一位移民精神科医生的孤独——新老移民都应该看
编者：书一，十几岁随父母移民加拿大，学习英语、法语、考取麦吉尔医学院都在短短几年内完成，现在是一名精神科医生。除了临床工作，书一敏锐观察移民群体精神世界的底色，她正试图用自己的专业与同理心，为所有在两种文化缝隙中泅渡的个体，寻找归属与释怀。文章原文为英文，编辑翻译成中文方便读者阅读，原文附在后面。
移民精神科医生的孤独
我常常想起在医学院上完第一堂人体解剖实验课后，从皇家山(Mount Royal)高处走下来的情景。
探知身体内部的奥秘，承载着一种近乎仪式般的沉重感。二十岁那年，不仅标志着我医学之路的起点，也意味着我与曾经联结这个世界的纯真彻底告别——更确切地说，是告别了那个我在六年前抵达、至今仍在摸索如何融入的加拿大。
直至今日，我依然在想，在众多学科中选择精神病学，是否在某种程度上源于我对生物医学知识所赋予的“过度知晓”与权威感感到不安。我内心深处曾害怕这种权威会带来孤立。不过我也意识到，这或许并不适用于所有移民专业人士——有些人会积极拥抱自己的专业技能，将其视作一种建立连接的方式，尤其是当他们曾经被忽视的身份特质终于开始找到表达的出口时。
我转向精神病学，部分原因是一场实验：探索真正的联结能否通过“存在”本身、而非仅仅通过“知晓”而产生。毕竟，精神病学是一个将“自我”同时作为诊断和治疗工具的领域。或许，正是因为必须在自己的心灵与患者的心灵之间有共同体验那片空间，才让我得以建立身为移民所极度渴望的深层联结。又或许，精神病学在医学领域内长期的边缘地位反倒让我感到安心，这似乎暗示着这个学科对“差异”有着更高的包容度——无论是对我们所面对的患者，还是对我们自己。
这些私密的心理博弈塑造了我的职业选择。在经历了数年的专业训练以及接受了精神分析之后，我才终于将这些碎片与“孤独”这一主题联系起来。如今，这个主题依然在我的诊疗室里，在与患者的互动中，不断展开并发生着蜕变。
我的首批心理治疗患者是母语为法语的魁北克当地人。出人意料的是，用第二语言进行治疗并没有想象中那么令人望而生畏，但他们滔滔不绝的自白，却让“孤独”这个词这一次更频繁地浮现在我的脑海中。精神病学家克劳斯·W·贝尔布林格(Claus W. Berblinger)曾写道：孤独渴望着缺席的对话。我在那种渴望中捕捉到了某种熟悉的东西。它将我带回了当年的那所French Catholic高中——在那里，我总是小心翼翼地为下一堂课排练自己的发言，试图在一种我尚未完全掌握的语言中，寻找能够准确表达意义的词汇。
无论那个瞬间应当被理解为一种创伤还是一次挑战，那都是一场与声音和脆弱性的静默交锋。在患者用母语流畅倾诉的轻松感中，我辨认出了一种自己曾经熟知的克制——那是一种因害怕找不到倾听者而产生的欲言又止，以及一种因深知语言常常绕过最难言明之痛而升起的惶恐。直至现在，在那些脆弱的停顿里——在那些“不知这能否说出口”的瞬间——我都会放慢脚步，去敏锐地捕捉那些塑造了治疗空间的、未曾言明的心灵暗流。或许，我试图在患者身上保护的，正是那种曾经让我陷入沉默的、微妙的矜持与退缩。
这段记忆推开了其他的门。我意识到，自己关于家庭移民初期的记忆十分匮乏。在接受治疗训练的早期，我们学到：大脑为了生存会选择压抑痛苦。而当我开始临床实践时，我敏锐地察觉到了心理治疗对“重访痛苦”的邀请，与移民“不断向前、以进步衡量生存”的本能之间，存在着一种微妙的冲突。移民往往背负着“过上更好生活”的隐形使命，在这种叙事下，前行的每一步都显得无比必要且正确，以至于几乎没有空间去感知沿途真正失去了什么。这些丧失是双向的：一方面是对故土那种自发的归属感日渐消逝;另一方面则是对戴维·恩(David Eng)和韩信熙(Shinhee Han)所称的“无法企及的白人性理想”的追逐——这构成了移民日常生活中挥之不去的底层忧郁。
我唯有通过自身的精神分析才真正看清这些真相。在那里，移民与精神病学的双重孤独交织在一起，加剧了一种悖论：我永远是一个倾听者，却极少被真正理解。在觉察到这一点的过程中，我开始看到治疗如何能够成为一个共享的记忆空间——在这里，患者与治疗师共同遭遇各自迁徙的余音，无论那是地理上的、语言上的，还是心灵深处的。正是在这种相互映照的觉察中，那曾经缺席的对话，或许终于可以开始发声。
随着我在移民与精神病学的道路上继续前行，这两者的里程碑已变得密不可分。新社会的未知呼应着心灵深处的隐秘暗流，在其中一处获得的洞察，往往能照亮另一处。一路上，我早期的孤独——无论是作为移民还是作为精神科医生——已演变成一种持久的觉察，直面那些归属与理解依然悬而未决的空间。正是带着这种挥之不去的张力，我继续前行，去丈量那些可以被跨越的鸿沟。那些曾经隐藏且痛苦的经历，如今化作一种敏锐的力量流淌在我的体内，塑造着我的反思、我的同在，以及我同时栖居于这两个世界的方式。
原文：The Loneliness of an Immigrant Psychiatrist
I remember walking down from my first human anatomy lab in medical school, high on Mount Royal, when I was suddenly surrounded by McGill undergraduates, their steps unsettlingly light. I caught myself thinking their ease was possible only through unknowing, a privilege I had just lost.
To know what lies inside a body carried an almost ritual weight. At twenty, it marked not only my beginning in medicine, but also a parting from the innocence that once bound me to the world --- my world in Canada more specifically, where I had arrived six years earlier, still learning what it means to belong.
Even now, I wonder how much of my choice of psychiatry among other disciplines arose from a discomfort with “knowing more”—from a sense authority that biomedical knowledge can confer. Part of me feared that such authority could be isolating. I realize this is perhaps untrue for other immigrant professionals --- some come to embrace their expertise as a way to connect, particularly when aspects of identities that were once unseen begin to find expression.
My turn towards psychiatry --- a field that employs the self as both diagnostic and therapeutic instrument, was, in part, an experiment in whether genuine connection might emerge from being, not just knowing. Perhaps it was the necessity of coexperiencing the space between one’s own mind and the patient’s that allowed for the deeper connections I longed for as an immigrant. Or it could even be Psychiatry’s historical marginality within medicine was somewhat reassuring, suggesting a field more receptive to difference --- both in the patients we meet and in ourselves.
These were private negotiations shaping my career choice. It took several more years of training --- and of psychoanalysis --- before I could link them to the theme of loneliness, a thread that continues to unfold and transform in my consultation rooms with patients.
My first few therapy patients were local Quebecers whose mother tongue was French. Surprisingly, delivering therapy in second language felt less daunting than I had imagined, yet the fluency of their monologues made the word loneliness come more readily to me this time. Psychiatrist Claus W. Berblinger once wrote that loneliness yearns for absent dialoguei, and I recognized something familiar in that yearning. It brought me back to my own French Catholic high school, where I where I carefully rehearsed my contributions for the next class, finding words that could hold meaning in a language I had yet to fully command.
Whether that moment is best understood as an injury or a challenge, it was a silent encounter with voice and vulnerability. Amid the ease of my patients’ speech in their mother tongue, I recognized a familiar restraint that I had once known— a hesitation to speak what might not yet find a listener, and the uneasy sense that language often bypasses what is hardest to name. Even now, I decelerate in those fragile pauses—the “if this can be said” moments—attuned to the unspoken currents that shape the therapeutic space. Perhaps what I try to protect in my patients is the delicate reticence that once silenced me.
This memory opens other doors. I realize that my recollections of my family’s early years of immigration are sparse. Early in therapy training, we learned that the mind represses pain as a means of survival. As I began to practice, I became attuned to a subtle dissonance between therapy’s invitation to revisit pain and the immigrant impulse to keep moving forward—to measure survival through progress. Immigration often carries the implicit mission of living a better life, and within this narrative, each step forward can feel both necessary and right, leaving little space to register what is lost along the way. These losses move in both directions: the fading sense of spontaneous belonging to one’s place of origin, and the pursuit—what David Eng and Shinhee Han call the “unattainable ideal of whiteness”—that shadows the everyday melancholia of immigrant life.
I came to recognize these truths only through my own analysis, where the twin loneliness of immigration and psychiatry intensified the paradox of being continually a listener, yet seldom understood. In recognizing this, I begin to see how therapy can become a shared space of remembrance—where patient and therapist alike encounter the echoes of their own migrations, whether geographic, linguistic, or inward. It is in this mutual recognition that dialogue, once absent, may finally begin to speak.
As I continue the journey in immigration and psychiatry, their milestones became more inseparable. The uncertainties of a new society echo the hidden currents of the mind; The insights gleaned in one illuminate the other. Alone the way, my early lonelinessas both an immigrant and a psychiatrist—evolved into a sustained awareness of the spaces where belonging and understanding remain unsettled. It is in this lingering tension that I move forward, attuned to what can be traversed. What was once hidden and painful now moves through me as a subtle force, shaping reflection, presence, and the way I inhabit both worlds.
October 2025
i Berblinger K. W. (1968). A psychiatrist looks at loneliness. Psychosomatics, 9(2), 96102. https://doi.org/10.1016/S0033-3182(68)71881-8
ii Eng, D. L., & Han, S. (2000). A Dialogue on Racial Melancholia. Psychoanalytic Dialogues, 10(4), 667–700. https://doi.org/10.1080/10481881009348576
