing to disclose when we meet – a different distinction between what is personal and what is private. In Italy, we would often ask about family and personal life, but here it is not always expected and can seem intrusive. I noticed this quite quickly, that I was the only one asking these questions, and conversations seemed to become more awkward.
We work in a profession which has relationships at the centre and knowing how to work with these relationships is essential. But I had to learn on my own – no-one told me about these things.
Mary: I think can be hard to induct people into a culture because we are not often aware of it, like the air we breathe. The codes are not always secret, it’s more that they are not apparent to people who have not experienced anything else. I imagine that people wouldn’t know what to tell you until they saw difference happening.
Lucia: Yes, then there is a correction. For example, being direct. I was asked to write a letter to a GP to let him know that we wouldn’t be offering a client any further sessions, and so l wrote that very clearly. But I was asked to change it a lot, to say that just at the moment further sessions might be difficult but that of course, in future, extending therapy might be possible to consider etcetera. That was the code.
Mary: Yes, that’s the not-so-direct English which is not concise at all – it has a lot of diplomatic wrapping.
Lucia: Exactly – these are skills of diplomacy and they are interesting and useful to learn and be aware of. In Italy we are simply more direct.
Mary: I notice this difference frequently in Italy. I think I am experienced as unnecessarily ‘polite’. I see diplomacy as quite different from ‘politeness’ but I understand the comment. Of course the example you gave is more like obfuscation!
Lucia: I think there is a fear in English of conflict, and an emphasis on keeping everything very steady and not emotional. In Italy conversation is more direct and conflict is simply part of conversation. Things are spoken directly, people can strongly react, and then it’s over.
Mary: Yes, I find the Italian way very attractive. But might it depend perhaps on more cultural commonality? Here, we focus a lot on giving and taking offence. It’s always been a characteristic, but perhaps amplified because of more cultural diversity and a wider variety of sensitivities and anxieties in the foreground.
Lucia: The choices and complexities are so interesting to me, and you have to learn to ask, and to check. I am also interested in the point at which I become less comfortable about adapting to the code, and have to make a decision about how much to conform to it. I am very happy in London and l love living here. I think it’s a bit easier because the differences are so obvious and so many.
Mary: Yes, you can sometimes reach a point of feeling more relaxed. In some settings, when the cultural mix reaches a certain level, there isn’t just one dominant code. There is a kind of freedom in that.
Lucia: I do think back to when I first came here, and wonder what people thought of me. I understand the threat of difference in more ways now, and I am more culturally aware.
One thing I do notice, and would say as a proposition, is that England seems to be a shame-based culture. People feel great shame about doing things wrong, about not knowing things, making errors or saying the wrong thing to people. Perhaps this is one of the reason why being polite is so important. People, included myself, say: ‘please’, ‘thank you’ and ‘sorry’ hundreds of times a day, both in verbal and in written conversations. I haven’t done any work on this – it’s just an observation. It would be a good thing for PCP to research.
Mary: A thesis waiting to happen!
Lucia: And also I think that Italy could be seen as a guilt-based culture, probably part of a Roman Catholic experience perhaps.
Mary: That’s a very interesting proposition because guilt and shame are connected but quite different also – generally guilt is personally felt, whereas shame is usually construed as a social experience.
Lucia: I would have to do a lot more thinking about it, but it often comes to my mind.
In the beginning I think the either/or of England and Italy was very apparent, but as my Nordic self has developed, the two aspects are more merged now. My anticipations were quite loose when I first arrived here, and not so complex. It has been a deeper, more important experience that I anticipated.
As you know, I will be moving back to Italy in the spring next year, and I am interested to see what that experience is like. I am going to offer a practice similar to the one I have developed here, but in reverse – offering therapy in English for non-Italians in Italy.
Mary: It’s the perfect way to continue this experiment in language and culture.