Résumé
Face à la douleur physique, ou à des symptômes somatiques sans substratum lésionnel (somatisation), la dimension culturelle de la plainte est souvent évoquée, et l’anthropologie est alors convoquée pour éclairer le «sens» des symptômes. En les interprétant comme un langage de détresse reconnaissable (idiom of distress) ou comme la forme ethnique d’un désordre psychique (culture-bound syndrome), la perspective anthropologique tend à exagérer le codage culturel des symptômes, au détriment de leurs significations pathologiques, psychodynamiques, ou politiques. Ce faisant, les anthropologues prennent le risque d’ignorer les importantes variations intra-ethniques, de reproduire des stéréotypes culturels, voire d’ouvrir la porte à la stigmatisation de certains groupes.
Au-delà des stéréotypes (par exemple sur les différences d’expression de la douleur d’un groupe ethnique à l’autre), les sciences sociales devraient permettre de porter l’attention sur le contexte socio-médico-moral complexe au sein duquel la plainte somatique est exprimée. Un modèle où le symptôme somatique peut avoir simultanément plusieurs «sens» est présenté.
Summary
The cultural dimensions of physical pain and somatic complaints without organic cause (somatization) are often evoked, and anthropology is then called up to shed light on the «meaning» of symptoms. Interpreting them as an idiom of distress, or as a culture-bound syndrome, the anthropological perspective tends to exaggerate the cultural coding of symptoms, to the prejudice of their pathological, psychodynamic or political significance. Doing so, anthropologists take the risk of ignoring important intra-ethnic variations, reproducing cultural stereotypes, or even opening the door to the stigmatization of certain groups.
Beyond stereotypes (for example on the varieties of the expressions of pain among ethnic groups), social sciences should drive their attention to the complex socio-medico-moral context in which the somatic complaint is expressed. A model in which somatic symptoms can have simultaneously several «meanings» is presented.
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Ce travail a fait l’objet d’une communication au colloque «L’ethnopsychiatrie en questions», Lille, 28–30 janvier 1998. Nous avons maintenu dans certains passages la liberté de ton de l’exposé oral.
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Cathébras, P. Douleur, somatisation, et culture: Peut-on aller au-delà des stéréotypes?. Doul. et Analg. 13, 159–162 (2000). https://doi.org/10.1007/BF03006597
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DOI: https://doi.org/10.1007/BF03006597