Is there an ethnopsychiatric approach to desire

Whatever its designation - ethnopsychiatry, transcultural psychiatry, psych iatric anthropology or any other terms-, confrontation between ethnology an d psychiatry in clinical practice assumes that various notions relative to one or the other field must be questioned. Usually cultural features will b e described before subsequent specific theorization. This approach admits a t once specificity (sometimes irreducible) of certain cultural features tha t overdetermine theorization without, however, assurance of the relevance o f selected features evidenced by the description. To avoid these pitfalls, the author calls for a reverse approach which would first address, in the s pecific cultural field, the significance of various concepts issued from cl inical practice. In this regard, desire is an appealing introduction to the debate, as it is a basic psychoanalytic notion which, however, lacks in th e field of anthropology. As it must at least be hypothesized that desire is beyond the scope of universality to be able to question its potential disa dvantages in other cultures, relationships between desire and cultural vari ability were analyzed. If, at structural level and according to psychoanaly tic concepts, desire assumes radical exteriority with respect to culture, o bviously this exteriority soon becomes relative when it is contextualized w ithin the area of its manifestation, i.e., clinical practice. When battling against objects peculiar to his/her culture, the subject will inevitably e xpress his/her desire according to his/her culture proposals. This contradi ction suggests that cultural diversity is not without effect on the organiz ation of desire, but that the place where this effect occurs is still a mat ter of debate for both psychoanalysts and anthropologists. To further illus trate this issue, a brief case report shows how language and culture combin e, thus masking the subjective stakes of desire. (C) 1999 Elsevier, Paris.