Psychiatric Times
Home page teaser: Finding social truth in poetic metaphors.
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/unfolding-rethinking-development-a-reportfrom-the-global-south
Title: “Unfolding”: Rethinking Development, A Report from the Global South
August 15, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
Belo Horizonte, Minas Gerais, Brazil
My last two columns featured my two-part interview (Part 1, Part 2) with Dennis Palumbo, a Los
Angeles psychotherapist and writer. Now, I am in Belo Horizonte in the State of Minas Gerais, Brazil
for the Brazilian National Congress of Family Therapy. Many Brazilian artists have inspired me, none
more so than Adélia Prado whose poem, Com Licença Poética – “With Poetic Licence,” was her entry
into the highest reaches of Brazilian letters.1
I call it her “mission poem” in which she makes her wager as a poet in the concluding lines:
Vai ser coxo na vida, é maldição pra homem.
Mulher é desdobrável. Eu sou.
Being lame in life is a curse for a man.
A woman is flexible, unfolding, I am.
(my translation)
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The key word was her description of women as desdobrável, who in contrast to men are able to
unfold – to be flexible and to adapt. And she personifies it (after all it is a poem, not a treatise)
by adding: Eu sou. I am. Since my first reading of her poem, I have substituted desdobrável for
development and see children as learning, growing, and adapting – unfolding in Adélia Prado’s
metaphor.
When I met Adélia Prado here in the small provincial city of Divinópolis (“divine city”) in the
inland state of Minas Gerais (“general mines,” named for its rich resources of gems and gold), I
brought my well-worn volume of her collected poems marked with my favorites. Curious, she
asked me to indicate the poems I favored and why. She nodded as I answered, saying those
were her favorites too, which gave me the courage to ask her to recite two or three of them,
starting with “With Poetic Licence.”
It is poetic justice that this encounter leading me to revisit how we think about children took
place in Brazil, which the Global North struggles to understand, using political (Third Word) or
socio-economic (developing area or world; lower and middle income countries, LMICs)
categories. I see it as part of “the Global South.”2
As it happens, how we think about children’s growth or unfolding and how we think about how
societies evolve is connected – not in the seemingly simple facts that children grow towards
maturity or that societies grow their economies in productivity and complexity but through an
ideology that we must first understand, then challenge, and as I have argued strenuously, reject
for both children and for societies.3
Adélia Prado’s metaphors, her examples and life lessons are consistently and meaningfully
drawn from her experience as a woman. When an interviewer, Ellen Watson, asked her when
she knows a poem is complete, she replied:4
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Adélia Prado: When it gives me joy. When I look and think, Oh, what a beautiful child!
Ellen Watson: How much conscious control do you apply along the way?
Adélia Prado: It’s mostly about cutting and cutting. Like with a newborn, you remove the
placenta, you wipe away the cheese, and the child gets clean. It’s born dirty, and you
clean it up. Inspiration brings dirt with it. But if I need to fix a poem too much—that’s a
signal that it’s a bad one. … It’s an abortion.
Ellen Watson: The poet as midwife!
Adélia’s poetry seamlessly fuses her experiences as a woman, from childbirth to cleaning and
gutting fish together in their kitchen after her husband’s fishing trip, with mystical resonances
of her religious faith. Her poems are unabashedly feminine and devotional. With her
conservative and traditional views, Adélia rejects modernism. As Brazilian literary critic Miguel
Sanchez Neto observed, “Adélia Prado’s poetry is striking, not just for its embrace of provincial
life, but also for its desire to give positive symbolic expression to everything devalued by the
dictatorship of modernism.”4
Similarly, we need to rescue social, psychological, and psychiatric thought from the constraints
of positivistic social science.
Freud’s Developmental Triad
[W]e attribute the same emotional attitudes to … primitive men that we are able to
establish by analytic investigation in the primitives of the present day—… our children.
– Sigmund Freud5
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A critical reading of Freud’s work reveals what I have called Freud’s triad of developmental
pathology: neurotics-primitives-children.6
The organizing principle for this grouping is the notion of “development” and its opposite,
“regression” in Freud’s terms. In his book on Group Psychology, Freud argued that the
characteristics of the herd instinct, “show an unmistakable picture of a regression of mental
activity to an earlier stage such as we are not surprised to find among savages or children.”7
In this book and others, Freud justifies an “identification of the group mind with the mind of
primitive people” and extends this, arguing that “this is also the case in the unconscious mental
life of individuals, of children and of neurotics.”8 In Moses and Monotheism, Freud argues that
“we attribute the same emotional attitudes to … primitive men that we are able to establish by
analytic investigation in the primitives of the present day—… our children.”5 This analogy
created an approach to the relation between ethnology and psychiatry that continued, notably
in the work of the Dakar School of Senegal.8
However, this approach created several problems:
1) The equation of primitive cultures with pathology and with the immaturity of childhood.
2) It retarded research into understanding the nature of children’s growth until child
psychology and the field of developmental psychopathology came along.9
3) It reduces childhood to a “savage” state.
The notion of regression as the reversal of the developmental process appears to have been
borrowed by Freud during his early neurological work from the British neurologist Hughlings
Jackson, MD. Jackson used the term “dissolution” for this reversal, borrowed from Herbert
Spencer’s work on evolution. From the general process outlined by Spencer, Jackson created a
more specific biological meaning.10 Freud freed himself to some extent of his early biological
determinism to make development and regression broader psychological metaphors.
4
Nonetheless, Freud limited his developmental theorizing to early childhood, speculating as far
as puberty, but not on what we now call adolescence.6
We have largely retained Freud’s triad, replacing primitive or savage with the innocuoussounding term “developing.” In fact, we could add Freud’s analysis of women to make it a
tetrad.11 A key feminist study by US psychologist Carol Gilligan offered the metaphor of
“different voices” to explain how girls and boys negotiate the challenges of mental and social
growth as “connected persons” (a feminine voice) versus “separate persons” (a masculine
voice).12
Yet, metaphors are imprecise and always bear the traces of their origins. Development became
a metaphor for the human life span and for the socio-economic growth of nations around the
world. The notion of development served for the 20th century what the concept of evolution
served in the 19th. In my call for a transcultural child psychiatry, two key variables – children
and culture – are commonly seen on a continuum of “development.”6
What I am arguing here is that development is not a fact or a necessary perception of the
natural or the human world, but the social construction of a metaphor that is sometimes
instructive, often muddling.
Just as Lévi-Strauss’ anthropology debunked the myth of la pensée sauvage (the savage
mind),13 so too we must divest ourselves of l’enfant sauvage (the wild child)14 and other myths
of childhood. And just as anthropologists turned to other cultures for comparisons and to learn
about our own cultures, we turn to childhood for instruction about our adult selves – not
always to children’s benefit!
The limitations of Freud seeing children as “the primitives of the present day” are now painfully
obvious. The metaphor is reductive and potentially harmful in both directions:
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“primitives” (meaning indigenous cultures) are seen as childlike while children are seen as
“primitive” (implying immaturity and lacking mental, cultural and social sophistication).
One of the problems in seeing children as primitive versions of adults is that we have ignored
and discounted their experiences. I was born in the 1950s. In every decade of my life, child
psychiatry “discovered” some new disorder – anxiety, depression, bipolar illness, early-onset
anorexia nervosa, and suicide – in young people.
When I was a resident in child psychiatry, I sat through a clinical case discussion about an 8year-old boy who showed symptoms of depression. Not only were children rarely medicated for
depression at that time, but a child psychoanalyst who followed British child analyst Melanie
Klein was adamant that the child could not be depressed because he did not have the psychic
maturity to experience loss as sadness and enter “the depressive position.” So, no depression, I
asked? No depression, he affirmed. I guess the child did not know he was not allowed to be
depressed because he has all the symptoms, I retorted. The analyst never talked to me again.
More importantly, if a theory cannot account for our observations, we should change the
theory, not discount the facts.
Just as disturbing, physical and sexual abuse were met with incredulity by even experienced
child specialists and children’s cries for help were understood as primitive projections. We need
nothing less than a #MeToo movement for kids!
And just as traditional societies had their worldviews and folk psychologies, modern societies
produced a psychological worldview with assumptions with which they constructed the modern
myths of mind, self and society. In the beguilingly simple but brilliant formulation of British
social anthropologist Mary Douglas, these myths become “self-evident.”15 They are so common
that through repetition and elaboration, they become believed and shared by everyone.
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Development is one of those modernist myths and developmental thinking is a hallmark of 20th
century modernism across all the social sciences, from economics to child psychology and
sociology. Postmodernism, which is just a way to point to the crises of modernism, means that
we need to question what seems obvious and self-evident. For the psy disciplines, that means
starting with developmental thinking.
Don Hebb (1975), my professor of psychology at McGill, gave a warning that ironically invoked
developmental thinking:16
Our problem in psychology may be to find better preposterous ideas, and we can only
expect that the further development of psychological thought if it is successful will take
us farther and farther from what common sense would approve of.
Instead of saying the “development of psychological thought,” we can substitute words like
adaptation, adjustment, analysis, change, correction, growth, and synthesis. These words can
take us farther from the prison of common sense which we accept as self-evident.
Conclusion
To return to Freud. Inspired by the powerful poetry of Adélia Prado, I propose, as psychiatristpsychoanalyst Jacques Lacan, MD did in Paris a century ago, to return to Freud by rereading
him. But Lacan’s project is a century old already. We need a new reading of Freud and what he
represents for the 21st century in contemporary terms, beyond his developmental triad or
tetrad:
If we could cut Freud from his 19th century moorings of biological determinism, he might
talk to us in wonderful words like text/intertext, syntagm, metonymy, rhizome, idiolect,
syncretism, chance, disjunction, indeterminacy and immanence. What different worlds
do such words conjure up!17
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Resources
•
Adélia Prado. Wikipedia. Accessed August 3, 2024.
https://en.wikipedia.org/wiki/Ad%C3%A9lia_Prado
•
For an introduction to her poetry in English, read: Adélia Prado, The Alphabet in the Park:
Selected Poems of Adélia Prado. Wesleyan University Press; 1990.
•
Interview: Adélia Prado by Ellen Doré Watson. Bomb Magazine. Winter 2000 Issue.
Accessed August 15, 2024. https://bombmagazine.org/articles/2000/01/01/ad%C3%A9liaprado/
Dr Di Nicola is a child psychiatrist, family psychotherapist, and philosopher in Montreal, Quebec,
Canada, where he is professor of psychiatry & addiction medicine at the University of Montreal
and President of the World Association of Social Psychiatry (WASP). He has been recognized
with numerous national and international awards, honorary professorships, and fellowships,
and was recently elected a Fellow of the Canadian Academy of Health Sciences and given the
Distinguished Service Award of the American Psychiatric Association. Dr Di Nicola’s work
straddles psychiatry and psychotherapy on one side and philosophy and poetry on the other. Dr
Di Nicola’s writing includes: A Stranger in the Family: Culture, Families and Therapy (WW
Norton, 1997), Letters to a Young Therapist (Atropos Press, 2011, winner of a prize from the
Quebec Psychiatric Association), and Psychiatry in Crisis: At the Crossroads of Social Sciences,
the Humanities, and Neuroscience (with D. Stoyanov; Springer Nature, 2021); and, in the arts,
his “Slow Thought Manifesto” (Aeon Magazine, 2018) and Two Kinds of People: Poems from
Mile End (Delere Press, 2023, nominated for The Pushcart Prize).
Acknowledgements
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I wish to express my gratitude to Adélia Prado, whom I call “the divine of Divinópolis,” for my
encounter with her and her work and to offer my heartiest congratulations for winning the
2024 Camões Prize, the most prestigious literary award in the Portuguese language.
References
1. Prado A. The Alphabet in the Park: Selected Poems of Adélia Prado. Wesleyan University
Press; 1990.
2. Di Nicola V. The Global South: an emergent epistemology for social psychiatry. World Social
Psychiatry. 2020;2(1):20-26.
3. Di Nicola V. Development and its vicissitudes – a review of Pluriverse: A Post-Development
Dictionary, ed. by A Kothari, A Salleh, A Escobar, F Demaria, and A Acosta. Tulika
Books/Columbia University Press, 2019. Global Mental Health & Psychiatry Review.
2023;3(1):17-19.
4. Watson ED. Adélia Prado. BOMB Magazine. January 1, 2000. Accessed August 15, 2024.
https://bombmagazine.org/articles/2000/01/01/ad%C3%A9lia-prado/
5. Freud S. Moses and Monotheism: Three Essays. In: The Standard Edition of the Complete
Psychological Works of Sigmund Freud, Vol. 23. Hogarth Press.
6. Di Nicola V. De l’enfant sauvage à l’enfant fou: A prospectus for transcultural child
psychiatry. In: N Grizenko, L Sayegh & P Migneault, eds., Transcultural Issues in Child
Psychiatry. Éditions Douglas; 1992:7-53.
7. Freud S. Group Psychology and the Analysis of the Ego. In: The Standard Edition of the
Complete Psychological Works of Sigmund Freud, Vol. 18. Hogarth Press.
8. Di Nicola VF. Review of Cimino’s “La Scuola di Dakar.” Transcultural Psychiatic Research
Review. 1988;25(2):123-127.
9. Cicchetti D. The emergence of developmental psychopathology. Child Dev. 1984;55:1–7
10. Lynn L. Jackson and Freud: the relation of dissolution to regression. Bulletin of the New York
Academy of Medicine. 1960;36(5):277-284.
11. Cherry K. Freud's Perspective on Women. verywellmind. Accessed August 15, 2024.
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https://www.verywellmind.com/how-sigmund-freud-viewed-women-2795859
12. Gilligan C. In A Different Voice: Psychological Theory and Women's Development. Harvard
University Press; 1982.
13. Levi-Strauss C. The Savage Mind. University of Chicago Press; 1966.
14. Favazza AR. Feral and isolated children. British Journal of Medical Psychology. 1977;50:105111.
15. Douglas M. Self-evidence. In: Implicit Meanings: Essays in Anthropology. Routledge;
2002:276-318.
16. Hebb DO. Science and the world of imagination. Canadian Psychological Review.
1975;16(1):4-11.
17. Di Nicola VF. The uses of diversity. Response to Dr. Kapuscinska’s discussion of my
prospectus. In: N Grizenko, L Sayegh & P Migneault, eds., Transcultural Issues in Child
Psychiatry. Éditions Douglas; 1992:229-235.
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