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Mini Review | DOI: https://doi.org/10.31579/2690-4861/367
Psychiatrist, Hospital Practitioner Mental Health Sector of Mayotte Bp 04, Rue De Hospital 97600 Mamoudzou, Mayotte.
*Corresponding Author: Lionel Buron, Psychiatrist, Hospital Practitioner Mental Health Sector of Mayotte Bp 04, Rue De Hospital 97600 Mamoudzou, Mayotte.
Citation: Lionel Buron, (2024), Mayotte, The Epitome of Insular Syndrome, International Journal of Clinical Case Reports and Reviews, 16(5); DOI:10.31579/2690-4861/367
Copyright: © 2024, Lionel Buron. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 11 December 2023 | Accepted: 12 March 2024 | Published: 26 March 2024
Keywords: mayotte, psychopathology; symbolism; myth; solitude; Confinement; expatriate; insularity
As A Result of The Rupture and Confinement Effects Experienced Following Arrival on The Island, Some Individuals Studied, Despite Having Been Unaffected By Psychiatric Disorders In The Past, Go On To Develop Some Particular Psychiatric Symptoms. We Will Show How the Discovery of An Exotic Insular Psychic Space Can Lead to The Emergence of Different Clinical Syndromes. This Study Was Born from The Psychiatric Treatment of Expatriate Patients On The Island Of Mayotte, Using Psychodynamic Techniques And Methods. The Island Is Associated with Specific Symbolisms That Are Sources of Vulnerability: Separation, Lack of Space, Promiscuity, Discontinuity of The Human Bond, Paradoxical Temporality. Moreover, The Mental Representation of Such A Confined, Limited Space, Invested With An Ancient Imaginary, Is Influenced By Some Universal Myths. As An Object of Desire, The Island Is The Source Of Phantasmatic Projections, And One’s Arrival There In Reality Proves To Be Potentially Pathogenic And Can Reveal A Previously Dormant Psychic Precariousness.
This study will analyze several clinical syndrom of expatriate patients on Mayotte island. We will rely in particular on psychodynamic methods and techniques.
The island as a psychic and geographical place carries specific symbolic equivalents that we will discuss later. The latter are sources of weakening and give this space a pathogenic potential [1] in certain individuals previously free from psychiatric disorders. Between the subject and the island there are interactions between specific signifiers and some internal parameters (personal history, neurotic functioning, personality traits) which can thus give rise to different syndromes. We will extract the psychopathological specificities linked to insularity.
Clinic of different island syndromes
Island hypomania or the paradise island solution
Psychopathological specificities of insular hypomania
We can observe how the emergence of an insular hypomania can be the product of a singular alchemy bringing into resonance the elements of personal history with specific insular signifiers:
Paradise representation of the island; -oceanic feeling with wild and isolated nature;
Detachment of autochthon people from any western social order;
Fluid identification with famous island figures (Robinson, Gauguin, etc.).
The internal world of the subject comes to “collaborate” with a concordant external world, leading to a dissolution of psychic boundaries and a hypomanic syndrome.
Island Depression or the Desert Island Solution
Psychopathological specificities of insular depression
The particularities of the advent of an insular depressive syndrome seem well linked to confinement and to experiences marked by isolation, cramped conditions, the discontinuity of human links and the loss. The initial appearance of somatization appears to be defensive in front of unacceptable feelings (self-esteem, anger, boredom and guilt, etc.) linked to the aforementioned island experiences. This attempt at psychological protection ends up to breaking down and giving way to the depressive solution. The psychomotor slowdown is particularly intense, increased by the suspended temporality of the island, the heavy humidity of the climate and this experience of transmissible fatality conveyed by the attitude and local religious belief. The impression of going in circles specific to the narrowness of the space induces a feeling of solitary confinement and internal expatriation (as if stranger to oneself).
Insular hypersexuality or the erotic solution
Psychopathological specificities of insular hypersexuality
The issues surrounding the occurrence of sexual addiction in an island environment. These symptoms would probably never have occurred outside of this trip. The emergence of this very particular addiction was the fruit of a meeting between:
A subject carrying his own history and presenting vulnerability factors linked to certain personality traits as exacerbated on the island: impulsivity, search for novelty and thrilling sensations, pleasure in transgression, low self-esteem, mental disorder, attachment disorder in the link to the other.
The exotic feminine “object” as an invitation to absolute sexual pleasure.
In a special sexual environment, local customs and an apparently free, unrepressed sexuality free from usual Western codes give the illusion that easy “consumption” appears accessible in a space where “enjoying without hindrance” turns out to be of the order of possibility. The sexual atmosphere is presented as uncovered by oppressive taboos, like a return to a free and candid love underpinned by the habits and customs of dissolute polygamy. This environment present itself as an incitement to sexual pleasures in this internal context of neurotic tension. The pleasure became excess. Excess became pathology.
Insular paranoia or the persecutory solution
Psychopathological specificities of insular paranoia
We have highlighted how the singular otherness of the island can give rise to a flamboyantly persecutive delusional experience. The mysticism, conveyed by the omnipresence of Islam and animist beliefs local, brings a mysterious and secret dimension to the atmosphere and exacerbates the anxiety and the feeling of hostility from the outside world. The weakening caused by the landmarks off-centering is increased by the sensation of oppression linked to the smallness and promiscuity of the island. The feeling of being in a confined and circumscribed place from which we cannot escape, promotes the impression of being prisoner of a community village, veiled and obscure, facilitate the perception of being scrutinized, mocked, deceived by transfiguring the other into an imaginary enemy.
The Island Perversion or the Island Kingdom Solution
We were able to observe how island expatriation can bring out the hidden part of an individual's iceberg in perverse narcissistic defensive ways. A phenomenon facilitated by a feeling of social ascension offering a position of power that the subject did not occupy in their usual environment.
The confinement and isolation of the island lead to an exacerbation of hierarchical positions where the balance of power is played out on another stage. Indeed, the island, as a separate space, can lead certain subjects to feel like they can act out fantasies of domination and control, without feeling guilt or a feeling of immorality. This resurgence of perverse archaic impulses leads, there more than elsewhere, to omnipotent attitudes with the sensation of becoming the king of an imaginary territory which only belongs to the subject. As if the distance from the State, from the father, from the motherland conferred the power to play without restraint, to subject and abuse the other. The individual can believe himself to be the originator of his law, in a space where a “law of the jungle” would be within the realm of possibility. Another place were certain behaviors, normally reprehensible, would be accessible there. A law of the strongest with accompanying situations of moral harassment.
This analysis was born less from the observation of abusers, very rarely encountered in consultation, than from the multitude of abused people taken into care.
Differential diagnosis and sonographic context of insular syndromes
These island syndromes are part of the field of pathogenic travel [2] where the fact of migrating to live in a territory where one was not born and where one has not acquired the necessary social codes triggers symptoms.
Depending on the motivation for the trip and its destination, the syndromes of Jerusalem (religious motive), Stendhal (artistic motive in Florence), India (pilgrimage motive to the sacred places of India) and Paris (cultural motive among the Japanese) have been described.
Like all pathogenic trips, island syndromes are differentiated from pathological trips by the occurrence of psychiatric disorders in reaction to a trip undertaken for a specific purpose in subjects free of mental pathology. In the pathological trip, the psychiatric disorders preexist and motivate the departure, most often underpinned by delusional ideas.
Psychic representation of island space
What is an island? Whether we all dream of it or fear it, it remains to clarify its representation to better understand the subjective experiences that can take place there.
A closed place, a circumscribed and isolated space, the island must be small enough to induce psychological confinement. Topos of rupture, anchored in an oceanic desert, the island is marked by separation and isolation. It is distance and inscription in another, exotic universe, removed from the world. A mythical enclave, object of desire. As Reverzy [3] points out, a sort of “island transfer” takes place between the subject and this object, where the island would be the place of fantasmatics projections drawing their source from personal history.
The island thus transports this dream of travel into an imaginary crossing. It is what we sail towards, carried by the current of our aspirations. The island is dreaming that we start from scratch, that we recreate, that we start again. There, separation and recreation are not mutually exclusive [4].
It is cramped and promiscuous in a microcosm. On a human level, the island is a village: the community spirit rubs shoulders with the heaviness (or the unbearable lightness...) of the gaze of the other islander whose obscurity makes communication uncertain.
The island also represents the scene of the passage of others, constantly renewed. The test of the discontinuity of the human bond, staged in the endless departure pots.
The subject bathes in a space punctuated by a temporality where the conjunction of two psychic tempos emerges, slow and fast where the alternation of an adagio and presto movement blows on the rational, mathematical time, which no longer has the same direction. Indeed, it seems that two temporalities coexist in this same elsewhere:
Island syndromes: a four-step dance
We will choose to articulate the dynamics of these emerging symptoms in several stages.
1. The time of the islands of desire
As an allegory of elsewhere and rupture, the island is a timeless, mythical place, conveying a collective imagination rich in literary productions, stories, tales and legends. The living island in each of us, sometimes without knowing it, has partially shaped our psyche, from childhood until now, as a driving force of dreams, fears and mysteries. The island becomes a point of capture for fantasmatics projections drawing their sources from certain significant myths:
The myth of Robinson Crusoe [5] known to everyone even without having read it, supports the figure of the hero, virile independence and pragmatic intelligence in the extreme elsewhere of a deserted, tropical, wild island to be beautiful. Its story depicts the organization of free time, outside civilization, towards an imposed movement of autarkic life, a return to ancestral gestures of self-preservation and self-sufficiency. It is the answer to the question “how did we do it before?” ".
The myth of the lost paradise illustrates the return to the Edenic ideal of the original garden where a generous and nurturing nature would suffice for immediate satisfaction. Paradise on earth is also located, for many, on an island! Isn't the island paradise more popular than ever in our modern world? It supports the image of absolute well-being, of an escape shimmering with a dream “vacation”.
The island as a paradigm of artificial paradise? Because beneath the beach, the cobblestones, the South, the Third World and poverty are hidden. Very improbable indeed seems, the meeting between this paradisiacal representation and the real island made of earth and sand: we understand better how certain psychological disorders can be present!
The myth of the noble savage who, far from being "a barbarian", is a pure, innocent being, close to the truths of the world, living in contact with nature, far from the vices of modern life.
The myth of the new Cythera (erotic utopia born from the stories of the great explorers of the 18th century discovering Tahiti). Sexual mores are described there as “a hymn to enjoyment”, “celebration of free love and performed in public”. This island territory was presented as a sexual paradise “where the only religion was love”. The young girls “like Eve before sin, offered themselves without prohibition” [6].
The myth of the hippies embodies the counter-cultural desire for a life outside the
system, a return to nature, peace and sexual liberation: “let's make love not war”, “let's enjoy without hindrance”. A whole philosophy associated with the consumption of toxic elixirs broadening the field of consciousness. Bali, “the gods island” represented the end of the road for the hippies, a haven of peace after the wanderings of Kabul and Kathmandu.
2. The time of the insular syndrome
3. The therapeutic time as a necessary inner journey an emerging psychiatric symptomatology in an island environment can lead the subject to develop more intimate desires which vibrated internally.
Metaphorically, this therapeutic time of exit from the syndrome can be compared to the maneuvers of the navigator seeking to escape the enclosure of the island: engaging in the “pass” of the coral reef while understanding as best as possible the pitfalls of the reefs. A bad handling of this weather raises fears of shipwreck. Its success, a liberation towards unprecedented navigation. As Jean Grenier [9] points out, “travel not to escape from oneself, an impossible thing, but to find oneself […] When one has managed to recognize oneself (and undoubtedly something else beyond oneself), this “recognition” does not is not always at the end of the journey we are making: in truth, when it has taken place, the journey is completed..." The symptoms will only have been a tormented stopover allowing the exploration of new horizons as an origin second existential.
We observed that the symbolisms carried by the island (confinement, separation, crampedness, promiscuity, paradoxical temporality, etc.), beyond the mythical imagination, amplify, like a resonance box, certain internal vibrations which would not have probably not resonated without this meeting.
In this particular expatriation, the encounter with the island offers a “transfer” to an elsewhere which provokes the most radical confrontations with our fears and our desires and therefore a possible encounter with ourselves. This comes at the cost of intense, singular, but often surprisingly transformative psychopathological emergences.
Returning from these tormented islands ultimately brings, echoing a secret quest, the promises of an inner exploration and an unanticipated recognition revealing to oneself the archipelago of one's psyche.
Links of interest the author declares that he has no links of interest relating to this article.
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