The clinical “savoir-faire” of ethnopsychiatry

Abstract

In a changing world with open borders, mental health caretakers (psychiatrists, psychologists and other therapists) interact in their everyday clinical practice with patients from all over the planet who belong to various cultural and religious universes. Thus contemporary mental health caretakers treat patients suffering from pathologies informed by notions traditionally foreign to psychiatry, psychology or psychoanalysis, notions such as God, Saints, faith, prayer, witchcraft, possession, curses, spirits, ghosts, defilement, etc. Often these patients simultaneously turn to antagonistic therapeutic settings, attending psychiatrists as well as healers or priests. This transpires particularly when Western therapies lack answers. Ethnopsychiatry is a methodology combining therapeutics and research whose purpose is the creation of a framework of acceptance, interrogation and understanding of Western as well as non-Western diagnostic theories and therapeutic methods. How these patients may be treated in the most efficient and respectful way and how to avoid applying contemptuous and reductive interpretations to theories and concepts from the patient's cultural world will be addressed. Specific characteristics of the ethnopsychiatric clinical setting will be described and analyzed. In addition, the therapeutic process that assisted a drug addict to confront his family and destiny (to be a master healer) and leave France for Africa will be explored. This clinical process is based on ethnopsychiatry theory and practice. Finally we will bring epidemiological psychiatric data and clinical vignettes concerning the cohort of patients of Ethiopian origin that has been hospitalized in an Israeli mental center.