Pour une approche thérapeutique interculturelle en situations d'abus sexuel à El Alto (Bolivie)

The research presented seeks to contribute to the creation of an intercultural clinic finding its way between what, in psychological sciences, is called systemic therapy and what, in the Bolivian universe of care, is called ancestral spiritual medicine. In such an intercultural facility, the two approaches each operate in following their respective logics and cultural practices but they may both intervene in the same situation, concerning the same case, if the family accepts it. This process of inter-relationship requires respect for the coherence of the other, which has implied our discovering the context of the ancestral spiritual medicine of the Aymara culture, primarily thanks to the amawt'as, spiritual guides responsible for public and community rituals. This has involved testing the intercultural clinical access in concrete situations of sexual abuse against children and teenagers. We illustrate this process through a case of intra-family sexual abuse against an adolescent. What is at stake in the approach is triple: clinical, epistemological and political. In the field of clinical human sciences, a major challenge is that of constructing knowledge skills which are neither external to the humans concerned and their sufferings, nor culturally univocal, nor founded on social power relations.