Psyche and culture: Perspectives based on the contributions and limits of ethnopsychiatry

Abstract

The unconscious often appears in the form of a question or answer to the difficult relationship between the psyche and culture, a difficulty that becomes exacerbated when we are dealing with cultural difference. This difficulty, evidenced for example by Freud's thoughts on Islam, reappears, albeit in a very different way, in ethnopsychiatric theory. The author discusses the blind spots of the binary logic of the unconscious present in the work of George Devereux, a logic that eventually leads him into the same trap he had himself criticized. This discussion allows us to open up other perspectives, by moving away from the analogies, confusions and splits between the psyche and culture towards what binds them together. This link is sustained by language and its dialectics, at the crossroads of individual singularity and cultural codifications. The author's approach is supported by two clinical vignettes: one from a case of a young Turkish woman, the other concerning a male Iraqi patient, a survivor of torture. This approach distances itself from any psychocentric view that would see the psyche as closed upon itself and thus ultimately exclude any object‐relations and inter‐subjective relationships; likewise, it rejects the ethnocentric conflation of the subject with his culture.

Culture et psyché : des perspectives basées sur les contributions et les limites de l'ethnopsychiatrie

L'inconscient apparaît souvent sous la forme d'une question ou d'une réponse relative à la relation difficile qu'entretiennent la psyché et la culture, une difficulté qui s'accroît lorsque nous avons affaire à une différence culturelle. Cette difficulté, comme en témoigne l'exemple des réflexions de Freud sur l'Islam, réapparaît, quoique différemment, dans la théorie de l'ethnopsychiatrie. L'auteure de cet article discute des tâches aveugles de la logique binaire de l'inconscient qu'on trouve dans l’œuvre de Georges Devereux, logique qui le conduit en fin de compte à tomber dans le même piège que celui qu'il avait dénoncé. Cette discussion, qui permet d'ouvrir d'autres perspectives, s’éloigne des analogies, des confusions et des divisions entre la psyché et la culture, pour se rapprocher de ce qui les relie l'une à l'autre. Cette relation est soutenue par le langage et sa dialectique, à la croisée de la singularité individuelle et des codifications culturelles. L'auteure illustre sa démarche à l'aide de deux vignettes cliniques: l'une a trait au cas d'une jeune femme turque, l'autre au cas d'un patient irakien ayant survécu à la torture. Son mode d'approche s’écarte du point de vue psychocentrique, où l'on a tendance à considérer la psyché comme un système clos, ce qui revient pour finir à en exclure toute relation d'objet et relation intersubjective; de même, ce mode d'approche rejette l'amalgame ethnocentrique entre le sujet et sa culture.

Kultur und psyche. perspektiven auf der grundlage der beiträge und grenzen der ethnopsychiatrie

Das Unbewusste taucht oft in Form einer Frage nach der schwierigen Beziehung zwischen Psyche und Kultur oder in Form einer entsprechenden Antwort auf. Noch komplizierter wird diese schwierige Beziehung, sobald kulturelle Unterschiede mit ins Spiel kommen. Diese Schwierigkeit, die zum Beispiel Ausdruck in Freuds Überlegungen zum Islam findet, tritt auch, wenngleich in ganz anderer Weise, in der Theorie der Ethnopsychiatrie wieder zutage. Die Autorin diskutiert die blinden Flecken der binären Logik des Unbewussten im Werk von George Devereux, einer Logik, die ihn am Ende in dieselbe Falle geraten lässt, die er kritisiert. Diese Diskussion eröffnet uns andere Perspektiven, indem sie den Blick von den Analogien, Verwechslungen und Spaltungen zwischen der Psyche und der Kultur weg‐ und auf die Kräfte hinlenkt, die sie miteinander verbinden. Konstitutiv für diese Verbindung sind die Sprache und ihre Dialektik am Kreuzungspunkt zwischen individueller Singularität und kulturellen Kodifizierungen. Illustriert wird diese Sichtweise anhand zweier klinischer Vignetten. Eines der Beispiele stammt aus der Behandlung einer jungen Türkin, das andere aus der Arbeit mit einem irakischen Patienten, der die Folter überlebte. Diese Sichtweise distanziert sich von jeder psychozentrischen Perspektive, die die Psyche so wahrnimmt, als sei sie in sich geschlossen und versperre sich letztlich jeder Objektbeziehung und intersubjektiven Beziehung; in entsprechender Weise lehnt sie auch die ethnozentrische Verwechselung des Subjekts mit seiner Kultur ab.

Cultura e psiche. prospettive fondate sui contributi e i limiti dell'etnopsichiatria

Spesso l'inconscio si presenta come interrogazione o risposta alla difficile relazione tra psiche e cultura, una difficoltà che viene esacerbata quando si approfondiscono tematiche relative alle differenze culturali. Questa difficoltà, evidenziata, per esempio, dalle riflessioni di Freud sull'Islam, riemerge, per quanto in modi differenti, nella teoria etnopsichiatrica. L'autore prende in esame le macchie cieche della logica binaria dell'inconscio presente nel lavoro di George Devereux, una logica che in ultima analisi lo ha fatto cadere nella stessa trappola che lui stesso aveva criticato. Questa discussione ci permette di aprire nuove prospettive, prendendo le distanze dalle analogie, confusioni e scissioni tra psiche e cultura, per accostare, invece, il nesso che le unisce. Questo legame è sostenuto dal linguaggio e dalla sua dialettica, nel punto di intersezione della singolarità individuale con le codificazioni culturali. Per avvalorare la sua tesi, l'autore utilizza due vignette cliniche: una tratta dal caso di una giovane turca e l'altra dal lavoro con un paziente iracheno sopravvissuto alla tortura. Questo approccio si allontana da qualsiasi vertice psico‐centrico che considererebbe la psiche come chiusa in se stessa ed escluderebbe, in ultima analisi, le relazioni oggettuali e intersoggettive; allo stesso modo rifiuta la fusione etnocentrica del soggetto con la sua cultura.

Cultura y psique. perspectivas basadas en las contribuciones y límites de la etnopsiquiatría

A menudo, el inconsciente aparece en la forma de una pregunta o de una respuesta a la difícil relación entre psique y cultura, una dificultad que se exacerba cuando abordamos diferencias culturales. Esta dificultad, evidenciada por ejemplo en las ideas de Freud sobre el Islam, reaparece, aunque de diferente manera, en la teoría etnopsiquiátrica. La autora discute los puntos ciegos de la lógica binaria de lo inconsciente presente en los trabajos de George Devereux, una lógica que lo conduce al final a la misma trampa que él mismo había criticado. Esta discusión nos permite abrir otras perspectivas, al alejarnos de las analogías, confusiones y separaciones entre psique y cultura y dirigirnos hacia lo que las vincula. Este vínculo está sostenido por el lenguaje y su dialéctica, en la encrucijada de la singularidad individual y las codificaciones culturales. Dos viñetas clínicas apoyan el enfoque de la autora: una de un caso de una joven turca, la otra relacionada con un paciente iraquí, sobreviviente de tortura. Este enfoque se distancia de cualquier visión psicocéntrica que considere a la psique como cerrada sobre sí misma y que por ello, en última instancia, excluya cualquier relación objetal y relaciones intersubjetivas; de igual modo, rechaza la fusión etnocéntrica del tema con su cultura.

Key words:

• unconscious
• psyche
• singularity
• culture
• language
• ethnopsychiatry

1. Translated from French by Kristina Valendinova.

1. Translated from French by Kristina Valendinova.

Notes

1. Translated from French by Kristina Valendinova.

2. This approach expands on previous analysis published by the author (Stitou, 2007) and is trying to open up new perspectives.

3. For example, the French psychoanalyst and author Daniel Sibony argues, based on the Freudian point of view, that for people from the Arabo‐Islamic tradition castration is not a psychic fact. For these subjects, the “endless hassle others call ‘castration’ becomes virtually meaningless” (Sibony, 1992, pp. 92–3).

4. A student of Freud and Ferenczi, a philosopher, anthropologist and psychoanalyst.

5. It is important to say that despite having undergone psychoanalysis and completed a number of trainings, Devereux was never recognized as a psychoanalyst. Despite being an advocate of rigorous formalization, this uncomfortable position led him to use the words psychoanalysis, psychiatry, psychotherapy, as well as ethnopsychiatry and athnopsychoanalysis interchangeably. This lack of distinction, which was linked to his personal situation, was then replicated in his successors, who were unable to ever really explain the difference clearly.

6. In France, this orientation was introduced by Tobie Nathan and later by Marie‐Rose Moro (1994), who nonetheless adopted a slightly different approach. Moro in fact distanced herself from the position that would see culture as the single and immuable determinant of our ways of being and thinking.

7. We should certainly give the discipline of ethnopsychiatry credit for being interested in the questions of subjects from other cultures, and for drawing attention to the clinician's need to reflect on these questions, which deserve further inquiry. This is strongly evidenced in Tobie Nathan's first book (1986), where he emphasizes the need to set up a common frame of reference shared by both patients and clinicians. His later work was nevertheless not exempt from certain excesses of culturalism. For example, he writes: “In societies with a high level of migration, ghettoes should be encouraged – yes, I say that loudly and clearly – they should be encouraged, so that a family never has to abandon its cultural system” (1994, p. 216) [translation].

8. Translator's note: Verlan is a type of French slang in which words are created by juxtaposing syllables.

9. Translator's note: Alan Sheridan's translation of Aulagnier's porte‐parole tries to account for her playing on the French word for spokesperson, as someone who literally holds or carries [porter] speech [parole].

10. From a linguistic point of view, we have known since Saussure that language is a code that allows speech to be expressed in the act, which in turn is always individual. For Benveniste, we cannot conceive of speech without its relation to enunciation; according to psychoanalysis, the latter is always linked to the unconscious.

11. A human being enters humanity at the same time as he enters culture and language, in other words the world of symbolization. This is emphasized by Benveniste: “We can never get back to man separated from language language & It is a speaking man whom we find in the world, a man speaking to another man, and language provides the very definition of man” (1971, p. 224) This represents a point of agreement among several disciplines, including anthropology, philosophy and psychoanalysis.

12. At first these sessions took place in the centre for refugees where I met Nadir and later, on his own request, in my private practice.

13. Contrary to Moroccan, which (together with French) is my native tongue, the Iraqui Arabic is much closer to classical Arabic, a language (both spoken and written) that I learned later in life. However, I use French to think and write about my clinical experience. Moroccan is an oral dialect which includes Arabic words, but depending on the different regions also heavily borrows from other languages, such as Berber, French or Spanish.