''A Stranger in The Family: Culture, Families, and Therapy'' is a text written by Canadian cultural psychiatrist and family therapist

Vincenzo Di Nicola Vincenzo Di Nicola is an Italian-Canadian psychologist, psychiatrist and family therapist, and philosopher of mind. Di Nicola is a tenured Full Professor in the Dept. of Psychiatry & Addiction Medicine at the University of Montreal, where he fo ...

integrating

family therapy Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychology and clinical social work that works with families and couples in intimate relationsh ...

and

cultural psychiatry Cross-cultural psychiatry (also known as Ethnopsychiatry or transcultural psychiatry or cultural psychiatry) is a branch of psychiatry concerned with the cultural context of mental disorders and the challenges of addressing ethnic diversity in psyc ...

to create a model of cultural family therapy. Di Nicola's approach to working with families across cultures brought together a new synthesis of family therapy and transcultural psychiatry. Critical reviews were positive and encouraging by leaders in family therapy, such as

Mara Selvini Palazzoli Mara Selvini Palazzoli (1916–1999) was an Italian psychiatrist and founder in 1971, with Gianfranco Cecchin, Luigi Boscolo and Giuliana Prata, of the ''systemic'' and ''constructivist'' approach to family therapy which became known as the ''Mi ...

and Celia Jaes Falicov, as well as those in transcultural psychiatry, such as Armando Favazza. This preliminary work was collected and integrated into his model of cultural family therapy in ''A Stranger in the Family'' in 1997. In a recent interview with the

Université de Montréal The Université de Montréal (UdeM; ; translates to University of Montreal) is a French-language public research university in Montreal, Quebec, Canada. The university's main campus is located in the Côte-des-Neiges neighborhood of Côte-de ...

where he teaches, Di Nicola traces the origins and motivations for this work to his childhood origins as an Italian immigrant with empathy for the plight of immigrant children and families.

Outline of the book

Introduction

Cultural family therapy (CFT) is a synthesis of family therapy and transcultural psychiatry. CFT is an interweaving of "stories" (family predicaments expressed in narratives of family life) and "tools" (clinical methods for working with and making sense of these stories in cultural context). By interweaving stories and tools, CFT is aimed at understanding and change. Neither one alone suffices, as each of them produces only part of the solution. The book recounts over two dozen family "stories" varying from brief vignettes and cameo portraits to longer, more detailed multigenerational narratives. Nine "conceptual tools" for CFT are described. "Tools" refers to the actions and thoughts of therapists, part of their toolkit. Some are actions (like "spirals"), others are like lenses (such as "masks"). The book is divided into three parts, each with an overarching theme.

Part I: Meeting strangers

Chapter 1. The strange and the familiar: intercultural encounters among families, therapists, and consultants An overture, sounding the main themes: intercultural consulting is introduced, stories of families moving across cultures, issues of translation. "Spirals", the first conceptual tool of CFT is introduced, describing a way of meeting strangers through negotiation and collaboration, integrating the work of

's Milan systemic family therapy and Michael White's

narrative therapy Narrative therapy (or Narrative Practice) is a form of psychotherapy that seeks to help patients identify their values and the skills associated with them. It provides the patient with knowledge of their ability to live these values so they can ...

. Chapter 2: Cultural family therapy: a new synthesis Outlines a synthesis of family therapy with transcultural psychiatry, critiquing family therapy's use of culture. The need for multiple descriptions of predicaments; two basic therapeutic temperaments (technocratic and phenomenological); and problems with family therapy across cultures. "

Paradigm In science and philosophy, a paradigm () is a distinct set of concepts or thought patterns, including theories, research methods, postulates, and standards for what constitute legitimate contributions to a field. Etymology ''Paradigm'' comes f ...

" and "syntagm" are contrasted, the latter calling for a fresh approach, seeing each family as a unique culture. Chapter 3: The presenting culture: a context for family therapy An update of the synthesis, reframing the presenting issue in therapy as the "presenting culture" as opposed to the "presenting problem". The second conceptual tool of CFT is "masks" or cultural costume and camouflage, inspired by the work of family therapist

Edwin Friedman Edwin Howard Friedman (May 17, 1932 – October 31, 1996) was an ordained rabbi, family therapist, and leadership consultant. He was born in New York City and worked for more than 35 years in the Washington, D.C., area, where he founded the Bethe ...

. The third conceptual tool of CFT is about "roles" of insiders and outsider, describing how the therapist positions in relation to the family.

Part II: On the threshold: language, identity, and cultural change

Chapter 4: Beyond Babel: cultural and therapeutic translation This chapter examines language and translation in culture and therapy, inspired by the seminal work on translation by

George Steiner Francis George Steiner, FBA (April 23, 1929 – February 3, 2020) was a Franco-American literary critic, essayist, philosopher, novelist, and educator. He wrote extensively about the relationship between language, literature and society, and the ...

in ''

After Babel ''After Babel: Aspects of Language and Translation'' (1975; second edition 1992; third edition 1998) is a linguistics book by literary critic George Steiner, in which the author deals with the " Babel problem" of multiple languages. ''After Bab ...

''. Translation across cultures is reviewed in light of the work of British cultural anthropologist

Mary Douglas Dame Mary Douglas, (25 March 1921 – 16 May 2007) was a British anthropologist, known for her writings on human culture and symbolism, whose area of speciality was social anthropology. Douglas was considered a follower of Émile Durkhei ...

' essay, "Self-evidence" in ''

Implicit Meanings ''Implicit Meanings: Essays in Anthropology'' is a collection of essays written in the 1950s, 1960s and 1970s by the influential social anthropologist and cultural theorist Mary Douglas. Publication history The volume ''Implicit Meanings'' was f ...

''. "Codes" is the fourth conceptual tool of CFT. Cultural and therapeutic translation are illustrated with clinical vignettes. Chapter 5: Changelings: children and families in cultural transition Examines identity and cultural change. The "presenting culture" is the royal road for understanding "mind", "self", and "identity". Changelings—children and families undergoing cultural change—are explored through five stories of migrant children. "Cultural strategies" is the fifth conceptual tool of CFT, exploring adaptation and acculturation. Chapter 6: Threshold therapy: liminal people and transitional states Calls for the study of ''liminal people'' and ''transitional states'', inspired by the work of British cultural anthropologist

Victor Turner Victor Witter Turner (28 May 1920 – 18 December 1983) was a British cultural anthropologist best known for his work on symbols, rituals, and rites of passage. His work, along with that of Clifford Geertz and others, is often referred to as ...

. The relationship between culture and mental illness is reviewed and culture-change syndromes are defined and illustrated with clinical vignettes of children with selective mutism. CFT is described as ''threshold therapy'' with liminal people. Chapter 7: Stones and bridges: the myth of independence Examines "the myth of independence" as a theme in Western psychological theories and therapies. Two aspects are examined: (1) how independence is enshrined as a goal in Western family therapy, (2) how this differs in India and Japan. Chapter 8: Stones without bridges: four orphan cases Four "orphan cases" are presented. Cut off from a more complete relationship to her family and society, each of these women suffered in a unique way. This illustrates the implications of the myth of independence and identifies the sixth conceptual tool of CFT—"bridges"—or understanding the family life cycle in cultural context.

Part III: Families as storying cultures

Chapter 9: The garden of forking paths: exploring a family's alternities of being Explores the use of CFT's conceptual tools in family narratives. "Stories" is the seventh conceptual tool of CFT—a family's evolving narrative and therapy itself as "

the garden of forking paths "The Garden of Forking Paths" (original Spanish title: "El jardín de senderos que se bifurcan") is a 1941 short story by Argentine writer and poet Jorge Luis Borges. It is the title story in the collection ''El jardín de senderos que se bifurc ...

", a metaphor from a short story by

Jorge Luis Borges Jorge Francisco Isidoro Luis Borges Acevedo (; ; 24 August 1899 – 14 June 1986) was an Argentine short-story writer, essayist, poet and translator, as well as a key figure in Spanish-language and international literature. His best-known bo ...

, meaning a series of choices. This year-long story of the course of family's therapy demonstrates all the tools presented so far in the book—spirals of negotiation, cultural translation, and playing with roles, masks, cultural strategies, and bridges. Chapter 10: The web of meaning: metaphor and the transformation of experience Metaphor and its power to transform experience is the subject of this chapter. Metaphor opens the "web of meaning" of other lives. Working with a Portuguese immigrant family illustrates the potential for narrative transformation, the eighth conceptual tool of CFT—"multiple codes"—multiple messages encoded in ''metaphor'' (figurative language) and ''somatics'' (embodied meaning). Chapter 11: Strangers no more: a family therapist meets his father Concludes with the author's own family story, with several layers: his journey to meet his father in Brazil, how to stitch fragments and outtakes into a coherent whole, and reflections on the nature of therapy. If family predicaments are "stories gone awry", as

sees it, then "suturing"—the ninth and final conceptual tool offers CFT as "story repair".

Reception

''A Stranger in the Family'' was well-received as an important contribution to working with immigrant families. Following this positive reception of Di Nicola's work on cultural family therapy, a Brazilian edition in Portuguese translation, ''Um Estranho na Família: Cultura, Famílias e Terapia'' appeared in 1998. Di Nicola continued to elaborate his model of cultural family therapy in articles, chapters, a follow-up volume, ''Letters to a Young Therapist: Relational Practices for the Coming Community'', as well as invitations to present the 4th Annual Stokes Endowment Lecture in family studies at

The George Washington University , mottoeng = "God is Our Trust" , established = , type = Private federally chartered research university , academic_affiliations = , endowment = $2.8 billion (2022) , preside ...

and a thirty-year perspective on his model presented at

McGill University McGill University (french: link=no, Université McGill) is an English-language public research university located in Montreal, Quebec, Canada. Founded in 1821 by royal charter granted by King George IV,Frost, Stanley Brice. ''McGill Universit ...

where he first developed it and the Accademia di Psicoterapia della Famiglia in Rome, Italy where Di Nicola's model is taught.

References

{{DEFAULTSORT:Stranger in The Family 1997 non-fiction books Books about social psychology Child and adolescent psychiatry Clinical psychology English-language books Family therapy