Paper long abstract:

During 1980s, while Basaglia's movement as well as anti-psychiatry ones bestirred Europe, the Cuban government re-thought the mental health care system. They rejected psychoanalytic patterns trying to create a "Cuban" psychotherapy model based on philosophical elements coming from the Soviet psychology theory mixed together with therapeutic practices of the systemic psychotherapy.

In this paper I will explore how this psychotherapic model works today, and its changes in relation to the impacts of the social, economical and political transformations.

I will use my ethnographical experience carried out a Mental Health Community Centre in Havana, to suggest that - even if the politics of cure service are fixed- the care practices are dynamic and informed by the way psychiatrists imagine their own role in the Cuban society.

Moreover, this need of imagining their own role is based on an awareness -shared by both psychiatrists and patients- to live a "vida dificil" that goes beyond mental health problems. This awareness is point out by the use of irony during the psychotherapeutic encounter. Irony is also used by therapists in order to bring the political dimension in to the therapeutic setting, for making also the citizenship an object of care