Ethnopsychiatry and Psychoanalysis: From Segregation to Dialectical Practices

According to Devereux, it was in 1951 that the Haitian psychiatrist Louis Mars coined the term ethnopsychiatry, a field of psychiatry that takes the cultural background of patients into account, going against psychiatric guidelines at a time when non-European cultures were regarded as uncivilized. In the same year, Devereux suggested that psychoanalytic interpretation should be based solely on the material the patient brings to the session, avoiding value judgments. Jacques Lacan praised this text when discussing segregational psychiatry and psychoanalysis that failed to value the speech of the subject within the subject’s own parameters leading to practices that disregarded cultural differences and individual singularities. Ethnopsychiatry was an attempt to introduce new clinical approaches that went against the segregation of neurotic and psychotic patients and subjects from other cultures, valuing their speech. Despite some important critics, it has an important role. We suggest that associating ethnopsychiatry with Jacques Lacan’s theory of the three registers—the imaginary, the symbolic, and the real, tied together in a Borromean knot of three consistencies—enables practitioners to make cultural and clinical interpretations that take into account the speech of the subject and their cultural frames of reference. We do not find this ethical position in Western psychiatry today, and this is exemplified with a clinical vignette.