VI. Self-awareness: Becoming
your own worldview (Adapted from Buhin et al. 2004)
1. Learning About Your Own
2. Understanding Your Personal Worldview
3. Appreciating Your Own Multiple Identities
4. Acknowledging assumptions and biases.
5. Accepting Responsibility and Tolerating Ambiguity
6. Recognizing Limits of Your Competence
1. Learning About Your Own Culture
According to Tervalon and Murray-Garcia, cultural
self-awareness requires a
life-long commitment to self-evaluation and critique (14). Before
a client-caregiver relationship, the individual must become aware of
cultural and historical background. By recognizing the different
from his/her cultural background, the individual will be able to
different influences in the client’s background and will be more likely
engage in a sensitive, therapeutic relationship.
Adapted from http://www.leron-line.com/Cultural_Self_Assessment.htm
Think of yourself as a cultural being whose life
has been influenced by
various historical, social, political, economic, and geographical
circumstances. This exercise will help you become aware of your
ethnic and cultural background.
were you born?
- When were
did you grow up?
did your parents grow up?
did your grandparents grow up?
did your great grandparents grow up?
is your earliest memory as a family?
is your earliest school memory?
a family, what events did you celebrate?
traveled or moved as a child?
traveled or moved as an adult?
international event that happened before you turned 18. Try to answer
following: Who was involved, what was the event, where did it happen,
it happen, and why did it happen?
event that happened in the country where you were born, before you
Try to answer the following: Who was involved, what was the event,
where did it
happen, how did it happen, and why did it happen?
your earliest recollection as a member of a group?
your first job?
- As an
adult, what events or holidays do you currently celebrate?
2. Understanding Your Own
Since our perceptions are shaped by our view of
the world, the caregiver
needs to examine and understand how she/he sees the world.
One’s worldview is learned through
socialization, from childhood to adulthood, and constantly reinforced
culture in which we live. It is the taken-for-granted view of “the way
are” and most of the time unquestioned and invisible.
“To understand worldviews, therefore, we must
examine the beliefs/belief
systems and the social values that they contain.” (LeBaron, M. 2003).
example of a belief system was Social Darwinism which held that life is
struggle for survival and dominance, and the most competent and
individuals will be most successful, while the incompetent and inferior
the least successful.
What is your worldview?
One Western worldview is “I am
the captain of my soul,”
which is in contrast to the
worldview of “God will provide”
which other cultures hold.
When one is blind to his own
culture, he will not be able to
see the differences in values between cultures. This could lead to
destructiveness, cultural imposition and cultural pain. This stems from
cultural ignorance of one’s own and other’s cultural identities, due to
intentional or unintentional isolation or separation. This leads to
dehumanizing others with different values than one’s own. The greater
difference, the more negative the evaluation of the other culture (16)
The manner of
their living is very barbarous, because they do not eat at fixed times,
often as they please. Amerigo Vespucci, when he discovered America.
#2: How do you view the following?
What is your
(Time is money?)
Space between you and the
(When do you start feeling
(Work relationships vs.
( How do you see
Religion or spirituality
(What about religion?)
(Tell the truth no matter
We all live within and identify with multiple identities.
Most of us can claim different identities related to gender, age,
ethnicity, socioeconomic status, profession, national origin,
When working with
clients from other cultures, the caregiver
should examine differences and similarities between herself/himself and
client. The caregiver takes into account “issues
related to diversity, marginalization,
and vulnerability due to culture, race, gender, and sexual orientation
(National Academy of
expert panel, 1990.)
By recognizing one’s multiple
identities, one is less likely to stereotype
others based on minimal information about another person’s historical,
and cultural backgrounds.
What are the shared
identities between two 30-year-old men,
one is a 30-year-old nurse who works
full-time, goes to school in the evenings to work on his master’s
raises three children and another 30-year-old man who works at two jobs
raises three children?
Exercise # 3. “I
Take a blank
sheet of paper and write the numbers 1-10 on
the left hand column. Complete the statement “I am______” using the
that come to mind.
What were your
first 5 answers? When did you start to slow
down in writing your answers?
What were the last 3 answers? Do
you feel that your list
accurately captures your multiple identities?
assumptions and biases
ANA Code of Ethics: Nurse provides care with respect to the
inherent worth of the individual. “The nurse establishes relationships
provides care with respect to human needs and values, and without
1.1, 1.2. ANA Code of Ethics.) (17)
possess knowledge and
understanding about how oppression, racism, discrimination, and
affect them personally and in their work. This allows them to
own racist attitudes, beliefs, and feelings” (18)
expected to be
aware of their own cultural
identifications in order to control their personal biases that
the therapeutic relationship. Self-awareness involves not only
culture, but also examining perceptions and assumptions about the
Through a self-reflective
assessment of their personal values,
attitudes, and assumptions about other cultures, and articulating these
assumptions and attitudes, the caregiver will gain the ability to sort
“bracket” the influences of their own cultural background in order to
respectful and unbiased care. (20)
Exercise # 4: Answer
the following questions:
- What racial group do
you identify with?
- What ethnic group(s)
do you identify with?
- What socioeconomic
class do you identify with?
- What is your
earliest memory of belonging in a group (other than your family)?
- What is your
earliest memory of being excluded from a group?
- What is your
earliest memory of excluding someone from a group?
Exercise 5: Adapted
from Luckman (1999)
How do you relate to
various groups of people in society?
Please answer honestly, not as you think might be socially or
desirable. Please do not record your
answers for this exercise.
Level of response:
- I feel I can
genuinely try to help this person without prejudice.
- Even though I do not
agree with this person, I feel I can accept this person as he is and
comfortable enough to listen to him/her.
- I do not feel that I
have the background knowledge or experience to help this person.
- I feel uncomfortable
taking care of this person.
- I feel biased and
prejudiced against this person.
Elderly person with
Unmarried expectant teen
White Anglo-saxon American
Morbidly obese man in his
Person with AIDS
Person with cancer
Person who does not speak
Responsibility and Tolerating Ambiguity
Caregivers accept responsibility for the continuous process
of becoming “aware of their own assumptions about human behavior,
biases, preconceived notions, personal limitations, and so forth” (Sue
means the caregiver keeps her certainty
that “her way is the right way” in check, and will attempt to
issues about a client’s supposed “non-compliance” with prescribed
Accepting responsibility means the caregiver will not assume that a
outcome to treatment stems solely from the client’s “non-compliance”
Ethnocentrism is defined as the tendency of
human beings “to think that their ways of
believing are the only right, proper, and natural ways” and that
values and practices that differ from one’s own are wrong.” (Purnell 1998).
assumptions about our biases and preconceived
ideas about others will “blind” us to our ethnocentric behaviors and
Leininger refers to cultural imposition and cultural pain as
consequences of ethnocentrism
Ethnocentrism is not an
acceptable attitude in health and
social care because it deters from relationship building between the
professional and the patient (23).
Exercise 6: (Adapted
from Luckmann 1999)
Indicate the degree to which you agree to the following
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- People are
responsible for their own actions.
- The outcome of
events is beyond our control.
- It is dishonest to
give vague and tentative answers.
- It is best to avoid
direct and honest answers in order not to hurt or embarrass someone.
efficient people use time wisely and are always punctual.
- Being punctual to
work or meetings is not as important as spending time with family or
- Stoicism is the
appropriate way to grieve.
- Loudly crying and
moaning is the appropriate way to grieve.
- The best way to gain
information is to ask direct questions.
- It is rude and
intrusive to ask direct questions.
- It is proper to call
people by their first names to show that you are friendly.
- It is disrespectful
to call people by their first names unless they give you permission to
- It is rude not to
look at a person who is speaking to you.
- It is rude to engage
in direct eye contact with persons of higher status.
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