Pain in intercultural perspective

Abstract

Pain is hard to express in words but it communicates itself in a nonverbal way. Chronic pain is often found within the migrant population. These syndromes are a challenge for experts. Meanwhile the psychoanalytic specialized literature about psychoso-matics does not contribute a great deal to the clarification of the health problems of this section of the population. We even have to ask if the diagnosis of psychosomatic as a remnant category of somatic medicine refers after all to homogenous psychic dynamics. Pain is important to the phenomena of illness and injury, torture and war, but it also plays an important part in the normal process of learning.

A hypothesis of the French ethno-psychoanalyst Tobie Nathan concerning processes of learning will be presented. This author claims that traumatism fulfils an important function in rituals of archaic cultures. A comparison of the, nowadays, often cited nonpsychoanalyt-ic theories of trauma with the Freudian one leads us to the issue of how to bridge the gap between language and bodily sensations in the course of therapies. The vignette of a patient whose life history is full of meaningful turning points shows that the difficulty of interpreting is not to be found in the content. The challenge for the therapist with patients whose cultural background is foreign to therapeutic thinking lies in finding an adequate language, capable of touching the patient immediately, as it were bodily, especially when unconscious conflicts show themselves through bodily symptoms or a tendency towards acting out.

Keywords:
Chronic pain; Migrant population; Learning process; Trauma