La enajenación de l@s otr@s. Estudio sociológico sobre el tratamiento de la alteridad en la atención a la salud mental en Barcelona y Paris
This PhD thesis analyzes the discourses that conceive the otherness as a challenge to healthcare provision. It takes as contemporary scenes of social heterogeneity, France and Spain. To obtain an in-depth analytical approach, it confines its scope to Paris and Barcelona and, the fieldwork is centred on nine mental health services specifically addressed to non-UE immigrants and people in exile (sociological study of multiple cases). Accordingly, it seeks to embrace the variety of theoretical models and therapeutic practices regarding the alienated otherness, in both cities. The alienation of the others is the metaphor that synthesises the topic of this research: it evokes the study of affliction and mental health problems, as well as, it emphases the construction of the subject as a stranger, requiring special treatment. By applying a socio-constructionist and critical theoretical and methodological perspective, this research seeks to explain 'the social production of otherness' and understand the reasons why the relationships between heterogeneities are as they are. It tries to discern the logics of the processes of integration/exclusion, in which the monopolisation of the resources of knowledge/power plays a key role.
The argumentative line of this PhD thesis is founded upon the interrelation of three conceptual axes: "otherness", "health" and "biopolitics". It proposes a conception of otherness as relative and relational, produced by the social distinctions that arise from the dialectics between the world of similarity (the identical and its equivalences) and the world of difference (the different and its divergences). Consubstantial to all human groups, its content is however, historically variable and socially shaped. Otherness evokes differences as well as unequal power relationships. The categories of otherness taken into consideration here are related to the EU construction and the widening gap between Centre and Periphery, whose geopolitical and socioeconomic configuration takes root in Colonial History. The reason why this study locates the analysis of the otherness into the field of health responds to the fact that research on health are extremely persuasive at rendering social inequalities visible: 1) in front of diseases and death, human beings are unequal and 2) the dimensions that structure the social position and determine the 'universes of social opportunities (volume and structure of capitals) exert effects on the biological nature of the being. Health is the tropo (common place) of the interrelation of the physical-psychic being (biological dimension of the difference) and the social and political world (social and political dimension of inequalities). Biopolitics give a fruitful framework to base this research object.
To sum up, this PhD thesis gives an answer to the following questions: I. What explains the launch of healthcare services specifically addressed to non-EU populations within national health systems whose access and medical care are based on the principles of universalism and equality? II. Which are the consequences in terms of health inequalities that produce a differentialist (and, in some cases segregationist) approach to assess and manage non-EU populations health needs? III. Which is the configuration of the power relations between heterogeneities that is underlying the different models of interpretation and treatment of the alienated bodies mental health?
I have sought to conduct a sociological research that brings together "the critical" (to put into question the principles that structure knowledge), "the crisical" (to take conscience about its own limits) and "the creative" (social and politics implications of discourses). In doing so, I looked for going beyond a conventional sociology of health and illness, able to approach the object of study with a sociology of knowledge that is extremely conscious of the political and ethical dimension of the research process itself.
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Advisor:Solé Puig, Carlota; Fassin,Didier (EHESS-París)
School:Universitat Autónoma de Barcelona
Source Type:Master's Thesis
Keywords:434 departament de sociologia
Date of Publication:03/18/2006