Migration—Maps of Meaning, Maps of Belonging

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SECOND THOUGHTS

The migrant has become the political figure of our time.

– Thomas Nail, The Figure of the Migrant¹

Migration: A hot topic in politics with implications for economics, education, housing, and not the least for global health and mental health. With passionate debates about the US southern border, the porous border between North Africa and southern Europe, claims about migration motivated the referendum that led to Britain leaving the European Union (“Brexit”), while European countries from Hungary to the Netherlands elected anti-immigrant leaders. And let’s not forget about massive internal migrations such as Brazil experienced in the 20th century and the flow of refugees from war, crime, and famine all over the world, with Ukraine, the Middle East, and Haiti in the headlines, to name just 3 places.

In this column, I want to move away from the polarizing and unproductive politics of migration to talk about human migration through 3 different lenses: (1) my work with refugees and migrants as a social and cultural psychiatrist; (2) how literature can illuminate the human stories behind migrations; and finally, (3) American philosopher Thomas Nail’s bold new theory of migration and mobility, offering a kinopolitics and kinopsychology along with a veritable “ontology of motion” with his masterwork, Being and Motion.²

People in Motion—A New Perspective on Social and Cultural Psychiatry

My career has been marked by working at the crossroads of culture, children, and families.³ As a transcultural child psychiatrist, I examined cultural syndromes that appear mainly under certain cultural conditions.⁴ A major contribution of transcultural psychiatry (TP), pioneered in the 1950s at McGill University where I trained, was the classification of culture-bound syndromes (CBS), that occur mainly in specific cultures. Examples included susto (somatic anxiety among Latinos), latah (an exaggerated startle reflex among Southeast Asians), amok (a dissociative behavioral syndrome, from the Malay word meaning “rushing in a frenzy”), and koro (“shrinking penis syndrome”).

The fact that these CBS were described in non-Western societies led to the charge that TP was exoticizing (“othering”) other cultures. In fact, TP did eventually turn its gaze on our own Western cultures, studying culture in our own backyard, as American psychiatrist Armando Favazza⁵ did with his pioneering work on self-mutilation and body modification in Missouri, the heart of middle America, brilliantly rebranding TP with the broader term “cultural psychiatry,” which is now the more widely accepted term.

A more recent critique of cultural psychiatry by American journalist Ethan Watters, Crazy Like Us,⁶ claims the opposite—that American psychiatry is exporting American and Western notions of mental illness and its treatment around the world through the global mental health (GMH) movement. Both critiques deserve serious consideration. Of the 2, Watters’ is the more serious one which the GMH movement has not adequately addressed.

Culture-Bound, Culture-Change, and Culture-Reactive Syndromes

During my psychiatric training at McGill, I became fascinated by psychiatric syndromes that appear under conditions of rapid cultural change, which I named culture-change syndromes (CCS).⁷ Examples in children and youth include eating disorders and selective mutism.⁴ Some psychiatric syndromes among children and youth fall into both groups. Eating disorders are a good example, being for at least a century associated with the upper classes of affluent Western societies (CBS) but now “democratizing” by spreading everywhere and presenting at even higher levels among migrant youth as CCS. My overarching term for both types of cultural syndromes is culture-reactive syndromes (CRS).⁷

This work led me to develop a therapy adapted to migration and to CCS, bringing together cultural psychiatry with family therapy in my model of cultural family therapy (CFT).⁸ CFT deals with families across cultures, interweaving families stories with clinical tools for conducting therapy, especially when their members manifest CRS.⁹

The 2 Kinds of Stories in Literature

There are 2 kinds of stories in literature and both concern movement. An immigrant myself, several times over, my work has followed 2 great themes of literature, as American writer John Gardner¹⁰ sets them out: someone goes on a journey and a stranger comes to town. This describes the heart of my work with children and families across cultures: going on a journey and arriving as strangers. My book was called A Stranger in the Family: Culture, Families, and Therapy and concludes with my own story, “Strangers No More,” narrating my first encounter as an adult with my Italian father in Brazil.⁸

While much of my career has been dedicated to working with migrants and refugees, whom I characterize as “people on the threshold”—“going on a journey” in Gardner’s phrase—my work today deals with the question of what to do when they get there—Gardner’s “strangers come to town”—and how to accompany their acculturation and adaptation to a new place. The journey and arrival are overlapping parallel processes but not the same. Many of us do not entirely leave our place of origin nor do we completely arrive anywhere else. Nobel laureate VS Naipaul’s late novel, reflecting his own life as a Trinidadian immigrant to the UK, is called The Enigma of Arrival.¹¹

Freud has been quoted as saying, “Wherever I go I find that a poet has been there before me.”¹² If we enlarge poetry to encompass all kinds of literature, we find that poetry and fiction have been there well before cultural psychiatry and even anthropology, telling the stories of human migration with maps of meaning and maps of belonging.

Maps of Meaning, Maps of Belonging

I dedicated my last column to Brooklyn’s premier novelist, Paul Auster (1947-2024), who recently passed away. Born in New Jersey, Auster migrated to France where he is lionized for his contributions as a translator of French literature into American English. Like Lucy Santé, he is an American Francophile who made French culture and literature more accessible.¹³ After returning to make his home in Brooklyn, Auster wrote his celebrated New York Trilogy,¹⁴ a contemporary map of the city’s demimonde through a confessional, almost conspiratorial style that sees the world as vaguely menacing, just shy of Thomas Pynchon’s outright paranoia.

So, as we help others navigate their journeys and arrivals in other places as therapists, what can literature teach us about finding and knowing our place?

The Road Trip, Yesterday and Today

First of all, there is a huge world literature about the journey. The forefather of the modern road novel is the ultimate road trip, The Odyssey by Homer, reimagined by American writer Zachary Mason in his The Lost Books of the Odyssey.¹⁵ The contemporary road trip without equal is by far Jack Kerouac’s On the Road,¹⁶ famously typed on 1 long, continuous roll of paper. It is no accident that Kerouac, who embodied the very American Beat movement, was a descendent of the great migration of Francophones from Canada to the United States, growing up in a French-speaking family in Lowell, Massachusetts.

Now James Joyce, the great modernist Irish writer in exile accomplished something absolutely stunning with his novel Ulysses, published in 1922.¹⁷ Not only did he restage the voyages of the Odyssey in 1 place—the Dublin of his youth—but set its inner, psychological journey in a single day, embodied by the ultimate European emblem of the stranger, the Jew Leopold Bloom. That day is now celebrated in Dublin as “Bloomsday” every June 16th. And by the way, the novel’s daylong odyssey concludes with the most sympathetic voicing of a female character by a man in Western literature, Molly Bloom, affirming her femininity in the closing soliloquy with the word, “Yes,” repeated no less than 22 times! This episode completes that 1 day, walking around Dublin, the city of his birth which he left as a young man and only briefly revisited, vowing nonetheless that if Dublin “one day suddenly disappeared from the Earth it could be reconstructed out of my book.”

Literary Walks, Maps of Meaning

Other great writers have similarly left their stamp on their native cities. Whether we know them in real life or not, they can take a hold on our imaginations beyond the pages of their works. Charles Dickens’ London can be visited through the pages of his novels or on walks revisiting their sites. I lived in London House in Bloomsbury around the corner from Dickens’ house on 48 Doughty Street for 2 years, but it was his novels that made it come to life. Other maps of London can be constructed through the work of the Bloomsbury group (Virginia Woolf lived on the same square as London House), Arthur Conan Doyle’s Sherlock Holmes and the Baker Street Irregulars, or the various detective stories set in London by Agatha Christie.

Before I ever set foot in it, I felt I knew Lisbon intimately through Portugal’s great modernist poet, Fernando Pessoa, with its Arcade on the Praça do Comercio and the Café A Brasileira where he met fellow poets; Bertrand’s, the bookstore on Rua Garrett in the Chiado, where he bought his books; the Hospital St. Louis, where he died; and the Prazeres Cemetery, where he was buried. After a first visit, I set a novella, “After Fernando”¹⁸ in Pessoa’s Lisbon where I had measured the steps between his haunts. This led to an invitation to lead a symposium on his life at the Casa Fernando Pessoa, examining his life and work from both psychological and literary perspectives. My other visits there have added color and nuance, but it remains Pessoa’s Lisbon for me.¹⁹ 

Greek poet Constantine Cavafy’s poetry makes Alexandria in Egypt seem as familiar as the neighborhood of my youth. His poem, “The God Abandons Antony”²⁰ is seared into my memory, leaving vicarious scars of exile, with its haunting closing line …

And say goodbye to her, to the Alexandria that you are losing.

We can repeat this with other places: Jorge Luis Borges’ Buenos Aires, where passionate young toughs still stage knife fights and an almost blind Borges is lost in the labyrinth of his own library; we can encounter Luc (now Lucy) Santé’s “other Paris”¹³—the Paris of the poor and the political pamphleteers before they were coopted, the prostitutes before they became sex workers, and yes, the poètes maudits before they were redeemed; we can visit Jerusalem like the “tourists” of Israeli poet Yehuda Amichai’s²¹ celebrated poem of that name, invading and destroying the city, desecrating its holy places. After reading it you will never feel comfortable as a visitor to Jerusalem again and that is the point.

And how about Milan Kundera’s scorned and feckless lovers prowling through Prague? As beautiful as Prague’s historical center is, far more memorable are the political history of “defenestrations” and Kundera turning the dial on Prague’s Orloj or Astronomical Clock in the Old Town Square into a symbol of time as a circular pattern of life in his novel Immortality.²²

Kinopolitics and Kinopsychology: A Bold New Theory of Motion

American philosopher Thomas Nail has fashioned a refreshing new approach to some of the most pressing problems of our times—the migrations of peoples around the globe. His message in a nutshell is simple: rather than seeing migration as an exception, we should see it as the rule in human history. More than that, Nail offers us a theory of movement, a veritable ontology of motion with his Being and Motion.²

With kinopolitics, Nail offers the politics of movement, not based on resentment (on the right) or rights (on the left), but rereading migration not as the exception to the rule of “political fixity and citizenship” but rather the rule, interpreting “political power from the perspective of the movement that defines the migrant in the first place.”¹ This offers us a new perspective of social division. Nail’s work turns our usual perspective upside down: “Instead of looking at borders as the products of societies and states, it looks at states and societies as the products of the mobile processes of bordering.”²³

Kinopsychology explores the human motivations and experiences associated with migration. Nail offers a philosophical framework to reread human history, no less; it is now up to us to translate that framework into clinical and social work with migrants.

Two psychiatrists from Latin America, Léon and Rebeca Grinberg, anticipated Nail’s kinopsychology with their brilliant work of applied psychoanalysis, Psychoanalytic Perspectives on Migration and Exile.²⁴ Their study of normal and pathological mourning explores the key elements of migration and exile, with 2 complementary perspectives. In one, the unconscious processes involved in leaving one world behind and adapting to a new one are at play. In another, the collective processes triggered by migration among those we leave behind are at work. Anyone who has revisited their native land and met again the intimate strangers they left behind knows what this nostalgic encounter entails.

Conclusion: Embracing Movement as Theory

I eschew binary choices and constraints (see my column on polarization). Torn between the tirades and mutual recriminations of Trump and Biden on the border? Try reading Cristina Garcia’s Dreaming in Cuban.²⁵ Or Richard Rodriguez on his argument with his Mexican father in Days of Obligation.²⁶

Tired of the limits and oppression of your place of origin? Overwhelmed by nostalgia and idealizations of the old world? Read Cavafy on his lost Alexandria and Pessoa on his lamented Lisbon. And Eva Hoffman in her celebrated memoir of a life in a new language, Lost in Translation.²⁷ Not sure that the place you are living is the same as your neighbors? Read Jonathan Raban’s Soft City, the personal, malleable place so different than the hard city of maps.²⁸ Exploring the underside and alternative history of your metropolis? Read Lucy Santé’s The Other Paris.¹³

Do you want to accompany migrants on their journey and their arrival as a therapist? Read my A Stranger in the Family.⁸

Finally, do you want to make sense of migration beyond polarizing politics and the received wisdom? Read Thomas Nail. This is not merely a different take on migration with a theory of movement, but a way to reimagine human history and society. And closer to home, cultural psychiatry is a field with 75 years of rich and varied but somewhat chaotic and contested observations in search of a theory. Psychiatry itself is lacking such a comprehensive general theory, as I have argued (see my interview in the resources). With his kinopolitics and kinopsychology, Nail’s philosophy of motion offers a radically new and promising theoretical framework for social and cultural psychiatry. If we are looking for a theory, this is it.

Resources

1. Chris Rawls, Thomas Nail. Time Will Tell: An Interview with Thomas Nail. Blog of the American Philosophical Association. October 2, 2020. https://blog.apaonline.org/2020/10/02/time-will-tell-an-interview-with-thomas-nail/
2. Maryellen Stohlman-Vanderveen, Vincenzo Di Nicola. The Crisis of Psychiatry Is a Crisis of Being: An Interview with Vincenzo Di Nicola. Blog of the American Philosophical Association. October 8, 2021. https://blog.apaonline.org/2021/10/08/the-crisis-of-psychiatry-is-a-crisis-of-being-an-interview-with-vincenzo-di-nicola/

Dr Di Nicola is a child psychiatrist, family psychotherapist, and philosopher in Montreal, Quebec, Canada, where he is professor of psychiatry & addiction medicine at the University of Montreal and President of the World Association of Social Psychiatry (WASP). He has been recognized with numerous national and international awards, honorary professorships, and fellowships, and was recently elected a Fellow of the Canadian Academy of Health Sciences and given the Distinguished Service Award of the American Psychiatric Association. Dr Di Nicola’s work straddles psychiatry and psychotherapy on one side and philosophy and poetry on the other. Dr Di Nicola’s writing includes: A Stranger in the Family: Culture, Families and Therapy (WW Norton, 1997), Letters to a Young Therapist (Atropos Press, 2011, winner of a prize from the Quebec Psychiatric Association), and Psychiatry in Crisis: At the Crossroads of Social Sciences, the Humanities, and Neuroscience (with D. Stoyanov; Springer Nature, 2021); and, in the arts, his “Slow Thought Manifesto” (Aeon Magazine, 2018) and Two Kinds of People: Poems from Mile End (Delere Press, 2023, nominated for The Pushcart Prize).

References

1. Nail T. The Figure of the Migrant. Stanford University Press; 2015.
2. Nail T. Being and Motion. Oxford University Press; 2018.
3. Di Nicola V. Borders and belonging, culture and community: from adversity to diversity in transcultural child and family psychiatry. J Am Acad Child Adolesc Psychiatry. 2018;57(10):S116.
4. Di Nicola V. De l’enfant sauvage à l’enfant fou: a prospec­tus for transcultural child psychiatry. In: Grizenko N, Sayegh L, Migneault P, eds. Transcultural Issues in Child Psychiatry. Éditions Douglas; 1992:7‑53.
5. Favazza AR. Bodies Under Siege: Self-Mutilation and Body Modification in Culture and Psychiatry. 2nd ed. Johns Hopkins University Press; 1996.
6. Watters E. Crazy Like Us: The Globalization of the American Psyche. Free Press; 2010.
7. Di Nicola V. Anorexia multiforme: self‑starvation in historical and cultural context. I: self‑starvation as a historical chameleon. II: Anorexia nervosa as a culture‑reactive syndrome. Transcultural Psychiatric Research Review. 1990;27(3):165‑196; 27(4):245‑286.
8. Di Nicola V. A Stranger in the Family: Culture, Families, and Therapy. W.W. Norton & Co; 1997.
9. Di Nicola V, Song S. Family matters: the family as a resource for the mental, social, and relational well-being of migrants, asylum seekers, and other displaced populations. In: Gogineni RR, Pumariega AJ, Kallivayalil R, Kastrup M, Rothe EM, eds. The WASP Textbook on Social Psychiatry: Historical, Developmental, Cultural, and Clinical Perspectives. Oxford University Press; 2023:244-255.
10. Gardner J. The Art of Fiction: Notes on Craft for Young Writers. Alfred A. Knopf; 1984.
11. Naipaul VS. The Enigma of Arrival. Knopf Doubleday; 1988.
12. This is an example of an apocryphal quote that sounds like Freud but it cannot be traced to anything he actually wrote. See this authoritative source: Freud Museum London. 10 Quotes Wrongly Attributed to Sigmund Freud. Accessed May 20, 2024. https://www.freud.org.uk/2019/04/30/10-quotes-wrongly-attributed-to-sigmund-freud/
13. Santé L. The Other Paris. Farrar, Straus and Giroux; 2015.
14. Auster P. The New York Trilogy: City of Glass, Ghosts, The Locked Room. Penguin; 2006.
15. Mason Z. The Lost Books of the Odyssey. Farrar, Straus and Giroux; 2010.
16. Kerouac J. On the Road. Viking Press; 1957.
17. Joyce J. Ulysses. Shakespeare & Co; 1922.
18. Di Nicola V. After Fernando. In: The Unsecured Present: 3-Day Novels & Pomes 4 Pilgrims. Atropos Press; 2012:39-111.
19. Di Nicola V. Um estranho em casa, uma casa estranha: Pessoa e psiquiatria [A stranger in the house, a house so strange: Pessoa & psychiatry]. Symposium with Commentaries by Professor Nuno Miguel Proença and Dr. Nuno Borja Santos. Casa Fernando Pessoa, Lisbon, Portugal. October 31, 2012.
20. Cavafy CP. The God Abandons Antony, in: The Collected Poems of C.P. Cavafy: A New Translation. Barnstone L, trans. W.W. Norton & Co; 2006:45.
21. Amichai Y. Tourists. In: Alter R, ed. The Poetry of Yehuda Amichai. Farrar, Straus & Giroux; 2015:299.
22. Kundera M. Immortality: A Novel. Kussi P, trans. Grove Weidenfeld; 1991.
23. Wolters E, Nail T. The figure of the migrant: interview with Thomas Nail. Critical Theory. December 1, 2015. Accessed May 20, 2024. https://www.critical-theory.com/the-figure-of-the-migrant-an-interview-with-thomas-nail/
24. Grinberg L, Grinberg R. Psychoanalytic Perspectives on Migration and Exile. Festinger N, trans. Yale University Press; 1989.
25. Garcia C. Dreaming in Cuban. Alfred A. Knopf; 1992.
26. Rodriguez R. Days of Obligation: An Argument with My Mexican Father. Penguin; 1993.
27. Hoffman E. Lost in Translation: A Life in a New Language. Penguin; 1990.
28. Raban J. Soft City. Collins Harvill; 1988.