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When Multispecies Ethnography Encounters a Shelter-Based Clinic: Uncovering Ecological Factors for Cultural Psychiatry

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Vincent Laliberté at McGill University
Vincent Laliberté
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Through a longstanding collaboration, psychiatrists and anthropologists have assessed the impact of sociocultural context on mental health and elaborated the concept of culture in psychiatry. However, recent developments in ecological anthropology may have untapped potential for cultural psychiatry. This paper aims to uncover how “ecologies” inform patients’ and clinicians’ experiences, as well as their intersubjective relationships. Drawing on my ethnography with Jerome, a carriage driver who became my patient in a shelter-based psychiatric clinic, and on anthropological work about how psychic life is shaped ecologically, I describe how more-than-human relationality and the affordances of various places—a clinic and a stable—influenced both Jerome’s well-being and my perceptions as a clinician. I also explore how these ecologies shaped our different roles, including my dual roles as psychiatrist and ethnographer. In the discussion, I define ecological factors, describe their implications for clinical practice, and suggest how they could be integrated into DSM’s cultural formulation.
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Vol.:(0123456789)
Culture, Medicine, and Psychiatry (2024) 48:875–899
https://doi.org/10.1007/s11013-024-09883-3
ORIGINAL ARTICLE
When Multispecies Ethnography Encounters
aShelter‑Based Clinic: Uncovering Ecological Factors
forCultural Psychiatry
VincentLaliberté1,2
Accepted: 13 September 2024 / Published online: 7 October 2024
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature
2024
Abstract
Through a longstanding collaboration, psychiatrists and anthropologists have
assessed the impact of sociocultural context on mental health and elaborated the
concept of culture in psychiatry. However, recent developments in ecological
anthropology may have untapped potential for cultural psychiatry. This paper aims
to uncover how “ecologies” inform patients’ and clinicians’ experiences, as well
as their intersubjective relationships. Drawing on my ethnography with Jerome, a
carriage driver who became my patient in a shelter-based psychiatric clinic, and on
anthropological work about how psychic life is shaped ecologically, I describe how
more-than-human relationality and the affordances of various places—a clinic and
a stable—influenced both Jerome’s well-being and my perceptions as a clinician.
I also explore how these ecologies shaped our different roles, including my dual
roles as psychiatrist and ethnographer. In the discussion, I define ecological factors,
describe their implications for clinical practice, and suggest how they could be inte-
grated into DSM’s cultural formulation.
Keywords Cultural psychiatry· More-than-human relationality· Shelter-based
care· Ethnography of clinical practice· Ecologies of psychic life
Introduction
In recent decades, psychiatrists and anthropologists have assessed the impact of
the sociocultural context on well-being and distress (Kirmayer, 2000; Kitanaka,
2011; Kleinman, 1980; Kleinman & Good, 1986; Holmes, 2014). They have also
* Vincent Laliberté
vincent.laliberte@mcgill.ca
1 Division ofSocial andTranscultural Psychiatry, McGill University, Montreal, Quebec, Canada
2 Lady Davis Institute forMedical Research, Montreal, Quebec, Canada
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Emplotment entails courts dictating facts of their past, past acts understood as manifestations of current mental disorders, and clinicians remaining vigilant against patients who relapse. Laliberté (2024) draws upon James Gibson's work to introduce ecological factors in clinical assessments. Gibson (1986) believed in "the mutuality of animal and environment," bemoaning that natural scientists "neglected that the words animal and environment make an inseparable pair" (p. ...
... 129). As a psychiatrist-anthropologist, Laliberté (2024) analyzes his interactions with a patient-informant in different configurations of the animal:affordance:environment relationship at a shelter clinic and a horse stable where both were carriage drivers. These environments produced different ways of being and interacting, underscoring that clinical settings restrict how patients and clinicians behave, and the interpretations that clinicians draw about patient distress. ...
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... This can, in turn, allow us to translate the "idealized" or decontextualized knowledge produced in the microworlds of laboratory experiments into the ecologically situated action of everyday human behavior. This can go beyond familiar contexts, where we rely on our tacit knowledge (which is often framed as "common sense") to allow us to engage with radically different cultural worlds, contexts, social positions, and predicaments (Laliberté, 2024). Through crosscultural comparison, ethnography alerts us to both our common humanity and the situated nature of experience that results in individual, cultural, and intersectional diversity. ...
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