Psychiatric Times Home page teaser: Embracing movement as theory Column: Second Thoughts Link: https://www.psychiatrictimes.com/view/migration-maps-of-meaning-maps-of-belonging Migration – Maps of Meaning, Maps of Belonging May 22, 2024 Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA The migrant has become the political figure of our time. – Thomas Nail, The Figure of the Migrant Migration. A hot topic in politics with implications for economics, education and housing, and not the least for global health and mental health. With passionate debates about the US southern border, the porous border between North Africa and southern Europe, claims about migration motivated the referendum that led to Britain leaving the European Union (“Brexit”), while European countries from Hungary to the Netherlands elected anti-immigrant leaders. And let’s not forget about massive internal migrations such as Brazil experienced in the 20th century and the flow of refugees from war, crime and famine all over the world, with Ukraine, the Middle East, and Haiti in the headlines, to name just three places. In this column, I want to move away from the polarizing and unproductive politics of migration to talk about human migration through three different lenses: (1) my work with refugees and migrants as a social and cultural psychiatrist; (2) how literature can illuminate the human stories behind migrations; and finally, (3) American philosopher Thomas Nail’s bold new theory of migration and mobility, offering a kinopolitics and kinopsychology along with a veritable “ontology of motion” with his masterwork, Being and Motion.

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Psychiatric Times
Home page teaser: Embracing movement as theory
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/migration-maps-of-meaning-maps-of-belonging
Migration – Maps of Meaning, Maps of Belonging
May 22, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
The migrant has become the political figure of our time.
– Thomas Nail, The Figure of the Migrant1
Migration. A hot topic in politics with implications for economics, education and housing, and
not the least for global health and mental health. With passionate debates about the US
southern border, the porous border between North Africa and southern Europe, claims about
migration motivated the referendum that led to Britain leaving the European Union (“Brexit”),
while European countries from Hungary to the Netherlands elected anti-immigrant leaders. And
let’s not forget about massive internal migrations such as Brazil experienced in the 20th
century
and the flow of refugees from war, crime and famine all over the world, with Ukraine, the
Middle East, and Haiti in the headlines, to name just three places.
In this column, I want to move away from the polarizing and unproductive politics of migration
to talk about human migration through three different lenses: (1) my work with refugees and
migrants as a social and cultural psychiatrist; (2) how literature can illuminate the human stories

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behind migrations; and finally, (3) American philosopher Thomas Nail’s bold new theory of
migration and mobility, offering a kinopolitics and kinopsychology along with a veritable
“ontology of motion” with his masterwork, Being and Motion.2
1. People in Motion – A New Perspective on Social and Cultural Psychiatry
My career has been marked by working at the crossroads of culture, children and families.3
As a
transcultural child psychiatrist, I examined cultural syndromes that appear mainly under certain
cultural conditions.4
A major contribution of Transcultural Psychiatry (TP) pioneered in the
1950s at McGill University where I trained was the classification of Culture-Bound Syndromes
(CBS), that occur mainly in specific cultures. Examples included susto (somatic anxiety among
Latinos), latah (an exaggerated startle reflex among Southeast Asians), amok (a dissociative
behavioral syndrome, from the Malay word meaning “rushing in a frenzy”), and koro (“shrinking
penis syndrome”).
The fact that these were described in non-Western societies led to the charge that TP was
exoticizing (“othering”) other cultures. In fact, TP did eventually turn its gaze on our own
Western cultures, studying culture in our own backyard, as American psychiatrist Armando
Favazza5
did with his pioneering work on self-mutilation and body modification in Missouri, the
heart of middle America, brilliantly rebranding TP with the broader term “cultural psychiatry,”
which is now the more widely accepted term.
A more recent critique of cultural psychiatry by American journalist Ethan Watters, Crazy Like
Us,6 claims the opposite – that American psychiatry is exporting American and Western notions
of mental illness and its treatment around the world through the Global Mental Health (GMH)
Movement. Both critiques deserve serious consideration. Of the two, Watters’ is the more
serious one which the GMH Movement has not adequately addressed.

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Culture-Bound, Culture-Change, and Culture-Reactive Syndromes
During my psychiatric training at McGill, I became fascinated by psychiatric syndromes that
appear under conditions of rapid cultural change, which I named Culture-Change Syndromes
(CCS).7
Examples in children and youth include eating disorders and selective mutism4
. Some
psychiatric syndromes among children and youth fall into both groups. Eating disorders are a
good example, being for at least a century associated with the upper classes of affluent Western
societies (CBS) but now “democratizing” by spreading everywhere and presenting at even
higher levels among migrant youth as CCS. My overarching term for both types of cultural
syndromes is Culture-Reactive Syndromes (CRS).7
This work led me to develop a therapy adapted to migration and to CCS, bringing together
cultural psychiatry with family therapy in my model of Cultural Family Therapy (CFT).8
CFT deals
with families across cultures, interweaving families stories with clinical tools for conducting
therapy, especially when their members manifest CRS.9
2. Two Kinds of Stories in Literature
There are two kinds of stories in literature and both concern movement. An immigrant myself,
several times over, my work has followed two great themes of literature, as American writer
John Gardner10
sets them out: someone goes on a journey and a stranger comes to town. This
describes the heart of my work with children and families across cultures: going on a journey
and arriving as strangers. My book was called A Stranger in the Family: Culture, Families, and
Therapy and concludes with my own story, “Strangers No More,” narrating my first encounter as
an adult with my Italian father in Brazil.8
While much of my career has been dedicated to working with migrants and refugees, whom I
characterize as “people on the threshold” – “going on a journey” in Gardner’s phrase – my work
today deals with the question of what to do when they get there – Gardner’s “strangers come to

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town” – and how to accompany their acculturation and adaptation to a new place. The journey
and arrival are overlapping parallel processes but not the same. And many of us do not entirely
leave our place of origin nor do we completely arrive anywhere else. Nobel laureate VS
Naipaul’s late novel, reflecting his own life as a Trinidadian immigrant to the UK, is called The
Enigma of Arrival.11
Freud has been quoted as saying, “Wherever I go I find that a poet has been there before me.”12
If we enlarge poetry to encompass all kinds of literature, we find that poetry and fiction have
been there well before cultural psychiatry and even anthropology, telling the stories of human
migration with maps of meaning and maps of belonging.
Maps of Meaning, Maps of Belonging
I dedicated my last column to Brooklyn’s premier novelist, Paul Auster (1947-2024) who recently
passed away. Born in New Jersey, Auster migrated to France where he is lionized for his
contributions as a translator of French literature into American English. Like Lucy Santé, he is an
American Francophile who made French culture and literature more accessible.13
After
returning to make his home in Brooklyn, Auster wrote his celebrated New York Trilogy,14
a
contemporary map of the city’s demimonde through a confessional, almost conspiratorial style
that sees the world as vaguely menacing, just shy of Thomas Pynchon’s outright paranoia.
So, as we help people navigate their journeys and arrivals in other places as therapists, what can
literature teach us about finding and knowing our place?
The Road Trip, Yesterday and Today
First of all, there is a huge world literature about the journey. The forefather of the modern road
novel is the ultimate road trip, The Odyssey by Homer, reimagined by American writer Zachary
Mason in his The Lost Books of the Odyssey.15
The contemporary road trip without equal is by

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far Jack Kerouac’s On the Road,16
famously typed on one long, continuous roll of paper. It is no
accident that Kerouac, who embodied the very American Beat movement, was a descendent of
the great migration of Francophones from Canada to the United States, growing up in a French-
speaking family in Lowell, Massachusetts.
Now James Joyce, the great modernist Irish writer in exile accomplished something absolutely
stunning with his novel Ulysses, published in 1922.17
Not only did he restage the voyages of the
Odyssey in one place – the Dublin of his youth – but set its inner, psychological journey in a
single day, embodied by the ultimate European emblem of the stranger, the Jew Leopold Bloom.
That day is now celebrated in Dublin as “Bloomsday” every June 16th. And by the way, the
novel’s daylong odyssey concludes with the most sympathetic voicing of a female character by a
man in Western literature, Molly Bloom affirming her femininity in the closing soliloquy with the
word, “Yes,” repeated no less than 22 times! This episode completes that one day, walking
around Dublin, the city of his birth which he left as a young man and only briefly revisited,
vowing nonetheless that if Dublin “one day suddenly disappeared from the Earth it could be
reconstructed out of my book.”
Literary Walks, Maps of Meaning
Other great writers have similarly left their stamp on their native cities. And whether we know
them in real life or not, they can take a hold on our imaginations beyond the pages of their
works. Charles Dickens’ London can be visited through the pages of his novels or on walks
revisiting their sites. I lived in London House in Bloomsbury around the corner from Dickens’
house on 48 Doughty Street for 2 years but it was his novels that made it come to life. Other
maps of London can be constructed through the work of the Bloomsbury group (Virginia Woolf
lived on the same square as London House), Arthur Conan Doyle’s Sherlock Holmes and the
Baker Street Irregulars, or the various detectives stories set in London by Agatha Christie.

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Before I ever set foot in it, I felt I knew Lisbon intimately through Portugal’s great modernist
poet, Fernando Pessoa, with its Arcade on the Praça do Comercio and the Café A Brasileira
where he met fellow poets, Bertrand’s, the bookstore on Rua Garrett in the Chiado, where he
bought his books, the Hospital St. Louis where he died, and the Prazeres Cemetery where he
was buried. After a first visit, I set a novella, “After Fernando”18
in Pessoa’s Lisbon where I had
measured the steps between his haunts. This led to an invitation to lead a symposium on his life
at the Casa Fernando Pessoa, examining his life and work from both psychological and literary
perspectives. My other visits there have added color and nuance but it remains Pessoa’s Lisbon
for me.19
Greek poet Constantine Cavafy’s poetry makes Alexandria in Egypt seem as familiar as the
neighborhood of my youth and his poem, “The God Abandons Antony”20
is seared into my
memory, leaving vicarious scars of exile, with its haunting closing line …
And say goodbye to her, to the Alexandria that you are losing.
We can repeat this with other places: Jorge Luis Borges’ Buenos Aires where passionate young
toughs still stage knife fights and an almost blind Borges is lost in the labyrinth of his own
library; we can encounter Luc (now Lucy) Santé’s “other Paris”13
– the Paris of the poor and the
political pamphleteers before they were coopted, the prostitutes before they became sex
workers, and yes, the poètes maudits before they were redeemed; we can visit Jerusalem like
the “tourists” of Israeli poet Yehuda Amichai’s21
celebrated poem of that name, invading and
destroying the city, desecrating its holy places: after reading it you will never feel comfortable as
a visitor to Jerusalem again and that’s the point.
And how about Milan Kundera’s scorned and feckless lovers prowling through Prague? As
beautiful as Prague’s historical center is, far more memorable are the political history of
“defenestrations” and Kundera turning the dial on Prague’s Orloj or Astronomical Clock in the
Old Town Square into a symbol of time as a circular pattern of life in his novel Immortality.22

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3. Kinopolitics and Kinopsychology: A Bold New Theory of Motion
American philosopher Thomas Nail has fashioned a refreshing new approach to some of the
most pressing problems of our times – the migrations of people around the globe. His message
in a nutshell is simple: rather than seeing migration as an exception, we should see it as the rule
in human history. More than that, Nail offers us a theory of movement, a veritable ontology of
motion with his Being and Motion.2
With kinopolitics, Nail offers the politics of movement, not based on resentment (on the right)
or rights (on the left), but rereading migration not as the exception to the rule of “political fixity
and citizenship” but the rule, interpreting “political power from the perspective of the
movement that defines the migrant in the first place.”1
This offers us a new perspective of social
division. Nail’s work turns our usual perspective upside down: “Instead of looking at borders as
the products of societies and states, it looks at states and societies as the products of the
mobile processes of bordering.”23
And kinopsychology explores the human motivations and experiences associated with
migration. Nail offers a philosophical framework to reread human history, no less; it is now up to
us to translate that framework into clinical and social work with migrants.
Two psychiatrists from Latin America, Léon and Rebeca Grinberg, anticipated Nail’s
kinopsychology with their brilliant work of applied psychoanalysis, Psychoanalytic Perspectives
on Migration and Exile.24
Their study of normal and pathological mourning explores the key
elements of migration and exile, with two complementary perspectives. In one, the unconscious
processes involved in leaving one world behind and adapting to a new one are at play. In
another, the collective processes triggered by migration among those we leave behind are at
work. Anyone who has revisited their native land and met again the intimate strangers they left
behind knows what this nostalgic encounter entails.

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Conclusion: Embracing Movement as Theory
I eschew binary choices and constraints (see my column on polarization). Torn between the
tirades and mutual recriminations of Trump and Biden on the border? Try reading Cristina
Garcia’s Dreaming in Cuban.25
Or Richard Rodriguez on his argumens with his Mexican father in
Days of Obligation.26
Tired of the limits and oppression of your place of origin? Overwhelmed by nostalgia and
idealizations of the old world? Read Cavafy on his lost Alexandria and Pessoa on his lamented
Lisbon. And Eva Hoffman in her celebrated memoir of a life in a new language, Lost in
Translation.27
Not sure that the place you are living is the same as your neighbors? Read
Jonathan Raban’s Soft City, the personal, malleable place so different than the hard city of
maps.28
Exploring the underside and alternative history of your metropolis? Read Lucy Santé’s
The Other Paris.13
Do you want to accompany migrants on their journey and their arrival as a therapist? Read my A
Stranger in the Family.8
And finally, do you want to make sense of migration beyond polarizing politics and the received
wisdom? Read Thomas Nail. This is not merely a different take on migration with a theory of
movement, but a way to reimagine human history and society. And closer to home, cultural
psychiatry is a field with 75 years of rich and varied but somewhat chaotic and contested
observations in search of a theory. Psychiatry itself is lacking such a comprehensive general
theory, as I have argued (see my interview in the resources). With his kinopolitics and
kinopsychology, Nail’s philosophy of motion offers a radically new and promising theoretical
framework for social and cultural psychiatry. If we are looking for a theory, this is it.

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Resources
• Chris Rawls, Thomas Nail. “Time Will Tell: An Interview with Thomas Nail.” Blog of the
American Philosophical Association. October 2, 2020.
https://blog.apaonline.org/2020/10/02/time-will-tell-an-interview-with-thomas-nail/
• Maryellen Stohlman-Vanderveen, Vincenzo Di Nicola, “The Crisis of Psychiatry Is a Crisis of
Being: An Interview with Vincenzo Di Nicola.” Blog of the American Philosophical
Association, October 8, 2021. https://blog.apaonline.org/2021/10/08/the-crisis-of-
psychiatry-is-a-crisis-of-being-an-interview-with-vincenzo-di-nicola/
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).

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References
1. Nail T. The Figure of the Migrant. Stanford University Press; 2015.
2. Nail T. Being and Motion. Oxford University Press; 2018.
3. Di Nicola V. Borders and belonging, culture and community: from adversity to diversity in
transcultural child and family psychiatry. J Am Acad Child Adolesc Psychiatry.
2018;57(10):S116.
4. Di Nicola V. De l’enfant sauvage à l’enfant fou: A prospectus for Transcultural Child
Psychiatry. In: Grizenko N, Sayegh L, Migneault P, eds. Transcultural Issues in Child
Psychiatry. Éditions Douglas; 1992:7-53.
5. Favazza AR. Bodies Under Siege: Self-Mutilation and Body Modification in Culture and
Psychiatry. 2nd
ed. Johns Hopkins University Press; 1996.
6. Watters E. Crazy Like Us: The Globalization of the American Psyche. Free Press; 2010.
7. Di Nicola V. Anorexia multiforme: Self-starvation in historical and cultural context. I:
Self-starvation as a historical chameleon. II: Anorexia nervosa as a culture-reactive
syndrome. Transcultural Psychiatric Research Review, 1990, 27(3): 165-196; 27(4): 245-286.
8. Di Nicola V. A Stranger in the Family: Culture, Families, and Therapy. W.W. Norton & Co.;
1997.
9. Di Nicola V, Song S. Family matters: The family as a resource for the mental, social, and
relational well-being of migrants, asylum seekers, and other displaced populations. In:
Gogineni RR, Pumariega AJ, Kallivayalil R, Kastrup M, Rothe EM, eds. The WASP Textbook on
Social Psychiatry: Historical, Developmental, Cultural, and Clinical Perspectives. Oxford
University Press, 2023:244-255. DOI: 10.1093/ med/ 9780197521359.003.0005
10. Gardner J. The Art of Fiction: Notes on Craft for Young Writers. Alfred A. Knopf; 1984.
11. Naipaul VS. The Enigma of Arrival. Knopf Doubleday; 1988.
12. This is an example of an apocryphal quote that sounds like Freud but it cannot be traced to
anything he actually wrote. See this authoritative source: Freud Museum London. 10 Quotes

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Wrongly Attributed to Sigmund Freud. Accessed May 20, 2024.
https://www.freud.org.uk/2019/04/30/10-quotes-wrongly-attributed-to-sigmund-freud/.
13. Santé L. The Other Paris. Farrar, Straus and Giroux; 2015.
14. Auster P. The New York Trilogy: City of Glass, Ghosts, The Locked Room. Penguin; 2006.
15. Mason Z. The Lost Books of the Odyssey. Farrar, Straus and Giroux; 2010.
16. Kerouac J. On the Road. Viking Press; 1957.
17. Joyce J. Ulysses. Shakespeare & Co.; 1922.
18. Di Nicola V. After Fernando. In: The Unsecured Present: 3-Day Novels & Pomes 4 Pilgrims.
Atropos Press; 2012:39-111.
19. Di Nicola V. Um Estranho em Casa, Uma Casa Estranha: Pessoa e Psiquiatria [A Stranger in
the House, A House So Strange: Pessoa & Psychiatry], Symposium with Commentaries by
Professor Nuno Miguel Proença and Dr. Nuno Borja Santos. Casa Fernando Pessoa, Lisbon,
Portugal, October 31, 2012.
20. Cavafy CP. The God Abandons Antony, in: The Collected Poems of C.P. Cavafy: A New
Translation. Barnstone L, trans. W.W. Norton & Co.; 2006:45.
21. Amichai Y. Tourists, in: The Poetry of Yehuda Amichai. Alter R, ed. Farrar, Straus & Giroux;
2015:299
22. Kundera M. Immortality: A Novel. Kussi P, trans. Grove Weidenfeld; 1991.
23. Wolters E, Nail T. The Figure of the Migrant: Interview with Thomas Nail. Critical Theory,
December 1, 2015. Accessed May 20, 2024. https://www.critical-theory.com/the-figure-of-
the-migrant-an-interview-with-thomas-nail/
24. Grinberg L, Grinberg R. Psychoanalytic Perspectives on Migration and Exile. Festinger N,
trans. Yale University Press; 1989.
25. Garcia C. Dreaming in Cuban. Alfred A. Knopf; 1992.
26. Rodriguez R. Days of Obligation: An Argument with My Mexican Father. Penguin; 1993.
27. Hoffman E. Lost in Translation: A Life in a New Language. Penguin; 1990.
28. Raban J. Soft City. Collins Harvill; 1988.