Inspiré par la conférence de la psycho-ethnologue Mme Dozoul à Nantes en 2008
Nowadays, all western countries are experimenting migration waves. From Honduras or Mexico to the USA, from Africa to Europe, we need to understand these “strangers” to offer them proper health care close to their needs.
Hospital is a place for all people, in France, free health care is available for everybody. Everybody is welcome with his cultural representations, his spiritual vision about illness and death.
As psychologists and healthcare workers in a hospital we need to understand that separate us and how to be in a real interaction with a person who as not the same culture.
Hereunder, some reflections given by Ms Dozoul, psycho-ethnologist, about transcultural psychiatry.
Ethnocentrism: first of all healing is encountering .
An emotional encountering based on codes, worth and representation of our own culture. Psychopathologize from our norms, judging everything from our culture references, here’s the trap. Listen to others only with our own prisma, our own worth field can lead us to judge only differences, here’s the risk, leading us to no therapeutic alliance creation, with a therapist on a defense position and a patient in a perpetual complaints.
Temporality : the state of existing within or having some relationship with time.
In hospital, time and space are often determined by caregivers. (lunchtimes, cure time, visits …)
As an example : for gypsies, sickness is faced as a group, and very often, rooms are quickly filled by family members, and that could be experienced by the healers as an offence to the rules in place.
So, oftenly medical team ask the family members to leave the room. This, considering that in the gypsy community the separation with the patient is a true process, could be experienced by the family as an offense and could create defiance against medical team. Furthermore, medical teams could experienced the same feelings. Similarly, as physical emergency is the priority for medicals team cannot be understand by the patient who prefer ritual and symbolic speeches to understand proposed healthcare. Finally, those differents points of vues are experienced by medical teams as « overoccupation » (suroccupation des lieux) or desorganisation of health chain.
However, it’s our responsability to make the hospital as a transitionnal space to help cultural or symbolic speak-up leading to a soothing transition from standard organisation to singular needs.
Spirituality and death : thoses reflections are the more necessary once the patient passed-out.
Then came the question of the last offices of the dead, of the body dressing for burials.
As the hospital is considered as a laic place, representing human rights universality, it’s hard to concieve spirituality in it. Some peoples find comfort in prays and rituals witch could be felt an exclusion by healers. the support of an interculturality trained psychologyst would allow for both sides to overcome the grief easily.
In conclusion: the search for an ethic of responsibility, based on transcultural knowledge, non-ethnocentric positioning, would allow us a creative dynamic of openness and non-renunciation, respectful of the framework of care giving way to the reciprocity of the unknown.
Going further : in France, transcultural psychiatry’s father is Georges Devereux, You can read « Un indien des plaines ». the author describes how he has abandon as is possible, his values to understand the pain of this indian patient who suffer from alcoholic dependence and nigntmares. His heir is Tobie Nathan who is the inventor of Centre Georges-Devereux, who is welcoming migrants family who need psychological support.
Be careful! It’s difficult as a French student to make a difference between cross-cultural psychology, transcultural psychiatry and cultural psychology. In France ethno-psychiatry has common roots with ethnopsychanalysis.
You can find the entire document of the conference at this address :
http://www.reseau-epsilon.fr/pages/intervention%20mme%20dozoul%2019%2011%2008.pdf