Larchanché, Stéphanie. Cultural Anxieties: Managing Migrant Suffering in France. Rutgers University Press, 2020, 240 pages

Larchanché’s writing displays a great deal of reflexivity in her position as the Centre’s Medical Anthropologist and through the theoretical approaches of the Centre as a whole. She identifies this potential conflict early on to reframe her perceived lack of objectivity as a strength in her critical praxis examination. This allows her to move between the spaces of observer and participant with ease. She writes this book not as a systematic ethnography of the staff and patients of Centre Minkowska, but as a complex and nuanced analysis of the greater context in which the centre finds itself: a clinic in France and an employer of the cultural competence approach. The naming of this book, Cultural Anxieties, serves to reflect the multiple perspectives that this ethnography examines. It discusses the cultural anxieties of the French population and how they seek to inform the structural factors that affect or even cause the migrants’ anxieties and access to the care needed to quell such problems. It also discusses the anxieties facing the healthcare practitioner in addressing complex cultural issues that are beneficial to their patients while complying with the French notions of universality expected of them. There are three sections in this book that are intentionally crafted to give the reader a strong historical and theoretical foundation to advocate the need for the approach the centre subscribes to. The first part, “The Context”, provides some background on the social construction of the migrant and their health needs, and well as the academic discourse surrounding the management of the aforementioned through the francophone lens. Chapter One offers a genealogy of migrant suffering to provide the imperial history of the social attitudes towards the communities that make up much of France’s current migrant population, before their widespread immigration through to the present. Larchanché shows how this shaped many of the immigration policies, and in turn, the infrastructure in which these communities find themselves today. France’s republican paradigm is focused on the ideas of universality, which have contributed to much of the attitudes towards migrants and their needs, attributing any issues, even those due to social inequalities, as a failure of the individual’s behaviour in need of correction (46). Larchanché draws parallels between the public and academic discourse concerning migrant care and suffering, particularly in the fields of anthropology and psychology as ethnopsychiatry. There is particular attention given to and much criticism levied against Tobie Nathan’s initial contributions to the discipline, due to its heavy emphasis on cultural relativism, but with acknowledgement of the useful concepts that still hold relevance. In the analysis of the development of ethnopsychiatry, the chapter arrives at transcultural psychiatric care focused on the individual as the basis of care at Centre Minkowska. This cultural competence approach is said to provide a holistic examination of the culture, psychological distress, and social issues of the individual in its practice. Larchanché is aware of the imperfections of this approach, offering her reflexive approach as a vehicle to allow her team to be intentional about mitigating such gaps in their care. The next chapter, “Transcultural Practise at Centre Minkowska”, serves to detail the development of the transcultural approach to care that the centre adopts concerning its creation and its position in the French healthcare system. The clinic lies in a liminal space between the public health system and a social justice institution to aid migrant suffering. Larchanché is reflexive about this work in a “moralized workplace” (69) where the staff are personally engaged with issues of immigration. The chapters “Referral Narratives” and “Ethnical Double Binds” comprise the fieldwork section of this book. Both chapters …