Two Spirit People: Gender and Transgender in Native American Tradition

In Native American cultures, people that we would usually call gay or transgender are known as 'two-spirit people': people who embody both male and female spirits. Sometimes these two-spirit people are known in anthropological literature as 'berdache'.

This video beautifully presents the two-spirit tradition. It emphasizes that the two-spirit role is a spiritual one, which makes it different from gay or lesbian identity, which is based on the physical and social.

"Traditionally, the Two-spirited person was one who had received a gift from the Creator, that gift being the privilege to house both male and female spirits in their bodies. " Having both male and female within gives two-spirit people the ability to transcend boundaries, including the boundary between the earth and the spirit world. Thus they can provide a conduit to the spirit world. For this reason, two-spirit people were traditionally respected, and held powerful and important roles as teachers and healers.

Native American writers Sandra Laframboise and Michael Anhorn say, "Many tribes had rituals for children to go through if they were recognized as acting different from their birth gender. These rituals ensured the child was truly two-spirit. If parents noticed that a son was disinterested in boyish play or manly work, they would set up a ceremony to determine which way the boy would be brought up. They would make an enclosure of brush, and place in the center both a man's bow and a woman's basket. The boy was told to go inside the circle of brush and to bring something out, and as he entered the brush would be set on fire. The tribe watched what he took with him as he ran out, and if it was the basketry materials they reconciled themselves to his being a 'berdache'."

Sandra Laframboise and Michael Anhorn have posted a detailed article on two-spirit people written from a positive gay identity. They point out the controversy between traditionalists and two-spirit people, in the post-colonial context of today's America, and urge us all to learn from this heritage, which can enrich all of us.

Stages of Acculturation

Acculturation is the process of adapting to living in a new culture. It's something all immigrants go through, and though most writers on the subject seem to think the stages last for weeks or months, I know from experience that it can take place over years. It has taken me ten years to proceed through them, and in the disorienting wilderness of the middle stages, it would have been helpful to have had a description of the process, as a map to guide me toward home.

Stage 1: Euphoria
In this stage, a person is full of excitement at their new surroundings. I remember sitting happily under the grapefruit tree in my tiny backyard during my first long California summer, smelling the jasmine and orange blossom, and living off corn tortillas and avocados. I loved racoons, NPR, all the ethnic food I could get so easily in California, and the natural beauty of the area. This stage lasted several years for me.

Stage 2: Culture Shock and Alienation
In this stage, a person becomes keenly aware of the cultural differences between him/her and the host culture. They feel the loss of aspects of home. Feelings range from irritability to panic. A person can feel deeply lonely and sad, homesick and confused, or angry and hostile at people who do not understand them, and customs that seem wrong. Immigrants in this stage seek out compatriots, and often complain about the local people, culture and customs.
I was filled with a feeling of homesickness in this stage, longing for Europe, seeking out French food, movies and books, and feeling lost in the US. I felt confused about where I ought to be, and found myself often despising the way things were done in America, while trying to hide my prejudices and judgements from my close US friends. It would have been very helpful to me at this stage to have known that it was a phase in a gradual process of settling in, rather than a sign that I had made a big mistake in relocating to the US.

Stage 3: Anomie, or Culture Stress
In this stage, a person gradually restabilises. Some of the stresses of culture shock are solved, and some continue. A person in this stage may experience an identity crisis, feeling at home neither in their home culture, nor in their new culture. In this stage, I used to joke ruefully that I was stuck in the middle of the Atlantic. I knew that there were many things about California that I loved and appreciated, but I still felt confused about my feelings of homesickness for Europe.

Stage 4: Assimilation or Adaptation
In this final stage, a person either assimilates or acculturates.
Acculturation permits a person to find value and meaning in both cultures and identify with both. An acculturated person accepts the new culture, and feels able to negotiate it and live within it, without compromising who they are. They are able to feel similarity with the people of the host culture, as well as identity with their own culture and language.
Assimilation means that a person's old cultural values and beliefs are replaced by the new culture. They leave behind the culture of their parents, for example, and take on "American ways".
As I acculturated to California, I began to take walks around the little Northern California town I live in, smiling at its beauty. I relished soy chai and Thai food, and local farmer's markets. I loved the vast computer-linked library system, the local geeks, quaint wooden cottages, and bay trees. I felt fully myself, with all of my European-ness, living in California, and I began to deepen my relationships with American friends. I decided to apply for citizenship.

All immigrants negotiate these stages differently. Our reasons for coming here make a difference to our acculturation process. For example, did we choose to come, or were we forced to leave our home as refugees, or political exiles? How much trauma and loss were involved? What and whom did we leave behind? What were we able to bring, and what were we able to recreate once we got here? Can we exercise our profession, or did we lose our socio-economic status and earning power when we took up residence here? Is our kind accepted here? Is our being here a matter of struggling to survive, or does it represent an opportunity to thrive?

Trauma Work In Congo Using Local Metaphors

Here's a nice blog post from 'Beyond Trauma', the Somatic Experiencing blog. It describes a group intervention using local metaphors to educate people in Congo about the effects of trauma. Instead of the usual metaphor of "it's like having the brake and the accelerator on at the same time", the trainer uses a locally applicable metaphor of being chased by a wild animal. The audience responds from their experience.

Somatic Experiencing is a trauma therapy methodology developed by Peter Levine. Its basic premise is that PTSD happens as a result of the body's normal fight/flight reactions getting blocked. For example, after a scary event, the body naturally trembles. If we stifle the trembling, then the adrenalin 'locks in', and the fear stays in the body. It's better to allow the body's natural processes of trembling, tears, and so on to move through, bringing calm in their wake. Levine's practitioners focus on retraining the body, and safe release of previously stored trauma.

The Anthropology of Money

Students at the University of California at Irvine have created an online exhibition on the anthropology of money, drawing on information from relatives and friends in immigrant communities in Southern California. The home page says:

"This project took the student researchers to Little Saigon, Little India, the Cambodian Corridor of Long Beach, Los Angeles's Chinatown, Little Armenia, the clubs of Hollywood, the dorms of UC Irvine and the barrios of East LA. It also involved phone calls to far-away relatives and friends, and travels through memories contained in family photo-albums, scrapbooks, and sacred texts."

The exhibition discusses:

• various types and uses of lucky money in Hawaiian, Chinese and Muslim culture
• tandas and cundinas: Mexican-American and Latino-American rotating credit associations
• Lakshmi and ritual uses of money in Hindu culture
• the mid-Lent festival in Armenian culture
• ghost money in Chinese culture
• 'edible money' in the form of dumplings in Chinese culture.

Roots Trump Radiation? A Vital Lesson from the Ukraine

I came across a fascinating article about a community of elderly Ukrainian women who live in the Chernobyl dead-zone, in evident good health. After initially being relocated out of the radiation-contaminated area around the nuclear plant, these women decided within a few weeks to return home to the villages that had been their ancestral home. They have been there for the last twenty-five years.
The women farm beets, potatoes and other crops in the irradiated soil, forage for berries and mushrooms, and hunt game in the forest. Deer are said to be heavily contaminated, yet they are eaten. Although one of the women has thyroid cancer (which is treated), they have, on average, out-lived their peers who did not come back, by ten years.
The article suggests that the psychological effects of forced dislocation, separation from one's land and one's roots, and from one's community, are more dangerous than massive doses of radiation.
This is a deeply provocative idea, but in the context of massive doses of radiation in Japan, some of which have drifted to the US, it's a paradoxically comforting one.
Could it be that grounding into a deep relationship with the land, living in a close-knit community, eating humbly and locally, and living a very simple lifestyle, is in itself curative? These elderly Ukranian peasant women know something profound, and their indigenous wisdom holds an important lesson for the rest of us.

Susto: Loss of Soul Through Terrible Fright

Susto is a disorder you might get in Central or South America, resulting from your soul having left your body as a result of a severe fright. (A more severe form of susto is called espanto, and considered potentially fatal.)

Symptoms of susto include: nervousness, insomnia, despondency, lack of attention to your appearance, listlessness, fear of the event happening again, and stomach upsets. Susto clearly has much in common with PTSD, including the fact that sometimes it doesn't set in until months or years after the event that caused it. See the list of symptoms listed by one curandera, and you will note that many of them correspond to those of PTSD.

But the notion of soul loss captures something essential to the experience of great fear--something that is not captured by the notion of PTSD and the neurological explanations that go with that diagnosis. Great fear (and also great loss) do make you feel as though you had lost some essential part of oneself. The lively, life-filled part: your soul.

Susto is treated by local healers in the US using herbal teas, limpias (cleansing rituals) and barridas (sweeping rituals). During the barrida the client recounts the traumatic event, and then receives a healing usually involving having his or her body swept with a crucifix or some other ritual object such as an egg. Usually a series of barridas is necessary to heal a person from susto.

According to Dr. Dennis O'Neil, at Palomar College, California: "Among the Maya Indians of Southern Mexico and Guatemala, [the] ceremony typically involves a lengthy series of ritual actions in the presence of the patient's friends and relatives. It usually begins with prayers to the Catholic saint of the village. Next, a chicken egg and special herbs are passed over the patient's body to absorb some of the illness. Later, the egg may be left where the soul loss occurred, along with gifts to propitiate the supernatural being who has the patient's soul. The patient is then partly stripped and "shocked" by liquor being sprayed from the curandero's mouth. The patient may then be massaged and finally "sweated" on a bed placed over or near a hot stove. Alternatively, the patient may be covered with many blankets to induce profuse sweating."

A Lacanian Reading of Koro

Koro is the belief that one's penis is retracting fatally into one's body--or that is has been stolen, through witchcraft or spirit medecine. It can be a personal or a social delusion, and it affects men in parts of Asia and Africa.

In 1967 there was a major epidemic of koro in Singapore, which lasted for about ten days of general panic. Emergency rooms filled up with men clutching desperately at themselves in an attempt to stop the syndrome.

In rural parts of China, penises have been traditionally stolen by a spirit in the form of a fox, who wanders the countryside looking for victims. It sounds whimsical, but in some parts of Africa, people have been lynched for stealing someone's penis.

Koro is listed in Appendix I of the DSM-IV-TR. Clearly in the West it corresponds to Panic Disorder, and perhaps to Body Dismorphic Disorder. But what underlies it is more interesting than its classification. In that respect, perhaps a rereading of Freud would be more useful--or perhaps better still Lacan.

Lacan rereads Freud's "penis" as the "Phallus"--not the physical, literal organ, but a metaphor for the power in the world that a man is granted by virtue of being male. Phallus envy makes sense in a way penis envy does not.

In the case of koro, narcissistic injury, symbolised as loss of Phallus (a man's power and status in the world), might be experienced as "my penis is shrinking". Interpreted this way, the disorder becomes less of a curious folktale for and more a deeply comprehensible expression of fear and distress.

Koro From A Taiwanese-American Perspective
This detailed comment was sent to me by Mindy Chang.
In some rural parts of China, there is the belief that fox spirits are responsible for stealing the penises of hapless male victims. The fox spirit is well known in Japanese folklore as a kitsune and in Chinese folklore as hu li jing. Some are good and some are bad. They are often feared because they are powerful and cunning, and if you anger one, you will be punished and cursed. Some of the bad ones appear in the form of beautiful women who seduce young men because they are deficient in yin life force; hence koro.

In some ways, they are similar to the Chinese snake spirits that appear as beautiful young women and seduce men, much like their Western succubae counterparts. The tiger spirit, a.k.a. tiger mother, also is invariably a female spirit that steals young babies to eat; male babies are especially desirable since they are traditionally valued more than girl babies. The snake and tiger spirits are also cunning like their fox spirit sisters.

Either way, these malevolent female spirits represent the unconscious fear Asian men often have of strong Asian women in a predominately patriarchal society. Therefore, it makes sense that a peasant living in rural China might believe these folk tales and be conservative enough to accuse a woman of stealing his penis or masculinity.

According to traditional Chinese medicine, a man’s life force resides in his seed, which is expelled through his penis. This belief is not unlike the passage in the Bible where God chides Onan for spilling his seed upon the ground. One may also recall the passage in Amy Tan’s book “The Joy Luck Club” where the woman who cannot get pregnant is confined to her bed so that her husband’s seed will impregnate her and his yin will not go to waste.

There are some Chinese people who still partake of traditional Chinese remedies that are particularly exotic, such as dried tiger penis. Although officially use of ingredients from exotic animals is illegal, there is a thriving black market trade, thanks to demand, that is met by poachers. The idea is that if a man eats a tiger penis, he will take on the strength and virility of the male tiger; essentially, the tiger’s yin.

When treating koro, it might be beneficial to use traditional Chinese remedies (other than the illegal dried tiger penis). Whether the remedies actually work or the effects are psychosomatic, it matters not so long as the patient believes he will get well because he believes in the remedy.

Dinner? Or Pot-Luck. High Versus Low Context Cultures

Anthropologist Edward T Hall codified cultures as either high-context or low-context. His distinction captures an otherwise indefinable set of nuances that can mysteriously rub you the wrong way if you spend substantial time in culture at the other side of the polarity from your own.

In high-context cultures, relationships are vital, and the meaning of much of what is going on is held in the context, rather than being explicitly said. Think of the Japanese tea ceremony, or about doing business in the Middle East, where you drink endless cups of tea and talk together about everything but business for hours, before you get to what a person from a low-context culture would think of as 'the point'. These cultures tend to be emotional and intuitive, valuing long term relationships and trust.

In low-context cultures, little is implicit. My favourite example is the way, when laughing at a joke, Americans will also say, "That's funny," as though laughing didn't already signal that the joke was funny. In low-context cultures, relationships tend to be shorter in duration, life tends to be action and task-oriented, and 'the rules' tend to be codified and made explicit.

Hall's distinction helps me to understand why I--a person from a high-context culture--miss French dinner parties, which go on for hours over carefully prepared food and carefully selected wine. Inviting people for dinner in America doesn't fill the gap of what I miss--for a start because here people tend to expect to eat and then do something: "dinner and a movie." Likewise, I abhor the pot-luck, because for me the careful, loving, planned preparation of the dinner makes it an aesthetic offering from me to my invitees--it's not just food to share.

But it's not just that. It's that here, a dinner invitation doesn't mean what it means to me. So I've found that though people may come to eat if asked, they don't necessarily invite me back, because (for them) my dinner party was not situated within an unfolding and implicitly understood network of back and forth invitations that create and maintain the basic fabric of social relationships. They're not being rude. It's just that we're operating in a different paradigm.

In a high-context culture, inviting someone to dinner is a bid for relationship. Accepting a dinner invitation is a response indicating openness to relationship. It implicates you. It may even imply a certain indebtedness, relationally. These cultures draw a clear distinction between public and private life, so inviting someone into your home implies trust and closeness. The different elements of behaviour--bringing a gift, preparing the food, praising the food, conversing appropriately and lengthily, spending the time--all evoke feelings of connection and belonging.

So what I miss is not the dinner party itself. The dinner party itself is empty. What counts is the depth beneath it, the meaning behind it, the implicit within it--the very aspects almost impossible to describe to a person from a low-context culture. If you're reading this and really don't get what I'm on about, or think it's ridiculous, you're probably from a low-context culture!

Neither type of culture is better than the other. People from a low-context culture can be intensely frustrated by high-context cultures, in which everything happens as a result of who you know, and in which everything takes seemingly endless amounts of time. Everyone is always late. You have to have connections to get anything done. Everything's based on gifts--or are they bribes? These cultures often seem charming and quaint from the outside, but within them you're an outsider, and as such you can feel mystified by the unwritten rules, subtly excluded, and stymied by the lack of clarity.

Edward Hall's distinction explains why the misunderstandings between America and the cultures of the Middle East are endless. The Middle East is seen as full of feuds and nepotism--aka they value long term relationships and are fiercely loyal, with an intense sense of honour. The US is seen as a false friend--aka they feel free to change their allegiances and renew their strategies according to the situation as it unfolds. No interpretation is more correct than the other, but they are very, very different.

Understanding the basis for the differing interpretation at least helps us to avoid getting caught up in our emotional reactions to what feels culturally 'wrong' based on our own norm.

You Are What You Speak: Sapir-Whorf

The Sapir-Whorf principle is also known as 'the principle of linguistic relativity'. It claims that our conception of the world is shaped by--even controlled by--our language.

The 'strong' version of the Sapir-Whorf hypothesis holds that that language determines thought--in other words, you can't think at all outside the boxes created by the words you use. The 'weak' version holds that language influences, but does not completely determine thought.

This theory led linguists in the 70's to investigate colour perception. They eventually found that although we tend to segment the colour spectrum according to the ways our language provides for us, we are nevertheless able to see all the colours. (This supports the weak version.) Traditional Welsh, for example, has the word 'glas', that describes a certain grey/green/blue colour. English speakers don't have that word, but they can see the colour.

In her science fiction novel, Native Tongue, Suzette Haden Elgin shows how linguistic relativity works, and how the words we have available to us control what we do and do not perceive. She does it by inventing both a word, and the concept that it describes:

"When you look at another person, what do you see? Two arms, two legs, a face, an assortment of parts. Am I right? Now, there is a continuous surface of the body, a space that begins with the inside flesh of the fingers and continues over the palm of the hand and up the inner side of the arm to the bend of the elbow. Everyone has that surface; in fact, everyone has two of them.
I will name that the 'athad' of the person. Imagine the athad, please. See it clearly in your mind -- perceive, here are my own two athads, the left one and the right one. And there are both of your athads, very nice ones.
Where there was no athad before, there will always be one now, because you will perceive the athad of every person you look at, as you perceive their nose and their hair. From now on.... Now it exists. Now I can say, 'What beautiful athads you have.' "

The process of learning another language in sufficient depth to really speak it changes us. Every language describes the world differently. Those of us who are bilingual can tend to feel we have two personalities inside us, with slightly (or considerably) different conceptions of the world. The way we are in the world, and who we feel ourselves to be, varies depending which language we are speaking.

Even if are monolingual, we may have had a flavour of what this is like. Most of us have probably had the experience of knowing something, but knowing that we knew it until someone named it for us. For example, I knew I had a certain way of interacting with nature, but couldn't describe it, or explain why it was different from another way of interacting with nature, until I read Martin Buber's book I And Thou. Buber coined the term "I/Thou relationship". When I read it, I knew instantly what he meant, that it described my experience, and that it rendered that experience communicable for the first time. This reflects the weak form of linguistic relativity--I was able to experience something, but that experience was not fully conceivable until I was provided with language that could express it.

This is why communication--especially therapy--is tricky across languages. It's one root of 'othering'--it's hard to really get the world view of a person of a different linguistic culture, and even harder to get that their 'strange' worldview is equally real, equally normal, and equally valid, unless you have had the experience of trying to squeeze your reality through the funnel of a foreign language.

First, Know Your Djinn: More on Ethnopsychiatry

Ethnopsychiatry was developed in Paris by Dr Tobie Nathan—a classically trained psychiatrist treating immigrant patients from West and North Africa, who did not respond well to methods based on a Western paradigm.

A significant part of the problem these particular clients have is that they have not been able to acculturate to the host culture, and so they live in a dislocated zone: between a culture from which they have been separated, and one within which they do not or cannot fit. Since much of their problem consists in this dislocation, the act of being reconnected with their ancestral culture, and strengthened in their identity as one who carries this culture, even in a foreign land, is a vital part of their return to health.

Patients at the ethnopsychiatry center are seen with their families, by a treatment team which includes an ‘ethno-clinical mediator’, who is a specialist in the patient’s language and culture. The consultation happens in the patient’s own language, with an interpreter so that the patient does not have to translate their reality through the filter of a foreign language which lacks or distorts the ideas they need to express.

Ethnopsychiatry: basic assumptions
Ethnopsychiatry posits that our culture is intrinsic to who we are, rather than something overlaid on top of a ‘neutral’ self. Our personal identity therefore is inextricable from our cultural identity.

Ethnopsychiatry is based on structuralist analysis: the idea that anything (including any symptom) has meaning only by virtue of its position at the intersection of a matrix of interwoven relationships. So behind any pathology is a whole system of thought, actions, actors, and purposes--which constitute its meaning and its usefulness in expressing psychic dis-ease.

In order to effectively treat someone, you have to use their own, culturally-ratified values and beliefs. Each culture has its own system of values and beliefs around personal misfortune, illness, therapists, and treatment techniques. This is of course not only true of people from traditional cultures—in Western society, we believe that talking about emotions will help, that crying is good for us, and that taking pills can make us better. These are no more ‘normal’ than going to a shaman and making a fetish doll; they just seem more normal to us, since we grew up being taught that these are effective means of curing ourselves.

“Curing” the client involves making meaning out of the patient’s symptoms, in terms of their own cultural mythology and values. This results not only alleviates symptoms, but helps the client (re)connect to their culture—strengthening their identity, as part of a stronger cultural identity.

Example 1: The djinn
The djinn (spirit), is an important part of the range of psychopathologies available to the people of North Africa. To think of a djinn merely as an imaginary spirit would be an error, since this leaves out the web of social and cultural factors that carry the real significance of the djinn in peoples’ lives. A djinn is radically other, but still the mirror image of the human being. Djinns have gender, they can reproduce by having children, and they have a religion, being Muslim, Christian, Jewish or Pagan. However, “they live in the other world; the world of the night, the desert, the forest, the bush, of rubbish, of ruins, of sewers, of the blood of animals”. Djinns are creatures of boundaries and limits. One of their functions is to mediate difficult transitions.

Since all djinns are different, in order to treat someone possessed by a djinn, the healer must get to know the djinn, find out its name and geneology, discover what its intentions are, investigate what it desires and needs, identify the objects it likes, and define the acts and rituals it expects. With this information, the healer can enter into rites that constitute negotiations with the djinn. Finally the healer can identify the benefits the client gains from his or her association with the djinn.

In this approach, ethnopsychiatry joins James Hillmann, with his insistence on respecting the pathology for its living message, rather than trying to diagnose it, dissect and label it, analyze and interpret it. It also joins with the most effective traditional healers in that the aim is not to cure the patient of believing in djinns, but rather to respect the djinn and treat with it in a creative, ritualistic way according to its nature, for the good of the patient, the healer and in some cases also the djinn itself.

Dr Nathan relates a case study concerning a child who becomes possessed by a djinn. The child is the identified patient, but in fact the symptoms relate to the parents’ problems with fitting into the host culture, as well as to the father’s past history, as a spiritually ‘pure’ man who was celibate for 40 years before marriage. The djinn possesses the boy when he starts school; in other words, when he enters into the foreign French society in which they live, and becomes therefore himself in some ways a foreigner, which makes him ‘impure’ culturally. (It’s notable that when the djinn possesses the boy, he insults his father in French, not in Arabic.) The djinn represents the otherness and impurity to which the father cannot adjust, and at the same she represents the solution to the problem, for the presence of the djinn takes the boy out of school and compels the family to return to tradition in order to treat the boy.

Treatment
Much of the treatment in ethnopsychiatry seems to consist in the patient being heard and understood by people who understand his or her language and culture. The normalization and validation, and the intrinsically healing effect of being mirrored within this containing relationship cannot be underplayed. Discussing the symptoms within the context of the client’s culture helps the client to constitute a meaning for the symptoms. This helps the patient to reinforce—or in the case of children of immigrants to create—their identity within their cultural framework. Which translates to a reinforcement or creation of his or her identity per se.

Sometimes however, the ethnopsychiatric team goes further, deliberately representing the patient’s problem to the patient in terms which it considers will most likely facilitate (re)construction of meaning, and subsequent healing. This is always done by taking into account not only the cultural interpretation of the symptoms, but also the key ways the culture itself is constituted. Example 2 shows how this is done.


Example 2: Drug addiction in a gypsy family

In gypsy (Roma) society one of the “basic cultural defense mechanisms lies in strengthening the cultural borders, constantly defining a limit between the inner and outer worlds”. Since the tribe moves continually, the culture is not held externally, but rather each individual holds the culture within them, and “is the guardian of the group’s soul”. Drug addiction is new in French gypsy society, and it threatens this system. Drugs come into gypsy society through the gadjé (mainstream house-dweller culture), and drug addiction is considered to be a sign of a kidnapped soul.

In the case of a young gypsy woman addicted to heroin, and rejected by her mother who considers her to have crossed over to the gadjé and to have become non-human, the ethnopsychiatry team points out to the mother and daughter that the drug problem is not part of gypsy culture. They then suggest that the problem is linked to the death of the grandmother, because since she died, the family has no longer been protected (magically). They do this based on their knowledge that gypsy culture is “organized on the basis of witchcraft logic, in which every individual is involved sooner or later, either as a victim or perpetrator of acts of witchcraft”.

The mother, it turns out, has long suspected that the mother of her gadjé daughter-in-law used witchcraft to attract her son. The team encourages the mother to follow the dead grandmother’s request that she go to church and pray regularly (this gypsy tribe is traditionally Christian). After this, the mother brings to them an object she has found, which is clearly a curse set by a member of the family.

The treatment has consisted in reducing the isolation both of the daughter within the family, and of the family within the culture, by reinserting both mother and daughter within the cultural belief system. The intervention has also set in motion various self-healing actions within the culture:
1. The evil was identified as coming from outside, from the gadjé, which activates the “closing-in response of the gypsy world”.
2. Drug-addicted people are seen as “kidnapped souls”, so the treatment has to follow that cultural meaning, and counterbalance the kidnapping. Identifying the cause of the addiction as a curse made by someone in the family restores agency to mother and daughter, who can now make meaning of the situation and resort to counter-curses to combat the drug addiction, within the system of the culture.

Conclusion
Ethnopsychiatry is a profoundly pragmatic practice, based on a structuralist analysis of meaning, the individual and society. It is similar to certain other strands of psychotherapy in that it considers a symptom to arise not from intra-psychic pathology, but rather to be the best and truest possible expression of a dis-ease that has a social or familial cause. Tobie Nathan, like James Hillman, believes that, “in cases of psychic disorder, the patient’s suffering expresses the deepest truth of his being.” And like Hillman he considers that “healing” the patient is an act of monotheistic aggression. Instead of analyzing the symptom and diagnosing it, ethnopsychiatry addresses it within its own (cultural) system of meaning.

Cultural Casebook: Still-Living Ancient Cultures

Wade Davis's book "The Wayfinders: Why Ancient Wisdom Matters in the Modern World" is an utterly compelling, beautifully written series of pieces originally presented as lectures. Each piece describes a particular ancient culture that is still living, thriving and evolving today.

For example, the first chapter is about the ancient Polynesian art and science of long distance ocean navigation--using no instruments other than the perceptions, knowledge and experience of the human navigator, and the design of the canoe itself. The navigator does not sleep during the entire voyage, in order to keep the whole narrative of the voyage intact in his or her mind, using dead reckoning to know where he or she is now, in relation to the voyage up till now. By virtue of his or her ability to combine knowledge of the currents and waves, the travels of birds, the colours of the sea and the sky, the rising the setting of the stars, and a myriad of other natural data, the navigator positions the canoe on its voyage, and 'calls the islands up from the sea'.

By sharing his detailed, loving, knowledge about certain human civilisations, Davis implicitly and explicitly pleads for us to drop the Modernist fallacy that the "Western" secular, rational world view is the pinnacle of our development, and open our minds to entirely different--and one could say far superior--systems of conceiving of and interacting with the world. What matters, he says, is not which belief system is right or wrong per se, but rather "the potency of a belief, the manner in which a conviction plays out in the day-to-day lives of a people, for in a very real sense this determines the ecological footprint of a culture...[determining] both the actions of a people and the quality of their aspirations, the nature of the metaphors that propel them onward".

What metaphors propel you onward?

Here's an extract from the beginning of the book:

"Just to know that in the Amazon, Jaguar shaman still journey beyond the Milky Way, that the myths of the Inuit elders still resonate with meaning, that the Buddhists in Tibet still pursue the breath of the Dharma is to remember the central revelation of anthropology: the idea that the social world in which we live does not exist in some absolute sense, but rather is simply one model of reality, the consequence of one set of intellectual and spiritual choices that our particular cultural lineage made, however successfully, many generations ago.

"But whether we travel with the nomadic Penan in the forests of Borneo, a Vodoun acolyte in Haiti, a curandero in the high Andes of Peru, a Tamashek caravanseri in the red sands of the Sahara, or a yak herder on the slopes of Chomolungma, all these peoples teach us that there are other options, other possibilities, other ways of thinking and interacting with the earth. This is an idea that can only fill us with hope.

Together, the myriad of cultures makes up an intellectual and spiritual web of life that envelops the planet and is every bit as important to the well-being of the planet as the biological web of life that we know as the biosphere. You might think of this social web of life as the "ethnosphere", a term best defined as the sum total of all thoughts and intuitions, myths and beliefs, ideas and inspirations brought into being by the human imagination since the dawn of consciousness. The ethnosphere is humanity's greatest legacy. It is the product of our dreams, the embodiment of our hopes, the symbol of all that we are and all that we, as a wildly inquisitive and astonishingly adaptive species, have created."

(The bolding is mine.)

Smile-Mask Syndrome

A new psychological syndrome is hitting headlines in Japan and neighbouring Asian countries. Named "smile-mask syndrome" by leading Osaka psychiatrist Makoto Natsume, the disorder primarily affects women in service industries whose jobs require them to smile all day. After a day of smiling, he says, these women find themselves increasingly unable to turn off the smile. Even devastating bad news can't wipe the inappropriate smile off their faces, much to their distress.

Dr Natsume predicts a national wave of mental illness including depression and other disorders as a result of women being forced to repress authentic emotions in order to wear a smile all day.

There may be another effect happening in addition to the repression of real feelings. According to the New York Times, "some researchers have tried to ... understand the states of mind that produce smiles. We think of them as signifying happiness, and indeed, researchers do find that the more intensely people contract their zygomaticus major muscles, the happier they say they feel. But this is far from an iron law. The same muscles sometimes contract when people are feeling sadness or disgust, for example."

So the wearer of the false smile may, paradoxically, be led to feel sad, by being forced to chronically contract the muscles required to produce smile.

Cultural Casebook: The Myth of American Innocence

Barry Spector's new book, Madness at the Gates of the City: The Myth of American Innocence, has been ten years in the making. It's a wide-sweeping, provocative look at on American culture, from mythical, psychological and political perspectives, incorporating wisdom from ancient Greek traditions as well as from indigenous cultures in African and Central America.

Using the central image of the Ancient Greece god Dionysus, Barry looks at the archetype of the Other. According to Jungian psychology, the Other allows us to define ourselves by what we are not--defining Self by contrast with Other. Here in America, the ruling white (male) culture has historically defined itself by that which it is not--creating Others out of Native Americans, Black Americans, women, and most recently the Islamic world.

Barry adds an interesting extra layer of his own, defining the Inner Other and the Outer Other--others within the culture, and others without, and says this way of seeing ourselves and those around us grew from the very roots of the development of America, which combined a predatory world view, with a paranoid world view. His examination of American history and current foreign policy in light of all this is fascinating, and thought-provoking.

Refering to Ancient Greece, which venerated Apollo--god of reason, rationality, masculinity--Barry says the god Dionysus represented the Other, and held the shadow of the culture. But the Greeks gave room to Dionysus, in rites that celebrated sexuality, wildness--and grief. We in America, however, do not acknowledge our shadow, or allow the Other any humanity. Barry Spector's thesis is that this is because if we did, we would be pole-axed by grief at the reality of our 400 year history of oppression at home and abroad.

Instead, America lives by an unexamined myth of innocence. Our central myth has been created through 400 years of narratives about our need to defend ourselves against the dangerous Other. So without thinking about it, we believe we have a destiny of violent clashes with an evil enemy, in service of good and innocence. It's a myth of violent redemption, in which we play the role of savior. This myth hides the reality of American disenfranchisement, injustice, colonialism, and empire.

This short review doesn't come close to doing justice to the book. I urge you to read it. It's important, it's wise, and it makes you wonder about the unexamined stories you yourself live by, projecting them onto the world about you.

Cultural Casebook: Counter Culture Kids

I just found a small gem in my local library. Wild Child: Girlhoods in the Counterculture, is a collection of memoirs written by women who grew up in hippie families.

"Tofu casseroles, communes, clothing-optional kindergarten, antiwar protests — these are just a few of the hallmarks of a counterculture childhood. What became of kids who had been denied meat, exposed to free love, and given nouns for names? In Wild Child, daughters of the hippie generation speak about the legacy of their childhoods."

The stories, collected by Chelsea Cain, describe a winsome existence, all too often underpinned by insecurity, neglect, and even outright abuse. This is essential reading for anyone who wants to understand the childhoods of the current 40 - 50 somethings who grew up in the counter-culture of the 70's in California and elsewhere.

Finding The Feet: Connecting Immigrant Children With Their Lineage

Much of the work I do with elementary school children who are immigrants to the US is an attempt to help them reconnect with their lineage, healing the internal split between them and their ancestral culture, in order to forge a positive bi-cultural identity.

In doing this I am drawing not only on theoretical work, such as Tobie Nathan's ethnopsychiatry or the writings of Gloria Anzaldua on bilinguality/biculturality. But also, and more profoundly, on my own experience as a multiply-dislocated and bilingual child--experience which informs the field of the therapy, as well as the narrative of my life.

While I lived in France, as a bilingual adult, I had several experiences where a bilingual child between the ages of about five and nine, whose parents were both monolingual, would be introduced to me in either French or English. The child would politely ignore me, as children do grown ups, until at some point I spoke equally fluently in the other language. Suddenly the child would become very animated, want to talk to me, and in some cases literally follow me around for the rest of the day. After this happened a few times, I realised these children were the only bilingual people in their family. Bilingual-bicultural children need bilingual-bicultural role models so they can integrate the dual self into a unified bilingual-bicultural identity.

Children of immigrants are not only living between and across two cultures, but are also coping, to a greater or lesser extent, with the trauma of dislocation. Working with this trauma takes many forms. Usually I begin by simply opening a space to talk about where their grandparents are, how their parents came to this country, and the fact that they themselves have two cultures and languages inside them--framing all of this in an unambiguously positive light. For example, talking about how brave their parents were to walk all that way.

Case example
For a while I was seeing a five year old girl from El Salvador*, who was referred following a series of tantrums during which she threatened to call the police, so they would take her away from her home.

In our first session the client drew her family in the US, with great care, and with a lot of very carefully shaded colours. The people were perfectly drawn, with smiling faces, but they had no feet. Their unfinished legs hovered above the carefully drawn green line of the ground.

I asked where her grandparents were, and she said, "El Salvador". I acknowledged that El Salvador was far away, and asked if they were here in her heart, and she said yes. So I suggested she might want to add them to the picture too. She drew them in the top right hand corner, and I was astonished to see that they had feet, connecting directly to a new green grounding line.

The contrast between the US family, who were 'ungrounded', and the family members in El Salvador, who had a connection, quite literally, with the land, was striking. I felt that this marked a dislocation-related trauma, and that this was probably linked to the theme of being taken away, as evidenced in the child's threats to her parents. In control mastery terms, this child was trying to control who would be taken away and when.

In subsequent sessions of undirected play the client chose to draw her grandmother's house in El Salvador, and then to make a meal of tortillas out of Play Doh. "My mom taught me to make tortillas", she told me. "And her mom taught her."

I repeated this. "Your grandma taught your mom, and then your mom taught you." And then added that when she had a little girl, she could teach her too, and then her daughter could teach her daughter--marking the thread of her lineage and the possibility of its continuation in this new country.

Whatever the client chose to draw, we would label, and whenever we labelled anything, I would do the writing in both English and Spanish, always asking the client what the Spanish word was. For example, we wrote 'Grandma" and then we wrote "Abuelita". Every time I did this the client seemed surprised and delighted. My Spanish is rudimentary, but this was less important than my openness (particularly as a representative of the host culture) to the fact that there were two languages in our shared field, and that their worldviews are equally true and valid.

Conclusion
This work was all about creating feet--establishing a connection backwards to the land that had been lost, which in turn would enable a more grounded existence per se.

It's noteworthy that the immigration trauma was announced and investigated within the child's own self-directed play, and that she used the play to re-connect to her lineage and integrate the split within her internalised family.

Six weeks after the start of therapy, the teacher reported that the child's family had called to tell her the child's tantrums had stopped.

*Details have been changed to protect the client's confidentiality.

Tobie Nathan: Ethnopsychiatry

I first encountered the notion of "ethnopsychology" in the works of Egyptian-born French psychoanalyst Tobie Nathan. His centres provided mental health services to African and North African families in France, using a unique combination of psychoanalytical diagnosis, family systems perspectives, multicultural clinical teams, and ritualised interventions designed within the mythical systems of the client's culture.

For Nathan's bio and bibliography in English, click here.

The ethnopsychiatry website is unfortunately one of the worst websites I have ever seen. For articles in English, click the link "Textes en anglais" in the left-hand menu bar. (Scroll for an article on PTSD and fright disorders: rethinking trauma from an ethnopsychiatric perspective.)

This site also contains articles in several languages on working with holocaust survivors and their children, written by Nathalie Zajde.

Nathan has edited several journals:

• the French-language ethnopsychiatry journal – Ethnopsychiatrica –published between 1978 and 1981.
  
• the Nouvelle revue d’ethnopsychiatrie, published by the Editions de la Pensée sauvage (Grenoble), which put out 36 issues between 1983 and 1998.
• and a new journal, Ethnopsy : les mondes contemporains de la guérison (Ethnopsyc. Contemporary Worlds of Healing), published by Les Empêcheurs de penser en rond, in Paris.

Here's a video of Nathan, talking about some differences between an African and a Western worldview: Le Chaos et la Fracture.

Loss of the World: The Trauma of Dislocation

In this video, Dr Salman Akhtar discusses the trauma of dislocation suffered by immigrants and exiles, and defenses we use to cope with it.

Surprisingly (but immediately it rings true), he says it is not the loss of human relationships that creates the trauma--those we can, and will replace--instead, it's the loss of the world itself. The loss of the way the world looks: the shapes of houses, the lay of the land, the way the everyday objects are designed. And more subtly, the way time is constructed, and the cultural ways we conceive of our lives within the world--ways we don't realise are culturally specific until we find ourselves in a different culture. ("When I was living in India, I was not living in India, I was just living. I didn't realise I had been living in India until I left and came to the US.")

These dislocations cause the immigrant to continually be subliminally looking for aspects of home, however banal--the colour of mailboxes, or the flash of bouganvilea--which feel somehow more trustworthy than the equivalents in the new country. The sudden flash of 'home', and the happiness of recognition of an aspect of home, reveals that we have been missing a feeling of home all this time. Furthermore, without the subtle triggering of memories implicitly evoked by familiar objects and surroundings, we are psychically impoverished.

The clinical situation
In a clinical situation, Akhtar says, it is vital to validate the fact of immigration in the client's identity from the start, showing interest so that this material is flagged as important, and psychic space is opened for its exploration.

People with migration trauma, he says, can take a while to settle into the physical surroundings of the office. The physical surroundings can be crucial to them--being transitional and also totemic objects. These clients bring things in, and want to borrow things, very often. This is all about the trauma of loss.

Defenses
The immigrant defends against the dislocation trauma through several means:
1. Denial, subtly repudiating the host country. "I am not really here."
2. The fantasy of return. "I'm here for a little while but I'll go back." This return is continually deferred, sometimes to the point of "I want to be buried at home when I die."
3. Minimisation, via the fantasy of replication. "I'll re-create my country right here." Home can become a shrine for the immigrant, who owns more cultural artifacts than they would if they were living in their home country.
4. Idealisation of the home country (aka lost and idealised object). This in turn causes wounding if you do return--you can never find what you are looking for when you go back, because it has changed, and no longer the ideal, lost object.
5. Reparation--this is the key to healing. It involves the awareness that I was the one who left, thereby attacking my good internal object. So I have fix it. With this awareness comes altruism, philanthropy and creativity.

Nostalgia for home
The client's nostalgia for home must be analysed. It can often serve to mask aggression and frustration in the now: "Bombay was so lovely" can hide the fact that life right now here seems intolerable. On the other hand, nostalgia can be acting as a method for displacement of transference love: "Bombay was so lovely" can indicate that the client is also happy to be here in your office.

Exiles may never show nostalgia, never mentioning their home country, or only negatively. It's like a bad divorce. They spread the trauma backwards, spoiling the good memories. Here the crucial thing is to analyse the defenses against nostalgia. Even though there was trauma, "there were also trees, and birds, and lollipops..."

Space has to be provided for the migrant to elaborate on the nostalgia. Then it will be easier to analyse its defensive functions.

Non-human transferences
When working with migrants remember and note the issue of non-human transferences. The relationship with objects and places around the child (chair, rain, moon,...). These are not merely symbolic of human relationships, they are important in themselves, particularly for immigrants, because they mediate our difference, and the difference between our worlds, old and new. Environment can be mother, reversing Winnicott's "mother as environment".

Conclusion
Finally, Akhtar reminds us that none of this is the main work in the analysis, but rather it sets a crucial background to the work, with immigrant and exiled clients. Analysis of the immigration trauma allows resumption of development, the search for new objects, and the internal journey of self actualisation.

On a personal note, Akhtar mentions bouganvilea several times. This touched me, because bouganvilea is important to my internal landscape also. Its bright splash serves me as a transitional object, linking me to external landscapes I have lost, and symbolising aspects of myself which I am still seeking to integrate in a new country.