Migrants in Translation
Caring and the Logics of Difference in Contemporary Italy
By Cristiana Giordano
UNIVERSITY OF CALIFORNIA PRESS
Copyright © 2014 The Regents of the University of California
All rights reserved.
ISBN: 978-0-520-27666-6
Contents
List of Illustrations,
Acknowledgments,
Introduction,
PART ONE. ENTERING THE SCENE: THE WALLS,
1. On the Tightrope of Culture,
2. Decolonizing Treatment in Psychiatry,
PART TWO. ENTERING THE SCENE: THE IMMIGRATION OFFICE,
3. Ambivalent Inclusion: Psychiatrists, Nuns, and Bureaucrats in Conversation,
PART THREE. ENTERING THE SCENE: THE POLICE STATION,
4. Denuncia: The Subject Verbalized,
PART FOUR. ENTERING THE SCENE: THE SHELTER,
5. Paradoxes of Redemption: Translating Selves and Experimenting with Conversion,
PART FIVE. REENTERING THE SCENE: THE CENTRO,
6. Tragic Translations: "I am afraid of falling. Speak well of me, speak well for me",
Epilogue: Other Scenes,
Notes,
Bibliography,
Index,
CHAPTER 1
On the Tightrope of Culture
The potential [of ethno-psychiatry] lies in the possibility of getting closer to the experience of the other, ... not with the aim to "understand" ... him, but to recognize his discourse ... as irreducible to dominant paradigms, something that clinical work with the local population rarely shows; the risk lies in potentially encouraging projective mechanisms of representation where the pain of the other appears as circumscribed and distant and the suffering of the migrant as exotic and culturalized.
—Simona Taliani and Francesco Vacchiano, Altri corpi
Mary was in her early thirties when social services referred her to the Centro Fanon. She wore an open expression on her face, often smiling and always willing to talk about her experiences and concerns, but she also looked sad. I met her on a late November afternoon at the Centro. She had migrated from Nigeria approximately three years before we met, and she was still undocumented. Over this period, she had gone back to Nigeria once. When she returned to Italy, she was pregnant and had just lost her husband in a car accident in Nigeria. She went to the hospital for a prenatal visit, where she was diagnosed as HIV-positive. Social services subsequently placed her in a locally funded program for pregnant HIV-positive foreigners. She lived with her sister in what social workers described as very precarious economic conditions, in a small, dark apartment where a lot of people of all ages, mostly Nigerians, cycled in and out. Her sister was probably involved in prostitution, but it was unclear whether Mary was as well. She gave birth to an HIV-positive son who became negative after several months of retroviral treatment. A year after giving birth, the social workers thought that she was "depressed"; she was crying a lot and felt guilty about her health and her son's future. They referred her to the ethno-psychiatric center, where the doctors knew, as one social worker put it, "how to deal with cultural difference."
A short time after the initial referral, Mary became one of Dr. L's patients. I sat in on her therapy sessions for several months, often conversed with the practitioners in charge of her case at the Centro, and spent some time with her outside the clinic, at the apartment she shared with her sister. Three people participated in Mary's sessions: Dr. L, a trainee, and me. In this case, no Nigerian mediator was available to assist in the consultation, but Mary spoke enough Italian and the doctor enough English for them to understand each other. In general, ethno-psychiatrists at the Centro would meet patients together with a cultural mediator who helped with issues of translation or cultural interpretation when necessary. Dr. L had a lot of experience working with Nigerian patients and had conducted several years of ethnographic research in West Africa on curing techniques, childhood, and witchcraft. Like other practitioners at the Centro, she held degrees in both psychology and anthropology and was committed to bridging the practices of both in her clinical work.
Over the course of several consultations, Mary spoke of her difficulties in Italy: she did not have a residence permit; she was afraid of getting caught by the police and sent back to Nigeria; she feared for her life and her son's future; and she was terrified at the idea that other Nigerians in Italy might find out about her HIV status, which felt like a death sentence to her. She was haunted by dreams about her dead husband and could not talk about him without ending in a desperate cry. The threat of death was a refrain in her stories. Although Dr. L explained to her that her illness did not mean imminent death and that retroviral treatments could make a great difference, her fears persisted. She once said, "If I take the medicines here, I will heal, but if the police send me back there, I will die." Because she referenced death in different ways, I wondered whether she was alluding to different kinds of death, not just corporeal. In this clinical context, patients often voice or express through symptoms the fear of social death (both in Italy and back home), the shame of returning home without proof of success, concern about family members' jealousy and envy, and the threat of revenge. Death also speaks to ruptured relationships, to symbols that no longer grant meaning to experience, and to the failure of her migratory process.
We spent a lot of time speaking about which social program could grant her a residency permit. Because she was the mother of a minor who was born HIV-positive in Italy, she could qualify for the "health reasons" that the state uses to recognize parents of offspring affected by life-threatening conditions. At first, the stories that emerged in our discussions were mostly about Mary's life in Italy and the pressing concerns she had about her health and legal status. As another ethno-psychiatrist pointed out to me:
It is easier to collect accounts of migrants' lives in Italy than to find out about their lives before they migrated; when you try to get to those stories, they are often impenetrable. In these cases, you gently try to reorient them to their cultural background by establishing connections with family members, practices, and rituals, so that slowly another story can be told.
People's premigration stories are impenetrable for various reasons. Many patients who are referred to the Center have experienced different forms of violence and abuse. Some have been persecuted and tortured in their countries, have experienced war, and have sought political asylum elsewhere. Stories about "home" often resist narration because they recall an inhospitable place, one that is impossible to reinhabit, both physically and symbolically. At other times, "home" is an opaque reality that has been overshadowed by the urge to assimilate, integrate, and become other in ways that live up to the receiving society's standards of behaviors and of desiring. Italian institutions that grant legal status to foreigners often require clear narrations of their migration trajectories and countries of origin. Such pressure often results in confused accounts that are symptomatic of an impossible encounter between bureaucratic language and the complexity of people's histories. For instance, how does one translate the desire to escape from poverty by accepting prostitution as a lucrative activity? Or understand the desire to use the body as a powerful tool that brings wealth outside of the...
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