Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
Transcultural Center, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Med Humanit. 2024 Sep 23;50(3):439-449. doi: 10.1136/medhum-2023-012790.
Martinican poet, novelist and cultural theorist Édouard Glissant (1928-2011) rejected contemporary simplistic notions of creole hybridity popularised in the 1980s and 1990s in favour of a unique and explicitly antiessentialist construct of Caribbeanness-a form of being that embraces place while shunning any associated ideas of rootednesss. Throughout his work, there is a constant tension between the local and the global, the particular and the universal, the essentialist and the homogenising, a tension that is never resolved but used creatively to stake out an emergent third position against a backdrop of a metaphorical Caribbean seascape. The purpose of this article is to shed light on a central idea developed by Glissant: the importance of acknowledging opacity in the encounter with the Other, in contrast to idealised notions of transparency as inherently desirable. This 'right to opacity' has been embraced in poststructural theory, postcolonial activism and contemporary art. However, I argue that opacity is also a highly relevant notion in clinical contexts, as an essential resource for understanding concepts such as first-person, second-person and third-person perspectives in the phenomenology of mental health and illness. For illustration, I point to a number of clinical tools and approaches-such as the Cultural Formulation Interview, Therapeutic Assessment and the employment of a not-knowing stance in mentalisation-based treatment-that successfully incorporate a respect for opacity as a core value in the clinician-patient encounter. This article is not an attempt to offer a definitive how-to guide on how to make use of the ideas of Édouard Glissant in the clinic; instead, I hope to inspire further discussion about how various notions of opacity and transparency come into play for mental health practitioners and how acknowledging alterity and difference may contribute to more fruitful and respectful ways of engaging with the patient-as-Other.
马提尼克岛诗人、小说家和文化理论家爱德华·格里桑（1928-2011 年）反对 20 世纪 80 年代和 90 年代流行的当代克里奥尔混合的简单观念，而赞成加勒比地区独特而明确的反本质主义构建——一种拥抱地方而回避任何与之相关的扎根观念的存在方式。在他的作品中，始终存在着地方与全球、特殊与普遍、本质主义与同质化之间的紧张关系，这种紧张关系从未得到解决，但被创造性地用来在一个隐喻的加勒比海景观的背景下，开辟出一个新兴的第三个立场。本文的目的是阐明格里桑提出的一个核心思想：在与他者相遇时，承认不透明性的重要性，而不是将透明性理想化，认为其本身是可取的。这种“不透明权”在后结构理论、后殖民主义行动主义和当代艺术中得到了认可。然而，我认为不透明性在临床环境中也是一个非常相关的概念，因为它是理解心理健康和疾病现象学中的第一人称、第二人称和第三人称观点等概念的重要资源。为了说明这一点，我指出了一些临床工具和方法，如文化构念访谈、治疗评估以及在基于心理化的治疗中采用不知立场，这些方法成功地将对不透明性的尊重作为临床医生与患者相遇的核心价值。本文不是试图提供一个关于如何在临床中运用爱德华·格里桑思想的明确指南；相反，我希望激发更多关于各种不透明性和透明度观念在心理健康从业者中如何发挥作用的讨论，以及承认他者和差异如何有助于以更富有成效和更尊重的方式与患者互动。
