Seleziona una pagina


My goal in this presentation is to identify guidelines which might help my colleagues involved in a multi-cultural therapy experience.
What I will say is part of my professional background, psychoanalysis and social studies, together with more than 20 years of private practice in Italy with international patients.

Last year, considering the emergency situation we have in Italy, where hundreds of people try to reach our Country in order to survive  war and terror, I decided to found an Association in order to create teams of experienced therapists able to give psychological relief  to these people, so needy and so lost, in many ways.

The person asking to become a Refugee is a human being who’s  trying to maintain the sense of his own identity but, in order to do that , has to enter a totally different social and human dimension. We need to give our patient, in this case, an immediate recognition.  When he enters our office and meets us,  he has to feel that we see in him the precious human values and traditions he had in his bag when he left his home.

We are ready, together with him, to rebuild parts of the recent past he wanted to hide, because they are too painful.

To do that we need to identify all possible codes to communicate empathy, respect, consideration for the individual in front of us. He belongs to a group – the Refugees – which is part of a socially recognised cathegory.  Giving him a role, we can help him to start feeling he belongs to the community, and he might have a lot to share.

In order to reach this goal, in the relationship with our patient, we have to start giving and sharing. After these first steps there will be room for the story of his life, emotions will start entering the session and  – since the barrier is broken – memories involving heavy traumas might appear. When the patient is trusting us, he will become more confident towards the new Country he is in, feeling better with the others etc. The ideal place where he can start a new life will become more real and much closer.

In our teams, before operating, we discussed a lot on the opportunity of having a translator present and interacting with the patient during the sessions. In my experience, the presence of this third person might create “setting” issues…. The kind of open welcome we are able to offer this special new guest entering our office is hardly possible to be kept  in such a different scenario.

As we know,  communicating means so many different aspects in the one-to-one meeting. First there is the eye contact, the body language, a few words in our client’s native idiom, then art, religion, shared traditions can play an important role. In my office hall I decided to show, in a few paintings, statues and objects, the symbols of many religions all over the world.

My international patients appreciated that since the very beginning of our way together…

In the group supervision with my colleagues we analise the many codes to use in order to give our patient a wide range of possible “doors to open” to live better with himself and with the others. As I was mentioning before, the approach has to be structured, passing through a variety of different methods. A few months ago I started the therapy with a young man coming from Africa discussing meanings and values in the contemporary African songs. This has been a great bridge, giving myself and the patient the opportunity to share opinions, to know each other much better through art, symbols, meanings etc..

Drawing is another great help when the spoken language is not a priority.

With my patients coming  from Asia this has always been a precious  way to express feelings, to describe memories, to share what’s impossible to express in words, like a war trauma or a violent separation. Figurative art can be used not just with kids or with very young patients; I have seen this code unifying families and giving new hope to depressed adults, especially after strong destructive events. When we are exposed to violence and shocks, our body sends messages of total discomfort, preserving more serious damages to the  mind-soul balance.

As we know, these physical symptoms are to be read, in order to help our patient  in a deeper and better way. Our body can protect us, but can easily become a prison, blocking us from sharing and even looking for help. Just because of that, many times it’s really useful to ask our patient to relax, slowly reducing the body barrier, getting rid of a lot of tensions. It’s very common, at this stage, that flashes from previous tough experiences or images involving home-sickness or loneliness might come out.

We can enter this  “imagérie” guiding the patient out of this labyrinth, from the dark past to a more positive future.

Opening the door to a deep human communication is the ground  on which our lost patient can start thinking of a possible life in front of him, overcoming the paralizing fears and the walls of prejudice. Usually, before starting the therapy, I go with a translator or a social worker to meet my future patient in the place where the Refugee lives,  where he studies Italian and he tries to rebuild his existence.

At this stage, not yet in my multi-cultural office entrance, I look for eye-contact and shake hands, offering my humble professional support, ready to start learning a brand new life lesson, trying to meet and to discover a new human being.

I hope this short presentation might lead to a wider debate on how to manage, being a psychotherapist, with people who are different, scared, confused and sometimes in full despair.

We are professionals of the mind, we should be able to read in bodies and souls, but just a few days ago a colleague of mine  – psychiatrist and psychoanalist – admitted being afraid of the incredible negativities coming from a patient who is a Refugee.

“After the Holocaust” my colleague said “I find the abnormal cruelty of this desperate migration totally unbearable.”

I personally think that’s an incredible challenge and this is the reason why  it’s part of our mission , professionally and individually, to face and overcome our personal difficulties. There’s an International Emergency; considering the many financial and political issues all over the world, the Migrants’ situation has become unpredictable. It’s even impossible to  draw a guideline for our European Countries, in order to follow a common policy.

We work on projects, we have volunteers and we get support, but the main difficulty is to reach a common project with shared  and accepted methods and goals.

What I’ll try to present in here is a proposal. My aim is to show a more precise approach to use with this kind of patient, shaping a possible common method, which is passing through different strategies, offering a wide range of intervention criteria.

This could help therapists to identify, when it’s specially urgent, how to face this peculiar kind of request. A common strategy, for professional psychologists all over Europe, might at least unify our efforts making us stronger and more coherent.

This is particularly important, since the Authorities seem unable to reach a mutual agreement in front of the Migration reality.

Giulia Remorino Ibry