Beyond Gramsci and De Martino: Medical Anthropology in Contemporary Italy Author(s): Mariella Pandolfi Reviewed work(s): Source: Medical

Anthropology Quarterly, New Series, Vol. 6, No. 2 (Jun., 1992), pp. 162-165 Published by: Wiley on behalf of the American Anthropological Association Stable URL: http://www.jstor.org/stable/649312 . Accessed: 07/01/2013 07:22
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INTERNATIONAL NEWS AND COMMENT

MARIELLA PANDOLFI

Universityof Rome Rome, Italy

Beyond Gramsci and De Martino: Medical Anthropology in Contemporary Italy

ore than once people in the anthropologicalsciences have joined with people in the medical and psychiatricsciences to thinkand act together in the areaof healthand illness in Italy. These collaborativeefforts have always startedout with the best intentions,but in the course of events the defense of disciplinaryboundarieshas raised insurmountable ramparts.Possible encountersbecamemissed opportunities,even thoughthe closing of psychiatrichospitals in Italy in the 1970s under the provisions of Law 180 certainly heightened the awarenessof people in social and health work to social factors, questions of power, and the relationshipbetween social class and mental illness. Italyrejectedthe insane asylumand put social discomfortback into the community,andeven the least reformistpsychiatristshad to try new therapeutic paths for the ill andgreatercollaborationwithinthe context of the family. This step was certainlycentralto the developmentof otherkinds of sensitivity in the subsequent two decades. But this enhancedsensitivity to social aspects, the attentionto the political dimension which certainly had importanteffects on changes in Italian of society, was not translatedinto genuine interpenetration "psychiatric" political militancyand "anthropological"political militancy. The influenceof Marxistthinkingwas certainlyvery strong in the two disciplinaryareas, and I should say that the results were often very interesting,yet ideological conflict from the 1950s to the 1980s was often so bitterthatjoint effortswere paralyzed.The two disciplines pursuedparallelroutesbut were hostile to each otherand quite uncommunicative. There were other difficulties as well in eluding the mistrustand the strict viewpoints of disciplinaryareas:the paralyzingstruggles to establish anthropological bordersand tendencies to polarize and dichotomize regionalpeculiarities or to overvalueor legitimize an anthropologythat was only "exotic." the between medicine and illness andthe anthropologCertainly relationship ical stance were strongly influencedfor many decades by an ideological opposition thatranthroughall aspects of Italiananthropology.It is fair to say that until the 1970s the greatdivide between Marxistanthropologists,influencedby Gramsci's thought, and non-Marxistanthropologistsblocked anthropologicaldebate
Medical AnthropologyQuarterly6(2):162-165. Copyright ? 1992, American AnthropologicalAssociation. All rightsreserved.Not for furtherreproduction.

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and restrictedit to the confines of Italy alone. Whatdeveloped then was chiefly attentionto Italianfolk and regional medicine, be it from a viewpoint that was or morephilological and historiographic from one that was more political. Thus, of for example, magic and the interpretation magico-religiousrites used in treatthe ing illnesses were reconsideredin termsof problemsof subalternity, dynamics and of social classes, the intrinsicrelationship betweenthe historyof the subaltern the cultureof the subaltern-in otherwords, a highly Gramscianview of the Italian peasantworld. The most interestingandproductivescholarin this line was certainlyEresto De Martino.His researchin southernItaly had a deep influenceon anthropological studies from the 1950s on. De Martinowas a protagonistat the centerof the conflict mentioned,but he was occasionally a victim as well. The conflict within the Italian anthropologicalmovement did not foster an understandingof the wealth of ideas of this philosopher-ethnologist,whose voice is full of "ethnographic" militancywhen he speaks of southernItaly as worthyand deservingof an ethnology all its own. SouthernItaly became centralto much ethnological research,calling to mind the metaphorof the Indias de por aca with which the Jesuits launched 17th-centuryevangelization in Europe with the same fervor that they had shown in other lands, the "exotic" lands of the Indias de por alld. of The interpretation illness, the relationshipbetween traditionaltherapies and official medicine, "the magic world" throughwhich the Gramsciannotion of hegemony was articulated,found a precise response in the anthropological studies from the 1950s on. The idea of reading illness and its corresponding courses of therapyand the survival of magic ritual as privileged aspects of the historic dynamic between a hegemonic culture and a subalternculture were of fundamental importancein those years, and they still form the keystone and specific weight of Italianmedical anthropologytoday. of This backgroundsketch is essential to an understanding the climate of intellectualdebate in which medical anthropologyin Italy arose and developed, and it is also necessary for appreciatingthe role played by the ItalianSociety of Medical Anthropology(SIAM), founded in 1988. The hardest and most chaldialogue among scholars in the lenging task was that of resumingthe interrupted differentdisciplinesconcernedwith healthand illness as well as bringingtogether again the different spirits that in the past decades had clashed and rejected dialogue. The need for an internaldebate that could accept pluralityof themes and interpretiveviewpoints was central to the foundation of the society. And it launched the difficult dialogue between methodological and interpretativeapproachesthat were so differentand field experience built up in anythingbut uniform ideological contexts. This new policy of dialogue andjoint projects has evolved in step with the need for profoundchange in choices thathas emerged in this disciplinaryarea in the last five years, chiefly underthe impactof new immigrationon Italy's fragile social texture. Italy has been accustomedto dealing with the wounds of its own emigrationand had to make importantand courageouschoices after the Second WorldWarinvolving profoundsocial differencesand conflicts between an industrial northand an all-but-archaicand rural south, where the interpenetration of differentsystems of medicine and types of therapeutictreatmentmeant constant confrontation between traditionaland official medicine.

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MEDICAL ANTHROPOLOGYQUARTERLY

But in recentyears, Italiansociety has had to operateon a profoundlyaltered historicaland social horizon. Italy is on a new course now: at the symbolic level it involves the configurationof the other, the different from us, and it involves operativedecisions on institutionalpolicy. This entails national programs, but chiefly it involves projectsfor cooperationand assistance to Third World countries that are integratedwith EuropeanCommunityprojects. Under the impetus of these developments,Italianmedical anthropologyis particularly active in several aspects of these programs.Activities in the field of cooperationinclude: the Mali projectunderthe directionof Piero Coppo, with, among others, anthropolFiore;the Nicaraguaprojectdirectedby Rosogists RobertoLionettiand Barbara albaTerranova Cecchini;work in several LatinAmericancountriesby the Mario Negri Instituteof Milan coordinatedby BenedettoSarceno;the anthropologically and orientedtrainingand researchprogramrunby P. Warrenand A. Caprara the Institutefor Healthin Rome. Thereare, in addition,manyotherresearch Superior projectsfor cooperationthatare well along in the planningstage, such as the program in supportof refugee indigenous people in CentralAmerica with medical anthropological componentscoordinatedby AntoninoColajanni. Besides researchand action programsin non-Westerncountries, there are many other programsconcernedwith the Italiancontext and the massive immigrationof recent years. These include researchwork on immigrationin Latiom underthe directionof Luigi M. LombardiSatriani,researchon new forms of racism in Italydirectedby ClaraGallini, and the studyof particular religio-therapeutic figuresby VittorioLanternari.Involvementin the debate on bioethics is also becomingmore widespread(see, e.g., Vincenzo Padiglione). The need throughoutthe nation for health policies that take account of the manysocial andculturalfactorshas engagedthe effortsof a largeandactive group underthe directionof Tullio Seppilli at the Universityof Perugia. Thereis ongoing study and interestin folk medicine and the magical aspects of illness, with strategicand practicaldevelopmentat regional and other levels. Elsa Guggino's work in Sicily is particularly original and significantin this area. Thereis an extensive surveyof this sectorof study andresearchin Medicinesand Magics, edited by Tullio Seppilli (Milan: Electa, 1989). Several Ph.D. candidates, Donatella Cozzi and Gianni Pizza among others, are working in this tradition and giving it new life within a Europe-widedebateon folk medicine. New ways are being advanced for looking at subjectivity, narrativity,and the dynamic and dialogical approachbetween illness and emotion and between debate and somagic and reason, applying particularnodes of the international called critical medical anthropology,without foregoing the Italianphilosophical roots of the debate. Work includes MariellaPandolfi'sItinerari delle emozioni,
Corpo e identitt femminile nel Sannio Campano (Milan: Franco Angeli, 1991),

and recentlythe work of Paolo Apolito; Fabio Dei also is preparing dissertation a on these topics. The youngergenerationof psychiatristshas developed a stronganthropological sensitivity. They are working in particularly difficultcontexts with neotraditional featuresof societies of southernItaly, with aspects of immigration,especially in urbanareas, and with problemsarising from the closing of insane asylums withoutcorresponding reforms. Interestingwork has been done by Giorgio

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Villa, VirginiaDe Micco, Salvo Inglese, and RobertoBeneduce, among others. The SIAM programstartedfromthese differentspiritsandhas takenconcrete form in a host of very specific initiatives:a new review, the first issue to appear in autumn1992;a series of books on medicalanthropology; twice-yearlysemand inars to foster direct confrontationof different viewpoints within the society in for preparation the firstnationalcongress in 1993. In addition to these initiatives, there are parallel undertakingsoutside the society showing how extremely rich the terrainis in terms of ideas, researchin progress,and publicationsin very differentsectors. These includethe firstPh.D. programin medical anthropology, run jointly by the universities of Perugia, Siena, and Cagliari, and postgraduatecourses at the universities of Rome and Paduawith seminarsin medical anthropologyand ethnopsychiatry.Seminarsin medicalanthropology have been organizedin the past two yearsby the University of Palermo(Elsa Guggino, Antonio Buttitta)in collaborationwith the ParisEcole des HautesEtudes, and by the Universityof Rome (Luigi M. LombardiSatriani, MariellaPandolfi)jointly with the Paris Ecole des Hautes Etudes and the Ecole Francaisein Rome. Tullio Seppilli played a key role in the transitionfrom the old to new. He workedwith De Martinoin the 1950s and is now Directorof the Instituteof Ethnology at the Universityof PerugiaandPresidentof the ItalianSociety of Medical Anthropology.With a deeply democraticmanner, he has made possible a dialogue that would have seemed inconceivable only a few years ago. In his view, the anthropologist called upon to mediate the widest range of social demands. is Between the Gramscianroles of intellectualand culturalworker in the field, he has fostered medical anthropologyas ideological choice and political militancy, an experienceunique in Italy and hardto matchelsewhere in the world. to at Correspondence be addressed the author Piazzade Ricci, PalazzoRicci, may 00186Roma,Italy.

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