Anne-Marie Ulman

Anne-Marie Ulman, MD

I am a French-born Israeli, of Jewish Polish origin. This is itself synthesizes quite well the multiple facets of my identity.

My parents were adolescents when WWII exploded on the scene. They lived in Galicia, Poland, the “cradle” of a proud Polish nation. It wasn’t easy to be a Jew in a country in search of its own identity. My parents are Holocaust survivors, the only survivors from their nuclear families. Destiny and historical circumstances brought them together in France where they met after the war ended.

I consider my first name to be an example of their endless quandary around identity: Anne-Marie. What could sound more French than this name, though its true meaning was my mother’s desire to commemorate her young sister Marisia and her beautiful aunt, Anna, and probably was also intended to commit me deeply to the duty of remembrance.

I completed my school years at the very selective “Ecole Alsacienne”. But the passionate discussions we had during French literature, philosophy and history classes about basic concepts like democracy, revolution, humanism etc. couldn’t compensate for my feeling of being an alien in France; as the daughter of Holocaust survivors in the midst of children from left-wing intellectual bourgeois French families.

Medical school, with the conservatism characterizing this very specific milieu didn’t diminish this feeling of being a stranger in my own country. As a matter of fact the question was not whether I should move to Israel but rather when I should move there. I concluded that the best timing was at the end of medical school and before starting residency training in psychiatry.

Israel has been an important part of my life since the very beginning. My parents and I used to spend summer holydays with relatives who had also survived WWII and had moved to the new country. Every summer we traveled for vacation in a “moshav” located in the very center of Israel. At that time, moshav was a type of cooperative agricultural community of individually managed farms. I believe in the importance of pre-verbal period experiences and the memories connected to my experiences living in the “moshav” are particularly dear to me. Growing up I could understand that everybody came from somewhere and had his/her own history; that Judaism was not something to hide or explain, but rather dictated the rhythm of everyday life. Here I could feel part of something positive and alive, so much more in accordance with the multiple aspects of my identity, and so different from the narrative of my school friends.

After psychiatric residency, I worked for nine years as a senior psychiatrist in a locked ward. In September 2004 I moved to a rehabilitation ward. Since the beginning of 2005 I have been involved in cultural psychiatry activities.

As strange as it may seem, cultural psychiatry is not a highly developed field in Israel. Some psychiatrists show interest in specific communities, but the general attitude is to refer to DSM, as it is applicable to everybody irrespective of cultural background. Concepts of culture as a significant influence on the clinical picture, as a factor contributing to the therapeutic attitude and as a possible therapeutic gap between therapist and patient are not widely considered in Israeli psychiatric practice. Accordingly, I felt ineffective with certain sub-groups of the population. But without guidance my didactic learning was not translated into effective clinical practice.

The turning point in my career was my meeting with Tobie Nathan, the French psychologist and psychoanalyst and founder of the Ethnopsychiatric School, while he was in Israel undertaking a diplomatic function. His knowledge about African populations and therapeutic practice in the context of migration was of great help in my encounters with Ethiopian immigrants to Israel, a group of the Israeli mosaic population for whom “acculturation stress” and “culture shock” are the most intense of any sub-group in the country. With his supervision I organized a cultural psychiatry consultation service where I meet with mostly patients of Ethiopian origin. Since then I have been developing progressively the issue of cultural psychiatry in Israel by taking part in diverse projects and activities, mainly research and teaching. I joined the Euromed-Network association as a founding member and Steering Committee member for Israel, and I am a member of the cultural psychiatry section of the European Psychiatric Association.

My purpose in joining the WPA-TPS is to create new contacts that will help me to develop my activity in the field. After failure of the “melting-pot policy”, decision makers in the field of health policy in Israel have become more open to concepts like cultural competence and culturally sensitive medicine.  Therefore I wish to encourage and further this process.

My priority goal is education. It’s time to develop educational programs that will invoke medical student sensitivity and develop psychiatric resident skills relevant to culturally competent clinical practice.  Every medical student coming to Beer Yaacov Mental Health Center (where I work) in the frame of clerkships has a lecture about culture and psychiatry.

Research is the second pillar of my interest. For example, I am involved in a pilot study on suicide prevention, which is an acute problem among people of Ethiopian origin in Israel, a study funded by the Israel National Institute for Health Policy Study, exploring the place of cultural factors in, diagnosis treatment and prevention of suicidal behaviors.