THE CASE OF SAMAN

If you are a mental health professional, or if you work in socio-educational contexts with the migrant population you will surely have felt a lesser grip on some complex cases that needed support, but were elusive.

You may have encountered refusals to proposals for solutions without understanding the reasons, or you may have encountered abandonment of taking charge.

Is conventional medicine or psychotherapy universal?

THE CASE OF SAMAN

One day we are asked for an operation for a 6 year old boy from Sri Lanka, his name is Saman and he is suffering from a very serious developmental disorder . The team assigned to the case works with the family, made up of parents and a sister around 10 years old, without being able to make a decisive contribution to improving the living conditions of the minor who, in fact, does not have the 104 and therefore no assistance at school . Despite the numerous interventions proposed, it fails to make any of the possible progress. The social worker in charge of the case tells us that it is very difficult to talk to this family , also because of the language barrier and the lack of mediation in their service; states that parents "do not adhere" to the path designed for their child . Parents are very busy with work, a key dimension of their migration project.

Saman's sister attends a very expensive and rigorous English private school, which makes the care team nervous, given the family's always precarious economic conditions, against which no major expenses are incurred for Saman's therapies.

Our involvement is requested in order to facilitate communication with the family, through the inclusion of a cultural mediator. During the cognitive interview it becomes clear that the communication problem does not only concern the outside world but deeply affects the whole family nucleus. Saman doesn't speak, because she can't make sounds and consequently, no word is addressed to him; interactions with parents are mainly mediated by the sister who does not know Italian but addresses the child in English, because Sinhalese is not spoken at home. Therefore, there seems to be no “common language”. Even the interactions with the mediator, although well received, appear clear-cut and censored.

The woman, kind in her manners, remains rigid in her chair and in her gaze, doesn't seem willing to use too many words, is hasty and asks to leave half an hour after the start of the interview. She claims to know that Saman is sick but also that she will never recover , because that is her destiny and their job as parents is to accept and respect it.

The mediator will then explain to us that as Buddhists, they believe in reincarnation: Saman did something very serious in his previous life, so now this condition falls to him (and them). [...]

If you wish to acquire a theoretical overview of the ethno-psychological intervention solutions necessary for those who work in the field of mental health with foreign people, read the Intensive Course in Transcultural Psychology sheet.