Transcultural Psychiatry Research Papers - Academia.edu (original) (raw)

BORDERS & BELONGING: From Adversity to Diversity in Cultural Child & Family Psychiatry Vincenzo Di Nicola, MPhil, MD, PhD, DFAPA Professor of Psychiatry University of Montreal Abstract: Objectives: To provide a perspective... more

BORDERS & BELONGING:
From Adversity to Diversity in Cultural Child & Family Psychiatry

Vincenzo Di Nicola, MPhil, MD, PhD, DFAPA
Professor of Psychiatry
University of Montreal

Abstract:

Objectives: To provide a perspective on a career in community and cultural child psychiatry through the triple lenses of children, families, and culture, focusing on culture change syndromes, migration, and trauma.

Methods: Employing the lenses of children, families, and culture, Di Nicola has argued throughout his career that we cannot simply add layers to our understanding of these domains but rather that these elements have to be brought into dialogue with each other, sometimes radically challenging each other: 1) To study children across culture is to revision how we think about development. 2) To take family therapy seriously is to radically rethink how we imagine all relationships, from attachment and belonging to diverse family configurations and evolving constructions of gender and sexuality. 3) It’s also true that for cultural psychiatry and family therapy to take children seriously, they have rethink received notions of families and culture. None of these domains are fixed, stable or unchanging - they are all in flux.

Results: This layered and dialogic approach to children, families, and culture led Di Nicola to forge these syntheses: 1) Cultural family therapy (transcultural psychiatry & family therapy). 2) Transcultural child psychiatry (child psychiatry & transcultural psychiatry). 3) Child- and family-centered global mental health (child & family psychiatry with the global mental health movement).

Conclusions: Beyond evidence-based medicine, child psychiatry is nourished by meaningful personal and professional values. Di Nicola concludes with metaphors that inspire his work from social adversity to cultural diversity: 1) “A stranger in the family” (title of his book on cultural family therapy that explores three levels of strangeness – the mentally ill child in the family, the family that finds itself estranged in society due to migration or other socio-cultural differences, and finally, the therapist who arrives as a stranger in their midst with often alien or estranging views of their predicament). 2) “Looking across at growing up” (developmental psychologist Charles Super’s view of anthropology's horizontal or cross-cultural approach). 3) “Cultural changelings” (children’s experience of migrating across all the domains relevant to culture, including class, gender, race, religion and other aspects of belonging and community).

Learning Objectives:

1. To provide a framework for the interaction of three crucial factors for child and family psychiatry: children (developmental psychology, developmental psychopathology), families (attachment theory, belonging, family systems theory and therapy), and culture (anthropology, cross-cultural psychology, transcultural psychiatry).

2. To demonstrate the relevance of the interaction of these domains with examples of their syntheses: (a) cultural family therapy (transcultural psychiatry with family therapy); (b) transcultural child psychiatry (transcultural psychiatry with child psychiatry; and (c) child- and family-centered global mental health (global mental health with child psychiatry and family therapy).

3. To give examples of theoretical implications of the interaction of child, family and cultural factors for culture-inclusive theories of child and family development and clinical examples of culture-bound and culture-change syndromes such as Selective Mutism and Trauma- and Stressor-Related Disorders.

Biography

Vincenzo Di Nicola, MPhil, MD, PhD, DFAPA is chief of child and adolescent psychiatry, Montreal University Institute for Mental Health, tenured full professor of psychiatry, University of Montreal, and clinical professor, The George Washington University. Dr. Di Nicola trained in psychology (McGill University, University of London) and medicine (McMaster University), with residencies in paediatrics and psychiatry (McGill), where his mentor was Professor Raymond Prince, and fellowships in family therapy (McGill) and child psychiatry (University of Ottawa). He later specialized in Refugee Trauma and Global Mental Health with Professor Richard Mollica at the Harvard Program in Refugee Trauma, leading to interdisciplinary investigations on trauma with a doctorate in philosophy (European Graduate School). Dr. Di Nicola was founding president of the Canadian Association of Social Psychiatry, co-founder and past chair of APA Caucus on Global Mental Health and Psychiatry, serving twice as President, APA Quebec District Branch. Currently, he is Representative to the APA Assembly and Chair, Assembly Committee on Psychiatric Diagnosis and DSM, as well as board member and Program Committee co-chair, Society for the Study of Psychiatry and Culture. He has won numerous scholarships and prizes throughout his career for both scientific and literary pursuits. Dr. Di Nicola characterizes his career as a community and cultural child and adolescent psychiatrist and cultural family therapist working with disadvantaged and cultural communities in Montreal, as well as teaching and consultations in child psychiatry and family therapy around the world, notably in Brazil and Haiti.