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Ethnopsychiatry and its Reverses: Telling the Fragility of the Other

Published online by Cambridge University Press:  28 February 2024

Jean-Godefroy Bidima
Jean-Godefroy Bidima*
Affiliation:
Collège International de Philosophie, Paris
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Reading the vast panorama of the history of Western medicine in general and psychiatry in particular sheds an interesting light not only on social constructions and representations but also on the perception of the Other by the medical institution. Colonial medicine in its struggle - praiseworthy, moreover - against epidemics, presents an interesting case here. We read in the Colonial Medical Archives at Berlin, that a certain Dr Roesener was sent to Kamerun (Cameroon), a German protectorate, to take charge of the eradication of malaria, hookworm (anchylostoma), filariosa and sleeping sickness. But he also found himself faced with mental illnesses and, in his report of October 1909, reported the case of a sick man of the Dwala tribe claiming to be a friend of the Kaiser and presenting all the symptoms of mental illness. A problem of nosography arose - stemming from the cultural perception of an illness and above all of the Other: did this Dwala merit being mad? To understand the meaning of this question, we must return to the German anthropology of the last century, which made a clear distinction between ‘natural people’ (Naturmenschen) and those that were civilized, who were part of Kultur. Moreover, in this report Roesener used the word Naturmenschen to signify the Dwala. In this perspective, as the doctor notes, mental illness was, in the medical teaching of that time, a disturbance of the mind, a malaise of civilization. The prerequisite for being mentally ill was being implicitly part of a civilization. Mental illness was, moreover, translated in German by Geisteskrankheit, in other words, literally, illness of the mind. Now, the ‘natural person’ (the Dwala) has no civilization and in consequence cannot be sick in his mind. And yet he presented all the symptoms which made him a classic mental patient. Could one apply the nosography proper to illnesses stemming from civilization to ‘natural peoples’? Without resolving the problem which his terminological usage posed, Roesener insistently demanded that Berlin send the logistical means to Cameroon to build a lunatic asylum (Irrenhaus). To the problem of mental fragility that was posed came the answer of incarceration in a society that knew nothing of confinement of its ‘mental patients’, the latter often not being considered as inferior.

Type
Research Article
Information
Diogenes , Volume 48 , Issue 189 , March 2000 , pp. 68 - 82
Copyright
Copyright © ICPHS 2000

References

Notes

1. Medizinal-Berichte über die Deutschen Schutzgebiete Deutsch-Ostafrika, Kamerun, Togo, Deutsch-Südwestafrika, Neu-Guinea, Karolinen, Marshall-Inseln und Samoa für das Jahr 1909/10 (Berlin: Mittler and Son, 1911).

2. Ibid. (1915 edition), pp. 419-420.

3. Ibid. (1911 edition), p. 314.

4. Antoine Porot (1952), Manuel alphabétique de psychiatrie clinique et thérapeutique (Paris: Presses Universitaires de France). There were six new editions by 1984.

5. Aubin, in Porot (1952), 3rd edition (1965), p. 388, repeating the quotation from previous editions. In the 6th edition (1984), this article no longer appeared in the manual: in 1965, therefore, the Blacks were still inferior for these French psychiatrists!

6. Ibid. p. 388.

7. Lyotard uses this term to designate his move condemning universalist discourses. He refutes ‘the prejudice anchored in the reader by centuries of humanism and “human sciences” that there is “man”, that there is “language”, that the former makes use of the latter for his own ends': Jean-François Lyotard (1988), The Differend: Phrases in Dispute, trans. Georges van den Abbeele (Manchester: Manchester University Press), p. xiii, originally published in 1983 as Le différend (Paris: Minuit), p. 11. It would be interesting to see how the ‘pagan' discourse of an ethnopsychiatrist like Tobie Nathan would relate to Lyotard's ‘paganism' (paganism is defined by Lyotard as ‘the denomination of a situation in which one judges without criteria': Jean-François Lyotard (1985), Just Gaming, trans. Wlad Godzich (Theory and History of Literature, 20, Minneapolis: University of Minnesota Press), p. 16. There is research still to be done on Lyotard's (1977) L'instruction païenne (Paris: Galilée) and Nathan's (1998) La psychologie païenne (Paris: Dunod).

8. On this point, see Elmar Holenstein (1999), Entente interculturelle (Paris: Cerf), p. 20; E. Leach (1980), L'unité de l'homme (Paris: Gallimard); Richard Rorty (1994) Objectivisme, relativisme et vérité (Paris: Presses Universitaires de France), English edition: (1991) Objectivity, relativity and truth (Cambridge: Cambridge University Press).

9. Roger Bastide (1970), Preface, in G. Devereux, Essais d'ethnopsychiatrie générale (Paris: Presses Universitaires de France), p. viii.

10. See Benoit Pollack (1965), ‘Tendances et questions actuelles dans la psychiatrie sociale', L'information psychiatrique, 41 (4); N. Bell and J.P. Spiegel (1966), ‘Social psychiatry: vagaries of a term', Archives of General Psychiatry, 14 (4). For a general reading of the evolution of the expression, see C. Dufrancatel (1967), La sociologie des maladies mentales (Paris: Mouton).

11. Daniel Charlemaine (1998), ‘Ethnopsychiatrie, histoire d'un mot', Psychologie et Éducation, 34.

12. The author cites T. Lemperière and A. Feline (1987), Psychiatrie de l'adulte (Paris: Abrégés Masson); H. Ey, P. Bernard and C. Perisset (1978), Manuel de psychiatrie (Paris: Masson); E. Rochette and P. Ayoun, Vade mecum de psychiatrie (Collection Scientifique Survector); E. Roudinesco and M. Plon (1997), Dictionnaire de psychanalyse (Paris: Fayard); N. Sillamy (1983), Dictionnaire usuel de psychologie (Paris: Bordas).

13. Charlemaine (1998), p. 48. The Devereux book at issue here is (1982), Psychothérapie d'un indien des plaines (Paris: Éditions Jean-Cyrille Godefroy); see his introduction, n. 10.

14. As for Devereux, it is not clear what term should be used to describe him: ‘In Henry Ey's Manual of psychiatry, p. 47, he is introduced as a sociologist … In the Grand dictionnaire de psychiatrie (by Postel) … he is this time psychoanalyst and ethnopsychiatrist'. Charlemaine (1998), p. 83. What is certain is that he was not a doctor.

15. Nathan, Charlemaine tells us, is ‘neither doctor, nor psychiatrist, although he seems to be the leader of present-day psychiatry in France', (1998, p. 82).

16. Ellen Corin (1993), ‘Le détour de la raison', Anthropologie et Sociétés, 17 (1-2).

17. Bastide (1970), p. ix.

18. Georges Devereux (1970), Essais d'ethnopsychiatrie générale (Paris: Gallimard), pp. 4-5.

19. See Georges Devereux (1972), Ethnopsychanalyse complémentariste (Paris: Flammarion), especially chapter 6.

20. Tobie Nathan (1977), Sexualité, idéologie et névrose (Paris: Éditions de la pensée sauvage), p. 144. This opinion of Nathan on Devereux's analyses of shamanism appears to have been called into question by Philippe Mitrani, who clarifies Devereux's confusion of the ‘function of the shaman and the personality of the individual': Philippe Mitrani (1982), ‘Aperçu critique des approches psychiatriques du chamanisme', L'ethnographie, 78 (87-88), p. 253.

21. Tobie Nathan and Marie-Rose Moro (1997), ‘Ethnopsychiatrie de l'enfant', in S. Lebovici, M. Soulé and R. Diatkine (eds), Nouveau traité de psychiatrie de l'enfant det de l'adolescent (Paris: Presses Universitaires de France), vol. I, p. 435.

23. D. Westermann (1939), The African To-Day and To-Morrow (London), cited in J.C. Carothers (1954), Psychologie normale et pathologique de l'Africain: Étude ethnopsychiatrique (OMS, Palais des Nations: Geneva, distributed by Masson et Cie).

24. P. Gallas Planques (1951), ‘Psychologie du Noir', Médecine Tropicale, 11, 5. This article by Gallas has been taken up by Aubin - who does not cite it - in Porot (1952).

25. R. Barbé (1951), ‘Sur la psychologie du Noir', Médecine Tropicale, 11, 33.

26. Ibid., p. 33.

27. François Laplantine (1974), Les trois voix de l'imaginaire (Paris: Universitaire).

28. J.-Marie Sauret (1982), Croire? Approches psychanalytiques de la croyance (Toulouse: Privat), p. 155.

29. Marc Augé (1997), ‘Vies de rêve des Indiens Mohaves', Critique, 53 (603-604), 590 (recension of Georges Devereux, Ethnopsychiatrie des Indiens, Paris: Ed. Synthélabo).

30. Devereux (1970), p. 73.

31. Didier Fassin (1984), ‘Anthropologie et folie', Cahiers internationaux de sociologie, 77, 270.

32. Alain Policar and Pierre André (1997), ‘Ethnopsychiatrie et exotisme: Devereux et les faussaires', Raison Présente (Paris), 123, 116. The book by Nathan which is cited was published as La pensée sauvage in 1993, p. 38.

33. Jean-No'l Férié and Gilles Boetsch (1993), ‘L'immigration comme domaine de l'anthropologie, Anthropologie et sociétés', 17 (1-2), 240.

34. Ibid., p. 240.

35. Didier Fassin (1999), ‘L'ethnopsychiatrie et ses réseaux. L'influence qui grandit', Genèses (Paris), 35.

36. Ibid., p. 148.

37. He notes the case of O. Mannoni who worked for the French colonial administration in Madagascar, citing M. Bloch, ‘La psychanalyse au secours du colonialisme', Terrain, 28, 103-118.

38. Ibid., p. 179. This ‘influencology' is taken from Nathan's book, Tobie Nathan (1994), L'influence qui guérit (Paris: Odile Jacob), p. 15.

39. He refers to Nathan's interview in Le Monde, 22 October 1996, entitled ‘Freud ressemblait au guérisseur africain' ['Freud is like an African healer']; the responses by Feth Benslama, ‘L'illusion ethnopsychiatrique' ['The Ethnopsychiatric Illusion'], in Le Monde, 4 December 1996, and by Alain Policar in Libération, 20 June 1997; and, finally, the views of Isabelle Stengers and Bruno Latour, Libération, 31 January 1997.

40. See Ellen Corin (1977), ‘Playing with Limits: Tobie Nathan's Evolving Paradigm in Ethnopsychiatry', Transcultural Psychiatry, 34, 345-358; Paul Freeman (University of California) (1997), ‘Ethnopsychiatry in France', Transcultural Psychiatry, 34, 313-319; Ursula Streit (Montreal), ‘Nathan's Ethnopsychoanalytic Therapy: Characteristics, Discoveries and Challenges to Western Psychotherapy', Transcultural Psychiatry, 34, 321-343.

41. Joseph Penda Melone (1983), Causes et signification des désordres psychologiques et leur thérapeutique chez les Bantu: Exemple Bakoko. Approche ethnopsychiatrique, doctoral thesis, Paris, p. 262.

42. Massamba Ma Mpolo (1976), La libération des envoûtés (Yaounde: Clé), p. 43.

43. Pierre Caussat (1989), De l'identité culturelle, mythe ou réalité (Paris: Desclée de Brouwer), p. 43.

44. As far as Africa is concerned, however much it is invoked in the arts, religion, forms of dance and magic, French-speaking countries have arrogantly ignored everything that has been done in the field of philoso phy. The universities are only with difficulty leaving their links with colonial clichés. The appropriate place reserved for African philosophers in the encyclopedias and dictionaries of philosophy published in France - where they are often introduced by Africanist ethnologists and muddled with ‘African wise men'- contrasts sharply with the serious position they have in American dictionaries and encyclopedias of phi losophy. The situation is understandable in France where the greater part of the Africanist universities were once linked either with ‘politically correct' Third-World prophecies or with colonial milieux. As for the African philosophers themselves, nationalist protest, the interiorization of colonial prejudices, the cult of difference, the fascination - of recent date - for postmodernism, have produced a reactive strain of thought (in the Nietzschean sense) which has sometimes stifled the multiple possibilities of African philo sophical discourse.

45. Placide Tempels (1948), La philosophie bantoue (Paris: Présence Africaine), trans. (1959) as Bantu Philosophy (Paris: Présence Africaine). The book was hailed by Louis Lavelle, Gaston Bachelard and Albert Camus.

46. Alexis Kagame (1976), La philosophie bantoue comparée (Paris: Présence Africaine).

47. John Mbiti (1973), Religions et philosophie africaine (Yaounde: Clé).

48. Alassane Ndaw (1983), La pensée africaine (Dakar: NEA).

49. This theory of communitarianism is still current with some French psychologists who are not au fait with criticisms of it by African philosophers. ‘His [the African's] freedom, his will, his desire take second place to the will of the group', says Silvana Olinda Weber (repeating Hampaté Ba!) (1988), L'acte suicide (Paris: Hommes et groupes éditeurs), p. 178.

50. Paulin Hountondji (1977), Sur la philosophie africaine (Paris: Maspéro).

51. Marcien Towa (1971), Essai sur la problématique philosophique dans l'Afrique actuelle (Yaounde: Clé).

52. Kwasi Wiredu (1980), Philosophy and an African Culture (London: Cambridge University Press).

53. Jean-Godefroy Bidima (1995), La philosophie nègro-africaine (‘Que sais-je?', Paris: Presses Universitaires de France).

54. Aimé Césaire (1955), Discours sur le colonialisme (Paris: Présence Africaine).

55. For this topic, see Adamah Ekué (1981), L'insaisissable africanité, doctoral thesis, University of Paris I, Paris; Ferdinand Ezembé (1997) ‘Les thérapies africaines revisitées, Le journal de psychologue', 147, May.

56. The significant analysis of Tobie Nathan and Isabelle Stengers (1999), Médecins et sorciers, manifeste pour une psychopathologie scientifique (including, I. Stengers, ‘Le médecin et le charlatan’) (Paris: Institut d'édition Sanofi-Synthélabo), should be noted here. The analyses contained in this work - comparisons between ‘scientific' therapies and ‘uncivilized' therapies, the history of medication in the West, etc. - is being continued in the journal recently established (by the same publisher), the goal of which is to highlight and give an account of the relevance of advances in ethnopsychiatry. Moreover, Nathan has been the instigator of a commercial film by Denis Amar - a thriller based on his novel, Sarakabô, in which, with his insight and ethnopsychiatric experience, he paints a picture of the reality of African immigration in France. These observations suffice to demonstrate the importance of Tobie Nathan for a certain audience, and how his discourse is able to satisfy some exotic fantasies which (alas!) still structure a certain Western attitude to non-Westerners.

57. They are the products of traditions (that they sometimes make fun of), of Muslim or Western education, reggae, football and jazz, and no longer those of the grove of ritual initiation.

58. When Nathan for example condemns the fact that African families in France are split up by the placement policy of the DASS (see Nathan 1994).

59. Nathan (1994), p. 72.

60. Ibid., pp. 72, 73, 74.

61. See M. Sankalé (1969), Médecins et action sanitaire en Afrique (Paris: Présence Africaine), pp. 250 ff.

62. Georges Dimy Tchetché (1996), Thérapies familiales et contextes socio-culturels en Afrique noire (Paris: L'Harmattan), pp. 49 ff.

63. Elisabeth Uchoa (1993), Indifférenciation et folie d'Ajaratou, Anthropologie et sociétés, 17 (1-2), 164.

64. Nathan (1994), p. 331.

65. Ibid., p. 332. Admittedly, for Nathan, brought up on Judaeo-Christianity, the assertion, ‘the fear of the Lord is the beginning of wisdom' is reversed into ‘the fear of the gods is the fount of all therapy… for Africans!' But what do the Africans think about it?

66. Eloi Messi Metogo (1998), Dieu peut-il nourrir en Afrique? (Paris: Karthala).

67. Junod (1936), Moeurs et coutumes des Bantous (Paris: Payot), p. 258.

68. Joel Caudau (1998), Mémoire et identité (Paris: Presses Universitaires de France), pp. 20-21.

69. Nathan, p. 331.

70. Ibid., p. 330.

71. Nathan (1995) in Revue Science et Nature, Feb. (cited in Taguieff, op. cit., 1997).

72. See Mary Kolawole (1997), Womanism and African Consciousness (Trenton, New Jersey: Africa Word Press).

73. Awa Thiam (1979), Paroles aux négresses (Paris: Denoël/Gonthier).

74. See Barthélémy Gayaba (1993), ‘La persistance de la médecine traditionnelle en Afrique Noire', in J.C. Beaune (ed.), La philosophie du remède (Éditions Champs Vallon), p. 293.

75. Louis-Vincent Thomas (2000), Les chairs de la mort (Institut d'Édition Sanofi-Synthélabo), p. 235.