Ethno-psychiatry and ethno-psychology experiment the paths to be followed so as to address the cultural differences within the disciplinary wisdom and practices (western) of psychiatry and psychology. It is not possible here to fully report on the complexity and fascination of these processes. We will simply present two aspects experienced by Tobie Nathan, a professor at the Paris VIII University and director of the Devereaux Centre providing psychiatric care for immigrants mostly coming from central Africa.
The first aspect consists in the valorisation of the experiences of the immigrants who turn to this centre. In them Nathan sees the wealth of those who have an immense baggage of experience and an extraordinary level of resistance. “I worked for over twenty years with migrant populations experiencing psychological and social problems. Having myself as a small child experienced migration, I was inclined to devote myself to this work to better understand what affected me very personally, to provide myself with a perspective that in a sense was a broader one; also out of loyalty to a certain idea of myself and my own family.
Whatever anyone may say, exile means suffering, and a very intense suffering, which consists in fulguration facing its mutism, the impossibility to smother the nostalgia, the ever-disappointed hope to return to the joy experienced in the past. But exile is also an adventure, on condition that the traveller’s memory resists being captured by the songs of the siren of simplification, on condition that one finds a place in which one can one day return to this accumulated experience (…) I have always been guided by an attitude I consider more a rule of hospitality rather than a technical device: a foreigner, even the one most in need, has the wealth of the languages he carries within himself, rich in fragrances and sensations, rich above all in explanations, beings, and the objects for which, thanks to the magic of travel, he becomes the representative for we who are his hosts.
Of course I have often been hurt by the poverty, both financial and social, experienced by immigrants who in a sense occupy today in France the social position occupied by the proletariat during the 19th Century. But a sort of intuitive kindness encourages me everyday to consider them as rich foreigners rather than as poor immigrants; to try and find the strength that allows them to laugh again, to be cheerful and alive, instead of remaining glued to the many weaknesses that make them “subjects of psychotherapy”. The second aspect consists in addressing seriously the migrants’ “affections”, hence the bonds binding them and simultaneously supporting them: a network of sensations consisting in languages, places, the ancestors and divinities that have accompanied them throughout their migration. This has resulted in bitter controversies because, especially in France, it is thought that a person is all the more “free” to the extent that they are free of bonds, and also because in this way Nathan introduces religious divinities and practices, mainly African ones, within a European scientific context.
Accepting these affections has led to Nathan’s proposal to include in the psychiatric team, not only interpreters but also “traditional” healers: “I reproach American psychiatry for excluding from investigations a large number of other real specialists, impossible to seriously interrogate and who take care of those who are really ill. This because not only psychiatrists and psychologists take care of patients, but also healers, shamans, the ministers of charismatic prayer groups… My theoretical proposal could be summarised as follows: one should do everything possible to ensure that this type of person is not excluded from the field of the analysis. If we have not yet found a way of rendering their theories interesting for scholarly schools of thought, because they are mainly based on the existence of invisible beings, their practices are however susceptible to refined and in-depth analysis and their clinical results are the objects of possible assessments.
And when I mention investigating their practices, I mean taking an interest in everything: in their actions but also in their being therapists, in their training, in their objects; their objects and therefore their instruments, but also their theories, their thoughts and, naturally (and perhaps above all?) their supernatural beings. (…) I believe that traditional therapies (for example: rituals for the possessed, the battle against witchcraft, returning order to the world after breaking a taboo, creating “therapeutic objects”) are neither illusions, nor suggestions nor placebo. I believe that these practices are exactly what the users believe they are: techniques used to influence and that are very often effective and therefore worthy of serious investigation. Since we are not alone in this world - others too think, at times with a lot of imagination, often with wisdom” [the cursive is the author’s].
There are however increasingly large numbers of psychologists and doctors trained in the West, in western universities, who remain close to traditional medicine and to the belief systems of their societies of origin. These are precious people because they act as a bridge between different scientific and professional worlds.
20 Nov 2006