VULNERABILIDAD ESTRUCTURAL Y MARXISMO LACANIANO: UNA PROPUESTA DE ARTICULACIÓN TEÓRICA PARA COMPRENDER LA DETERMINACIÓN ESTRUCTURAL DE LA SALUD MENTAL EN MIGRANTES INDÍGENAS
STRUCTURAL VULNERABILITY AND LACANIAN MARXISM: A PROPOSAL FOR A THEORETICAL FRAMEWORK TO UNDERSTAND THE STRUCTURAL DETERMINATION OF MENTAL HEALTH IN INDIGENOUS MIGRANTS
DOI: https://doi.org/10.4067/s0717-73562026000100521
Verónica Jiménez-Rocha
and Carlos Piñones-Rivera
Key Words: Structural violence, critical medical anthropology, critical theory, migrant health, health of Indigenous peoples and psychoanalysis
Abstract
Approaches to the mental health issues of Indigenous migrants have been criticized for their culturalist and psychologistic biases, their ahistoricity, and depoliticization — in short, for their lack of structural understanding. This article aims to contribute to the development of such a structural understanding by discussing critical medical anthropology and critical psychology and proposing a complementarity between the Structural Vulnerability and Lacanian Marxism frameworks. To this end, a literature review and qualitative content analysis were conducted to highlight the contributions of each perspective. In summary, Structural Vulnerability stands out for offering a pragmatic critical approach that goes beyond a culturalist understanding of patients to focus on the structural forces that determine poor health outcomes, promoting structural intervention and direct dialogue with health professionals. In turn, Lacanian Marxism stands out for its epistemological openness to other subalternized psychological logics, allowing subjectivity to be addressed by overcoming certain entrenched habits of thought such as the mind/body division. The article concludes that the consideration of the structural determination of health and the notion of structural violence serve to articulate both perspectives, allowing each to remedy the other’s limitations.
