e-ISSN 2395-9134 |
Articles | Estudios Fronterizos, vol. 20, 2019, e034 |
https://doi.org/10.21670/ref.1913034
A proposal for complementarity between migration and psychoanalytical studies in mental health
Una propuesta de complementariedad entre los estudios de migración y psicoanalíticos en salud mental
Ángel
Lunaa
*
http://orcid.org/0000-0003-3734-7000
Silvia
Mejía-Arangob
http://orcid.org/0000-0002-6416-1159
a El Colegio de la Frontera Norte, Doctorado en Estudios de Migración, Tijuana, Baja California, México, e-mail: angellunadem2016@colef.mx.
b El Colegio de la Frontera Norte, Departamento de Estudios de Población, Tijuana, Baja California, Mexico, e-mail: smejia@colef.mx.
* Corresponding author: Ángel Luna, e-mail, angellunadem2016@colef.mx
Received on March 20, 2019.
Accepted October 25, 2019.
Published November 6, 2019.
CITATION: Luna, Á. & Mejia-Arango S. (2019). Una propuesta de complementariedad entre los estudios de migración y psicoanalíticos en salud mental [A proposal for complementarity between migration and psychoanalytical studies in mental health]. Estudios Fronterizos, 20, e034. doi: https://doi.org/10.21670/ref.1913034 |
Abstract:
The objective of this article is to discuss the epistemological foundations of psychoanalytic studies and their possibility of complementarity with migration studies based on sociology. The methodology used was the review of theoretical production about epistemology in psychoanalysis, the tradition of research in sociology, as well the migration studies focused on mental health. Among the results, important epistemological and methodological coincidences between both disciplines were found. From this, a brief proposal is presented that highlights the feasibility of generating complementary studies on migration, specifically in border contexts. It is argued that the value of this article lies in the exploration of a methodological possibility little developed in migration studies, which delves into subjective and intersubjective aspects in the experience of migration. It is considered that this proposal can serve as a guide for further studies.
Keywords:
Epistemology,
migration,
mental health,
psychoanalysis,
subjectivity.
Resumen:
El objetivo de este artículo es discutir los fundamentos epistemológicos de los estudios psicoanalíticos y su posibilidad de complementariedad con los estudios de migración basados en la sociología. La metodología utilizada fue la revisión de producción teórica sobre el tema de epistemología en psicoanálisis y la tradición de investigación en sociología, así como sobre estudios de migración enfocados en salud mental. Entre los resultados, se encontraron importantes coincidencias epistemológicas y metodológicas entre ambas disciplinas. A partir de eso, se presenta una breve propuesta que pone en evidencia la viabilidad de generar estudios complementarios sobre migración, específicamente en contextos fronterizos. Se sostiene que el valor de este artículo radica en la exploración de una posibilidad metodológica poco desarrollada en los estudios de migración, la cual profundiza en aspectos subjetivos e intersubjetivos en la experiencia de migrar. Se considera que dicha propuesta puede fungir como guía para estudios posteriores.
Palabras claves:
Epistemología,
migración,
salud mental,
psicoanálisis,
subjetividad
Original article language: Spanish.
Introduction
The objective world has been exhaustively researched in migration studies. This is evident in approaches based on theories ranging from those related to the causes of migration to those that focus on the continuity and social and economic integration of migrant subjects, as well as theories about their incorporation into the labor market. However, although these investigations broadly explain the phenomenon of migration, it is important to identify the extent to which they include subjective aspects inherent to the migration experience. For example, in some cases, migrant subjects have been found to hold jobs they consider below their expectations and to live in precarious conditions, experiencing persecution due to their undocumented status or living with long-term emotional distress (Sarzuri-Lima, 2013).
In geopolitical terms, border contexts are regions where the repercussions of migratory processes become palpable. They are spaces where people experience adaptation, becoming accustomed to baggage that contains not only belongings but a series of life experiences. When a person emigrates, he or she is confronted by emotional development tasks that are not always successful and may, in many cases, result in a nostalgia that prevents the individual from integrating into his or her final destination (Piastro, 2015). Consequently, in migration scenarios, we not only encounter objective situations or facts but also subjective experiences involving internal or mental conflicts, which become a challenge and require methodologies suitable for understanding them.
Along those lines, it has been argued that the migration process itself may be linked to the origin of mental disorders. The migrant subject is recognized as existing in a state of psychosocial vulnerability, which becomes comprehensible when the migratory act is seen as a process, i.e., as comprising three steps: a) premigration, b) migration and c) postmigration (Bhugra, 2004).
It is important to highlight the existence of studies that have identified the psychosocial vulnerability experienced by the migrant population. Such studies have integrated aspects of the subjective experience of people who migrate, emphasizing that although not all of them suffer from significant imbalances in terms of mental health, a significant percentage does (Achotegui, 2004; Ingleby, 2008). However, those studies clearly focus on explaining reactions to and, in some cases, the potential mitigation of the distress experienced at the destination, or, schematically speaking, in the third stage of the migration process. While this focus is not considered inadequate, it is limited. Although traumatic experiences prior to a migration are addressed, these studies focus on explanations and adjustments that the migrant person experiences at the destination without thoroughly examining his or her internal imbalance, which may have a greater impact and a much earlier and more enduring origin and thus requires an analysis that integrates psychosocial elements of primal experiences. This refers to the fact that when research has sought to understand suffering or the experience of misery in migrant subjects, little or no attention has been paid to understanding psychosocial and personality-building experiences prior to migration.
It may seem inappropriate and irrelevant to consider that factors that affected and shaped the mental functioning of migrant subjects continue to have an impact in the present, even when they took place in the remote past. It also seems that very little is understood about how the subconscious works, of which-paradoxically-the migrant subjects themselves may not have total knowledge or complete control. The subconscious refers to hidden elements that are decipherable through specific methodologies, such as those proposed by psychoanalytic studies, that explore the subjects’ history through their own subjectivity; specifically the subconscious is explored through listening to the subjects’ own words, experiences, meanings, fantasies and energized thoughts on an unconscious level, which are also linked to sociocultural elements of the past environment in which the subjects developed.
From a metaphorical perspective, it is possible to argue that there are also borders in academia, which lead to exclusive concentrations and separations between disciplines. These borders are evident in migration studies and psychoanalytic studies. However, in their study of every human psychic manifestation, psychoanalytic studies are tasked with traversing theoretical borders and making connections in a space where common objects of study converge; for example, in the case of migrants, psychoanalytic studies approach the border with migration studies. If the aim is to understand the phenomenon of migration broadly and to integrate subjective and intersubjective experiences of those who migrate, both disciplines must pursue an exchange through complementarity.
Historically and epistemologically speaking, psychoanalytic research has shifted from a more psychopathological perspective towards an exploration of human phenomena involving other disciplines, such as sociology and anthropology. For Caruso (1979), human beings are modifiers of themselves and the world and, in turn, are modified by that world. The psychoanalytic technique thus continuously seeks to understand subjects in their subjective and intersubjective complexity, i.e., through their own internal processes and those constructed in interaction with other people. For psychoanalytic studies, this reality presents important potential for integration in terms of sociocultural elements. This is not unreasonable if one considers that the formation of ideals in individuals, as well as the formation of social relationships, can only be understood in the context of broader relationships involving historical and normative structures in social terms. Psychoanalytic studies therefore become social when they give relevance to and analyze reciprocal social relationships-relationships that influence and interdetermine each other-with an understanding that this entire structure has an important impact on people in terms of both the construction of their mind and their fate.
Although authors such as Bleichmar and Leiberman (1989) offer warnings about the diversity of schools of thought and developments in psychoanalytic studies, this article will make an effort to focus on basic elements shared by the different lines of thought in psychoanalytic studies that can complement migration studies from a sociological perspective. This process refers to the integration of social and subjective elements and the rejection of strictly clinical and individual perspectives in order to understand internal dynamics. There is a long-standing problematization that requires the psychoanalytic discipline to take new methodological paths, as the multiplicity of contradictory clinical theories and psychotherapeutic schools presents serious limitations.
This observation is relevant if one remembers that this discipline initially relied on the case report, largely because of its focus on clinical or psychotherapeutic activities. However, despite its value in clinical settings, the case study is not the only methodology used to understand human phenomena, particularly in social fields (Kachele & Thoma, 2003). This does not mean that there have been no attempts to interrelate the migratory experience, mental functioning and the psychoanalytic discipline, as authors such as Grinberg and Grinberg (1982) set an important precedent.
It is thus essential to examine previous studies on migration and mental health with the aim of tracking their study perspectives in order to subsequently examine the epistemological foundations of the sociological and psychoanalytic disciplines, respectively. The intention of such efforts is to arrive at a clarity that makes it possible to propose lines of study with a coordinated methodology that supports the description of the migratory phenomenon in an internal and subjective sense, integrating elements of understanding from the mental health and social fields.
Regarding the study of mental health in migration: The psychological, biographical and narrative perspective
Traditionally, research on the phenomenon of migration has been supported by economic and social explanations. In contrast to that tendency, Lee (1966), in A theory of migration, argued that the decision to migrate is never completely rational and that, for many individuals, the irrational component is much more significant, and migration can be explained through fleeting emotions, mental illnesses and accidental events. In agreement, Germani (1969) accused migration studies of holding on to rational motivations, such as economic ones, without considering the potential complexity of the psychological process that results in the decision to leave or stay.
Although critics have pointed out a number of unresolved issues in migration studies, only in recent years has the effort to link the phenomenon of migration and the field of mental health borne fruit. Investigations that have applied the stress model to the migrant population, associated epidemiological and acculturation studies, and migration narratives have proposed responses in this regard.
There are a number of important examinations, such as that of Bhugra (2004), who argues that the migration process itself may be linked to the origin of mental disorders. Bhugra distinguishes the psychosocial vulnerability associated with the act of migration, understanding it as a process; beginning in the premigratory stage, it is possible to trace risks based on an individual’s personality type, which can explain why migration is traumatic for some personalities, but not for others. Regarding the migration journey, Bhugra considers the experiences of loss, grief and possible posttraumatic stress as potential sources of imbalance; finally, at the final destination or during the postmigration stage, imbalance can be experienced through culture shock, which exacerbates the sensation of loss.
Relatedly, Alvarado (2008) argues that to understand the relationship between the migration process and the development of a mental health problem, it is necessary to consider different dimensions, including the individual’s personal characteristics, the conditions prior to migration, the characteristics of the migration process and the conditions in the new society where the individual now lives.
Based on his research and taking a candid perspective that relates migration to the development of a psychopathology, Ingleby (2008) argues that the greatest evidence of this relationship is found for schizophrenia. In his studies, he identified a high correlation between schizophrenia and migration. In turn, Achotegui (2004) explains that a certain type of migrant experiences excessive stressors and grief, which can create a reaction in the mental health area. He alleges that if such individuals’ migrant status is not considered, the symptoms they present can be incorrectly diagnosed, causing them to receive inadequate treatment, and that in such cases, the care situation paradoxically becomes a new stressor. Along those same lines is the study by Nathan Venturini (2006), who reports that cultural change produces loss of identity and irreparable trauma. Considering that migration involves a cultural change, it is always experienced as catastrophic for the psyche since the culture of origin is irreplaceable. The immigrant population will thus experience severe failures in the transmission of their identity to their descendants, causing transgenerational trauma. In Venturini’s opinion, the social problems experienced by those populations and their descendants are the result of a cultural change.
In turn, Moro (2004) considers the migratory event a psychic act that leads to the breakdown of subjects’ internalized cultural framework. For this reason, emigrating is often traumatic. However, she states in her conclusions that migratory trauma is neither constant nor inevitable and may occur regardless of the emigrant’s previous personality. In her opinion, hostile social factors (in the country of origin and in the new country) are aggravating factors. However, even when trauma occurs, it does not necessarily produce pathogenic effects. Sometimes, as with any trauma, it can create and support a new dynamic for the individual; it may even be the germ of a transformation or the source of new creativity. Migration, therefore, can also have creative potential. Hence, there is a need to identify the factors that make it possible to control the cross-cultural risk (Moro, 2004).
In line with Moro and unlike the other authors mentioned above, Vilar and Eibenschutz (2007) conclude that migration alone is likely not the cause of a deterioration in mental health. However, they argue that this deterioration may be related to and triggered by complications with the employment situation, for example, and to previous traumatic events during and after migration, which may be sufficient reasons to for migrants to experience psychological distress.
From the systemic approach, it is important to mention the studies by Falicov (2001) on how migration has contributed to the emergence of new family arrangements, i.e., transnational families, which literally live on two sides of a border; these families are fragmented and experience disadvantages as well as advantages for both the family members who leave and those who remain in the country of origin. Along those same lines are the studies by Andolfi (2009), who focuses on knowledge from the psychological field regarding families belonging to different cultural and social contexts, delving into the challenges that must be addressed provide better care for these families. This author also points out the need for therapists to review their assumptions about diversity and their own prejudices, strengthen their personal resources and develop a real capacity to reach the patient.
Along another line of thought, authors such Hwang et al. (2007) have studied the impact of culture on mental health and have found that, for example, the immigrant population in the United States exhibits significant suffering. At the intervention level, these authors observe inequality in access to health services. They argue that these systems may not be adequately prepared to meet the needs of specific populations, such as migrants. Such findings also reflect a limited understanding of the cultural factors involved in migrants’ suffering.
In this regard, there is also research in the context of Mexico. In epidemiological terms, particularly noteworthy is the study by Bojorquez et al. (2015), who focused on the prevalence of mental disorders in migrants deported back to Mexico. In their investigation, these authors found significant percentages of people in need of mental health care. They also concluded that the incidence of mental health disorders is higher among Mexican immigrants in the United States than among Mexicans in Mexico. Thus, they suggest the design and implementation of public health policies. Along those same lines is the proposal by Temores-Alcántara et al. (2015), who explored the state of mental health and expectations for care among Central American transit migrants in the context of the border city of Tapachula, Chiapas. These authors found that the migrants had signs and symptoms of mental health impairment related to experiences in their place of origin and their transit through Mexico. The authors concluded that it is necessary to strengthen the response of the mental health care system using cooperative strategies and emphasized the need to take actions in mental health that move beyond a biomedical construct.
All the studies mentioned above concur in the finding that there is specific psychosocial vulnerability in the migrant population. Even if not all migrant subjects suffer from mental health imbalances, a significant percentage of them do. However, these studies focus on the third stage of the migration process, which implies a downplaying of the understanding of mind-building experiences, experiences that would illuminate the need to migrate, the associated fantasies, the expectations placed on the act of migration and their relation to reality.
Through its genetic hypothesis, the psychoanalytic perspective considers the current suffering and personalities of subjects through the exploration of their distant past. Moreover, authors such as Grinberg and Grinberg (1982) consider migration a potentially traumatic experience that creates a crisis situation marked by previous unconscious dynamics during and after migration. Along those same lines are proposals such as those by Nathan, Moro and Venturini.
Taking a critical stance, Venturini (2006) highlights the reactions of rejection and closure of borders to migration movements in receiving societies, which results in assigning the status of problem to migrants viewed as products of misery from other regions of the world. This conception is not necessarily reasonable. Venturini also notes that, although the fields of psychiatry and psychology have been interested in analyzing the psychic repercussions of migration, they don’t escape to this misconception. This author questions the lines of thought that stigmatize some of the psychic manifestations of migrants labeling them as traumas or illnesses; her argumentation is based particularly on the idea that human beings are shaped by an identity given to them by the culture in which they were raised. In her conclusions, and from a Lacanian psychoanalytic perspective, she argues that defining migration as a traumatic experience limits the ability to listen to the unique ways in which the emergence of the subject can occur, restricting knowledge of their own interpretations of experience and the way they shape their identity. Thinking that way, she notes, reduces the complexity of an internal dynamic in migrant subjects that is full of significance.
As mentioned above, the biographical and narrative perspectives in migration studies have also maintained an important presence. The biographical method makes it possible to study and collect personal life documents, stories, accounts and narratives that describe moments of change at an individual level. Among such phenomenon, migration has proven particularly.
The application and consideration of this method in migration studies is highlighted below:
All these biographical and narrative works follow common paradigmatic principles of listening as the researcher’s primary mindset and of the perspective of a self-contained vital world, which assumes that life stories or narratives are constructed by the subjects themselves. Equally, the author engages in controlled empathy, understood as the act of understanding a person and becoming familiar with his or her context of meanings and particular way of interpreting reality. Finally, these works share the projection of time, stimulating the episodic reconstruction of the past and the projection of future desires. In conclusion, these investigations understand that what is related does not necessarily correspond to reality; for them, faithfulness is not essential, and they focus instead on the ways in which subjects reconstruct and reinterpret the symbolic meanings of their specific experiences. All this has a broad convergence with the psychoanalytic perspective. Next, the corresponding epistemological intersections with the discipline of sociology will be examined.
The methodological traditions of sociology
In terms of their origins, the methodological traditions in sociology reflect a specific context: Europe in the late nineteenth and early twentieth centuries. In France, the work of Emilio Durkheim is particularly noteworthy, as is the work of Max Weber in Germany. Although the two authors represent different theoretical and methodological lines of thought, they provide the foundations from which the traditions adopted by the communities of social scientists have developed (Tarrés, 2013). In the present day, sociology is a discipline that uses diverse approaches and theories, which makes it complex and moves it beyond a monolithic knowledge. However, as in the case of the psychoanalytic discipline, the decision was made to examine the field beginning with its classical foundations, which still remain valid.
In France, Durkheim argued that social phenomena are things and should be treated as such in sociological studies. He uses thing to refer to everything that exists and can be observed. To treat phenomena as things is thus to treat them as data, which is the starting point of science (Durkheim, 1895). The task of sociology, he proposes, is therefore the study of social facts, which he conceives as “ways of acting, thinking and feeling, external to the individual, endowed with a power of coercion, through which they are imposed” (Tarrés, 2013). In his opinion, the sociologist’s first task is to define the things being addressed. Phenomena should be addressed not based on an ideal notion, but in terms of their function and properties inherent to them, i.e., external elements that integrate their nature. Durkheim argued that the sociologist’s attitude should be similar to that of natural scientists, who are required to distance themselves from sensitive data that may be too personal and instead retain only those that are sufficiently objective (Durkheim, 1895). Coincidentally, this ideal, which separates the researcher and exempts him or her from any effect on the investigation, also proved to be the ideal applied in the earliest Freudian psychoanalytic studies.
Freud (1910) discovered that the psychoanalyst’s work is affected by a phenomenon similar to that experienced by the patient. He believed that elements of the psychoanalyst’s own psychic functioning were also reactivated, creating impulses and feelings towards the patient that were extraneous to the task of understanding and interpreting the infantile resistances and complexes of those seeking their help. Freud called this phenomenon countertransference, and authors such as Racker (1986) note that in the early days of the psychoanalytic technique, this phenomenon was considered disruptive and a serious danger to the analyst’s work that should be avoided in pursuit of an ideal of objectivity. Undoubtedly, this is similar to the ideal of objectivity presented in Durkheim’s sociological studies.
Subsequently, Freud himself and later authors, such as Racker (1986) and Heimann (1950), redefined the phenomenon of countertransference as a crucial instrument for understanding patients and for the psychoanalyst’s role as an interpreter. Freud himself eventually argued that the only way to avoid disrupting the unconscious processes in the analysis was to ensure that the psychoanalyst recognized his or her own complexes; this recognition is achieved through a self-analysis process called didactic analysis. This self-analysis acknowledges that countertransference is an unavoidable reaction that affects the psychoanalyst’s way of being and behavior and that paradoxically can be made available to improve the patient’s understanding; through countertransference in an objective situation such as the analytical encounter, a person might gain a better understanding than they previously had of their reality or fantasies.
Durkheim considered comparative investigation the most appropriate method as it permits comparisons of the same social fact in similar or different societies and eras; thus, comparison could have a role equivalent to that of experimentation in the natural sciences (Tarrés, 2013). However, despite this seemingly rigid methodological position, Durkheim was a researcher who used qualitative information in his investigations, as can be observed in his study on suicide (Durkheim, 1897). It is therefore obvious that his method and theory accept both quantitative and qualitative examinations of the reality being investigated. In his words, “the sociologist can turn to history, to observations from anthropological texts or to statistics to construct his or her object” (in Tarrés, 2013, p. 47).
The second important tradition in sociology is oriented towards understanding the meanings of actions and social relationships. This paradigm criticizes the positive assumption that social facts are solely objective. For Weber (1922), the purpose of sociology is to attain an understanding of the subjective meanings of actions, which are linked to rational reasons that can be empirically identified, making it possible to explain the causes of an action. Along these lines, Weber proposes the conception of laws under very specific conditions different from those proposed by the natural sciences. He refers to the identification of typical probabilities, confirmed through observation, that are comprehendible through their common motives, through the meanings reported by the subjects of an action and through the intellectual efforts of those studying it. These probabilities thus become clear and comprehensible in a rational sense according to their purposes. It is thus possible to identify a critique of naturalistic prejudices in Weber, as-until his proposals were published-everything that was called scientific was expected be an exact simile of the natural sciences, a direct extrapolation. However, in sociology, this had led to a kind of automation, with the consequent misunderstanding of the meaning of the theoretical formations studied (Weber, 1958).
Sociology therefore constructs concept types and attempts to find general rules for reality. This, Weber argues, is achievable through the application of rational concepts and rules. However, he (Weber, 1922) continues, sociology also seeks to apprehend irrational phenomena using theoretical concepts appropriate for their meaning. This is useful for sociology insofar as by indicating the degree to which these concepts and rules approximate the phenomena, they are ordered conceptually. Therefore, in the domain of his sociological proposal, only “averages” and “average types” can be constructed, and-since they are plural- they converge on a single reason.
The task of sociology is thus more limited but also more complex than that of psychoanalysis. It should be oriented towards establishing generalizations capable of defining tendencies regarding the nature, course and consequences of social behavior. This is possible because social behavior tends to present regularities and to follow repeated patterns. However, it is not sufficient to express a tendency in quantitative or statistical terms; it must be based on a comprehensive interpretation of the behavior for its meaning to be understood.
Linked to this, it should be added that for Weber (1922), all interpretation seeks evidence, but no interpretation of meaning, however obvious it may be, can claim to be a valid causal interpretation just because it is obvious. These types of realities promote rather obvious causal hypotheses, which often hide motives that are not clear even to the social actors themselves. Such realities contain a real connection, a storyline to their action, such that the subjective testimony itself-however sincere and conscientious-only has relative value. In this case, the task of sociology is to examine and interpret those connections, even if they have not surfaced in the consciousness. This process is an attempt to understand contrary impulses, although deduction is not completely reliable. It will therefore be the subject’s results, his or her actions or the very reality of the phenomenon that illustrates how wise or wrong the presumed understanding of them was.
When the work of both authors was integrated for the purposes of this article, several aspects were brought to the fore. First, beyond the sharp dichotomy between explanation and understanding, methodological debates cannot be separated from the theoretical traditions and their epistemological foundations. It is essential to match the object of study with the theoretical foundation on which the approach is based; understanding the epistemological foundation of this or that line of thought therefore makes it possible to understand the scope of the study and what it will demand from the researcher, regardless of whether it is an observation and detailed analysis of the phenomenon through explanation or an empathic approach undertaken through the exercise of understanding and the search for meanings. Second, although the research ideal requires one epistemological position, neither author embraced this purism; they incorporated both foundations in their research due to the complexity of social study. Mixed methodologies are therefore considered important when carrying out social studies.
Authors such as Creswell (2009) argue that mixed methods are characterized by the use of both qualitative and quantitative methodologies in a single line of investigation; mixed methods can also be associated with specific areas of knowledge, such as research in social sciences and health sciences, and are useful for addressing the complexity of those phenomena. They also allow a deeper analysis than is permitted with isolated studies. Subsequent sections will provide an overview of this approach in psychoanalytic studies, which have also experienced the epistemological dilemmas of quantitative and qualitative traditions but with important points of intersection that cause them to converge with studies in the social sciences.
The foundations of psychoanalytic theory: A discussion of its epistemological origins
Although it may be surprising to some, the first stage of the construction of psychoanalytic theory favored an epistemic monism and an adherence to physicalist postulates, according to which only chemical and physical forces act on the organism. Accordingly, for a number of years, the metapsychology founded by psychoanalysis and sustained largely by positivism configured the epistemic identity of psychoanalysis (Herrera, 2013).
During this stage, the line of approach was the topic, i.e., the hypothetical conception of a psychic anatomy that moved from medicine to neurology. However, this empirical proposal was based on the specific reasoning that there was a psychic anatomy, as well as psychopathologies, such as hysteria, that behave as if that anatomy did not exist. This reasoning alluded to the existence of unconscious processes and mechanisms with their own specific workings. These workings were complex and, in some cases, contradictory to what was already known; they challenged discoveries that had been made in the nineteenth century through experimental psychology and neurology. The nascent discipline confronted a problem of epistemological delineation as the recorded data contradicted pathological and anatomical expectations. It is important to remember that Sigmund Freud was trained in a tradition in which physiology was considered a continuation of physics; energy was the substance that united the two previously dissimilar fields of neurology and psychology (Herrera, 2013).
The then-nascent psychoanalytic proposal would require efforts that defined it based on its specificity and differentiated it from the dominant knowledge of that time. There is also an important epistemological distinction in psychoanalytic thought that distinguishes it from other approaches associated with the mental health field. It is common knowledge, for example, that what is most important in neurological and medical studies is looking. Psychoanalysis instead privileges listening as the primary access route to the unconscious and, therefore, to the workings of the psychic apparatus (Herrera, 2013). This is a key element that distinguishes psychoanalytic study, but it also causes it to converge with social studies based on biographical and narrative methods, which privilege listening to and analyzing speech to understand migrant persons. This convergence is evident when considering approaches such as those of Weber, which seek the meanings of an interaction and use listening to analyze and make conclusions. This example illustrates the important convergence with the psychoanalytic methodology.
Therefore, sociological methods that place a crucial importance on listening, searching for meaning and considering the reality of the subjects to be valuable converge. Reference is made to studies that attempt to humanize the experience (contrary to the hard statistical data) of subjects such as migrants, which represent a viable intersection or exchange with psychoanalytic studies.
The results of the psychoanalytic effort is clear: a symptom designates more than mere dysfunction. While every symptom is revealed by a failure in the normal functioning, the symptom itself is only the access door, rather than the endpoint, as it is linked to the emergence of a truth. The elimination of the symptom is therefore not the primary aim of psychoanalytic understanding and intervention; instead, the aim is to interpret the symptom, which is equivalent to deciphering the truth it contains. The symptom is thus conceived as an alteration that can be understood within the broad spectrum of subjective defense strategies (repression, denial, rationalization, dissociation, etc.). The anomaly is therefore not pathological in and of itself, although it is called a pathology by health experts. In psychoanalysis, the symptom is understood as an expression of other possible norms of life. According to the transition of the field’s epistemological delineation, psychoanalysis has been distinguished as a discipline different from how it was initially conceived and separate from even the so-called psychologies of consciousness (Herrera, 2013).
In short, there is no denying that the beginning of psychoanalysis was positivist. However, there has also been a gradual transition from the pursuit of measurements in favor of listening, which was determined to improve quality and comprehension as it is mediated by consciousness and is therefore uncertain. When consciousness is used as a measurement, what is measured is the intensity at which a psychic fact reaches the consciousness; only that is measured as there is still a lack of knowledge about the quality of the fact itself, and information about that quality will be sought using the psychoanalytic methodology. In short, psychoanalytic studies have an epistemological line of thought that cannot be pinned down strictly to the positivist realm or strictly to the humanistic realm, as both are applied. Regarding the necessary evidence in scientific communities, Shedler (2010) notes that few psychoanalysts focus on research, and thus, despite the accumulation of empirical evidence in psychoanalytic studies, such evidence does not typically support practice. Shedler considers important to integrate empirical evidence to psychoanalytic research even though statistics have been hardly used by psychoanalysts, i.e., studies with an empirical foundation or those that apply some quantitative approaches to human phenomena. This reflection converges with the methodological soundness sought from sociology and raises the additional possibility of dialogue between the two disciplines; this is specifically true for migration studies, which, as described at the beginning of the manuscript, have a long quantitative or objective tradition through which psychoanalytic studies could approach an understanding of the phenomenon.
Perrés (1988), based on a deep historical examination of theoretical developments in psychoanalysis, questions the assumption that psychoanalysis is both positivist and humanist given that when it is studied, there is a desire to integrate all the elements that construct it and honor its object of study, i.e., that it is crucial to integrate the unconscious element when speaking about psychoanalytic epistemology.
Herrera (2013) reveals the startling fact that a careful examination of Freud’s complete work will show that the word epistemology does not appear even once, with the exception of a letter to Carl Jung in which he writes, “I have a glimmer of an idea for a study on the ‘epistemological problem of the ucs.,’ and I shall take a few books away with me for it” (Letter to Jung from July 1, 1907, in Herrera, 2013, p. 176). For Perrés (1988), this fact is crucial and not always considered by psychoanalytic theorists. The absence of deep epistemological reflections in psychoanalysis reveals an evasion that should be examined.
It is important to point out that there is a lack of agreement on the epistemological foundations of psychoanalysis, which has led Althusserian humanist philosophers and those who claim the need for a unique epistemological approach to use a positivist foundation in their studies. Authors such as Otto Fenichel, Franz Alexander, Karl Meninger, Santiago Ramírez and Miguel Kolteniuk have lead positivist efforts in psychoanalysis, without overlooking the psychologists of the self (Perrés, 1988).
The school founded by the philosopher Louis Althusser sparked important interest in the epistemological problems of different scientific disciplines, including psychoanalysis. To Althusser, psychoanalysis clearly has an object of study-the unconscious and its effects-and offers a theory and a technique (method) for understanding it. This led him to recognize Freud’s discovery and propose sound theoretical concepts-i.e., the unconscious and its laws-in a rigorous way. For Althusser, Freud’s proposal has the structure of a science, that is, it contains a) a practice (the analytical cure), b) a technique (the method of the cure), and c) a theory related to the practice and the technique. He notes that this assemblage-organic-practical, technical and theoretical-evokes the structure of any scientific discipline (Althusser, 1965).
Perrés (1988) makes the articulation of the foundations of psychoanalytic knowledge more complex, arguing that they cannot be reduced to theoretical production but rather comprise a complex interaction among theoretical production, clinical production and the dimension of analysis (i.e., the analysts themselves). Building on Mannoni’s reflections, Perrés considers that the scientific status of psychoanalysis is not linked only to theorization (the Althusserian line of thought) or empirical-clinical discoveries with patients (the positivist line of thought) but also to the interaction of those aspects with the internal movement related to the dynamic of transference. Before delving into that dynamic, it is important to reiterate that in psychoanalysis (as in the sociology of Durkheim and Weber), the dichotomy between explaining and understanding is not a radical one; since Freud, natural explanation and hermeneutical understanding have followed one another, and the epistemological reflection inherent to psychoanalysis does not belong solely to the theoretical discourse or clinical discourse but instead should be able to speak from both, continually demonstrating their interactions.
Returning to the topic of the analyst’s transference (technically called countertransference, as mentioned above), one possible example is that an analyst understands theory differently when he has only theoretical knowledge than when he experiences through analysis itself. Therefore, it is important to differentiate two discourses in psychoanalysis-theoretical and clinical-that are not directly homologous but rather keep their own records of functioning.
Returning to the topic of transference, Perrés (1988) will argue that in psychoanalysis, both the researcher and clinician should be wary of the theory’s protective capacity. For example, when a psychiatrist situates him- or herself as “healthy” compared to the patient, he or she does so to avoid the anguish of transference, taking refuge in their role and relying on the protection of the theory. If psychoanalysis is presented as a discipline with specific characteristics that make it different from other disciplines, its epistemology should integrate those characteristics instead of discarding them; otherwise, the discipline is tragically inconsistent.
The elements of integration are crucial to broadening the scope of psychoanalysis to allow complementarity with migration studies as the method used to understand the migrant subject implies that the researcher is a subject who is involved in the dynamic and is reacting to the discourse and presence of the migrant person; these elements could provide greater insights if they are integrated into study.
The idea of envisioning psychoanalysis as a hermeneutical theory would therefore result in further reductionism. This line of thought is undoubtedly present and is extremely valuable, but it is not the only one, as the dimension of understanding (hermeneutics) is paired with explanation in psychoanalysis. Another aspect of the specificity of psychoanalysis thus lies in the union of the two key basic fields of scientific history: understanding and explaining.
It is essential to return to Devereux (1967), who, as a social researcher with psychoanalytic training, identified the dynamic of transference in research processes, linking it to concepts such as anxiety and identifying its role in the creation of knowledge. From this perspective, the researcher is not free from countertransference-which is the sum total of the distortions in their perception of the study object-and the researcher’s reaction to countertransference causes him or her to respond as if it were an early image and to act in the situation according to his or her generally unconscious needs, desires and fantasies.
For Devereux, the question about which path to follow to achieve clarity and redirect anguish in the investigation leads to the following response: it is necessary to treat the scientist’s reactions to his or her material and work as the most fundamental data in that science; otherwise, there will only be the illusion of simplicity. Authenticity will be evident when there is an understanding that people who participate in the development of knowledge must perfectly aware of their own humanity, particularly when they apply it fully to their scientific work, and must understand that any investigation is always-deeply-an investigation of the researcher him- or herself and brings the researcher’s unconscious motivations to the surface (Devereux, 1967). Linked to this, and not as a minor issue, is the crucial need to address the topic of the researcher’s narcissism, which offers a potential explanation for blind spots in studies that, among other things, could be related to the ability to tolerate the narcissistic wound, which, for the scholar, for example, could be the collapse of their working hypothesis or theoretical developments or a lack of agreement from scientific communities.
Authors such as Kachele and Thoma (2003), despite directing their efforts towards psychoanalytic research at the clinical level, argue that it is essential to refine what has been understood as the epistemological specificity of psychoanalysis and, as a guiding axis, its connection with migration studies. Those authors claim that hermeneutics offers support for the psychoanalytic clinic based on thorough examinations.
For them, hermeneutic activity, understood as an exercise of understanding in investigations, provides a viable connection with comprehensive psychology in terms of to the demand for empathy or putting oneself in the place of the other. This demand makes the psychoanalytic psychotherapeutic process possible. Introspection and empathy are essential characteristics of the technical rules of psychoanalysis. To Kohut, Freud made introspection and empathy usable as scientific instruments for systematic observation and discovery (Kachele & Thoma, 2003). The guide for this is related to the psychoanalyst accessing current behaviors in a patient that are incomprehensible but that become meaningful when their development is pursued, making room for historical-genetic understanding, an understanding of the psychological and/or pathological phenomena most closely related to the patient’s biography (a key element in research on migrant populations based on the biographical method).
According to Ricoeur, there is a problem related to illusion when interpreting consciousness. For him, interpretations can be misleading, which leads him to carefully examine the phenomenology that considers studying and understanding the totality. For this author, the problem of consciousness is as opaque as the problem of the unconscious. Solving these problems would require a double confession: “‘I cannot understand the unconscious from what I know about consciousness, or even preconsciousness,’ and ‘I no longer even understand what consciousness is’” (Ricoeur, 1969, p. 95).
The understanding of the unconscious, as well as consciousness, is therefore neither complete nor direct. Ricoeur (1969) argues, based on Freud, that drives are only expressed through representations. He refers to empirical realism when he states that the unconscious is knowable through its “representative representations” of drives, which are part of the order of significance and therefore converge with the scope of speech.
According to Ricoeur (1969), psychoanalysis focuses, strictly speaking, on studying derivatives of the unconscious rather than the unconscious itself; therefore, it is valid to argue that the unconscious has a real existence, like that of a physical object, while at the same time it only exists (or can be apprehended) in terms of its “derivatives,” which cause it to appear in the field of consciousness. Through this argument, Ricoeur confronts us with a new epistemology, a new line of knowledge that can be discovered through a specific hermeneutics related to the very rules of the analysis. It is in this analysis or setting that the intersubjective dynamic emerges and analyses of the unconscious are meaningful for the other (the analyst) and can be deciphered. Along these lines, some have spoken of a second consciousness in the therapeutic relationship. However, the unconscious is essentially produced by the other (the analyst) as an object of a hermeneutics that the consciousness itself cannot perform alone. The consciousness that is witness to the unconscious maintains not only a therapeutic relationship but also a diagnostic one. Ricoeur discussed the therapeutic relationship of decipherment in psychoanalysis:
The unconscious has generally been defined within the limits of its relationship to the consciousness in which it is “contained.” The role of the other consciousness is considered to be accidental rather than essential and is reduced to a relationship of therapy. But it is essential to the unconscious to be an object elaborate by someone other through a hermeneutics which its own consciousness cannot perform alone (Ricoeur, 1969, p. 101).
He adds:
We can say, therefore, that the unconscious is an object in the sense that it is “constituted” by the totality of hermeneutic procedures by which it is deciphered. Its being is not absolute but only relative to hermeneutics as method and dialogue. This is why we should not see in the unconscious some fanciful reality with the extraordinary ability of thinking in place of consciousness (Ricoeur, 1969, p. 101).
Kachele and Thoma (2003) argue that it is through the assumption of the unconscious that the philological and historical rules of interpretation take on a deeper dimension, making it possible to call the interpretive technique used in psychoanalysis a “deep hermeneutics,” as suggested by Habermas and Lorenzer. The experience of knowledge in the psychoanalytic clinic therefore emerges from the first encounter between researcher and subject in a technical system that allows the emergence of a specialized language based on a theory and technique, which is used to seek casual connections that make it possible to understand behaviors that would otherwise be unintelligible.
Kachele and Thoma (2003) argue that it is crucial to consider intuition as a source of interpretations. However, this scientific examination does not end there as it is completely valid to be skeptical of an intuition that is believed to work without making retroactive reassurances based on objective data and without constantly being subject to verification. This converges with Weber’s position, in the sense that systematized evidence is used as a support. For those authors, the psychoanalytic cannot be reduced to an emphatically epistemological line of thought, an explanation or an understanding; it is, instead, an interaction.
It could be argued that Freud revealed the phenomena discovered and interpreted in psychotherapy sessions through a controllable description and placed them in a causal and historical-genetic relationship; of course, he interpreted this placement, but he did not limit himself solely to that and instead formulated explanatory theories that proved to be correct to different degrees (Kachele & Thoma, 2003).
As a final reflection, we return to the position of Allport, who characterizes scientific work as an attempt to “understand, predict and control” a specific phenomenon. We return here because the role of understanding in the creation of knowledge is frequently devalued and is aligned with philosophical and reflexive speculation, overlooking the facts that the hermeneutic principle is a precondition for any other step of scientific activity and that the work of understanding in academic practice is based on and systematized using a method (Kachele & Thoma, 2003). The complexity of psychoanalytic studies lies in the intersection of the lines of thought regarding explanation and understanding at the level of the study object. However, the task does not end there; it also considers the researcher and psychoanalyst as subjects who experience unconscious psychic reactions that are related to the methods used to interpret and explain various phenomena.
A proposed route for complementarity between the two disciplines
Throughout the article, important points of contact between psychoanalytic studies and migration studies based in sociology have been identified. These contact points indicate the problematization of and need for studies that emphasize the subjective experiences of migrant subjects and humanize the migration process. Within this exploration, convergent epistemological foundations were identified. Below is a brief discussion of the proposed route of study, which considers the potential complementarity between the two disciplines, namely, a joining of two disciplinary discourses that respects the autonomy of both paradigms and theoretical discourses and structures them in an epistemic convergence. Thus, the following proposal is presented:
Finally, a few specific elements are proposed that should be considered when considering the complementarity between the two disciplines:
Final reflections
The integration of subjective dynamics into migration studies based in sociology is considered important and necessary, as is the humanization of subjects in investigations and the pursuit of understanding on an empathetic level. In epistemological terms and at the investigation level, it is essential to define the types of knowledge and information that are being examined; clarity regarding the explanatory and/or comprehensive aims of the studies will determine the route to be followed. However, in both sociology and psychoanalysis, the dichotomous differentiation between subjective and objective information has not been radical, as both disciplines have integrated them into their knowledge.
In sociology, it is important to emphasize the foundations of Emilio Durkheim and Max Weber, who, despite respectively relying on what are currently called quantitative and qualitative paradigms, did not rule out elements of a contrary nature in their investigations, thus implying that the complexity of social phenomena requires both types of data and explorations. Psychoanalysis has been experiencing a similar situation in terms of the consolidation of its study object, which has progressed from the quantitative to the predominant integration of qualitative elements. It therefore follows that psychoanalysis does not include either of these two paradigms exclusively, as both are emphasized in the theory.
The link between migration studies based in sociology and psychoanalytic studies thus becomes feasible insofar as both disciplines seek to identify behavioral elements and identifiable patterns as subjective elements that can be interpreted and have particular meanings. Moreover, it is possible to achieve a greater understanding of mental functioning when sociocultural conditions are assumed to have an impact on the construction of the mind. In turn, the primacy of listening and the attempt to humanize the people participating in the investigations are convergent elements in both disciplines that in turn, integrate the researcher into the dynamics of the process as another subject in the research scenario, a phenomenon that has a long history in psychoanalytic studies.
Finally, a proposal for a methodological approach to complementarity was presented, emphasizing elements applicable to migration studies. Specifically, this proposal included integrating sociocultural and psychological elements into explorations, avoiding a clinical-medical approach and integrating the reasons underlying the encounter between the researcher and the study subject. The theory that will guide such study was also defined, and although it moves away from psychoanalysis, a number of internal theoretical developments in psychoanalysis are part of its theoretical foundations.
Such an approach would make it possible to avoid superficial approaches based on cursory theoretical readings or based exclusively on experience in practice. The proposed approach would make it possible to define the theoretical development to be used, examining its convergence with the ultimate aims of research on migrants. It is also important to analyze the variables related to the reasons behind a subject’s participation in a study and to consider the researcher as a subject with his or her own reasons for undertaking the study. Finally, an examination of the gratification variable, i.e., reflecting on what study subjects gain by offering and sharing information about their mental functioning and revealing traumatic or painful experiences as part of a study that seeks to collect information rather than to provide a treatment, is considered a viable topic for analysis.
The proposal presented here can be a starting point for deeper examinations of the complementarity of both disciplines as well as a reference for migration studies that can delve into the subjective dynamics of individuals based on psychoanalytic theory.
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Ángel Luna Mexican.
Doctor in Migration Studies from El Colegio de la Frontera Norte. He is a master in psychoanalytic psychotherapy from the Unversidad Intercontinental and a degree in psychology from the Universidad Autónoma de Baja California. Research lines: complementation of psychoanalytic studies with migration studies from a sociological perspective, as well as the study of mental health at the migratory level.
Silvia Mejía-Arango
Colombian. Doctor in Psychology from the Universidad Nacional Autónoma de México. Research professor at El Colegio de la Frontera Norte. Research lines: mental health of older adults of Mexican origin living in Mexico and the United States, migratory flows and mental health on the northern border, and deported population in Tijuana, Mexico. Recent publication: Mejía-Arango, S., Saenz, R. & Singelmann, J. (2018). Cognitive decline among the elderly: A comparative analysis of Mexicans in Mexico and the United States. United States: Springer Press.
This work is licensed under a Creative Commons AtribuciĆ³n no comercial 4.0 Internacional.