Vincenzo Di Nicola, MD

Society for the Study of Psychiatry & CultureNew York, New YorkMay 11, 2012

On the Threshold: Liminality versusCommunity in Immigrant Families in Therapy

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3Liminality vs community in immigrant families in therapy

Vincenzo Di Nicola, MPhil, MD, FRCPC, FAPA

• Chief, Child and Adolescent Psychiatry, HMR

• Professeur titulaire de psychiatrie, Université de Montréal

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Learning objectives

1. Understand a model of cultural family therapy and families as unique cultures

1. Recognize the dilemmas of liminality versus community in treating immigrant families

1. Demonstrate the limits of multiculturalism with increasing globalisation

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Key words

1. Cultural family therapy (CFT)

1. Families as unique cultures

2. Liminality versus community

1. Threshold people and transitional states

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Cultural Family Therapy (CFT)

An integration of cultural psychiatry

(McGill social and transcultural psychiatry with elements of French ethnopsychiatry)

and family therapy

(Milan systemic family therapy with Andersen’s reflecting team)

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Elements of CFT

Milan family therapy: Positive connotation

Andersen: Reflecting team

Nathan: Bombardement sémantique

Bakhtin: Dialogism

Lévinas: Face-to-face encounter

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Family therapy is the starting point

for the study of ever wider social units.

—Mara Selvini Palazzoli (1974)

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Key Features of CFT

• Recognizing families as unique cultures

• Immigrants as threshold people in transitional states

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Key Features of CFT

• Family therapy is the space that we open to explore

the possibilities of the family

13 Soins partagés en pédopsychiatrie

Key Features of CFT

• Family therapy is the space that we open to explore

the possibilities of the family

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Family Therapy Interventions

Family therapists do three simple things:

• enhance uncertainty• introduce novelty, and• encourage diversity

(Di Nicola, 1997)

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Negative and Positive Conceptions of Cultural Encounters

Negative conceptions

Shock

Trauma

Anxiety

Mourning

Overall theme –

Dislocation and loss

Positive conceptions

Surprise

Learning

Delight

Celebration

Overall theme –

Discovery and growth

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Adaptation and Its Vicissitudes

• Alexis – from Burkina Faso – query psychosis

« Why choose me? »

• Afrah – from Iraq – trauma sequelae probable

« I want to forget / The memory clinic »

• Senga – from Congo – behavior problem

« An African restavek »

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Key Theme: Liminality vs Community

• Victor Turner: The Ritual Process

Liminality – « betwixt and between »

• Jean-Luc Nancy – La Communauté désœuvrée (1983) –

The Inoperative Community (1986)

"The community that becomes a single thing (body, mind, fatherland, Leader) ... necessarily loses the in of being-in-common.

Or, it loses the with or the together that defines it. It yields its being-together to a being of togetherness. The truth of community, on the contrary, resides in the retreat of such a being."

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Key Theme: Liminality vs Community

• Giorgio Agamben – La comunità che viene (1990) –

The Coming Community (1993)

A philosopher of the threshold – he has written on indeterminate being, infancy, potenza, potentiality

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Conclusion: Après-coup

• Nachträglich - deferred action – Freud

• Après-coup – Jacques Lacan

A chronologically anterior event as supplement to a posterior one

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Conclusion: Après-coup

• Après-coup – Jacques Lacan

A chronologically anterior event as supplement to a posterior one

What has always troubled me about “King Lear” is that Shakespeare gives his characters no past. In “Ran,” I have tried to give Lear a history. —Akira Kurosawa

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ConclusionTo sum up, suturing a number of concepts and practices together –

• The family as a storying culture where narrative (Bakhtin’s dialogism) and culture (anthropology) are privileged

• liminality is acknowledged and threshold people in transitional states (Victor Turner) become more visible and more present to us

• in the face-to-face encounter (Levinas)

• where witnessing (Primo Levi, Agamben, Richard Mollica) is possible for the resignification of past experiences (Freud/Lacan, Michael White)

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Après la Coupe mondiale - 2006 Photo : V Di Nicola

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