I have recently come across several helpful articles by psychiatrist Renato Alarcón. For instance, in this Article in Psychiatric News, he explains how cultural factors are very important in diagnosis, and says that outcomes would be much improved if psychiatrist paid more attention to them.
Taking culture into consideration enables psychiatrists to depathologize behaviors they might otherwise view as symptomatic, and to obtain a fuller picture of what patients are experiencing. Knowing patients’ traditions and beliefs may allow psychiatrists to employ culture in a psychotherapeutic role, by building rapport and collaboration.
Of course, this is easier said than done. To help shift attitudes, Dr. Alarcón helped develop the DSM-5 Cultural Formulation Interview, which helps clinicians account for the influence of culture in their clinical work, improve patient-clinician communications, and ultimately improve outcomes.
In his work, Renato Alarcón demonstrates the power of liminality – of actually meeting people. (See Key Concepts Page on this blog.)
The important thing is to understand the human entity, the patient’s background, why he or she comes to see you now but didn’t come earlier, and how he or she explains their symptoms and causes of those symptoms. The individualistic approach, a strong aspect of American life and of Western culture in general, stresses that people need to take responsibility for their own behavior. It often neglects, however, a cultural background that encourages reliance on family and friends. If psychiatrists fail to ask about cultural issues, he said, their work is incomplete.
Xavier Le Pichon – Global expert on plate tectonics and people
In a recent post, I wrote about the philosophy of disability – the practice of thinking through issues without giving privilege to able-minded or able-bodied perspective. As I begin to practise this philosophy, new horizons of learning are opening up for me (and giving me inspiration for future blog posts!)
In other words, I am beginning to appreciate the value of socio-diversity, and why it is just as critical for our survival as biodiversity. Here are quotes from two recent articles which have provided me with helpful background and context:
People began to use the word “normal” in the early 19th century. With progress in medical statistics, scientists began to figure out what “typical” species functioning was, and this gave them a standard endorsed by evolution. The typical human being was seen as a successful example of the species. Anyone who was not “normal” was a deficit – a threat to the species. This was the beginning of eugenics.
...paraphrased from an interview with Anita Silvers. Professor of Philosophy, San Francisco State (CBC Ideas podcast, minute 38)
As I knew from my own scientific experience, the weaknesses, the imperfections, the faults facilitate the evolution of a system. A system, which is too perfect, is also too rigid because it does not need to evolve…One can ask whether it is not also true of our societies. We tend to dissociate the individuals who are well adapted to our social life from those that have difficulties to follow the pace that is imposed on them by our life style. Yet a society that separates the producers from the others considered as dead weight, even as marginal or excluded individuals, is a hard society, characterized by conflicts and often by complete rejection of minorities. It is sad and pessimistic. On the contrary a society where all are well integrated has a much more adaptable structure, with a different, easier and more conciliatory mode of life. It is often happier and more optimistic.”
…Xavier Le Pichon, quoted in a blog post by Trent Gillis
United we stand, divided we fall.
I am not a regular reader of Now Magazine. (I am white, over 60 and living in the suburbs, so maybe I’m a little out of touch.) However, the cover story of the current issue caught my eye. Radheyan Simonpillai describes the harrowing experiences of 5 different Tamil refugees, who somehow managed to keep their sanity through it all. And their new stories are just beginning.
Simonpollai also writes a brief review of the movie Dheepan, which opens this Friday at the TIFF Bell Lightbox:
Jacques Audiard’s beautiful, angry story about three Tamil refugees posing as a family to escape Sri Lanka’s brutal civil war and build new lives in France understands displacement on a sensory level. Adjusting to new customs and languages feels like stumbling in the dark. Every face looks judgmental, suspicious or mocking…
Canada is earning a good reputation for welcoming refugees. But after reading stories like this, I wonder if we are doing enough. As well as digging into our pockets, maybe we need to dig a bit deeper into our souls. It’s a rite of passage for us too.
Note: As well as Dheepan, there are several other liminal film events this weekend, including:
The World Wide Weave is a travelling fabric art exhibit with contributions from Camphill communities around the world. (The image on the left is from Vietnam; click here to see a wide selection of other images.) The Weave has been enthusiastically received by audiences across Europe, and arrives at the Collier St. United Church in Barrie on April 7th. It runs until April 22. I encourage you to come – it’s a once in-a-lifetime opportunity! While you’re in Barrie, be sure to visit the Camphill Store. (More information)
As well as being a beautiful exhibit in its own right, the Weave is also a demonstration of the power of social art. When a group of people with diverse backgrounds collaborates on a piece of textile art, they are not just weaving physical threads – they are renewing, strengthening and re-shaping the fabric of community life. I believe this exhibit will be inspiring for many!
Malidoma Patrice Soma was born in a Dagara village in Burkina Faso. He tells his story in the book, Of Water and Spirit (Penguin 1994). He spends much of his early childhood with his grandfather, who introduces him to the spiritual ways of the tribe. At age 4, he is abducted and taken to a Jesuit mission school, where he is harshly indoctrinated in European ways, He flees back to the village 15 years later, so he can re-connect with his roots. After enduring a harrowing initiation rite, he goes out into the wider world with a healing mission.
Malidoma thus experienced TWO rites of passage. At the Jesuit school, his birth identity was literally beaten out of him, and he learned to excel in European intellectual arts. His subsequent tribal initiation was just as shattering. In a way, he is saved by his name – be friends with the stranger/enemy. He finds his destiny as a builder of bridges between radically different cultures.
An important message in Malidoma’s story – and in many of the stories on this blog – is that the deepest meaning in life is revealed to us by others.
All real living is meeting – Martin Buber
Joyce Elming, 83
In a recent series of three articles, Lisa Queen describes many of the ups and downs – the highs and lows – of growing old in York Region. (See links at the end of this post.) It is remarkable how much dedicated effort, ingenuity and heartfelt concern can be found in all corners of our region. There are indeed many hands hard at work.
It is also apparent, however, that seniors’ isolation is growing, and reported cases of elder abuse are becoming more frequent. In spite of strenuous efforts, things don’t seem to be improving for many folks. What’s missing?
One could say that the psycho-social fabric of community is breaking down. Traditional networks of social fellowship and mutuality are disappearing and being replaced by a confusing array of programs and services. Of course, the service providers do the best they can, but it is really difficult to cope with the growing burden of complex policies and regulations. The human relationships just get lost in the shuffle.
The best way to get things back on track is to become stronger advocates for community living. Of course we should help folks stay in their private homes if that works for them, but we should also be helping them to consider options – communities like Hesperus Village for instance, Peer support goes along way to reducing the need for expensive funded services – and restores the magic healing power of human contact.
York Region senior population to increase 148% over 2 decades
York Region senior citizens face highs, lows of aging
York Region senior caregivers share ups, downs
Oprah Winfrey has earned a worldwide reputation as a champion for oppressed and marginalized people. There is no doubt that she has been a positive influence for millions, and I have great respect for her work.
A recent article by Nicole Aschoff describes Oprah from a different angle:
Oprah Winfrey: one of the world’s best neoliberal capitalist thinkers
Aschoff writes: Oprah is appealing because her stories hide the role of political, economic and social structures in our lives. They make the American dream seem attainable.
This critique goes right to the heart of the theme I am developing on this blog. So many of our efforts have the goal of assimilating marginalized people into “normal” mainstream culture. What if we had the interest, patience, and courage actually to meet these folks, and shape something new together. Imagine the possibilities!
Empathy can be disruptive.