Cultural Alienation Syndrome

English Translation (GOOGLE TR) della presentazione originale.

Adolescence Florence Conference October 9, 2010
An atypical psichic breakdown of adolescents in immigrant families: The Cultural Alienation Syndrome.
Authors: Benedetti Gianmaria °, Silvana.Russo. ° °, Daniele Losco.L. °
° Child psychiatrist, ° ° psychologist,
Children Adolescent Mental Health Service - ASL Florence

The expression of cultural alienation is used in the analysis of colonialism and post-colonialism, with the meaning of 'process of devaluation or abandonment of their culture or their own cultural back-ground' on the part of indigenous peoples subjected to colonization and forced into a rapid modification of their traditional values. It is implicated in the processes of decay of whole populations or individuals deprived of their traditional cultural and social values. Another expression often used 'Cultural cringe' is translated as 'cultural humiliation', and is used in the studies of social and cultural anthropology to denote a kind of inferiority complex that causes people of one nationality to devalue their own culture as inferior to the dominant one. We believe that we can find similarities in the cases of adolescents breakdowns, we treat below.
In this particular type of break-down of adolescent, which we call Cultural Alienation Syndrome for the reasons explained below, immigrant families are dramatically "divided" and thrown into turmoil by symptomatic acting out of his teenage son while the communications between the parties will be interrupted abruptely. This is a sudden and dramatic request of the boy or girl (more or less influenced by someone) placed at different medical or social agencies such as helpline or hospital emergency room, etc.., Not to go home, accusing parents of physical abuse . It 'worth noting that this situation is not recognized by the operators involved as a form of psychological decompensation, because disguised under the social, cultural, ideological issues. It is usually seen, even for existing environmental factors more or less ideological, only as a conflict between different cultures.
We feel that the 'cultural conflict' , in which the teenager appears to make an irreversible choice, is very similar to situations of marital conflict of separated parents where at one point, a son , or most often a daughter, takes a stand against a parent (the 'weaker', usually), accuses him of various abuses and refuses to continue to have relations with him, in an almost delirious. It's 'the well-known parental alienation syndrome that creates many problems and difficulties in situations of conflict separation which invest the courts.
By analogy we think we can speak here of a cultural alienation syndrome, in which the adolescent is 'disputed', not only externally but also within him, between two conflicting cultures, the family one and the environment one, in which he grew up. When the situation becomes intolerable, for some reason, then the boy or girl resolve psychopathologically the conflict with a choice of field that aliens / amputates an half of his personality and of his life, in ways almost too crazy here (and sometimes frankly delusional) and with consequences that can be tragic. The family in fact, like almost all actors and institutions involved, does not understand what is happening to her daughter and sometimes reacts so incongruously: between actions and reactions you can get the worst effects.
The purpose of this presentation is to draw attention and awareness that incidents of this type usually have a psychopathological meaning and need an immediate psychological / psychiatric, intervention, together or perhaps even earlier than a social one.
We report briefly, for reasons of privacy, two episodes of which we have dealt with recently, the first ending with the full return home after 18 months, the second with the overcoming of psychopathological aspects and the start of a more realistic confrontation and 'negotiations' betweem the adolescent and her parents.

Two clinical cases
First case

Family of Asian origin. The eldest was 13, in seventh grade, called the helpline and claims to be beaten by their parents and no longer wanted to stay home.
It was immediately picked up by police and taken to the mandate of the TDM in a reception center, where he would spend a month next to older children, illegal aliens, 'unaccompanied minors'. Viewed from a social worker, he is then moved, again under provision of the Juvenile Court, in a religious community that is home to some younger children with social problems. After stopping for a month of school to these facts, the last week and will attend the eighth grade in a different school, closer to the new residence. Will then be enrolled in a school chosen by the community.
In the meantime he have stopped all contact with the environment of origin, it is stated in various writings AS officers and judges, the boy "does not want to reconnect."
Comment: It does not recognize the situation of emergency psychological / psychiatric but only the 'social' psychological intervention will not begin until several months after the fact.
The project will allow the boy to come home permanently, but only a year and a half after the events mentioned. The recovery of the boy's contact with its environment after many months was difficult pareticolarmente .-
In retrospect it was found that at the time and previously had in place a major change in psychopathology. The failure was preceded by a prodromal phase of progressive intra-family conflict in a family with little parental restraint and communication tools, also for linguistic reasons (parents and children speak different languages, practice) and then exploded with the events' cultural 'described. The amount of suffering and hardship is the family of the boy who perhaps could have been lower if it had recognized the psychological situation of failure and emergency psychiatric / psychological intervention at the time of the first social.

Second case
Simultaneously with the dismissal of the first case, we were immediately addressed by another social worker who had the experience before, a second case appeared in the same vein.
This time it is a 17 year old girl, a North African family, who suddenly, at the suggestion of Italian friends, this was accompanied by a PS to hospital and reported beatings by his father and asked not to toprnare home. Immediately he was collecting his complaint, was visited with prognosis of 7 days for physical injuries but was not however be seen by a psychiatrist or psychologist on the disposal of the TDM was accompanied immediately by a shelter protected by the Social Services custody.
It 'worth noting that even in this case there is an induction at leisure by leaders in Italian culture, heavily involved. And will therefore only ten days after the events, unlike the first case. Better, but still not enough: the separation of the environment is already done and time will not, however brief.
From our assessment of psychiatric / psychological disorders do not emerge clear of thought, behavior or relationship back but signs of a mental developmental problems manifested by the growing rejection of the previous year and recent repeated absences from school and increasing conflicts with parents, as we see in many cases of non-adolescents. The talks are parallel progressive image of the recent emergence of the family and the girl a few years a growing crisis seems clear, however, not accompanied by sufficient awareness of the family. The dominant theme is the "can not talk with their parents' and his' shut themselves up 'behavior in progressively more problematic to the crisis.
You can still start work almost immediately on one side with the girl and the community and social service, the other with the family.
Contact between young people and families will resume after a few months with various difficulties, gradually overcoming the fear that had arisen in the girl and also in the family: this is indicated by the fact that after a short time after meeting uncasuale outside, also a sister will use the PS to repeated crises of anxiety (diagnosed Panic at PS), which will then be better understood in family meetings as a sign of the critical state of relations within the family to work to change a dysfunctional family set-up ..
Gradually seem to surface modes of the dysfunctional family that appear to put the teenage daughters (the third is still prepubertal) in front of insoluble conflicts, with no way out if not symptomatic.
The second child of phobic anxiety symptoms, along with its renunciation of the world most of his peers, seems to do a companion piece to 'escape' of the eldest daughter, as opposite ways of resolving the irresolvable conflict not only because of different cultures, but for the particular mode of operation where cultural traditions of the family were very strict functional family organization.
(We can in fact make the comparison with a family having the same period of the same nationality and culture and religion, but with a different organization and method of operation, family faced a major crisis in a different way of teenage daughters: in this case the parents had addressed themselves to the service for specialist help.)
Thanks to the work of the clash within the family, who had symptomatic aspects of denial and escape from his environment, takes the appearance of a confrontation and negotiations to change the family rules. Have been widely taken up relations with the family, also expanded, but the full back home is still conditioned by the 'negotiations' in progress. She has overcome the crisis, has taken over the frequency of school with excellent results and shows a great personal development in place and a great clarity, at this point in assessing the situation and think about possible opportunities. As sometimes happens with the crisis, appropriate content, is indicative of a developmental maturation that was previously locked.

Concluding remarks
The described events seem to read, as in other situations of adolescence breakdown, as moments of the collapse in family organizations based on rigid rules, no longer functional to age and developmental needs. Our work seems to have been mainly to restore the broken lines of communication and promote the development and communication as soon as he had become unmanageable.
Aspects of 'cultural' which provide the most striking manifestation of these situations, with an apparent 'choice' by the external culture of the adolescent and family rejection of traditional culture are just a manifestation of mental decompensation. The risk is real and not taking them to recognize the role symptomatic of form, they have.
The symptomatic act, which might otherwise content may fall faster, active in our view inadequate institutional responses that channel events at predetermined locations that secure and perhaps more complicated situations. Hence the complexity and length of intervention to break the heart in an evolutionary and avoid divisions and ghosts that can weigh on subsequent development.
It seems particularly appropriate to report the existence of these cases and the nature of psychopathology of individual and family psychological decompensation and the need for early intervention of psychological type.
The delineation of these events as a specific cultural alienation syndrome may be useful to recognize more easily and focus on needs and directions by changing the existing socio-medical emergency procedures to make room for urgent action in an individual psychological and family area health and social host does not immediately, as happens in other types of adolescent mental breakdowns.

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