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.

Tensions and Symmetries in the Ethnographic Unconscious: Lacan, Rain of the Children, Cross-Cultural Trauma

“…Merkur (2005, 7-11) details other concerns, ranging from Freud's emphasis on the child over the parents' fantasies, or doubts about how to interpret Sophocles' play from which the Oedipus myth itself is taken. Stitou (2016) traces other concerns, including the belief that 'Buddhist and Islamic cultures supposedly function without the Oedipus complex ' (2016, 1659). He also notes that 'Lacan himself (1972, 4-7) also struggled with the question of the differences between symbolic universes', wondering whether the Japanese, for example, were 'analysable'.…”

“…Yet it still adopts an inherently Western perspective where two or more sociocultural systems confront each other through the dominating lens of one. Stitou (2016Stitou ( , 1657 observes of French ethnopsychiatry, 'The unconscious often appears… as an answer to the uneasy relationship between culture and psyche, a relationship that becomes even more complicated when we are dealing with cultural difference'. Bidima (2000, 77) articulates the fragility of this perspective, enumerating tensions around power, the use of theory and the construction of meaning.…”

“…It does so by being situated at the intersection of a number of tensions: the registers of psyche and culture (Stitou 2016), psychoanalysis and anthropology, colonial and postcolonial, mediation and re-representation, visual and aural. What it proposes is a move from a perspective inflected through the kinds of Western epistemes articulated, for example by Lacan (1977), to one that acknowledges and articulates non-Western perspectives (Serafini n.d.).…”

“…Yet, these debates are within the social sciences and, themselves, are often ambivalent or silent on the notion of both the unconscious or clinical work, despite these directly engaging cross-cultural trauma experience (Proudfoot 2015). Where writers, such as Lacan or Zizek (2006), have discussed the unconscious, a further difficulty arises: the discussion is often developed through an implicitly Western discourse (Stitou 2016) with universalising assumptions that themselves are at issue. In contrast, this paper argues that a dynamic, non-Cartesian unconscious quite variably configured across cultures involves fluid, embodied, sensory, culturally specific practices.…”

Clinician’s Subjective Experience in the Cross-Cultural Psychiatric Encounter

“…A number of scholars, in both psychopathological and anthropological fields, have dealt with this issue, raising the question of whether and how the cultural otherness affects the clinician's capacity to empathize effectively with -and then understand -the patient's suffering. The psychoanalytic work on the problem of the ethnocultural countertransference [47][48][49][50], the studies on emotion recognition across cultures [51,52], and the anthropological reflections on the issue of crosscultural empathy [53,54] are well-known examples of this debate. These contributions bring into focus the clinician's lived experience of encountering and evaluating a foreign patient, and mostly relate to the classical controversy about whether the human capacity of understanding the other is a basic, universal, culture-independent function or whether it is constitutively rooted in a shared cultural context [6,55].…”