A relation of complementarity between psychic universalism and cultural plurality: Human life, psychic unity, and cultural d
In the sphere of international relations, the end of colonialism brought into focus the need to achieve a lasting peace in the face of the plurality of different legal and political systems. This inevitably meant taking an intercivilizational
Deconstructing the concepts 49 approach to the problem of the relation among such systems, proceeding from the premise of a mutual understanding among the civilizations out of which those systems have sprung. Now, much the same point can be made about the sphere of domestic law, where the plurality of values and cultures we are now confronted with can be enabled to coexist only by singling out a foundation that everyone can share, making it possible to set in motion a process of integration and mutual recognition. But what might that foundation look like? This is a problem that Ronald Dworkin turned to in the early 2000s as he set out to answer the question, is democracy possible in a pluralist society? In answering that question, he identifies two principles of human dignity that democracy ought to take as its shared foundation, or common ground.
The first of these he calls the principle of intrinsic value: it “holds that each human life has a special kind of objective value. It has value as potentiality; once a human life has begun, it matters how it goes” (Dworkin 2006, 9). The second is a principle of personal responsibility: it “holds that each person has a special responsibility for realizing the success of his own life, a responsibility that includes exercising his judgment about what kind of life would be successful for him” (ibid., 10).
These two principles together act as necessary conditions for the dignity of each human being. The first one corresponds to the ideal of equality, the second to that of liberty (ibid.). And the first one can be said to be the condition for the second one. If we recognize the objective value inherent in every human life, regardless of ideological or cultural interpretations of it, we will not introduce the kinds of discriminations that derive from denying the associated rights, such as the right to citizenship.
The implications of such a denial are quite serious, for a denial of rights introduces a condition of inferiority that inevitably translates into a judgment of anthropological inferiority, which amounts to claiming that someone has no rights because they are not like us. Recognition of the objective value of each individual life instead acts as the condition enabling everyone to freely choose the kind of life they want to live, even if this life is culturally different from those of the people who make up the majority.
Recognition of the objective value of each individual life is what protects each person’s dignity, and it means that everyone is owed the same consideration and respect. The recognition of dignity so conceived means that equality is not merely a formal concept—the idea of equality as equal treatment under the law, which does nothing to address the disparity of conditions—but should rather be understood as substantive equality, meaning that all persons are to be treated as equals, with the same concern and respect for everyone, regardless of how different they may be from us.
Unlike the formal conception of equality, the substantive conception takes account of differences, such as we find in our understandings of health and sickness, and it requires that the delivery of care be mainly aimed at overcoming conditions of inequality. It is on this basis, then, that we need to tackle problems of inequality, such as we find them, for example, in health care.
On the basis of the substantive concept of equality just mentioned, this conception intends to specify the conditions that will make it possible to overcome all forms of racism, discrimination, and marginalization. But the Western organization of knowledge tends to apply and impose its own criteria. As Foucault has observed,
this organization has its own discourse, that is, a paradigm of its own that frames a specific conception of health and sickness, of normality and pathology.
This mindset—a vestige of the colonial era—has not been entirely overcome, such that certain conditions that by our own criteria count as disease are in fact understood to be entirely physiological in other cultures. Indeed, in the West, the physician looks at the patient’s body in strictly biological or medical terms, without in any way considering the patient’s cultural background (Quaranta and Ricca 2012). That is because this biomedical reductionism counts as irrelevant “the meaning that patients attach to their own experience of illness” (ibid., 25; my translation).
Illness conjures up a tight-knit web of words, conceptions of reality, and images of the body. This suggests the need to critically reflect on the concept of culture, a concept that, as has been compellingly argued in cultural and medical anthropology, is best understood not in essentialist terms but in processual ones: culture, in other words, is a process that unfolds within a web of relations. It is therefore within this same web that patients live their sickness, along with their loved ones and caregivers, and medical practitioners need to be mindful of that fact as they approach the patient.
This complex biological and cultural reality needs to be taken into account as we train doctors, psychologists, psychiatrists, social workers, and government administrators, in such a way that we can ultimately come to appreciate the normality of diversity. It is certainly a difficult road that needs to be travelled to get to that stage, but not an impossible road.
This desirable outcome brings out the paradox of multiculturalism, in that the relativistic approach it calls for—the equal legitimacy that ought to be bestowed on the different cultural outlooks and practices—is predicated on a universal principle, that is, on an appreciation for the equal value that ought to be recognized for the life of every human being. This same approach underpins a fundamental discipline, namely, ethnopsychoanalysis, which recognizes the complementary relation that exists between psychical universality and the plurality of cultural constructs.
Indeed, according to Georges Devereux, the father of complcmcntarist ethnopsychoanalysis, there is a complementary relation that holds between the individual and society: “The human psyche and culture are methodologically and functionally inseparable concepts.” (Devereux 1953, 630). At the foundation of this conception we find a couple of tenets: the first is “the psychic unity of mankind, which includes its capacity for extreme variability” (Devereux 
One of the leading exponents of this discipline, Marie Rose Moro, writes as follows in this connection: “In effect, from a theoretical point of view, there is a postulate without which ethnopsychoanalysis could not have been built, and that is the postulate of psychical universality, referring to the basic unity of the human psyche [Devereux 1980]. This postulate means that the same ethical status, as well as the same scientific status, needs to be accorded to all human beings, to their cultural and psychical constructs, and to their way of living and thinking, regardless of how different and divergent they may be. [...] The universal is the point of view towards which all knowledge tends in the human sciences without ever having the certainty that it has been attained” (Moro 2005, 128; italics mine).
1976, 83); the second is the influence exerted by different cultures, which can shape a great variety of behaviours.
In short, both psychoanalysis and ethnology are branches of anthropology, defined by Devereux (1953, 634) through the words of Kant as “the science of that which is distinctively human in man.” With these elements in place—meaning an understanding of psychical universality and a recognition of the value inherent in every human life, coupled with a willingness to embrace the plurality of its manifold cultural expressions—we have a basis on which to build a society capable of appreciating how important and rich coexistence in diversity can be.
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