2002 

Speaking in the Borrowed Language: Mental Health as an Agent of Cultural Oppression

Presentation by  David Walker, Ph.D.

Academy Introduction 

by Linda J. Young, Ph.D.

I'd like to begin by welcoming all of you to our conference. My name is Dr. Linda Young. I am the Vice President of the Academy and the chair of the Programming committee. I expect this is going to be a rather extraordinary afternoon. I also expect that we who  choose to be here today come from different walks of life and have taken very different pathways to find ourselves here at a common meeting place. This afternoon, many of us will be introduced to a culture that might seem rather  different from our own. And we will be hearing about it from someone who has, in the language of the Yakama Indians "hollowed his bones" to allow that which is unfamiliar to enter into the skeletal system of his being-a hollowing  or space making, which allows him to resonate with the people with whom he works, and make a kind of music with them which  perhaps he has  never heard before, let alone been an instrument for in its expression.

To be perfectly frank, the Academy for the Study of the Psychoanalytic Arts, unlike Dr. Walker, has not devoted any of its time, its energies or its modest resources to addressing the plight of the native American Indian. What it HAS done, and hopefully will  be doing today is to work toward
creating and protecting a space where the kind of work Dr. Walker will describe doing with the Yakama Indians, can continue to exist. There are certain prerequisites needed for insuring such a space-pre-requisites for both the person who seeks services and the practitioner. For those who come for help these prerequisites would include, among other things,  the freedom and opportunity to share openly and yet confidentially, the world as they have come to know it-a world articulated by rich traditional customs and a heritage which not only refers back in time for centuries but a heritage that necessarily informs present day meanings and assumptions about life. This would include too, the  freedom to have the communicative meanings of their behaviors deciphered from the perspective of their culture  as opposed to the imposing of meanings arising out of the  priorities and standards of the  dominant culture, expressed through the practitioner as its representative and enforcer. 

An analogous freedom for the therapist is also necessary-a freedom to listen and to be involved with those with whom he or she works without being forced legally, professionally or ethically by the dominant culture's agenda into listening and treating in particular prescribed and rote ways. And in today's industrialized health care society, this agenda of the dominant culture is   bio-medically based and one which speaks the language of pathology, illness, disorder and  disease.  It is a mental health culture, which speaks the language of the white man dressed up in the familiar white coat, trading in the currency of colorful pills and psychobaubble.

The Academy believes that it is indeed possible to work psychoanalytically with people of a very different culture. But more to the point, perhaps, is the Academy's belief that if one is really open to listening rather than to imposing and applying pre-determined assumptions onto others, that what is always encountered in the clinical setting is a different culture, for each individual arrives  with unique idiosyncratic ways of using language, and of comprehending  the world with  his or her own customary  and traditional ways of being a person within this world.

From this perspective, culture is inescapably with us. Any utterance, any behavioral gesture, any so-called symptom is  'enculturated' not  just insofar as the person exists in a particular culture that has overt and covert rules and assumptions about the definition, significance and meaning of all of these things, but also insofar as each individual is a meaning making being and everything he or she says, does and thinks exists within a unique constellation of organizing principles, determined by that person. And if the mental health worker  incorrectly and arrogantly assumes to know ahead of time what something means, and what his patients'  lives SHOULD look like, by applying his/her culture's meanings, values and expectations onto them, then applied psychoanalysis means just that--applying the psychoanalysis onto  patients, in an 'enlightened' modern day form of
oppression.

Dr. Walker will describe today work which the Yakama  Indian elders refer to as the "power of naming." From the Academy's perspective too, naming does indeed wield enormous power. In a dominant culture whose skeletal system is comprised of a bio-medical framework, what is breathed, and spoken is the lexicon of sickness, pathology and cure, and the "naming" of all who enter the system is by necessity a naming of diagnoses-a labeling of the individual with the" name" of a mental disorder of illness. In our health care industry culture today, federal, state and professional rules and regulations in the form of standards of care and guidelines of treatment are being developed to accompany these diagnostic names such that if an individual is given such a label at the outset, it is expected that  he or she will receive a prescribed manualized treatment for it. 

We will hear a lot today about one particularly popular  diagnostic "name" -A.D.D.-or Attention deficit disorder, tattooed reflexively upon the charts and beings of the majority of individuals who enter the Yakama mental health system. Along with such a naming comes directives for treatment  and cure. And the white medicine man delivers pills  to  those who are labeled with  the name
A.D.D. in an alleged effort to take away this  presumed  illness. Little or no attention is paid to the communicative meaning of the so called "symptom". Perhaps, an attention deficit has indeed existed, but in the form of a  deficit of attention paid to  individuals, especially  when it comes to listening to their stories from their perspective and taking the time to glean the meanings of their words and behaviors as contextualized by their matrices of meaning and fundamental assumptions about the world. A.D.D. viewed in this way,  may ADD up to the urgent need to create a space within a culture, within a clinical setting and equally important, within the minds of those who work together where some space can be hollowed out in the bones-in the bones of the culture, in the structure of the clinic and in the minds of individuals who call themselves therapists. If this can occur, there is room potentially for the other to enter- And a true intercultural exchange is actually possible.

I believe we are honored today to be able to  listen to and talk with someone who has had the courage to speak out for what he believes in an environment which has not wanted to listen. And just as important as his speaking out is his capacity to allow those with whom he works to speak 'in '--that is,-to speak sacred life stories in to another person's listening ears and mind and culture. Dr. Walker will be telling us today something about how this process has changed him as a person and as a therapist. I'd like to suggest that with every instance of this happening, regardless  of where in the world it takes place, the culture of psychotherapy also changes, from one of oppression into one of humanistic possibility.

Now to introduce Dr. Walker.