Monday, 4 November 2013

Diplomacy and Ethnopsychiatry

Latour mentions the ethnopsychiatrist Tobie Nathan in AIME and also in his book Iconoclash. Here’s a section from a very interesting article by Nathan On Ethnopsychiatry:
[…] the traditional drama of a therapeutic session involves a patient and an expert: the former is an expert of his own affliction, the latter, an expert in Illness. The purpose of the dialogue is to bring the subject to realize that the expert is right, and that he, as patient, understands very little of what is happening within his own mind and body. The admission of a third person into this otherwise standard battle scene changes the interaction so that the dialogue no longer serves to establish which is of the two is right, but rather to find common ground. 
An example of this might be found in the case of an African immigrant, a Manjak man from Casamance, living in France. The patient, who claimed to be the ninth of 14 sons, had mourned the death of his eight older brothers, and was worried that he would be the next to die. “My eight brothers are gone,” he explained, “because my father sold all of his sons to a sorcerer in exchange for wealth and power.” A therapist, alone with the patient, would be inclined to think that this was what the patient literally believed, or that fear and anxiety were putting words in his mouth. The therapist might decide to focus on the patient’s latent aggressiveness towards his father, or delve into his past in other ways, merely as a result of dealing one on one with his patient’s words. On the other hand, the expert might choose to introduce a translator, another Manjak from the same region as his patient, to mediate between them. When asked to interpret, this third person (for this approach was indeed applied), answered that it was common in his home country, not to sell one’s sons, but to use this expression. In other words, the patient was speaking realistically, acceptably, but with the words of his own culture, which to a foreigner might sound delusional. It is irrelevant, at this point, whether the interpreter understands the patient’s past or his particular use of the expression; simply by intervening, this “mediator” enlarges the parameters of what is normal, thus introducing a dimension of the Possible where the cultures of patient and therapist overlap. His presence makes a peaceful agreement possible, when it might be said that psychotherapy is a form of conflict. In the war of psychotherapy, both parties oppose one another in order to prove which of the two is right. Translation, on the other hand, is peace, because it seeks means of sharing a world, or a common ground of language.
The resonance with Latour’s 'diplomacy' project is obvious. The whole thing is well worth reading.  It makes the whole fetishism/iconoclash thing make a lot more sense.

7 comments:

  1. wouldn't say that in psychiatry the clinician is an expert in disease or that the patient is an expert in his/her condition, but certainly they need to find ways to coordinate their related behaviors as much as is possible, this is more about creating common goals/methods than finding common ground/world, further complicated of course to the degree that clinicians also represent 'state' and other '3rd' party interests.
    http://en.wikipedia.org/wiki/Principle_of_charity
    -dmf

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  2. He's setting up the clinician as something of a straw man, it's true. In fairness it's a short piece and he makes a compelling argument despite being a little simplistic. He goes on to list some more explicitly political examples, which makes his notion of 'peace' rather than simply 'treatment' make more sense.

    I'm not sure which came first, Nathan's ethnopsychiatric 'peace settlements' or Latour/Stengers' 'cosmopolitics' but they are uncannily similar. Presumably these ideas have developed alongside each other to some extent.

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  3. for me "peace" is about a relative degree of less conflict, but we are always already renegotiating our ways in/thru/with the world, and in a compromise no one gets what they wanted...
    -dmf

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  4. http://lareviewofbooks.org/interview/on-the-logic-of-anthropological-inquiry-a-conversation-with-paul-rabinow

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  5. If you work in psychiatry this strawman can be seen walking about quite often, and the idea that the patient is an "expert from experience" is quite popular.

    Ethnopsychiatry is very interesting, definitely look into it more. Just to say that the practice of advocacy appears to be a version of ethnopsychiatry that is already much less "diplomatic". I think this search for a peace settlement might be fine in certain situations but it is widely inappropriate in others. In the latter situations advocacy is much more about conflict insofar as it introduces a third who is explicitly partisan for the patient.

    We should also recall that "the psychiatrist" in the assessment room is almost never the only psychiatric worker the "new assessment" will encounter- and that in any case the psychiatrist is never just there own body- as dmf points out.


    I'd remind people that there have been (only in the UK) over 3,000 deaths in the last 10 years in psychiatric detention.

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  6. http://tobienathan.wordpress.com/

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  7. might be interesting to investigate various attempts to "civilize" people in relation to diplomacy.
    http://www.abc.net.au/radionational/programs/latenightlive/civilising-china27s-internet/5072532
    -dmf

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