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Primary Care, Mental Health and Public Health
Integration
• WPA Bucharest Congress
• “Innovation & Excellence”
• April 10, 2013
Belonging Without Boundaries: Social Psychiatry in the
21st Century
Co-chairs:
Vincenzo Di Nicola
Rachid Bennegadi
A Symposium on Belonging
Panelists:
Vincenzo Di Nicola Ileana-Mihaela Botezat-AntonescuDrozdstoj StoyanovAnnelle Primm
A Symposium on Belonging
Panelists:
Vincenzo Di Nicola: “Belonging Without Boundaries: Settlers, Sojourners and Travellers in the 21st Century”
A Symposium on Belonging
Panelists:
Ileana-Mihaela Botezat-Antonescu:“Belonging to the Group of Psychotherapy Professionals: Between Interdiction and Proliferation in Different Political Contexts in Romania”
A Symposium on Belonging
Panelists:
Drozdstoj Stoyanov:“Belonging Dimensions in Psychological Climate and Personality as Predictors of Vulnerability to Burn-out”
A Symposium on Belonging
Panelists:
Annelle Primm:“Belonging by Bridging Divergent Worlds”
A Symposium on Belonging
Discussant:
Rachid Bennegadi
Special Thanks
Eliot Sorel
Pierre Loebel
Geopoliticus child watching the birth of the new man
– Dali
Belonging Without Boundaries: Social Psychiatry in the 21 st Century
It takes so little, so infinitely little, for a person to cross the border beyond which everything loses meaning: love, convictions, faith, history.
Human life—and herein lies its secret—takes place in the immediate proximity of that border, even in direct contact with it; it is not miles away, but a fraction of an inch.
– Milan Kundera, The Book of Laughter and Forgetting
Belonging Without Boundaries: Settlers, Sojourners and Travellers in the 21 st Century
Vincenzo Di Nicola
Belonging …
Belonging Without Boundaries: Settlers, Sojourners and Travellers
in the 21 st Century
Vincenzo Di Nicola MPhil, MD, PhD, FRCPC, FAPA
• Psychologist (McGill/London)• Child Psychiatrist (McGill/Ottawa)• Philosopher (McMaster/McGill/EGS)
• Professor – Université de Montréal/UFRGS – Brazil
• Chief – Hôpital Maisonneuve-Rosemont
Belonging Without Boundaries: Settlers, Sojourners and Travellers
in the 21 st Century
Vincenzo Di Nicola
• Mid-career child psychiatrist and early-career philosopher
• Tender-minded vs tough-minded –William James
• An Italian heart, an Anglo-Saxon brain and a Jewish soul
Key words
• Belonging
• Social psychiatry
• Relational being vs individual identity
Pedagogical objectives
1. To propose belonging as a key notion for social psychiatry
Pedagogical objectives
2. To offer an overview of the aporias* imbricated in thinking about belonging
* Aporia – Gk: impasse, confusion, puzzlement
“The Church of God sojourning in Rome to the Church of God sojourning in Corinth.” — Clement’s
Letter to the Corinthians
• paroikousa – Gk: a provisional abode,“sojourning”
• katokein – Gk: the citizen with a residence
• parokein – to sojourn like a stranger• katokein – to reside like a citizen
“The Church of God sojourning in Rome to the Church of God sojourning in Corinth.” – Clement’s
Letter to the Corinthians
Message:
• The Church itself was not a permanent structure but a sojourn
• Christians live in messianic time
20th Century
• Displacements across borders, languages and cultures
• Emigrants, immigrants, migrants
• From displaced persons (DPs) to refugees
• From law to literature, from politics to philosophy, and from psychiatry to psychoanalysis
20th Century
• “Global flows” – Rand Corp
• Social psychiatry & social medicine• Public health & epidemiology
• Transcultural psychiatry & medical anthropology
• Ethnicity & culture
• Multiculturalism
21st Century
• From a bipolar world and the Cold War rhetoric of the end of history (Francis Fukuyama) to a multicentric world of liquid modernity (Zygmunt Bauman)
• Where culture has replaced class as the
dominant signifier
• Language as the major expressive vehicle of this shift
21st Century
• From multiculturalism to globalization
• From diversity to pluralism
• From transcultural psychiatry to global mental health
Whither belonging?
Belonging is now a critical issue for
• Sociocultural psychiatry • Global mental health
What is belonging?
• Belonging has a bi-valent, ambiguous, deeply unresolved/unresolvable quality
• What philosophy calls an aporia – a puzzle
Sojourners vs settlers
• We can begin to describe this puzzle with the dichotomy settlers or sojourners
• Katokein – those who are “here” to settle
• Parokein – those who sojourn for work or other reasons, for shorter or longer periods, but do not make their home “there”
Liminality
Third state of being-in-the-world …
• Intermediate between sojourners who are passing through and settlers who plant roots
• Those still on the journey, in transit –“betwixt and between” (Victor Turner)
• Neither here nor there – travellers on the threshold
Liminality
Travellers on the threshold …
• Stato di eccezione, state of exception
State of exception
• Giorgio Agamben (b. Rome, 1942)
State of exception
• Giorgio Agamben (b. Rome, 1942)
• Key notions:
• Homo sacer/Sacred Man (1998)• Stato di eccezione, État d’exception, State of Exception (2005)
Liminalitas vs communitas
Liminality(threshold being/state of exception)
vs
Community(settler/citizen)
What is belonging?
• Whether it accompanies a language, a nation, a profession, or other organizing system of meaning
• The construct of belonging can be more than
an aporia for imagining identity
• To achieve the definition of subject and subjectivity
What is belonging?
• “Belonging” is a way of rethinking relational and social being
• How we define mental health
• How we understand the expression of its vicissitudes
• How we organize care and healing for sufferers
What is belonging?
To do this …
• We need to recognize how belonging is experienced and negotiated
• Free of the constraints of our habitual patterns of practice and thought
• To imagine belonging without borders for settlers, sojourners and travellers in the 21st century
Some negations
What belonging is not and cannot be …
• Belonging is not identity(belonging is not simply part of personal
being, cf. Rom Harré)
Cf. Amin Maalouf, Les Identités meurtrières/In the Name of Identity: Violence and theNeed to Belong (1998/2000)
Some negations
What belonging is not and cannot be …
• Belonging cannot be bounded by geographic or any other kind of boundaries
(eg, nation-state)
• Nor reduced to home, physically defined(cf. house/home; patria, homeland, heimat)
Some negations
What belonging is not and cannot be …
• Belonging cannot be disembodied(virtual reality, the internet or other
simulacra; cf. Jean Baudrillard)
• Corollary: Neither metaphor nor metonymy can instantiate or describe belonging
(ie, belonging is neither a metaphoric nor a metonymic relation, neither a
displacement nor a condensation of affects and cognitions, and cannot be described as such)
Some negations
What belonging is not and cannot be …
• Belonging cannot be exhausted, explained or contained by notions of ethnicity or other associations(eg, race, religion/system of belief,
ideology, profession, gender, sexuality, or intellectual/other cultural traditions)
Some negations
What belonging is not and cannot be …
• Belonging cannot be defined by essentialist, reductive, deterministic or other
causalistic models
Some negations
What belonging is not and cannot be …
• Belonging is not ownership(regardless of the lexical origins or deconstructive meanings of the term in
English or other languages, belonging cannot be conflated with ownership and must be specifically separated from any notion of ownership, slavery or any other materialistic enterprise)
Some affirmations
What belonging is and possibly must be …
• Belonging is part of social being (cf. Rom Harré)
Some affirmations
What belonging is and possibly must be …
• Belonging is proposed as a key notion of social and cultural psychiatry
(not a subset of psychiatry but a larger and more embracing definition of psychiatry)
Some affirmations
What belonging is and possibly must be …
• Belonging is a critically important aspect of developmental psychology (cf. Jerome
Kagan) and child and adolescent psychiatry
• With implications for developmental psychopathology (cf. Sir Michael Rutter)
Some affirmations
What belonging is and possibly must be …
• Belonging can embrace and contextualize such specific approaches as attachment theory and systemic or family therapy
(belonging has no parentheses or brackets)
Some affirmations
What belonging is and possibly must be …
• Belonging can address the irreducibly philosophical* question of defining the subject
* philosophical = metaphysical or ontological
Some affirmations
What belonging is and possibly must be …
• Belonging is contingent (ie, chance, not fate),non-essentialist, non-deterministic, non-causalistic, and fundamentally irreducible
Some affirmations
As a result …
• Belonging is synonymous with fidelity to an Event, which generates both subject and belonging
The science of being: Ontology
• Alain Badiou (b. Rabat, 1937)
The science of being: Ontology
• Alain Badiou (b. Rabat, 1937)
• Key notions:
• Theory of the Subject (1982/2009)• Being and Event (1988/2005)• Logics of Worlds (2006/2009)
Reflexions
Belonging is to social psychiatry what attachment is to child psychiatry
Reflexions
Belonging is a bridge between the individual and the community
(ie, between personal being and social being)
Belonging …
Contact Vincenzo Di Nicola
• Blog – Trauma & Event:
http://philoshrink.blogspot.ca/
• Facebook:https://www.facebook.com/dinicola.vincenzo
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