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17 - Failures of Imagination: The Refugee's Predicament

Published online by Cambridge University Press:  27 July 2009

Laurence J. Kirmayer
Affiliation:
James McGill Professor and Director Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University; Director Culture and Mental Health Research Unit, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec
Laurence J. Kirmayer
Affiliation:
McGill University, Montréal
Robert Lemelson
Affiliation:
University of California, Los Angeles
Mark Barad
Affiliation:
University of California, Los Angeles
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Summary

There is such a thing as absolute power over narrative. Those who secure this privilege for themselves can arrange stories about others pretty much where, and as, they like. Just as in corrupt, totalitarian regimes, those who exercise power over others can do anything.

(Achebe, 2000)

INTRODUCTION

Understanding stories of suffering and healing depends on a shared world of assumptions, ideas, values, and motivations. When stories deviate from our expectations for plausibility, intelligibility, order, and coherence, we have several options: We can expand our vision of the possible; we can interpret the narratives as defective, indicating cognitive dysfunction or some other form of psychopathology; or we can question the motives and credibility of the narrator.

The clinical encounter is a microcosm of the larger social world, and the interpretation of stories told in the clinical setting depends crucially on knowledge of that wider social sphere. When the social worlds of patient and clinician are substantially different or unshared, the stories they tell each other may be mutually unintelligible. In this chapter, I examine this problem of the intelligibility and credibility of clinical narratives in a special setting: the psychiatric assessment of asylum seekers in the context of a cultural consultation service (Kirmayer, Groleau, Guzder, Blake, & Jarvis, 2003). This example throws into relief some basic questions about the grounding of clinical narratives and the social consequences of “clinical epistemology.”

Type
Chapter
Information
Understanding Trauma
Integrating Biological, Clinical, and Cultural Perspectives
, pp. 363 - 381
Publisher: Cambridge University Press
Print publication year: 2007

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  • Failures of Imagination: The Refugee's Predicament
    • By Laurence J. Kirmayer, James McGill Professor and Director Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University; Director Culture and Mental Health Research Unit, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec
  • Edited by Laurence J. Kirmayer, McGill University, Montréal, Robert Lemelson, University of California, Los Angeles, Mark Barad, University of California, Los Angeles
  • Book: Understanding Trauma
  • Online publication: 27 July 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511500008.023
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  • Failures of Imagination: The Refugee's Predicament
    • By Laurence J. Kirmayer, James McGill Professor and Director Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University; Director Culture and Mental Health Research Unit, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec
  • Edited by Laurence J. Kirmayer, McGill University, Montréal, Robert Lemelson, University of California, Los Angeles, Mark Barad, University of California, Los Angeles
  • Book: Understanding Trauma
  • Online publication: 27 July 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511500008.023
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Failures of Imagination: The Refugee's Predicament
    • By Laurence J. Kirmayer, James McGill Professor and Director Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University; Director Culture and Mental Health Research Unit, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec
  • Edited by Laurence J. Kirmayer, McGill University, Montréal, Robert Lemelson, University of California, Los Angeles, Mark Barad, University of California, Los Angeles
  • Book: Understanding Trauma
  • Online publication: 27 July 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511500008.023
Available formats
×