Anxiétés culturelles et régulation institutionnelle (santé mentale "spécialisée" et "souffrance immigrée" à Paris)

Cette thèse a pour objet l'expertise en santé mentale spécialisée telle qu'elle se pratique en France et analyse la prise en charge institutionnelle et les représentations de la différence culturelle dans ce pays aujourd'hui. Par santé mentale "spécialisée", je fais référence aux structures qui s'adressent aux immigrés en leur offrant des soins de santé mentale qui prennent en compte les représentations culturelles de la souffrance. J'identifie et étudie en particulier trois modes d'expertise et de traitement des troubles: la psychiatrie transculturelle, l'anthropologie médicale clinique, et la médiation ethnoclinique. En proposant une généalogie des institutions de santé mentale spécialisée, et en appréhendant ces dernières comme "nœuds méta-discursifs" - autrement dit, comme points de rencontre entre idéologies étatiques, institutionnelles, et individuelles - je propose une analyse des anxiétés culturelles, des contradictions, et des doubles contraintes qui relèvent de l'opposition entre une idéologie républicaine universaliste et régulatrice, et un champ d'expertise qui s'efforce de promouvoir des soins de santé mentale sensibles aux particularismes culturels dans l'expression des troubles. Je soutiens que, tant qu'elle se situe à l'intersection de "la question immigrée" et de "la question sociale", la "souffrance immigrée" (Sayad, 2004) est devenue le moyen d'exprimer les "difficultés" des immigrés - qu'elles soient liées à la santé mentale ou aux problèmes d'ordre structurel - en termes de différence culturelle. Par conséquent, les représentations culturelles qui stigmatisent les immigrés sont intériorisées, rendant difficile l'identification et la prise en charge des inégalités structurelles qui engendrent effectivement la souffrance.This dissertation looks at "specialized" mental healthcare expertise in France as a lens through which to address the institutional management and representations of cultural difference in France today. By "specialized" mental healthcare centers, I refer structures that provide culturally-sensitive mental health services to immigrants specifically. I identify and explore three contemporary expert approaches: namely, transcultural psychiatry, clinical medical anthropology, and ethnoclinical mediation. By providing a genealogy of specialized mental healthcare institutions, and by construing them as "meta-discursive nodes" - that is, as points of encounter between state, institutional, and individual ideologies - I provide an analysis of the cultural anxieties, contradictions and double-binds that arise from the opposition between a regulative, universalist republican ideology, and a field of expertise which strives to promote culturally-sensitive mental healthcare for immigrants. I argue that, as a product of the conflation of the "immigrant issue" (la question immigrée) and the "social issue" (la question sociale), "immigrant suffering" (Sayad, 2004) has become a medium that problematically couches immigrants' "difficulties" - whether they relate to mental health pathology or structural problems - in terms of cultural difference. As a result, generic cultural representations of immigrants are uncritically reproduced, making it difficult to identify and address the structural inequalities that do engender suffering.PARIS-Médiathèque MQB (751132304) / SudocSudocFranceF

Childbirth and authoritative knowledge: cross-cultural perspectives

This benchmark collection of cross-cultural essays on reproduction and childbirth extends and enriches the work of Brigitte Jordan, who helped generate and define the field of the anthropology of birth. The authors' focus on authoritative knowledge - the knowledge that counts, on the basis of which decisions are made and actions taken - highlights the vast differences between birthing systems that give authority of knowing to women and their communities and those that invest it in experts and machines. Childbirth and Authoritative Knowledge offers first-hand ethnographic research conducted by anthropologists in sixteen different societies and cultures and includes the interdisciplinary perspectives of a social psychologist, a sociologist, an epidemiologist, a staff member of the World Health Organization, and a community midwife. Exciting directions for further research as well as pressing needs for policy guidance emerge from these illuminating explorations of authoritative knowledge about birth. This book is certain to follow Jordan's Birth in Four Cultures as the definitive volume in a rapidly expanding field