“Unfolding”: Rethinking Development, A Report from the Global South

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SECOND THOUGHTS

From Belo Horizonte, Minas Gerais, Brazil

My last 2 columns featured my 2-part interview (Part 1, Part 2) with Dennis Palumbo, a Los Angeles psychotherapist and writer. Now, I am in Belo Horizonte in the State of Minas Gerais, Brazil for the Brazilian National Congress of Family Therapy. Many Brazilian artists have inspired me, none more so than Adélia Prado whose poem, Com Licença Poética – “With Poetic License,” was her entry into the highest reaches of Brazilian letters.¹

I call it her “mission poem” in which she makes her wager as a poet in the concluding lines:

Vai ser coxo na vida, é maldição pra homem.

Mulher é desdobrável. Eu sou.

Being lame in life is a curse for a man.

A woman is flexible, unfolding, I am.

(my translation)

The key word was her description of women as desdobrável, who in contrast to men are able to unfold—to be flexible and to adapt. And she personifies it (after all it is a poem, not a treatise) by adding: Eu sou. I am. Since my first reading of her poem, I have substituted desdobrável for development and see children as learning, growing, and adapting—unfolding in Adélia Prado’s metaphor.

When I met Adélia Prado here in the small provincial city of Divinópolis (“divine city”) in the inland state of Minas Gerais (“general mines,” named for its rich resources of gems and gold), I brought my well-worn volume of her collected poems marked with my favorites. Curious, she asked me to indicate the poems I favored and why. She nodded as I answered, saying those were her favorites too, which gave me the courage to ask her to recite 2 or 3 of them, starting with “With Poetic License.”

It is poetic justice that this encounter that led me to revisit how we think about children took place in Brazil, which the Global North struggles to understand, using political (“Third World”) or socio-economic (developing area or world; lower and middle income countries, LMICs) categories. I see it as part of “the Global South.”²

As it happens, how we think about children’s growth or unfolding and how we think about how societies evolve is connected—not in the seemingly simple facts that children grow towards maturity or that societies grow their economies in productivity and complexity but through an ideology that we must first understand, then challenge, and as I have argued strenuously, reject for both children and for societies.³  

Adélia Prado’s metaphors, examples, and life lessons are consistently and meaningfully drawn from her experience as a woman. When an interviewer, Ellen Watson, asked her when she knows a poem is complete, she replied⁴:

Adélia Prado: When it gives me joy. When I look and think, Oh, what a beautiful child!

Ellen Watson: How much conscious control do you apply along the way?

Adélia Prado: It’s mostly about cutting and cutting. Like with a newborn, you remove the placenta, you wipe away the cheese, and the child gets clean. It’s born dirty, and you clean it up. Inspiration brings dirt with it. But if I need to fix a poem too much—that’s a signal that it’s a bad one… It’s an abortion.

Ellen Watson: The poet as midwife!

Adélia’s poetry seamlessly fuses her experiences as a woman, from childbirth to cleaning and gutting fish together in their kitchen after her husband’s fishing trip, with mystical resonances of her religious faith. Her poems are unabashedly feminine and devotional. With her conservative and traditional views, Adélia rejects modernism. As Brazilian literary critic Miguel Sanchez Neto observed, “Adélia Prado’s poetry is striking, not just for its embrace of provincial life, but also for its desire to give positive symbolic expression to everything devalued by the dictatorship of modernism.”⁴

Similarly, we need to rescue social, psychological, and psychiatric thought from the constraints of positivistic social science.

Freud’s Developmental Triad

[W]e attribute the same emotional attitudes to … primitive men that we are able to establish by analytic investigation in the primitives of the present day—… our children.

– Sigmund Freud⁵

A critical reading of Freud’s work reveals what I have called Freud’s triad of developmental pathology: neurotics-primitives-children.⁶

The organizing principle for this grouping is the notion of “development” and its opposite, “regression” in Freud’s terms. In his book on Group Psychology, Freud argued that the characteristics of the herd instinct, “show an unmistakable picture of a regression of mental activity to an earlier stage such as we are not surprised to find among savages or children.”⁷

In this book and others, Freud justifies an “identification of the group mind with the mind of primitive people” and extends this, arguing that “this is also the case in the unconscious mental life of individuals, of children and of neurotics.”⁸ In Moses and Monotheism, Freud argues that “we attribute the same emotional attitudes to… primitive men that we are able to establish by analytic investigation in the primitives of the present day—… our children.”⁵ This analogy created an approach to the relation between ethnology and psychiatry that continued, notably in the work of the Dakar School of Senegal.⁸

However, this approach created several problems:

1. The equation of primitive cultures with pathology and with the immaturity of childhood.
2. It retarded research into understanding the nature of children’s growth until child psychology and the field of developmental psychopathology came along.⁹
3. It reduces childhood to a “savage” state.

The notion of regression as the reversal of the developmental process appears to have been borrowed by Freud during his early neurological work from the British neurologist Hughlings Jackson, MD. Jackson used the term “dissolution” for this reversal, borrowed from Herbert Spencer’s work on evolution. From the general process outlined by Spencer, Jackson created a more specific biological meaning.¹⁰ Freud freed himself to some extent of his early biological determinism to make development and regression broader psychological metaphors. Nonetheless, Freud limited his developmental theorizing to early childhood, speculating as far as puberty, but not on what we now call adolescence.⁶

We have largely retained Freud’s triad, replacing primitive or savage with the innocuous-sounding term “developing.” In fact, we could add Freud’s analysis of women to make it a tetrad.¹¹ A key feminist study by US psychologist Carol Gilligan offered the metaphor of “different voices” to explain how girls and boys negotiate the challenges of mental and social growth as “connected persons” (a feminine voice) vs “separate persons” (a masculine voice).¹²

Yet, metaphors are imprecise and always bear the traces of their origins. Development became a metaphor for the human life span and for the socio-economic growth of nations around the world. The notion of development served for the 20th century what the concept of evolution served in the 19th. In my call for a transcultural child psychiatry, 2 key variables—children and culture—are commonly seen on a continuum of “development.”⁶

What I am arguing here is that development is not a fact or a necessary perception of the natural or the human world, but the social construction of a metaphor that is sometimes instructive, often muddling.

Just as Lévi-Strauss’ anthropology debunked the myth of la pensée sauvage (the savage mind),¹³ so too we must divest ourselves of l’enfant sauvage (the wild child)¹⁴ and other myths of childhood. And just as anthropologists turned to other cultures for comparisons and to learn about our own cultures, we turn to childhood for instruction about our adult selves—not always to children’s benefit!

The limitations of Freud seeing children as “the primitives of the present day” are now painfully obvious. The metaphor is reductive and potentially harmful in both directions: “primitives” (meaning indigenous cultures) are seen as childlike while children are seen as “primitive” (implying immaturity and lacking mental, cultural, and social sophistication).

One of the problems in seeing children as primitive versions of adults is that we have ignored and discounted their experiences. I was born in the 1950s. In every decade of my life, child psychiatry “discovered” some new disorder—anxiety, depression, bipolar illness, early-onset anorexia nervosa, and suicide—in young individuals.

When I was a resident in child psychiatry, I sat through a clinical case discussion about an 8-year-old boy who showed symptoms of depression. Not only were children rarely medicated for depression at that time, but a child psychoanalyst who followed British child analyst Melanie Klein was adamant that the child could not have depression because he did not have the psychic maturity to experience loss as sadness and enter “the depressive position.” So, no depression, I asked? No depression, he affirmed. I guess the child did not know he was not allowed to have depression because he has all the symptoms, I retorted. The analyst never talked to me again. More importantly, if a theory cannot account for our observations, we should change the theory, not discount the facts.

Just as disturbing, physical and sexual abuse were met with incredulity by even experienced child specialists and children’s cries for help were understood as primitive projections. We need nothing less than a #MeToo movement for kids!

And just as traditional societies had their worldviews and folk psychologies, modern societies produced a psychological worldview with assumptions with which they constructed the modern myths of mind, self and society. In the beguilingly simple but brilliant formulation of British social anthropologist Mary Douglas, these myths become “self-evident.”¹⁵ They are so common that through repetition and elaboration, they become believed and shared by everyone.

Development is one of those modernist myths and developmental thinking is a hallmark of 20th century modernism across all the social sciences, from economics to child psychology and sociology. Postmodernism, which is just a way to point to the crises of modernism, means that we need to question what seems obvious and self-evident. For the psy disciplines, that means starting with developmental thinking.

Don Hebb (1975), my professor of psychology at McGill, gave a warning that ironically invoked developmental thinking¹⁶:

Our problem in psychology may be to find better preposterous ideas, and we can only expect that the further development of psychological thought if it is successful will take us farther and farther from what common sense would approve of.

Instead of saying the “development of psychological thought,” we can substitute words like adaptation, adjustment, analysis, change, correction, growth, and synthesis. These words can take us farther from the prison of common sense which we accept as self-evident.

Concluding Thoughts

To return to Freud. Inspired by the powerful poetry of Adélia Prado, I propose, as psychiatrist-psychoanalyst Jacques Lacan, MD, did in Paris a century ago, to return to Freud by rereading him. But Lacan’s project is a century old already. We need a new reading of Freud and what he represents for the 21st century in contemporary terms, beyond his developmental triad or tetrad¹⁷:

If we could cut Freud from his 19th century moorings of biological determinism, he might talk to us in wonderful words like text/intertext, syntagm, metonymy, rhizome, idiolect, syncretism, chance, disjunction, indeterminacy and immanence. What different worlds do such words conjure up!

Resources

• Adélia Prado. Wikipedia. Accessed August 3, 2024. https://en.wikipedia.org/wiki/Ad%C3%A9lia_Prado
• For an introduction to her poetry in English, read: Adélia Prado, The Alphabet in the Park: Selected Poems of Adélia Prado. Wesleyan University Press; 1990.
• Interview: Adélia Prado by Ellen Doré Watson. Bomb Magazine. Winter 2000 Issue. Accessed August 15, 2024. https://bombmagazine.org/articles/2000/01/01/ad%C3%A9lia-prado/

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).

Acknowledgements

I wish to express my gratitude to Adélia Prado, whom I call “the divine of Divinópolis,” for my encounter with her and her work and to offer my heartiest congratulations for winning the 2024 Camões Prize, the most prestigious literary award in the Portuguese language.

References

1. Prado A. The Alphabet in the Park: Selected Poems of Adélia Prado. Wesleyan University Press; 1990.

2. Di Nicola V. The Global South: an emergent epistemology for social psychiatry. World Social Psychiatry. 2020;2(1):20-26.

3. Di Nicola V. Development and its vicissitudes – a review of Pluriverse: A Post-Development Dictionary, ed. by A Kothari, A Salleh, A Escobar, F Demaria, and A Acosta. Tulika Books/Columbia University Press, 2019. Global Mental Health & Psychiatry Review. 2023;3(1):17-19.

4. Watson ED. Adélia Prado. BOMB Magazine. January 1, 2000. Accessed August 15, 2024. https://bombmagazine.org/articles/2000/01/01/ad%C3%A9lia-prado/

5. Freud S. Moses and Monotheism: Three Essays. In: The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 23. Hogarth Press; 1939.

6. Di Nicola V. De l’enfant sauvage à l’enfant fou: a prospec­tus for transcultural child psychiatry. In: N Grizenko, L Sayegh, P Migneault, eds. Transcultural Issues in Child Psychiatry. Éditions Douglas; 1992:7‑53.

7. Freud S. Group Psychology and the Analysis of the Ego. In: The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 18. Hogarth Press.

8. Di Nicola VF. Review of Cimino’s “La Scuola di Dakar.” Transcultural Psychiatic Research Review. 1988;25(2):123-127.

9. Cicchetti D. The emergence of developmental psychopathology. Child Dev. 1984;55:1-7.

10. Linn L. Jackson and Freud: the relation of dissolution to regression. Bull N Y Acad Med. 1960;36(5):277-284.

11. Cherry K. Freud's Perspective on Women. verywellmind. Accessed August 15, 2024. https://www.verywellmind.com/how-sigmund-freud-viewed-women-2795859

12. Gilligan C. In A Different Voice: Psychological Theory and Women’s Development. Harvard University Press; 1982.

13. Levi-Strauss C. The Savage Mind. University of Chicago Press; 1966.

14. Favazza AR. Feral and isolated children. Br J Med Psychol. 1977;50(1):105-111.

15. Douglas M. Self-evidence. In: Implicit Meanings: Essays in Anthropology. Routledge; 2002:276-318.

16. Hebb DO. Science and the world of imagination. Canadian Psychological Review. 1975;16(1):4-11.

17. Di Nicola VF. The uses of diversity. Response to Dr. Kapus­cinska’s discussion of my prospectus. In: N Grizenko, L Sayegh, P Migneault, eds. Transcultural Issues in Child Psychiatry. Éditions Douglas; 1992:229‑235.