CARIBBEAN HEAllNG
HEALING TRADITIONS
As Caribbean communities become more international,
international , clinicians and scholars
must develop new paradigms for understanding treatment preferences and perceptions of illness. Despite evidence supporting the need for culturally appropriate
care and the integration of traditional healing practices into conventional health
and mental health care systems,
systems , it is unclear how such integration would function
since little is known about the therapeutic interventions of Caribbean healing
traditions.
Caríbbean Healing
Caribbean
Healíng Traditions:
Tradítíons: Implications
Implícatíons 10r
for Health and Mental Health fills
fùls this
clinicians , scholars,
scholars , and researchers
gap. Drawing on the knowledge of prominent clinicians,
of the Caribbean and the diaspora,
diaspora, these healing traditions are explored in the
context of health and mental health for the first time,
time , making Caribbean
Caríbbean Healing
Healíng
TTraditions
切dítíons
an invaluable resource for students,
students , researchers
researchers,, faculty
faculty,, and practitioners
in the fields of nursing,
counseling,, psychotherapy
psychotherapy,, psychiatry,
work,, youth
nursing, counseling
psychiatry, social work
and community development,
development, and medicine.
Patsy Sutherland
Sutherland,, MEd,
MEd , is a psychotherapist and PhD candidate in counseling
psychology at the University of
ofToronto.
Toronto. She has authored or coauthored over 15
Counselí
咆
peer-reviewed papers and book chapters and served as a reviewer for the Counseling
Psychology Quarterly. Patsy cofounded the Society for Integrating Traditional
Healing into Counseling,
Psychotherapy,, and Psychiatry.
Psychology, Psychotherapy
Psychiatrγ.
Counseling, Psychology,
Roy Moodley,
Moodl
町， PhD,
PhD , is associate professor of counseling psychology at the
University of Toronto. He is the director for the Centre for Diversity in
Counselling and Psychotherapy. He has authored or edited severaljournal articles,
articles ,
book chapters and books,
books , including Outside
Outsíde the Sentence and Handbook of
Counseling and Psychotherapy in an International Context.
Barry Chevannes,
Chevannes , PhD,
PhD , was emeritus professor of social anthropology at the
University of
ofthe
the West Indies,
Indies , Mona. He authored three books,
books , one edited collecof
articles
on
the
Rastafari
and
Revival
religions,
tion,
and
scores
religions, male socialization,
socialization,
tion,
and culture. A public scholar
Jamaica,, the
scholar,, he served as chair of the Institute of ]amaica
Commission, and the ]amaica
National Ganja Commission,
Jamaica ]ustice
Justice System Reform Task Force.
Th
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This
CARIBBEAN HEALING
TRADITIONS
Implications for Health
and Mental Health
Edited by
Patsy Sutherland,
Sutherland, Roy Moodley,
Moodle
抖
。nd
and Barry Chevannes
Fi
First
rst published 2014
byRoudedge
Roudedge
by
711 Third Avenue,
Avenue , New York,
York , NY 10017
Simultaneously published in the UK
by Roudedge
byRoudedge
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Road,, Hove,
Hove , East Sussex
Su 臼exBN32FA
BN3 2FA
@
©
2014 by Taylor & Francis
Routledge is an imprint <if the Taylor & Pra
Francis
阳is Group,
Group, an informa business
The right of the editors to be identified as the authors of the editorial
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material , and of the contributors for their individual chapters,
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asserted in accordance with sections 77 and 78 of the Copyright,
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Li
Library
brary <if Congress Cataloging in Publication Data
Caribbean healing traditions:
traditions : implications for health and mental health /
Sutherland,, Roy Moodley,
Moodley , and Barry Chevannes.
edited by Patsy Sutherland
pages cm
Includes bibliographical references and index.
1. Traditional medicine-Caribbean
medicine-C aribbean Area-History. 2. Healin
Healing-Caribbean
g-Caribbean
Magic,, mystic
mystic,, and spagiric-Caribbean area.
Area-History. 3. Medicine,
Medicine, Magic
I.
II. Moodley
Moodley,, Roy. III. Chevannes,
1. Sutherland,
Sutherland, Patsy,
Pa 町， 1965- 11.
Chevannes, Barry.
GR120.C382014
610.9729-dc23
2012051145
978-0-415-88339-9
0-4 15-8 8339-9 (hbk)
ISBN: 978978 一ι415-8 4233 --4 (P
bk)
ISBN: 978-0-415-84233--4
(Pbk)
978-0-203-8 4450-2 (ebk)
ISBN: 978-0-203-84450-2
Typeset in Bembo
by Swales & Willis Ltd,
L 时， Exeter,
Exeter, Devon
In loving memory
memo 叩 oj
OJ Kennedy Salim
-PS
Th
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blank
This
CONTENTS
Acknowledgements
Contributors
Foreword
x
xi
xv
Introduction
1
PARTI
PART I
History,
Histor
弘 Philosophy,
Philosoph
如 and
and
Healing Traditions
Development of Caribbean
1 The History,
History, Philosophy,
Philosophy, and Transformation of Caribbean
Healing Traditions
Patsy Sutherland
2
The Evolution of Caribbean Traditional Healing Practices
Wendy
F 饪ndy Y.
Y. Crauford-Daniel
Crm 价rd- Daniel and Jicinta
]icinta M. Alexis
3
Caribbean Traditional Medicine: Legacy from the Past,
Past ,
Hope for the Future
Arvilla Payne:fackson
Payne:lackson
4
Herbal Medicine Practices in the Caribbean
卫4ri Clement
Yuri
13
15
29
41
52
vlll
vIII Contents
PART 11
II
Caribbean Traditional Healing and Healers
63
5 Obeah: Afro-Caribbean Religious Medicine Art and Healing
Nathaniel Samuel Murrell
65
6 Vodou Healing and Psychotherapy
Ghislene
Ghislène Meance
Méanæ
78
7 Sango Healers and Healing in the Caribbean
Stephen D. Glazier
89
8μ
8 La Regla
RegIa
De Ocha (Santeria):Mro-Cuban
(Santería):Mro-Cuban Healing in Cuba
and the Diaspora
Camille HernandezHernandez-Ramdwar
Ra mdwar
9 Puerto Ri
Rican
can Spiritism (Espiritismo): Social Context,
Cont
础，
Healing Process,
Mental Health
Process , and
and 岛1ental
Jesus Soto Espinosa and Joan D. Koss-Chioino
10 Revival: An Indigenous Religion and Spiritual Healing
inJamaica
Practice in
Jamaica
T# den ψ and
and Claudette A. Anderson
William T--tedenoja
11 Spiritual Baptists in the Caribbean
FT¥t:zllace
号公llaæW W Zane
101
113
128
140
PART 111
III
Spirituality,
Spiritualit:
如 Religion,
Religion
， and Cultural Healing
151
12 Christian Spirituality
Spirituality,, Religion and Healing in the Caribbean
E. Anthony Allen and Abrahim H. Kh
Khan
an
153
13 Rastafa
RastafarI:
rI: Cultural Healing in the Caribbean
KaiA. D. Morgan
164
14 Hindu Healing Traditions in the Southern Caribbean:
History and Praxis
McNeal,, Kumar Mahabir,
Keith E. McNeal
Mahabi r, and Paul Younger
176
Contents Ix
15 Islamic Influence
In:fluence in the Caribbean: Traditional and
Cultural Healing Practice
Abrahim H. Khan
188
PARTIV
PART IV
Traditional Healing and Conventional Health and
Mental Health
16 Community Mental Health in the English Speaking
Caribbean
Gerard Hutchinson
17 Psychology
Psychology,, Spirituality
Spirituality,, and We
Well-Being
l1-Being in the Caribbean
Omowale Amuleru-MarsJ
Amuleru-Marshall,
ωll ， A
Angela
咆ela Gomez
Gomez,, and
Kristyn O'Rita Neckles
18 Practical Magic in the US Urban Milieu: Botanicas
Botánicas and the
Informal Networks of
ofHealing
Healing
Anahi Viladrich
201
203
215
227
19 Caribbean Traditional Healing in the Diaspora
Roy
Moodley and Michel' e Bertrand
R
叩 Moodley
239
Glossary
lndex
Index
249
258
ACKNOWLEDGMENTS
We extend our sincerest appreciation to all of the contributors in this book for
sharing their expertise in the way that the book necessitated. Thank you for your
patience and understanding in configuring your chapters in accordance with our
specifications.
Our deepest gratitude to family and several colleagues for their unwavering
support
Louis,, Melina Sutherland,
supp 。此 throughout
throughout
this project; they are Clarence St. Louis
Sutherland ,
Natasha Sutherland,
Sutherland, Diana Cassie,
Cassie , Anissa Talahite,
Talahite , Zina Claude,
Claude , Tara Isabelle,
Isabelle ,
orence , Roisin Anna,
Anna , Daniel McGrath,
McGrath , and Uwe Gielen.
Maya Fl
Florence,
We would also like to acknowledge the help
he 怡 and
and support of the editors,
editors , copy
Roudedge , Dana Bliss,
Bliss , Christopher Tominich
Tominich,, Anna Moore
Moore,,
editors and staff at Roudedge,
and Sam Rosenthal.
It is with profound sadness that we remember the death of our colleague and
co-editor Dr. Barry
Ba 町y Chevannes who died during the preliminary stages of this
book.
We would like to thank the Caribbean healers (in Toronto and Grenada) who
in many ways contributed direcdy and indirecdy to this book and to our
understanding of Caribbean healing traditions.
一
Patsy
Sutherland and Roy Moodley
- Patsy
CONTRIBUTORS
Jicinta M. Alexis
Alexis,, BA,
BA, obtained her degree from St. George's University. Her
interest is in community health with special focus on gender and traditional
medicine.
E. Anthony Allen
Allen,, MDiv,
MDiv, MRC Psych,
Psych , is a psychiatrist and a consultant with
Wholistic Health Ministries. He has pioneered community-based whole person
nistries in local congregations. He has also authored the books Caring
Car Í1 忽
ministries
healing illÍ
如
for the
the Jf'h
Mole
ole Person and Simple
Símple Steps
St ψ
， ω
to Wellness.
Welln
ω.
Omowale Amuleru-Marshall
Amuleru-Marshall,, PhD,
PhD, MPH,
MPH , is a counseling and public health
psychologist. He is originally from Guyana and is currendy the director of
Community Health and Outreach in the office of the Provost at St. George's
University in Grenada.
Claudette A. Anderson
Anderson,, PhD,
PhD, obtained her degree
degree
丘om
from the Graduate Institute of
the Liberal Arts at Emory University. Her research and scholarship focuses on
Jamaican Ethno-medicine and Mrica-derived religions with a specialization in
Revival and Obeah.
Michel'e Bertrand,
Bertrand, MEd,
MEd, is an EdD
E dD candidate in counseling psychology at the
University of
ofToronto
Toronto and a psychotherapist in private practice in Toronto.
Yuri Clement, PhD, holds the post of senior lecturer in pharmacology at the
University of the West Indies
Indies,, Trinidad and Tobago. His laboratory research
includes evaluation of medicinal plant extracts for anticancer and hepatoprotective
properties using in vitro and in vivo techniques.
xll
xII Contributors
Wendy Crawford-Daniel,
Crawford-Daniel, PhD,
PhD, is a research sociologist,
sociologist, assistant professor
professor,, and
acting chair of the department of liberal studies at St. Georges University in
Grenada. Her areas of interest include cultural competency in working with
diverse populations and international
intemational organizations.
Espinosa, PhD,
PhD, is a clinical psychologist who has carried out research
Jesus Soto Espinosa,
ofPuerto
Puerto Ri
Rico
co Medical
into asthma as a member of a team from the University of
Sciences Campus. Dr. Soto is a co-investigator on a research project that studies
spirituality and Spiritism among Puerto Ri
Rican
can doctors.
Stephen D. Glazier,
Glazier, PhD,
PhD, is professor of anthropology and a graduate faculty
fellow at the University of
ofNebraska-Lincoln.
Nebraska-Lincoln. He is author and/
and/or
or editor of seven
The Encyclopedia cif
if African and
books , including Marchin' the Pilgrims Home and The
books,
4African
斤ican American Rel
Religions.
忽ions.
Angela Gomez,
Gomez, PhD,
PhD, is an applied anthropologist. Her research interests are on
human
hm 丑an vulnerability with an emphasis on poverty
pove 民y and the impact of social policies
America, the Caribbean
Caribbean,, and
and programs aimed at its alleviation in Latin America,
developing countries.
Camille Hernandez-Ramdwar,
Hernandez-Ramdwar, PhD,
PhD, is an associate professor in the department
of sociology at Ryerson University in Toronto,
Toronto , Canada,
Canada , who also teaches in
Caribbean studies. Her areas of research include Caribbean cultures and identities
and Mrican traditional religions in the Caribbean.
Gerard Hutchinson,
Hutchinson , MD,
MD, is currently the head of the department of clinical
medical sciences and unit lead in psychiatry at the school of medicine at the
ofthe
the West
W耐 Indies,
Indies
， St Augustine.
Au 织lstine.
His research interests are in rnigrationmigr 拍on­
University of
related issues in mental health and suicidal behaviour in the Caribbean.
Abrahim H. Khan,
Khan, PhD,
PhD, is professor in the faculty of divinity at Trinity College
in the University of
ofToronto
Toronto and director of
ofits
its advanced degree studies program.
studies,, religion and intemational
international
His publications are in the areas ofKierkegaard studies
diplomacy
diplomacy,, and comparative studies in religion.
Joan D. Koss-Chioino,
Koss-Chioino, PhD,
PhD, is professor emerita of anthropology at Arizona State
University and research professor of psychology at George Washington University.
Her primary interest is the etiology and treatment of illness and emotional
problems.
Kumar Mahabir,
Mahabir, PhD,
PhD, is an assistant professor in the Centre for Education
ofTrinidad
Trinidad and Tobago. Hi
Hiss most recent books are
Programmes at the University of
lndian
Indian Caribbean Folklore Spirits,
Spirits, The
The lndian
Indian Diaspora in the Caribbean,
Caribbean, and Traditional
Medicine and Women
vt 旬 men Healers in Trinidad.
Contributors xlll
xIII
Keith E. McNeal,
McNeal, PhD,
PhD, is an anthropologist and assistant professor of comparative
cultural studies at the University of Houston. He is the author of Trance and
Modernity
Popular
Moderníty in
ín the Southern Caribbean:
Caríbbean: 4African
向can and Hindu
Híndu Popu
切r Religions
Relígíons in
ín Trinidad
Trínídad
and Tobago.
Ghislene
Ghislène Meance,
Méance, PsyD,
PsyD, is a licensed psychologist. She is the founder of the
Multicultural Counseling and Testing Center which provides culturally sensitive
psychological evaluation
evaluation,, individual
individual,, group
group,, and family therapy to individuals from
all cultures.
Kai A. D. Morgan,
Morgan, PsyD,
PsyD, has been lecturing in clinical psychology at the
Indies,, Mona
Mona,, Jamaica for the past 12 years and serves
University of the West lndies
se 凹es as
the consultant psychologist in the department of psychiatry.
Murrell, PhD,
Nathaniel Samuel Murrell,
PhD, is associate professor of philosophy and religion
ofNorth
North Carolina,
Carolina , Wilmington. His book publications include
at the University of
Chantíng Down Babylon and
Chanting
and,, most recendy
recendy,, 4Afro-Caribbean
斤。 -Caríbbean
Relígíons: An lntroductíon
Religions:
Introduction
to their
theír Historical,
Hístorícal, Cultural
Cultural,, and Sacred Traditions.
Tradítíons.
Kristyn O'Rita Neckles,
Neckles, MA,
MA, MS,
MS, is a doctoral student in clinical psychology at
Albizu University in Miami,
Miami , Fl
Florida.
orida. Her current research interest is in
Carlos Albizu
exploring the influences of culture and spirituality on the behaviors of Caribbean
people.
PhD, is a professor at Howard University. Her primary
Arvilla Payne-Jackson,
payne-Jackson, PhD,
areas of research are in the fields of medical anthropology
anthropology,, sociolinguistics,
sociolinguistics ,
evaluation, and service learning.
ethnographic evaluation,
Anahí
Viladrich , PhD,
Anahi'Viladrich,
PhD, originally
originally
丘om
from Argentina
Argentina,, is an associate professor in the
departments of sociology and anthropology at Queens College and in the public
ofthe
the City University of
ofNew
New York. She
health program at the graduate center of
has published more than 50 articles and book chapters on immigrants and folk
traditions,, and on gender and culture.
healing traditions
Wedenoja,, PhD,
PhD, is professor of anthropology and head of the department
William Wedenoja
of sociology and anthropology at Missouri State University,
University, where he also serves
as director of the master's in applied
app 且ed anthropology program. Dr. Wedenoja has
published on Revival Zion,
Zion, trance,
trance , healing,
healing, Pentecostalism,
Pentecostalism, cultural psychiatry,
psychiatry,
conservation, and multicultural education.
heritage conservation,
Paul Younger
Younger,, PhD,
PhD, professor emeritus,
emeritus , McMaster University
University,, is the author of8
books and 40 book chapters. His most recent book is: New Homelands: Hindu
Híndu
Communítíes in
Communities
ín Mauritius,
Maurítíus , Guyana,
Guyana , Trinidad,
Trínídad, South 硕ica
Africa,， Fiji
Fijí and East 4Africa.
斤íca.
xlv Contributors
Wallace W. Zane
Zane,, PhD,
PhD, is an anthropologist,
anthropologist, teaching at California State
University,
Northridge,, at Santa Monica College,
Universi
町， Northridge
College , and Art Center College of
Design. He studies religion and culture. His book about the Spiritual Baptists is
Journeys
Journeys ω
to the
the Spiritual
Spírítual Lands: The
The Natural History
Hístory of a West Indian
Indían Rel
Religion.
忽íon.
FOREWORD
Biomedical psychiatry and Western psychology incorporating west-European
post-Enlightenment ideologies of the hurnan
human condition-its division into mind
and body,
body , its dependence on individual striving as opposed to communal harmony
h 组mony
and so on-has
dominated mental health systems in Europe and North America.
on 一-has
America.
However
of"mental
"mental health" and
and 山ness-both
illness-both "psychological" and
However,, the meaning of
"somatic" if we think in those reductionist terms-are
terms-are culturally
cultura1ly determined. As
a result of colonialism and postcolonial Westernization the Euro-American
Euro-American system
of mental health has been promoted to a greater or lesser extent in the rest of
world, the Global South. As Western psychiatry and psychology come to dominate
world,
mental health systems in countries with predominandy non-Western cultural
backgrounds , the loss to cultural diversity (which 1I think most of us value in all
backgrounds,
tl han one of machines) is obvious.
things and makes for a truly human world rather 由
than
But what is less evident but equally
eqψually true is 由
that
t ha 刽t the alleviation
a址
llev 归la刽
ati位io∞
nofhu
of human
1日
皿
mma扭
nsu suffering,
盒岳
enn
臼
ln吨
1喀
g，
which is an inevitable 归
ppart
ar 眈t of our existence,
existence , is ill-served by such a loss.
Healing traditions have been there in all human societies from time
immemorial-they may well be a sine
síne qua non of the very existence of human
beings as social beings-in other words we would not be here if not for such
alive ,
traditions. But cultural traditions never stand still; they are dynamic and alive,
changing according to the social and political forces that impinge on the societies
that they underpin and sustain. The Caribbean is a place where people from many
together-s ometimes by forcible
different cultural traditions have come together-sometimes
transportation-and survived,
transportation-and
survived , fought,
fought , and suffered
su 岳red together. Out of all this have
emerged what are called "new ethnicities" with hybrid (creolized) cultural formsexcept of course that all people everywhere are culturally
cultu
ra1l y 吁lybrid"
"hybrid" in one way or
another. The editors of this book have got together an impressive collection of
contributions to present us with a vivid picture of the healing traditions that are
XVI
xvi
Foreword
alive and well in the Caribbean. This is particularly welcome at a time when
Caribbean diasporas in other parts of the Westem world-especially in the UK
and Canada
Canada-are
-are concerned
concemed by the inadequacy of the mental health systems they
encounter. They are being over-diagnosed as "schizophrenic" clearly because of
the limitations
lirnitations of the psychiatric system to properly understand the nature of their
cultural backgrounds and the problems they face in living and thriving in an
environment that is institutionally racist. But even more importantly,
importantly, what
Caribbean users of mental health services complain about is the lack of spirituality
in the types of "treatment"
"treatment"
。岱red
offered to them in the systems of psychiatry and
American
psychology that they encounter. But of course white British and North American
people,
people , too,
too , often complain of this; so there is obvious need for statutory services
to take heed and take some lessons,
lessons
，就
at least
least
from healing traditions that may well
altemative approaches that we should all have access to-and
to-and perhaps a
show us alternative
knowledge of these traditions would result in fundamental changes to the way
mental health services are delivered.
Today there is much discussion around the concept of a "global" mental
health-the implication being that what Western
Westem psychiatry and psychology have
developed in Europe and North America
America should be actively exported to the Global
South-the countries of the "third world." Fortunately this so-called "global
mental health movement" has stimulated a countermovement proposing that
matter乱nd that systems for promoting mental health must
mental health is a local matter-and
take on board the traditions of local communities and what they want from
"health." In this context there is a rising demand for knowledge and understanding
of local customs,
customs , local ways of seeing health and illness,
illness , and,
and, above all,
all , of local
healing systems. Healing traditions coexist and overlap with medical traditions the
world over and so in planning mental health services,
services , there is an imperative to take
on board both local medical traditions and local healing traditions. And what is
even more important,
important, is the need for knowledge about ways of healing that are
people-currently
e-currently active systems of
ofhealing.
healing.
currently being used and nurtured by peopl
The more we know about systems of healing that are serving people in different
world, the better prepared are we to think about and plan services that
parts of the world,
t world over.
are culturally consistent with the needs and wishes of communities the
We know something about healing systems in Asia and Mrica but we have very
little knowledge in this respect about the Caribbean region. This book is then a
valuable resource at this point of the "global" debate.
So for all these reasons, it is my pleasure to welcome this book.
Dr. Suman Fernando
Honorary Professor, Faculty of Social Sciences & Humanities,
London Metropolitan University; Formerly Senior Lecturer in Mental Health,
European Centre for Migration & Social Care (MASC) University of Kent;
Consultant Psychiatrist, Chase Farm Hospital, Enfield, Middlesex
INTRODUCTION
Traditional , cultural
Traditional,
cultural,, and indigenous healing practices have been a part of the
sociocultural and geopolitical
geopoliticallandscape
landscape of the Caribbean since the time of slavery,
slavery,
and possibly before
Amerindians would have had a form of health care
before,, since the Amerindians
system in place. In the colonial period very little attention was paid to the health
of enslaved Mricans and indentured Indians; they had to rely on the knowledge,
knowledge ,
skills,, and expertise that came with them from West Mrica and India. Most,
skills
Most , if not
all
all,, of these individuals used religion,
religion, knowledge of herbs,
herbs , and folk medicine to
manage their health and mental health (see Handler & Jacoby,
Jacoby, 1993
1993,, for discussion). This practice of traditional medicine was made possible through its
integration with Christianity which in tum resulted in the formation of new forms
of religion,
religion, spirituality,
spirituality , and healing,
healing, such as Shango,
Shango , Vodou
Vodou,, Spiritual Baptists
Baptists,,
Santeria
Santeria,, Obeah
Obeah,, and Spiritism to name a few; practices which are currently in
place in the Caribbean. Despite the hegemonic influences of colonialism these
religions and their healing practices have remained strong and are continuing to
grow (Gibson,
(Gibson, Morgado,
Morgado , Brosyle,
Brosyle , Mesa,
Mesa, & Sanchez,
Sanchez , 2010).
Any critical and reflective view of Caribbean healing traditions must take into
Any
slavery, the racism of colonialaccount the complex and traumatic experience of slavery,
ism, and the postcolonial need for social stability and economic development.
ism,
Against this background,
background, globalization and neoliberal policies of health care
practices often dictated by capitalist multinational pharmaceutical companies
appear to influence how individuals and communities understand their health and
mental health. In this environment of constant change the medical model and
Westem psychological sciences are seemingly failing
fa 出ng to address the complex needs
Western
of the Caribbean people. Critics assert that this can be attributed to the imposition
of
ofWestem
Western medical and psychological theories and methods that have hindered a
holistic and accurate understanding of the health and mental health needs of
2
Introduction
Caribbean and other non-Western individuals and groups (Poortinga,
(Poortinga , 1999). The
result,
result, according to a Baptist leader,
leader, Reverend Simpson
Sirnpson (as cited in Rahming,
Rahrning,
2001) is a zombification
zombifìcation or colonization of the consciousness and "theft of spirit"
of the Caribbean people.
In the Caribbean context,
context, the colonial past is not simply
sirnply a historical
historicallegacy
legacy but
a lived reality for many contemporary individuals in the Caribbean diaspora. Its
e 岳cts may be evident in the higher rates of involuntary detainment in
lingering effects
secure psychiatric settings and the greater involvement of the police in this process
(see Littlewood,
Littlewood, 1986,
1986 , for a discussion),
discussion) , greater elevated risk (with incidence ratios
above 7) of all psychotic disorders when compared to the majority population
(Harrison et al.
al.,, 1997)
1997),, disproportionate representation
representa
位on among clients diagnosed
as schizophrenic
(Boast
& Chesterman,
1986,, Dunn & Fahy,
schizophrenic
但
oast
Chesterman, 1995; Littlewood,
Littlewood, 1986
Fa 峙，
1990) and the fact that Caribbeans are 44% more likely to be detained under the
Mental Health Act,
Act, than their White
White counterparts,
counterparts, despite this group having similar
(Samuels , 2008). Furthermore
rates of mental ill health as any other ethnic group (Samuels,
counseling, rather,
rather, they are more
this population is far less likely to be offered counseling,
often treated with chemotherapy with higher prescribed drug dosage than Whites
(Callan & Littlewood,
Littlewood , 1998). While these occurrences can be attributed to the
stigma associated with mental illness and the beliefs that individuals hold about its
discrirnination within mental health services (Samuels,
(Sar 丑uels ，
causes to some degree,
degree , discrimination
2008) , intergenerational traumatic experiences,
experiences , a dearth of culturally competent
2008),
treatment and distrust of conventional establishments (Centre for Addiction and
Mental Health,
Health , 2008) were also cited as contributing factors to the mental health
problems of Caribbean people. Current mental health care practices must reflect
a consciousness of these histories and realities in order meet the needs of this
population.
Shortcomings of Western Health Care Practices
Critical race and culture scholarship has highlighted the failures and shortcomings
shortcornings
of mental health practices in psychiatry (see for example,
example , Fernando
Fernando,, 1988);
Palrner, 2005); and counseling
psychotherapy (see
(see,, for example
example,, Moodley & Palmer,
(see ，也
Vontres
唱， 2010).
2010).
psychology (see,
forr example
example,, Helms
Helms,, 1990; Sue and Sue
Sue,, 1990; Vontress,
Without exception,
exception, all these scholars agree that the current health and mental
A 丘ican ， and Asian communities falls short of
health care provision for Caribbean,
Caribbean, African,
the ethical claims to ensure social justice,
justice, equity,
equity, and non-oppressive practice.
However, some progress is being made by the multicultural and cross-cultural
However,
example,, Lago
Lago,, 2012; Sue and
counseling and psychotherapy movement (see,
(see , for example
Sue
shortcornings.
Sue,, 1990) to redress these shortcomings.
眈 of
of the philosophical
Historically , mental health counseling has been papart
Historically,
traditions of
ofEuropean
European religion and spirituality. Ri
Richards
chards and Bergin (1997) argue
that psychology as a whole located itself within a 19th-century naturalistic science
that is based on deterministic,
deterrninistic , reductionist,
reductionist, and positivist assumptions
assurnptions that viewed
Introduction
3
religious and spiritual beliefs and practices negatively. Hence,
Hence , spirituality has
been overlooked as a representation of diversity in health and mental
health care systems. While there has been some significant
signifìcant research attempts
a 忧empts
to
consider a new synthesis between religion,
religion , spirituality and traditional healing,
heali
吨， and
and
mental health counseling,
counseling, extending notions of health and well-being to include
concern for the spirit (see,
(see ，也r
for example,
example , Fukuyama & Sevig,
Sevig, 1999; Moodley &
West, 2005; Sutherland
West,
Sutherland,, 2011; Sutherland & Moodley,
Moodl
町， 2010;
2010;
Vontress,
Vontr
邸， 2005),
200 日，
many health and mental health care practitioners persistently choose to maintain
their historical ambivalence over cultural competence in this important area of
client diversity (R
(Russell
ussell & Yarhouse,
Yarhouse , 2006).
Among
Among minority
rninority communities,
comrnunities , there is an awareness of the failure
fai1ure of mainstream mental health care systems to treat the whole person. Western models of
health care understand illness as located in the body or the mind;
rnind; consequently,
consequently,
predorninantly on the mental and emotional components (see,
(see ,
treatment focuses predominantly
for example
example,, Duran
Duran,, 1990; Garrett & Carroll,
也r
Carroll , 2000; Ross,
Ross , 1992). This compartcompa
眈­
mentalization of the individual is a legacy of the dualist Cartesian paradigm which
claims that the body and mind
rnind are separate entities. This is in sharp contrast to the
Caribbean worldview which is based on holism,
holism , collectivism
collectivism,, and spirituality.
lndeed
problerns in living often find
fìnd the
Indeed,, clients who hold such worldviews about problems
process of categorizing personal problems and distress in accordance with a
scientifìcally constructed statistical manual of mental disorders be
scientifically
bewildering
wi1dering (see
Soulayrol
Soulayrol,, Guigou
Guigou,, & Avy,
Avy, 1981,
1981 , for discussion).
d 肌ussion).
Moreover, in Western approaches to mental health care,
Moreover,
care , there is little attention
paid to the larger historical and contemporary contexts that shape and reshape the
sociallives
social
lives of these traditional cultural variables,
variables , namely,
nam 哟， holism,
holism, collectivism
collectivism,, and
spirituality. There are many historical and ideological forces underlying cultural
values,
psychological 丘ames
frames of thinking,
identity, psychological
thinking, and approaches to health and
values , identity,
well-being in the Caribbean; the colonial past continues to overshadow individuals
in respect to self,
self, identity
identity,, and social related struggles. lndividuals
Individuals from the
Caribbean continue to struggle with issues pertaining to racial identity often
referred to as Roast Breadfruit Psychosis (Hi
(Hickling
ckling & Hutchinson,
Hutchinson, 1999) and MroA丘0Saxon Psychosis (B
(Best
est 1999; Maharajh,
Maha 呵 h ， 2000); in other words,
words , in
individuals who are
Black on the outside but White on the inside. The writings of the psychiatrist and
renowned postcolonial theorist Franz Fanon (1965; 1967) were influential in this
regard, particularly due to his emphasis on the dehumanizing aspects of colonialism
and racism, dissolution of the self and the fragmentation of the psyche.
Similarly, illness representations and conceptualizations of physical and psychological distress are predicated on knowledge systems that are often at odds with
traditional knowledge systems and wellness ideologies. Intervention models that
are based on Eurocentric assumptions and values are often imposed on the
Caribbean people; "such imposition is reminiscent of colonialism and can
potentially be retraurnatizing" (Sutherland & Moodley, 2010, p. 271). Indeed, in
seeking to inscribe a liberatory discourse of health, mental health, and well-being,
frequently
丘equently
4 Introduction
scholars and researchers often run the risk of inadvertently recreating the very
exarnined and spotlighted; such endeavors conducted
trauma that is being critically examined
under the guise of an objective and humanistic
hurnanistic process to acknowledge and respect
the Caribbean and its people end up doing the opposite and prevailing racist
notions of the Caribbean people and their cultural and healing traditions are
reinforced.
Integrating Caribbean Healing Traditions
As Caribbean populations become more global and their traditional healing
practices spread along with them,
them, the need to understand these practices has
become an increasingly pressing concern.
concem. In many metropolitan cities in Canada,
Canada ,
the UK,
UK, and the USA it is not difficult to find healers practicing their various
Caribbean healing traditions. For example,
example , in the inner city hamlets we find
Santeros from the Santeria tradition which is commonly practiced in Cuba; Haitian
Hougans and Mambos from the V odou tradition; Shango and Spiritual Baptist
healers from the English speaking Caribbean; Imams and Hindu healers from
Guyana , Trinidad
Guyana,
Trinidad,, and Surinam; Revival healers from their homeland of
ofJamaica;
Jamaica;
Spiritist healers
from the Espiritismo tradition practiced predorninantly
predominantly in Puerto
healers
丘om
Ri
co; and Rastafari and Christian practitioners who are ubiquitous throughout the
Rico;
ofhealth
health and mental health care. Many
Caribbean region,
region, all practicing their type of
of these practices represent an amalgamation of religious,
religious , spiritual,
spiritual , and social
Amerindian, African
African,, Indian
Indian,, and the Europeans and all have
traditions of the Amerindian,
incorporated Christian
Christian,, particularly Catholic rites and rituals
rituals,, into their practices
to varying degrees.
While aspects of ritual,
ritual , classification of the spirits,
spirits , the schemas used for
identifYing
ai1ments , the method of healing,
healing, and the use of symbols may differ,
di 岳飞
identifYi ng ailments,
Koss-Chioino (2006) contends that these differences are more elaborations of
content rather than process; the basic philosophy of the healing process and the
role of the healer remain the same. Furthermore,
Furthermore , the conceptual distance between
body and mind,
rnind , physical and spiritual healing,
healing, or between health beliefs and their
vast, in fact,
fact , the practices can be considered different
di 岳rent
hues
treatments is not very vast,
of each other (du Toit
Toit,, 2001). In addition,
addition, there are several characteristics that are
fundamental to these religions. They all represent an amalgamation of monotheism
and polytheism with one Supreme Being in addition to a pantheon of gods or
deities (p
(patterson,
atterson, 1967). Central to these religions and healing traditions is the
relationship between human beings and the spirits; spirits of both the ancestors
playaa role in the lives of the living
and of other living entities are thought to play
well , spirits and power are thought to become
(Femández Olmos,
(Fernandez
Olmos , 2003). As well,
centralized into one individual,
individual , often the leader or healer,
healer, who can then pass
knowledge to others,
others , as well as heal various ail
ailments. Inorganic objects can also
be permeated with supernatural powers. The connection between the human
world and the spirit world is an integral element of Caribbean healing traditions
Introduction
5
and spirits may be manifested in the bodies of
ofboth
both healers and clients (Fernandez,
(Femandez ,
2003; Patterson
heavi1y on rituals,
rituals , channs,
channs ,
Patterson,, 1967); all of these traditions draw heavily
music
dance , and chants as a way to summon the deities from the spirit world.
music,, dance,
Moodley,
Sutherland,, and Oulanova (2008) maintain that when Caribbean
Moodl
町， Sutherland
rituals , the fundamental
clients engage in traditional healing ceremonies and rituals,
principles of holism and the body-rnind咀pirit
body-mind-spirit
connection upon which their
Hence , this service is not only
worldviews are predicated are reaffinned. Hence,
First, the cultural
historically and politically germane
gennane but also culturally appropriate. First,
similarity
sirnilarity results in a tacit understanding between healer and client and ailments
ai1ments
are located within their particular cultural context. This is underscored by
NGOMA (2003) who states,
st 抗战 "The
"Themostemost effective
岳ctive
therapeutic agents are those who
embody the culture of their clients. In a sense,
sense , the client's
client' s culture is the healing
Vontress , 2005,
2005 , p. 133). Second,
Second, through a collective,
collective ,
instrument" (cited in Vontress,
undisputed conviction in the powers of the healer,
healer , psychological relief from
ai1ments and reduced anxiety are attained (Fi
nkler, 1994). Furthennore,
Furthennore , when a
ailments
(Finkler,
patient consults a traditional healer,
healer, he or she is expected to have a clear sense of
the nature of the presenting ailment
ai1ment and its treatments; in this way,
w 呵， the patient is
reassured of the healer's legitimacy in the healing role. Clients also feel confident
that the healer knows their anguish
afflictions
an 织úsh because they too have suffered
su 岱red afHi
ctions before
becoming healers since it is usually a condition of the initiation process.
becorning
ofthe
the "wounded healer" (Jung,
(Jung, 1954 [1982]). refers to the process
This notion of
by which a healer connects with his or her own defenselessness to help others
suffering from similar
sirnilar experiences (see Koss-Chioino,
Koss-Chioino , 2006
2006,, for a discussion).
This helps to ensure that clients will find a diagnosis
d 吨nosis
that resonates with their
understanding of their core issues and they are reassured that the treatment will be
acceptable and useful. In addition,
engaged
addition, clients are expected to be meaningfully
meanin
阱llyengaged
with the healing process by being in a state of alacrity as well as to hold a finn
belief in the spirits and the techniques of the healer (McCabe,
(McCabe , 2007). Other factors
impo 眈ance
of the quality of the relationship between the healer and
include the importance
the client,
client, as well as the time dedicated to the process (p
(press,
ress , 1978; Ross
Ross,, 2008).
client
丑， traditional healers ensure that the symptorns
By taking their cues from their clients,
symptoms
and illness pre
preferences of their respective clients will be validated.
Traditional healing appears to be an effective, culturally appropriate and
widespread fonn of treatment for physical, mental, and psychological ailments
in the Caribbean. This is also true for Caribbean communities in the diaspora.
Given its pivotal role in addressing mental health concerns in particular, the
underutilization of conventional mental health care services and the prevalence of
mental and psychological ailments in this population, it is crucial that these
practices are understood in their appropriate historical and cultural context. At the
same time, attempting to write about traditional healing in an academic way is in
some way counterintuitive to the essence of traditional healing, which is effectively
an experiential process. However, if traditional healing is to be integrated into
health and mental health care with Caribbean clients, we must find ways of
6 Introduction
non-dual , anti-Cartesian and,
deciphering its non-dual,
and, at times
times,, contradictory nature into a
common clinical
clinicallexicon
lexicon that will
wi1l enable healers and health and mental health care
practitioners to effectively make sense of the system of meanings of the Caribbean
client' s personal,
client's
personal, psychological,
psychological , and sociocultural experiences. The lack of a
common language can often lead to the pathologizing of culturally sanctioned
Moodl
町， 2011).
2011).
Hence the collection
conceptualizations of distress (Sutherland & Moodley,
of chapters in this book is one attempt to promote knowledge and understanding
of these healing systems and to articulate the potential of and urgency in integrating
Caribbean healing traditions into psychology and the healing professions.
How the Book is Organized
This book is divided into four parts.
Part 1:
I: History,
History, Philosophy,
Philosoph
μ and
and Development of
Caribbean Healing Traditions
Part 1I begins with Chapter 1,
1, The History,
Histo
町， Philosophy,
Philosophy, and Transformation of
Caribbean Healing Traditions by Patsy Sutherland,
Sutherland, who explores the specific
specifìc
economy,,
historical processes of colonialism,
colonialism, slavery,
slavery, indentureship,
indentureship , and plantation economy
as well as the broad political interests that have shaped and reshaped traditional
healing in the Caribbean. Patsy argues that current healing practices are a response
to these processes and must be seen as such if they are to have any relevance to the
ways in which we deal with the physical,
physic
址， social
social,, and psychological illnesses of the
2 , The Evolution of Caribbean Traditional
contemporary Caribbean. In Chapter 2,
Healing Practices by Wendy Crawford-Daniel and ]icinta
Jicinta M. Alexis,
Alexis , the evolution
of traditional healing practices in the Caribbean is explored,
explored , as well as the
relationship between Caribbean traditional healing practices,
practices, the illness beliefs,
beliefs , and
health seeking strategies of the people. As many Caribbean societies transitioned
from traditional to modem,
modem, culturally normative healing practices and belie
beliefS
fS were
in conflict with modem Western
Westem medicinal practices and beliefs. Chapter 3,
3,
Caribbean Traditional Medicine: Legacy from the Past
Past,, Hope for the Future by
Arvilla
Arv 血a Payne-Jackson,
Payne-]ackson, discusses
discus
唱es how the traditional medical systems evolved in the
beliefS and rituals
ritu 尬
Caribbean during slavery,
slavery, with traditional medical and religious beliefS
。f
of Mricans forming the primary basis. The chapter also explores the current status
ofhealth
ofbiomedicine
of
health care provision where the presence of
biomedicine and traditional medicine
play a significant
signifìcant role in health care throughout the Caribbean. Chapter
continues to playa
Clement, and det
details
ai1s the
4 , Herbal Medicine Practices in the Caribbean by Yuri Clement,
4,
herbal pharrnacopeia
pharmacopeia in the Caribbean which developed primarily from
potpourri of
ofherbal
indigenous Amerindians,
Amerindians , enslaved Africans,
A 丘icans
， indentured Asians,
Asians , and
contributions of
ofindigenous
European setders. Supematural
Supernatural belie
beliefS
fS and the dichotomous ‘'hot-cold'
hot-cold' concept of
health and disease guide the prescriptive use of
ofherbs
herbs for simple conditions such as
the common cold to complex gynecological conditions.
Introduction 7
Part 11:
II: Caribbean
Caribbean
Traditional
卉。ditional
Healing and Healers
Part II starts with Chapter 5,
5 , Obeah: Mro-Caribbean Religious Medicine Art and
Healing,
Healing, by Nathaniel Samuel Murrell who discusses the art and science of Obeah
in traditional religious medicine. He discusses the oppression and persecution of
Obeah practices during the colonial governments,
governments , driving Obeah underground.
He asserts that Obeah practitioners are reluctant to reveal their association with
the art,
art, so health care providers may have difficulty
di 伍culty
merging modem medicine
with Obeah healing because of its secrecy. Chapter 6,
6 , Vodou Healing and
Psychotherapy by Ghislene
Ghislène Meance,
M 臼nce ， is an exploration of Vodou philosophy and
health and mental health. With a particular focus on Haiti the chapter
its practice of
ofhealth
attempts to show that Vodou can be an effective tool in health and mental health
care in the West. Ghislene
Ghislène explores how some Haitian immigrants integrate mental
health care services and Vodou healing. This chapter will increase readers'
awareness of several cultural and religious issues to address when caring for V odou
followers and clients from the Caribbean. In Chapter 7,
7 , Sango Healers and Healing
in the Caribbean,
Caribbean, Stephen Glazier examines
exarnines Sango rituals and belief systems. He
ooffers
岳rs a postcolonial critique as a way to situate the resurgence and development
of Shango in contemporary Caribbean culture. In Chapter 8,
8 , La Regia
Regla De Ocha
(Santeria): Afro-Cuban Healing Methods in Cuba and the diaspora,
diaspora , Carnille
Camille
Hemandez-Ramdwar explores La RegIa
Regla de Ocha (Santeria)
(Sante
巾) as an Afro-Cuban
religion that has played a central role in the healing of Cuban communities.
C arni11e discusses the common beliefs about illness and well-being from the Santeria
Camille
perspective and the resurgence of interest in La Regia
Regla de Ocha in the Caribbean,
Caribbean,
particularly in Cuba. In Chapter 9,
9 , Puerto Rican Spiritism (Espiritismo):
(Espírítísmo): Social
Context, Healing Process,
Process , and Mental Health by Jesus Soto Espinosa andJoan
and Joan D.
Context,
Koss-Chioino , the cultural and historical context of Spiritism (Espiritismo),
Koss-Chioino,
(Espírítísmo) , as a
philosophical,
"scientific,"
," and ethical movement,
movement , is reviewed. The focus on
philosophical , "scientific
Spiritism and its underlying principles in Puerto Ri
Rico
co are explored. In Chapter
inJ Jamaica,
缸丑<llCa ，
10, Revival: An Indigenous Religion and Spiritual Healing Practice in
10,
Claude
配Anderson
William Wedenoja and Claudette
Anderson discuss Revival as a religious tradition
with
withanA an African
丘ican
foundation and Christian influences that is indigenous to the island
of
Jamaica. Healing is central to the practice of
Revival and takes place
in sacred
ofRevival
p
ofJamaica.
places called "balmyards," where it is usually performed by women called Mothers
who have received the power of healing as a spiritual gift. W edenoja and Anderson
argue that Revival healing has been marginalized by the medical profession and
criminalized by the law. They assert that Revival is an authentic and popular form
of folk psychiatry or spiritual counseling that should be legalized. In Chapter 11,
Spiritual Baptists in the Caribbean, Wallace Zane brings to our attention the
complexities of the Spiritual Baptist religion as an Mro-Caribbean Christian
tradition. The religion is revelatory, with differences in practice between the
various Caribbean islands and between local traditions within islands.
8 Introduction
Part 111:
III: Spirituality,
Spiritualit
弘 Religion,
Religion
， and Cultural Healing
Part III begins with Chapter 12,
12 , Christian Spirituality,
Spiritua1ity, Religion,
Religion, and He
Healing
a1i ng in
the Caribbean by E. A. Allen
All en and Abrahim Khan
Khan,, who explore an integrative
he a1i ng ministry
rninisttγwithin
within a traditional and
model of Christianity as a whole person healing
Afrocentric
A
丘ocentric
cultural matrix in the Caribbean. In Chapter 13,
13 , RastafarI: Cultural
Healing
He
a1ing in the Caribbean by Kai Morgan,
Morgan, the philosophy ofRastafarI is discussed.
The origins and development ofRastafarI as well as its current challenges,
challenges , development
Healing
a1ing Traditions in the
ment,, and experiences are explored. Chapter 14
14,, Hindu He
Southern Caribbean: History and Praxis
Pr 旺is by Keith McNeal,
McNeal, Kumar Mahabir
Mahabir,, and
he a1ing ttaditions
traditions in the West Indies by situating
Paul Younger,
Y ounger, explores Hindu healing
practices of religious and popular healing within changing social and historical
prorninent forms of contemporary Indocontexts. It examines the two most prominent
Caribbean Hindu therapeutic prpraxis:
但由: the psychosomatic healing
he a1ing technique known
as
asjharay
jharay,, as well as trance-based catharsis and exorcism offered
off 泣ed by heterodox Shakti
Shaktí
Puja. The colonial
coloniallegacy
legacy and postcolonial dynamics are discussed with regard to
implications for health and mental health. In Chapter 15
15,, Islamic Influence in the
a1ing Practice by Abrahim Kh
Khan,
an, Islamic
Caribbean: Traditional and Cultural He
Healing
healing practices are discussed as an adjunctive therapy in the cultural and political
economy of the Caribbean. Khan explores the connections between counseling
psychology and spirituality,
spirituality , between religion and medicine.
Part IV:
1\ 行 Traditional
Traditional
Healing and Conventional Health and
Mental Health
Part IV begins with Chapter 16,
16 , Community Mental Health in the English
Hutchinson, who describes the development of
Speaking Caribbean by Gerard Hutchinson,
community mental health services in the English speaking Caribbean. He argues
ttaining of mental health
that the driving force behind this process has been the training
professionals with an initial focus on psychiatry and a more recent emphasis on
psychology, thus ignoring Caribbean indigenous or traditional
psychology,
ttaditional healing
he a1ing methods.
In Chapter 17,
17 , Psychology
Psychology,, Spirituality
Spirituality,, and W ell-Being in the Caribbean,
Caribbean ,
Omowale Amuleru-Marshall,
Amuleru-Marshall , Angela Gomez
Gomez,, and Kri
Kristyn
styn Neckles discuss the
contexts and processes by which traditional healing practices can be a papart
眈 of
of
Western counseling and psychotherapy. Chapter 18,
18 , Practical Magic in the US
Urban Mili
Milieu:
eu: Botánicas
Bocinicas and the Informal Networks of
ofHeHealing,
a1i吨， Anam
Anahí Viladrich
Latino healers as informal
infon
丑al counselors among diverse groups of
discusses the role of
ofLatino
Latino immigrants in New York City (NYC). The chapter explores these issue
through empirical research conducted in NY
NYc.
c. The study explored the convergence of spirituality,
spirituality, the social and the physical realms,
re 过rns ， in conceptualizing their
main therapeutic approaches and the resulting treatments.
treatInents. And finally
finally,, in Chapter
19 , Caribbean Traditional Healing and the Diaspora,
19,
Diaspora, Roy Moodley and Michel'
Michel' e
Bernand
hea1ing traditions
ttaditions
Bertrand explore the evolution and development of Caribbean healing
Introduction 9
in the West,
West, the complexities,
complexities , confusions,
confusions , and contradictions within which
Caribbean traditional healing practices survives. The chapter also explores how
these healing traditions can be integrated into mainstream mental health care
practlces.
practices.
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This
PART I
History,
History, Philosophy,
Philosoph
头 and
and
Development of Caribbean
Healing Traditions
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This
1
HISTORY,, PHllOSOPHY
PHILOSOPHY,, AND
THE HISTORY
TRANSFORMATION OF CARIBBEAN
HEAllNG
HEALING TRADITIONS
Patsy Sutherland
Introduction
The use of traditional healing practices and rituals can be traced back to the genesis
of human history. The Shaman is arguably the first spiritual healer deemed an
psychotherapist
但
(Bromberg,
romberg
， 1975).
archetype of the contemporary physician and psychotherapist
Defined as the practices and knowledge that existed before the beginnings of
modern medicine that are used to promote
promote,, maintain
maintain,, and restore health and wellbeing
being,, traditional healing practices are ubiquitous in diverse societies globally and
have , for centuries
have,
centuries,, met the health care demands of populations
populations 但
(Bannerman,
annennan
，
Burton, & Ch'en,
Ch'en, 1983). Nevertheless,
Nevertheless , the particular ways in which these healing
Burton,
traditions have been developed and expressed over time are reflective of varied
histories,
cultures , environments,
environments , resources,
resources , and the needs of the populations they
histories , cultures,
ane & Sutherland,
Sutherland, 2010). Caribbean healing traditions are no exception.
serve (W
(Wane
Any understanding of
ofhealth
health,, healing
healing,, and medical care in the Caribbean inevitably
inevita
崎
Any
draws our attention to the configuration of history and gives emphasis to the
transfer of cultural and healing practices
practices
丘om
from Mrica
Mrica,, India,
India , and Europe.
The different territories that encompass the Caribbean region share a complex
and captivating history derived exclusively from the greed and struggle for hegemony by European nations in concert with slavery,
slavery, indentureship,
indentureship , and plantation
Barros , Palmer
Palmer,, & Wright,
Wright, 2009; Mintz
Mintz,,
agriculture from their inception (De Barros,
1975). As a general rule
rule,, oscillating patterns of sugar production are critical to any
discussion of traditional healing in the Caribbean as they account for the importation of slaves as well as their eventual destination in the Caribbean. The shifting
shi 丘mg
configurations of sugar production meant that the greatest volume of slaves was
climax, most industrially
dispersed to locations where production was at its climax,
advanced , and protracted. This resulted in the intense process of cultural exchange
advanced,
16 P. Sutherland
from which traditional systems of healing were ultimately derived (Fernandez
(Fernández
Olmos,, 2003; Voeks
Voeks,, 1993). Following the abolition of the
Olmos
the 由ve
slave trade,
trade , South Asian
indentured workers also brought their religious and cultural healing traditions to
the Caribbean thereby,
thereby, adding to the cultural complexity of these healing systems.
Moreover, as tools of colonial power
Moreover,
power,, Christianity
Christianity,, and Western medical science
were superimposed on this complex healing system and maintained with remarkBarros , Palmer
Palmer,, & Wright,
Wright, 2009).
able fidelity into the neo-colonial era (De Barros,
Collectively, these processes have shaped notions of
Collectively,
ofhealth
health,, healing
healing,, and medical
care in the Caribbean.
Indeed , the health and medical care of the newly arrived Mricans and,
Indeed,
and, later
later,,
Indian indentured laborers were gravely threatened by the ghastly life conditions
imposed by the European colonizers. Absolute negligence by the colonial masters
and the high cost of medical services exposed these individuals to the full violence
of diseases and outbreaks,
outbreaks , compelling them to tend to their own health care needs
(Brizan,， 1984; Laguerre,
但rizan
Laguerre , 1987; Voeks,
Voeks , 1993; Weaver,
Weaver, 2002). As a result,
result, they relied
on rudimentary knowledge of Amerindian
Amerindian healing systems,
systems , their Mrican and
Indian traditions,
traditions , and the utilization of plants that were available to meet their
health care needs. According to Laguerre
La 织lerre
(1987),
(1987) , their survival depended
predominantly on their effective
e 岳 ctive
use of traditional or folk medicine.
Caribbean healing traditions developed in response to these specific historical
forces and represent powerful resources for survival,
survival , embody responses to
oppression and exploitation,
exploitation, and speak to the determination
deterrnination of the Caribbean
people to resist their dehumanizing,
dehumanizing, life-threatening,
life-threatening, and morally offensive
0 岳nSlve
(Suthe
由时， 2011). This chapter begins with an examination of the
conditions (Sutherland,
historical influences that have shaped and reshaped traditional healing in the
Caribbean. This is followed by a discussion of the ph迫osophical
philosophical underpinnings of
Caribbean traditional healing systems. Lastly,
Lastly, it explores the broad political interests
that have supplanted traditional healing to a reductive place in mainstream society
and argue that current healing practices are a response to these processes and have
physical , social,
social , and psychological illnesses are conshaped the way in which physical,
ceptualized, represented
ceptualized,
represented,, and presented in the contemporary Caribbean.
Historical Background
The study of the Caribbean people has not consistently analyzed the complexity of
their historical experiences (Mintz,
(Mi n 钮， 1992). The extant historical records represent,
represent ,
in a fragmented and compartmentalized manner,
manner, segments of the past that has been
expounded
expounded
丘om
from a European perspective. Therefore,
Therefo
时， any attempt to evaluate the
worldviews , spiritual beliefs
worldviews,
beliefs,, and healing practices distinctive to the Caribbean
culture , cannot ignore the physical relocation imposed on the people who brought
culture,
them to the New World (Mintz,
(Mintz , 1992). In discussing the Caribbean region,
region, it is
important to recognize that while distinct Caribbean societies share many
similarities , each is in its own way particular and unique. The historical and cultural
similarities,
History,
History, Philosophy,
Philosophy, and Transformation
17
development of each country is defined
defìned by elements such as the European culture
by which it was colonized (English,
(English , French,
French, Spanish,
Spanish, or Dutch),
Dutch) , the intensity of
slavery and the different
di 岳rent
struggles against it
it,, the degree of economic
econornic deprivation,
dep 町ation
，
(Mintz,,
and racial and ethnic heterogeneity and the ensuing identity problems (Mintz
Whil e these differences
di 岳rences
specifìc traditions
1989). While
may be more evident in the way specific
islands , they must not be overlooked if one is to gain
are practiced on the various islands,
a precise understanding of these societies and their cultural and healing practices.
The Caribbean region,
region, often referred to as part of the New
N ew World,
W orld, is comprised
of approximately 50 distinct societies,
societies , all of which have endured similar
sirnilar historical
experiences (Mintz,
(Mintz , 1989). It is the only geographical region in the world where
entire societies were brought into existence and sustained by the obliteration of
an indigenous population and the massive relocation of an ethnic group from its
Mrica, forthe
ofslavery
slavery (Patterson
(Patterson,, 1967). When Christopher
homeland, Mrica,
homeland,
for the purpose of
Columbus arrived in the Caribbean in 1492,
1492, the region was already inhabited by
indigenous people (B
(Brizan,
rizan, 1984). Geographically disoriented
disoriented,, he
populations of
ofindigenous
erroneously labeled these individuals as "Indians" and characterized them as
prirnitive savages in need of humanizing,
primitive
humanizing, thereby justi
justifying
马ring
European intrusion
and subsequent colonization
colonization,, enslavement,
enslavement , and indoctrination to Christianity
(Yelvington,
(Y
elvington, 2000). The indigenous people were unprepared militarily to defend
against the invaders. Furthermore,
Furtherrnore , they had no imrnunity
immunity to European diseases and
eventually they were eradicated though traces of their ancestry remain in various
Caribbean
但
(Brizan,
rizan
， 1984; Yelvington,
Yelvington, 2000). Subsequently,
Subsequently , the
parts of the Caribbean
Europeans imported massive numbers of slaves from Mrica and established sugar
plantations. It is estimated that approximately 40% of the more than nine million
W orld were
enslaved Africans who survived the Middle Passage to the New World
1
dispersed throughout the Caribbean (Y
(Yelvington,
elvington, 2000).
extended
丘om
from the
Pradel (2000) posits that the Mrican origins of the slaves extended
coast of Senegal to the south of Angola resulting in a clash of different
di 伽ent
ethnic
trade , its intensity,
intensi
町，
groups. She further contends that the magnitude of the slave trade,
duration,
duration, and the lack of any coherent selection process of captives meant that
New
ew World.
W orld.
most of the existing rituals from these regions were initiated in the N
di 面cult
m
It is not difficult
to imagine that many
intellectuals and healers ended up the
Caribbean as a result of this undifferentiated selection process. According to V oeks
(1993) many priests, magicians, and herbalists were included among the newly
arrived Mricans and they maintained some degree of their previous status, thereby
making possible the continued existence of a shaman class in spite of their
enslavement. Voeks (1993) added that the practitioners of these African magicosystems were instrumental in reinforcing this collective knowledge in the New
World. Enslaved Africans secured a connection with their particular kingdom and
home of their gods and it was this continuity that provided the crucial resources
for maintaining a sense of identity, culture, and religion (Taylor, 2001).
Both during and after slavery, however, other groups also supplied labor in the
Caribbean. For example, more than half a million Indians, of both Muslim and
18 P. Sutherland
Hindu faiths,
faiths , were brought to the region; the majority
m 司jority
were sent to Trinidad and
(Mintz ,
British Guyana,
Guyana , with smaller numbers going to Dutch Guyana (Surinam) (Mintz,
1975). Theoretically speaking,
speaking, indentured laborers were not slaves; however,
however, there
are many parallels between the two systems. For example,
example , Samaroo (1987) notes
that the recruitment ofIndians
ofI ndians was conducted by a regularly organized system of
kidnapping and/
and/or
or deceiving unsuspecting individuals into offering themselves
thernselves for
indenture. The absence of a selection process also ensured that the Indians who
arrived in the Caribbean originated from various economic
econornic castes,
castes, religions,
religiOI
毡， village
groups
groups,, and geographical regions resulting in the creation of a mini
rnini India in the
Gonzales , 2010) and
and,, thereby deepening the complexity
Caribbean2 (Edmonds & Gonzales,
of cultural and healing traditions already present in the region. Similar
Sirnilar to enslaved
A
丘icans
， indentured Indians identified with their ancestral culture and belief
Africans,
systerns and looked to India for inspiration in the face of their oppressive
systems
conditions; new traditions were created by borrowing from their homeland and
myths , rituals,
rituals , and festivals that culminated
culrninated into vernacular
incorporating new myths,
Go 皿ales ，
religions that are very distinct from their place of origin (Edmonds & Gonzales,
2010). Many identified with various gods to help cope with the dehumanizing
conditions of colonial domination
dornination and exploitation. For example,
example , an important
aspect of Caribbean Hinduism was the adoption of the Ramayana tradition into
tradition, the main protagonist Ram was exiled
everyday life. In the Ramayana tradition,
from his home; Hindu labourers identified with the character Ram and saw
motherland, anticipating their eventual return
themselves as exiled from their motherland,
(Mahase
(Mahase,, 2008).
The Caribbean,
Caribbean , therefore
therefore,, represents an ethnically
ethnically,, racially
racially,, and culturally
Am erindian, European,
European, Mrican,
Mrican, Asian,
Asian , and East
diverse region influenced by Amerindian,
Indian cultures. These waves of migration
rnigration of people from virtually everywhere
eve 巧而There
di 岳rent
ethnic
have made this region the site of an unparalleled collision of different
groups. Hobsbawm (1973) described the Caribbean region as a
space-station
丘om
races , torn
curious terrestrial space-station
from which fragments of various races,
from the world of their ancestors and aware both of their origins and of the
them, can watch the remainder of the globe
impossibility of returning to them,
with unaccustomed detachment.
。.
(p. 8; as cited in Mintz
Mintz,, 1975)
At the same time,
time , it is important
impo 眈ant to note that these horrific events did not result
in "social death" even though the Middle Passage,
Passage , slavery
slavery,, and indentureship
Mricans , indentured Indians
Indians,, and their offspring in the
dehurnanized
dehumanized all enslaved Mricans,
seerns that people of Mrican and
most injurious way possible
possible 例ishida
(Nishida,， 2003). It seems
resource
也lness.
Indian descent demonstrated a remarkable degree of resilience and resourcefulness.
Indeed,
Indeed, the paradox is that it was the dislocation,
dislocation, transportation
transportation,, and insertion into
populations ,
the plantation economy by Western colonialism that integrated these populations,
despite their differences,
di 盗erences
， in as much as it severed direct retrieval of and connection
History,
History, Philosophy,
Philosophy, and Transformation
19
to their past (Hall,
(Hall, 1994),
1994) , and gave rise to the profusion of healing traditions and
of resistance present in the Caribbean region today. According to
Femandez (2003) it was the fluidity of these religions that enabled individuals to
Fernandez
draw on spiritual power from wherever it was generated to acclimatize to their
new milieu. Notwithstanding,
Notwithstanding, neither cultural components
componen
臼 nor
nor
historical factors
alone can capture the entire significance of these healing traditions. An exploration
of spiritual beliefs,
beliefs , as well
wel1 as beliefs about the causes of illness and their functional
roles , are important for a broad understanding of Caribbean healing traditions.
roles,
Ssymbols
严nbols
The Philosophical Basis of Traditional Healing
It seems that over time different
di 岳rent
cultural groups have developed their own
explanations and conceptualizations of
of 血ness
illness,， mental health
health,, and well-being,
wel1-being, and,
and,
consequendy,
consequendy , identified culturally sanctioned coping strategies (Lee & Armstrong,
Armstrong,
1995). At the heart of the collection
col1ection of hybrid or creolized healing traditions in
the Caribbean is the worldview that everything in the universe is of one source
and will,
will , and that the world is animated by numerous ancestral spiritual entities,
entities ,
gods,, and deities that frequendy intervene in the everyday lives of individuals
gods
(Vontress,， 1991; Wane & Sutherland,
(飞Tontress
Sutherland , 2010). For example,
example , it is believed the
body, llÚ
body,
mind,
nd, and spirit are all interconnected and whatever affects
a 岳 cts one
one,, impacts
perspective , illnesses and disorders may derive
derive
丘ommany
from many
the other. From this perspective,
sources including natural,
natural , social
social,, spiritual
spiritual,, or psychological disturbances that create
physical , social,
social , or mental
disequilibrium which can be expressed in the form of physical,
ill health
(Laguerre,
迦
health
(L
aguerre , 1987; Wane & Sutherland,
Suthe
出时， 2010). Causality for natural illness
is typically attributed to elements in the natural environment and can be prevented
by maintaining humoral balance within the body or health can be restored with
(Miller, 2000). On the other hand,
hand , superthe use of herbs and regulated diets (Miller,
naturally engendered illness may originate with the spirits,
spirits , a rupture in the
reciprocal relationship with the ancestors,
ancestors , or be inflicted by a malevolent person;
consequendy, they are treated by spiritual or traditional healers (Laguerre,
consequendy,
(L a ♂lerre
， 1987).
During the colonial epoch,
epoch, issues around mental health were deemed to have a
supematural basis,
supernatural
basis , making the interventions of traditional healers most critical in
the treatment of mental illness (Laguerre,
(Laguerre , 1987). This trend has persisted into the
neocolonial era.
In addition to the philosophy of holism,
holism, traditional healing systems are
grounded in a philosophy that is intrinsically empowering. The belief that the
etiology of adversity is with demons and spirits,
spirits , regardless of whether the adversity
is within the family
fanúly or the society at large,
large , serves two functions. First
First,, it positions
detect, eradicate
eradicate,, or placate the offending
0 征岱
en时
din
the healer as the one with the power to detect,
sψpi
回
rit 飞， and second,
second, it creates a sense of order in the context of instability
instab
且ity and
spirit,
insecurity (McGuire,
(McGuire , 1991). This is an essential element in healing. Clearly,
Clearly , the
particular stresses that the Caribbean peop
people experienced reflected the repressive
social conditions under which they existed; accordingly, traditional healers
20
P. Sutherland
understand ailments
ai1ments and
and,, therefore
therefore,, their cures as encompassing the social realm.
By 10cating
locating causality outside of the individual,
individual, these rituals he1p
help to contain disorder
healing and control.
and trauma by creating a sense of
ofhealing
control. This was particularly relevant
during the periods of slavery and indentureship as individuals struggled to gain
(Sutherland , 2011).
some semblance
semb1ance of agency over their lives (Sutherland,
Another crucial function of traditional healing that is inextricably
inextricab1y linked to its
philosophy of connectedness and the essential role
ro1e of 配
the
d he比
e body 扫
is
is 由
that
t ha 挝t of
ofa 衍
assuaging
ssua山
la唁唔
gm吨
g
1喀
t由
h叫
E trauma associated with the process of enforced acculturation (press, 1978). The
the
physical
phy
严si 比cal and 萨
ppsychological
sy严cho1o~ ♂员cal dislocations
dis1ocations produced by slavery,
slavery, indentureship,
indentureship , and
vio1ence and rupture have resulted in what Sweeney (2007)
ensuing chronicles of violence
peop1e that is grounded in a
describes as an "unvoiced" history among Caribbean people
loss. Any attempt
a 忧empt
to heal these historical wounds
central notion of absence and 10ss.
would be remitted
rernitted without a comprehensive understanding of how these psycho10gical injuries have been consolidated in the collective memories of the
chological
Caribbean people
peop1e and reenacted transgenerationally (Apprey,
(Apprey, 1999). The challenge
for the Caribbean people
peop1e is that the nature of their historical injury has produced
trans1ated into
a predicament in that the collective traumatic experience cannot be translated
healing,
narrative. Given that the assimilation
assirnilation of trauma is a central component to healing,
without an avenue for expression,
expression, it is ultimately
ultimate1y manifested as a "latent symps 严np­
tomatic injury" (Sweeney
ofhistorical
historical traurna
trauma was
(Sweeney,, 2007
2007,, p. 51). This specific kind of
Knadler
adler (2003) who described it as "a reflexive memory of the body
captured by Kn
that refuses to ‘'pass'
pass' into any recognizable
recognizab1e story" (p. 75).
In Caribbean healing traditions,
traditions , the body is perceived as a conduit through
which individuals can unearth the 1atent
latent causes of their symptoms.
s 严nptoms.
In her analysis
of energy healing and psychotherapy Woessner
W oessner (2007) states
states,,
The body becomes,
becomes , in a sense,
sense , a record of everything that has ever
will happen ...
happened,
happened, is happening,
happening
，飞Nill
. . . You take a joumey through the
body
. . . and in the journey
body,, because everything will be he1d
held in the body ...
you find the story that is manifesting in symptoms.
s 严nptorns.
(p. 62)
In the Caribbean context it is a particularized story that seems to disallow the
Indeed , in her influential
discursive negotiations of conventional psychotherapy. Indeed,
work on trauma,
trauma , Cathy Caruth (1995) explains,
exp1ains , "to be traumatized is precisely to
be possessed by an image or an event" (p. 5). This notion of "possession" and
of"demons"
"demons" or exorcisms
exorcisrns are pivotal to Caribbean healing
consequent casting out of
wimessed a Caribbean healing ceremony can attest
traditions; anyone who has ever witnessed
to central ro1e
role of the body with its rituals and dances that often culminate in trancelike states where healers and clients engage in a dialogue with the body and spirits
to bring about a sense of healing (see Moodley,
Sutherland,, & Oulanova,
Moodley, Sutherland
Oulanova, 2008,
2008 ,
ceremonies , according Sartre (1961)
(1961),,
for a discussion). In these healing rituals and ceremonies,
History,
History, Philosophy,
Philosophy, and Transformation
21
they dance ...
. . . the dance secretly mimes
mimes,, often unbeknownst to them,
them, the
No they dare not voice,
voice , the murders they dare not commit. In some regions
reso 眈: possession. What was once quite simply a religious
they use the last resort:
act, an exchange between the believer and the sacred,
act,
sacred, has been turned
tumed into
a weapon against despair and humiliation.
(p. Ii
liii)
。.
ii)
It seems
seerns that this unique healing process is accomplished through what Dow
(1986) describes as a complex sequence of exchanges that transpire in a mythic
world that is shared by healers and clients. He explains the term "mythic" to
denote that that there are cultural experiential certainties delineated in this world
hurnan experiences as well as solutions to these experiences.
that are symbolic of human
traurnatic events replicated in this
Healing is accomplished by the reformation of traumatic
mythic world through a particular mechanism in which the healer acts as a
conciliator between the spirit world and the client; through the chants,
chants , dances and
epitornize Caribbean healing traditions,
traditions , painful emotions are
trance-states that epitomize
expres
在ed to bring about a sense of
ofhealing
healing and resolution. What is possible in these
expressed
bodily metaphors and rituals is that a certain kind of history can be "voiced,"
"voiced,"
traumatic experiences and aspirations of
ofliberation
liberation can be "acted out,"
out," and the
irnagined community and traditions of the ancestral homeland,
imagined
homeland, whether it is Mrica
or India,
India, can be symbolically
s 严丑bolically
reconstructed to bring about healing and empowerment (D
(Dow,
ow , 1986: Hall,
Hall , 1994; Sutherland,
Sutherland , 2011). At the same time,
time , these
rather, it is their transformation
traditions were not preserved in their pure form; rather,
that forces us to interrogate the configuration of power entrenched in the processes
of
ofknowledge
knowledge production,
production, justification,
justification, and utilization of these healing traditions.
The Transformation of Caribbean Healing Traditions
Dominant discourses have marginalized Caribbean healing traditions and pushed
Dorninant
them to the fringes of society where they have had to transform themselves to
adapt to ever-shifting sociocultural and political milieus. The implications of
slavery and indentureship were not simply intense labour on the plantations and
master, a rich body of literature explores
absolute dehumanization by the slave master,
how the colonial subject was created through elaborate systems that measure,
measure ,
compare
hur 丑an difference
di 岳rence
(see Bhabha
Bhabha,, 1994; Fanon
Fanon,, 1961; 1967;
compare,, and explain human
Said 1978). More specifically,
specifically, Said (1978) argued that Western
Westem scholarship's
Westem colonial and imperial hegemony,
hegemony , particularly in its
complicity with Western
non-Westem cultures as subjects in need of civilization and
representation of non-Western
processes , predicated
acculturation, served the European exercise of power. These processes,
acculturation,
on the assumption of the colonizer's
colonizer' s obvious superiority in all aspects of culture,
culture ,
history,
history , political and social systems,
systems , and religion,
religion, justified the extreme imposition on the colonized as people in need of intervention. For example,
example , traditional
healers are often referred to as "witchdoctors,'
"witchdoctors ,' a common nomenclature that was
22
P. Sutherland
constructed under colonialism
colonialism
何Tane
(Wane and Sutherland
Sutherland,, 2010). This derogatory
categorization erroneously defined traditional healing as witchcraft and perpetuated
the perception of these poorly understood practices as evil,
evi1, thereby justifying
forced conversion into the sanctity of Christianity.
While Christianity has always been a basic tenet of life in the Caribbean,
Caribbean ,
Fanon's (1961) contention was that the church in the colonies did not call the
colonized to the ways of God,
God , but to the ways of the colonial masters. Fanon's
Fanon' s
ofthe
the colonial project was echoed by Grier and Cobbs (1971) who note,
note ,
analysis of
"Christianity in the hand of the slave-owner held a potentiality for wickedness that
is
lstemterrifying,
阳ng ， and one that is awed by its perfection for evil
ev 且 purposes"
purposes"(p.
(p. 165). The
original purpose of Christianity in the Caribbean drew on 山
its principle
principle of the
afterlife to keep slaves enslaved; it provided the motivation for slaves and
indentured workers to work themselves to death in the present life (Grier &
Cobbs , 1957). Indeed,
Cobbs,
Indeed , slaves and indentured labourers were indoctrinated into
Christianity and prohibited
prohibited 丘om
from practicing their own religions; the tradition of
Obeah , for example
Obeah,
example,, was unequivocally proscribed and resulted in either death or
transportation (B
(Brizan,
rizan, 1984). As a result,
result, enslaved Mricans engaged in a covert
systematic process of preserving Mrican religions in the New World by
syncretizing them with elements of Catholicism. The shared philosophy of
polytheism made it possible to mask African
A 丘ican
deities with Catholic saints,
saints , and for
corτesponding Catholic saint (Femandez
(Fernandez,,
every Mrican god or deity there is a corresponding
2003; Voeks
Sirnil
缸片， the majority of the indentured labourers did not
Voeks,, 1993). Similarly,
sirnply embrace the religion of the colonizers but resisted,
simply
resisted, however possible
possible,, and
perpetuated the cultural and traditional healing practices that they brought with
them to the New World. 3 The Hosay Riots in Trinidad in 1884 was a clear
example of such resistance (see Mahase,
Mahase , 2008 for a discussion). It was this actuality
that transformed
transforrned Caribbean healing traditions into the hybrid,
hybrid , and at times,
times ,
perplexing collection of religions that exist in the modem day Caribbean.
Another important
irnportant factor in the transformation
transforrnation and marginalization of traditional healing is its relationship with modem medicine which is grounded in an
dornination with traditional healing representing subjugated or
intercourse of domination
rejected ideology. The power and authority of the natural science paradigm from
which biomedicine
biomedic
draws its legitimacy are incontrovertible and the rhetoric of
scientific objectivity is alluring (Brodwin, 1998). Consequently, the universality
of its model is often speciously accepted in the assumption that it is or ought to be
appropriate in the assessment of the effectiveness of traditional healing systems in
spite of divergent epistemologies regarding illness and health (Waldram, 2000).
Traditional healing or medicine is clearly a cultural phenomenon; therefore, its
configuration and purpose are obscured by the application of the allegedly culturefree language of science, as Waldram (2000) notes, "even the basic concepts of
traditional and medicine are fraught with Eurocentrism and English-language biases,
and they may be little more than very crude approximations, at best, of complex
indigenous thought" (p. 607). What is at issue here is that the hegemonic practices
History,
History, Philosophy,
Philosophy, and Transformation
23
of conventional medicine have distorted conceptualizations of the efficacy
e 伍 cacy
of
traditional healing rendering it rejected knowledge to be scoffed at by the larger
est 由lished
churches,
churches , demoted by the
society, condemned on the pulpits of established
society,
education system,
and,, at
times,， prohibited by the authorities (Laguerre,
system, and
at 由丑es
(La 织lerre
， 1987).
Traditional healing in the Caribbean represents a structured nosological classitreatrnent similar to
fication of diseases and ailments with notions of causality and treatment
the biomedical model which is clearly one of many healing traditions (Kleinman
(Kleinman,,
Sutherla
时， 2010). Hence,
Hence , the marginalization of Caribbean
1995; Moodley & Sutherland,
healing traditions appear to be a deliberate strategy in colonizing the elements of
human experience over which medical practitioners can allege authority and
maintain control by promoting the practices and ideologies of their respective fields
al. , 1981; Waldram,
Waldram, 2000).
(Mishler et al.,
The emergence of mental health research and practice has followed a similar
trajectory which parallels the subjugation of the Caribbean people and their healing
traditions. The mental health paradigm in the Caribbean also became apparent in
the context of plantation economy when slaves who attempted to run away from
their dehumanizing conditions were diagnosed with drapetomania 4 or the impulse
(Cartwright, 1851). This is a clear example of the influence of political
to run away (Cartwright,
ideology on psychopathology and mental health; from the colonizer's perspective
mentally
血
ill to
to contemplate escaping the conditions of slavery and
one had to be mentally
indentureship. Conventional psychiatry and psychology advances the idea that
psychological, social
psychological,
social,, and emotional problems are a function of some underlying
biological pathology,
pathology , hence mitigating every feasible kind of psychiatric intervention 但arker
(Barker,， 却
2003).
2 00伪
3匀). This
Th怡
1臼s 囚川
is 1口
in
ms 巾
sharp
ha呻
a
contrast to the philosophical underpinnings
hea 址
aling
i llness
of traditional healing
which attributes the etiology of mental 血
illness
to the social
and
spiritual realm. Furthermore,
andsψpiritual
Furthermo
时， manifestations and presentations of spirit possessions , visions
sions,
visions,, curses
curses,, and spells are consistent with the Diagnostic and Statistical
Manual's (D
(DSM)
SM) criteria for psychotic disorders upon which Western notions of
psychopathology are determined. The result for Caribbean clients who endorse
traditional systems of etiology are often inaccurate diagnosis,
diagnosis , poor compliance,
compliance ,
overrepresentation in involuntary detainment in secure psychiatric settings,
settings , and
higher
hi
prescribed psychotropic drug dosage than their white counterparts (Callan
& Littlewood, 1998; Harrison, Barrow, & Creed, 1995).
Indeed, there is an entire movement and a body of literature which challenges
dominant psychiatric and psychological thinking and practice on a range of issues,
including religion and spirituality, with the goal of enhancing mental health care
with diverse populations. This has given rise to an initiative within this field of
multicultural counseling and psychotherapy aimed at integrating traditional healing
practices into counseling and psychotherapy (Fukuyama & Sevig, 1999; Moodley
& Sutherland, 2010; Moodley & West, 2005; Sutherland, 2011); however, this
may be a double-edged sword for Caribbean healing traditions. Regardless of their
intentions, the ideologies and theoretical approaches of researchers will always
determine what gets studied, the findings that are obtained, and, ultimately, how
24
P. Sutherland
they are implemented (Hutchinson & Sutherland,
Sutherland , 2012; Sutherland & Moodley,
Moodl
町，
2011). What this means is that Caribbean healing traditions may once again have
to transform and reconstruct themselves under the guise of culturally
cultura1ly appropriate
mental health care for Caribbean clients. These and other issues will
wi1l continue to
haunt these traditions and their very existence must be subsumed under the rubric
of
ofWestern
Western scientific paradigms regarding health and mental health where political
power
rat 阳
阳四阳
he ertha than
四
a汩I盯
岳
E
ec伽
d盯
venes
is pivotal to legitimacy (Laguerre, 1987). It is only
power,, rather
effectiveness,
when we 叽
view
v iew
these healing
heali 口
ing practices in their wider historical,
historical, sociocultural,
sociocultural, and
political contexts that we can understand the profound extent to which they
represent the unending interplay of interconnected spheres of power,
power, and their
remarkable capacity for transformation. Current healing traditions in the Caribbean
are a direct consequence of these processes and must be viewed as such if they are
to have any relevance to the manner in which we deal with the physical,
physical, social
social,,
mental,, and psychological ailments in the present context (Moodley,
mental
(Moodl
町， Sutherland,
Sutherland ,
& Oulanova,
Oulanova, 2008).
Conclusion
What is articulated in the preceding discussion is that Caribbean healing traditions
resistance , identity,
identity, and healing since the beginning of the
have been a source of resistance,
slave trade. The direct reference to history is at the core of understanding the
transformation of these healing traditions in their repeated confrontation with the
insidious machinations of colonialism. The Caribbean region has always represented a contested site in which the Mrican and Indian presence have been in a
quiet and,
and, at times
times,, not so quiet struggle with the European presence for selfassertion,
encounter, slavery,
slavery, indentureship,
indentureship ,
assertion, a struggle spanning the entire period of encounter,
colonialism,
Religion,, health,
illness,， and
and,, consequently
consequently,,
colonialism, and neocolonialism. Religion
health
，山ness
current healing traditions are symbolic of this struggle for agency,
agency, control
control,, and
gods ,
survival. Grounded in the principles of holism and a connection with the gods,
spirits,, deities
deities,, and ancestors
ancestors,, traditional healing transcends everyday experiences
spirits
of diseases and its cures to confront
con 丘ont historical wounds of absence and loss. Through
its rituals and metaphors,
metaphors , individuals are symbolically reconnected to their places
of origins which lie at the center of their experiences of rupture,
rupture , dislocation,
dislocation ,
fragmentation , and trauma. By extension,
extension, these traditions are resources with which
fragmentation,
to confront
co 吐白 nt the pathological ways in which these experiences have been reconstructed within the dominant
Western science,
medicine,, psychiatry,
dOllÚnant discourses of
ofWestern
science , medicine
psychiatry,
psychology,
psychology, and Christianity.
Clearly, there is renewed interest in traditional healing
heali
吨 practices
practices globally. This
Clearly,
眈 to
to the failure of conventional health and
renewed interest may be due in papart
mental health systems to effectively address the physical and existential ailments of
the population. In spite of a growing consciousness of the need to integrate
care , a lack of
traditional healing into conventional health and mental health care,
knowledge about Caribbean healing traditions has promoted a view of these
History, Philosophy, and Transformation
25
primitive,, and evil,
healing systems as witchcraft,
witchcra
丘， sorcery,
sorcery , primitive
evil , and its adherents as
pathological. These erroneous beliefs have resulted in a particular focus on specific
abnormal behavior that are classified as psychoses and disordered
categories of abnorrnal
personalities among Caribbean populations. While conceptual frameworks
regarding health and mental health may vary according to particularized sociocultural milieus
milieus,, ironically the overarching agenda must remain constant. Any
ethical engagement with traditional healing and the Caribbean people as clients
w
山 seek
seek
to expand modes of
ofhealth
health and healing beyond the discourses of
ofWestern
Western
will
health and mental health to account for particular contexts like the Caribbean
where conditions of oppression and trauma and, consequendy, patterns of
resistance and healing are shaped by Western incursion. Such a process would
reposition traditional healers
healers
丘om
from the margins to the centre, and situate traditional
healing in its rightful place alongside the other healing traditions such as biomedicine,, psychology
medicine
psychology,, counseling,
counseling, and psychotherapy.
Notes
1. For a breakdown of the distribution of slaves
slave唱 and
and
patterns
pattems of sugar production see
Fernandez
Yelvington,, 2000.
Femandez 2003; Voeks,
Voeks , 1993; Yelvington
2. Indians who arrived in Trinidad alone
alone,, for example
example,, immigrated from Bihar
Bihar,, Utter
Pradesh,
Kashmir,
and Andhra
Prad 吨 Bengal,
Bengal
， Punjab,
Punjab , Himachal Pradesh,
Pradesh, Kas
hmir, Tamil Nadu,
Nadu, Kerala,
Kerala , andAndhra
Pradesh (Edmonds & Gonzales, 2010).
instance , in Trinidad in 1891 only 12% of the total Indian population were
3. For instance,
religions 仕扭sported
transported 丘om
from
converted to Christianity while 88% continued to practice religions
the total number of
Hinduism,, Islam
Islam,, and Buddhism; by 1911
1911,, only 3.3% of
India - Hinduism
ofthe
Indians who were brought to the Caribbean had converted to the various Christian
sects (Mahase
(Mahase,, 2008).
4. Drapetomania or the disease causing slaves to run away was coined by an American
physician Cartwright
mind
，孤
as any
any species of mental
Cartwright,, and described as a disease of the mind,
alienation only much more curable
curable,, that induces
induce
唱 the
the
Negro slave to run away from
service. Cartwright further identified a preventative measure called "whipping the devil
them" (p. 708).
out of
ofthem"
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2
THE EVOlUTION
EVOLUTION OF CARIBBEAN
TRADITIONAl
TRADITIONAL HEAllNG
HEALING PRACTICES
Wendy
Wendy
巨
Y. Crawford-Daniel
Crawford-Daniel
and Jicinta M. Alexis
Introduction
The Caribbean has a rich heritage that extends not only to the cultural practices,
practices ,
but also knowledge and experiences of the benefits of the use of traditional
medicine. This rich heritage is comprised of diverse cultures that coexisted whether
voluntarily, and can be traced back to the original inhabitants of the
forcibly or voluntarily,
Europe , Mrica
Mrica,, Asia,
Asia, and the Middle and Far
islands. The setders who hailed from Europe,
East all brought with them traditions that eventually creolized over the years
(Brereton,
但
rereton
， 1989).
The earliest known inhabitants of the Caribbean,
Caribbean, the Kalinago and the T ainos,
ainos ,
have had their own indigenous systems of caring for the health and well-being of
their people which included rituals,
festivals,, spiritual ceremonies
ceremonies,, rites of passage,
rituals , festivals
passage ,
and dietary habits all contained within their own indigenous political organization
possessed
岱 essed
all that was needed
(Steele , 2003). They believed that the natural world po
(Steele,
to sustain their existence (W
(Wilson,
ilson, 1997). It was the common belief that each
them
丘om
from birth. Most feared
person had a good or protective spirit looking over them
sickness , accidents
accidents,, and
were the evil spirits upon who were blamed for all sickness,
misfortunes
llÚ
sfortunes of the individual,
individual, community,
community, and the tribe (Khan
(1王han 2003).
The healers were highly respected by all and considerably gifted with the
knowledge of medicinal herbs,
herbs , as well as the power to perfonn spells to heal the
sick and injured (Makinde,
(Makinde , 1988). The indigenous people made extensive use of
the juices of roots,
roots , the use of tobacco for special ceremonies,
ceremonies , festivals
festivals,, and rites,
rites ,
and herbs for healing and spiritual ceremonies. Balms and oils were used
used,, among
T oday many of these herbs,
herbs , plants,
plant
丑，
other practices
practices,, in the preparation of the dead. Today
have
and roots 矶山
still have
widespread use in many islands of the Caribbean.
30 W. Y. Crawford-Daniel and ].J. M. Alexis
Immediately following Christopher Columbus' voyage to the Americas
Americas in the
th century, the European powers (portugal, Spain, England, The Netherlands,
15
15 由
cent 町，
(p ortugal , Spain, England,
Netherlands ,
and France) came to the Caribbean in search of gold and to set up profitable
colonies. Realizing the limited
li 日1Íted gold deposits and the potential for agriculture,
agriculture , the
colonial powers introduced a plantation system,
system, which was initially manned by an
indigenous workforce but eventually supplanted by forced African labor. The
European colonialists brought a different philosophy and orientation to health care
and healing than existed in the indigenous Caribbean. Contrary to the indigenous
view the Europeans saw nature as a phenomenon to be scientifically understood,
understood ,
controlled , manipulated,
manipulated , and transformed
transformed
但
asalla
， 1967). In this regard they
controlled,
(Basalla,
embarked upon an assault of the cultural traditions and healing practices of the
inhabitants including the enslaved Mricans they brought to the Caribbean.
The settling of the Caribbean region by the European colonizers and the
ensuing lucrative,
lucrative , labor-intensive sugar industry gave rise to the need to import
th century,
fromA Africa
缸ca (B
rereton, 1989). Thus,
Thus , in the 17
17 由
centu
町， a new workforce,
workforce ,
labor from
(Brereton,
the Mricans
Mrica, were introMricans,, who were mainly culled from the west coast of Mrica,
duced to the Caribbean sugar plantations to provide the essential
essentiallabor
labor required to
make the sugar industry sustainable
(Brereton,， 1989). The Mrican slaves,
sustainable
但rereton
slaves , though
removed from their homeland,
homeland , retained their medicinal knowledge which was
inexorably tied to their religious beliefs (Goldberg,
(Goldberg, 2000). The slaves believed that
山ness
cosn1Íc
illness and death had a spiritual causation which occurred as a result of a cosmic
imbalance in an individual's aura (Handler,
(Handler, 2000).
The colonial administration
adnrinistration and plantation owners were convinced that the
cultural heritage which included the religion,
religion, music,
music , and traditional healing
ev 且， pagan rituals practiced by the healer and
practices of the enslaved were in fact evil,
his adherents. In the French Caribbean,
Caribbean, the terminology to refer to the Mrican
odun , in the Spanish
slave beliefs and practices was Quimbois
Quimbois,, Voodoo or V odun,
Caribbean and in the Dutch Caribbean,
Caribbean , the terminology used was Santeria,
Sant 巾， Regla
R唔
(Khan,
Voodoo,, or
dee Ocha
Ocha,, or Lukurni
d命
Lukunri (Kh
an, 2003). Whether the term was Obeah,
Obeah, Voodoo
Santería, there was a negative connotation associated with it.
Santeria,
slavery , indentured servants from west and south
Following the abolition of slavery,
plantations ,
Asia were enticed to the Caribbean to replace the labor force on the plantations,
fr
Mricans. The indentured workers comprising mainly
vacated by the recendy freed
East Indians were distributed to 14 colonies in the Caribbean and British, Dutch,
and French Guiana between 1836 and 1917 (Clarke, 1990). They were primarily
of Hindu and Muslim religions, the majority of which setded in Trinidad and
Guyana, and who later converted to Christianity, much like their predecessors,
the Mricans. For the Hindu there was a strong belief that one's life was predetermined by his or her good or bad deeds in a previous life. When ill, a diviner
may be consulted to determine which spirit is angry and what ceremony might
appease it. Some of the practices that have survived to date include a pageantry of
rituals, balancing of body system through diet and emotions, herbs, meditation,
self-restrain, acupuncture, and rhythmic music, all of which are integral aspects of
Evolution
31
traditional healing practices in the Caribbean (Moore,
(Moore , 1995). These practices
practices,,
however
however,, were not as widespread and pervasive. The practices of the indentured
attention
丘om
attracted litde attention
from the colonialists unlike the practices of the former
enslaved Mricans.
The current health belief system of the people of the Caribbean demonstrates
a coexistence of practices of the various civilizations who occupied the islands over
the centuries,
centuries , (Abrahams
(Abrahams,, 1967). Healing practices of the indigenous people and
the many civilizations that occupied the Caribbean have resulted in a multiplicity
of health belief systems and healing practices. Some of these practices are mutually
refeηal system at formal and informallevels
informal levels,,
exclusive , some coexist in a reciprocal referral
exclusive,
and others have incorporated
inco 叩 orated
various aspects of each other in a plethora of
approaches to healing (Abrahams,
(Abrahams , 1967).
wi1l illustrate how these practices,
practices , referred to as traditional,
traditional , have
This chapter will
feared ,
evolved from a position of primacy prior to modern medicine to being feared,
discredited, and oudawed during the colonial and postcolonial era (Paton,
(Paton, 2009).
discredited,
It begins by discussing the influence of West Mrica,
Mrica , this is followed by an
eras , and finally
exploration of traditional healing in the colonial and postcolonial eras,
Caribbean , in light of the shortcomings
shortcornings
the gradual return to significance in the Caribbean,
of modern medicine (Aarons,
(Aarons , 1999).
Influence of West African Traditional Healing
West Mrican traditional medicine adopts a tripartite approach to healing which
includes herbal medicine,
(Makinde,, 1988). In the
medici
时， divination,
divination, and incantations (Makinde
West Mrican tradition,
tradition, the healer's knowledge is believed to be derived from 屿，
lfa,
sciences ,
a Y oruban deity who is responsible for embodying the knowledge of all sciences,
soci 址， natural,
natural , and ψiritual
(Makinde ,1988). Akin
Akin Makinde noted that
including social,
spiritual (Makinde,1988).
God, who embodied wisdom and knowledge of
"Ifa" was considered an angel of God,
"lfa"
physics , zoology,
physics,
zoology, botany,
botany , herbs,
herbs , oral incantations,
incantations , and medicine (Makinde
(Makinde,, 1988).
Ifa' s gift of knowledge,
knowledge , including the
Apart from the aforementioned sciences,
sciences , lfa's
ofherbal
herbal medicine
medicine,, is imparted
impa 此ed to the world through a medium
healing properties of
known as an "Orunrnila" (otherwise referred to as Osanyin or Onisegun),
Onisegun) , who is
credited with being the father of traditional healers (Makinde,
(M 汰inde ， 1988). The typical
typic
址
wi1l include the lfa
Ifa priest who would divine the nature of the illness
healing process will
or disease,
disease , and the Onisegun who would prepare the herbal remedy in consultation
instances , the Babalawo
with an lfa
Ifa priest
priest,, otherwise called a Babalawo. In some instances,
may also be an Onisegun
Onisegun,, which would result in a complete cure for the patient
divination, and incantations were employed (Makinde,
(Makinde ,
because herbal medicine,
medicine , divination,
o fI鱼， s knowledge of
1988). The complete cure can be achieved only as a result ofIfa's
the origins of diseases,
diseases , the names by which they are called,
called, and the power behind
the diseases (Makinde,
(Makinde , 1988). Therefore
Therefore,, an understanding of the root cause
of disease coupled with prescribing the most effective
etfective traditional remedy to treat
32
W. Y. Crawford-Daniel and ].
J. M. Alexis
it,, whether herbal,
it
herbal , divination,
divination , incantation
incantation,, or any combination of the three,
three ,
according to the Y oruban standard,
standard, was best practice medicinally.
According to the Y oruba,
oruba , a human being has three main elements: Ara,
Ara,
body; 四口，
emi, otherwise called the soul; and the ori
ori,, otherwise
otherwise called the body;
called the inner head. The ori has the distinction of being the bearer of human
destiny,
and,, as such,
destiny, and
such, in some instances,
instances , the patient would be expected to sacrifice
sacrifìce
to the ori as part of the treatment to avert death (Makinde,
(Makinde , 1988). There are
sacrifìces in the Mrican traditional medicine milieu. Due to the belief
instances of sacrifices
that one's soul was immortal,
immortal , and the need to appease the ancestral spirits to
intercede on the living's behalf,
sacrifices would be offered to the spirits to aid the
behalf, sacrifìces
(Green, 1980).
treatment process (Green,
Another key aspect of the Y oruban belief system is the belief in evil forces,
forces ,
otherwise known as willful
w诅ful maleficia.
malefìcia. This evil force is responsible for illness,
illness , disease
disease,,
and death. Thus,
Thus , in an effort
e 班ort to appease the evil forces that are at work
work,, sacrifìces
sacrifices,,
otherwise known as ebo/etutu,
ebo/etutu , are offered as a countermeasure. Protective
ill-e 岳cts of evil forces include amulets or madarikan,
madarikan,
measures to guard against the ill-effects
curses or epe,
epe , and incantations or ofo/ase/afose (Makinde,
(Makinde , 1988).
It was this encapsulation of traditional medicine cultural heritage that migrated
into the Caribbean with the arrival of the slaves. The slaves brought both tangible
odys 在ey of transmigration and
and intangible links to their past,
past, as they began the odyssey
preserve
凹e their sense of cultural identity (Goldberg,
(Goldberg, 2000),
2000) , the
slavery. In order to prese
slaves maintained their language
language,, religious,
religious , and traditional medicine heritage.
Early Traditional Healing in Colonial Caribbean
the indigenous workforce was depleted
depleted,, the European colonizers devised an
ingenious scheme for labor replacement. Slaves primarily from West Africa
A 面ca were
introduced to the plantation economies of the Caribbean. The slave population
was far larger than the plantation owners,
owners , and as a result the few European medical
practitioners could not provide medical care to the slaves (D
(Dee Barros,
Barros , 2007). It was
therefore the traditional healers in the Caribbean who were recognized as the
ofhealth
health care. The healing practices of
ofWest
West Africa,
A 缸ca ， brought to
prime providers of
Mricans , quickly became the predominant method
the Caribbean by the enslaved Mricans,
of healing. Thus
Thus,, it was necessary for the majority
m 司jority
of slaves to rely on their
traditional healers to deal with their medical and/or spiritual issues
issues
但andler
(Handler,， 2000).
2000).
Apart from the limited access to Western medical practitioners,
practitioners , the slaves did not
trust their captors to provide medical assistance. The healers had to treat physical
illness and spiritual malaise alike (R
(Roach,
山ness
oach , 1992).
The healers called on their previously acquired knowledge of healing,
healing, and
though many of the original herbs,
herbs , plants
plants,, and roots were not readily available,
avai1able ,
they were able to adapt to the new environment and utilize substitutes wherever
(Roach , 1992). The healers had to treat physical illness and spiritual
necessary (Roach,
malaise alike. They were responsible for providing healing treatments and remedies
A
After
丘er
Evolution
33
in the following areas of medicine: obstetrics
obstetrics,, pediatric,
pediatric , gastrointestinal,
gastrointestinal, psychological,
maladies , to name a few (Roach,
(Roach , 1992).
logical , and spiritual maladies,
Over time the healers were also treating the plantation owners and their
overseers. Due to the fact that the Mrican healers were familiar with tropical
climates and diseases,
diseases , they were able to provide a more effective cure than the
Western trained physicians (Handler,
(Handler, 2000). However
However,, though the healers were
providing an invaluable service by improving and maintaining the physical and
slaves , albeit that they were considered mere comspiritual well-being of the slaves,
modity, the plantation owners developed an underlying mistrust of the importance
modity,
of the role that healers played in the slaves' lives (Goldberg,
(Goldberg, 2000). Apart from
being the spiritual and healing authority,
authority, they were also the cultural repository of
the
theA African
丘ican
heritage. Thus,
Thus , the healer was perceived as a threat to the conditioning
measures implemented by the plantation owners to make the slaves amenable to
ab 出ty to
their present condition. The plantation owners grew to fear the healer's ability
inspire resistance among the adherents,
adherents , and,
and, more importandy,
importandy , the healer's ability
ab 血ty
to incite the slaves to passively resist the owners control by alluding to a threat far
worse than what the owners intimated (Goldberg,
(Goldberg, 2000). The psychological hold
of the healer over their adherents,
adherents , as well as the belief in the power of the healer,
healer,
was more potent than any physical threat or torture that the plantation owner
could inflict. Consequendy,
Consequendy, a concentrated effort
e 班ort to discredit the effectiveness of
traditional medicine and its healers,
healers , as well as weaken the hold that the healers had
over their adherents,
adherents , was implemented by the colonial institutions in the British
Caribbean.
To this end,
end, the Europeans
Europeans
丘om
from the British administrated colonies coined the
term Obeah,
Obeah , which referred to the slave acts and practices which were considered
supernatural or evil in nature (Goldberg,
(Goldberg, 2000). Eventually,
Eventually, the term Obeah was
(Handler,
used as a "catch-all term for a range of supernatural ideas and behaviors" (Handler,
2000,, p. 87). This term,
2000
term, however,
however, was a misnomer of a valid religious belief of
ofthe
the
slaves. For the Africans,
Africans , Obeah practices had a "positive or morally neutral
meaning" which emphasized the spiritual aspect of the healing process (Khan,
(Khan,
2003). In fact,
fact , the term Obeah may have been derived
derived
丘om
from Obi
Obi,, a Y oruban deity
(Handler
(Handler,, 2000).
Traditional Healing in the Post-Emancipation Era
Two of the foremost,
foremost , formidable
forrnidable British institutions led the way in the attempt
a 忧emptto to
officially rein in traditional medicine in the British Caribbean: the judiciary and
the church (Paton,
(Paton, 2009). Both institutions were successful in further advancing a
and,
negative stereotype of the traditional healing/religious beliefs of the slaves and,
era , the recendy introduced indentured servants.
circa the post-emancipation era,
There was already a generally held view that Africans
A 臼cans
were primitive,
primitive , subhuman
ritu 也 designed
designed
to cause supernatural harm
pagans that frequendy engaged in evil rituals
to adherents and non-adherents (Goldberg,
(Goldberg, 2000). That perception was further
34 W. Y. Crawford-Daniel and ].J. M. Alexis
modified to encompass the point of view that 1) the traditional healers or Obeah
men were in fact charlatans trading on the susceptibility
susceptib
血ty of the believers,
believers , and 2)
once the believers adopted the Christian teachings,
teachings , they would be less vulnerable
(Dee Barros
Barros,, 2007). Hence
Hence,, by prosecuting the healersl
healers! Obeah practitioners,
(D
practitioners , the
adherents would recognize that their perception of the healer's omniscience and
supernatural power was flawed. The struggle between the Obeah man and the
British institutions intensified approximately around the time that calls for
Caribbean, as well
ernancipation were echoing around the sugar plantations in the Caribbean,
emancipation
th century
as the House of Parliament in Britain in the early 19
19 由
century
但rereton
(Brereton,， 1989).
After repeated allegations of the Obeah man using the supernatural to intimidate
After
adherents and non-adherents,
non-adherents , legislations were enacted to criminalize the practice
of Obeah in many British Caribbean islands (Brereton,
(Brereton, 1989). The statute's
wording may have been amended according to each country's
count
町 's specific needs;
however,
however, the basis remained the same. The emancipated slaves' and indentured
laborers' ability to freely practice their traditional beliefs were now strictly
regulated. In light of the fact that the healers (Obeah men) faced the possibility of
prosecution for practicing their healing in their customary traditional manner
(Roach , 1992)
(Roach,
1992),, it was necessary for them to covertly perform their healing rituals.
Healing rituals in urban communities were incorporated into religious services
which insulated the practitioners from being legally charged.
The church also played a key role in the societal regulation of the role of the
healer and traditional medicine. The Mricans and East Indians were taught the
Christian doctrines. However
However,, though these doctrines contradicted the traditional
cultural values of the slaves and indentured servants,
se 凹ants ， it was in their best interest to
fa 伊de of accepting the plantation owners' religious belief
belief 但
(Brereton,
rereton
，
maintain the favade
Eventually,, the slaves incorporated
1989). Eventually
inco 叩 orated
some of the Christian doctrines into
result, a tenuous duet of a dual
their traditional belief system (Henry,
(Henry, 2003). As a result,
worship relationship was danced by the slaves,
slaves , which involved covertly
maintaining their traditional beliefs,
beliefs , while overtly adopting the Christian teachings.
Emancipation saw a resurgence of independent thought among the Mricans.
The exhilaration of
ofbeing
being able to worship
worship
丘eely
freely was celebrated with the opening
of Orisha enclaves (Henry,
(Henry, 2003).
2
Orisha was an amalgamation of the traditional
Yoruban religion and the newly introduced Christian doctrines. However,
Orisha's underlying belief system was predominantly Mrican, and as such retained
the traditional healing practices of yesteryear. Unfortunately, the legislative and
societal regulatory bodies continued to work to drive the Mrican belief system
underground (Roach, 1992), thereby maintaining control of the major ethnic
segment of the Caribbean population.
The Obeah Act was passed in the Anglophone Caribbean between the late
1800s and early 1900s (Antigua and Barbuda, Dominica, Grenada, St. Lucia, and
St. Vincent 1904; Trinidad, Jarnaica, and Barbados 1898). These Acts prohibited
the practice of Obeah on the islands. Violation of these Acts was punishable by
imprisonment with hard labor and whipping (Handler, 2000). This punishment
Evolution
35
was meted out to practitioners and users of the service alike,
alike , and men and women
equally.
Many of the bona fide
fìde healers were unable to practice their chosen profession
openly in the urban communities,
communities , which grew rapidly with the onset of emancim 姐y repercussions to the continued
pation. They faced one major barrier with many
(Brereton,
rereton, 1989). However
However,, in rural
practice of their trade: social upward mobility (B
communities , which were mainly agricultural communities
communities,
communities,, the practice continued
relativ
哟 unchecked
ong, 1976).
relatively
unchecked (W
(Wong,
In the interest oflongevity,
oflongevity , it was customary to pass on the traditions orally
丘om
importandy, the knowledge of healing was
from generation to generation. More importandy,
leamt as an apprentice to an experienced healer (Green,
learnt
(Green, 1980). Though in some
healing,, they were still
st 诅
instances the apprentices may have shown a calling for healing
skilled, experienced healers. As a result of the
expected to train for years under skilled,
crirninalization of Obeah and the attendant stigma and discrimination
criminalization
discrirnination associated
with the continued practice and belief,
belief, the healers were hard-pressed to find
fìnd
fìll the vacant role of apprentice,
apprentice , particularly in the urban
willing applicants to fill
communities. Consequendy,
Consequendy , the extensive knowledge of
oftraditional
traditional healing died
with the healer practitioners,
practitioners , who embodied the link to the adherents' Mrican
heritage as well as being the cultural repositories.
Sociocultural Dilemma in Contemporary Caribbean
Healing Practices
A
Ammajor
司jor factor that was a deterrent to the healer practitioner was the drive for
respectability among the rniddle
middle class Mricans in urban communities. The rush to
transmigrate
transrnigrate
丘om
from the agricultural communities to the urban communities was
A 正Ìicans ， because it meant an escape
escape
丘om
from the plantations and the
signifìcant to the Mricans,
significant
horrendous memories of that period of their lives (All
(Allahar,
ahar, 2005). Rural to urban
of 且fe
life in the
migration
rnigration meant the possibility of better jobs and a better way of
industrial sector. Education was embraced as one of the means to improve their
movi 吨 up
up the social
soc 凶 ladder
ladder
(Hall
(Hall,, 1994). These educated
social standing,
standing, thereby moving
rniddle class respectability;
respectab
出ty;
however
however,, for that to
Mricans hoped to achieve middle
materialize it was necessary to disassociate themselves
thernselves from the cultural beliefs that
they had known all their lives.
Thus,
inanaan attempt
忧empt
to acquire respectability,
respectab
血町， Mricans worshipped and engaged
Thus , in
in activities within the Catholic and Protestant churches (All
(Allahar,
ahar, 2005). It was an
impo
眈ant
criteria for social advancement to be seen worshipping at the right
important
oftheir
their
church. Additionally,
Additionally, the traditional healing beliefs and other components of
elite ,
cultural heritage was laid aside to adopt the Eurocentric culture of the elite,
(Allahar,
ahar, 2005).
colonial upper class (All
Even the age-old utilization of traditional healing was relegated to the uneducated masses with the educated,
educated, upwardly mobile segment electing to choose
Western
Westem medicine (Roach,
(Roach , 1992). In some instances,
instances , the ambitious social climbers
36 W. Y. Crawford-Daniel and ].
J. M. Alexis
were the harshest critics of the traditional Mrican culture. They had internalized
intemalized
the negative perception of traditional healing that the British plantation owners
regard, the institutions were indeed able to
and legislators had generated. In this regard,
however,, they overlooked one major
m 司jor aspect of
discredit the traditional practices; however
the belief
beliefsystem.
system. Regardless of
ofthe
the advances of
ofsociety
society,, the population continued
to believe in the spiritual causation of illness (Roach,
(Roach, 1992). In this case the
suppr
臼s their beliefs in order to
adherents , i.e. patients
adherents,
patients,, in some instances would suppress
others ,
conform. Hence
Hence,, in an attempt to present an acceptable image of self to others,
they would visit Western
Westem trained physicians,
physicians , receive treatments,
treatments , and either selfselι
treat with herbal medicines or use them in conjunction with Western
Westem medicines.
If healing occurred,
occurred, subconsciously
subconsciou
由 they
they
would attribute
att 出ute
it to the traditional
medicines , while simultaneously giving their physicians the impression that it was
medicines,
Westem medicines that worked. On the other hand,
hand , the denouncers who had
the Western
acquired the tool,
tool , education
education,, which would eventually facilitate social upward
mobili
町， needed to present a scientific,
scientific , modem,
modem, rational image,
image , which was
mobility,
Hence , the actions of the denouncers reflected their
befitting of the ascribed roles. Hence,
social ambitions. As a result,
result, the healers were still
st 且1 called on
on,, albeit in a covert
manner, by persons of varying ethnicities and social standings to treat their ailments
manner,
(Raphael,
(Raphael , 2005).
Implications for Health and Mental Health
The health beliefs which have evolved after centuries of institutionalized
conditioning represent the sociocultural and psychological dilemma that exists
today in the Caribbean with regards to healing practices. Traditional or cultural
knowledge had a conflicting but meaningful relationship between the people's
values and social reality. Traditional medicine surpasses the action of self-treatment;
it assists the user to maintain ties to social relationships by calling on the wisdom
oftheir
of
their ancestors and elders for treatment (Sigerist,
(Sigerist, 1951). Firstly
Firstly,, the practice of
traditional medicine was sustained by the illness belief of the people. The belief
that illness had a spiritual connotation which required alternative
altemative approaches to
Secondly, the people's trust in
treatment was consistent in the Caribbean region. Secondly,
traditional medicine was absolute; it was passed down from generation to
generation and consequently it had an established historical basis. As a result,
result , the
practice of traditional medicine as a social action was occurring because of the
attached meaning.
Despite all of the institutional,
institutional, legal,
legal, and psychological strategies embarked upon
to promote modem medicine and discredit traditional healing practices,
practices , the people
of the Caribbean continue to hold to the traditional beliefs system. In a similar
sirnilar
vein in which Christianity and traditional religions have found ways to coexist in
modem society,
society, so have traditional and modem medicine. The use of divination,
divination,
medicine , spiritual counseling
perr 丑uta­
herbal medicine,
counseling,, and modem medicine or different permutations of these methods is very much alive in the healing practices of the Caribbean.
Evolution
37
Modern medicine
rnedicine on its own accord is failing
fa 出ng to meet
rneet the health needs of the
people of the Caribbean,
Caribbean, both in scope and quality of care. The cost of modern
rnodern
medicine,
care , puts it out of the reach of the average
rnedicine , particularly specialized care,
Caribbean citizens (Aarons,
(Aarons , 1999). In recent years there has been a significant
return in the English-speaking Caribbean to the philosophy and healing practices
of traditional medicine to address many of the modern and chronic illnesses both
at a preventative and curative level (Aarons,
(Aarons , 1999).
Modernity and its emphasis on multiculturalism and cultural relativity have
created and encouraged a climate of tolerance and appreciation for differences
di 岳rences
in
culture , in worldview,
culture,
worldview, and in ways of
oflife.
life. This cultural awareness is creating a shift
away from the negative attitudes towards traditional medicine. Accomplished
historians , psyCaribbean scholars and researchers,
researchers , like cultural anthropologists
anthropologists,, historians,
sociologists , are engaging in research and scholarship focusing on
chologists and sociologists,
traditional medicine in the Caribbean (p
(payne-Jackson
ayne-Jackson & Alleyne,
All eyne , 2004; Quinlan
& Quinlan,
Quinlan, 2007). For instance
instance,, various universities and institutes throughout the
Caribbean are dedicating research grants to furthering research in the field of
traditional medicine,
medicine , as well as incorporating the conducted studies into their
formal curriculum.
curriculurn.
These developments at the academic
acadernic level coincide with the development at
the general public level where there is a significant resurgence of traditional
religions and traditional healers,
healers , and a renewed appreciation for the cultural
heritage of the region.!
region. 1 The antagonistic nature of the previous relationships that
dirninishing in the
existed between formal and informal medicine is gradually diminishing
Caribbean as modern medicine increasingly embraces the bio-psychosocial model
of care-the
care-the biological
biological,, psychological
psychological,, and social components that are essential
components of traditional medicine,
medicine , hence long subscribed to by traditional
healers.
It is important
impo 眈ant to factor in the cultural practices of a people in any attempt
a 忧empt
to
develop an efficacious health model.
model. Kl
Kleinman,
einman , Eisenberg,
Eisenberg, and Good (2006)
posited that illness was culturally shaped; hence perception honed by experiences
and social standing would influence an individual's ability to cope with illness
但leinman
(Kleinman et al.
al.,, 2006).
Consequendy
Consequendy,, any health model that is not cognizant of the people's beliefs
will experience resistance in application. The imposition of the biomedical model
as a stand-alone approach did not have any cultural relevance in the psyche of the
Caribbean people. This approach resulted in a lack of adherence to Western
medical treatment, and widespread prevalence of self-treatment with traditional
medicines. The more recent forging of formal and informal medicine into official
practices from reciprocal referral systems to treatment regiments are indications
of the growing collaboration (Dresang, Brebrick, Murray, Shallue, & SullivanVedder, 2005). Further, due to the fact that traditional medicine promotes health
by preventing illness (Lowenberg, 1989), whereas Western medicine focuses on
treatment of illness, the logical health model should incorporate traditional and
38 W. Y. Crawford-Daniel and ].
J. M. Alexis
Western medicines.
rnedicines. A concerted thrust towards a complete integrative
integrative
叩proach
approach
would ensure improved health outcomes.
An integrative health model which would unite the traditional medical
approach,
approach , which embraces the psychological,
psychological , physiological,
physiological , and spiritual wellbeing of the individual,
individual , with the biomedical approach,
approach , which focuses on the
biological and physiological well-being of the individual,
individual , would best serve to
However, this integrative
incorporate the health beliefs of the Caribbean people. However,
model would require the revoking of existing legislature
legislature,, thereby allowing
Further,, regulation of the practitioners ensures
traditional healers to legally practice. Further
field would be limited to the qualifìed
that the fìeld
qualified who have honed their abilities either
by apprenticeship or fonnal training at institutions that offer alternative medicine
ttraining.
raI mng.
Conclusion
As Caribbean societies moved towards modernity,
modernity, traditional medicine experisystematic attempts
enced consistent and systernatic
a 忧empts
to eradicate the psychological and spiritual
stronghold it had on its adherents. Though the educated
educated,, legislature,
legislature , church,
church ,
modern medicine,
medicine , and other institutions deployed covert and overt mechanisrns
mechanisms
to achieve cultural erasure,
erasure , they all proved unsuccessful. Unfortunately
Unfortunately,, these
institutions/individuals did not acknowledge that traditional medicine is a cultural
(Geertz , 1973). In identifying
identi
马Ting traditional
system which has meaning to the people (Geertz,
medicine as a cultural system
system,, it would therefore establish a degree of consistency
in the practice.
Additionally,, traditional medicinal knowledge and practices were internalized
Additionally
and reinforced by repeated reenactment for centuries. Interestingly,
Interestin
钩， some of
ofthe
the
individuals that publicly denounced the practice of traditional healing were,
were , in fact,
fact ,
covert believers/users. The growing reciprocity between traditional medicine and
modern medicine will have positive outcomes for the health and well-being of the
people of the Caribbean.
Note
1. Many of the practitioners are now advertising their services on audio
audio,, print,
print, and
Jamaican Gleaner newspaper carried an article on a
electronic media. In fact the ]amaican
"scientist" (traditional
(仕aditional
Kingston
ngston selling Obeah
healer) who has opened a supermarket in Ki
and the tools of the trade on the open market. Not to be outdone
outdone,, many Westem
Western
位ained
fon 丑al and informal
infonnal referral
refe rra1
trained doctors in the Caribbean are increasingly developing formal
systems between themselves
systerns
thernselv
臼 and
and traditional healers (Aarons,
(Aarons , 1999).
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Aarons
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Brebrick, L.,
L.，如1urray
Sullivan-Vedder, L. (2005).
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inte ψretation
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(pp.
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3
CARIBBEAN TRADITIONAl
TRADITIONAL
MEDICINE
Legacy from the Past
Past,, Hope for
the Future
Arvilla Payne-jackson
Payne-Jackson
Introduction
The World Health Organization (W
(WHO)
HO) defines traditional medicine as: "the sum
knowledge,, skills and practices based on theories,
total of
ofknowledge
theories , beliefs,
beliefs , and experiences
indigenous to different cultures that are used to maintain health,
health , as well as to
prevent, diagnose
prevent,
diagnose,, improve or treat physical and mental illness" (W
(WHO,
HO , 2012,
2012 ,
p.1). In this chapter the term traditional medicine is used to refer to healing
practices developed prior to the advent of biomedicine,
biomedicine , the dominant
dorninant cultural
system of medical care today.
The traditional medical systems that evolved in the Caribbean during the
colonial period and that persist today are in large papart
此a
a continuation of generalized
ofWest
West Mrican traditional religious and medical practices combined with
practices of
Amerindian medical systems
the colonial European humoral medical system and Amerindian
但也y
， 1993;
La 伊erre ， 1987; Lowe,
Lowe , Payne-Jackson,
Payne-Jackson, & Beckstrom-Sternberg,
Beckstrom-Sternberg, 2002;
(Bilby,1993;
Laguerre,1987;
All ey 肘， 2004). Factors such as the herbal and medicinal
medicin
址
Payne-Jackson
Payne-Jackson,, & Alleyne,
knowledge brought to the New World by Europeans and Mricans,
Mricans , the physical
environment
environment,, and the flora and fauna found in the New World have influenced
the development of
these medical systems
(Laguerre,
Lowe,, Payne-Jackson
Payne-Jackson,,
ofthese
systerns (L
aguerre , 1987; Lowe
& Johnson,
Johnson, 2009).
Contemporary
systems provide a microcosm
Contempora
可 traditional
traditional
medical systerns
rnicrocosm through which
dynarnics of
Caribbean culture and healing practices can be understood. The social dynamics
the interplay between ethnic community and separateness,
separateness , on the one hand,
hand,
and the emergence of some integrated "creole" socio-cultural system,
system, on
the other hand,
hand, are reflected in the existence and practice of generalized
traditional medical belief systems. The role of the supernatural and natural
42 Ä.
payne-Jackson
A. Payne-Jackson
elements in traditional etiology reflects the general worldview of the
populations they serve.
(Payne :Jackson and Alleyne,
(Payne:Jackson
Alleyne, 2004,
2004, p. 6; see also Alleyne,
Alleyne, 1988)
In this chapter traditional medicine in the Caribbean is discussed including the
cultural , and functional context of traditional medicine. This is
social,, historical
social
historical,, cultural,
fo l1owed with a discussion on beliefS,
followed
beliefS, perceived etiologies
etiologies,, types of practitioners,
practitioners ,
and treatments used in treating illness. Fi
Finally,
nally , the reasons for the tenacity and
resurgence of traditional medicine and implications for collaboration
col1aboration and!
and/or
or
integration with mainstream health and mental health are examined.
Social,, Historical
Historical,, Cultural
Cultural,, and Functional Context of
Social
Caribbean Traditional Medicine
Traditional medicine has been the primary source of healing for people in the
slave
町， throughout slavery,
slave
町， and up until to today. Official
Caribbean since before slavery,
medicine while present during slavery was basically inaccessible to enslaved
Africans
A
臼cans
both before and after emancipation and in many instances even today.
However, the relationship between traditional medicine and biomedicine is
However,
a 岱cted
by social,
social, political,
political, historical,
historical , and economic factors. For
complex and is affected
example,
example , the conditions under which enslaved Mricans were brought to the New
W orld and the health care available throughout slavery were horrendous. During
World
the Middle Passage slave ships were breeding grounds for a long list of diseases,
diseases ,
injuries,
均
uries
， and wounds (Sheridan,
(Sheridan, 1985)
The unavailability of
ofEuropean
European doctors contributed to the lack of
ofhealth
health care.
Sheridan (1985) estimates the ratio of doctors to enslaved Mricans in British
colonies was 1: 1600. Other factors were the high cost to plantation owners to use
the
these services
凹ices
of medical doctors,
doctors, doctors' reluctance to reside outside the main cities,
cities ,
and the lack of their success in treating many of the illnesses and diseases
encountered in the New World (Payne-Jackson & Alleyne,
All ey 肘， 2004; Lowe et al.,
al. ,
2002). Another major
m 习 or factor contributing to the dependence on traditional
medicine was the enslaved Mricans' mistrust of white doctors. The methods of
treatrnent used by white doctors included blood-letting,
treatment
blood-letting, purging,
purging, sweating,
sweating, and
the use of mercury,
mercury , opium
opium,, and antimony. These methods were often both
unsuccessful as well
wel1 as dangerous (Genovese,
(Genovese , 1976; Payne-Jackson & Alleyne,
All eyne ,
Sheridan,, 1985). White doctors also did not recognize the Mrican-based
2004; Sheridan
supematural etiology of disease and this in tum did not meet the social or spiritual
supernatural
the enslaved Mricans (p
(payne-Jackson
needs of
ofthe
ayne-Jackson & Alleyne,
Alleyne , 2004).
Once restrictions were placed on the slave trade,
trade , plantation owners established
black hospitals (call hothouses). Medical doctors were paid to visit the hospitals
once a week. These hothouses were attended by black doctors,
doctors , nurses,
nurses , midwives,
midwives ,
attendants , who administered the orders and prescriptions of the white doctors.
and attendants,
Unlike the fear and distrust of white doctors,
doctors , patients and families had close ties
Legacy from the Past,
Past, Hope for the Future 43
and trust with the hothouse practitioners (Eisner,
(Eisner, 1961; Gardner,
Gardner, 1873; Lunan,
Lunan,
Sheridan, 1985; Thomson,
Thornson, 1820). Some medical doctors acknowledged the
1814; Sheridan,
"1 must candidly acknowledge
efficacy of slave medicines. Thomson (1820) wrote: "I
that the effects
e 岳 cts of my most laboured prescriptions have not unfrequently been
superseded by the persevering administration of their [slaves']
[slav
白'] most simple
remedies" (p. 10). The presence or absence of owners was another contributing
example , JJamaica
amaica had
factor to the development of traditional medical systems. For example,
a greater incidence of absentee owners and a greater proportion of Africans to
Europeans than in Barbados. The result was a stronger presence and influence of
the Mricans' practices than the Europeans. Also
Also the number of poor whites and
indentured servants present in a society was a factor in the social dynamics and
In Jamaica this influence was weak but,
social structure of a society. 1nJamaica
but, on the other
hand, for 40 years
hand,
years,, Barbados was a societe
soci 是té d'habitation (of small holdings) before
being replaced by the plantation society (Payne-Jackson & Alleyne,
All eyne , 2004).
farming , where practiced,
practiced, allowed enslaved Africans
A 丘icans
to
Furthermore
Furthermore,, subsistence farming,
develop a wider range of therapies. A contributing factor to this was the recognition of flora and fauna common to both Mrican and Caribbean countries,
countries , which
provided a basis of familiar
farniliar medicinal herbs (Ayensu,
(Ayensu , 1981; Payne-Jackson &
Alleyne,
All ey 肘， 2004).
2004).
The constant resupply of Mricans to the New World provided a
A 丘ican
medical rituals
rituals,, therapies
therapies,, practitioners
practitioners,, and plants
continual flow of African
(Ayensu,
Berlin,, 1980; Payne-Jackson & Alleyne,
Alleyne , 2004).
(Ayensu , 1981; Berlin
The health care situation in the 19th century post-emancipation period
presented the same basic question that existed during slavery. Were the freed
enslaved Mricans going to continue to
to 呻
rely on
on their traditional medical systems
systemω
as
a result of the absence of
of,, difficult accessibility
accessib
出ty to,
to , and mistrust
rnistrust of the formal
government medical systems? Bryan (1991) postulates that both the absence of
th
political will and the declining socioeconomic
socioeconornic environment during the 19
19 出
century hindered colonial administrations from carrying out improvement to
health facilities and health care. This was further hampered by transportation issues
and the shortage of medical personnel.
personnel. These conditions contributed to the
preservation of traditional medical practices.
The poor socioeconomic
socioeconornic conditions that existed in the post-emancipation
period resulted in an ever increasing distance both culturally and ideologically as
well as geographically between the freed slaves and the white and brown classes.
As freed slaves left the plantations they established villages in remote areas and had
little contact with the ruling classes. Missionary activity promoted the continuation
and in many instances the deepening of Mro-Jamaican religions (payne-Jackson
& Alleyne, 2004). The neglect and! or failure of colonial administrations to provide
basic essential services to the freed enslaved Africans contributed to the preservation
and strengthening of traditional practices (payne-Jackson & Alleyne, 2004).
Many people throughout the Caribbean operate within a continuum between
traditional medical systems, at one end of the continuum, and the biomedical
medical system at the other end. The continuum reflects the social dynamics and
44 Ä.
payne-Jackson
A. Payne-Jackson
interplay between ethnic continuity and separateness,
separateness , on the one hand,
hand, and
system, on the
the emergence of some integrated "creole" socio-cultural system,
other hand. Individuals differ
di 岳r in the ways in which aetiology,
aetiology, practitioners
and treatments correlate;
coηelate; they differ in the range of illnesses attributed to
different causes; they differ in the priority given to different practitioners for
the treatment of different illnesses.
(Payne-]ackson & Alleyne,
(Payne-Jackson
Alleyne, 2004,
2004 , p. 8; also see Alleyne,
Alleyne, 1988),
1988),
Independence brought new pride in ethnic identity and traditional culture. The
result has been an intertwining of traditional and biomedical ideas. The constandy
evolving system is flexible enough to include the occult and spiritual as well as
new diseases (Snow,
(Snow, 1993). This flexibility
flexib
血ty allows the urban,
urban, educated,
educated, elite and
rural, poorly educated,
educated, poor to accommodate
accomrnodate their needs and beliefs about illness
rural,
whether predorninandy from the biomedical worldview or
or 丘om
from the traditional
ofboth
both depending on where on the continuum of
worldview or a combination of
culture the individual identifies him/herself
Traditional Medical Beliefs and Practices
Traditional healing systems
systerns throughout the Caribbean recognize natural,
natural, spiritual,
spiritual ,
and occult causes of diseases and illnesses. Natural illnesses result from an imbalance
in the human body caused by natural elements such as heat,
heat, cold
cold,, wind
wind,, and dew
or impurities in the food,
food , water
water,, and air. However
However,, a strong belief exists in the
supernatural as a causal factor in illnesses and accidents. Supernatural causes of
illness fall into two categories---spiritual
categories
一→piritual
and occult. Spiritual causes of
ofillness
illness result
from hurnans
humans who break social and moral taboos of the culture. illnesses of this
nature are seen as punishment sent by God for sins. Yet another source of spiritual
illness is malevolent forces of the supernatural world such as Satan,
山ness
Satan, demons
demons,, fallen
deceased-duppies
-duppies or Jumby IJumbe. Spiritual
angels
angels,, and wandering spirits of the deceased
illnesses are also seen as ways to witness for the faith or as calls to service (Payne,
(Payne ,
1991; Payne-Jackson & Alleyne,
Alleyne , 2004).
Occult causes of illness in the Caribbean are those illnesses that have been
intentionally sent by human agents such as an Obeah wolman.
wo/man. In the Caribbean
Obeah is a learned art and is associated with black magic and sorcery and is seen
as a form
forrn of witchcraft. It was so feared by the Europeans that laws were instituted
th century
in the 19
19 出
century
banning 山
its practice.
practice.
Occult practitioners,
practitioners , however,
however, can use
harrn
their powers to bring health and benefits to their clients as well as to cause harm
(PayneτJackson & Alleyne,
Alle 严le ， 2004).
2004).
and death (Payne-Jackson
Traditional practitioners receive their call to serve through a variety of
experiences: dreams,
drearns , visions
visions,, encounters with supernatural beings (e.g.,
(e.g. , merrnaids)
mermaids),,
or near death experiences. Some are recognized as healers due to special gifts or
characteristics at birth,
birth , such as being born with the veill caul (p
(placenta
lacenta over the
face),
face) , or being born with teeth. Often times the roles of traditional healers are
Legacy from the Past,
Past, Hope for the Future
45
passed down family lines. No set age is established for when a practitioner can
begin his/her work. Training for practitioners may be formal or informal. An
apprenticeship is often required. Training ent
entails
ai1s learning the medicinal value
value,,
quality,, and use of different
quality
di 岳rent
herbs and other objects used in treating
treating
血ne
illness
岱 as
as well
as the needed rituals. Practitioners are trained in how to diagnose the cause of an
沮ness
suffering, what treatment is required to treat an illness,
illness , and what prevenillness or suffering,
ofillness
illness or suffering. Practitioners need
tive measures to recommend for the relief of
magic , witchcraft,
witchcraft, and sorcery. Spiritual
to be versed in how to diagnose and treat magic,
and occult healers in particular must also be versed in the nature of and how to
handle spirits and the living-dead (Payne-Jackson & Alleyne,
All eyne , 2004).
Traditional practitioners are consulted for treatment of all forms of illness from
the common cold to chronic illnesses such as diabetes and hypertension as well as
new illnesses such as HIVI AIDS. The perceived cause of an illness determines
which practitioner is sought out for healing. An illness thought to be of a natural
self 二treated
or treated by a herbalist (b
(bush
ush doctor,
doctor, leaf doctor
doctor,, et
etc.).
c.).
cause can be self-treated
Ill
ness thought to be of a spiritual or occult cause can be treated by a spiritual healer
Illness
or an Obeah wolman.
wo/man. Practitioners may be consulted simultaneously. For example , a person with an
ple,
an 血ness
illness may consult a herbalist for a bush remedy and the
Obeah wolman
wo/man to determine who sent the
the 血ness
illness and what medicine to take to
reverse the curse. In many cases a biomedical doctor is consulted concurrently.
concurτently.
Fai1ure on the part of the biomedical practitioner to successfully diagnose and/or
Failure
treat an illness often validates for a patient the need to seek the help of a spiritual
and/or occult practitioner (see Patrick & Payne-Jackson,
Payne-Jackson, 1996).
The primary form of treatment for physical,
physical , mental,
mental , and spiritual illnesses in
the Caribbean includes a wide array of concoctions made from herbs such as teas,
teas ,
poultices,, baths
baths,, tablets
tablets,, ointments
ointments,, powders
powders,, and oils. A primary method of
poultices
treatment for
for 血ne
illnesses
岱es of a spiritual or occult nature includes the exorcism of evil
evi1
spirits in addition to herbal remedies. Exorcism by transference (direct,
(direct, indirect,
indirect,
or symbolic),
symbolic) , incantation and prayers,
prayers , and intimidation to drive out the evil
evi1 spirits
are three examples of methods used to force evil spirits to leave the body. Deities
exorcisrns (Hand,
(Hand , 1980; Lowe et al.,
al. , 2009).
are also called upon to aid in the exorcisms
The Tenacity of Traditional Medicine
Medical systems are closely integrated with the social,
social , cultural,
cultu
时， and political
institutions of a society. The resurgence and tenacity of traditional medicine can
be contributed in papart
眈 to
to social,
social , econornic
economic,, and ecological factors and government
policies. Rising costs for health care and health insurance
insurance,, and the global econornic
economic
crisis have created a serious decrease in the availability
av ai1 ab 出ty and accessibility
accessib
出ty of
ofmodern
modern
health care services and personnel.
personnel. As a result the use of traditional medicine is
increasing as people are relying more on their extensive knowledge of and use of
the bush teas for both the more common types of illnesses such as colds as well as
chronic illnesses.
46 Ä.
payne-Jackson
A. Payne-Jackson
The ever increasing decline in economic
econornic and moral situations has led people to
tum to religion to find fulfillment
fulfùlment through spiritual pursuits. The holistic approach
of traditional medicine addresses and reinforces the importance
impo 眈ance
ofthe
of
the use of
ofherbs
herbs
and spiritual and community support in healing the mind/body/spirit
rnind/body/spirit as a whole.
The perception of disease and illness is perhaps one of the most important contributing factors to the tenacity of traditional healing. As Snow (1993) points out
out,,
Traditional ways of
ofhealing
healing are still to be found because they serve a purpose.
They allay the physical ills of the body
body,, of course,
course , but they heal the spirit
rnind and heart as well ...
. . . Traditional practices are not simply old ways
and mind
of treating old problems,
problems , for better or worse they are also used to deal with
the newer scourges of drugs and AIDS. They may not offer
0 岳r the "cure"
sought by biomedicine but they do provide the individual with explanation
and accommodation in an increasingly difficult world. They offer empowerment to those who,
who , on the surface,
sur 白白， have not much power at all.
(p.279)
。
.279)
Biomedicine is recognized as the modem,
modem, scientific approach to treat
treat
山ness.
illness.
This cultural approach treats the mind
rnind and body as separate entities. The
biomedical etiology is based on natural explanations and excludes the supernatural.
supematural.
diagnosis , treatment,
treatment, and management of
Patients have minimal
rninimal input into the diagnosis,
their illness as the power and control over the illness resides in the hands of the
However, three questions a biomedical practitioner
biomedical practitioner. However,
cannot answer is "why,"
"how,"
"why," "how
," and "who sent the illness."
The culture of traditional medicine is based on a "holistic approach" (rnindl
(mind/
supematural as explanations for
body/spirit) which incorporates the natural and supernatural
山ness.
(why/how/
illness. Patients are encouraged to take an active part in the diagnosis (why/howl
who) and treatment of their illness and encouraged to use magico/
magicol religious items
and rituals to aid in regaining balance in their lives. The psychological impact of
this approach is that it empowers patients and provides explanations for and gives
a sense of control over the illness.
culture , its cosmology
cosmology,, and its healthA complex relationship exists between a culture,
related beliefs and actions taken. Religion permeates the lives of people in the
personal, social,
social, and natural events (p
(payne-Jackson
ayne-Jackson
Caribbean and is used to explain personal,
&
&AllAlleyne,
e 严le ， 2004). As Pachter (1994) notes,
notes ,
Personal
旺periences
Personal
experiences,， fanúly
family attitudes
attitudes,, and group beliefs interact to provide
an underlying structure for decision making during illness. These factors may
a 岳ct communication between the sufferer and others who may be
also affect
recruited to provide support during illness ...
. . . [E]ffective
[E ]ffective communication is
maximized when the patient and the health care provider share beliefs about
the sickness.
命
(p..690).690).
Legacy from the Past,
Past, Hope for the Future 47
The attitudes of biomedical practitioners (including other health care professionals such as nurses and health aides) have,
have , perhaps
perhaps,, the greatest
greate
唱t impact on a
ofhealth
health care system and his or her compliance with the prescribed
patient' s choice of
patient's
treatment. The asymmetries
of social status and power such as education,
as 严nmetries
education,
socioeconornic class,
class , and rural/urban provenance are direcdy related to dialectal
socioeconomic
differences within the Creole continuum and have been shown to lead to
ineffective communication between biomedical practitioners,
practitioners , who use only
jargon, and their patients,
patients , who use varieties oflanguage along
scientific/ medical jargon,
scientific/medical
the Creole continuum. This lack of communication in tum affects
a 岳cts patients' health
(Alleyne,
Gregg,, Crell
Crell,, Cruickshank
Cruickshank,,
eyne , Gregg
behavior and confidence in doctors' abilities (All
& Morrison,
Moreover,,
Morrison, 1991; Fisher & Todd,
Todd , 1993; Payne-Jackson,
Pa 严le-Jackson
， 1999). Moreover
biomedical practitioners tend to hold traditional medical practices and beliefs in
spiritual and occult causes of illness in contempt,
contempt, referring to it as that "mumbojumbo." Patients,
Patients , not wanting to be humiliated by physicians or be treated as
foolish or unintelligent,
unintelligent, do not tell their doctors of their beliefs or their
consultation with traditional healers or using their treatments (Payne-Jackson &
Alleyne,
All eyne , 2004). The relationship between traditional practitioners and their
patients is of equal importance. As the practitioner and patient are usually of the
same social and cultural
culturallevel
level and use the same language of communication the
results are better communication and understanding.
Implications for Integration
The WHO recognizes four conditions that need to be met for the successful
integration of traditional medicine into national health care systems. They suggest
that first,
first , traditional medicine should be supported and integrated into national
products ,
health systems in combination with national policy and regulation for products,
practices,
practices , and providers to ensure safety and quality; second,
second, the use of safe,
safe ,
eeffective,
岳ctive
， and quality products and practices should be ensured; third,
third, traditional
care , to increase access
medicine should be acknowledged as part of primary health care,
prese
凹e knowledge and resources; and lasdy,
lasdy , patient safety should be
to care and preserve
ensured by upgrading the skills and knowledge of providers of traditional medicine
何THO
(WHO,， 2012).
2012).
岛但l1s
Mills (1991) suggests a review of the role of traditional health care practices and
beliefs is needed.
[A] positive reason for looking again at health care as our ancestors did ...
...
[is] we shall see how their perspective was essentially a whole-world view,
view,
with each part irreplaceably contributing to a pattern:
pattem: diseases were seen as
imbalances to be corrected rather than as alien invasions to be attacked.
Herbal remedies were judged by their ability
ab 血ty to adjust patterns of disorder,
disorder,
not by any conventional "antidisease" or allopathic activity. In times
tir 丑es when
gerrns and the other usual "bad
germs
"bad
织lyS"
guys" of disease are proving harder and
48 Ä.
payne-Jackson
A. Payne-Jackson
harder to attack,
attack, we may be ready to look again at medicines that treat
treat
山ness
illness
di 岳rently.
differently.
(p. 7)
命.刀
Discrepancies in beliefs and behaviors are often greatest when the physicians
and patients have different cultural orientations and explanations of the etiology
and treatment of illness. Reconciling and/or adopting the cultural differences in
traditional and biomedical approaches will be a major part of the process if
integration is to be achieved. It can be expected that appropriate use of health
interventions , and improved health outservices , compliance with therapeutic interventions,
services,
comes have a higher likelihood of being realized when the health care provider
and the patient acknowledge and respect each other's beliefs about illness,
illness , even
though these beliefs may not be wholly concordant (p
(payne-Jackson
ayne-Jackson & Alleyne,
All eyne ,
2004).
m 习 or problems
problerns in
Lowe et al. (2002) note that health educators face two major
attempting to integrate traditional medicine and biomedicine. Fi
First,
rst, they must
educate people about both the positive and harmful
harrn
虱11 aspects of traditional medical
practices and how the community can benefit from modifying
modi 趴ng some practices.
Second,
nurses,,
(doctors , nurses
Second, they need to educate biomedical health practitioners (doctors,
midwives,, etc.) and social workers as to the advantages,
midwives
advantages , disadvantages and public
health implications of traditional practices. Lowe et al.,
al. , note:
Within this framework will be the need (for the benefit of patients) to
investigate , identify and offer inforrnation
investigate,
information concerning: (1) the types of
illnesses for which patients consult a doctor or ethnopractitioners; (2) the
illnesses which patients prefer to treat at home; (3) the attitudes of patients
towards health facilities and health professionals in general; and (4) the
reasons for the attitudes.
(p. 35)
3月
At the same time,
time , biomedical personnel will need to be trained in the premises
of traditional medicine and how to integrate this knowledge with biomedicine so
that they can communicate effectively with patients without denigrating their
technology, the increase in the use
beliefs and practices. The impact of science and technology,
of
ofherbs
herbs in medicine,
medicine , and the incorporation of
ofherbal
herbal medicine into the legislative
laws of many countries has resulted in a change of traditional medicine as oral
traditions to a commercial enterprise (L
(Lowe
al.,, 2009
2009,, p. 61).
owe et al.
Am
‘ jor issue for the integration of herbal medicine is the problem of
A major
standardization. The scientific process focuses primarily on determining the
e 岱cts.
This
phytochemicals in different herbs and the potency of the chemical effects.
ignores and loses vital information
inforrnation about mixtures of herbs and the cultural and
t' s experience in the treatment
social relations linked to rituals,
rituals , faith
faith,, and the patien
patient's
of illnesses by traditional healers (p
(pool
ool & Geisler,
Geisler, 2007).
Legacy from the Past,
Past, Hope for the Future 49
The international
intemational recognition of the healing qualities of many herbs has resulted
in patients having more confidence in traditional remedies. A review of the
literature has shown that many herbs are safe to use and have significant
signifìcant clinical
implications; however,
however, other herbs are considered unsafe or unfit
unfìt for human
consumption. If the establishment of standards related to indigenous drugs in
phannaceutical preparations is to be effective,
effective , then proper quality control must be
established and maintained (Lowe et
et 址，
al., 2002).
2002).
Lowe et al. (2002) propose a model
for the development of an indigenous drug industry and the incorporation of
herbal medicines into current biomedical training and practices. This would
involve developing an infrastructure for research and development to determine
deterrnine
the chemistry
chernistry and phannacology of
ofherbal
herbal materials including screening programs
and intensive research into those areas that show greatest promise
prornise and relevance
to the health requirements of the people.
The pragmatic merit of integration of
ofbiomedicine
biomedicine and traditional medicine is
that
that" "it
让 already
already
exists in part even though unplanned and unprogrammed" (PayneAll eyne , 2004,
2004 , p. 168). The challenge is to facilitate modernization but
Jackson & Alleyne,
not at the expense of the traditional cultural base which can be seen as "the spiritual
and moral force which drives the development process and can become the
springboard for scientific
scientifìc technological development" (Payne-Jackson
(PayneτJackson & Alleyne,
All eyne ,
2004).
Conclusion
The traditional medical systems found in the Caribbean that evolved as a result of
contact among Amerindians,
Amerindians , Mricans
Mricans,, and Europeans are a rich source of
ofhealing
healing
knowledge and are a common bond across the cultures in the Caribbean. The
value of and use of
ofherbs
herbs by traditional practitioners bridges cultural,
cultural , religious,
religious , and
ethnic differences.
times, receive their calling through
Traditional practitioners today
today,, as in colonial times,
recognized special features (e.g.
(e.g.,, being born
bom with the veil),
veil) , dreams
dreams,, visions
visions,, and/or
near death experiences. Training is primarily infonnal,
infonnal , passing down family
farnily lines,
lines ,
or more fonnally through apprenticeship. The worldview of traditional practiillness-natural , occult,
occult, and spiritual. As in
tioners includes a tripartite etiology of illness-natural,
colonial times,
times , practitioners today are consulted for all fonns of illness from the
chronic disease,
cold , to the new scourge.
disease , to the common cold,
The persistence of traditional medicine across cultures and across time can be
understood by looking to the past. Local conditions during slavery were significant
signifìcant
in accounting for the development and prevalence of traditional medicine among
the enslaved Mricans. The lack of medical services for the enslaved Mricans led to
reliance on traditional practices,
practices , including magico-religious practices and rituals to
treat illness. Emancipation saw no improvement in accessibility to health care.
socioeconornic classes of
Health care for many today,
today, especially those oflower socioeconomic
urban and rural provenance,
provenance , continues to be traditional medicine. Contributing
50 Ä.
payne-Jackson
A. Payne-Jackson
factors to this tenacity include the lack of medical facilities,
facilities , inaccessibility either
fìnancially , the high cost of transportation and medication,
medication, sociologistically or financially,
rnistrust of doctors,
doctors , miscommunication
rniscommunication between
cultural and linguistic barriers
barriers,, mistrust
patients/practitioners , perceived cause of illnesses,
patients/practitioners,
illnesses , and incompatibility
incompatib
血ty of
ofworldworldviews and religious beliefs. The holistic approach of traditional practitioners allows
them to empower patients to have more input in the diagnosis and treatment
treatrnent of
their
山ness.
their
illness.
An important
ir 丑portant
contributing factor to the resurgence of reliance on traditional
medicine today is that many consumers do not trust modern biomedicine to have
all the answers and they believe that natural products are "naturally" safe as they
have been used for centuries. This contrasts with biomedical medicines that come
with myriad warnings about side effects,
effects , some of which can be fatal. These
warnings often come several years after a product has been on the market.
However,
However, the dosage and toxicity of traditional remedies,
remedies , either self-subscribed
selιsubscribed or
subscribed by traditional practitioners,
practitioners , is a major concern for biomedical practiharrnful while others can mask
tioners as is the fact that some bush teas can be harmful
symptoITlS of serious
symptoms
serious
山nesses
illnesses such as diabetes. Development of an indigenous
medical system that can provide standardization of
ofherbal
herbal remedies would promote
integration of the two systems together with a side benefit
benefìt of an economic
econornic boost
to local economies.
econornies.
The WHO has called for integration of traditional medical systems and
this , education of
ofboth
both biomedical
practitioners into health care. To accomplish this,
worldviews , beliefs,
beliefs , and
and traditional healers is needed to address differences in worldviews,
treatment practices. This includes re-evaluation of the cultural differences that
du 址 (mind/body)
(rnind/body)
approach of biounderlie the two traditions including the dual
medicine and the holistic approach (mind/body/spirit)
(rnind/body/spirit) of
oftraditional
traditional medicine to
irnportant part of traditional
health and wellness. As religious belief and ritual are an important
healing, it is for biomedical practitioners to understand the importance of
healing,
recognizing both natural and supernatural etiologies,
etiologies , the natural and supernatural
properties of herbs used to treat
treat
山ne
illnesses,
岱es ， and incorporate methods of treatment
treatrnent
remedies , underand rituals that address both perceived etiologies. Using herbal remedies,
standing and appreciating differing worldviews and explanatory models of illness,
illness ,
heal
into the health care systems are
and formally integrating traditional healers
important steps to bringing health care to all peoples throughout the Caribbean.
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de. 臼'sc ωYη
巾
t华p严
伊tion
and an 邮
account
a αθ
刷unt '!f
cifthe
仇
t he virtues,
vi刷
i
& c. cif
i仰
ts 仰
i叫
nld饨
i忽
ge臼
仰
m
削
n1ωouω5叩
p内
l切
d耐仰删
例
nlt 白sh μ
it 加
h加E 付仰
0 阳
own as also '!f
the most usiful
us Ç，向 1exotics
exoti α
， (2 vols.).Jamaica:
vols.).]amaica: St.Jago
St.]ago
its
indigenous
plants
hitherto
known
cifthe
de la Vega Gazetre.
Mills,
M
山s ， S. (1991).
(1991).
刀le
The essential book '!f
cifherbal
herbal medicine. Arkana:
Arkana: Penguin Books.
journal '!f
cifthe
Pachter,
Pachter, L. (1994). Culture and clinical care.
care.joumal
the American Medical Association,
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271 ,
690-6 94.
690-694.
Patrick
，丑，
Payne-]ackson, A. (1996). Functions of Rasta talk in a ]amaican
Jamaican Creole
Patrick,
P., & Payne-Jackson,
healing narrative: "A bigfoot dem gi' me".journal
me". joumal '!f
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Anthropology, 6(1),
Anthropology,
6(1) , 1-38.
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Pa 丁yne ， A. (1991). The traditional concepts of ]amaican
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lA tin Ameri
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Essays, 3,
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ackson, A. (1999). Biomedical and folk medical concepts
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B
Bilby,
过峙，
4
HERBAL
HERBAl MEDICINE PRACTICES
IN THE CARIBBEAN
Yuri Clement
C1ement
Introduction
There is a long heritage of medicinal plant use in the Caribbean. Before the 15 th
century arrival of Europeans into the region,
region, native Amerindians
Amerindians practiced
indigenous health care rituals which included the use of endemic plants for
medicinal purposes. Over the last five centuries these peoples have been largely
Europeans , enslaved Mricans,
Mricans , indentured Indian labourers,
labourers , and other
displaced by Europeans,
minority ethnic groups. These migrant peoples brought with them indigenous
health care practices which incorporated the local flora and over time a potpourri
herbal pharmacopoeia emerged (Mi
(Mischel,
schel , 1959; Simpson,
Simpson, 1962; Wong,
Wo 吨， 1967).
Although over 20
,000 vascular plants exist in the Caribbean,
Caribbean, with about 7,000
7 ,000
Although
20,000
(Davis,
avis , Hywood,
Hywood, Herrera-MacBryde,
Herτera-MacBryde ， Villa-Lobbs,
Villa-Lobbs , & Hamilton,
H ami1ton,
endemic species (D
1997) , only a small number are used in traditional medicine. For instance,
insta
配 e ， 170
170
1997),
species (includingjust
(including just 8 endemic species) were used in herbal remedies (Cano &
Volpato , 2004) in Eastern Cuba,
Volpato,
Cuba, where over 3,000
3 ,000 species of vascular plants
plan 臼 have
have
been identified. Similarly,， surveys
beenidentified.Similarly
su 凹eys in
inJamaica
Jamaica (Meeks Gardner,
Gardner, Grant,
Grant, Hutchinson,
Hutchinson,
& Wilks,
Wilks , 2000) and Trinidad (Clement et al.,
al. , 2007) identified only a small
small
丘action
fraction
of the plants being used in herbal preparations.
In this chapter I will review the traditional concepts of
ofhealth
health and disease in the
herbs for the treatment of disease and health maintenance
Caribbean and the use of
ofherbs
in this context. I will also discuss the spectrum of herbal remedies ranging from
selιlimiting conditions such as the common cold to the
the treatment of minor self-limiting
diseases , such as hypertension and
treatment of non-communicable chronic diseases,
diabetes mellitus.
Herbal Medicine Practices
53
Traditional Concepts of Health and Disease in the Caribbean
The various peoples who came to the region practiced health care based on their
cultural concepts of health and disease,
disease , with varying degrees of incorporation of
some aspects of resident Amerindian
Amerindian concepts on the different islands. Two
dominant concepts included the belief that there was an involvement of the
supernatural and the balance between "hot" and "cold" humors in physical wellbeing.
In traditional Mro-Caribbean healing practices there was always the link
between natural and supernatural with respect to disease and health,
health , with little
distinction between body,
body , mind,
mind, and spirit (McCarthy Brown,
Brown , 2003). In this
context, herbal use facilitated the relief of symptoms while spiritual rituals addressed
context,
underlying supernatural causes. Many enslaved Mricans had confidence in their
"self-help" spiritual healers and "herbalists/doctors" (Handler,
(Handler, 2000) where
where""bush
bathes"
bat
由
hes"
or "bush
"bus 也
h teas" were accompanied by songs,
songs , chants
chants,, drumming
drumming,, dancing
dancing,,
and prayers to deities in communal ceremonies. Although
Although many of these rituals
originated in Mrican cultures,
cultures , such as Y oruba from Nigeria,
Nigeria, most of the herbs used
were from the region (Handler,
(Handler, 2000).
Enslaved Mricans in the Caribbean existed under brutal conditions where
sickness and premature death were constant companions,
companions , especially during the
early periods of chattel slavery where slaves were an expendable commodity.
Consequently, Mricans with residual "hands-on" experience and those "apprenConsequently,
ticed" locally provided health care for their counterparts in the face of scarcity of
medical attention from plantation overseers (D
(Dee Barros,
Barros , 2004).
With forced European indoctrination of
ofWestern
Western religious practices
practices,, a fusion
between W est/West Central Mrican religions and ChristianityIRoman
Catholicism emerged. The European "hot-cold" humoral concept of medicine
A 丘。 -Caribbean
medicinal systems. For instance
became incorporated into the Afro-Caribbean
instance,, the
Mro-Cuban Santerfa rituals (an amalgamation between the Nigerian Orisha
religion and Roman Catholicism) incorporated a wide range of herbs to treat
spiritual and health conditions (Brandon,
(Brandon , 1991; Wedel,
Wedel , 2009). In Trinidad and
Grenada the "bush doctor" of the Shango cult,
cult, an amalgamation ofY oruba beliefs
Catholicism, integrated ceremonial rituals with the use of herbs in
and Roman Catholicism,
healing practices (Mischel,
(Mischel, 1959: Simpson,
Simpson, 1962).
In many Caribbean islands the term
terrn "Obeah" was originally associated with
varied Mrican ritualistic practices,
practices , but over time it was largely relegated
rel
to the use
of the supernatural for evil magic especially by the colonial European plantation
overseers (Ordenson, 1842). In many of these territories the colonial authorities
moved swiftly to outlaw such practices and practitioners were punished, some
being killed to deter others. This environment has had a lasting impression over
time. In the contemporary Caribbean the use of "bush" medicine is sometimes
associated with these negative 'Obeah' connotations.
During the period of slavery, the "hot-cold" dichotomy of health and disease
was widely accepted and practiced in Western medicine (Foster, 1979; 1988). An
54 Y. Clement
imbalance in "hot" or "cold" humors resulted in excessively "hot" or excessively
"cold" diseases Oackson,
Oackson , 2001). Restoration of good health was achieved when
"hot"
"hot"
也
diseases
seases
were treated with "cold" remedies and "cold" diseases treated with
"hot" remedies.
"Hot" conditions included fever,
fever , infections,
infections , diarrhea,
diarrhea , constipation,
constipation, kidney
ailments , sore throat
problems , rash and skin ailments,
problems,
throat,, liver problems
problems,, ulcers
ulcers,, and menstruation and were treated with "cold" plants. Herbs were categorized according to
being""cold"
cold" and used
taste and colour of flowers,
flowers , with bitter or bad tasting plants being
as "cooling" to treat "hot" conditions (Anderson,
(Anderson, 1984; Schoental,
Schoen
时， 1957).
1957).AsurveyA survey
by Wong (1967) in a remote village in Trinidad identified 214 plants as being
either "hot" or "cold,"
"cold," with 31 "cooling" recipes being used as "blood cleansers"
and "purifiers." Most "cooling" plants were termed "cold" and were used to treat
or prevent disorders such as rashes,
rashes , measles,
measles , yaws,
yaws , and sexually transmitted
transrnitted
infections.
labourers
仕om
With the abolition of chattel slavery in 1845 indentured labourers
from the
Indian subcontinent entered the Caribbean sociocultural landscape. These
transplanted people brought with them many aspects of the centuries-old
traditional medicinal systems,
systems , such as Ayurveda and Unani,
Unani , which resembled the
European "hot-cold" humoral concept. Several plants used in Hindu rituals and
fever , skin infection,
infection, women's health
for the treatment of conditions such as fever,
region' s
problems , and diabetes mellitus now constitute a significant portion of the region's
problems,
Tamaríndus indica,
indíca , Momordica charantia,
charantia ,
herbal pharmacopoeia. These include Tamarindus
Mangij
Mangifera
切 indica,
índ 仰， Curcuma domestica,
domestica , Cannabis
Cannabís sativa,
sativa , Cymbopogon citrates,
cí 仰的， and Ocimum
Ocímum
gratíssímum (Payne-Jackson & Alleyne,
gratissimum
All ey 肘， 2004).
2004).
The first Chinese emigrants
ernigrants arrived in Trinidad in 1806 and they brought many
aspects of established traditional Chinese medicine,
medicine, as well as herbs. A recent survey
su 凹ey
in Trinidad showed that several medicinal plants currendy used for skin and
stomach problems have their origins in Chinese traditional medicine including
Abelmoschus moschatus,
moschatus , Achyranthes aspera,
aspera , Eupatorium macrophyllum,
macrophyllum , Phyllanthus
urinaría , and Portulaca oleraceae (L
urinaria,
(Lans,
ans , 2007a).
Herbs used for the Common Cold,
Cold, Feve
Fever,r, and Flu
Traditional "bush tea" remedies for the common cold,
cold, fever
fever,, and flu symptoms
s 严丑ptoms
Trinidad, 42 plant species were cited for
abound in the Caribbean. In a survey in Trinidad,
the treatment of the common cold and cough and included Le
Leonotis
onotis nepetifolia,
nepetifolia ,
Zingiber
Zi
咆iber
officinale, Chromolaena odorata,
officinale,
odorata , Cymbopogon citrates,
cit ωes ， and Neurolaena lobata
(Clement et al.,
plants such as La
Lantana
al. , 2007). In Wong's
Wo 吨's (1967) survey,
surv 町， planωsuch
ntana camara,
camara ,
Pimenta racemosa,
racemosa , Myristica fragrans,
fragrans , and Bambusa vulgaris
vulgarís were used to treat cold
fever , and it is interesting to note that most of these plants were classified as either
fever,
"hot" or "very hot" according to classical humoral definition.
A survey in six geographically diverse Jamaican communities showed that 33
plant species were used to treat fever and 22 for the common cold,
cold, with overlap
Herbal Medicine Practices
55
use of Annona reticulata,
retículata , Argemone mexicana,
mexícana , Cymbopogon citratus,
cítratus , Ocimum
Ocímum basilicum,
basílícum ,
& Beckstrom-Sternberg,
and Momordica
Momordíca charantia
charantía (payne-Jackson
(p a 严le-Jackson
Beckstrom-Stemberg, 2006). Among
Among
Haitian communities λlomordíca
Momordica charantia,
charantía , Bidens
Bídens pilosa,
pílosa , Costus speciosus,
specíosus , and
Phyllantus procerus were popular for fever (Volpato,
Godinez,, Beyra,
01olpato , Godínez
B 句ra ， & Barreto,
Barreto ,
2009).
Herbs as "Blood Purifers" and Anthelmintics
The blood plays a central role in the maintenance of health and the medicocultural concept of "bad blood" is firmly
fìrmly rooted in many Caribbean traditional
beliefs. "Bad blood" leads to diseases such as skin disorders and sexually transmitted
medicine , abnormalities of the eyes,
eyes ,
infections. According to Haitian folk medicine,
fingernails,, and skin would necessitate the administration of a herbal "blood
fìngemails
purifier"
purifìer" to "cleanse" the liver,
liver, kidneys,
kidneys , spleen,
spleen, and bowels. Among
Among immigrant
havanense, Roystonea regia,
regía , Momordica
Momordíca charantia,
charantía , and
Haitians in Cuba Erythoxylum havanense,
Senna occidentalis
frequendy used as "blood purifiers"
occídentalís were
were
丘equendy
purifìers" (Cano & Volpata,
Volpata, 2004;
Volpata et al.,
al. , 2009). In another survey
su 凹ey in Trinidad,
Trinidad , Aloe vera was the most
commonly used herbal "blood cleanser" (Clement et al.
al.,, 2007).
There is the medico-cultural construct of intestinal worms thought to be
located within a "worm bag." It is also believed that these intestinal worms either
confer health benefits,
digestion , or harm and cause "gripe,"
"伊pe ，"
benefìts , such as aiding in digestion,
flatulence , or even seizures when there is an overabundance. Yet other comflatulence,
munities believe that excessive worms
wonns are associated with the supernatural.
supematural. Herbal
preparations are given over a few days to either kill or cause worms to "sleep" so
that they could be expelled in the feces.
A survey in Dominica identified
identifìed Chenopodium
Chenopodíum ambrosioides,
ambrosíoídes , Aristolochia
Arístolochía trilobata,
trílobata ,
Ambrosía hispida,
Ambrosia
híspída , and Portulaca oleracea as herbs commonly used to treat intestinal
worms (Quinlan,
(Quinlan, Quinlan
Quinlan,, & Nolan,
Nolan, 2002). Another survey in Haitian immigrants
and descendents in Cuba corroborated the use of these plants and also cited Cocus
nucifera,
nucij 切 ， Crescentia
Crescentía cujete,
cujete , and Momordica
Momordíca charantia
charantía L. as being commonly used for
al. , 2009). In Trinidad and Tobago,
Tobago , Lans (2007a)
intestinal wonns
worms (Volpato et al.,
Cítharexylum spinosum,
spínosum , Cucurbita
Cucurbíta maxima,
maxíma , Tagetes patula,
patula , and
identified
identifìed the use of Citharexylum
Eupatoríum triplinerve
Eupatorium
tríplínerve for the treatment
treatrnent of intestinal worms.
wonns.
Herbs used for Sexual
Sexual,, Women's Reproductive,
ReproductivE
乙 and
and
Child Health
Herbs play
playaa major role in the traditional management of the reproductive health
of women in the region,
region, ranging from alleviation of menstrual pain to "womb
cleansing." A literature review and fieldwork
fìeldwork in the Dominican Republic revealed
that herbs were used to treat many women's health conditions including uterine
fìbroids , excessive uterine bleeding
fibroids,
bleeding,, endometriosis
endometriosis,, and hot flushes in menopause.
In this study,
study , 87 plant species were cited including Agave sp.,
sp. , Beta vulgaris,
vulgarís ,
Saccharum officinarum,
and
Kalanchoe
gastonis-bonnieri
(Osaski
et
al.,
2002).
0 庐cínarum
，
gastoní
扑bonníerí
al. ,
56 Y. Clement
In the Caribbean,
Caribbean, sexual potency and vitality are highly valued. In the recent
ab 血ty to father many
rnany children and a woman'
woman'ss ability
ab 血ty to bear children
past a man's
rnan's ability
were highly esteemed in society; and infertility
i 吐e 时ility
is still
st 血 considered
considered
taboo. In
Trinidad, a survey by Lans (2007b) identified
Trinidad,
identifìed Chamaesyce hirta
hírta and Cola nitida
nítída as
useful plants commonly used to treat female infertility. In the Dorninican
Dominican
Republic,
Allium cepa,
cepa , Petroselium
Petroselíum crispum
críspum and Serenoa serrulata were cited as being
Republic , Allíum
i 吐汪民出ty (Osaski et al.
al.,, 2002).
useful to treat infertility
Throughout the Caribbean the prized bois
boís bande
bandé (l
(loosely
oosely interpreted from the
French to mean "potency wood") has been used traditionally to aid sexual
perfon
丑ance
with assumed potent aphrodisiac qualities. In Trinidad,
Trinidad, bois
boís bande
bandé
performance
in fact represents two distinct plant species: Parínarí
Parinari ω
campestris
mpestrís
and Richeria
Ríchería grandis
grandís
(Lans , 2007b). In eastern
(Lans,
eastem Cuba several plants have been identified
identifìed as being used to
perfon
丑ance ， the most common being
treat impotence and enhance sexual performance,
Stachytarpheta
Stachyta
ψheta
jamaícensís
jamaicensis,, Chiococca
Chíococca alba,
alba , and Roystonea regia
regía (Cano & Volpato,
Volpato ,
2004). In this survey
su 凹ey Scoparia
Scoparía dulcis,
dulcís , Ageratum conyzoides,
conyzoídes , Gomphrena globosa,
globosa , and
Cucurbíta maxima
Cucurbita
maxíma were also cited as plants useful in the treatment of prostate
problerns.
problems.
Among
Among the Surinamese Maroons the popular practice of
of"dry
"dry sex" is facilitated
by female genital herbal steam baths which dry and tighten the vagina to the
identifìed over
increase sexual pleasure for the male partner. A survey in Suriname identified
177 herbs used in genital herbal baths,
baths , including Vismia
Vísmía macrophylla,
macrophylla , Piper
Píper
marginatum,
ma 吃lI ínatum
， and Xylopíaj
Xylopiafrutescens
切tescens
(van Andel et
et 址，
al., 2008).
2008).
The traditional use of
ofherbs
herbs to treat sexually transmitted
transrnitted infections is a common
practice throughout the region and is believed to be caused by "bad blood." A
su 凹ey in eastern
eastem Cuba identified
identifìed several herbs as being used to treat sexually
recent survey
transrnitted infections including Erythoxylum havanense,
transmitted
havanense , Chiococca
Chíococ
ω
， alba,
alba ， Roystonea
昭lía
reglia,， Senna occidentalis,
occídentalís, Solanum Torvum,
Torvum , Cassia
Cassía
户ωμ
fistula,， and Swietenia
Swíetenía mahogoni
mahogoní (Cano
& Volpata,
Volpata, 2004).
In this survey
su 凹ey several plant species were also identified
identifìed that treat menstrual
irregularities including Cissus
Císsus sícyoí
sicyoides,
缸， Senna occidentalis,
occídentalís, and Cassia
Cassía
乒stula
fistula (Cano &
Volpata, 2004). In the tradition of
Volpata,
ofSurinamese
Surinamese Maroons,
Maroons , vaginal baths commonly
Mangifera
咆沪ra indica
índíca to "cleanse" the uterus and vagina after childbirth
use the leaves of Ma
Andel, van de Putte,
Putte , & van Damme,
Damme , 2009; van Andel,
Andel, de Korte,
Korte ,
(Ruysschaert, van Andel,
(Ruysschaert,
Koopsmar Behari-Ramdas, & Ruysschaert, 2008). In Trinidad and Tobago,
Koopsman,
Abelmoschus moschatus, Aristolochia rugosa, and Aristolochia trilobata are given as "bush
teas" to expel the "afterbirth" or placenta and cleanse the uterus after delivery
(Lans, 2007b).
The control offertility to regulate their reproductive capacity, especially during
the period of chattel slavery, was an area of grave concern for enslaved Mrican
women. Many herbs were employed to "regulate" menstrual flow and may also
have been used as abortifacients by enslaved Mrican women " ... to abort their
children, so that they will not become slave like themselves ... " (Schiebinger,
2008, p. 718). Many herbs in the Caribbean have been identified which induce
Herbal Medicine Practices
57
abortion or "increase uterine flow." In eastern
eastem Cuba Cocus nucifera,
nucf 仰， Roys
Roystonea
ω nea regia,
regía ,
and Cinnamomum
Cínnamomum verum were the most commonly cited abortifacients,
abortifacients , whereas in
Trinidad Ambrosia
Ambrosía cumanensis,
cumanensís , Aristolochia
Arístolochía rugosa,
ru}Zosa , and Aristolochia
Arístolochía tri/obata
trílobata were cited
(Cano & Volpata,
Volpata, 2004; Lans
Lans,, 2007b). About 20 herbs have been identified in
Haiti with traditional use as abortifacients or emmenagogues which included
Casearía ilicifolia,
Casearia
ílícifolía , Eleutherine
Eleutheríne bulbosa,
bulbosa , Rhoeo spathacea,
spathacea , and Stemodia
Stemodía durantifolia;
durantifolía; and
extracts of these plants have demonstrated significant activity against in vitro mouse
eniger, Haag-Berrurier,
Haag-Berru
时r ， & Anton,
Anton, 1982).
uterine smooth muscle (W
(Weniger,
Herbal remedies,
remedies , especially those for oral consumption,
consumption, are used cautiously in
children, with "stronger" herbs being reserved for adults. These "bush teas" were
children,
used as tonics and to self-treat commonly occurring ailments
ai1ments such as cough,
cough, fever
fever,,
and intestinal worms. In a survey in Dominica,
Dominica , Chenopodium
Chenopodíum ambrosioides
ambrosíoídes (which
preferred antihelminthic medicinal remedy for
was considered safe) was the prefeηed
intestinal parasites in children,
children, with limited use of Aristolochia
Arístolochía tri/obata,
trílobata , which has
known toxicities (Quinlan et al.,
al. , 2002). A survey
su 凹ey in a pediatric clinic inJamaica
in Jamaica
showed that 71% of mothers gave their children "bush teas" (Michie,
(Michie , 1992).
Medicinal plants commonly used included Mintha
Míntha viridis,
vírídís , Momordica
Momordíca charantia,
charantía ,
Annona muricata,
murícata, and Cymbopogon citratus.
cítratus.
Surinamese Maroon communities have a rich herbal pharmacopoeia where
herbal baths are commonly used in newborns
newboms and infants
i 吐白ts to strengthen,
strengthen, promote
health, and protect against malevolent supernatural
health,
supematural forces. A recent survey showed
usi 吨 178
178 plant species by Maroon mothers in
the use of over 400 preparations using
childcare in Suriname (Ruysschaert
(Ruy 配haert
et al.,
al. , 2009). The most commonly used
medicinal plants included Anacardium
Anacardíum occidentalis,
occídentalís, Gossypium
Gossypíum barbadense,
barbadense, Rolandra
frutí
fruticosa,
ωsa ， Eleusine
Eleusíne indica,
índíca , Paspalum conjugatum,
conjugatum , Stachytarpheta cayennensis,
cayennensís , and
Stachytarpheta
Stachyta
ψheta jamaicensis
jamaícensís for herbal baths for infants. Herbal baths are also used in
these communities to "cleanse the belly" as an effective purgative,
purgative , where babies
are given small amounts of the bath water to drink.
Herbs used for Diabetes Mellitus and Hypertension
There has been an increasing prevalence of chronic lifestyle diseases in the
Caribbean, such as hypertension and diabetes mellitus,
Caribbean,
mellitus , and over recent decades
herbal remedies have been applied to alleviate associated symptoms.
syr 呻toms.
In Morton's
(1981) guidebook of
ofmedicinal
medicinal plants several species useful in the management of
diabetes mellitus were identified and include Ageratum conyzoides,
conyzoídes , Aristolochia
Arístolochía
tri/obata,
trílobata , Bixa
Bíxa orellana,
orella
时， Borreria
Borrería verticillata,
vertícíllata , Caesalpinia
Caesalpínía bondou,
bondou , Cassia
Cassía fruticosa,
jrutícosa ,
Chromolaena odorata,
odorata , Eryl
Eryngium
忽íum foetidum,
foetídum , Gomphrena globosa,
globosa , and Scoparia
Scoparía dulcis.
dulcís. A
survey of public prim
primary
狂y health care facilities in Trinidad and Tobago revealed that
symptorns , particularly for the
24% of patients used herbs for diabetes-associated symptoms,
burning sensation or numbness in the feet (Mahabir & Gulliford,
Gullifo
时， 1997). Another
An other
su 凹巧T several years later in a larger sample at similar public health care facilities in
survey
Trinidad showed that just 9.3% of diabetic patients reported the use of herbs
58 Y. Clement
(Clement, 2009). Plants most commonly used in these patients included Momordica
(Clement,
Momordíca
charantia,
Allium sativum,
charantía , Aloe vera,
vera , Catharanthus roseus,
roseus , Allíum
satívum , and Panax ginseng.
gínseng. It is
noteworthy that all herbs mentioned by Trinidadian patie
patients
时s in this survey
Dorninica, "bush teas" for diabetes were made
originated in Asia and Europe. In Dominica,
using Pluchea symphytifolia,
symphytifolía , Stachytarpheta jamaicensis,
jamaícensís , and Chaptalia
Chaptalía nutans (ACCT,
1985). Additionally
Additionally,, Anacardium
Anacardíum occidentale
occídentale and Artocapus altilis
altílís were cited as useful
inJamaica
Jamaica (Payne-Jackson & Beckstrom-Stemberg
Beckstrom-Stemberg,, 2006).
anti-diabetic herbs in
Allíum
Allium sativum
satívum (garlic) was the most popular herb used by hypertensive patients
attending public primary health care facilities in Trinidad (Clement,
(Clement, 2009). In
another survey in eastern
eastem Cuba a small number of respondents identified Annona
muricata,
murícata , Annona reticulata,
retículata , Citrus
Cítrus aurantifolia,
aurantifolía , and Bidens
Bídens pilosa
pílosa as ingredients of
traditional herbal mixtures
rnixtures used in hypertension (Cano & Volpato,
Volpato , 2004). Among
Among
Haitians in Cuba Citrus
Thevetia
Cítrus sinensis,
sínensís , Tamarindus
Tamaríndus indica,
índíca , and Th
evetía peruviana
peruvíana were most
commonly used for hypertension (V
(Volpato
olpato et al.,
al. , 2009). InJamaica,
InJamaica , other herbs
used for hypertension were Artoca
Artocarpus
ψus altilis,
altílís , Catharanthus roseus,
roseus , Persea americana,
amerícana ,
and Sechium
Sechíum edula (Payne-Jackson
(Pa 丁yne-Jackson
& Beckstrom-Sternberg,
Beckstrom-Stemberg, 2006).
Documenting and Preserving the Caribbean's Herbal Legacy
A vast amount of traditional knowledge of herbal remedies has been lost due to a
combination of lack of intergeneration transfer and disinterest by the current
generation. Although
Although many ethnobotanical surveys have been conducted in several
islands , TRAMIL (Traditional Medicine in the Islands) is by far the most
islands,
coordinated and comprehensive effort to document and preserve the Caribbean
herballegacy.
herbal
legacy. It is a region-wide research network which attempts to document
commonly used herbs and objectively assess safety and efficacy using pre-clinical
methods (R
(Robineau
obineau & Soejarto,
Soejarto , 1996).
The TRAMIL program was started in 1982 in the Dominican
Dorninican Republic and has
since conducted over 50 ethnophannacological surveys in over 27 territories. The
ethnophannacological
ethnop 庐
harr
survey is designed to identify medicinal plants used for
sel 匹
ιμlirni
niti 口
丑
mgc ∞
ondi 眈
tlωons and tωod
at 优
e monographs
monogra
叩
phs 览s have been 伊
pprepared
re叩
pa 衍
red 也
f or
common 优
self-limiting
conditions
to 由
date
for
plants.
99 plan
岱. Although
Although many plants are identified in these surveys
surv 町S only those with over
20% citations or "significant
"sigrrificant use" for a specific condition are included in the
TRAMIL Caribbean herbal phannacopoeia. It is interesting to note that over 40 of
these 99 documented plants were introduced into the region
region
丘om
from Asia,
Asia, Europe,
Europe, and
A
面向飞Nith
with only two species (Bignonia
(B 忽nonía
longíssíma and Pimenta
longissima
Pímenta racemosa)
ra αmosa)
being endemic
endernic
Africa,
to the Caribbean islands. It has been shown that some of the "significant
"si 伊ificant
use" plants
have actually been shown to be toxic by scientific methodology and TRAMIL
provides warning
waming against their use. Some of these plplants
姐.ts include A
Argemone
伊mone
mexícana,
mexicana,
Datura stramonium,
stramoníum , La
Lantana
ntana camara,
camara, 1Piper
学er auritum,
aurítum , Pouteria
Poutería sapota and Th
Thevetia
evetía peruviana.
peruvíana.
In some territories such as Cuba, Dominican
Dorninican Republic, Honduras, Nic
Nicaragua,
红agua ，
and Panama some commonly used plants (with satisfactory safety and efficacy
testing) have been integrated into primary health care programs.
Herbal Medicine Practices
59
The Future of Traditional Herbal Medicine in the Caribbean
In addition to the lack of
ofknowledge
knowledge transfer,
transfer, traditional herbal knowledge has also
been lost due to the combined effect of the institutionalized post-emancipation
A 丘ican
cultural practices (which utilized various herbal remedies)
suppression of African
and the emergence of and reliance on the dominant evidence-based Western
Westem
medicine culture in the last century. As there is little intergenerational oral transfer
of traditional knowledge,
knowledge , and it has rapidly disappeared without adequate documentation , TRAMIL should be applauded and supported
mentation,
supp 。此ed for its efforts. Most
territories in the Caribbean Basin have attained certain levels of economic
development where individuals have easy access to Westernized public health
facilities , and health care workers actively discourage the use of traditional herbal
facilities,
remedies. Many persons using herbal remedies as their primary source of health
facilities , or do so without informing
care have limited access to these public health facilities,
their attending clinicians and use concomitandy with conventional synthetic
al. , 2007; Delgoda et al.,
al. , 2004).
medicines (Clement et al.,
There are many obstacles to the integration of herbs into conventional
medicines , ranging
medicines,
from standardization to the lack of sufficient clinical evidence
ranging
丘om
to support their use (Clement,
(Clement , 2008). Unlike developed countries where attempts
inqui
巧， the use of this
are made to validate herbal medicines by rigorous scientific inquiry,
ofthe
the folklore. However
However,,
modality in the Caribbean remains largely in the domain of
TRAMIL with its ethnobotanical approach to identifying "significant
use" herbs
"si 伊ificant
and its associated pre-clinical studies should be a used as a springboard to advance
to the next level of scientific validation. With the emphasis on evidence-based
medicine the inevitable path forward would be to conduct human clinical trials to
provide the support
suppo
眈 for
for the use of Caribbean herbs for an integrated health care
approach in the region.
Conclusion
There is a wealth of traditional knowledge regarding medicinal plant use in the
Caribbean which exists as an amalgam of medico-cultural concepts from
Amerindian and European settlers,
settlers , enslaved Africans,
A 丘icans
， indentured Asian
indigenous Amerindian
Indians , and other minority groups that have arrived over the last five centuries.
Indians,
There is significant loss of this traditional knowledge across generations as the oral
Western medicine
tradition has been severely eroded and pervasive evidence-based Westem
has taken root in Caribbean societies over the previous century. There is an urgent
need for the preservation of this folkloric knowledge and TRAMIL has begun the
work to document and validate "significant
"si 伊ificant
use" plants using pre-clinical models.
This validation needs to be carried further using clinical trials to facilitate integration into the highly Westernized health care systems that currendy exist in the
Caribbean.
60 Y. Clement
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This
PART II
11
Caribbean Traditional
Healing and Healers
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This
5
OBEAH
Afro-Caribbean Religious
Medicine Art and Healing
Nathaniel Samuel Murrell
Introduction
Obeah is a secretive medicine art
a 眈 that
that
involves a range of religious practices,
practices ,
activities , and beliefs designed to help persons in distress deal with crisis response
activities,
to tragedy,
tragedy , batde psychological and physical illness
illness,, withstand or protect themselves
abuse , and fight for survival. In this Mro-Caribbean
A 丘o-Caribbean
religious
against human abuse,
tradition, believers use herbal remedies and mystical or unnatural means to address
tradition,
their physical,
physical , social,
social , and emotional needs. Practitioners blend their practical
knowledge of phannacopeia with beliefs in divine powers and psychological
conditioning as a means of securing physical well-being and social justice. Through
this religious art,
art, uprooted Mricans,
A 正Ìicans ， in the past,
past, tapped into traditional medicines
trauma , and historical contradictions of their lives under
to deal with misfortunes,
rnisfortunes , trauma,
colonialism and slavery.
The meaning and existence of
ofObeah
Obeah,, quite naturally,
naturally , have been contested in
Caribbean history; though its influence may still be felt psychologically in areas of
law , politics
law,
politics,, religion,
religion, culture,
culture , and even health care economics
econornics (Murray,
(Murray, 2007).
Since historically Obeah has been a secretive and "transgressive" medicine art (it
colonialism) , its
worked outside of the endorsement and control of society against colonialism),
existence continues to generate debate as to whether it is: a figment of some
Caribbean people's imagination,
imagination, the destructive use of ritual objects and practices
on the simpleminded,
simplerninded, a naive appeal to spiritual powers in a community for good
or
ill fortune,， or (for British colonials),
or 山岛民une
colonials) , "almost the entirety of Mrican Caribbean
aton, 2009
religions" (p
(paton,
2009,, p. 4).
This chapter exarnines
examines the practice of Obeah in the Caribbean. It begins with
a discussion of Obeah as a Creole healing phenomenon in Caribbean religious
consciousness,
evolution,, legal proscription,
proscription , and practice as a medicine of
consciousness , its evolution
66 N. S. Murrell
defense under British colonialism. The chapter discusses also the transgressive
Obeah , its healers
healers,, their training in preparation to deploy Obeah medinature of Obeah,
cine , and the role of pharmacopeia in this healing tradition. The chapter concludes
cine,
by noting the challenges posed for a collaborative relationship between modern
di 面culties
medicine and Obeah healing; and the difficulties
Obeah poses for students in
mental health.
The Obeah Phenomenon
Obeah , as an atypical phenomenon,
Obeah,
phenomenon, does not have its own identifiable
identifìable religious
system or organization. It is an oral culture that thrives on different religious
(Case , 2001). The results of that
traditions and among varying ethnic groups (Case,
versatility are Creole practices that practitioners draw on through a rich variety of
religious traditions. Obeah is practiced in traditional religions and cultures,
cultures , in
remote and impoverished communities where alternative medicine is a last lifeline,
lifeline ,
as well as in upscale or middle-class
rniddle-class society. During slavery,
slavery, Obeah was practiced
among the Maroons,
Maroons , slaves,
slaves
，丘ee
free Mricans
Mricans,, and poor whites. Later,
Later, it knew no
boundaries; it found reception among peoples of different
di 岳rent
faiths
faiths,, ethnicity
ethnicity,, and
social standing. It
Itss practitioners were ]amaican
Jamaican Myalists
Myalists,, Pocorninists
Pocominists,, and
Kurninists;
Kuminists; it is among the Trinidad and Tobago Spiritual Baptists and Orisha (or
P 可 ah ， as well as
Kabbalists) avatars; it is found in Guyanese Hindu Kali Mai Pujah,
Muslim and Christian sects. Obeah appeals
appe 址s to descendants of indentured immiimrnigrants , people of Mrican and European descent,
grants,
descent , and other Creole peoples; so
Obeah is not a religion of illiterate maladjusted
mal 呻 usted
Mricans. Caribbean people of all
hue and faith may visit Obeah men-to receive pharmacopeia or to be corralled
by their blessings and receive their amulets of fixed
fìxed trinkets,
trinkets , beads
beads,, necklaces
necklaces,, and
other good luck charms.
charrns. A politician may
m 町 discreetly
discreetly
visit the Obeah practitioner
during a political campaign; business people occasionally seek spiritual baths for
"ev 且 eye,"
eye ，" or to come into good fortune.
fo 此une.
protection from the "evil
Obeah operates outside of constricted boxes of traditional ways of
ofbeing
being and
conceiving the religious and human health care. This script-evading religious
suppression ,
tradition is not publicly embraced. Because of the long history of suppression,
proscription, and punishment (not to mention the stigma associated with the art),
art) ,
proscription,
adrnit their association with Obeah or identify themselves
people do not openly admit
as an Obeah woman or Obeah man to an informant.
inforrnant. Few people will 础由t
admit to
practicing Obeah and,
and, as Katrin Norris (1962) said,
said , "For the same reason that an
court, it is difficult for sociologists to learn a
obeah-man is rarely convicted in a court,
ofVodou ,
great deal about the obeah-man's influence" (p. 16). Unlike the avatars ofVodou,
Candomble , Santería
Candomble,
Santeria,, or Orisha,
Orisha, whom a researcher may
ma叮
y interview in pe
person,
岱 on ，
Oωbe
咄
a边
hprapractitioners
肌
ct 创
itio 侃
ners
盯
a r配
edi difficult
面
伍lCαu
E
山
1 to identify with certainty. Rather than carry the
Obeah
are
title Obeah woman,
woman , or Obeah man,
man , one may take the title "health provider,"
provider ,"
goo health," or "servant of God." One may also claim another
"facilitator of good
Afro-Caribbean religion as his/her religious affiliation and base. As traditional
Obeah 67
medicine in a broad sense,
sense , Obeah is not restricted to one modus operandi; it uses
therapeutic , protective,
protective , and punitive effects-its
e 岳cts-its
medicines
medicines for causative,
causative , therapeutic,
aim at treating psychological (spiritual,
mental,, social) and physical health while
(spiritual , mental
offering protection against detractors and punishment for offenders-it works like
medical provision,
provision, psychiatric help
help,, and law enforcement combined.
Evolution of Obeah in Colonialism
Obeah originated in West Africa
Africa as one of the continent's
continent' s least significant
sigr 凶cant
religious
unti1 its obliteration from
traditions but was an obscure practice in the Caribbean until
society became a phobic preoccupation of colonial governments. The African
practices "were transformed in the crucible" of colonialism and slavery "into
spiritual support for the Mro-Caribbean
A丘o-Caribbean
community" (Savory,
(Savory , 1999
1999,, p. 218); it
provided the oppressed alternative avenues through which they could procure
medical treatment
treatrnent and access their Mrican powers for psychological reinforcement
岱 of
of plantation life. During slavery,
slavery, Mricans also used
to survive the wretchedne
wretchedness
Obeah to intimidate others who habitually plundered their meager huts,
huts , hog sties,
sties ,
and garden plots; to them,
them, Obeah was an indispensable defensive medicine
weapon. After
unemployed,, ex-slavesAfter emancipation,
emancipation, the poor property-less,
property-less, and unemployed
wards of the British Crown-were personae non grata,
grata , estranged in colonial society,
society,
fìght poor health,
health ,
and had to rely on Mrican traditional religions and medicines to fight
injustice , new forms of oppression,
oppression, and other colonial miseries.
rniseries.
injustice,
The British helped
h 句 ed to pperpetuate
呻etuate
Obeah's existence by adopting the name as a
label for a number of religious traditions of Mrican origin in the Caribbean. Before
Vodou , Santeria,
Santer
旬， Myal,
Myal, or Shango entered common vocabulary,
voc 站ulary
， Obeah meant any
Vodou,
Mrican religion or "superstition" and was assigned many sinister designations
A 缸can ， disquietingly secretive
(Murrell , 2010). This is partly because Obeah was African,
(Murrell,
and stealthy,
stealt
峙， vaguely understood,
understood , and historically transgressive in naturenatureofficially, it constituted outlawed alleged iniquitous superstitious Mrican
officially,
A 正ncan
beliefs
and practices that did not follow the European-Christian
European-Christian
且k;
ilk; it made colonists
A 丘icans
given to slave uprising (see
(see,, for example
example,, Ri
Richardson,
chardson, 1999;
nervous of Africans
Patterson
Patterson,, 1967); and it was seen as working against the harmony and welfare of
colonial society. So since the 1700s,
1700s, Obeah was criminalized
crirninalized throughout the
Anglophone
Anglophone Caribbean and remained that way un
until
ti1 recent times
tir 丑es in many island
states (Murrell,
(Murτell ， 2010; Paton,
Paton , 2009). Of course,
course , the laws did not stop uprooted
A
Mricans
缸cans
from contemplating and embracing "transgression" for their own survival
Americas.
and freedom in the strange colonial world of the Americas.
British Robinson and Walhouse (1893) referred to Obeah as a "science"
possessed
only by "natives of Mrica" who brought it with them to the colony,
pos
在 essed
colony ,
"where it is so universally practiced,
practiced, there are few of the large estates, possessing
native Mricans, which have not one or more" Obeah men (p. 207). To these
colonials, Obeah "science" constituted neither a subject worthy of study nor
religion, terms reserved for "civilized" society. As Murray (2007) observes, "it is
68 N. S. Murrell
very unlikely that any Mrican-derived traditions,
traditions , such as British West Indian obeah
...
. . . would have qualified as appropriate for research as a science" (p. 813) or a
A 缸cans
as uncivilized,
uncivilized, backward,
backward, primitive,
prirnitive , and void
religion. Many colonials saw Africans
of
of"religion"
"religion" and "culture;" so Mrican Obeah was not to be given such privileged
privi1 eged
beliefs and practices
designations reserved for established institutions and systems of
ofbeliefs
of "civilized and enlightened" peoples of European origin. Even some modern
scholars are not ready to accord Obeah the title religion. British colonial society
feared , despised
feared,
despised,, and relentlessly pursued Obeah and its practitioners for over 200
years. Whites feared Obeah because of its clandestine activities,
activities , dreaded poisons,
poisons ,
its alleged relation to secret deaths and slave revolts,
revolts , and the fact that it was
irrational to the scientific worldview of Enlightenment Europe. This fear often
worked to the advantage of slaves,
slaves , largely on small plantations,
pla 时就ions ， who were able to
treatment
丘om
garner better treatment
from their rnasters
masters overcome by fear of Obeah.
The British brought Obeah to prominence
prorninence in the English-speaking Caribbean
through the concern over its subversive nature as a transgressive force against the
"drum and beat" of the colonial plantation. Among
Arnong the many non-conventional
slaverγwere:
were: secret revolts,
revolts , arson,
arson,
weapons available to slaves in the fight against slavery
poisoning,
poisoning, suicide,
suicide , and spiritual science (Obeah) which slaves had known in Mrica
or creolized in the Caribbean to meet their needs. As a facilitator of resistance and
rebellion,
revolt, Obeah "provoked an "ideological rallying point" in sanctioning rebellion,
revolt,
afforded meeting places and leaders
leaders,, and formed a repository for the collective
memory of the slaves by preserving African
A 缸can traditions which could be opposed to
the dominant
(Richardson,
chardson, 1999). Its peculiar acts of resistance
dorninant colonial culture" (Ri
revolts , poisoning a master or a slave
occasionally necessitated violence: aiding slave revolts,
snatcher,
snatcher, or "fixing" an overseer with a fatal illness or paralysis. This subversive
character of Obeah was evident in the slave revolts of the 1700s. In a Caribbean
challenges ," virtually every
arena that constantly brewed "new and unpredictable challenges,"
(Murray, 2007,
2007 , p. 818),
818) , even subversively
group had to be creative to survive (Murray,
transgressive.
transgresslVe.
clairns of
ofits
its use as a dreaded science in black resistance
Myths of evil Obeah and claims
to slavery were enough to keep legislative prohibitions in place and feed satire and
racial and religious stereotypes
stereotype even to modern times. As Murray (2007) noted,
"The English were constantly creating new institutions to control the enslaved
Africans, protect their plantations and ... themselves. The slave court and its laws
was one ... such British innovations" (p. 818). Regarding Obeah works as
detrimental to colonial Caribbean society, the authorities made the practice a
primary target for legal proscription and control. Between 1760 and 1792, Obeah
became a criminal act in Jamaica through a series of laws prohibiting Obeah
practices on penalty of death upon conviction (Bisnauth, 1989; Newall, 1978). In
the early 1800s, the official view of Obeah shifted from being exclusively related
to witchcraft, as a "primitive" religious activity, to charges offraud, deception, and
pretention (paton, 2009) and carried serious punishment under draconian laws. In
a British courtroom, Obeah was "non-falsifiable"; one could not rationally believe
Obeah 69
in the factuality of Obeah,
Obeah , and thus officials regarded the art as primitive Mrican
result, the legal prohibition against
superstitious pretensions (Murray,
(Murray, 2007). As a result,
Obeah sought to punish practitioners' "pretentions"; an odd crime in the field of
jurisprudence but
but,, as Paton (2009) says,
says , "In this law and others passed during
pretending to have communication
slavery, the primary definition of obeah was ‘'pretending
slavery,
with the devil' or ‘'assuming
assuming the art of witchcraft'"
witchcra
丘"， (p. 4).
Scholars noted that
from 1838 governments maintained Obeah laws in force in
that
丘om
British Caribbean colonies by also linking the practice to "vagrancy" laws,
laws , specific
Obeah acts,
acts , deception by "rogues and vagabonds,"
vagabonds ," so-called "persons pretending
or professing to tell fortunes,
fortunes , or using any subtle craft,
cra 丘， means,
means , or device,
device , by
palmistry or otherwise,
otherwise , to deceive and impose" and attempt to secure "financial
gain" (Paton,
2009 , p. 6). The legal prohibitions extended throughout the
(Paton, 2009,
Anglophone
Anglophone Caribbean
Caribbean,, where other colonies followed
followedJamaica's
Jamaica's lead in legislating
against Obeah: Barbados adopted Vagrancy Acts 1840 (CO 11113012) and 1897
(CO 30/35). "An Act for the Punishment ofIdle
o fI dle and Disorderly Persons,
Persons , and
Rogues and Vagabonds in British Honduras" was passed 1863 (26 Vict. C. 5),
5) ,
Grenada enacted "Summary Conviction Ordinance 1897 (CO 103122,
103122 , no 2)
2),, and
Trinidad and Tobago adopted several anti-Obeah laws between 1838 and 1888.
From 1872 to 1905 St. Lucia,
Lucia, Dorninica
Dominica,, and the Leeward Islands passed nine
ordinances all targeting Obeah (p
(paton,
aton, 2009,
2009 , p. 17); and Obeah conviction carried
Vincent
例ewall
(Newall,， 1978
1978,, p. 29). Despite legislative instruthe death penalty in St. Vincent
works , British law and its penal threats failed to
ments for punishment of Obeah works,
eradicate the secret but highly influential art; in spite of the severe penalties,
penalties , postplayaa significant role in colonial culture (B
(Bridger,
ridger,
slavery Obeah continued to play
1973,, p. 51; Norris
Norris,, 1962,
p.15),
1973
1962, p.1
日， a role though exaggerated and made prominent
prorninent
by a colonial Obeah obsession through legislation.
Resurgence of Obeah
The many controversies surrounding Obeah,
Obeah , the question of its existence or lack
thereof
"di 岳rentiated
meanings" (Paton
p.l) in Africa
A 缸 ca and the
thereof,, its widely "differentiated
(Paton,, 2009
2009,, p.1)
Mrican diaspora,
diaspora, and its seerningly
seemingly ephemeral legacy in Caribbean people's
consciousness , account for the significant resurgence of interest in the subject in
consciousness,
popular culture and the academy,
academy, especially in the United States since the midrnidth century.
20 出
decades , health-care providers also have taken a new
20
century. In the last few decades,
interest in the study of
ofObeah
Obeah relative to mental health and healing; and economic
econornic
circumstances have driven many Caribbean people to explore alternative
altemative means
of
health care (Aarons,
McClure , 1982; Wing,
Wing, 1998). Colonial governments'
ofhealth
(Aarons, 1999; McClure,
attempt to obliterate Obeah from its proto-Christian society drove the art
underground where it became most potent and given to stealth. Obeah comes to
public attention and scrutiny only in times of economic
econornic hardship,
hardship , stress,
stress , sickness,
sickness ,
and critical need.
70 N. S. Murrell
In the postcolonial cultural zeitgeist of Caribbean nationalism,
nationalism, many colonial
Obeah , were repealed. In 1951 Trinidad
religious regulations,
regulations , including those on Obeah,
and Tobago repealed its Obeah ordnances and St. Vincent followed suit in 1965.
In 1973,
1973 , Forbes Burnham's socialist government abrogated Obeah laws in Guyana,
Guyana ,
with a proviso that it was not to be used for
"capitalist gains" (Paton,
for
气apitalist
(Paton, 2009).
forr 丑
Leonard Barrett (1988) still made the claim that Obeah "is the most dreadful form
of Caribbean witchcraft plaguing both blacks and whites in the days of slavery and
today"
也
(p. 28).
28).
This is partly because a culture of
continuing to haunt Jamaicans today"
Obeah paranoia or obsession still prevails-largely
prevai1s-1argely among Mrican peoples on both
sides of the Atlantic-and
Atlantic-and is encouraged in horror movie-stories,
movie-stories , myths
myths,, and stories
of missing
rnissing persons
persons,, suspicious affiictions,
affiictions , mysterious deaths
deaths,, and in legends of
Obeah-fixed persons,
Occasionally,, packages allegedly
persons , objects,
objects , and places. Occasionally
containing magic potions
potions,, accessories suspected of Obeah "works" are intercepted
in them
the mail
ai1 by authorities. The anxiety and curiosity that surround these suspected
"bundles" prese
preserve
凹e the aura of the Obeah practitioners' personae as "terrifying
"terri
马Tmg
ewall, 1978) with respect in their communities. Another stimulus that
figures" (N
(Newall,
keeps the aura of
ofObeah
Obeah alive comes from the academy. There is a well-spring in
the study of Obeah
Obeah,, as evident in the substantial scholarly production on this
transgressive medicine art,
a 此， seen partially in the sources that significantly
signifìcantly informed
inforrned
this chapter. So the religious medicine art is alive and well in 21 st century
literature , and in Hollywood. Karla
Caribbean people's consciousness,
consciousness , in popular literature,
(1999)
町s
says,， "the pull of Obeah remained strong enough to foster doubt in
Frye (1999)
the minds
rninds of even the staunchest disbeliever and naysayer"
n 叮S 叮er" (p. 199) and its toolsspirits,
spiri 俗， natural objects
objects,, pharrnacopeia
pharmacopeia,, magic
magic,, fear
fear,, fantasia
fantasia,, and faith-continue
faith-continue to
maintain their efficacy in peoples' cultural subconscious.
In modern times,
times , peoples with Caribbean ancestry (some of whom live in
Britain, the United States,
Britain,
States , and Canada) who believe in Obeah's efficacy,
efficacy, use the
religious medicine art
a 眈 to
to seek personal desires,
desires , treat poor health,
health , secure good
fortune,
fortune , win a tough litigation battle,
battle , discourage conjugal
co 咱ugal
infidelity or unfaithfulness , protect their property
fulness,
prope
民y from larceny,
larceny , and settle scores in domestic feuds.
Someone may "turn the affections of the objects of
his love or lust towards himself,
ofhis
himself,
evince revenge upon his enemies,
enernies , and generally
general manipulate the spiritual forces of
the cosmos in order to obtain his will" (Morrish, 1982, p. 41). Economic distress
that depresses medical provisions among Caribbean peoples creates a market for
Obeah to marshal natural and spiritual forces to battle poor health and other crises.
Aarons (1999) has noted the growing decline in governments' ability to maintain
good medical health-care standards in Caribbean states-which "are low-income
developing countries with open free market economies" (p. 23) but serving large
unemployed and underemployed populations-where "governments try to
balance their budgets among competing social goods, such as crime prevention,
education, housing, transportation, health, and employment for the less privileged
in their societies" (p. 23). At the same time, the cost of Western medical care
continues to spiral, requiring "the complex interplay of people's beliefs, practices,
Obeah 71
and the accessibility"
accessib
血ty"
(p. 23) of alternative
altemative fonns of
ofhealth
health care (see also McClure
McClure,,
1982; Wing
Wing,, 1998). Mro-Caribbean religions' folk medicine become some
Obeah, Vodou,
Vodou , Santeria,
Santer
旬， Candomble,
Candomble , and other
peoples' last lifeline; they resort to Obeah,
A
Mrican-derived
缸can-derived
medicine traditions "because of poverty,
poverty, personal beliefs
beliefs,, spiritual
(Aarons , 1999,
1999 , p. 25).
awakening,
awakening, or the inaccessibility" of medical providers (Aarons,
Respect for this service,
economic retums
returns in
efficacy, and Obeah's econornic
service , claims of its efficacy,
hard times perpetuate its success and vitality in Caribbean cultural consciousness.
Obeah Healers and Their Training
By dint of circumstance,
circumstance, Obeah practitioners work undercover and keep secret their
woman
"transgressive medicine" out of fear of prosecution. The Obeah man and wornan
healer,, medicine man
man,, conjurer doctor,
doctor, root-worker,
root-worker, diviner
belong to the tradition of
ofhealer
procurer of cures,
cures , and agent or finder. These varied possessors of magical arts are
said to be "double-sighted"; they have the ability to see the spiritual world operating
in the physical (B
(Baer,
aer, 2001
2001,, p. 149). Mro-Caribbean religions often combine the
roles of
ofhealer
healer,, priest,
priest, medium,
medium, herbalist,
herbalist, and medicine woman (man) who work
with herbal and other recipes. Healer,
Healer, Obeah woman,
wornan, and Obeah man
rnan are often
one and the same;
sar 丑e; some Obeah men are more adept at healing medicine than others
who might
rnight be better at protective and punitive medicine. Clients seek the same
sarne
ai1ments , solutions to social
practitioners for consultation to securing cures to ailments,
arnulets so to ward off spells cast
problerns , justice for wrongs
problems,
wrongs,, or obtain channs and amulets
appren
咀ceship
period
by an "evil eye." An Obeah initiate undergoes an infonnal apprenticeship
leam its secrets. However
However,, this training is
to develop knowledge of the craft and learn
infonnal and acquired by observation,
"inheritance,"
observation, "inheritance
," or special "endowment." As
Baer (2001) observes,
observes , one may
rnay become an Obeah specialist "in one of three ways:
position , apprenticeship under the tutelage of an established
inheritance of the position,
practitioner, or a ‘'calling'
practitioner,
calling'
丘om
from god" (p. 149). Most Obeah healers' knowledge is
filial in origin-learnt
origin
一Ieamt
from a mother,
mother, grandmother,
grandmother, grandfather,
grandfather, uncle,
uncle , and other
family
farnily members. Some claim a special gift
from God and might
gi 丘 (endowment)
(endowment)
丘om
rnight begin
rninor (a prodigy may
rnay start as early as six to seven years old). Others
healing as a minor
vision, dream,
dre 缸丑， epiphany
epiphany,, or in a situation of crisis
receive the gift of healing in a vision,
(e.g. , terrninal
(e.g.,
terminal illness or death of a loved one).
Women
omen have always featured prominendy
prorninendy in Obeah magic
rnagic and herbal medicine
W
and they used the system to their own economic
econornic and social advantage. Because of
their skill in religious magic,
magic , knowledge of plant phannacopeia and other
medicines , and pardy through their strong leadership roles in Mrican religions,
medicines,
religions ,
women are highly respected and feared in Mro-Caribbean religions. Historically,
Historically,
Caribbean women were more likely than men to tum to Obeah for social and
supp 。此 in
in the face of inequities,
inequities , unemployment,
unemployment, underemployment,
underemployment,
econornic support
economic
and the domestic abuse they experienced.
The tide Obeah woman
wornan represents somet
something far more loathing than Obeah
man. To British colonials, Obeah women epitomized the wicked Mrican witch
72 N. S. Murrell
who works dangerous magic with poisons,
poisons , the fierce Nanny Maroon leader or the
Wicked Witch of Rose Hall Oamaica),
Oamaica) , and the evil
ev 迫 Queen
Queen
]ezebel
Jezebel in ancient
Hebrew tradition; these women used stealth,
stealth , deception
deception,, and aggression to
accomplish their ends and so corral
corra1 a mystic around them that is foreboding. Often
robust, curvaceous,
curvaceous , and oversize the woman,
woman, the more dread
the more physically robust,
her appearance,
appearance , and the more effective her remedies,
remedies , the more respect she
f 民s). Healing is percommands , and the higher her "donations" (consultation fees).
commands,
formed for consultation fees,
fees , in cash or kind. For an Obeah practitioner,
practitioner, this
"medicine" activity derives a small supplemental income but Obeah can be
profitable if done professionally. As Newall (1978) says "The obeah practitioner,
practitioner,
who is professional,
professional , and performs sorcery [services] at the request of
ofhis
his clients ..
..
..onpa
on payment
严丑ent of a fee,
fee , is frequently enjoying a higher living standard than the other
ofhis
his [or her] community" (p. 35).
members of
Whether male or female,
female , Obeah practitioners are the sole arbiter of their
cra 丘; they are answerable to no one,
one , fear none
none,, but respect one another.
magical craft;
They work in realms of the mysterious and their magic,
magic , though apparently
miraculous
rniraculous or supernatural,
supernatural , are learned crafts and principles employed to a desired
end. To perform the unconventional and "transgressive" services,
services , an Obeah avatar
must study and dispense medicine believed endowed with sacred powers for
healthy and protective or punitive purposes. An Obeah woman or man must be
arti1l eries of sorcery,
sorcery ,
able to operate with coded magic and co-opt esoteric artilleries
prescience
prescience,, and witchcraft to deploy psychological medicine. This requires special
gained
丘om
hurnan talent or through training. The Obeah
knowledge gained
from a natural human
healer must be "four-eyed,"
"four-eyed," "having developed the gift to see both the visible and
in 丘ont
front and behind
behind,, in
(Murphy , 1994
the invisible world" (Murphy,
1994,, p. 121); she must see in
the future and in the past. Divine problems,
problems , illnesses,
illnesses , conditions,
conditions , and situations
affecting her clients and prescribe treatment based on a range of acquired
knowledge. She depends on "psychological analysis" and the power of suggestion
ab 血ty to mesmerize believers with her mystical spells
for her success and ability
medicines. As specialist in herbal pharmacopeia,
pharmacopeia, the Obeah man must also know
and master the use of
ofherbal
herbal medicines and their healing potential; Obeah medicine
is largely plant based. Pharmacopeia and balmyard works from Caribbean flora are
vast and one can
ca take significant time attempting to master the art of producing
and applying the right herbal medicines to psychological and biomedical or
physical ailments. Skill in Obeah medicine comes from practice and practical
knowledge.
Deploying Obeah
Obeah "services" often fall into two general categories: psychological or nonbiomedical medicine,
medicine , which affects mainly the mind
rnind and spirit of the client
(inquirer) , and physical or biological medicine intended to heal or protect the
(inquirer),
body. Most problems for which people seek Obeah healing might
rnight be classified as
Obeah 73
sociological and psycho-physiological or psychosomatic. Sociological problems
property,
眈y ， stopping a
include: forcing a harmful person out of a neighborhood or prope
fa 时 attraction,
attraction
， settling a score in a love triangle,
triangle , salvaging a broken
stalker in a fatal
relationship , punishing a malicious enemy
relationship,
enemy,, getting even with a landlord or
employer, fighting a lawsuit
employer,
lawsuit,, or increasing one's business chances,
chances , etc.
etc. The mys0 丘en serves as a deterrent to
tique that an Obeah man carries in his community often
the acts of nefarious persons who otherwise would have committed offenses/
violence against people who were not "Obeah protected." In this way,
w 呵， Obeah
works as a code of conduct in communal morality; it is used to catch thieves and
women, for example,
example , use
crirninals and punish dishonesty or cheating; some women,
criminals
Obeah medicine to inhibit the sexual deviance of their partners,
pa 眈ners ， others employ it
to seal a desired or unrequited relationship. So in a believing community,
community, the belief
functions-and more so among ecoand practice of Obeah can serve positive functions-and
nornically stressed peoples who cannot better protect themselves.
nomically
Obeah as non-biomedical medicine is outside of traditional scientific verification and may be the most problematic for mental health practitioners. It focuses
on restoring relations,
relations , a sense of
ofharmony
harmony,, or accord in the person's conflicted life
because of a perceived breach in "yin-yang"
"yin-yang"
句pe
type balance in their world; this may
rnay
world,, between lovers,
lovers , families,
farnilies , enemies,
enernies ,
be between an individual and the natural world
or competitors. Some physical conditions may
rnay amend
ar 丑end after disharmony is restored.
paraphemalia is employed in this psychological traditional
A range of healing paraphernalia
Among those spiritual services are: therapy,
therapy , prayers
prayers,, spells,
spells ,
medicine endeavor. Among
psychological conditioning
balms , herbal baths
conditioning,, oath taking
taking,, balms,
baths,, striking on a sick part
of
ofthe
the body ‘"in
'in the spirit,"
spirit," exhorting or counseling,
counseling, and performing
perforrning other actions
with special words. As the need arises,
arises , these are accompanied by spirit-infused
potions,, charms,
oobjects
均曰ts or things: spiritual entities,
entities , amulets,
amulets , magic potions
charms , trinkets,
trinkets ,
personal effects,
e 岳cts ， clothing,
clothing, unusual objects (e.g.,
(e.g. , birds' feathers,
feathers , grave dirt,
di 此， animal
offal) , powders
powders,, love and healing oils,
0 匙， to name a few. Traditional healing
parts or offal),
client' s behavior,
behavior, mental imbalance,
imbalance , and demeanor or
also uses herbs to alter a client's
state. A change in dietary habits,
habits , vices
vices,, and profession (e.g.
(e.g.,, a stressfuljob) may be
recommended as effective medicine. A healer may council divorce,
divorce , rernarriage
remarriage,, or
change of environment to reduce
r
stress or restore peace and harmony in a client's
life. These non-biomedical medicines often are applied with prayers and "rituals
of power" involving dancing, singing, magic spells, sorcery, and witchcraft. There
may even be meditation, incantations, exorcisms, and curses under spirit possession
(Murrell, 2010).
Obeah works involve seance (an ability to communicate with ancestral spirits),
intuit cause and effect reality, divine future events, and use magic spells or
substances to deal with what Murphy calls "the disintegrative forces of a society
under stress" (1994, p. 120). In Caribbean mythology, Obeah practitioners have
effected retributive justice and caused disease or other misfortune through
sympathetic magic. This involves infusing "fixed energy" into an object or effigy
that represents a person and, through a mysterious transference of the energy, the
74
N. S. Murrell
aaffliction
fRi ction reaches the individual targeted without the "sponsor" making any direct
contact with the affiicted. Obeah healers also are consulted for what is called
"telling," an ancient art of seeing what the stars predict for a business
"reading," or "telling,"
"reading,"
or personal venture; it is magically foretelling one's future or fate. A practitioner
might also require a client to perfume herself with the "oil of love,"
love ," a
pharmaceutical that carries a very pleasant fragrance. This perfume is supposed to
around, like the proverbial fly on the wall that
attract the spirits who then loiter around,
aids the couple in their romance. A client seeking advice on increasing her chances
for success in business might receive a solution based on common sense; like
putting a mirror or some important object in her shop to attract more customers'
attention (Murrell,
(Murrell , 2010).
impo 眈ant
psychological
Notwithstanding its use of magic and witchcraft as important
healing tools,
tools , Obeah medicine is partly biomedical or health related; its healing is
largely natural pharmacopeia accessories that have a large plant base (Murrell,
(Murrell, 2010).
Many Obeah paraphemalia come from plants and animals. The healer uses an array
of
herbs,, some very common and well known but most are unusual and unfamiliar
ofherbs
(Aarons , 1999). Some floras are used in mixtures with other herbs while others are
(Aarons,
applied by themselves to cure a variety of ailments,
ai1ments , skin irritations
irritations,, or diseases.
Believers allege that Obeah can treat malfunctions in women's reproductive system
as well as a range of other maladies (Seaga,
plant (ganja,
(Seaga, 1963). The marijuana
ma 均uana
(ganja, Indian
hemp , or cannabis) has been a major
m 习 or healing pharmacopeia since early colonialism.
hemp,
The practice of smoking ganja in nighdy dances and healing rituals,
rituals , for the curing
of a variety of
of 组lments
ailments,， was very common in West and Central Africa,
A 丘阳， parts o
ofIndia
fI ndia
and the Caribbean. Herbalist
Herbalist,, Obeah men/women,
men/women, and medicine men use the herb
problems , stomach disorders,
disorders , rheumatism,
rheumatism, hot flashes,
flashes ,
for asthma,
asthma, respiratory problems,
cramps,
hypertension,, and other conditions.
cramps, overheating,
overheating, depression,
depres
唱ion ， hypertension
A diversity of citruses is among the common healing folia. The Palma Christi,
Christi ,
used intemationally to treat colds,
colds , is applied as a poultice for cuts,
cuts, bruises,
bruises , and some
skin infections. It also works as a laxative or purge for constipation and lower
bowel irregularities (McClure,
(McClure , 1982,
1982, pp. 296-297). Just like the Jamaican Akee
Akee
when picked before it is ripe,
ripe , the Palma Christi also can produce a deadly toxin
s
for Obeah defense. Obeah poisoning is medicine for both protection of someone
and revenge against another and is deployed with magical powers. According to
McClure (1982),
Poisoning for revenge is a customary ritual among followers of Obeah. In
1809 , on the isle of Antigua,
1809,
Antigua , poisoning was so
so 丘equent
frequent that the law
intervened to subdue it. The old people were acquainted with both the
medicinal and the poisonous plants of the island"
Although Obeah is thought
and sold potions at a price (McClure,
(McClure , 1982
1982,, p. 298). Although
of more for its "negative" medicine,
medicine , its poisons are applied only in rare cases and
under adverse circumstances. The healing and other services Obeah men offer
0 岳r are
Obeah 75
usually sought as a last resort; few Caribbean people who are ill tum first to a healer
or Obeah man. A patient first applies "bush remedies" (homemade balms),
balms) , then
modem medicine,
medicine , and only when these fail
fai1 or are unavailable
unavai1able does she search for
a spiritual cause and cure (Seaga
(Seaga,, 1963
1963,, p. 12) in Obeah or another Mro-Caribbean
A 丘。-Caribbean
healing tradition.
Obeah and Conventional Medicine
Perhaps the biggest problem mental health professionals may
rnay face in dealing with
Obeah healing is the one that researchers encounter,
encounter, the secrecy-invisibility
phenomenon. Obeah is an indistinct religion; its practitioners are difficult to
identify with certainty and their operation is often covert-information
covert-inforrnation about their
anecdotes
丘om
from and about clients. The loathing
practice is almost always indirect anecdotes
stigrna attached to Obeah in the Anglophone Caribbean,
stigma
Caribbean, alleged association with
worship , curses,
curses , suspicious disappearances and poisonings,
poisonings , and legal
evil,
evil , devil worship,
proscription keep believers in Obeah under a code of secrecy. Documenting who
Obeah clients and practitioners are and precisely what they do and how they
perforrn their healing can be a daunting task; also,
perform
also , although Obeah may
rnay address
psychological and even psychiatric conditions,
conditions , they are often not a mental health
suffer
丘om
from mental
treatment provider and neither practitioners nor clients may suffer
instab
血町， or serious mental illnesses. Non
Normal
丑al people's interest
imbalance,
imbalance , cerebral instability,
in Obeah can be spun by a number of concerns
concems or causes: medical,
medical , religious,
religious ,
psychological
econornic.
psychological,, social
social,, or economic.
Medical practitioners and mental health students know that much of modem
medicine comes from plan
plants
臼 and
and animals and that often some home remedies that
evolved from years of experiments with plants and animals in ancestral traditions
ve 巧re effective
岳ctive
in treating some
some
山nesses.
illnesses. Such health provision should
have proven very
not be disregarded at face value as mere folklore. Obeah is also an oral tradition
that is yet to document its practices as a healing tradition. So students in mental
health may be concerned
concemed about the absence of documentation and 伊ide
guide for
dealing with various herbal remedies and treating health conditions with folk
0 伍cial
av ai1able on how many
rnany clients receive healing and
record is available
medicine. No official
if any were harmed
harrned with permanent
perrnanent damage
darnage from Obeah application of
ofherbs
herbs with
toxic properties. This is another cataract on the path to the merging of modem
medicine with traditional healing such as Obeah. Unless
Unles
唱 practitioners
practitioners
break their
code of secrecy and allow for their public identification with Obeah,
Obeah, the art will
remain mysterious,
mysterious , indistinct
indistinct,, and off-limits
0ιlirnits to collaboration between modem
medicine and folk healing.
Conclusion
Obeah had a noted existence in Caribbean history and survived every colonial
obliterate it from people's consciousness and society. As an oral tradition
to
aattempt
忧empt
76
N. S. Murrell
that thrived on human imagination especially in
in 由丑es
times of hardship,
hardship , trauma,
trauma , and
distress , this art evolved as a medicine of defense against oppression and abuse as
distress,
well as good health. Though often confined to Caribbean folklore and past
primitive Mrican superstition,
superstition, Obeah still
sti11 exists in Caribbean people's consciousness as a protective medicine that can be used for a variety of human
hurnan needs. The
art has the potential for significant value derived
derived
丘om
from herbal medicine,
medicine , psychological conditioning,
conditioni
吨， and as a medicine that discourages harm and abuse of the
vulnerable. The secretive,
secretive , oral,
oral , and mystical nature of Obeah practice poses
serious-though not insurmountable-challenges for academic
acadernic study and use in
modern medicine.
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6
VODOU HEAllNG
HEALING AND
PSYCHOTHERAPY
Ghislène Meance
Ghislene
Méance
Introduction
Vodou is defined
defìned as a system of magic that may include sacrifice,
sacrifìce , divination
divination,, and
conjuring (Metraux
(Metraux,, 1972); however
however,, Vodou rituals may also involve root doctors
Haiti , V odou is an official and organized
and herbalists. Practiced predominandy in Haiti,
religion combining elements of Mrican V odun and Roman
Rornan Catholicism-revering
the spirit world of ancestors and designed to both heal the sick and injured body
and soul,
soul , promote success and wealth as well as to guide the spirit to God. Haitian
families believe in certain forces or principles that comprise an order by which they
can live and to which they are subject.
su 均 ect.
It is estimated that about 80% of the Haitian
population practice some aspects of V odou regardless of their religion and
socioeconomic status. Vodou healers are consulted when clients are looking for
answers for problems
problerns that neither medicine,
medicine , nor other religions are able to answer.
In addition to being a religion Vodou is also an art of
ofliving
living,, focused on daily life's
life' s
problems. Haitians usually turn to Vodou for counseling,
wealth,,
counseling, protection,
protection, help,
help , wealth
health,, and justice. Aspects of the religion or ways of
health
ofliving
living are also observed within
ex 组nples
of
ofVodou
V odou
the Haitian diaspora,
diaspora, particularly in the United States where examples
practices have been observed.
Haitian Vodou has an affinity with many other religions and mythologies; it is
known in Cuba and throughout South America
America under names such as Hoodoo,
Hoodoo ,
Santeria , Chango,
Santeria,
Chango , Nafiiguismo,
Nañiguismo , Candomble,
Candomble , and Macumba. A V odou priest cited by
Bodin (1990) explains that,
that, "Vodou is an organized religion combining elements
of
ofA African
丘ican
Vodun and Roman
Rornan Catholicism-revering the spirit world of ancestors
and designed to both heal the sick and injured body as well as to guide the spirit
to God" (p. 1). According to local beliefs,
beliefs , families inherit ancestral
ancestral
叩irits
spirits from
Dahomey,, West Mrica. These spirits are worshiped through elaborate rituals,
Dahomey
rituals ,
which include drumming
drumming,, sacrifìce
sacrifice,, singing,
and
praise.
singing,
Vodou Healing and Psychotherapy 79
A
After
丘er centuries of persecution and de-valorization by other religions and by
some political regimes,
regimes , Vodou was decreed an official religion by the Haitian
Historically, Vodou existed as a subversive political force that
government in 2003. Historically,
fueled the Haitian Revolution from French control in 1804,
1804 , which may papartly
眈ly
explain its marginalization and devaluation by Westem society. For several decades,
decades ,
V odou has attracted attention from social scientists,
scientists , in papart
眈 because
because it has acted as
a positive force in promoting Haitian liberation from colonial domination
dornination
但artkow
此 1998).
1998).
In fact,
fact , in 1804 Haiti became the first Black Republic in the
(Bartkowski,
world after the Haitian revolution led by Vodou practitioners and followers.
Simpson (1978) found that Vodou followers rely on that religion for solidarity
and a sense of belonging. During initiation,
initiation , followers gain confidence that the
spirits will
w 山 protect
protect them and cast away any harm.
harrn. Vodou followers also understand
that it is considered a blasphemy against God to disclose secrets of Vodou. Bibb
and Casimir (1996) explained that Vodou encompasses both the religious and the
s 呵， see causes of mental illness as derived from the
medical worlds. Haitians,
Haitians , they say,
supernatural external world and V odou as providing solutions to problems
emanating from this world.
This chapter will focus on Vodou as practiced in Haiti where it is also
designated as Vaudou,
Vaudou , Vodou,
Vodou , and Vodu. 1 It begins with a discussion of the religion
and its divinities. This is followed by an exploration of the healers and their healing
how 山ness
illness and wellness are conceptualized in this system. Lastly,
Lastly, the
practices and how
chapter highlights the need for collaboration between Vodou and conventional
mental health care systems.
Vodou Religion and Divinities
The Y oruba religion is the most widely spread manifestation of Mrican religions
in the N
New
ew World.
W orld. Y oruba followers,
followers , who live mostly in West Mrican countries
Coast,, and Ghana
Ghana,, believe in a supreme being,
such as Togo,
Togo , Benin,
Benin, the Ivory Coast
being,
divinities,, and spirits that have been deified (Horton,
primordial divinities
(H 。此on ， 1989). Bibb and
Casirnir
Casimir (1996) note that these forces are not visible and are referred to as les
invisibles
ínvísíbles or the "unseen,"
"unseen ," and they
th 巧T are perceived only when showing concrete
signs of their presence through experiences of "possession" during religious
ceremonies , and therefore take a nurninous
ceremonies,
numinous or mysterious quality. According to
Deren (1970),
(1970) , their personification became known as divinities or lwas. A lwa
which,
which, in the Y oruba language,
language , means mystery is a specific spirit such as Legba,
Legba , the
spirit of the gate,
gate , Erzuli,
Erzuli , the spirit oflove,
oflove , or Gede,
Gede , the spirit of the dead. In the
Vodou religion,
Deren,, is to celebrate what he
religion, worshipping the lwa,
lwa , according to Deren
calls
"the principle not the matter" in which it may be momentarily or percalls
气he
manently manifest.
De Vos (1988) reported that there are 401 lwa. Furthermore,
Furtherrnore , there are different
phenomena,, such as plants and
categories of lwa. Some of them exist in natural phenomena
trees , and animals,
trees,
animals , such as snakes. A different class or category of lwa is thought to
80 G.
G.MMeance
画ance
reside in situations or special individuals who serve them. These lwa need these
that, according
phenomena or special individuals in order to exist. De Vos reports that,
to the Vodou worldview,
worldview , as the lwa and person live in mutual interaction,
interaction ,
mutations in their form
fon 丑 and
and
qualities may occur with the passage of time and
within the changing environment. Relationships and interactions between lwa and
person,
people are very important and when there are conflicts between a lwa and a person,
example , it can be manifested through symptoms
symptorns of depression and anxiety.
for example,
Michel (1996) understands Vodou teaching and learning as referring to
balancing commonalities or universal knowledge with differences to create global
hannony
harmony and peace among people and between people and Nature as well as the
spirits. Indeed,
Indeed , teachers and leamers
learners play equally active roles in guiding and
facilitating , making the most use of tangible and intangible resources. This
facilitating,
"democratic foundation" makes Vodou quite a progressive system compared to
other more doctrinaire,
doctrinaire , authoritarian religions. Unlike other major religions of the
world, the V odou priest or priestess does not necessarily wear a recognizable garb
world,
or uniform
unifonn that conveys their social status. Nevertheless,
Nevertheless , they are perceived as
respectable and important members of society in Haiti.
Vodou Healers and Healing Practices
In Haiti there is one Vodou healer for every 100 Haitians versus one medical
doctor for every 100,000
100 ,000 (Cohen,
(Cohen, 1997),
1997) , therefore,
therefore , Vodou healers and their
healing practices are critical. Worship
W orship and healing are sustained by adherents led
by a Vodou
V odou priest called hungan
hu 咆an or priestess called manbo. The main function of
the hungan or the manbo is to heal. It takes about five years to become a V odou
healer followed by years of training before initiation. In order to qualify for this
vocation, the person is required to have specific talents and attend various trainings.
vocation,
Above all it is considered an inherited gift from the family's ancestors and spirits.
intemational Vodou apprentices and is considered the best
Haiti attracts a lot of international
place for formal
fonnal and informal
infonnal training in V odou healing. Vodou practitioners who
are non-Haitians and students interested in the religion tend to make the trip to
Haiti to be initiated "into the rites ofVodou" and are able to practice various levels
of V odou ritual based on their advanced training. A Y oruban Vodou priestess
Louisiana , interviewed by Bodin (1990),
(1990) , confessed that her
currendy practicing in Louisiana,
training in Haiti was a process of getting herself" spiritually straight." This V odou
priestess considers the Haitian Vodou and the Y oruba V odou as sister religions
because both religions treat their ancestors with great respect. Touloute (1998)
notes that respect for ethics is highly valued by the Vodou community. Vodou
priests and priestesses receive counsel and treatment from one another because
"Vodou does not discriminate on the basis of gender,
race,, age
age,, sexual orientation,
gender, race
orientation,
affùiation" (Touloute,
(Touloute , 1998
1998,,
national origin requirements or pre-existing religion affiliation"
p. 5). Vodou priests who violate Vodou ethics are called boko or evil
ev 且 charlatans.
charlatans.
They are said to serve certain
ce 眈ain lwa called dyab or wild
wi1d spirits. These dyab and boko
bðkð
Vodou Healing and Psychotherapy 81
are said to be invoked on behalf of clients for magical compensation,
compensation, and they may
suppo
时 to
to protect practitioners from
affect a person's demise. The dyab is also supposed
possible acts of random aggression according to Touloute (1998).
It is estimated that the training period may last as long as five years,
years , where the
master ougan or manbo passes along formal knowledge to an apprentice. Then for
years , the master supervises the work of the apprentice before
several more years,
traini
吨 is
is considered as a beginni
beginning
吨 of
ofa a long
10 吨 journey
journey because in
initiation. The training
the V odou world the growth in knowledge is attained over time and with
experience. Moll and Greenberg (1990) note that the Haitian culture believes in
the social distribution of
ofknowledge;
knowledge; accordingly
accordingly,, knowledge is not something to
be possessed personally because it is available
avai1able and accessible through different
di 岳rent
social
networks including spiritual inheritance. Following from this logic,
logic , there are no
written directions or sacred books that contain dogma,
dogma, formula,
formula , and rules.
Healers work at the hunfo or Vodou temple,
temple , located near churches or markets,
market
丑，
heal, worship,
worship , and communicate with the spirits. These hunfo can be identified
to heal,
by a flag displayed on the roof of the building,
building, and the style and decoration of the
flag indicates which lwa the priest or priestess serve. Also
Also in the V odou world,
world,
cemeteries,, crossroads
crossroads,, oceans
oceans,, rivers
rivers,, chutes
chutes,, fields
fields,, households
households,, and other sites are
cemeteries
prominent and meaningful places of worship and treatment
treatrnent according to Michel
(1998) , "the Vodou priesthood performs such
(1996). According to Touloute (1998),
functions as healing,
healing, pacifYing
pacifYing the spirits,
spirits , initiation,
initiation , foretelling,
foretelling , dream reading,
reading,
spell casting and creating potions for various purposes like protection love and
death" (p. 5).
Illness
IIIness Representations and Wellness
Well ness Practices
In Haiti mental illness is considered supernatural and mainly treated with
techniques ofVodou healing. According to Charles (1986),
(1986) , in Haiti the majority
m 得 ority
of people live without any knowledge of psychiatric care. He notes,
notes , "Religion,
"Religion,
society,
society, family and supernatural belief systems provide resources for dealing with
addition, Morrison
Morriso
川nd
and Thornton
stressors that impinge mental health" (p. 186). In addition,
(1999) found that some Haitians simultaneously practice both Christianity and
However, they might not admit being Catholic/Protestant and Vodouizan
Vodouízan
Vodou. However,
(V
(Voodooist)
oodooist) at the same time. According Morrison and Thornton (1999),
(1999) , this
American slave masters have
attitude is related to the fact that white European and American
painted V odou with a negative image for centuries. In order to reconcile these
exteriorly imposed negative beliefs,
beliefs , Vodou rituals integrate elements of Christian
theology in an unusual religious syncretism.
Bibb and Casimir (1996) revealed that it is common for many Haitian Catholics
and Protestants to practice and believe in Vodou in varying degrees. Bibb and
Casimir (1996) explained that V odou practice is most commonly associated with
m 习 ority
of Haitians.
the lower socioeconomic classes
classes,, which comprises the vast majority
Their members practice Vodou more openly than the middle and upper class. This
82 G.
G.MMeance
画ance
may be because the lower class Haitians are more connected to the Mrican
traditions brought over by the slaves,
slaves , while the upper class identifies more with
European cultures. When Haitians suffer
su 岳r from psychiatric and psychological
the healing process starts at the Vodou temples,
ssymptoms
严丑ptoms
temples, continues at the Church,
Church ,
and ends at the psychiatric hospital or other mental health facilities (Charles,
(Charles , 1986;
Philippe , 1974). Hence,
Hence , Western forms of
ofhealing
healing are used only when traditional
Philippe,
medicine and familial resources have been exhausted and unsuccessful. The process
is not necessarily linear but this pattern is the one most likely to be observed
obse 凹ed in
rural areas.
a 忧empt
to find
fìnd out the cause of
Clients visit the V odou priest or priestess in an attempt
their
their
山ness.
illness. Charles (1986) defìned
defined foure pye-w nan dlo,
dlo , an expression literally
water," as the initial attempt made by the client
meaning "put your feet into the water,"
to find
fìnd out the cause of the problem. Generally,
Generally, if the person is too sick to do so
by himself or is a minor,
rninor, a member of the family is supposed to help them seek
mentally
血
ill to
to the ounfo
treatment. They usually make an overnight trip with the mentally
or Vodou temple where the Vodou priest's
priest' s job is to provide a diagnosis or pase
leson to find
fìnd out basically what kind of problem it is,
is , who did it,
it , why the problem
exists , and how it can be treated.
exists,
During the first
fìrst visit to the V odou temple the ppase
ωe leson or diagnostic interview
is focused on social relationships and religious beliefs,
beliefs , current or past mistakes.
rnistakes. In
the Vodou religion,
religion , it is believed that nothing happens by chance or accident. A
Vodou priest may ask: Do you have any enemies?
enernies? Have you lost a piece of cloth
job , school? Are
Are you having an affair
a 面ir with
recendy? How well do you do in your job,
somebody's wife/husband? Do you have spirits in your family? Do you respect
the traditions?
The healer then suggests some kind of hypothesis on the cause of the client's
client' s
disease after consulting his or her own spirits or colleagues. Observations reported
by Charles (1986) of the interaction between mental patients and Vodou prie
priests
如
indicate that "there are 3 categories of diagnosis: a) giyon
gíyon or bad luck b) lwa kenbe or
retaliation
retaliation
丘om
from the spirits and c) anvoutman or possession by a malevolent spirit"
(p.188).
(p
.188). Brown (2001) identified
identifìed a subcategory ofgiyon
ofgíyon called dyok,
dyok , described as a
su 岳rs 丘om
from getting too much attention from the public.
public.
condition in which a patient suffers
Gíyon is the Vodou term used to describe what the Western psychologist would
Giyon
call depression. Clients present with a high level of anxiety and also report
sensations of weakness and vulnerability. Charles (1986) indicated that the Vodou
priest attempts to remove the giyon or bad luck by restoring the client's selfconfidence. He or she does so by trying to reinforce the coping strength of the
client while helping him build a greater sense of personal protection. This process
helps convince the client that there are no more obstacles to recovery. Charles
found that the following techniques are used in the recovery process:
a) cleansing the person,
person , with ointments,
ointments , oils
oils,, magical potions
potions,, bath with
wines and perfumes
perfumes,, b) cleansing the client's
client' s environment-typically
plan
plants,
旬，
Vodou Healing and Psychotherapy 83
the house-with incense,
incense , candles and magical waters
waters,, and c) construction
of an amulet or special necklace that the client will have to wear for personal
protecnon.
protection.
(p. 188)
命.
18 叼
All of these techniques may involve
invo1ve a magical potion that the client is supposed
to drink in order to gain greater strength.
Lwa kenbe or retaliation from the spirits is the term used for clients presenting
with
hysteria,, and overtly paranoid de1usions
delusions
withs symptoms
严nptorns
similar to those of phobias,
phobias , hysteria
ofpersecution.
of
persecution. Charles (1986) notes that when dealing with lwa kenbe the Vodou
pri
priest
创t explains
exp1ains to the person that the sickness is related
re1ated to a failure
fai1ure to keep a specific
commitment with a lwa or spirit and has discontinued worship. It is believed that
ce 眈ain spirits are protector lwa and,
and, in some cases,
cases , dead ancestors or guardians who
certain
have been neglected. Such offenses are said to occur through violations
vio1ations of taboos
or special
speci
址 traditions
traditions
and according to Charles (1986),
(1986) , "the treatment is then focused
on supernatural strengthening,
strengthening, which includes renewing alliances with the lwa.
This technique also focuses on appeasement of the angry or offended spirits" (p.
188). Treatment includes ceremonies with rituals using foods,
foods , animal sacrifices
sacrifices,,
and cleansing baths. They end with a ritual called the "paying back" in which the
left over bathwater,
bathwater, and destroy
client had to throw seven pennies into the 1eft
accessories that were used for the treatment while repeating the formula: "Now 1I
am paying for all my past debts. Now 1I do not owe anybody anything. 1I want to
be
be 丘ee
free again
again,, to continue a decent life
life 川
as a normal
nom 叫 human
human
being" (Charles,
(Charl
白， 1986,
1986 ，
p. 189). The Vodou pripriest
臼t then takes all the waste and discards it
it,, typically in the
forest or a cemetery. The supposed meaning of this action is an engagement taken
by the client to start his life over and focus on the future while acknowledging
acknow1edging his
past mistakes.
rnistakes.
Anvoutman or possession by a malevolent
malevo1ent spirit,
spirit, as described by Charles (1986)
of
hallucinations,, hos
hostile
delusional systems
systems,, paranoid ideation
ideation,,
includes symptoms
s 严nptorns
ofhallucinations
ti1 e de1usional
disorders,, and other symptorns
symptoms associated with schizophrenia.
pronounced thought disorders
Anvoutman is the 10ss
loss of control
contro1 over one's own ego and the 10ss
loss of
ofprotection
protection of
the self,
se1f, and it may be manifested by expression of suicidal and homicidal
hornicidal ideation.
(1986) , in the Vodou worldview "every human being is
According to Charles (1986),
assumed to have a supernatural shield,
shie1d , which is believed to maintain a balance
between positive and negative influences and to constitute a magnetic envelope
enve10pe
that protects one from harm" (p. 189). He explains
exp1ains that inherited familial
fanúlial protective spirits supposedly set up this human shield.
shie1d. A client suffering
su 岱ring
from
anvoutman would
wou1d have his supernatural
su
shield penetrated by bad spirits.
At times, the initial intervention of the Vodou priest will focus on making a
deal with benevolent spirits that can offer protection to the client and therefore
work to restore his supernatural shield. Exorcism is another technique used to fight
anvoutman. After the initial episode of the illness, if the client experiences the
symptoms again,
84
G.MMeance
画ance
G.
the client is given magical formulas
fonnulas to repeat whenever hel
he/ she experiences
a feeling of relapse. At other times there are special mandates to be followed
as burning a prescribed number of candles,
candles , paying a visit to the Church or
cemetery or making a charitable gift.
(Charles , 1986,
(Charles,
1986, p. 190)
In addition to anvoutman,
anvoutman , dyok
dyòk or Bad Eyes is described by Brown (2001) as a
particular condition where the client is suffering from the fact that too many people
are thinking and talking about him/her. Some of the presenting symptoms are:
distractions and lack of awareness preceding potential professional errors because
the patient is absorbed with the glory provided by the public attention. In the
philosophy , all this unusual attention can push the person offbalance.
off balance . This
V odou philosophy,
however, does not indicate a conscious intent
intent
丘om
from the public to harm
han 丑
diagnosis,
diagnosis , however,
the client.
There is no time limit set by the V odou healer or the client for treatment; it all
depends on how well everybody plays their papart
眈 in
in the therapy process,
process , including
a筑
t
(Philippe , 1974).
凹
1 9叨
74份). 日
F i 臼眈tt 配
he client
clientmu must
山stbe be kept
kep 仙
t inside
insi 耐
id忧
deap a 严阳阿
peristil
eristil ω
il (clinic)
(clini 眈叫
lC均
Cο) tω
that
hat
the ψirits
spirits (Philippe,
First
the
i扫
iss located in the countryside. Later,
Later, the client is sent home where his/her family
hut 怨。 n or Vodou priest's
priest' s instructions until
unti1
takes care of him/her and follows the hungan
complete recovery. In case of failure,
failure , the client consults another Vodou healer,
healer,
but this time one who is considered to be more competent.
In general,
general , Vodou is mostly respected and practiced for its reactive/protective
reshaping, supernatural strengthening
strengthening,, and
aspects. Techniques such as spiritual reshaping,
s 严nptorns
or "reactive
exorcism are used to help the client get rid of supernatural symptoms
a 忧empt
to eliminate or repair harms
hanns made to
rituals" ofVodou. They involve an attempt
elements ,
the individual. But the religion also has some proactive or preventive elements,
which help to maintain mental health. Garey (1991) defines possession,
possession, or lwa
monte, as a behavioral manifestation of communication with the spirit where the
monte,
and 叩P
白白 to
to be excited physically
individualloses
individual
loses complete control over their self and
appears
drums ,
and emotionally. In a particular context of ritual involving incantation of drums,
singing
singing,, and powerful environmental suggestibility
suggestibility,, the client is more likely to
achieve a trance-like state. Members of the assembly believe that the client is
possessed by a specific lwa or spirit and may say and do things of which he or she
may not be able to later recall. Usually their speech contains a message from the
warning, a prediction,
prediction, or advice and as Garey (1991) notes,
notes ,
spirit, which can be a warning,
spirit,
"through possession of a member of the congregation,
congreg
拍on ， spirits can also enter into
punish , admonish
admonish,, reward and encourage them as
the midst
rnidst of the congregants to punish,
well as treat and cure their
the ills and worries" (p. 65). By entering in a trance the
body expels stress through shaking and convulsion (Charles, 1986; Garey, 1991).
This is in sharp contrast to conventional mental health care.
Vodou Healing and Psychotherapy 85
Vodou and Conventional Mental Health Care
Bibb and Casimir (1996) noted that some Haitians might appear to be unresponsive
Westem therapy because they tend to minimize,
minimize , intellectualize
to Western
intellectualize,, or relegate their
system, the traditional
problems to God or spirits. Within the mental health care system,
(e.g. , psychoanalysis) have operated
formulation of some psychotherapy approaches (e.g.,
to maintain inequalities among people even while claiming to address universal
human problems.
problerns. Psychotherapy is less likely to predominate as a healing technology in a collectivistic culture because there are larger organizations such as the
church, govemment
church,
government,, and extended families that will care for individuals in distress.
Psychotherapy as a helping mechanism expresses the values of independence and
Westem culture. Therefore
Therefore,, it may be of
individual responsibility found in the Western
limited value when applied to clients
clients
丘om
from other cultures where these values are a
眈 of
of the web of significance. Haiti is known to be a country where
lesser papart
collectivism as opposed to individualism has helped in shaping its identity as the
ack Republic,
Republic , and as a resilient nation in the face of poverty and natural
first Bl
Black
catastrophes.
(1961) , psychotherapy is an attempt to unify two
According to Van den Berg (1961),
bodies: the cornmunity
community and the individual that were once one. But how can the
Western psychology unify the Haitian client
client,, already essentially collectivist
collectivist,, to an
Westem
es 在 entially
individualistic worldview that was never theirs in the first place? To
essentially
answer this question the reader is referred
referτed to Cushman
Cushrnan (1995),
(1995) , who describes
phílosophícal hermeneutics
philosophical
hermeneutícs as an approach to understanding human experience as
interpreted in one's historical and cultural contexts. For Cushman,
Cushrnan, people and
things exist only within a certain political and cultural context,
context, and they are not
understandable when abstracted out of these contexts. Cushman
Cushrnan argued against
what he called "psychological imperialism" over a local community or "the act of
equating the self-package of one culture with that of another,
another, or to analyze the
self
二package
or
frame
of
reference
of
one
culture
solely
through the distinctions
self-package
ofanother"
another" (1995,
(1995 , p. 25).
and understandings of
When professionals fail to understand Haitian clients' perspectives of their
disappointed, and some give up on treatproblem, many times those clients are disappointed,
problem,
0 丘en ， these individuals choose to seek help in the V odou religion.
ment. Often,
worldview, professionals may
rnay be
Therefore , with a better understanding of their worldview,
Therefore,
able to show more competence in providing psychological treatment to Haitian
clients. It is also important that clinicians be culturally sensitive enough to differentiate how their Haitian clients perceive normal and abnormal symptoms; what
is considered a psychiatric disorder in Western society might not be considered
abnormal in Caribbean communities.
Mental health care professionals should be aware that some alerting symptoms
for Western clients, such as symptoms of depression, delusions, and so on may
not be interpreted as symptoms by Haitians. So the reasons motivating the first
group to seek psychological help will not necessarily motivate the second group.
86
G.MMeance
画ance
G.
Therefore , clients' interpretations of their feelings are an important
Therefore,
impo 眈ant factor toward
implementing treatment for the client.
Vodou priests interviewed by Meance (2005) showed genuine
genuine
飞Nillingne
willingness
岱 to
to
share their knowledge and make themselves accessible to a stranger with "an
agenda." In Haiti,
Haiti, they rarely reject invitations to collaborate with psychologists
if it is necessary to help a pítítpitit卢y
fiy or client. Anthropologists and sociologists have
ofV
Vodou that the chance of a frank and genuine
painted such a disparaging picture of
collaboration between the V odou priest and the psychologist at this historical
juncture is minimal.
rninimal. Despite the fact that both the psychologist and the V odou
priest are healing the soul and relationships,
relationships , they
they
丘ame
frame healing situations or
symptoms quite differently. One critical difference between a Vodou healer and
fìrst believes in the existence of spirits and the latter
a psychotherapist is that the first
does not need to have such a belief to provide treatment. If Haitian patients
consider their lwa as real spiritual beings,
beings , the explanation and interpretation
emíc system (cultural context of their
Western therapists offer does not address their emie
problems) , and therefore is not helpful. It is important to ask patients how they
problems),
perceive their problems in order to understand what psychological function they
play in their lives.
One aspect of
ofHaitian
Haitian Vodou healing that clearly describes the difference in the
concept of relationship healing between Vodou healing and psychotherapy is
possession. Because the phenomenon often surprises devotees,
devotees , it is perceived as a
sign of approbation by God and that he listens when a group of people gathers to
spiri
臼. Bourgignon (1976) considers
ask for a sign of his existence by sending his spirits.
people's wish to be possessed to be positive if the individual embraces the
即es that they benefit
benefìt from it. Brown (2001) argues
ar ♂les that this
experience and bel
believes
acceptance of
ofbeing
being possessed involves a "surrender of self,"
self," a passive/receptive
relationship not seen in this degree in most Western psychotherapies. This egoexchange with the spirit seems necessary because it benefits
benefìts the people around the
mountee , and the process of mounting specifically
specifìcally refers to when a spirit mounts
mountee,
a participant. It is called mounting because the spirit takes control of the participant
much as a rider takes control of a horse. It is a sacred moment for the assembly to
receive messages from their ancestral spirits. It is also an occasion for spirits to
communicate to their
the devotee about what the spirits expect from them. This
mutual exchange proves that the spirit needs the V odou follower as much as they
need the spirits. It is a mutual relationship that holds significant meanings to the
devotees, and surrender of self to the spirits also contains an active element, a "leap
offaith," in contrast to the Western therapy concept of "resistance." When people
are possessed, it also implies that their gros bon an} or met tet (guardian angel) is in
good terms with them and will protect them. In that sense, possession can be
considered as a renewal of faith, protection, and good physical and mental health.
Vodou Healing and Psychotherapy 87
Conclusion
Vodou is not
notjust
just a religion but a way of
oflife
life in some countries of
ofthe
the Caribbean,
Caribbean,
particularly in Haiti. People refer to V odou to maintain good health and wealth
as well as to heal and soothe when in pain. V odou followers also refer to V odou
instead of psychotherapy when all else ffails
ai1s to effectively address psychological
distress,
distress , emotional dysregulation,
dysregulation, and existential dilemmas.
Psychotherapists and Vodou healers have a lot in common in their attempt
a 忧empt
to
help clients heal. They both listen carefully to the client's
client' s story and their perception
of the cause of their suffering,
suffering, attempt
a 忧empt
to validate the client in distress and offer
0 岳r
comfort,, and offer unconditional and genuine empathy while attemptsupportive comfort
ing to come up with a collaborative treatment plan. In addition,
addition, they both place
great emphasis on self-care
selιcare and protective measures to avoid decompensation and
to maintain homeostasis and,
and, above all
all,, they both place great emphasis on relational
issues that affect the human psyche and behavior. Without the spiritual aspect in
the equation,
equation, Vodou healing and psychotherapy seem to be have similar objectives;
hence , the reasons why Vodou healing seems to be a substitute for mental health
hence,
in the Caribbean and in Haiti in particular. Therefore,
Therefore , collaboration between the
V odou healer and the psychotherapist is critical for the benefit of the clients
se 凹e.
they serve.
Note
1. Different spellings
from many languages
spellin
箩 of
ofthe the word are due to Creole's development
development
丘om
and dialects (Dayan
(Dayan,, 1991). For the sake of uniformity and to make the phonetics more
accessible to English speaking readers
readers,, Vodou will be used throughout
this chapter
throughout
由is
Creole , an official
officiallanguage
language in Haiti.
because it is phonetically the closest to the Haitian Creole,
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7
SANGO HEALERS
HEAlERS AND
HEALING
HEAllNG IN THE CARIBBEAN
Stephen D. Glazier
Introduction
•
There is a long-standing interest in religious healing in the Caribbean. During the
1980s,
(1924-2002)
2002) underscored the therapeutic
1980s, psychiatrist Michael Beaubrun (192
potential of Mrican-derived religions like Sango
Sango
何Tard
ard & Beaubrun,
Beaubrun , 1979).1
(Bascom,
ascom, 1972; Houk
Houk,, 1995) with devotees
Sango is the Y oruba god of thunder (B
throughout the Caribbean and Latin America.
America. As the Yoruba god of thunder,
thunder,
Sango can kill as easily as he can heal. 2 He is sometimes depicted as a mulattomaking him attractive in multiracial societies like Puerto Rico and Brazil. In Haiti
(Brandon,， 1990)
1990),, Brazil
Matory,, 2005),
(Desmangles,
1992),, Cuba
(D
esrnangles , 1992)
Cuba
但randon
Braz 丑 (Hale,
(Hale
， 2009; Matory
200 日，
Rico
(Romberg,
Dominican Republic (D
(Deive,
1975),,
Puerto Ri
co (R
omberg, 2007; 2009),
2009) , and the Dorninican
eive , 1975)
th century
prominent place from the 17
Sango occupied a prorninent
17 由
century
onward. In the Englishrnid-19 th
speaking Caribbean,
Caribbean, however
however,, Sango was not a major presence until the mid-19
century (Henry 1999; Trotman,
Trotman, 2007). The popularity of Sango has ebbed and
tit 丑es ， it was
waned over time. Sometimes,
Sometimes , Sango was practiced openly; at other times,
practiced in secret. While it is clear that the Sango religion was perceived as a form
of "protest" by colonial authorities,
authorities , it is also clear that many
rnany of Sango's earliest
followers probably saw themselves as maintaining ties with the collapsed Oyo
th century
Empire. In other words,
words , Sango 19
19 由
century
devotees saw themselves as reaffirming
reaffirrning
A 丘ican
state religion (Trotrnan
an established,
established, African
(Trotman,, 2007).
Trotman (2007) has suggested that the designation of all Orisa religion as
"Shango" may have come about because in Mrica the rulers of the Ki
Kingdom
ngdom of
Oyo used the Orisa Sango to consolidate imperial power. Trotman (2007)
contends that in Trinidad and Grenada various sub-ethnic Y oruba groups sought
to "transcend intra-religious animosities by emphasizing the common symbol of
Sango" (p. 219). This may be one reason the Orisa religion was designated as
c:w
90 S. D. Glazier
"Shango" in Trinidad and Grenada,
Grenada , but does not explain why the Orisa religion
is not designated "Shango" elsewhere in the New World
World
但
(Bascom,
ascom
， 1972).
Sango healers travel extensively. Prominent
Prorninent Sango healers consult with clients
cent 叫 on
on multiple Caribbean islands,
islands , in the United States,
Stat 白，
(and maintain religious centers)
Canada, and Europe. In Trinidad,
Trinidad, nearly half of
ofSango
Sango healers were born and/or
Canada,
raised in Latin America
Am erica and the Caribbean 01enezuela,
enezuela , Guyana
Guyana,, Grenada
Grenada,,
Barbados
Rico,
co , and Aruba) (Glazier,
(Glazier, 2008).
Barbados,, St. Vincent
Vincent,, Puerto Ri
Prior to the 1980s,
1980s, many traditional healers in Trinidad,
Trinidad , St. Vincent
Vincent,, and
Grenada were known locally as "Sango Baptists." The Baptists (also known as
Spiritual Baptists) are an international religious movement with congregations in
St Vincent,
Grenada,, Guyana,
Vincent , Grenada
Guyana , Venezuela,
Venezuela, London,
London, Toronto,
Toronto , Los Angeles,
Angeles , and
New York
Y ork City. Ninety percent of Sango devotees also participate in Baptist
ritu 埠， and 40% of Baptists also participate in Sango (D
(Desmangles,
esmangles , Glazier,
Glazier, &
rituals,
Murphy , 2009; Rocklin
Murphy,
Rocklin,, 2012). Sango is but one member of a larger pantheon of
A
Afro-Caribbean
丘o-Caribbean
deities; for example,
example , when researcher Frances Henry (2008) first
met Pa Neezer (one of
ofTrinidad's
Trinidad's most renowned Sango healers),
healers) , Henry told Pa
"It's not
she wanted to learn about "Shango." He corrected her responding: "It's
Shango. It
It's
's Orisha ...
. . . It
It's
's the ‘'Mrican'
Mrican' work" (Henry,
(Henry, 2008,
2008 , p. xi). Pa Neezer
emphasized that the religion should not be known as "Shango" since other Orisas
are always involved in Sango's ceremonies.
This chapter examines
exarnines Sango beliefs and illness representations with a primary
addition , it explores divination and spirit
focus on Sango healing practices. In addition,
possession within the Sango tradition and examines
exarnines relationships between Sango
healers and biomedical practitioners. Lastly,
Lastly, this chapter documents the resurgence
of
ofSango
Sango in contemporary Caribbean societies and implications of
ofthis
this resurgence
for biomedicine and mental health care in the region.
San
Sango
go Beliefs and IIIness
Illness Representations
A central idea is that illness and misfortune
rnisfortune result
result
丘om
from a lack of attention to the
Orisas , when properly attended,
attended , care about their
Orisas and a belief that the Orisas,
devotees and are both willing and able to help them in their daily lives. The Sango
events , every event is determined
deterrnined at a higher
universe does not allow for random events,
(Olupona , 2004).
level and is subject to retroactive change (Olupona,
Orisas' powers,
limited,, and many events are outside of
Sango
、 are
are lirnited
powers , including Sango's,
their control.
control. But because the Orisas lack bodies and therefore are not bound by
time and space,
from the past
past,, to the present and the future,
space , they canjourney
canjourney
丘om
futu 时， and
0 岳r predictions and practical advice to their devotees. While devotees
thereby offer
aattempt
忧empt
to establish binding contracts with the Orisas,
Orisas , Orisas are not bound to
agreements with humans. Relations with Orisas are fluid,
fluid , and there is a high degree
of uncertainty; at times,
tir 丑es ， the Orisas keep their promises
prornises and at other times they do
not (Glazier,
(Glazier, 2003).
Sango Healers and Healing 91
For healers and their clients,
clients , all illness is interpreted as a "call" to participate in
Sango
Sa 吨。 and!
and/or or Spiritual Baptist ceremonies. But relatively few clients
clienωfollow
follow this
entai1s
path because sponsorship of ceremonies demands both time and money. It entails
"too much" personal sacrifice (Glazier,
(Glazier, 2009). For Sango healers with strong
Baptist connections,
connections , the most likely suggested "cure" is participation in Spiritual
Baptist mourning ceremonies. Psychiatrist Ezra E. H. Griffith (1983; 2010) has
suggested that sponsorship of Spiritual Baptist ceremonies may be therapeutic as
clients gather necessary ritual items and,
and, in the process,
process , experience positive,
positive ,
mutually reinforcing contact with believers and non-believers alike.
The most popular way
w 町 to
to treat affiictions is through private consultations.
Consultations allow for direct interactions between the Orisas,
Orisas , healers,
healers , and clients.
0 岳rings
Interactions include ceremonial spirit possession; offerings
and sacrifices to gain
丑ents
from the Orisas; divinatory procedures including
favor and avoid punishr
punishments
casting obi
obí and 功;
ifa; the use of
ofherbal
herbal medicines; ritual baths; and employing charms
charms,,
amulets
grís gris
grís bags. 3
amulets,, and gris
Sango healing is never
never
丘ee.
free. A clien
client's
t' s willingness to sacrifice (whether by a
monetary contribution
contribution,, sponsorship of a Sango feast,
feast , or providing a live animal) is
seen as integral to the healing process. Sacrifice is a sign of commitment to the Orisas
and is considered a first step toward a "cure." Within the Y oruba tradition,
tradition, all
all 迎ness
illness
is seen as a call to sacrifice. Sacrifices vary (a coin,
coin, an ear of com,
com, a chicken,
chicken, or a
goat),
Sometimes , depending
goat) , but are the only way to gain the attention of the Orisas. Sometimes,
on the reputation of the healer and the desperation of the client,
client, payments
pa 严nents
to Sango
and, in
healers may be considerable (in the hundreds of dollars over several years) and,
some instances,
instances, more cosdy than biomedical treatment (p
(paton,
aton, 2009).
Since Orisas are gods,
gods , they are not obliged to answer all questions posed nor
are they obliged to answer questions unambiguously. In my experience,
experience , Orisas
seldom allow for follow-up questions (Glazier
(Glazier,, 2008). An Orisa decides when a
session is over; sometimes stating blundy
blundy,, "Bring the next child." Orisas'
comments can be cryptic,
c 巧rptic
， metaphorical,
metaphorical, and contain arcane phrases that require
further explication. The Orisas reveal only what they wish to reveal,
reveal , no more or
less. At times,
times,, they may answer in an "Mrican"
times , they are silent and,
and, at other times
tongue
ton ♂le or in "Creole" (Caribbean patois).
patoís). Such answers may be further interpreted
interpre
for the client (usually for an additional fee). Older Sango healers might know 5-15
"y oruba" phrases, but many of these phrases are "Mrican" sounding nonsense
words which they believe to be of "Yo rub a" origin (Simpson, 1965). These words
mayor may not be understood by Y oruba speakers or understood by other Sango
healers (Warner-Lewis, 1989).
Sango Healers and Healing Practices
Some healers prefer Sango over Ogun (who some consider an even stronger
(Glazier , 2003). Sango
healer) because Sango is less demanding of his devotees (Glazier,
healing is fluid,
dynamic,
transactional,
and
contractual.
fluid , dynamic , transactional,
92 S. D. Glazier
George Eaton Simpson (1965) suggested that "all" leaders in the Sango tradition
1960s, it was not true
also acted as healers. If this was an accurate assessment in the 1960s,
by the 1970s. There is little formal training,
training, and most Sango healers claim to have
been selected by the Orisas. This contrasts with Ifa diviners (B
(Bascom,
ascom, 1980; Hucks,
Hucks ,
Olupona, 2004) all of whom have undergone extensive training in Trinidad,
Trinidad,
1998; Olupona,
Cuba , and/or in Mrica. A small number of Sango healers have trained under
Cuba,
established practitioners,
practitioners , but a majority
m 习 ority
emphasize that they have been inspired
("called to heal") direcdy by an Orisas.
Sango healers have participated in a variety of religious traditions during their
lifetimes and often borrow healing techniques from each other. Each healer's
practices (and/or "operations") reflect his or her personal religious history and
a 值liations
(which might
rnight include Roman
travels as well as prior religious affiliations
Catholicism, mainstream European denorninations
Catholicism,
denominations,, Pentecostalism
Pentecostalism,, and indigenous traditions like the Spiritual Baptists). What ultimately differentiates Sango
healers from all other healers is that they say their healing powers come direcdy
from Sango. Whatever techniques may have been borrowed from other religious
traditions , they believe it is Sango who makes these techniques efficacious (Glazier,
traditions,
(Glazier,
2009).
While clients of Sango healers represent all age groups,
groups , Sango healers are
rnid-30s , most are in their 50s and
predominandy
predorninandy "old heads." A few are in their mid-30s,
rnany years to develop a following as a Sango
60s with few in their 80s. It takes many
healer, and clients are reluctant to try anyone new. Healing powers are based on
healer,
personal reputation,
reputation, and reputation is largely based on "word of mouth." Healers
thernselves and the most powerful healers are those
are not expected to promote themselves
who have been practicing the longest. This is consistent with Max Weber's (1960)
prediction that traditional authority usually outweighs personal charisma.
charisrna.
In Trinidad,
Trinidad , St. Vincent,
Vincent , and Grenada,
Grenada , Sango healers are male and female;
older,
older, and educated,
educated , in fact,
fact , all are literate and a number have advanced university
nurses ,
degrees. Some Sango healers have also received medical training as nurses,
chiropractors,
chiropractors, and pharmacists.
pharmacis
岱. Over time,
time , this has had an impact on Sango healing
practices. But there is a high degree of
of"comp
"compartmentalization"
狂回lentalization"
and Sango devotees
with biomedical training separate their Sango beliefs from their professional duties
in biomedical settings. For example,
example , one Sango healer with pharmaceu
pharmaceutical training
dispenses biomedicines five days a week in a suburban drug store and dispenses
traditional 'bush medicines' exclusively at Sango ceremonies.
Sango healers often choose to live considerably beneath their means to avoid
being accused of Obeah and/or witchcraft (Paton, 2009). In spite of their
prominence, a number of prominent Sango healers choose to live in small woodframe houses without electricity or running water claiming that this is what the
Orisas demand.
Healing practices vary considerably from religious center to religious center,
and (sometimes) even from week to week within the same center depending on
individual practitioners and the particular needs of clients. Clients make gifts to
Sango Healers and Healing 93
the healer. Healers
Healers,, in turn,
turn, make gifts to the client. Sango healers always offer
amulet , a cloth sachet,
sachet , a candle,
candle , a cloth or
clients something to take home: an amulet,
pebble with the blood of sacrifice,
herbal tea,
sacrifìce , a satchel of
ofherbal
tea, a lithography of a saint,
saint,
pages from a sacred book
book,, a twig,
oils,, and so on.
twig, a bag of herbs and spices,
spices , bath oils
Ul
timately, healing rituals mobilize specifìc
Ultimately,
specific actions by both healers and their clients
taboos , incantations,
incantations
，也口丑al
formal
including absolutions,
absolutions , observance and/or breaking of taboos,
oofferings,
岳rings
， sponsorship of ceremonies,
ceremonies , and animal sacrifìce
sacrifice (Houk
(Houk,, 1995; Mischel,
Mischel,
1959).
Within Sango Baptist tradition,
tradition, "healing" is broadly conceived and,
and, as noted,
noted,
problerns that would not ordinarily be treated by biomedical practitioners.
includes problems
Despite myriad differences among practitioners,
practitioners , Sango healing is united by a
common focus on the Orisas.
Sango healers meet with some clients once or twice a week. Other clients only
consult a Sango healer once or twice during a lifetime. Most Sango healers set aside
two or three mornings each week for healing although some very prorninent
prominent
healers receive clients four days a week and consult with as many as 20 clients each
day. This is atypical. About 30% of consultations are carried out in Spiritual Baptist
churches. Most consultations,
consultations , however,
however, are carried out at the healer's home. Sango
healers who can afford
a 也 rd it dedicate separate areas of their homes to the Orisa. Those
(Houk, 1995;
with smaller residences use their kitchens or parlours for consultations (Houk,
Glazier,, 2009).
Glazier
Consultations are by far the most common Sango healing technique. Most
Sango consultations are fairly straightforward. Healers are possessed by Sango and
carry on conversations with the afBi
afBicted;
cted; Orisas speak through the healer. The
client' s job is to listen and follow the Orisas' advice. In many cases,
client's
cases , Sango speaks
clearly in English. But Orisas' pronouncemenωare
pronouncements are not always clear and forthsometimes , there is considerable ambiguity surrounding the cause or
corning, and
coming,
and,, sometimes,
causes of an illness. Consultations are ostensibly private,
private , but often a thin curtain is
all that separates other clients (and the visiting anthropologist)
anthropologist)
丘om
from the Orisas'
comments. Some consultations are highly informal and brief (l
(less
ess than five
fìve
fìrst name
minutes).
rninutes). The Orisas express their opinions addressing supplicants on a first
forr 丑al. In general,
general, Orisas refuse
basis. Other consultations with Orisas are more formal.
to deal with clients who they consider disrespectful or who have not followed their
in the past.
adv
advice
Sango healers also consult with and make referrals to other traditional healers,
as previously noted. Sango healers sponsor joint healing ceremonies with devotees
of Osun or Oyo (and/or other of Sango's multiple wives). Healers recognize
limitations to their techniques and often encourage clients to explore alternative
remedies. Sango healers also encourage their clients to consult with Westerntrained doctors. For instance, there is little Sango healers can do for clients
diagnosed with advanced forms of cancer except to prepare them for the next life.
They attempt to make clients comfortable and prescribe soothing herbs, fasting,
Spiritual Baptist mourning ceremonies, animal sacrifice, sponsorship of Sango
94 S. D. Glazier
feasts,
feas 仿， and perfonning acts of charity. Nevertheless,
Nevertheless , collaboration
collabor
抽on between Sango
practitioners and biomedical practitioners is often one way. Sango healers refer
their clients to biomedicine,
biomedicine , but biomedical practitioners rarely refer their patients
to Sango healers.
areas , there
Access to traditional healers is a persistent problem. In many rural areas,
professionals , but traditional
are more traditional healers than trained health care professionals,
have
町
secular
ular
jobs
healers do not work "full-time" as healers. Most Sango healers have
Sometimes ,
and additional religious obligations that take up much of their time. Sometimes,
it is easier to consult an urban biomedical specialist than consult with a well-known
Sango healer. Cost is also a factor. Biomedical treatment in the Caribbean is often
avai1able at little or no cost. Traditional healers such as Pentecostals,
available
Pentecostals , Charismatics,
Charismatics ,
expected, but
and others provide healing at very low cost (a small contribution is expected,
is not mandatory); however
however,, Sango healing is never free. As noted,
noted, a clien
client's
t' s
willingness to make a monetary contribution,
contribution , help sponsor a Sango feast
feast,, or
provide an animal for sacrifice is seen as an integral papart
眈 of
of the healing process. It
is a sign of commitment to the Orisa and is the first step toward a "cure" (Olupona,
(Olupona,
2004).
Divination and Spirit Messengers
Much of
ofSango
Sango healing is centered on diagnosis. The first step is to detennine the
behaviors , relations with others,
others ,
exact cause of illness. Causes are sought in past behaviors,
world, and treatment of ancestors (E
(Elder,
lder, 1970). Private
relations with the spirit world,
consultations are direct and personal while divination is indirect,
indirect, less
les 唱 personal
personal,， and
more focused on technique. In those instances where consultations are inconclusive , divination is the first step in the healing process. As in other areas of
clusive,
religious life,
life , Sango devotees are pluralists and experiment with multiple forms of
divination; in some cases,
cases , the results of divination are unclear forcing them to
explore multiple options. There is a sense in which all
all 血nesses
illnesses are characterized
by uncertainty and,
and , as Winkelman and Peek (2004) astutely noted
noted,, divination
circurnstances and meaning,
meaning, of which
becomes "a broader inquiry into life circumstances
diagnosis of the immediate causes of a malady is a part" (p. 166). Again,
Again, healing is
defined very broadly; to heal is to address everything that troubles a client: physical
illness , anxiety
illness,
anxiety,, social disruption
disruption,, and/or help in making difficult decisions. The
assumption is that divinatory procedures reveal information that is accessible to the
gods but would otherwise be inaccessible to humans.
But, as noted
For the client,
client, divination is an enormously practical enterprise. But,
autornatically resolve uncertainty;
unce 眈ain 可 at
at times it raises
previously, divination does not automatically
previously,
as many questions as it answers; it is "edification by puzzlement" (Fernandez,
(Fernandez ,
1986). The popularity of a particular divinatory technique is largely detennined
by its perceived cost,
cost, efficacy,
efficacy , and the level of personal commitment engendered.
Healers and clients within the Orisa movement have recourse to a variety of
divinatory techniques including Ifa (Hucks,
(Hucks , 1998) and "Sixteen Cowries"
Sango Healers and Healing 95
(Bascom,
(B
ascom, 1980). Other options include: Kabala,
Kabala , astrology,
astrology, a seance,
seance , private
consultations with Orisa,
Orisa , reading tea leaves,
leaves , reading animal entrails,
entrails , breaking
boards,,
chicken bones,
dreams , Spiritual Baptist mourning ceremonies,
ceremonies , Oiji boards
bones , dreams,
throwing bones,
bones , tossing coins,
coins , throwing dice,
dice , and consulting Obeah men and!or
and/or
Obeah women. Many Sango healers utilize a combination of the above techniques
although consulting an Obeah man or Obeah woman is usually a last resort because
f 白red
since Obeah is seen as witchcraft
practitioners of Obeah are greatly feared
仰山ams
(Williams,， 1932).
1932).
Most divination entails dealings with spirit messengers (intermediaries)
(interrnediaries) in
various guises,
guises , and some messengers are more reliable than others. Messengers like
the Orisa Exu are tricksters and often distrusted. But as Hale (2009) observed,
observed ,
"Without the trickster spirit Exu
Exu,, one can do nothing" (p. 27). Exu is a key
member of the Y oruba pantheon,
pantheon , and is a go-between. Like the Greek god
Herrnes (Crapanzano,
Hermes
(Crapanzano , 1992),
1992) , Exu is impossible to coerce,
coerce , predict,
predict , and!
and/or
or control.
control.
He/she has mixed
He!she
rnixed loyalties and is not bound by human conventions. Therefore,
Therefore ,
ye 红S of training and even more years of experience. It
dealing with Exu requires years
takes a lifetime to establish rapport with Exu and to master the techniques of Ifa.
Sango,
Sango , too,
too , can be something of a trickster. As noted,
noted, Sango healers sometimes
prefer to deal with other more predictable members of the Y oruba pantheon such
as Oyo,
Oyo , Oshun,
Oshun, Sakpana,
Sakpana, and Ogun (Glazier,
(Glazier, 2003).
]ules-Rossette
Jules-Rossette (1978) deftly outlined what she saw as continuities between
discovery processes in divination and discovery processes within Western science.
Mrica , divination is the major
m 司jor vehicle for uncovering and
She emphasized that in Mrica,
relieving social conflict. ]ules-Rossette
Jules-Rossette also noted that Mrican diviners offer
interpretations that are central to the social distribution of information. At the same
time,， she acknowledged that some information should never be accessible and!
由丑e
and/or
or
made public. Healing rites,
rites , for example,
ex 汩nple ， are not always public events,
events , and most
divination is conducted for individuals and is carried out in private settings.
Divination's main goal is to reduce randomness and establish hitherto
unrecognized patterns. Clients may have experienced a set of events that they
already see as interconnected. Diviners are charged with the task of discerning
linkages and commonalities. As Evans-Pritchard (1937) suggested in his study of
the Azande poison oracle,
oracle , divination can be a closed system
sy
entailing "circular
reasoning" but its results are difficult if not impossible to refute. Similarly,
Winkelman and Peek (2004) emphasized that divination constitutes a potent "way
of knowing"; it enables its practitioners (diviners and their clients) to see and
participate in an alternate, more predictable, coherent world.
Divinatory procedures are accessible while at the same time being deliberately
misleading and mysterious. They are simultaneously public and private, clear and
opaque, and attempt to bridge the gap between the mechanical and the magical.
Furthermore, all forms of divination collapse time and space. In divination, the
present partakes of the future as well as the past; everything is contingent on
everything else and, most importantly, through divination the future can be
96 S. D. Glazier
changed by blood sacrifice
sacrifìce which makes Ifa among the most potent divinatory
however,, are ambivalent about animal sacrifìce
sacrifice,, as
options. Some Sango devotees,
devotees , however
one devotee stated,
stated, "the gods call for it,
it, but it vexes me" (Glazier,
(Glazier, 2009).
Divination may be impromptu or highly organized. The two major contexts
of divination are: preparation of sites for religious ceremonies,
ceremonies , and healing. Ahnost
Ahnost
every aspect of preparation for Spiritual Baptist and Orisa ceremonies must be
confìrmed and reconfirmed
confirmed
reconfìrmed by the Orisa before being implemented (see,
(see , for
example,
Houk's
(1995)
description
of
Leader
Scott's
frequent
use
of
obi.
As
Sango
ex 组呻le ， Houk' s
ofLeader Scott' s fi 叫阳川 se
obí.
ceremonies , he repeatedly tossed obi
obí seeds
healer Scott began preparations for ceremonies,
discem the Orisas' preferences.
asking a series of "yes or no" questions to discern
According to Houk (1995),
(1995) , Scott mainly cast obi
obí seeds while preparing for Sango
obí on a ddaily
ai1y basis. Other Sango leaders cast obi
obí throughout
ritual; he did not cast obi
the day.)
Within the Sango tradition,
tradition, divination also occurs with Bush healers or private
consultations and healing constitutes the major occasion for divination. Bush
ofJamaican
Jamaican
healers mosdy read "signs" like tea leaves and bath rings. In his study of
Bush healers Wedenoja
Weden
呗 (1989)
(1989)
noted that healers seldom ask patients to describe
symptoms,, rather they divine the cause of affliction
their symptoms
afHiction by "concentration." A
competent
compete
时 healer
healer
is already expected to intuitively know the cause of a client's
client' s
space , a cup of water in which a coin has been placed
problem. They may stare into space,
or at the direction of a flame;
flar 丑e; they may pass their hands over the afflicted
afHi cted or just
look into a client's
client' s eyes to immediately understand what is wrong. Dolls also play
(Femandez-Olmos & Paravasini-Gebert,
Paravasini-Gebert,
a part in Caribbean healing ceremonies (Fernandez-Olmos
"Barbie,"
2001). Even commercially-produced dolls like Matters
Mattel' s "Barbie
," can be brought
into the service of diviners.
Healers are expected to "know" clients' problems in advance. They seldom
question their clients since this would constitute an insult to the Orisas and the
client , and an open admission of lack of ability
client,
ab 血ty as a healer. Some healers have
developed a wide network of trusted healers who "help each other out" with
diagnoses; however,
however, less senior healers seldom refer clients to other healers,
healers , adding
obí; tea leaves) to their healing rites instead.
formal divinatory procedures (casting obi;
Herbal medicines feature prorninendy in Sango healing and are widely utilized
throughout the Caribbean. Each healer has his/her own pharmacopoeia and most
herbal medicines are taken as teas or baths (see Barrett, 1976; Stewart, 2005; and
Price, 2007 for a description of ritual baths). Sango herbalists are" called" by plants
who revealed their healing powers in visions and dreams. Plants "speak" to them,
shouting "Pick Me! Pick Me!" as healers pray about a particular client's needs.
Gathering plants is an integral part of the healing process and healers typically offer
a libation of white rum before each plant is picked followed by salutations. Some
Bush medicines mayor may not possess biomedical efficacy (Lans, 2007; Mischel,
1959), nevertheless, metaphorical and symbolic connections often override
pharmacological properties. For example, one Sango healer rubs ginger root on
the hands of her arthritic clients because the root resembles a gnarled hand.
Sango Healers and Healing 97
Recently,, Trinidad herbal medical practitioners
Recently
practitioners,, like aromatherapists,
aromatherapists , have been
organizing to gain greater official recognition (and possible insurance co-payments)
however, so far,
far , Sango healers have not joined in these efforts.
e 证orts.
for their services; however,
In addition,
addition , time is integral to the Sango healing process. Ill
Illnesses
nesses that stem
rnany years. It takes months,
months , and
from bad relations with the Orisa develop over many
problerns because 1) it takes considerable time to
sometimes years,
years , to overcome problems
organize Orisa feasts,
f 白白， make preparations for
for 阳rifice
sacrifice,， and so on,
on, and 2) outcomes
tradition , every positive event (good
are not immediately apparent. In the Sango tradition,
travel connections
connections,, successful shopping trips,
trips , positive family
fami1y interactions) indicates
an improving relationship with the Orisa. On the other hand,
hand , bad travel connections and negative family
fami1y interactions can indicate worsening relationships with
detennine when and if one is sick,
sick, it also takes
the Orisa. Because it takes years to determine
years to determine
detennine when and if one has been "cured."
Sango and Biomedical
8iomedical Practitioners
There are perhaps as many as 80,000
80 ,000 Sango healers in the Caribbean indicating
that contemporary Sango is on a rebound (Glazier,
(Glazier, 2008). This may
rnay be due to a
number of factors. Much of the time,
time , biomedical professionals (clinical
and/or
or biomedical practitioners) are of a different
di 岳rent
social
psychologists
psychologists,, counselors
counselors,, and!
class than their clients and do not share a common worldview with those they
respect , Sango healers may possess an advantage. They are usually of
serve. In this respect,
the same social class and possess the same educational backgrounds as their clients.
Most important,
important, they share a common worldview. Sango healing is predicated on
a holistic view of
ofhealth
health and illness (All
(Allen,
en, 2001; Moodley & West,
West, 2005) that
includes physical (b
(biological)
iological) maladies as well as what biomedicine would classifY
classifY
as "bad luck." For Sango healers,
healers
，山ness
illness is a "call" to serve the spirits; a call to
sacrifice , a call to divine,
sacrifice,
divine , and a call to sponsor a feast honoring the Orisas.
obI) encourages clients to take a more active role
Divination (Ifa
(Ifa,, Kabala
Kabala,, casting obt)
in their cures. Such a holistic approach is not generally available within Caribbean
effective , biomedical
National Health Systems.
Systerns. Therefore,
Therefore , in order to be most effective,
practitioners need to acknowledge their clients' belief
in the Orisas (Glazier,
beliefin
(Glazier, 2009).
Conclusion
Sango has been reported
rep 。此ed in the Caribbean since the mid-18
rnid-18 th century. In the
popular mind,
rnind, Sango healers were lumped with other Caribbean healers like
Obeah,, and colonial authorities attempted
Obeah
a 忧empted
to curtail the spread of Obeah,
Obeah, Sango,
Sango ,
clairning that these religions were disruptive,
disruptive ,
and the Spiritual Baptist faiths claiming
th century,
uncontrollable
otentially) subversive. By the latter half of the 20
20 由
centu
町，
uncontrollable,, and (p
(potentially)
ordinances against Sango had been abolished and Sango healing was no longer
order, but instead was perceived
perceived as a threat to the established political order,
as a direct challenge to European medicine.
98 S. D. Glazier
Itss persistence and resurgence may be
Currently, Sango is on a rebound. It
accounted for both in terms
terrns of media support and a more prominent
prorninent place in
popular culture. Sango receives favorable coverage in the media and has been the
subject of numerous television documentaries and editorials as well as articles and
Jamaica Gleaner and the Trinidad
Trínídad Guardian.
Guardían. Clearly,
Clearly, Sango healing
editorials in the Jamaíca
provides a mechanism for Caribbean people to validate their past and recover their
A
缸can "roots." Furthermore, its contribution to health and mental health both
African
historically and in the present context cannot be overlooked. Indeed,
Indeed, a number of
Sango healers (some of whom have earned advanced acadernic
academic degrees) have
sought formal affiliations with regional mental health centers and foreignrnade contributions to the treatment
sponsored faith based organizations and have made
of some symptoms
ofsome
s 严丑ptoms
of mental disorders in an attempt
a 忧empt
to address the health and
mental health care needs of their followers.
Notes
1. Beaubrun was born in Grenada. He received medical training at the University of
Edinburgh, and served as a professor of medicine at the University of the West Indies
Edinburgh,
Indie
咀
丘om
from 1976 to 1988. Simultaneously
Simultaneously,, he served as director of the psychiatric unit at St.
Ann's.
Ann 's. Beaubrun served ωa
as a Trinidad and Tobago Senator from 1976 to 198
1981.
1. As a
Senator
Senator,, he actively
treatment.
activ
吻 incorporated
incorporated
indigenous religions into mental health treatrnent.
Another
Another prominent psychiatrist, Trinidad-born Ezra E. H. Griffith of
ofYale
Yale University,
has conducted extensive research on the mental health benefits
benefìts of Sango and Baptist
ceremonies (Griffith,
(Gri 伍th ， 1983; 2010).
2. Once an African
A 副can king,
king , Sango is sympathetic to human
human
丘ailties.
frailties. His magic failed him;
he was betrayed by his wives; and
and,, eventually,
eventually, he lost his kingdom. But Sango is also
ofhis
his violent temper. Sango seldom holds aa 箩udge.
grudge. His punishment is
feared because of
swift
swi 丘 and
and severe
severe,, but even if offended on one day
day,, he can be asked for assistance
assist
租ce on the
next. As noted,
noted, Sango is sometimes por
portrayed
位ayed
as a mulatro
mulatto,, but members of the Trinidad
Orisa movement perceive him as black (Houk,
(Houk, 1995; Hucks,
Hucks , 1998).
3. Gris gris bags are cloth sacks filled
fìlled with assorted objects
0 问jects
such as finger
fìnger nail clippings,
clipping
声， torn
pages from books of ancient wisdom
wisdom,, twigs
twigs,, dirt
dirt
丘om
from cemeteries
cemeteries,, human hair
hair,, and
animal bones.
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8
LA REGLA DE OCHA (SANTERIA)
(SANTERiA)
Afro-Cuban Healing in Cuba
and the Diaspora
Camille Hernandez-Ramdwar
Introduction
La Regia
Regla de Ocha 1 (otherwise known as Santerfa or Lucumt) is a syncretic Afro-
Cuban religion derived
derived
丘om
from the traditions of enslaved Y orubans who were
brought to Cuba beginning in the 18th century. The religion played an important
healing role for Mro-Cuban communities in the dearth of available health care
prior to the 1959 revolution. Post-revolution,
Post-revolution, practitioners were eventually
forbidden
丘om
forbidden
from practicing and had to go underground. In contemporary Cuba the
religion has undergone a revitalization and resurgence,
resurgence , partly due to the government's
me 时 's support and realization that the religion attracts foreign tourists and is
therefore a lucrative state venture. Although
Although La RRegia
怨la de Ocha is the most widely
known of the Mro-Cuban religions,
religions , one also 曲曲
finds Regla
Regia de
de 伊(埠。
ifa (also of
ofYoruban
Yo rub an
origin,, and often practiced in tandem with La Regia
origin
Regla de Ocha),
Ocha) , Palo Monte,
Monte, Abakua,
Abakuá,
and Vodou in various parts of the island. Often practitioners of one religion may
also follow or be initiated into more than one system (Ayorinde,
(Ayorinde , 2004; Brandon
Brandon,,
Wambaugh , 2007).
2001; Garoutte & Wambaugh,
In Cuba today,
today, there has been a resurgence of interest in La Regia
Regla de Ocha as
the health care system falters and conditions for many Cubans continue to
deteriorate. Furthermore,
Furthermo
时， for decades La Regia
Regla de Ocha has had a wide following
Santer{a has been
diasporically , and is a growing religion worldwide. In the diaspora Santeria
diasporically,
placed under scrutiny and restrictions based on a general misunderstanding
rnisunderstanding and
fear of the religion; for example,
example , difficulty in acquiring the proper herbs due to
restrictions , and prohibitions regarding animal sacrifice.
restrictions,
sacrifìce. A general
generallack
lack of
ofknowknowledgeable elders,
elders , institutional structure and licensing within the religion has also
led to a number of problems,
problems , as the potential
potenti
址 for
for exploitation,
exploitation , commercialization,
commercialization,
and misrepresentation
rnisrepresentation of the religion increases in a market economy (Hearn,
(Hearn, 2004;
Ramos,
Ramos , 2006).
102 C. Hernandez-Ramdwar
In La Regia
Regla de Ocha the basis of belief includes many spiritual causes for
rnisfo
此une ， including illness. Often illness is read as a particular spiritual entity
misfortune,
person
何Tedel
(Wedel,， 2004). As
calling for attention and/or devotion from the affected person
well, the malintentions of other human beings (whether direct or indirect) are
well,
w 血 ooften
丘en suggest spiritual remedies
commonly attributed to cause illness. Healers will
along with a visit to the local medical practitioner.
There were many attempts to outlaw La RegIa
Regla de Ocha in the 19th and early 20 th
centuries , for racist reasons. For example,
centuries,
exarnple , "In 1922,
1922 , legislation prohibited MroCuban gatherings involving drumming
drumrning and dance" (Ayorinde,
(Ayorinde , 2004,
2004 , p. 52).
Regla de Ocha was of Mrican origin and practiced predominantly
predorninantly by
Because La Regia
poor people of Mrican descent,
descent , it was seen by white Cubans to be primitive,
prirnitive ,
barbaric , heathen,
heathen, and linked to criminality
crirninality (Ayorinde,
(Ayorinde , 2004). The religion
barbaric,
(oríchas) ,
revolves around the veneration of the ancestors and several deities (orichas),
therefore
therefore
丘om
from a Eurocentric perspective its apparent polytheism was seen to be
unevolved compared to Christianity2 (Ayorinde,
(Ayorinde , 2004; Lachatafiere,
Lachatañer
层， 2004).
However
However,, many white Cubans did secretly (and sometimes openly) participate in
and become knowledgeable about La Regia
Regla de Ocha,
Ocha , largely through the influence
and instruction of their black slaves or servants (Canizares,
(Canizares , 1999; Sandoval
Sandoval,, 1979).
Furthermore,
Furthermo
时， the lack of
ofEuropean
European doctors in the colonial days meant that "during
the nineteenth century,
century, medical treatment was partly adrninistered
administered by healers of
A
African
臼can origin and their pharmacopoeias"
pharmacopoeias" 何Tedel
(Wedel,， 2004
2004,, p. 32). As Cuba developed ， African
A 丘ican
medicine , and "Mro-Cubans
"A 丘。-Cubans
oped,
practices took a back seat to European medicine,
relied increasingly on orthodox health care for the treatment of infectious and
organic diseases; while the religious system's strengths in solving problems of
spiritual and emotional nature remained intact" (Sandoval,
1979,, p. 142).
(Sandoval, 1979
In post-Revolutionary Cuba,
Cuba, La Regia
Regla de Ocha was attacked as a cultural
anachronism, not papart
眈 of
of a new,
new, modem,
modem, revolutionary Cuba. In regards to one of
anachronism,
the main sources of pride for the revolutionary government-health
govemment-health care-it
care-it was
thought to be that they (practitioners of La Regia
Regla de Ocha) promoted
dependency on divination and traditional cures,
cures , which could lead people to
imbibe harmful substances or to delay seeking medical advice. In spite of
free health care,
care , revolutionaries asserted
asserted,, people were dying in the clutches
of babalawos,
babalawos, healers and spiritists.
(二4yorín
(Ayorinde,
仇， 2004,
2004 ， p. 118)
Conversely, the Cuban revolution actually helped the religion to grow in Cuba:
Conversely,
emplo
严丑ent
arnong the traditionally marginalized Mro-Cuban popuincreased employment
among
lation meant more people could afford
a 他rd the expensive initiation ceremony,
ceremony , and the
religion continued to grow.
A
丘er the apertura (p
(political
olitical and cultural opening) in the 1990s,
1990s, the state in Cuba
After
Regla de Ocha,
Ocha , and began marketing the religion
co-opted many of the symbols of La Regia
as an aspect of cultural tourism (Am
(Amores,
ores , 2010). In Cuba today,
today, there has been a
La Regia
Regla De Ocha (Santerfa)
(Santería)
103
resurgence of interest in La Regia
Regla de Ocha as the health care system falters and
Arguably, the promises
prornises of the
conditions for many
rnany Cubans continue to deteriorate. Arguably,
Cubans , particularly for a younger
Revolution have not materialized for many Cubans,
generation born
bom in the 1970s and 1980s,
1980s, and the religion is being regenerated by a
initiates
何Tedel
C:Wedel,， 2004). The increase in tourism in
young, multiracial population of initiates
young,
Cuba since the 1990s has exposed the religion to high numbers of foreign travelers,
travelers ,
rnany who become interested in the religion and may
rnay become initiates themselves,
thernselves ,
many
(Arnores,
ores , 2010).
thereby spreading it to their countries of origin (Arn
This chapter examines
exarnines some common beliefs about illness and well-being from
Santer
旬， looks at a variety of healing methods employed and
the perspective of Santeria,
explores the healing practices of La Regia
Regla de Ocha. It begins by discussing the
principles and practices. This is followed by an exploration of the healers and
Subsequently, the chapter discusses La Regia
Regla de Ocha as
representations of illness. Subsequently,
an integrative approach to healing and,
and , lastly
lastly,, explores the implications for
conventional health and mental health.
Principles and Practices of
Santería
Santeria
Central to the beliefs of La Regia
Regla de Ocha is the practice of divination. One must
prescriptions , remedies which often
consult the diviner to ascertain problems and prescriptions,
(ebbo) , to appease or gain the assistance of a particular oricha.
orícha. Like
include sacrifìce
sacrifice (ebbo),
allliving
living
many earth-based religions,
religions , Santeria proposes the interconnectedness of all
spirit , and that the human
things,
things , that everything in nature is imbued with a spirit,
condition expands beyond the material plane. Therefore,
Therefore , in La Regia
Regla de Ocha the
ofbelief
belief includes many spiritual causes for illness,
illness , which is "prevented and
basis of
healing is achieved by creating and maintaining relations with these divine beings
spirits"
何Tedel
C:Wedel,， 2004,
2004 , p. 47). For adherents,
adherents , "ire
"íré ariku
aríku - blessings of good
and spirits"
health - (is) the most important ire
iré of all,
all , and it is the first
fìrst blessing they ask the
2005,, p. 181).
orishas for"
(Nodal & Ramos,
for"
例odal
Ramos , 2005
The main purpose of divination,
divination, ritual,
ritual , and sacrifice
sacrifìce in the religion is to reestablish harmony for those who are "off-path,"
"o fI二path
，" or to "make firm"
fìrm" the blessings
oys.
santerolas
ωand
and
that the practitioner currently 呵
enjoys.
Priests of the religion-the santero/
babalawos-are
babalawos
一-are the intermediaries who can communicate by divination between
Oludumare , the orichas,
Oludumare,
oríchas , and the client. There are many methods of divination,
divination, each
involving varying levels of intricacy,
intricacy, det
detail,
ai1, and accuracy. Santeroslas
Santeros/as3 (otherwise
known in Y oruban as babalochas and iyalochas,
íyalochas , literally "father"
"如her"
and "mother" of
the orichas,
oríchas, or simply as Olorichas)
Oloríchas) generally perform consultations using 16 cowrie
díloggun). The priests of lfã
Ita (babalawos),
(babalawos) , a
shells (a practice known in Cuba as diloggun).
Regla de Ocha open only to
somewhat separate yet interconnected aspect of La Regia
men, use a chain to which four pieces of coconut shell are attached,
men,
attached, known as an
opele; as well they may
rnay use ikin
íkín (the seeds of the oil palm) with which to divine.
Both systems of divination are performed in order to achieve a letra or odu,
odu , 1 of
16 bodies of
ofknowledge
knowledge contained in the entire corpus ofIfa,
ofI函， a compilation of
104 C. Hernandez-Ramdwar
verse and wisdom developed in the oral culture of the Yorubans centuries ago.
parables,, advice
advice,, examples of correct
allegories , parables
Each odu contains a wealth of allegories,
conduct , patakis
patakís or moral fables,
fables , as well as the remedies for any potential osogbo or
conduct,
imbalance that may befall a client for whom this letra has fallen,
fallen , or,
or, alternatively,
altematively,
íré (good luck,
luck, fortune) of a client who is being blessed by this
remedies to seal the ire
particular odu. In these sometimes lengthy and detailed consultations with santeros
or babalawos,
babaZawos , it may be revealed that the client has a health issue that must be
attended to. In addition,
addition , it is very common that letras will advise clients on how
to conduct themselves in a variety of ways,
ways , for example
ex 缸nple
avoiding certain foods,
foods ,
abstaining
from alcohol and tobacco
tobacco,, being careful where they eat
eat,, etc.
etc.,, advice
abstaining
丘om
which may be read as preventative medicine.
In the case where a client is flagged
fl.agged as having a pertinent or even serious health
m
肘， the first
fìrst advice is usually that the client seeks immediate medical attention,
attention ,
issue,
after which several prescriptions are given by the diviner to restore health and
edel, 2004). Prescriptions may include various forms of ebbo
spiritual alignment C:Wedel,
or sacrifice.
sacrifìce. Nodal and Ramos (2005) state that ebbo "is an indispensable element
in Lukumi Orisha Worship. It serves
se 凹es as the means to various ends,
ends , all conducive
to the mental and physical well-being of the devotee and the religious community
in general" (p. 167). Ebbo is directed at specific
specifìc oricha
orícha and sometimes marked for
the dead (egun or ancestors).4
religion, and to Cubans in general,
general ,
San Lazaro
Lázar0s5 holds much importance in the religion,
especially as he "is considered
consi
世时 a
a miraculous
rniraculous healer" C:Wedel,
edel, 2004,
2004 , p. 85). San
orícha BabaM-Aye,
Babalú-Ayé , who in West
Lázaro
Lazaro is the Catholic saint syncretized with the oricha
Africa was the god of smallpox,
smallpox, leprosy
leprosy,, and infectious diseases
diseases,, and in Cuba is
associated with infectious diseases such as syphilis and AIDS,
AIDS , illnesses with which
he can both punish and cure. The fact that San Lá
Lazaro
zaro is well
wellloved
loved and respected
by so many Cubans,
Cubans , of all faiths,
f 与iths ， is significant
signifìcant in that he is believed to be a great
healer, full of compassion for the afflicted.
healer,
a 但icted.
c:w
c:w
SanterÎa
Santeria Healers
Most of the healers in the religion are initiated priests (santeros and babalawos) while
orícha who may be at varying levels of initiation or affiliation
affùiation
others are devotees of oricha
with an ile
íle (spiritual house). Most training is
is 丘om
from elders in the religion through
knowledge and through hands-on apprenticeship
apprenticeship,, attending
an oral transference of
ofknowledge
various ceremonies
ceremonies,, rituals
rituals,, etc. La Regia
Regla de Ocha is traditionally a hierarchical
involvement , and encompasses varying
religion that requires years of practice and involvement,
(2006) , Fl
Florencio
orencio
levels of initiation. An elder Cuban informant of Sandoval's (2006),
Regla de Ocha in Cuba in the 1940s and 1950s,
1950s,
Baro,
Baró , recalls his experiences of La Regia
in which he makes a distinction between Catholic priest and santero:
the priest studies a lot to become a priest,
priest , while santeros are born
bom with
religious faculties. The priest advises according to his knowledge,
knowledge , with his
La Regia
Regla De Ocha (Santerfa)
(Santería)
105
heart,
Santeros,,
heart , and by invoking the saints and God,
God , but he cannot divine. Santeros
however, are fortune-tellers who can predict and cure.
however,
(p. 58)
命.5
叼
Sandoval echoes this by stating that "In the past most believers were not
initiated; the oracles generally did not advise devotees to go through initiation
unless they showed particular signs of possessing faculties as a medium of other
similar gifts"
gi 缸" (2006,
(2006 , p. 93). Today people are not only initiating because of their
inherent "gifts": some initiate for health reasons,
reasons , others for the pursuit of power
and of money,
money, and others because they have been instructed to do so,
so , either by
the orichas,
oríchas , or by elders whose intentions mayor
may or may not be honorable. The
expectations placed on prie
priests
如 today
today
are therefore more based on knowledge of
rituals rather than healing and/or divining abilities. The worldwide spread of the
religion and the emphasis,
emphasis , particularly in North America,
America , on "immediate" results,
results ,
competent , traditional elders in the diaspora have led to an erosion
and a lack of competent,
of the typical apprenticeship of days gone by. For this reason,
reason, there are priests in
the diaspora who have not been properly trained or not trained at all.
Not all practitioners of Santeria
Santer{a are initiates; Canizares (1999) identified
identifìed varying
varγing
levels of involvement in the religion,
religion, ranging from least to most involved:
interested observers,
clients,, habitual clients
clients,, amulet recipients
recipients,, EllEllegua
怨ua
observers , occasional clients
initiates,
initiates , Guerreros initiates,
initiates , Collares initiates,
initiates , santeros,
santeros , and babalawos (in Newby,
Newby,
Ril
Riley,
ey, & Leal-Almeraz,
L 叫-Almer
2006, p. 291). It is therefore the last two categories who
世
i诅ly be considered the healers
hea 址ler 岱s in the 配
r elig
时 ♂ion.
Sa扭
ndova 址1 (1979)
(1979 列) states
would primar
primarily
religion.
Sandoval
Santeria is characterized by its lack of homogeneity. It is not a religion
governed
govemed by a narrow and strict orthodoxy. On the contrary,
contrary, each santero
subjectively interprets the beliefs and frequently introduces variations in the
rituals and mythology according to his own knowledge,
knowledge , religious
ofhis
his followers.
experience
experience,, convictions and needs of
(p. 138)
。.
There are pros and cons to this lack of organizational structur
structure-positively,
e-positively , it
allows for re-adaptation to current circumstances and environment; more
negatively it can result in charlatanism and corruption of important basic tenets of
the religion,
religion, as well as "openness" of morality/ethics.
moralityI ethics.
It must be noted that a great part of the divinatory
divinato
巧T process lies in the diviner's
energy/power, known as ache.
aché. It therefore follows that initiatory status or
spiritual energy/power,
years in the religion does not an effective
e 岳ctive
healer make-part
mak -part of this must come
through the blessings of the 。优has
orichas and one's
0 肘 's own head (Or
(Ori/eleda/Angel
íleledalÁngel de
Guardía). Without this,
Guardia).
this , the diviner is just casting objects and following form. By
the same token,
token, someone relatively low in the religious hierarchy may have natural
aché that imbues them with the ability
ache
ab 血ty to heal with very little effort. Interestingly,
Interestingly,
one can see a gendered component to this: in the early days of Santeria,
Santeria , women
•
106 C. Hernandez-Ramdwar
he1d powerful positions as oriates,
held
oría 的， or "master of ceremonies,"
ceremonies ," in initiation rituals
(Brown,
rown, 2003; Clark,
C1ark, 2005). Presently,
Presently, as
and were highly accomplished diviners (B
La
Regia
in Cuba,
La R
吃gla de Ocha has become a viable
viab1e money making opportunity
oppo 时unity
Cuba, one
sees 1ess
less and 1ess
less women acting in the ro1e
role of oriate;
oríate;
也rthermo
furthermore,
时， women in Cuba
are prevented from becorning
becoming babalawos. These are the upper echelons
eche10ns of the
made) , in which men now
religion (i.e.,
(i.e. , p1aces
places where the most money is to be made),
predorninate. Consequently,
predominate.
Consequently , women practitioners may find
fÌ nd it more difficult
di 伍cult
to
initiate
，也r
econornic reasons,
reasons , yet they are followers of the faith and continue to
initiate,
for economic
practice , often without vestal authority. Many may find
practice,
fÌ nd more powerful
powerfu1 positions
in the practice of espiritismo
espírítísmo rather than Santeria due to ongoing patriarchy in the
1atter
latter (B
(Brandon,
randon, 2001). However,
However, Tracy (2005) argues that "healing through ritual
possib1e by gender based mythology,
mytho1ogy, through the
for women in Santeria is made possible
comp1ex female
fe 叫e deities" (p. 4). In this instance,
instance , it is the
presence of powerful and complex
presence of the female
fernale divine in this religion (in a multitude of forms) that is in
and of
ofitse1fhealing
itself healing for women,
women, men,
men, and societies.
Representation of IIIness
Illness
Illness can sometimes be attributed to the punishment
punishr
丑e 时 of
of an oricha,
orícha , for wrongdoing
or for 1ack
lack of devotion. Each oricha
oríc. 加 has
has rulership over specific parts of the body
body,, for
ex 组np1e
Obatalá rules the head,
Obatala
head, and punishment
punishr
丑e 时 could
could
therefore be mental
mental
迎ness
illness,，
example
blindness, or addictions. Believers in La Regia
Regla de Ocha are frequently told
to1d to appease
blindness,
oríchas , to offer them specific foods,
foods , flowers
flowers,, candles
candles,, or actions to ensure that
the orichas,
one stays in their good graces. In general,
general, followers of La Regia
Regla de Ocha believe that
illness and bad 1uck
luck are attributable
attributab1e to one or more of the following: anger or punishment of an oricha;
orícha; the evil
evi1 eye (malojo); witchcraft or sorcery (brujeria); congenital
abíku or "bom
"born to die"); spiritual
"weakness" (such people
peop1e are often referred to as abiku
attachment; a weakened head (eleda,
loss of one's soul,
(ele 旬， On),
。吟， or 10ss
soul, whereby sorcerers,
sorcerers ,
paid by an enemy,
enemy, buy the person's head (Sandoval,
(Sandoval, 1979; 2006; Wedel,
Wedel, 2004).
The physical manifestation of illness is but a cruder form of the spiritual/
invisib1e made visible.
visib1e. For this reason,
reason , clients
metaphysical manifestation: it is the invisible
of 迦ness
illness,，
are often sent to the physician to deal with the physical manifestation of
while santeros deal with the metaphysical or spiritual causes. Practitioners also
fÌ rst or in tandem
believe that unless problems
prob1ems are dealt with in the spiritual realm first
with the physical,
physical , no genuine healing
healing
飞Nill
will take p1ace.
place. The prescriptions of oricha,
orícha ,
伊
lfa or
or the spirits of the dead are meant to be heeded with all seriousness. Clients
retum to the diviner to see if they are
are advised to follow the advice and then return
now "on path." However,
However, ebb6 can still be ineffective.
ine 任ective.
This is often revealed
e1se fails
fails,, the orichas
oríchas will simply
simp1y probeforehand through divination. When all else
nounce that there is nothing 1eft
left that can be done. In Y oruban belief everyone
has a predestined day of death; everything in life can be altered except for that.
(1979) , the bulk of
ofwhite
white Cubans did not know about
According to Sandoval (1979),
or visit healers in La Regia
Regla de Ocha prior to the Castro era as it was very
ve 巧 much
much
La Regia
Regla De Ocha (Santerfa)
(Santería)
107
relegated to the Afro-Cuban,
Afro-Cuban, lower class population. However,
However, in the revolutime in Cuba of great upheaval,
upheaval, many Cubans of all backgrounds
tionary period,
period, a tirne
similarly, those who migrated
rnigrated to the United States
sought out religious support; similarly,
found themselves in upheaval again and,
and , feeling a sense of powerlessnes
powerlessness,
币， tumed
turned
to La RegIa
Regla de Ocha to ground them (Brandon,
(Brandon, 1997). In contemporary Cuba,
Cuba ,
fIx the multitude of their everyday
many clients come to the santera to resolver or to fIx
nding food and money
country , etc.),
etc.) ,
problems they face (fI
(fInding
money,, trying to exit the country,
problems which contribute to levels of extreme stress
stres 在 and
and anxiety. Both Sandoval
(2006) and Wedel (2004) describe the difficulties and stresses Cubans face: "people
often expressed how insecure they felt by saying ‘'I1 don't know what is going to
happen to me',
me' , or ‘'I1 don't understand what is happening'"
happening'"
何Tedel
(Wedel,， 2004
2004,, p. 41).
nervíos or anxiety/mental
an 沮ety I mental illness
Such conditions of uncertainty contribute to nervios
何T
edel, 2004),
2004) , and Cubans often believe that this is the result of the malpensimientos
m 呻ensímíen
削
(Wedel,
(b
(bad
ad thoughts) of others,
others , or other maldiciones
maldícíones (curses). Others come to the diviner
for physical maladies that medical science has been unable to cure. The
involvement of Cubans in the religion runs the gamut from those for whom the
religion is a way of
oflife
life and a lifetime comrnitment
commitment,, to those for whom the religion
is seen as a quick fIx,
fIx , a magical solution to their problems.
The versatility and openness of La RegIa
Regla de Ocha,
Ocha , both historically and in
contemporary
contempora
巧 times,
tirnes
， allows for a fluidity of experience. Unlike fundamentalist
religion, there is no wrongdoing in seeking out other spiritual paths,
paths , or
forms of religion,
in practicing several at the same time. For this reason,
reason, many practitioners and
Regla de Ocha will also consult a palero (Palo Mon
Monte)
时 or
or espiritista
e 早írítísta
believers in La RegIa
(espírítísmo) , prpray
(espiritismo),
町 to
to Catholic saints,
saints , and perhaps also work with voudouisants
voudouísants
(devotees of Vodou). Several initiates of La Regia
Regla de Ocha have been initiated in
other Mro-Caribbean paths,
paths , and many practice espiritismo
espírítísmo on a regular basis
cases,,
(Brandon,， 2001; Dodson
Dodson,, 2008; Garoutte & Wambaugh,
但randon
Wambaugh , 2007). In many cases
suffering and ailment
ai1ment are seen to be the result of a negative spirit attachment. The
remedy for this is a misa
mísa or spiritual mass for the dead,
dead, a central activity in espiritismo.
espírít
必mo.
Practitioners of La RegIa
Regla de Ocha are often involved in espiritismo,
espírítísmo , and many
oríchas.
maintain altars to both the dead and the orichas.
Santería
Santeria and Mental Health Practices
Once a diviner has ascertained what kind of problem a client faces,
faces , the remedies
for healing often include ebbo (sacrifIce)
(sacrifI ce) and/or the use of
ofherbs.
herbs. Ebbo can be an
egunn or orichas,
(plant,
ooffering
岳ring
(p
lant, animal,
anim 泣， object,
object, etc.) to the
theψ
oríchas , or it can mean sacrifIcing
sacrifI cing
(giving up) something such as a behavior or a particular food. Herbs can be used
in a variety of ways-for baths,
baths , limpiezas
límpíezas (cleansings),
(cleansings) , infusions
infusions,, or teas.
Healers will often suggest spiritual remedies along with a visit to the local
medical practitioner. In Wedel's
Wedel' s 2004 study of 100 client consultations with a
santero in Matanzas,
Matanzas , Cuba
Cuba,, he found that in 68% of the cases,
cases , clients were advised
to visit a biomedical doctor. According to Wedel:
108 C. Hernandez-Ramdwar
Today in Cuba,
Cuba , it is not uncommon that physicians and other health
santería. In Havana
personnel practice,
practice , or have some common knowledge of santeria.
many
rnany physicians are also babalaos ...
. . . When santeros and babalaos work as
medical doctors,
doctors , they frequently encourage patients to become involved in
santería if religious healing is thought to be a more effective for of treatment
santeria
than biomedicine.
ρ
(2004,
004 ， p. 119)
Cuban babalawo Marcos Govarrubia states:
Hay personas no se sienten
síenten bien,
bíen, que duermen mal,
mal, tienen
tíenen algo
a 险。 de
de psí
psicosis,
ω巾， hay
personas que no saben movilizar
movílízar situaciones
sítuacíones en su vida,
vída , tan disorientada,
dísoríentada , entonces
estan buscando un estimulo;
estímulo; entonces nosotros utilizamos
utílízamos en este religi6n
relígí6n a veces
veces
ωmo
como
"
un pStCOLOgO.
psic6logo.
There are people who don't feel well,
well, that sleep badly
badly,, that have some type
of psychosis,
psychosis , persons that don't know how to mobilize situations in their
life,
M
七 very
very
disoriented, then they are looking for a stimulus; we function,
function, then,
at times like psychologists in this religion.
(Go
(Gonzalez,
nzalez, 1990
1990,, translation
translatíon current author)
The olorisha
olorísha or babalawo can therefore act as a doctor, psychologist, confidante,
client, the
religious elder,
elder, and/or parent figure. Their role varies depending on the client,
client's
client' s situation,
situation , their own ache,
aché , and their own level of commitment to their
olorísha or
godchilden (or ahijados/as-those who have been initiated by an olorisha
babalawo.
babala
仰. This bond between the two is considered to be lifelong and sacred) and
clients.
Ebb6 and initiation into the religion are also used as forms of preventative and
curative practice. Ebb6
is best understood as a religious act consisting of ritual procedures for
establishing communication with spiritual and supernatural beings in order
to modify
modi 马T the condition of the persons on whose behalf it is perforr
performed,
丑ed ， or
or
of objects with which they are concerned.
(Nodal & Ramos,
Ramos , 2005,
2005, p. 172)
17 勾
For example,
example , a santero will
w 山 ooffer
岳r ebb6 based on specific instructions provided
orícha who spoke through
through divination; this ebb6 will commonly be to the oricha
orícha of the person being seen;
divination to offer their assistance; to the guardian oricha
or to the oricha
orícha who "owns" the illness or body part afRi
afflicted
cted by the client. An ebb6
may
rnay be as simple as a bath or a cleansing using an animal that is then sacrificed to
orícha consulted,
consulted, or it may involve more intense and costly endeavours.
the oricha
Sometimes ebb6 requires a change of
ofbehaviour
behaviour (e.g.,
(e.g. , constant arguing,
arguing, or smok-
La Regia
Regla De Ocha (Santerfa)
(Santería)
109
ing); they "give up" or "sacrifice" this behaviour is order to achieve healing
he a1ing and
ire.
íré. lnitiation
Initiation is perhaps the highest form
forrn of ebb6--literally
ebb 在一lite ra1l y sacrificing
sacrifìcing one's head to
the oricha,
orícha , after which the oricha
orícha becomes the lifelong
lifelong
织lardian
guardian of that person's
person' s head.
In all cases,
cases , healing"
he a1ing "comes
comes from within" in that"
that "one
one gains a sense of agency over
one's destiny as well as through the transference of energy" (Tracy,
(Tracy, 2005,
2005 , p. 32).
The use of herbs is central to healing
he a1i ng practices of La RegIa
Regla de Ocha (Cortez,
(C 。此ez ，
2000). Santeros and babalawos traditionally possessed a large body of
ofknowledge
knowledge of
herbs for healing.
he a1ing. Enslaved Mricans had to find
fìnd plants similar to the ones they had
used in Mrica; therefore many of the herbs used by the Y orubans have been
substituted by those found in Cuba. Obviously,
Obviou
句， such use of
of 丘esh
fresh herbs can not
always be transferred to other parts of the world; practitioners in Fl
Florida
orida may be
able to procure!
procurel grow the same herbs as those used in Cuba,
Cuba , but in the more
temperate zones of
ofNorth
North America,
America, or other parts of
ofthe
the world,
world, this is much more
difficult. The unavailability of proper and fresh herbs in abundance can gready
he a1ing practices
practices,, a major
m 习 or problem for
hinder the efficacy of religious rituals and healing
diasporic practitioners.
santeros , a virtual bible of
ofherballore
herbal lore is found in the book EI
El Monte by Lydia
For santeros,
Cabrera (1996). EI
El Monte is an encyclopedia of
ofherbal
herbal and spiritual knowledge as
told to Cabrera,
Cabrer
毡， an ethnologist and anthropologist,
anthropologist, by Mro-Cuban
A 丘。-Cuban
religious elders.
Cabrera delineates the otherworldly connection between human and plant thusly:
"Curan,
[They (p
(plants)
cure,, because they are the same
"Curan, porque ellas mismas
mísmas son brujas
bruJ ω[They
lants) cure
as sorcerers]"
sorcerer
斗" (1996
(1996,, p. 11
11,, translation
translatωn current author). It is the ache
aché of the plants
mysticallink
oríchas and with all spiritual forces,
forces , good
themselves , their mystical
themselves,
link with the orichas
and evil,
evil , that make them so powe
powerful;
币ù; this is why the use of them is so intrinsic to
El Monte delineates how each plant is linked with different
di 岳rent
oríchas and
the religion. EI
orichas
is attributed to have special powers,
powers , medicinal and spiritual. A good santero or
babalawo has an extensive knowledge of
ofherbs
herbs,, knows how to procure them
them,, and
is familiar with their specific
specifìc uses. They also know which oricha
orícha is the dudio
dueño or
owner of each herb.
Some of the common healing
he a1ing techniques involving the use of herbs include
limpiezas
límpíezas (cleansings),
(cleansings) , baths,
baths , infusions
infusions,, and teas. A limpieza
límpíeza is effectively
etfectively a transfer
of (negative) energy from a person to an object (flowers,
(flowers , herbs
herbs,, vegetables
vegetables,, fruits,
frui 毡，
grains
grains,, animals)
animals),, after which tthe cleansing object is discarded and! or sacrificed.
Limpiezas may also be effected with cigar smoke and! or spraying the person with
alcohol (through the mouth of the santera). Limpiezas can be done to remove a
troublesome or negative spirit. It is believed that even the negative thoughts and
intentions of others can make you ill, therefore the necessity for constant cleansing
of oneself and one's surroundings. Baths may be made with herbs alone, or
sometimes additional ingredients are added (Cortez, 2000), and are often taken for
a set period of days. Clients may also consume herbs in teas or by eating them.
Scholarly research on La Regia de Ocha began in Cuba early in the 20 th century
(1900s-1950s) through the works of ethnologist Fernando Ortiz, anthropologist
Lydia Cabrera, and ethnographer R6mulo Lachataftere. In later years, Cuban
11 0 C. Hernandez-Ramdwar
and international scholars have continued to research the religion and expose
many formerly secret practices to a worldwide audience. Ortiz graduate Miguel
A 丘。 -Cuban
Barnet (2001) continues to document the practices and history of Mro-Cuban
religions
religions
丘om
from inside Cuba,
Cuba , while others,
others , such as cultural anthropologist Migene
ofPuerto
Puerto Ri
Rican
can origin
origin,, can be credited with popularizing and
González-Wippler, of
Gonz:ilez-Wippler,
demysti
马Ting
Santeria diasporically outside of the Cuban and Spanish-speaking
demystifying
communities with a number of books she published in the 1970s. Given the
González-Wippler's books,
books , many publishers became
extreme popularity of Gonz:ilez-Wippler's
interested in the topic of Santeria,
Santer
旬， and a new body of literature on the subject
evolved. Nodal and Ramos (2005) note that:
...
. . . in the last few years more and more medical personnel and people in
such professions as therapy,
therapy, social work
work,, and counselling are beginning to
realize the importance of Lukumi
Lukunú religion in Hi
Hispanic
spanic communities in the
United States: the therapeutic value of its magical
rnagical and spiritual practices in
treating different kinds of illnesses,
illnesses , as well as dealing with certain kinds of
social and adaptational problems. Gonzalez-Wippler reports that Belleview
Hospital in New York
Y ork City has an Olorisha on the counselling staff for those
who seek such assistance.
(p. 181)
命.
Some of these authors are initiates of La Regia
Regla de Ocha; this is of note because
Regla de Ocha community the importance of guarding ritual secrets and
within the Regia
protecting sacred knowledge is still
st 山 practiced.
practiced. For this reason,
reason , some of these
which, in the eyes
researchers have come under criticism for making public that which,
of many elders in the religion,
religion, is not meant for everyone.
Despite its growing popularity and visibility,
Regla de Ocha
visibility, in the diaspora La Regia
is often under scrutiny and restrictions based on a general misunderstanding
rnisunderstanding and
(Mu 叩 hy ， 1993). Difficulty in acquiring the proper herbs,
herbs ,
fear of the religion (Murphy,
ordinances prohibiting animal sacrifice,
general lack of
sacrifice , and a generallack
ofknowledgeable
knowledgeable elders
elders,,
structure , and licensing within the religion itself
itselfhas
institutional structure,
has led to numerous
exploitation, commercialization,
commercialization, and misrepresenrnisrepresenproblerns , as the potential for exploitation,
problems,
discrirnitation of the religion increases. Diasporic practitioners frequently face discrimisacrifice , noise
nation, particularly in areas where ordinances banning animal sacrifice,
nation,
(drumrning
(drumming is an important
impo
眈:ant
pa
part
眈 of
of ritual work),
work) , certain herbs,
herbs , and the use of
mercury (Newby et al.,
al. , 2006) exist. Furthermore
Furthermore,, debates internal to the religion
ensue over issues such as exposure to blood and the necessity of practicing proper
precautions against the spread of HIV and other infectious diseases (some rituals
ofthe
the body).
involve cutting,
cutting, shaving
shaving,, or scratching of
In terms of
health care
care,, La RegIa
ofhealth
Regla de Ocha in the diaspora has become a "viable
system, which offers support,
support , counselling,
counselling, and socialization
mental health delivery system,
opportunities to many people who are suffering from the tensions that characterize
acculturation and deculturation processes" (Sandoval,
(Sandoval , 2006
2006,, p. 333). This is
La Regia
Regla De Ocha (Santerfa)
(Santería)
111
certainly the case in major
m 习 or American
American urban centres with large Cuban populations
ami and New York areas).
(notably the greater Mi
Miami
For Cubans in the United States who adopted the religion here,
here , Lukumi
LukulIÚ
function , since it served a purpose for them
religion has had a major healing function,
that it did not serve in Cuba. It has become a system through which
adjustments to a foreign land and an alien culture may be mediated ...
. . . They
use rituals like eb6
ebó to help them cope with illness,
illness , isolation,
isolation, unemployment
unemployment,,
mental problems,
problems , discrimination,
discrimination, social and personal difficulties,
difficulties , and many
other conflicts that may arise.
(N
(Nodal
odal & Ramos
Ramos,, 2005
2005,, p. 184)
18 句
The same can be said for other Latino
Latino,, Caribbean,
Caribbean, and African
A 丘ican
American
American groups
for whom it may offer important alternatives
altematives in a racist and discriminatory society.
Conclusion
One can only hope that the growth in La Regla
Regia de Ocha
Ocha
飞Nill
will be positive,
positive , with an
adherence to ethical practices and accountability. Furthermore,
Fu 眈hen 丑ore ， it is hoped that in
the diaspora Santeria
Santer{a will be recognized,
recognized , respected,
respected, and accommodated as a legitiMiddle
colonialism,,
mate religion. The orichas
oríchas have survived the Mi
ddle Passage,
Passage , slavery,
slavery, colonialism
prohibition
oríchas and
prohibition,, and oudawing. This is a testament to the strength of the orichas
to their believers
believers,, a strength that can surely be utilized and respected in the ongoing
healing of
ofhumanity
humanity that is taking place in the 21 st century.
Notes
1. 1I have chosen to preference the tenn RRegIa
怨la de Ocha (rule of Oricha) for
for 由e
the religion
rather than the more commonly known term Santeria
Sante
巾 as
as the latter is "a derogatory
creation imposed on the religion by white Cuban Catholic clergy to ensure it is
distanced
distanced
丘om
from their Christian faith" (Murrell
(Murrell,, 2010).
2. Adherents do believe in a supreme omniscient being-OIodumare/OIorun/OIqfin.
being-Olodumare/Olorun/Olrifin
3. Santero (male) and santera (female)
(fema1e) are the Spanish names given to oricha pries
priests
臼 in
inCuba.
Cuba.
Here 1I use them interchangeably.
4. An ebbo may be very elaborate or very simple,
simple , ranging from omi tutu or cool water
offered to an oricha, to various limpiezas
limpiez
ωor
or cleansings utilizing herbal baths,
baths , grains,
grains , or
cigar smoke
smoke,, to anima1
animal sacrifìces
sacrifices that may require a significant
signifìcant investment of work,
work ，目me
time,，
and money. Sometimes
Sometimes
由e
insist
由at
the orichas insist
that the person who has come for divination
must be "crowned" or initiated into the religion
religion,, and that only this will appease the
oricha and perhaps save that person's
person's 且fe.
life.
Lazaro are made by the faithful to El Santuario de San Lazaro,
5. Pilgrimages
Pilgrirnage
唱 to San Lázaro
Lázaro , a
leprosarium and chapel in the town ofEl Rincon,
Ríncon , just outside of
ofHavana
Havana,, especially
on his feast day December 17. Each year,
year , Cubans
Cubans
岛lfill
fulfill promise
promises唱 to the saint/oricha in
gratitude for health restored,
miles , or dragging heavy
restored , some crawling on their knees for miles,
bricks,, many dressed in the sackcloth with which this saint/oricha is associated.
bricks
112 C. Hernandez-Ramdwar
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9
PUERTO RICAN SPIRITISM
(ESPIRITISMO)
Social Context
Context,, Healing Process
Process,,
and Mental Health
jesus Soto Espinosa
Esp 的osa and Joan
joan D. Koss-Chioino
Jesus
Introduction
Spiritism is a philosophical and "scientific" movement codified by a French
núd-19 th century. Espiritismo
Espírítísmo (Spiritism) developed from a
scholar in Paris in the mid-19
"scientific exploration" of disincarnate,
disincarnate , eternal spirits that survive the death of
human beings,
beings , using records of the experiences of young mediums in seances,
s 臼nces ，
and later collecting sinúlar
(Kardec ,
similar data from many groups across the world (Kardec,
1994). The scholar,
scholar , Allan
All an Kardec (1804-1869),
(1804
一 1869)
， a pseudonym chosen by Leon
Hippolyte Denizarth Rivail,
Rivail , published six books and a review organ
organ,, which were
translated and republished throughout many countries. These works codified the
practices and philosophy of Spiritism. The movement spread first to Spain and
then to Latin America,
America, carried by scholars who studied in France or Spain. The
ideas and moral philosophy of Kardec lead to Latin American
Am erican elites' view of
Spiritism as a special psychological science. Moreira-Almeida
Moreira-Almeida and Kl
Klaus
aus Chaves
(2011) note:
Allan Kardec was a pioneer in proposing scientific investigation of psychical
Allan
phenomena. Kardec was an influential scholar in Europe during the second
xvi). According to Monroe (2008,
half of the 19 th Century (Sharp,
(Sharp , 2006,
2006 , p.
p. 泪过).
(2008 ,
p. 96)
96),, he was one of the most widely read philosophers of the period; his
Spiritism, Le Livre
Lívre des Esprits
Espríts (The Spirits' Book),
Book) , was a best
first book on Spiritism,
seller,
seller, with 22 editions in 17 years. Despite his historical relevance and the
fact that Kardec's
languages,, and continue
Kardec' s books were translated into several
severallanguages
to be quite popular selling millions of copies,
copies ,1 his research work and methods
historians , Spiritists,
Spiritis
臼， and parapsychologists.
are still poorly known by historians,
(p. 136)
。.
114 ].J. 50to Espinosa and].
and J. D. Koss-Chioino
This is still
sti1l the view of many educated Spiritists
Spiritisωin
in the 21 st century; however,
however,
less educated people in the rural and urban barrios in Puerto Ri
Rico,
co , Latin America
America
and the Latin Caribbean syncretized Spiritism with their indigenous systems
systerns of
healing, consisting of folk,
healing,
folk , Catholic and Afro-Caribbean beliefs and practices
(Nuñez Molina,
(Nunez
Molina, 1991) This movement includes ethical and moral regulations
oth incarnate and disincarnate),
disincarnate) , and an ontological
about spirit behavior (b
(both
specifìes a cycle of disincarnation and reincarnation
epistemology that specifies
reincamation with a goal
of the inevitable evolution of the individual spirit. Disincarnated spirits reside in a
apa 时丘om
dimension apart
from incarnated beings
beings,, but they contact that world mainly
(Kardec , 1998).
through mediums
mediurns who have developed their faculties (Kardec,
Spiritism, its history,
histo
巧，
This chapter fìrst
first offers an overview of the principles of Spiritism,
philosophy, and belief system. It then offers a discussion of the impact of Puerto
philosophy,
Ri
Rico's
co's colonial status vis-à-vis
vis-a-vis Spain and then the United States on the acceptance
of Spiritist healing. It then reviews the principles and belief system of Spiritists. It
describes healing practices and the processes by which one becomes a healer and
how it is viewed by the mental health profession. We then consider the current
signifìcant for well-being among
sociocultural perspective towards spirituality as significant
cans. Finally
Puerto Ri
Ricans.
Finally,, we briefly describe the implications of spirit healing for
mental health,
health , and for broadening an understanding of spirituality. We propose
that this understanding is important to training mental health professionals who
treat both Puerto Ri
Ricans
cans and other Latin Americans.
Americans. A brief description of a
Rico
co in the late 1970s is included. The project aimed
training project in Puerto Ri
to create a bridge among community mental health workers,
workers , medical residents and
Spiritist healers over three years in three large mental health catchment areas.
Spiritism under Spanish and American Colonial Influence
Allan
Allan Kardec established Spiritism in France during the year 1857 with the
The Spirits'
Spírí 白 ， Book. This was just after the foundation of the Spiritualist
publication of The
movement by Emanuel Swedenburg in England (in 1840),
1840) , and the Fox sisters'
phenomena in the United States in 1848. Spiritualism was accepted by many in
the United States,
States , while Spiritism spread to Latin America
America and the Hispanic
Espírítísmo was introduced into Puerto Ri
Rico
co during the second half of
Caribbean. Espiritismo
the 19 th century. Puerto Ri
Rico
co was then a Spanish colony and,
and, therefore
therefore,, Puerto
Ricans
Ri
cans went to Spain to obtain university degrees. Consequendy,
Consequendy, the educated
islanders were influenced by Spiritist ideology and brought it back to the Island.
1881 一"Centro
Officially the first
fìrst Spiritist group was instituted in the year 1881-"Centro
Union,"
informal Spiritist
Union," known today as "Centro Renacimiento." Nevertheless,
Nevertheless , inforrnal
1881 , as recorded by some Puerto Ri
Rican
can
activities took place many years before 1881,
(Ramos-Perea,
amos-Perea , 2011). By 1889 Spiritists
Spiriti
归 founded
founded
their first
fìrst
philosophers' writings (R
socioeconornic and religious backgrounds
charity hospital,
hospital, open to persons of all socioeconomic
(Rodriguez-Escudero , 1991).
(Rodriguez-Escudero,
Puerto Rican Spiritism (Espiritismo) 115
The first
fìrst reference to Spiritualism in Puerto Rico was in 1856 in La Guirnalda,
Guírnal
旬，
a popular Spanish magazine that reported an abundance of seance
s 臼nce
activity in San
]uan.
However, under Spanish political influence all Spiritist activities were
Juan. However,
suppressed,
suppressed, both by the government,
government, the Catholic Church,
Church , and the protomedicates. These last two basically were one social body. However
However,, a number of
Puerto Ri
Rican
can patriots acted to develop progressive legislative reform and spread
1873 , Don Manual Conchado ]uarbe
Juarbe,, a
Spiritism throughout the community. In 1873,
Rico,
co , presented to the Spanish Cortes a revision of a bbill
血 for
for
deputy from Puerto Ri
educational reform in which Spiritism should be substituted for the teaching of
metaphysics in secondary schools (R
(Rodriguez-Escudero,
odriguez-Escudero , 1991). In sum,
sum , the
Spanish period was characterized by social-political intolerance towards the
Spiritist movement-and
movement
一-and sporadic,
sporadic , active repression.
Under the American
American influence,
influence , however,
however, repression was released to a large
extent , giving way to the development of a significant
extent,
signifìcant presence of the Spiritist
movement in the early 20 th century. An example of this is that,
that, mainly due to the
Spiritist Federation campaign
campaign,, the death penalty was elirninated
eliminated as a corrective
option of
ofthe
the Puerto Ri
Rican
can penal code (R
(Rodriguez-Escudero,
odriguez-Escudero , 1991).
The North American
American Spiritualists' movement influenced the Island's belief
system towards accepting Espírítísmo.
Espiritismo. Overall,
Overall , America
America presented a sort
so 眈 of
of religious
and spiritual crisis; the romanticist and rationalist values,
values , together with new
perspectives of science and the need for a more personal encounter with the
spiritual, made Spiritism a perfect vehicle for the nourishment of its movement
spiritual,
(Herzig, 2001). Spiritism,
(Herzig,
Spiritism, in Puerto Ri
Rico,
co , is also associated with a nationalist
ideology. Spiritism teaches independence as a natural consequence of the spirit's
spirit' s
Ricans
cans adapted this knowledge,
knowledge , from a
evolution. Therefore
Therefore,, many Puerto Ri
sociological perspective,
perspective , as a way to appraise the Island's social-political reality.
But
But,, such ideas made Spiritism fall under prejudice and suspicion from the Spanish
colonial government. Religious freedom and tolerance was truly practiced after
American invasion in 1898. North American's
American's political dominance
dorninance gave way
the American
to the progressive movements of modernization and classical
classicalliberalism.
liberalism. Kardec's
work advocated that the State facilitate the expressions of fundamental civil
rights-free from harassment,
harassment, censorship
censorship,, and repression (Garcia-Leduc
(Garcia-Leduc,, 2009).
U
Under the new flag of U.S. colonialism, the Spiritist Federation was established in
1903. It campaigned to optimize civic democracy, separation between the church
and state, literacy, feminism, the abolition of the death penalty, and the right to
vote (Herzig, 2001).
Under this new air of social tolerance, by the last half of the century, behavioral
health professionals began to explore Spiritist healing procedures and their health
relevance in a systematic manner (for example, Koss, 1975; Rogler & Hollingshead,
1965). As the Puerto Rican migration made Puerto Ricans more visible on the
mainland, the American health system needed to better understand Puerto Ricans'
attitudes towards the health system. It had to find ways to encourage this group of
Latinos to engage with it.
116 ].
J. 50to Espinosa and].
and J. D. Koss-Chioino
The Social and Political Context of Popular Healing
in Puerto Rico
Puerto Ri
Ricans
cans are heirs to two equally popular but competing worldviews from
th century:
the 19
19 由
century:
the "scientific" and the "spiritual." Examples
Ex 组nples
of this conundrum
th century,
are the persistence,
persistence , since the late 19
19 由
centu
町， of the widespread philosophy of
"Spiritism" (Espiritismo)
(Espírítísmo) and the ready reception of the Cuban cult,
cult, Santeria,
Sante
1"i 旬， since
centu
巧. There are actually three main types of Spiritism in Puerto
the mid-20th
mid-20 th century.
Rico:
"Popular,"
oriented,"
Ri
co: "Popular
," "Christian oriented
," and "Kardecian." Popular Spiritist healing
rituals are focused on "working" with spirits in small home-based αntros
centros staffed by
four to six mediums,
mediums , most of whom are usually women. These centers hold two
or more weekly sessions with as many as 25 to 40 attendees. The mediums may
incorporate spirits and!
and/or
or experience visions in order to heal (sanar) supplicants,
supplicants ,
who bring a wide diversity of health and social problems (Garrison,
(Garrison, 1977;
Harwood, 1977; Koss,
Harwood,
Koss , 1975; 1977; Rogler & Hollingshead,
Hollingshead, 1965). Christian
oriented Spiritism is known as the Consejo Moral movement,
movement, which is even more
American countries such as Brazil,
Brazil , Colombia
Colombia,, and Mexico.
popular in Latin American
Although
Although healing is practiced,
practiced, this religious movement focuses more on the study
of moral and philosophical implications of individual distress as communicated by
spirits (Saavedra,
(Saavedra, 1969). The Kardecian movement has centers in most towns and
cities in Puerto Ri
Rico.
co. It values all of the above mentioned practices,
practices , including
healing. However,
However, it also focuses on philosophical and scientific study of the spirit
world
as "free thinkers,"
worldω"free
thinkers ," constandy seeking knowledge of the dual worlds of
incamate and disincarnate
incarnate
disincamate spirits (Ai
(Aizpurua,
zpurua , 2000).
Spiritist adherents and those who utilize healing rituals in Puerto Ri
Rico
co range
in social-economic
social-e conomic strata from lesser educated rural persons
persons,, to relatively rich upper
class persons,
persons , some of whom are politically influential. There is a wide range of
reasons for utilization of
ofSpiritist
Spiritist healing as detailed
detai1ed below.
The popular acceptance and practice of
ofSpiritist
Spiritist healing appears to be the result
ofwidespread
of
widespread social conflicts within a difficult island economy (Hohmann et al.
al.,,
1990). These situations are generated by a continuing quasi-colonial status which
creates numerous acculturative stresses. Variations on this form of popular ritual
healing have developed over the last three decades; Santeria,
Santeri
旬， a Cuban import,
import, based
on mosdy West Mrican religious beliefs and rituals,
rituals , has gained in popularity since
the mid-20th
mid-20 th century (Fernandez
(Fer 丁landez
0Olmos & Paravisini-Gebert, 2003). It has been
syncretized with Spiritism, mainly in the United States (often referred to as Mesa
Blanca), but may now be waning in Puerto Rico. There are also other religious
groups with healing practices that have steadily increased in popularity, such as
hundreds of Evangelical and Pentecostal churches. What we now call "comprehensive and alternative medicine" (CAM) has been increasingly accepted in this
mix of popular healing systems over the last three decades, and includes some
spiritually based healing disciplines (Koss-Chioino & Soto Espinosa, 2013).
Early observers of spirit healing among the less educated noted that popular
Spiritism was a resource for the less educated and lower socioeconomic classes to
Puerto Rican Spiritism (Espiritismo) 117
use to manage emotional and behavioral problems. Popular healing is used as a
chronic
血ness
illness,， difficult ffamily
ami1y problems
problems,, and
strategy to overcome the despair of chronic
discornfort-all
-all of the persistent
persistent 山s
ills that plague human beings. Although
Although
existential discornfort
the community mental health system was established in Puerto Rico beginning in
1963 , mandated to deal with severe behavioral problems,
1963,
problems , such as addictions and
Ricans,
cans , nevertheless persons from all socioeconomic
mental illness for all Puerto Ri
Rico
co take recourse to Spiritist healers in times of emotional
classes in Puerto Ri
distress. This is the case whether they are being treated by mental health
professionals in the public health system or privately seeing a pastoral counselor,
counselor,
psychiatrist, or prie
priest.
创. Theirs is a pragmatic approach to dealing with emotional
psychiatrist,
problems , whether caused by stress or physical
problems,
physical 血ne
illness.
岱.
Principles of Espiritismo: History,
Belief System
Histo
叩" Philosophy,
Philosoph
弘 and
and
Spiritism's basic principles have been borrowed from different philosophical,
philosophical ,
cultural, and religious traditions. It
cultural,
Itss ideas about the Supreme Being
Being,, life as eternal
and spiritual and as an evolutionary experience,
experience , the immortality of the soul,
soul, spirit
communication
communication,, the Law of Cause and Effect,
Effect, and reincarnation are not new.
However,, Spiritism contributes a new theoretical approach and an understanding
However
of these ideas from rationalist,
rationalist , naturalist,
naturalist, humanistic,
humanistic , non-dogmatic
non-dogmatic,, and
and
丘ee
free
is , in Spiritism,
Spiritism , the
thinker perspectives. The idea of a Supreme Being or God is,
acknowledgment of the existence of a greater intelligence that organized life. Life
is inexorably without end,
end, where the spirit continuously progresses through
different
di 岳rent
experiential stages of existence that
that
伊ide
guide it toward greater levels of
spiritual maturity,
maturi
町， individuality,
individuality , and humanism (D
(Denis,
enis , 1909; Novich-Hernandez,
Novich-Hernandez ,
1999). Therefore,
Therefore , the spirit/Self or consciousness,
consciousness , which is an emotional and
intellectual entity,
entity, develops from being unconscious to conscious of its self
individuality and independent decision making processes (Geley,
(Gel 町， 1995; GuimaresAndrade , 1992). The dynamics of
ofthis
this process is guided by free-willed decisions
Andrade,
which generate positive and negative outcomes that influence the souls'
evolutionary process. The spirit utilizes reincarnation as a method to access
nature , as well. Each
corporal life experiences,
experiences , beyond those of non-corporal nature,
dimension, assesses its moral and intellectual evolutionary
entity, while in the spirit dimension,
entity,
physicallife
life environment that cultivates
necessities to then select an appropriate physical
and complements the continuous formation of the Self
Self. In sum,
sum, life is viewed
essentially as one,
one , where sometimes the spirit acquires schooling through corporal
times without a body.
bodies,, and
and,, at other
other
由丑es
bodies
It is the reincarnation principal that mainly distances Espiritismo
Espírítísmo (Spiritism)
(Spiritism)
丘'Om
from
Spiritualism; reincarnation is not accepted by spiritualists
spirituali
血 (Moreira
(Moreira
& LotufNeto,
LotufNeto ,
2005a). Nevertheless,
Nevertheless , Spiritists,
Spiritists , through the use of the reincarnation factor,
factor ,
consider themselves to be better equipped to theorize upon concerns associated
with natural differences among individuals,
individuals , societies,
societies , justice,
justice, and ethical/moral
inequities at large. Although
Although Kardec considered Espiritismo
Espírítísmo a science,
science , it is equally
118 ].
J. 50to Espinosa and].
and J. D. Koss-Chioino
viewed by him as a philosophy. Science is the instrument that facilitates the
ofthe
the spiri
spirit's
t' s world (D
(Delanne,
elanne , 1990; Grosvater
Grosvater,, 1974).
exploration and validation of
The core Spiritist belief is that after a person's
person' s corporal death there is life after
life. This means that the disincarnated person's spirit can communicate with
incarnated spirits after the disposal of its body. The return of a spirit or its consciousness may present positive or negative effects over the environment where
such intelligent energy communicates. Communication will be dependent upon
the level of spiritualization to which each spirit has evolved within the spiritual
levels. Materialistic spirits tend to focus their psychological necessities towards the
reality, therefore,
therefore , insisting
material world; these tend to deny their new spiritual reality,
on reenacting activities they performed while incarnated. On the other hand,
hand ,
incarnated , limited to the purpose of
spiritualized beings may reappear among the incarnated,
sharing some idea that may inspire the observed to evolve on intellectual and moral
terrns. Therefore,
terms.
Therefore , Spiritist sessions continuously assess each of their participants'
intrusive , persistent
persistent,,
spiritual needs. And
And,, if a spirit is detected that insists on being intrusive,
the 丘ee
will of another person,
person, using the Spiritist diagnostic
and recurrent over the
free 飞Ni1l
obsession," mediums act to correct this situation.
condition,
condition, "spirit obsession,"
differs
丘om
from Christian possession in that Spiritism does not
Spirit obsession differs
acknowledge that a spiritual being was created with the only purpose of developing
destructive behaviors. Spiritism postulates that neither demons nor evil exists;
instead that life is surrounded by independent self-evolutionary decision-making
e fI汪cts towards the self and its
processes that develop positive and negative effects
environment. People and spirits are neither good
good,, nor bad; their moral character
is dependent upon their spiritual,
spiritual , intellectual
intellectual,, and moral self-evolution. Therefore
Therefore,,
the Spiritist psycho-spiritual therapy to treat spiritual obsession is known as "disobsession" therapy. Here mediums basically first educate the incarnated participants
Then, the mediumistic
about the existence of spirits and their possibilities of action. Then,
therapeutic team (mediums
(mediurns with clairvoyance,
cla 盯oya 配 e ， incorporation
incorporation,, telepathy
telepathy,, magg---among other faculties) works to detach the spirit
netism
netism,, automatic writin
writing---among
obsessor, and educate it. The incarnated person affected is informed about the ties
obsessor,
that attach them
them,, and about the mutual
mutua benefits for the spirit's retreat and
spiritualization. Another general core treatment issue, treated many times during
mediumistic sessions, is the identification of persons who are suffering due to their
misunderstanding of spiritual experiences, once mainstream medicine has been
exhausted. For example, some persons begin to hear voices that are logical,
coherent, relevant, intelligent, and able to offer details that are verifiable.
Nonetheless, these experiences are usually taken by psychiatrists for psychotic
symptoms that in spite of psychiatric treatment do not end. These participants in
the sessions are often viewed as mediums who are beginning their mediumistic
development. Consequently, if the participant agrees, he/she is trained to carry
out mediumistic work. Hence, what once was interpreted as psychopathology,
now, through knowledge of Spiritist work, is understood as an opportunity to
Puerto Rican Spiritism (Espiritismo) 119
spiritually develop and engage within a community healing network (KossChioino,
Chioino , 2012; Moriera-Almeida
Moriera-Almeida & Lotufo,
Lotufo , 200Sb).
2005b).
Spiritism and the Healing Process
In the early 70s,
70s , at the request of the Department
Departr
丑ent of
ofHealth
Health of
ofPuerto
Puerto Ri
Rico,
co , the
Health
例IMH)
(NIMH) for a
second author applied to the National Institute of Mental Health
inte 的ce between Spiritist healers and the public (mental)
grant to develop an interface
health
可stem
Rican
can Department of Health
health
system (Koss-Chioino
(Koss-Chioino,, 2008). The Puerto Ri
proposed that encounters of traditional spirit healers with mental health
professionals might
rnight facilitate the health department's
department' s mandate to deliver community care to the mentally
mentally
血，
ill, because popular healers saw more troubled persons
than did mental health care professionals. The NIMH division that received the
application sponsored a site visit of one of its project officers. At the San Juan
airport
airpo
眈 at
at the specified time Koss-Chioino and students met a distinguished older
distressed, claiming
clairning that our typical Puerto Ri
Rican
can hospiman. He was somewhat distressed,
airport , or arranged
tality was excessive,
excessive , that we should not have met him at the airport,
for his accommodations. That evening he was taken to a Spiritist healing session.
hir 丑 to
to the table to be
Halfway through the three-hour session the spirits called him
treated. In good grace he went to the table where the mediums
mediurns were seated and
afterwards demanded
dernanded that we translate what they (actually the spirits) had said. In
considerable discomfort,
discornfo
时， we softened the spirits' words: he would suffer
su 岳r from
cancer in the next several years! Despite his open disbelief in their prediction and
our fears,
fears , he recommended that the project be funded. Three years into the project
we received word
word
丘om
from the NIMH that he was no longer there,
there , having succumbed
to cancer!
This sort of revelation occurred many times in the course of research in Puerto
Rico. It was especially startling when a consultant or friend attending a healing
session for the first time
tirne would be told by the spirits about a serious illness that the
丘iend
friend had never discussed. How could the spirit mediums divine problems so
accurately when these visitors had never attended a Spiritist session?
Although educated Spiritists study and discuss Kardec's writings,
writings , and
Although
some channel the spirits' advice and predictions,
predictions , most adherents' contact with
Spiritism in Puerto Ri
Rico
co is in healing rituals at a centro as a medium or supplicant.
Explanations in the literature do not adequately account for Spiritist healers' work
work,,
the spirits' diagnoses and predictions
ofboth
both healers and supplicants,
supplicants ,
predictions,, or the affects of
both positive and negative. Here we describe a model of ritual healing
healin process
related to becoming a medium for most healers. There are three foundational
components: spiritual transformation, relation, and radical empathy. In this model
of the core elements of ritual healing process, spiritual transformation is both the
entry event in healer development and an ongoing personal experience of
healers-often begun when they undergo their initiatory experience (see, for
example, Csordas & Lewton, 1998; Katz, 1993; Katz & Wexler, 1990; Peters,
120 ].J. 50to Espinosa and ].J. D. Koss-Chioino
1981). Sufferers
Su 岳rers
in many healing traditions also undergo spiritual transformation
as a result of their contact with a tradition that recognizes its importance in healing
Among the Puerto Rican Spiritist healers studied,
studied, some sufferers
su 岳rers
were
practices. 2 Among
diagnosed as "in development" as a healer when they showed signs,
signs , such as vivid
illness , which
visions or communication with spirits during or following severe illness,
indicated that an spiritual awakening and/or transformation was taking place
(Pargame
叽 2006).
2006).
(Pargament,
Koss proposes a model supported by the assumption that cultural variations in
ritual healing-very different mythic worlds,
worlds , including different schemas to
procedures-are
re
identify illness and disorder and variations in many ritual procedures
elaborations of content and context rather than process (Koss-Chioino,
(Koss-Chioino , 2006). This
Hu 班ord's
of"core
"core spiritual experiences (CSE)" that "show
parallels Hufford's
(2005) notion of
complex and consistent subjective patterns independent of cultural context" (p.
33). Hufford proposes that core spiritual experiences form a "distinct class of
experience with a stable perceptual pattern"
pattem" (2005,
(2005 , p. 33). This is also characteristic
of spiritual transformation,
transforrnation, which could be considered a special variant of CSE.
Spiritual transformation appears to be particularly associated with rituals that heal
with spirits,
spirits , which have very similar forms across diverse cultures and regions of
the world.
We note that some healers do not undergo a painful wounding and transforrnation. Instead,
formation.
Instead, they experience deepening knowledge of the spirit world that
becomes inspirational and spiritually redirects their lives. Observations show that
they are no less effective as mediums who undergo transformative experiences;
they also serve to anchor a therapeutic space on behalf of sufferers. Whatever the
mediurns may
m 勾T employ or specialize in the use of clairvoyance,
clairvoyance ,
path to mediumship,
mediumship , mediums
automatic writing,
writing, intuition,
intuition, healing at a distance,
distance , telepathy,
telepathy, and incorporation of
spirits.
spmts.
•
Relationship of Healers to the "Sacred"
In most cultures living beings and spirit/god
spirit/ god beings are commonly believed to
occupy separate realms. In Spiritism spirits are visible under special ritual
circurnstances but may also appear to persons outside of the ritual context who
circumstances
have developed the faculties to see into or communicate with the spirit world
(Koss-Chioino , 2006). Actual contact with what is deemed sacred is often achieved
(Koss-Chioino,
when living beings and spirit/god
spirit/ god realms
realrns interpenetrate. Sacred space is created
spirits/gods. Communion
anew at each ritual session through communion with spirits/gods.
(defìned this way) may take three main forms:
(defined
forrns: visions of the spirit world; journeys
joumeys
to that world; and voluntary (but
(b ut 址so
also involuntary for persons who are not
"developed") intimate contact (i.e.,
(i.e. , embodiment,)
embodiment,) with spirit beings. In Spiritism
for example,
example , embodiment both by a protector/guide
protector/guide spirit or by an intrusive,
intrusive , often
0 丘en
ham 由Iψirit
0 肘 's own spirit).
harmful
spirit takes place (the latter resulting in displacement of one's
Healers leam
learn how to control communication with spirits or gods through the
Puerto Rican Spiritism (Espiritismo) 121
tutelage and!or
and/or observation of other healers. The most important
ir 丑portant
aspect is that
in ways that are both personally and cosmically
they experience spirits
spiriωlnw町s
cosrnically meaningful
meanin
弹ù
(Koss-Chioino,， 2006). In fact,
0王oss-Chioino
fact , all of the spirit-medium
spiri medium healers worked with (over
100) did not identify themselves as "healers,"
"healers ," but rather as the vessels through
which healing forces are summoned and transmitted
transrnitted to and from supplicants.
spirits , high or low,
low, good or
Spiritist healers say that they "lend their bodies" to spirits,
misguided , who are agents of
misguided,
ofboth
both distress and removal of distress.
Given widespread belief in the special qualities of extraordinary beings across
many
rnany cultures
cultures,, experience of these beings during a life-threatening illness can make
aa 吨nificant
IS in
m a state of high emotional
significant irnpression
impression on the sufferer (who is
arousal-confused, fearful,
arousal-confused,
fearful , desperate,
desperate , and socially withdrawn). As Frankl (1959)
since) , there are many reports of tranobserved long ago (and many writers since),
scendence in the context of suffering,
suffering, facilitated by both psychological and physical
present
时 who
who
establishes a meaningful association between a
factors. If a healer is prese
from , danger and!
and lor
or suffering,
su 岳ring ， the
spiritual entity and the hope of,
of, or actual relief from,
spirit can take on significant personal meaning for the sufferer. This then appears
(spirits , God
God,,
to reinforce or establish belief in the power of extraordinary beings (spirits,
gods)
gods),, as has been noted throughout years of anthropological writings on illness
rnight say,
s 町， following Csordas (1994)
(1994),, for those who hold a
and healing. One might
self, that the spirit-other becomes "embodied" within
worldview centered on the self,
lf. In Spiritism and numerous other spirit-healing cults,
cults , embodiment of spirit
the se
sel£
continual, often lifelong,
lifelong, presence of one or more spirit
can be experienced as the continual,
protectorl
alters with whom a special relationship is maintained. A personal spirit protector!
guide (or several) in Spiritism makes healing work not only possible but also safe
from contagion,
contagion , that is,
is , free of being affected by distress-causing spirit beings
brought to the healing session on behalf of suffering clients.
Spiritist healers described vivid,
vivid , dissociated states during their initiation illness:
"doubled ," "suspended from the ceiling looking down on
they saw themselves as "doubled,"
themselves lying in bed,"
bed ," and said they
th 句 "knew"
"knew"
they
th 句T were dead and their soul had
retum to
separated from their body. A strong emotional impact
irnpact lingers after their return
the daily world; familiar
farniliar landmarks of adaptive feeling and thinking appear to lose
th internal passage of time is either distorted or missing
their meaning. Marking of the
during the crisis phase of the illness. In this state of consciousness the novitiate
healer acquires the capacity to see into and then direcdy experience the spirit!
God! gods realm. The affects in this experience of the sacred are deep fear, awe,
and fascination. Later, the novitiate gradually learns how to interact with beings
in this realm and loses some of the fear and awe, but never all of it. These
experiences seem to have a strong effect on the sufferer's view of their life world
and their role in it. What the recovering person reports is a sea change, a transformation that includes the realization of a mission on which they feel compelled
to embark, albeit with the aid of the extraordinary being(s) encountered during
their illness. Heightened social bonding is also a common outcome. And there is
•
122 ].J. 50to Espinosa and ].J. D. Koss-Chioino
fear and awe,
awe , as well as fascination,
fascination , much as Otto (1923) describes. These changes
are not always or immediately acted upon,
upon , however. 3
Facility at visual imagery,
imagery, as the beginning and most common form
forr 丑 of
of communion with the spirit realm
realm,, seems to emerge from the initial crisis event when
the novitiate healer begins to interpret
interpret,, concretize
concretize,, and integrate belief in what
she/he has "seen" while in an altered state. In Spiritism,
Spiritism , as in other shamanic
healing practices
practices,, this ability is cultivated and expanded through the tutelage of
healer-adepts , but it also seems to be cultivated by the healer herself/himsel
healer-adepts,
herself/himself
f. Many
ascribe this ability
ab 血ty to the teaching of a spirit.
Although
Although largely speculative,
speculative , we will attempt to briefly describe the current
ofSpiritism
Spiritism in Puerto Ri
Rico
co and the United States. In general,
general ,
extent of popularity of
in both places,
places , spirituality as an interest and experience among Latinos is more
widespread now than it was in the 20 th century,
century, both within and without religious
Rico , many Catholics attend mass and observe the
institutions. In Puerto Rico,
sacraments but also may take recourse to Spiritist rituals when they or family
fanúly
members are in distress. This is not the case,
case , however
however,, for those involved in
evangelical churches,
churches , such as Baptist or Pentecostal. More Puerto Ri
Ricans
cans and
North Americans
Americans now enjoy a college education
education,, and many exercise an intellectual
interest in spirituality. In Puerto Ri
Rico
co this is aided by visiting lecturers
lecturers
丘om
from the
US
USandand 丘om
from some Latin American
American countries,
countries , such as Brazil and Venezuela. Small
town folks,
folks , outside of the large metropolitan areas,
areas , continue to practice spirit
th century.
20 出
century.
healing in their home-based centers as they have since the early 20
In Puerto Ri
Rico
co we are now documenting how conventional medical doctors
who experienced Spiritism as papart
此 of
of early family
fanúly life,
life , or have been spiritually
transforrned by traumatic
traurnatic events
events,, incorporate their beliefs in spirits,
spirits , or their ability
ab 血ty
transformed
to be psychic
psychic,, into their
their,, mainly allopathic
allopathic,, clinical work.
A group of
ofBrazilian
Brazilian Spiritists have been establishing centros across the United
States , in addition to several of
States,
ofPuerto
Puerto Ri
Rican
can origin dating back to the 1950s and
1960s. There is a Brazilian Spiritist Medical Association
As sociation that has held two annual
meetings in the Washington,
Washington, DC area and also one in Fl
Florida.
orida. This is one aspect
of a series of conferences
conf 泣ences
that
that
组m
aim to link Spiritist principles and healing techniques
with mainstream medicine in the United States,
States , according to the model of
psychiatric hospitals in Brazil
Bra (Bragdon, 2012). Given this growing popularity, the
future of Spiritism looks quite promising, even though beliefin and experience of
spirits is still suspected of heresy and superstition in many formal religious settings,
and of pathology in many conventional psychiatric institutions.
Espiritismo and Mental Health Care Practices
As referred to above
above,, Koss-Chioino was invited by the NIMH to submit
subrnit a proposal
Rico
co that would incorporate
inco 叩 orate
Spiritist healing practices as a
for a project in Puerto Ri
community mental health resource. The Division of Mental Health of the
Department of Health of Puerto Ri
Rico
co had been reorganized as a community
Puerto Rican Spiritism (Espiritismo) 123
mental health program in accordance with the U.S.
u.s. Community Mental Health
pa 眈 of
of its community
Act (1963),
(1963) , and its chief agreed to sponsor the project as part
mandate. Moreover
Moreover,, Spiritist practitioners were perceived as seeing more persons
in emotional distress than did the community mental health clinics. The general
goals of the Therapist-Spiritist Training Project as conceived in 1975 were: 1) to
establish a forum for the meaningful mutual exchange of information between
Spiritist mediums and mental health professionals (p
(primary
rimary care medical doctors in
training were later added); 2) to offer a training curriculum to transfer knowledge
and skills across the two healing systems; and 3) to develop new psychotherapeutic
approaches from a synthesis of the most relevant and effective healing techniques
in both systems. It was decided to run the same program in three different
di 盗erences
in community
communities for three years,
years , in order to explore possible differences
response and conditions for replication.
Data from the Spiritist-Therapist Training Project documented the types of
complaints taken to the Spiritists compared with those brought to the mental
Almeida & Koss-Chioino,
Koss-Chioino ,
health system (Koss-Chioino,
(Koss-Chioino , 1992; 1995; MoreiraMoreira-Almeida
2009). Forty-nine medium healers were the focus of several studies that included:
interviews in which they told their life stories,
stories , especially their development as spirit
healers; videotaped observations of them at work in their centros (p
(portrayed
ortrayed in four
ai1able); and interviews with a sample of new clients
video-shows that are still
sti1l av
available);
they treated at centro sessions. Participants who contributed their life stories and
samples of patients also included 38 mental health professionals and 17 medical
residents. These data showed a clear division oflabor: non-serious emotional and
Spiritis
队 and
and
severe emotional
bodily distresses were more often brought to the Spiritists,
mental
山ness)
illness) was most often seen by mental health
distress (diagnosable as mental
professionals. However
However,, many
rnany persons used the two systems consecutively according to the amount of relief each was expected to provide,
provide , or due to dissatisfaction
with any of the interventions.
The most salient outcome was that Spiritists and therapists began to refer
themselves to the other healing system for help; they later began referring a few
patients. The possibility of formalizing referrals was realized when a mental health
project, who had experience with Spiritism through
technician participating in the project,
seeking help for her schizophrenic mother, made a suicidal gesture. She was found
by a boyfriend who took her to a health center in a town they were visiting. The
attending physician had been at the project seminars and agreed with her plea that
she not be referred to mental health services. Instead she self-referred to a wellknown Spiritist medium who participated in the project. She told the physician
that she was afraid she would lose her job if treated in a mental health setting. He
also felt that she might get better care (i.e., protection against another attempt)
from the Spiritists, since he was dissatisfied with the lack of attention given another
of his patients at the Community Mental Health Center (CMHC) emergency
service. When the crisis had passed the therapist called a meeting of her colleagues
and her supervisor at the home of the Spiritist who had cared for her and whose
124 ].J. 50to Espinosa and ].J. D. Koss-Chioino
sessions she was still
sti1l attending. Under the thin disguise of an anonymous
anon 严nous
recording
as a "training" vehicle,
vehicle , she told the story of her psychological crisis. Since the
(i.e.,, taken over by a spirit),
spirit) , she could
Spiritists had diagnosed her as "obsessed" (i.e.
claim lack of awareness of her actions and lack of responsibility;
responsib
血ty; therefore,
therefore , she did
clairn
not expect negative sanctions. Her plan worked. It illuminated
illurninated the dilemma faced
by mental health professionals who feel they cannot seek help for emotional crises
from their colleagues. This lead to the establishment of a referral unit at the
CMHC where we held the program during the second year.
The referral unit had its beginnings in the very first year of the Project's
Project' s
programs when four therapists and eight other CMHC staff participants consulted
anon 严丑ous patients. In years 2 and 3 a few referrals by Spiritist
Spiritists about their anonymous
themselves , to mental health professionals,
professionals , and
participants
participants,, of their relatives or themselves,
referrals by therapists to Spiritists also occurred. We documented this process for
four mental health workers and six medical doctors; in addition,
addition , four Spiritists
consulted mental health professionals for their own problems. Once they acquired
more knowledge about mental illness the Spiritists developed a new etiological
category,
cause,"
," an addition to the usual dichotomy into material and
category, "psychic cause
spiritual causes
causes,, and a label that pointed to the need for psychological or psychiatric
treatment.
Conclusion
Research into Spiritism as an ethnomedical practice continues to be important
impo 眈:ant
since distressed persons of various social strata and ethnicity in Puerto Rico and
solace
丘om
Spi 由ist mediums,
mediums , as well as
as 丘om
from compleelsewhere seek help and solace
from Spiritist
mentary and conventional medicine. One attraction of Spiritist healing is that it
avoids the stigrna
stigma of psychiatric
psychiatric 血ness;
illness; it is also person-centered and empathic. It
deals with spiritual crises without being dogmatic;
dogrnatic; supplicants feel supported and
Spiritism as an ethnomedical system illuminates
illurninates one kind of
understood. Study of
ofSpiritism
spirituality that is a model for health and mental health clinicians.
Notes
1. In Brazil alone
alone,, the three main publishing houses of the Spirits' Book (Federação
(Federac;ao Espirita
Espírita
Brasileira,, Instiruto de Difusão
Difusao Espírita
Espirita,, and LAKE) have sold more than 4
4.5
Brasileira
.5 million
copies and new editions have been continuously printed.
2. What
What is healing? There are many
rnany versions of what healing means; a common
the word as "wholeness
"wholeness,"
its many
ten 丑 translates
translates
由e
," with all of
ofits
explanation of the English tenn
implications. Barasch (1993) provides a useful
use 岛llistlist of
offive
five healing outcomes (apart from
sensitization,, in which healing restores communication
curing a disease or injury): 1) sensitization
within onese
oneself;
lf; 2) acceptance of pain; 3) finding meaning; 4) restoration of balance
(Physical,
social,, emotional
emotional,, spirirual
spirirual,, etc.); and 5) willingness
(p
hysical, social
w 山ingnes
唱 to change one's behavior
and
and 且fe
life style
style,, to adapt to new circurnstances.
circumstances. The model implicates all of these aspects
of healing and is also inclusive enough to chart how each
each
句pe
type is facilitated for both
healers and clients. However,
However, that exercise is beyond the scope of this chapte
chapter.
r.
Puerto Rican Spiritism (Espiritismo)
125
3.
3.
阻挡ly
Highly significant
si 伊ificant
mystical or transcendent experiences
experiences
缸'
aree reported to be associated
with extensive change in the person's life in Puerto Rico,
Rico , apart
apa 时丘om
from development as
a spirit healer or santero. It might also be noted that spontaneous visions of deceased
persons are frequently reported
repo 眈ed by non-healers and nonbelievers in Spiritism,
Spiritism, but they
often involve personal meanings rather than cosmic or mystical associations.
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10
REVIVAL
REVIVAl
An Indigenous Religion and Spiritual
Healing Practice in Jamaica
William Wedenoja and Cl
Claudette
audette A. Anderson
Introduction
Revival is an indigenous ]amaican
Jamaican religion,
religion, with roots in West and Central Mrican
religious traditions and a slave religion known as Obeah. It took shape under the
Although a unique product
influence of Christian missionaries in the 19th century. Although
of
Jamaican history
history,, Revival
Revival,, which is also known as Zion or Revival Zion and
of]amaican
as Pocomania,
Pocomania , has much in common with other Mrican-derived religions of the
Caribbean. It is fundamentally Mrican in the centrality of spirit possession and
warfare , but it has also made significant
spiritual healing,
healing, as well as spiritual warfare,
accommodations to European Christianity.
Revival healing or Balm generally occurs in places called "balmyards" as well
as in Revival healing services,
services,, and various "duties
"duties,"
"tables,"
services , worship services
," "tables
," and
Spiritualists , Mothers or
feast services. Practitioners-known variously as Spiritualists,
"Moddas",
Pastors,, and PhysiciansPhysicians-specialize
"Moddas" , Bishops,
Bishops , Pastors
pecialize in the relief of suffering,
su 岳d 吨，
mental
山nesses
Although marginalized and
including mental
illnesses,， seen as spiritual illnesses. Although
and, in our view,
view, is an effective
e 岳ctive
criminalized
criminalized,, Revival healing is practiced widely and,
and indispensable complement to the ]amaican
Jamaican biomedical system.
period ,
Indigenous religion and healing were demonized during the colonial period,
which formally ended with independence in 1962,
1962, but they have gradually gained
period, beginning with a famous report on the Rastafari
respect in the postcolonial period,
movement (Smith,
(Smith , Augier
Augier,, and Netdefo
Netdeford,
时， 1960) that paved the way to its
Kumina , Revival
Revival,, and even Obeah have been
acceptance by society. Since then Kumina,
subjects of research by prominent ]amaican
Jamaican scholars such as Seaga (1969),
(1969) ,
(1978) , and Chevannes (1995); articles in the popular periodicalJamaica
Brathwaite (1978),
A 正ncan
Journal issued by the Institute of ]amaica;
Jamaica; and exhibits produced by the Mrican
Caribbean Institute of
of]amaica
Jamaica,, including one on Obeah in 2011.
201 1.
•
Revival
129
The public is generally supportive of traditional healing
healing,, particularly the use of
herbs or "bush,"
"bush," so the practice ofBalrn is likely to persist for some time,
time , even if
the Revival religion itself does not. The medical profession,
profession, on the other hand,
hand,
takes a dim view of it,
it, believing that healers are guilty of practicing medicine
without a license. From the perspective of the law,
law , healers are also engaging in
sorcery or Obeah,
Obeah, which is prohibited by Acts passed in 1760,
1760 , 1810,
1810 , 1817,
1817 , 1833,
1833 ,
be practiced clandestinely,
and 1898 and renewed in 1973. Therefore,
Therefore , healing
heali
吨 must
must
clandestinely,
wi1l "look the other way" so long as healers keep
although police and government will
profùe or operate within the setting of a church.
a low profile
Spiritual healing is not a dangerous activity. Nothing in our long association
concemed about them. Indeed,
Indeed, we have
with Revival healers gives us reason to be concerned
wise , caring
caring,, trustworthy
trustworthy,, and sincere people who
found Moddas to be generally wise,
are skilled in human
hurnan relationships. Nor is spiritual healing antagonistic to medicine.
In fact,
fact , healers themselves seek medical attention when necessary,
necessary, and they refer
their patients as well. Healers and doctors are not competitors but complementary
ofhealth
health care that have coexisted for centuries C:V
c:vom
parts of a single overall system of
Eigen, 1992). Although
Eigen,
Although biomedical and ethnomedical systems are based on different epistemologies,
epistemologies , and serve different needs,
needs , patients demand both. They go to
the medical doctor with natural illnesses and injuries,
injuries , and seek herbal medicines
as well as spiritual counseling and emotional support from spiritual healers. Healers
are not practicing medicine in the biomedical sense; nor are they practicing
roots , a tradition of
sorcery. They are carrying on a cultural tradition with Mrican roots,
problem solving that relies on spiritual experience and knowledge. According to
this tradition,
tradition, spirits influence our lives,
lives , for better or worse,
worse , and we must therefore
attend to them. Those of us who cannot believe in spirits can at least concede that
healing is a form of
ofpsychotherapy
psychotherapy (Frank,
(Frank , 1974; Torrey,
Torrey , 1972) or
or" "folk
也lk psychiatry"
但时，
symbolically
叩esent
represent subjective or mental
chiatry"
(Kiev, 1964) in which spirits symbolically
realities. Healers are more like counselors or psychotherapists than doctors. But
professional counseling and clinical psychology are not well established inJamaica.
in Jamaica.
And
And even if they were,
were , healers would sstill
ti11 be in demand because of their spiritupsychologists,,
ality,
ality, which is immensely
irnmensely popular and something that counselors,
counselors , psychologists
and doctors gener
generally do not provide (Griffith, 1983).
Traditional healers should be allowed to practice publically, perhaps as "spiritual
counselors." But some regulation would be necessary to protect the public, as is
the case with other professional services. The distinction between Revival and
Obeah is fuzzy. The Obeah Worker has the reputation of being a charlatan who
takes advantage of desperate people. In addition, herbal remedies, like medicines,
can be harmful. Government should therefore set standards and license and regulate
healers. It is too easy for government to be repressive, or at least to be perceived
as such, particularly by a profession that has always been marginalized. Therefore,
healers need to regulate themselves as much as possible, by forming an association.
One possible solution could be to create an advisory or regulatory board comprised
130 W. Wedenoja and C. A. Anderson
of representatives from the biomedical community,
community, the healing community
community,, and
researchers.
One of the main advantages of licensing is that healing would come under
public scrutiny. Healers could be made
rnade to pay licensing fees and taxes and maintain
proper accounting standards and hygiene. They would have to adhere to a
professional code of ethics. Government could provide training in health care to
licensed healers and facilitate referrals to biomedical practitioners. Surely these
measures would lead healers to a higher standard of practice while reducing the
illne
岱 and
and meeting the needs of
stigma of traditional healing practices and mental illness
the poor in particular.
The first step is to repeal the Obeah Act,
Act, l which defines Obeah so broadly that
it could encompass any form of religious activity,
activity, if not the study of it. The law
Man, 2) being in possession of instruments of
proscribes 1) consulting an Obeah Man,
Obeah,, and 3) composing,
Obeah
composing, printing,
printing, selling,
selli 吨， or distributing printed matter
promoting "the superstition of Obeah,"
Obeah ," the punishment being imprisonment
and/or
and/
or flogging. Obeah laws were originally passed to deter resistance to slavery;
A 缸can culture
hence , they are unnecessary today and only serve to marginalize African
hence,
and privilege European culture,
culture , which "has left very deep scars" on the Jamaican
psyche , according to the psychologist Madeline Kerr in her classic and incisive
psyche,
book Personality
Personalíty and Conflict
Confiíct inJamaica
ínJamaíca (1952,
(1952 , p. x).
Additionally,
Additionally, government can and should promote research on healers. This
can be accomplished via grants to the Institute of
Jamaica,, the Mrican Caribbean
ofJamaica
Institute ofJamaica,
o fJ am 组ca ， and the universities,
universities , all of which have a mandate
rnandate to investigate
and promote the cultural heritage of Jamaica. The results of this research should
be disseminated
disserninated to the public. Healers would be encouraged to dialogue with
researchers and with each other in conferences and workshops. A systematic
systernatic study
of balmyards and healers would be necessary
nece 岱ary to assess the income potential and
health benefits of integrating folk psychiatry and psychotherapy into Jamaica's
perrnitting healers to practice
biomedical system. Repealing the Obeah Act and permitting
postcolonial, postopenly are vital first steps in healing the mental dis-ease of a postcolonial,
(Wedenoja,
edenoja, 2012).
slavery society that has long been forced to reject its own roots (W
The Emergence of Revival
Religion is a central facet of
ofJamaican
Jamaican life
life,, and it seems to have three forms: 1)
Moravians,, Baptists,
European denominations,
denorninations , including Anglicans,
Anglicans , Moravians
Bapti
邸， Methodists,
Methodists ,
Congregationalists,
Congregationalists , and Presbyterians (now merged in the United Church),
Church) ,
Quakers
Army , which are waning; 2) American
American evangelical and
Quakers,, and the Salvation Army,
Pentecostal churches such as the Adventists and several branches of the Church of
God,, which are very popular; and 3) religions that are indigenous to Jamaica,
God
Jat 丑aica ，
Kromantí or Maroon religion,
religion , Myalism,
Myalísm , the Native Baptists,
Baptists , Kumina,
Kumína ,
including Kromanti
Revival , Pocomania,
Revival,
Pocomanía , "Science,"
"Science ," and Jah Rastafarí
Rastafari,, which emanate,
emanate , to varying
de 罗ees ， from Obia
Obía or Mrican spiritualism (Anderson,
(Anderson, 2010).
degrees,
Revival
131
Revival is built on a syncretic foundation that includes Central and West
Mrican religion and European missionary
uússionary Protestantism. It is fundamentally
A
缸can in its emphasis on ritual possession by a pantheon of intermediary spirits
Mrican
that bear messages from God; a papattern
忧em of worship based on polyrhythmic
polyrhythnúc drumming,
uúng, dancing,
dancing, and polyphonic song; elaborate mortuary rites to satisfy departed
ancestors; healing practices that extend to all problems in living; and spiritual
duppies, restless souls that linger near the roots of silk cotton trees and
combat with duppies,
living
何redenoja
(Wedenoja,， 1988
1988,, p.l06).
p.106).
can be captured and set on the living
The first recorded indigenous religion and medical practice was known as
Obeah. Obeah Doctors interceded with spirits,
spirits , to practical ends; healing the sick,
sick,
protecting crops from thieves,
property,
revenge,,
thieves , finding lost or stolen prope
此y ， gaining revenge
predicting the future
0 岳ring
protection from sorcery (Edwards
future,, and offering
(Edwards,, 1794). But
Obeah acquired a sinister reputation. Obeah Doctors were feared for their skill in
poisons , and they led numerous revolts,
poisons,
revolts , such as Tacky's Revolution in 1760,
1760 ,
which led the Jamaica Assembly to pass the first of several
severallaws
laws criminalizing
crinúnalizing
Obeah.
Obeah Men allegedly performed a ceremony called the "Myal Dance" to bring
people back from death by administering a tonic and dancing around a subject "in
a circle,
(Lewis,
circle , stamping the ground loudly with their feet" (L
ewis , 1834,
1834 , p. 354),
354) , as in
the "shouting" or "laboring" ritual practiced by Revival groups today. This
practice became the core of an indigenous slave religion called Myalism. Myalists
were also skilled at herbal remedies and often employed in the "hot houses" or
slave infirmaries on plantations during the latter years of the 18th century (Sheridan,
(Sheridan,
1985).
A
uúnister named George Lisle euúgrated
A 丘eed
freed slave and ordained Baptist minister
emigrated to
Jamaica from America
America and established the Jamaica Baptist Free Church or "Black
Baptisω" in Kingston in 1784 (B
(Brown,
rown, 1975). His church grew rapidly,
rapidly, but some
Baptists"
of his leaders deviated
deviated
丘om
from his teachings,
teachings , apparently drawing on Myalism as they
emphasized visions,
visions , dreams
dreams,, and spirit possession and formed independent "Native
Baptist" groups (Schuler
(Schuler,, 1979). Lisle sought assistance from the British Baptist
uússionary in 1814,
1814, and the Baptists quickly grew to be the
Society
Society,, which sent a missionary
most popular mission
uússion (Phillippo,
(Phillippo , 1843). A major insurrection known as "the
Baptist War" occurred over the Christmas holiday of1831 in northwest
northwestJamaica.
Jamaica.
The revolt was organized by a slave and Baptist deacon by the name of Sam or
"Daddy" Sharpe (Reckord, 1969). The seriousness of this revolt, which the
planters blamed on missionaries, particularly the Baptists, and the severe reprisals
inflicted by planters on slaves and missionaries, led Parliament to pass an Act of
Emancipation in 1833 ending slavery in the British Empire.
A peasant society emerged after Emancipation with assistance from missionaries.
But there was great hardship, due to the abrupt shift to free labor, demands for
rent, wage disputes, severe drought, and a cholera epidemic, which was blamed
on duppies and Obeah. Myalist "angel men" searched for Obeah substances using
a talisman called the "amber," hunted down Obeah Men, and recovered lost
132 W. Wedenoja and C. A. Anderson
"shadows" (souls) in the "Great Myal Procession" of 1841-1842,
1841-1842 , with similar
1845 , 1848
1848,, 1849,
1849 , and 1852
1852
但
(Buchner,
uchner
， 1854). Membership in the
incidents in 1845,
Christian denominations declined dramatically (patterson,
pp. 214-215).
(P拙erson
， 1967,
1967 ， pp.21
←215).
Missionaries sought to counter their decline by initiating a revival campaign in
1860 , which spread rapidly across the island,
1860,
island, as thousands sought redemption from
sin. This "Great Revival" took on an ecstatic fonn in 1861 under the influence of
Native Baptists and Myalists,
Myalists , who led proce
processions
岱ions
from village to village,
village , singing,
singi
吨，
drumming
," and gaining powers such as divination
drumming,, becoming possessed by "angels
"angels,"
and healing (Gardner,
(Gardner, 1909; Henderson,
Henderson , 1931). A new indigenous religion
"Revival," which persists
persisωto
to this day. Revival became
emerged, known simply as "Revival,"
emerged,
the spiritual backbone of the emerging peasant culture,
culture , in a society increasingly
jamaicas,"
," black
divided into what the historian Philip Curtin (1955) called "Two Jamaicas
and white,
white , indigenous and European.
Revival , with healing
Revival flourished for several decades after the Great Revival,
lkins , 1977) due to chronic distress,
distress , rampant
r 缸丑pant
becoming increasingly prominent (E
(Elkins,
disease , and lack of medical care. The religion also continued to evolve,
evolve , being
disease,
influenced by the arrival of the Salvation Anny from England and Holiness
churches from the United States. The culmination of the Revival tradition was
the millenarian movement of Alexander
Al exander Bedward
Bedward,, a healer who blessed the waters
of the Hope Ri
River,
ver, near Kingston
Kingston,, and invited crowds numbering as many as
12 ,000 to be cured by it. Bedward was arrested and committed to an asylum
12,000
asylur
丑 in
m
1921 (Beckwith,
(Beckwith , 1929). Revival was eclipsed by the Adventist and Pentecostal
century
何Teden
(Wedenoja,
叩， 1980
1980,, 2002) and came to commovements during the 20 th century
mand a very small following as a religion,
religion, although remaining popular as a healing
practice. Today,
Today , however
however,, the religion seems to be enjoying a resurgence.
The Revival Healer
Revival healers are almost always women,
women, commonly called "Mothers" or
"Moddas,"
"Moddas ," who define themselves
thernselves as spiritualists or spiritual healers. Revival
"physicians," and say they are doing
healers may also refer to themselves as "physicians,"
"physician work" (in the esoteric sense). Healing is understood to be a "gift"
"gifγof
of
the Holy Spirit,
God that teaches one how
Spirit, bestowed by a "messenger,"
"messenger," an angel of
ofGod
to heal and guides the practice. The messenger may take one on a journey
joumey in the
world , to gain knowledge and power. In return,
retum , the healer is obliged to
t。
spirit world,
"feed" the spirit. Healing is also a duty or obligation incurred in a "vision,"
"vision,"
typically during a severe
severe
山ness
Therefore , one
illness,， as a condition for getting well. Therefore,
cannot refuse this calling. People who become healers typically say they had strange
drearns and visions as a child and were often sickly or otherwise different. These
dreams
calling, which is often resisted but finally accepted.
episodes are interpreted as a calling,
A healer has at least two major powers. In addition to healing,
heali
吨， there is the gift
of discernment;
discemment; that
that
民
is, healers
healers
can see and identify
identify
职
spirits
rits
others cannot
cannot,, and
interpret messages from the spirit world. Discemment
Discernment also allows the healer to
Revival
133
"read" the condition of a client,
client, as well as their past and future. Some claim to
even feel the condition of the patient in their body and"
and "draw"
draw" their pain. Revival
prophecy, to see into the future,
future , and often issue
leaders commonly have the gift of prophecy,
"warnings" of ‘,:Judgment."
Judgment." Leaders and healers have mastery over the experience
of trance,
trance , and can enter and exit the state seemingly at will,
w 血， to consult their
messengers.
The charismatic authority of a 叩
spiritual
s pirit 阳
u 址 calling
callir 吨 and
an时
dsψpiri阳a
spiritual
过I ♂f
gifts
缸
ts are
aref 也
foundations
∞
01 un叫
d缸
ation
t岛
or healing
ir 丑portant
too. Healers are
for
healing,, but certain personality characteristics are important
often strict,
strict, authoritarian figures,
fìgures , who command respect. They have to show selfconfrontational, using
confìdence to retain a following and clientele. They may be confrontational,
confidence
the force of their personality to change the direction of people's
people' s lives. At the same
m
时， they must be caring and empathetic too. Hence
Hence,, as Wedenoja (1989) has
time,
mother-fìgure , and mothers are revered in ]amaica.
Jamaica.
argued, a healer is a strong mother-figure,
argued,
Most Moddas are associated with a Revival church. Revival provides the
theological rationale for their work
work,, which is always defined
defìned as spiritual healing.
Typically, the founder and leader of a church is a healer.
Typically,
The Revival Church and Balmyard
Revival is a pragmatic,
pragmatic , this-worldly religion based on dramatic rituals and an
ofThe
The Spirit to affect
a 岱ct human affairs. Virtually every
unshakable beliefin the power of
group , formed by an inspired leader,
leader,
Revival congregation is an autonomous group,
typically in response to a vision or dream. Congregations are normally small,
small ,
ranging
from 10 to 50 in number. The membership is generally poor
rangrng
丘om
poor,, although
forr 丑
some Revival churches are now attracting middle-class followers. Members form
a close-knit,
close-knit, supportive community and worship together several times a week.
The place of worship could be as simple
sirnple as a bamboo "booth" or a board shack
with a tin roof,
roof, but some older and more successful groups have built
b ui1t substantial
ui1dings. The leader typically lives in a house next to the church.
concrete bbuildings.
Some Revival
receive a special "gift"
Revivalleaders leaders 配eive
"gifγof
of healing from God and operate
center, where healing is performed regularly,
regularly, both in public
a balmyard or healing center,
irnportant source of income for the
services and in private sessions. Healing is an important
leader and for the church. Private healing sessions are particularly remunerative.
church , but some do not have
A balmyard is generally associated with a Revival church,
congregations , although they usually hold a short service before seeing clients. In
congregations,
either case,
case , the ]amaican
Jamaican balmyard is understood to be a holy place where people
e 岱ct healing.
are "working The Spirit" to effect
and/or
or balmyard is one or more tall poles
A common sign of a Revival church and!
with colorful banners,
"pilgrims," particularly
banners , erected to attract spirits as well as "pilgrims,"
everγchurch
church there will be a circular clearing
those in search of healing. Outside every
with a pillar in the center and a glass
gla 岱 of
of water with "leaf-of-life"
"leaf二 of 二life"
in it and various
丘uits
fruits on top. This is a sacred place called the "seal" or "seal ground" where
"angels"
"angels"
但
(Biblical
iblical
spirits) dwell. Services include announcements,
announcements , invocations,
invocations ,
134 W. Wedenoja and C. A. Anderson
prayers,
Bible,, fasting,
prayers , readings from the Bible
fasting , "testimonies,"
"testimonies," sermons,
sermons , and hymns and
"lively choruses" sung to musical accompaniment during which people stand and
often dance.
Every effort is made to attract spirits to a service,
service , using banners,
banners , altars,
altars , candles,
candles ,
uniforms , specific colors,
colors , flowers,
flowers , oils
scents , drumming,
drumming, singing,
singing, and the like.
uniforms,
oils,, scents,
The spirits are called ‘"‘、
"angels"
but they include Old Testament prophets and
angels"
arch 四19 e1 S (particularly Michael,
Michael , Gabriel,Jeremiah,
Gabriel , Jeremiah , and Miriam),
Miriam) , New Testament
archangels
spi 町， an Indian spirit,
spirit, a fish spirit or an Mrican
aposdes , and sometimes a dove spirit,
aposdes,
spirit. Spirits are "messengers,"
"messengers," conveying "warnings"
from God and empowering
"warnings"
丘om
pa
眈icipants
in myal or possession,
possession, commonly known as "being in The Spirit."
participants
Possession is facilitated by a joyful state encouraged by lively singing and dancing,
dancing,
formerly to the tune of two goatskin drums and tambourines but now commonly
to an electric
guitar,， keyboard,
electric
织lÍtar
keyboard , and trap set. Revival services have a structure,
structure , but
there is much room for improvisation or spontaneity as The Spirit manifests itself
itself.
In addition,
addition, services are highly participatory events; everyone
eve 巧Tone is encouraged to get
direcdy involved.
Revival churches typically set aside at least one day a week for a public healing
service. Each patient is commonly given a glass of "consecrated water" to drink
in the service and then escorted individually to a private room where a bather rubs
them
them,, naked
naked,, with a wet cloth soaked in a basin of water in which herbs have been
boiled, to cleanse their spirit (Barrett,
boiled,
(B a 町e 扰， 1976). Then the patient will have a private
consultation with the healer in her "office."
"0 伍ce."
Healers also see clients privately
throughout the week
week
何redenoja
(Wedenoja,， 1989). People with serious problems,
problems , as well as
those of higher social status,
status , generally prefer a private consultation,
consultation, not wanting
their condition to be public knowledge.
A private consultation with a healer begins with a "reading" or diagnostic exam,
ex 汩n ，
which can be done in various ways. According to Joseph Long (1973),
(1973) , Mother
Rita read a patient's
patient' s tongue,
tongue , whereas Leonard Barrett (1976) said she read the
client' s hands. Steve Weaver (2003) reported that a healer selected
palms of the client's
passages at random from a Bible. Edward Seaga (1955) mentioned card-cutting
and reading a leaf or the flames of a candle or a glass of water with a coin in it.
Whatever the means,
client' s problem and prescribe a
means , the healer is able to "see" a client's
ofher
her messenger,
messenger, who may speak to her or put a
cure for it
it,, with the assistance of
thought in her head.
he
In a study by Long (1973), which compared the patients of doctors' and healers',
patients preferred healers. As Keith Vom Eigen (1992) noted, healers spend more
time with patients than do doctors. They conduct a more thorough diagnostic
exam and provide a more detailed explanation of the problem. Healers and their
clients are typically from the same social class and share a common worldview,
whereas doctors are much better educated and of higher standing than the majority
of patients. Therefore, healers usually have better communication and rapport with
their clients (Wedenoja, 1989). Lower-class patients are generally submissive and
deferential to a doctor because of their social standing, and are often reluctant or
Revival
135
embarrassed to speak freely,
freely , partic
particularly
由rly conceming
concerning spiritual matters. Healers are
more attuned to interpersonal relationships and the psychosocial matrix of illness
experiences , and they engage in much more counseling than doctors. The medical
experiences,
doctor sees illness in material and impersonal terms,
terrns , as a natural condition,
condition, whereas
client, sees it in a more personalistic and moral
morallight
light,, as
the healer,
healer, and usually the client,
something done to the client by another person,
person , in which case it is an act of
aggression. Healers are not just dealing with sickness,
sickne
民 they
theyare are often
0 丘en ∞
confronting
c onfron 时
ntin
eVl
且1.
.
evil.
Conceptualizations of IIIness
Illness and Health
Like the rest of Caribbean,
Caribbean, ]amaicans
Jamaicans are very health-conscious,
health-conscious , and pursue a
well-being, such
variety of natural and spiritual strategies to maintain health and well-being,
as: 1) eating good,
good , clean
clean,, carefully prepared,
prepared, and preferably natural,
natural , fresh,
fresh , and hot
foods; 2) keeping the body clean,
clean , not just externally but more importandy
internally, including a periodic "washout" or purging of the colon; 3) avoiding
internally,
imbalances created by mixing "hot" and "cold" matter; 4) drinking "bush teas"
potency, vitality,
vitality, and nerves;
for preventive purposes and "roots tonics" to build
b ui1d potency,
5) being careful not to strain one's
0 肘 's "nerves
"nerves,"
," which is to say avoiding stress and
regularly,, and getting baptized
overwork; 6) going to church,
church , fasting and praying regularly
to build The Spirit; 7) refraining
re 丘aining
from evil ways and living "good" by avoiding
burning 丘ankincense
frankincense and myrrh
offense to others or giving cause for envy; and 8) burning
in the house and keeping a Bible handy to ward off demons.
Two kinds of illness are generally recognized,
recognized, "temporal"
"tempor
址" or natural and
unnatural 何Tedenoja
(Wedenoja,， 1989,
cold,,
"spiritual" or unnatural
1989, p. 79). Natural illnesses are due to cold
gas,
bile,, blood imbalances,
germs (Mitchell
(Mitchell,, 1983). Caribbean culture
gas , heat,
heat, bile
imbalances , and gerrns
th century
follows the humoral theory of illness of 18
18 出
century
European medicine,
medicine , which
classified
classifìed substances as hot or cold and strived to maintain a balance,
balance , often using
2004,, p. 39; Vom Eigen,
(payne-Jackson
ayne-]ackson & Alleyne,
All eyne , 2004
Eigen,
bitter and sweet substances (p
1992,, p. 431). Spiritual illness could be a "chastisement" from God or an ancestor,
1992
ancestor,
but it is usually ascribed to a supernatural "trick" or "blow,"
"blow," employed through
ofObeah
Obeah and motivated by envy,
envy, jealousy,
jealousy, or hatred.
the medium of
Self 二medication
is the first
fìrst course of action when illness appears
appears
何redenoja
(Wedenoja,，
Self-medication
1989). One of the easiest,
easiest, cheapest,
cheapest, and most popular remedies is "bush" or herbal
an 血ness
illness does not respond to self-medication,
self-medication, then it is time to see a
medicine. If an
medical doctor. A sick person will generally visit a healer under three conditions:
1) in cases where biomedical practice has failed to provide relief,
relief, 2) upon
experiencing vague
va 伊 e symptoms
s 严nptoms
that lead to feelings of disquiet and unease known
as "bad
feeling" or "funny feeling,"
the occasion of prolonged or sudden
部
"bad
feeling," and 3) on
0 川he
Mental
山ness
any one of the foregoing
rnisfortune. Mental
and catastrophic misfortune.
illness may fall into anyone
categories. However,
However, because of the stigma attached to mental illness and to
treatment in a mental institution,
institution, many people take their mentally
mentally
山
ill to
to the Revival
practitioner as a first
fìrst resort,
resort , even in extreme
ext
cases.
136 W. Wedenoja and C. A. Anderson
Mental
Ment 在1 illness is conspicuously public inJamaica
in Jamaica,, and one of
ofthe
the main illnesses
(Wedenoja,
edenoja, 1995). It is generally attributed to 1) natural
treated by Revival healers (W
causes , 2) supernatural causes or malevolent spirits,
spirits , or 3) a spiritual calling to the
causes,
healing profession. In the capital city of
ofKingston
Kingston and surrounding parishes many
flags , but by numerous
balmyards can be recognized not by the usual multicolored flags,
"mad" persons milling about. In many cases
cases,, Revival healers assume the role of
caretaker, often feeding
caretaker,
f 民ding
them
them,, taking them to hospital,
hospital , and ensuring they are
marginal
即d ， the Jamaican
medicated by a medical doctor. Accordingly,
Accordingly , although marginalized,
uússion or balmyard may be seen as the preferred
Revival Church and its healing mission
form of mental health care for many Jamaicans.
Revival and Mental Health Practices
Signs of mental illness are sometimes interpreted as a divine call to become a
spiritualist. Mter a diagnosis is made,
made , clients are usually "put on the ground" to
t。
''journey,''
''j ourney,'' so they may receive various "gifts" and begin to heal others. In this
W呵，
way, illness is normalized and the client assumes an elevated position of prestige
and authority as well as a new role. However,
However, if the patient is an "unwilling
spiritualist," illness may persist so long as the individual refuses her divine vocation.
spiritualist,"
normal life with acute episodes,
episodes , or an extended
This could mean a somewhat normallife
"visions ," as well as vivid
period of chronic illness. Hearing voices and seeing "visions,"
Spirit," to be employed in the practice of
dreaming, are seen as "gifts of The Spirit,"
dreaming,
healing. The client's
client' s ability to perfect these gifts under proper tutelage leads to
unquestionable spiritual authority and makes for a successful and reputable healing
pract1 ce.
practice.
Agitation and confusion resulting from stressful situations are often treated with
counseling, bush teas
counseling,
teas,, and bush baths. Recitation of verses from the Bible,
Bible , chanting
and the singing of hymns are also employed,
employed, along with head,
head , foot,
foot , and hand
Spirit, conceived as a
massages. Revival healers are skilled at working with The Spirit,
form of spiritual energy,
energy, and energy work is one of the hallmarks of their trade.
This is particularly true of healers whose balmyards or churches are located near
rivers and ponds or where working with water is one of the healer's
heal 町's gifts. In such
cases , people congregate at these places simply because being in the space makes
cases,
them "feel better." Individuals are often obsessively concerned with maintaining
marriages , and relationships; securing the welfare
welf 与re of their children; and
their jobs,
jobs, marriages,
preserving their health,
health , status,
status , and possessions. Very often small misfortunes
uúsfortunes are
m 习 or disasters. One must be constantly on guard to protect
seen as preludes to major
hard-won respect and material possessions. Therefore,
Therefore , clients seek out healers for
spiritual control and protection.
The use of spiritual techniques for personal retribution is widespread.
"Madness" is sometimes said to result from a "spiritual blow" or "spiritual
"spirituallick
lick,"
,"
which requires an involved and extensive treatment as well as protection from
future attacks. In some cases people are said to be "set fi
fì mad" for a specific
specifìc number
Revival
137
of days,
days , after which they will
wi1l return to full health. In such cases,
cases , where the period
promotion, the Revival healer's
healer'sjob
job
responds to a major event such as an exam or promotion,
is simply to see that the patient comes through the period without undue harm to
self. These acute cases contrast with the more chronic ones where individuals are
sel£
said to be made to eat garbage,
garbage , roam the streets naked
naked,, and inflict violence on
themselves and others. If the patient can be taken to a healer then they generally
remain with her until they have been cured. In cases where a patient has to be
hospitalized , the healer may visit them in hospital or work on the case from a
hospitalized,
distance. Healers often counsel clients on the importance
impo 眈ance
of good living,
living, and try
aw 句r from destructive behaviors and relationships.
to steer them away
Conclusion
As we have seen,
seen , Revival is a pragmatic,
pragmatic , this-worldly
this-worldly,, indigenous religion of
that is intimately associated with healing. Revival healing takes place in
church services,
services , healing places called balmyards,
balmyards , and in the offices of Revival
healers. Revival healers are spiritual counselors who rely on trance or possession
client
丑， and their spiritual charisma gives them their
and spiritual insight to help clients,
authority and influence. They address the fears and anxieties of people,
people , particularly
the poor,
poor, in culturally appropriate ways that seem to be generally effective. Revival
A 丘ican
beliefs and practices that were transformed under
has its foundation in African
slavery, colonialism
slavery,
colonialism,, and Christian rnissionization. It was marginalized and
crirninalized by a Eurocentric power structure and has to be practiced surreptireligion, because of the Obeah Acts. Nonetheless,
Nonetheless ,
tiously today
today,, under the guise of religion,
Revival is an essential papart
眈 of
of the J
Jamaican
amaican heritage that should be embraced rather
than disparaged. It has been healing the sick and comforting the distressed for
publicly,, ideally in conjunction with the
centuries and should be allowed to do so publicly
biomedical system.
JJamaica
缸丑aica
Note
1. "The Obeah Act
Act,"
," in The
Th e Revised La
Laws
ws rif jamaica,
jamaica , Ministry of ]ustice.
Justice. Retrieved
February 22,, 2011
2011,, from http://www.moj.gov.jm/law
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一240).
11
SPIRITUAl
SPIRITUAL BAPTISTS
IN THE CARIBBEAN
Wallace W. Zane
Zane
Introduction
Spiritual Baptists
Baptisωare
are followers of an Mro-Caribbean religion found predominantly
on the islands of
St. Vincent
Vincent,, Trinidad,
ofSt.
Trinidad, Tobago,
Tobago , Grenada,
Grenada, and Barbados,
Barbados , and that,
that,
carried with migrants,
migrants , has a presence in England,
England , Canada
Canada,, and the United States
(Zane , 1999).1 Like other religions in the West Indies,
(Zane,
Indies , its practitioners are sought
out for healing by adherents and non-adherents alike.
The Spiritual Baptists
Baptisωhave
have been called different
di 岱rent
names in different
di 岳rent
islands and
at different times in their history: Converted,
Converted, Penitent,
Penitent, Shakers,
Shakers , Shouters,
Shouters , Wesleyan
Baptists,
Baptis
邸， Tie-heads. The name
narne most used today is "Spiritual Baptists,"
Baptis
包，" or sometimes
just "Baptists." This has caused some concern
concem among
arnong North American
American Baptist
denominations as they feel the name
narne should belong to their tradition alone (Hazell,
(Hazell ,
1994).
Though influenced by Africa,
Africa , the Spiritual Baptist religion is a form of
Christianity that reflects the British colonial reality at the time of the formation of
the religion. The basic initiation ritual and most of the practices that make up a
typical church service are African
A 丘ican
in origin,
origin, but apart from form,
forr 丑， are not Mrican,
Mrican,
as they are given Christian meanings. Other practices of the Spiritual Baptists
Bapti
归 are
are
primarily derived from British Methodism. The religion is not dogmatic,
dogmatic , but
mystical and revelatory. For example,
exarnple , customs and items found in the church
service that Spiritual Baptists claim to come from Africa are often more easily
traceable to other sources. However,
However, that fact does not matter to the Spiritual
Baptists; any contradiction is perceived only as a surface contradiction,
contradiction , possibly
even laid by God to confound those who have worldly as opposed to deep
knowledge gained in the spiritual world.
islands , have significance
Spiritual Baptists,
Baptists , though a minority in each of the islands,
beyond their numbers,
numbers , in part because it shows an alternative
altemative to the lived social
Spiritual Baptists 141
reality of limited
linúted opportunity for poor people. Hence,
Hence , an understanding of the
Spiritual Baptist tradition is critical in order to understand the social context of
Caribbean people as well as their conceptualizations of illnesses and their cures.
This chapter begins with a consideration of the history of Spiritual Baptists and
Then , healing practices are detailed,
detailed, with an emphasis
an outline of their beliefs. Then,
on the spiritual nature of both healing and oflearning the techniques of healing.
Fi
nally, the chapter will make recommendations for how this knowledge may be
Finally,
used by health and mental health specialists who encounter Spiritual Baptists in
their practice.
History and Development
Spiritual Baptist tradition is a Christian religion that originated in the 1800s in the
Caribbean, and has antecedent sources in the Fon and Kongo cultures of Mrica
Caribbean,
(see ，也
ex 缸丑ple ， Bilby & Bunseki,
Bunseki, 1983). It is not an Mrican religion adapted to
(see,
forr example,
Christianity, nor a form of Christianity molded out of an Mrican religion; it is
Christianity,
its own phenomenon,
phenomenon, a syncretic product of the colonial encounter. Various
researchers have labeled them as Protestants (Houk,
(Houk, 1995; Simpson,
Simpson, 1966),
1966) , as an
"Mrican-Protestant synthesis"
s 严lthesis"
(Herskovits & Herskovits,
Herskovits , 1947)
1947),, as a monastic
order (Malm,
1983),, as polytheistic (Glazier,
1988),, and as related to
(Malm, 1983)
(Glazier, 1983; 1988)
shamanism (Gullick,
(Gullick, 1998; Zane,
Za 肘， 1999). The adherents themselves often call their
religion a mystery,
mystery, and people who want to understand the faith and practice are
told,
words , the only way to truly understand the
told, "Come and taste." In other words,
religion is to convert andjoin
and join them in their work.
The Spiritual Baptist religion increased in popularity in the early 20 th century,
century,
and with its insistence that spiritual power can be conferred by God alone and does
not need to be given by a temporal authority (including an ecclesiastical one),
one) , the
European-dominated legislature on St. Vincent voted to make the religion
religion
山egal
illegal
under the Shaker Prohibition Ordinance of 1912. Other islands followed,
followed , with
Trinidad in 1917,
1917 , and Grenada in 1927 (Zane,
(Zane , 1999). In the struggle to make the
religion legal,
legal, worshippers continued their practices under a variety of names. The
name that met with the least resistance was the Trinidadian name "Spiritual
terr 丑， is the name most often used by followers
Baptist," and although a fairly recent term,
Baptist,"
in the Caribbean and in the Caribbean diaspora today. The cultural power of
Trinidad in the Eastern
Eastem Caribbean is reflected in the fact that the Trinidadian name
has wider recognition than the Vincentian term
terr 丑 for
for the religion
religion,, the "Converted."
In fact,
fact , Vincentian Converted are just as likely to call themselves Spiritual Baptists.
The Spiritual Baptist religion was finally made legal in Trinidad in 1951 and in
St. Vincent in 1965. In 1996,
1996 , the govemment
government of
ofTrinidad
Trinidad and Tobago declared
Spiritual Baptist (Shouter) Liberation Day would be a national holiday to be
celebrated every March 30th. By the early 21 st century,
centu
巧， the religion had become
politically normalized,
normalized, although its adherents are still often looked down upon by
others in the islands.
142 W. W. Zane
When speaking with West
W侃 Indians
Indians
one may sometimes hear the term "Shango
Baptist,"
Baptist
," a reference to the Trinidadian religion,
religion , Orisha. 2 There are Spiritual
traditions , the spirits are experienced as
Baptists who also practice Orisha. In both traditions,
realities in the spiritual world,
world, even though the Spiritual Baptist tradition originated
in St. Vincent and Orisha developed on Trinidad. The tradition is referred to
Spiritual Baptist or to Orisha (or commonly Shango or Shango Baptist),
Baptist) , not to
both interchangeably. Historically,
Historically , both traditions are quite separate,
separate , Spiritual
originating
丘om
Baptists originating
from a Fon and Kongo base while Orisha is predorninandy
Yoruban.
Beliefs and Practices in the Spiritual Baptist Tradition
Spiritual Baptist symbolism of items
iterns and images in a church setting,
setting, and the meaning given to spiritual events and to Bible verses,
verses , differs between islands. Ri
Rituals
tuals
di 岳rent
islands may have quite different meanings. 3
that have the same name in different
Between churches even within the same island,
island, rituals may be performed
di 岳rendy.
The religion is mystical,
mystical , and practitioners believe that God may decide
differendy.
to reveal one item,
item, ritual
ritual,, or meaning to one individual or congregation or island
di 盗马rent
one to another. Overall,
Overall , we can consider Spiritual Baptist practice
and a different
to be a framework for individual and group spiritual exploration and revelation,
revelation,
leading to wide differences
di 岳rences
between local Spiritual Baptist traditions.
The core of the Spiritual Baptist religion is work. The necessary
necess
狂y skills to do the
work are obtained on spiritual travels. The work itself,
itself, healing non-members or
guiding other Spiritual Baptists on their spiritual path,
path, largely requires symbolic
ses 在lons ，
travel in spiritual lands. These travels are accomplished in trance sessions,
sometimes alone or in groups.
As in many religions,
religions , the supernatural world is a reflection of the secular world;
in the Spiritual Baptist spiritual world,
world, each city has a port,
po 矶 a
a school,
school, a hospital,
hospital ,
school ,
and a watchman at the gate. While the school may resemble an ordinary school,
and, like many teachers,
teachers , the spirit teacher may punish students
studen
岱
the teacher is a spirit and,
who are unruly or inattentive. One must study in order to learn one's work or
role: captain,
captain , nurse,
nurse , teacher,
teacher, or other spiritual roles. Although
Although this world may only
be experienced while in trance,
trance , the spiritual
spiritualjobs
jobs that one learns become tides for
(Physical)
hysical) church sessions
sessions,, it is not unusual to hear
church members. In the (p
John,, or Nurse Susan.
members referred to as Captain
CaptainJohn
All authority and healing power are received by members as gifts from God
during their spiritual world travels and,
and, as previously mentioned,
mentioned, this takes place
features , are common to the religion;
during trance states. This
This,, like many other features,
however , its revelatory nature leads the tradition to manifest differendy in the
however,
religion,
various places where it is found. Laitinen noted of the Spiritual Baptist religion,
"Because of its inherent innovativeness,
innovativeness , it evades essentialist notions of religion
(Laitinen,
2002a,, p. 323).
and culture as pure,
pure , bounded,
bounded, and static" (L
aitinen , 2002a
Spiritual Baptists 143
Spiritual Baptist Healers and Healing Practices
Spiritual Baptists are consulted for healing by many in the Caribbean and in its
Many health problems are often believed to be 配
the
"jumbie,"
diaspora.
di 呻ora.
t he result of a
a ‘丁
1如
um时
bie ，'
an evil 叩
s pl 回口t t 由
ha 挝tcωau
山se臼s phy
严sical
illness or insanity.
insanit
句
y. If that is the case,
case , individuals
spirit
that
causes
physical
may seek out the help of Spiritual Baptists. Spiritual Baptists can also counteract
e 岳cts of "Obeah" and are sought if Obeah is suspected. Lum (2000) found
the effects
B 叩tists
that the Spiritual Baptists
are used by Caribbean people specifically to cure mental
However,, if a person under Baptist care
problems , with enduring success. However
health problems,
is not spiritually prepared,
prepared , he or she may be affiicted
aillicted with a particular kind of
insanity. In Trinidad,
illness
Trinidad, the condition is referred to as "Baptist-crazy,"
"Baptist-crazy," a mental
mental
山ness
"said to be the result of a bad experience during the ceremony" (Lum,
(Lum , 2000,
2000 ,
p.73).
As Gullick (1998) and Duncan (2008) observed,
observed, Spiritual
Spiritu
址 B叩ti
Baptists
归 treat
treat
people
of the community,
community, even those who do not belong to the religion. For ordinary
applied, or
or,, if it is a serious
serious
山ness
illness,， medical
sickness , a home remedy is likely to be applied,
sickness,
work, then a supernatural cure
cure
丘'Om
from
assistance is advised. If either of those does not work,
the Spiritual Baptists may be considered. Spiritual Baptists are a normal
norrnal ppart
狂t of
ofthe
the
traditional mix of
ofhealth
health options available to Caribbean people.
The essence of the Spiritual Baptist religion is a call to service that begins with
"mourning." During mourning,
mourning, members of
ofthe
the religion enter days-long trances
in which they
th 町 symbolically
symbolically
travel to a number of spiritual
spirituallands
lands,, attend schools
there
there,, and learn spiritual occupations. The highest status jobs acquired spiritually
Furtherrnore , since the Spiritual
are similar to those in the "physical world." Furthermore,
Baptists tend to be the poorer people in the islands who would be unlikely to be
able to afford higher education,
education, going to school in the spiritual
spirituallands
lands is one way
of gaining the status and power that are denied to them in the physical world.
The jobs are ranked with the higher levels devoted to healing. 4 The healing
ranks such as "pointers,"
"pointers," "pointing mothers,"
mothers ," "mothers,"
"mothers," and sometimes "leaders"
or "healers" take a number of
ofyears
years and many spiritual
spiritualjourneys
journeys to acquire. Most
nurse , assistant pointer
pointer,, or assistant mother before
healers are given ranks of assistant nurse,
they attain the full rank. This allows for several years of attending alongside the
more experienced healers before beginning healing independently. A poi
pointer
时er is
IS
the highest in the Spiritual Baptist
Baptis spiritual hierarchy. A female pointer is called a
"pointing mother" or sometimes just "mother." The pointer is the spiritual role
that most resembles a shaman in Spiritual Baptist practice, entering the spiritual
world at will to retrieve lost souls, initiate others into the healing role, and to heal
both physical and spiritual sickness. Spiritual jobs, both healing and non-healing,
are ranked in a hierarchy.
Spiritual Baptist churches will often operate under a dual hierarchy. On one
side is a government recognized denominational hierarchy of pastors, bishops, and
archbishops, who have the ability to marry, bury, and christen. Alongside is a
hierarchy derived solely from gifts given in the spiritual world, including the gift
144 W. W. Zane
of healing. While few in the religion have a position in the secular hierarchy,
hierarc
峙， all
all
have a spiritual tide,
tide , from water carrier to pointer or pointing mother
mother,, and all are
eligible , and often required to assist in the spiritual work. The hierarchies are not
eligible,
mutually exclusive; each bishop is also a pointer,
pointer, as are most of the pastors.
The primary training of a Spiritual Baptist healer is undertaken in the spiritual
world. Very experienced pointers or mothers will be able to enter the spiritual
travel, a process called
world simply by closing their eyes with the intention to travel,
"meditation." Others who are experienced may need to make special vigorous
kinetic driving
ritual motions named "doption" or "adoption,"
"adoption," which is a type of
ofkinetic
Typically, "doption" will appear as
used to assist in entering an altered state. Typically,
rhythmically stomping the feet at a quick pace,
pace , while shouting on the stomp and
throwing the body forward and downward simultaneously so that the torso bends
forcefully at the waist.
Whether the healer is able to enter the spiritual
spirituallands
lands by doption or meditation,
meditation,
in each case they must have received the ability to enter first by mourning. This
is a period of
ofblindfolded
blindfolded seclusion lasting for 7 to 14 days depending on the local
emser, 2004). Mourning is also done for baptism.
tradition (see,
(see , for example
example,, Kr
Kremser,
In preparation for baptism,
baptism, one mourns for three days only. Baptism is not
necessarily training to become a healer; baptism itself can be seen as a type of
healing (D
(Duncan,
uncan, 2008).
Healing takes place both privately and publicly and both sets of rituals are
healing, wakes or memorials are services
conducted by a pointer. In addition to healing,
that Spiritual Baptists provide to the larger community on one of the traditional
wake nights,
nights , usually 9 or 40 days after a death (see also Gullick,
Gullick, 1998). Regardless
of the denomination of the deceased,
deceased , the Spiritual Baptists may be called to
conduct the wake. As people privileged by God to do spiritual work
work,, Spiritual
Baptists feel that they must provide the service and often do it for nothing more
than a nominal gift in kind.
The private work that Spiritual Baptists
Baptisωdo
do for the community is varied; for
(Laitinen,
example,
Tobago , "Exorcising evil spirits is part of a healer's duties" (L
aitinen,
example , in Tobago,
2002a, p. 329). The idea of evil spirit possession is not found among
ar 丑ong Vincentian
2002a,
(Zane,, 1999). Further
Further,, in Tobago,
Tobago ,
Spiritual Baptists (Zane
service;
也
Healing can take place within a church service;
forr example
example,, a healer can
dedicated, or to a sick person who has come to
see to an infant as it is being dedicated,
healer,
the service. Most times people come to seek help at the home of the healer,
though.
(La
(Laitinen,
ítínen , 2002a,
2002a , p. 329)
It is worth noting that,
that, in Tobago,
Tobago , dedicating an infant in the church is equated
with healing; on other islands,
islands , it is a ritual associated with identity. Otherwise
separate categories often overlap for the Spiritual Baptists.
Spiritual Baptists 145
In St. Vincent,
Vincent, "lock up" is the most common condition treated by a Spiritual
s 严丑ptoms
of"lock
of
"lock up" are: lethargy,
lethargy, sadness
sadness,, the feeling of a
Baptist healer. The symptoms
heavy weight on one's chest or shoulders. The method of treating "lock up"
appears similar to some types of
ofWestem
Western talk therapy. The session begins with a
discussion of
life history,
up ," and finally to the
oflife
history , then proximal events to the "lock up,"
眈 of
of the healer,
healer, but
treatrnent itself which consists of ritualistic actions on the papart
treatment
also active input from the patient. Symbolically,
Symbolically , or spiritually,
spiritually , but certainly
spirituallands
lands to the particular spiritual
experientially, the pointer will travel in the spiritual
experientially,
city where the soul is locked up. The pointer will obtain release of the soul from
the spiritual jailor
ci 町， or paying (spiritual) money to
j ai1 0r by singing the song of the city,
the jailor.
j ai1or. Many adherents and non-adherents report
repo 眈 a
a great sense of relief at having
their soul back after treatment
treatrnent by a pointer.
up ," the most common physical
For natural or spiritual illness other than "lock up,"
action prescribed or performed is a spiritual bath. Some pointers bathe the
individual themselves;
thernselves; some give bathing instructions to the person seeking help.
doctor,
A pointer who may give a spiritual bath is also called a doctor or a spiritual doctor,
or may be referred to by his specialty as a "bush doctor" or "bark doctor" (use of
leaves , bark,
leaves,
bark, and roots)
roots),, or "chemical doctor" (use of perfumes and oils). The
process of giving a spiritual bath is sometimes called "barking" someone. The
physical effectiveness
e 岳ctiveness
of the plants and chemicals used is of little import: the
problems the pointers treat are spiritual (see for example,
example , Laitinen
Laitinen,, 2002a). Some
pointers may perform a ceremony known as "smoking" that uses the smoke of
rosemary or other aromatic herbs. In St. Vincent smoking is only used to cleanse
a baby from sickness caused by covetousness
covetousnes
在 (that
(that
is,
is , someone loving the baby too
much) or envy,
envy , known locally as "maljo." The baby is held over the smoke and
(Zane , 1999).
the sickness goes away (Zane,
Other illnesses are caused by curses,
curses , spirits,
spirits , including a number oflocal spiritual
monsters,
adultery,
monsters , and by acts the patient may have committed such as stealing or adultery,
resulting in punishment from God or other actors in the spirit world. The
treatrnent in these cases is still spiritual or spiritually-inspired. Ill
treatment
Illnesses
nesses from natural
home , but may also be treated by a Western-oriented
Westem-oriented
causes are normally treated at home,
specialist or a Spiritual Baptist.
Spiritual Baptists and Mental Health Practices
Two main issues make Spiritual Baptists worth noting for health professionals,
professionals ,
namely
namely,, the normalization of the religion within Caribbean communities and
migration. Frances Henry (2003) has shown that the Spiritual Baptist religion has
plurality
且ty of religions in Trinidad. Where,
Where , in
come to be an accepted part of the plura
the past,
past, affiliation
affùiation with the religion may have been hidden due to its
its 沮egality
illegality,， it
is now openly acknowledged. Caribbean people who are not Spiritual Baptists may
rnay
religion, seeing it as an authentic Caribbean
sympathize with the Spiritual Baptist religion,
cultural expression.
146 W. W. Zane
Migration between islands has always been a factor in Caribbean history and
America has increased in the past halfhalι
migration from the Caribbean to North America
century (McCabe
(McCabe,, 2011). Health and mental health professionals who have contact
with
from the Caribbean may
benefit 丘om
from knowledge of
withanyoneanyone 丘om
rnay benefit
ofSpiritual
Spiritual Baptists,
Baptis
仿，
as it reflects a Caribbean way of viewing the world.
Looking at the adherents themselves,
themselves , Spiritual Baptist practices have been
demonstrated to produce positive psychological benefit. Griffith,
Gri 伍th ， Mahy
Mahy,, and
Y oung (1986) and Griffith
Young
Gri 曲h and Mahy (1984) found that Spiritual Baptist mourning
mourning,,
session,, is a significant source of improvement
the long-term blindfolded trance session
in both life satisfaction and physical health. Spiritual Baptists are able to avoid
mental health problems
problerns by participation in their rituals and involvement with their
commuruty:
community:
Mourners cited six benefits of the practice: relief of depressed mood;
attainment of the ability
ab 出ty to foresee and avoid danger; improvement in
decision-making ability;
ab 血ty; heightened facility to communicate with God and
to meditate; a clearer appreciation of their racial origins; identification with
church hierarchy; and physical cures. Mourning appears to be a viable
psychotherapeutic practice for these church members.
(Griffith & Mahy,
Mahy , 1984
1984,, p. 769)
Additionally , much of Spiritual Baptist practice appears similar
Additionally,
sirnilar to Western
dream therapies that emphasize intentional dreaming and analysis of one's actions
in the dream (La Berge,
Berge , 1985; Stewart
Stewart,, 1990). Stewart claimed that,
that, with experience,
thinking, problem
ence , Senoi dream life becomes "more and more like reflective thinking,
solving,
people , emotionally satisfYing
satis 命ing social
solving, exploration of unknown things or people,
intercourse
ofknowledge
knowledge 丘om
from a dream teacher or spirit guide"
intercourse,, and the acquiring of
(Stewart,
1990,, p. 201). The same pattern holds for Spiritual Baptist mourning and
(Stewa
眈， 1990
other spiritual travel (Zane,
(Zane , 1999).
Given the benefits of mourning as found by Griffith
Gri 伍th and Mahy
Mahy,, the question
may arise as to whether workers in health and mental health should use Spiritual
Baptists as a resource for consultation and referral. Some in the Eastern Caribbean
systerns. However,
However,
and its diaspora will welcome the integration of the two systems.
Spiritual Baptist religion is still a minority religion that is very different
different
丘om
from the
region, and,
and, as such,
such , is
mainstream Christianity practiced by most people in the region,
not accepted by everyone. For people sympathetic to Spiritual Baptist practice,
practice ,
referral or consultation may be beneficial.
The best outcomes for health and mental health specialists who encounter
people in the Caribbean or in North America
America or England who are Spiritual Baptists
would derive from an attitude of understanding. For example,
example , in speaking with
Spiritual Baptists,
Baptists , it can be difficult to recognize which parts of their experience
0 丘en use the terms
terrns
are spiritual and which are physical. They recognize this and often
"carnal" or "natural" to refer to their physical experiences and reserve "spiritual"
Spiritual Baptists 147
for their spiritual experiences. Yet,
Yet , they often omit
OllÚt the qualifiers
qualifìers since
since,, to them,
them ,
all of these are genuine experiences and, in that sense, both are real. Awareness
and acceptance that such a distinction may be present can build
b ui1d trust between a
health professional and a Spiritual Baptist. Simply asking the question "Is this camal
carnal
or spiritual?" can illustrate a willingness to accept their reality as valid. Certainly,
Certainly,
their spiritual experiences are valid in the sense that they influence their behavior
in the physical world.
Conclusion
Local explanations for medical conditions are sometimes considered by WesternWestemoriented specialists
speciali
如 to
to be superstitions, but these explanations follow local patterns
pattems
oflogic. Spiritual Baptists,
Baptis
俗， in experiencing the spiritual world,
world , are not exhibiting
deviant or psychotic traits, but rather behavior derived from the history and culture
of the islands. Although the religion is often ridiculed by non-believers because of
its close association with Mrican practices,
practices , the Spiritual Baptists would say of the
outsiders,
outsiders , "They talk bad about us in the day,
day , but seek us out at night."
Notes
1. The author conducted research among
arnong Spiritual Baptists in St. Vincent and among
Vincentians in New York City
C 町 (Zane,
(Zane
， 1999). Carole Duncan (2008) and Maarit
Laitinen (Laitinen
(Laitinen,, 2002a; 2002b) have provided thoughtful ethnographies on Spiritual
Baptists in Toronto and in Tobago,
Tobago , respectively. Stephen D. Glazier has written
Baptis
臼 (e.g.,
(e.g.
， Glazier,
Glazier, 1983). There are works that give
voluminously on Spiritual Baptists
valuable information about Spiritual Baptists by researchers who primarily focused on
other cultural traditions (Goldwasser,
(Goldwasser, 1996; Gullick
Gullick,, 1998; Herskovits & Herskovits,
Herskovits ,
1947; Litdewood 1993; Lum,
As well,
Lum, 2000). N,
well, Spiritual Baptist leaders themselves have
written on the religion (e.g.,
(e.g. , De Peza,
Peza, 2007; Thomas
Thomas,, 1987).
2. These tend to be adherents
adheren
臼 of
of the Shango (Orisha) religion who use some Spiritual
rarely , Spiritual Baptists who use some elements of the Orisha
Baptist practices,
practices , or more rarely,
religion. Actual "Shango Baptists" are fewer in number than either Orisha practitioners
or
orSp Spiritual
让itual
Baptist practitioners,
practitioners , but because both have an African
A 丘ican
focus
focus,, non-adherents
tend to lump them together in a general non-European African-oriented
A 丘ican-oriented
religious
category.
3. For example
example,, in St. Vincent a "pilgrimage" is one church visiting another church in a
fun , light-hearted manner; in Trinidad it is a serious religious joumey to a spiritual site
fun,
(Glazier,
(Glazier, 1983).
4. Depending on the island or specific
speci
且c tradition within an island
island,, the list of ranks will
w 迦 differ.
di 丘也
A typical
list of ascending hierarchy is
typicallist
is,, for males: bell-ringer,
bell-ringer, cross-bearer
cross-bearer,, shepherd
shepherd,,
messenger,
messenger, watchman,
watchman, surveyor,
surveyor, captain,
capt 剖n ， diver,
diver , prover,
prover, assistant leader,
leader, leader,
leader, assistant
pointer,
pointer, teacher,
teacher, pointer,
pointer, inspector. The list for females will often include: florist,
florist , water
carrier,
trumpet blower,
carrier, flag-waver,
flag-waver , bell- ringer,
ringer
，位umpet
blower, surveyor,
surveyor, diver,
diver, assistant nurse,
nurse , nurse,
nurse ,
nurse matron,
warrior,
matron, African
A 丘ican
warrior, leadress,
leadress , shepherdess,
shepherdes
币， assistant mother,
mother, pointing mother,
mother,
inspector. Each of these may have the tenn
ten 丑 "crowned"
"crowned"
or "king" or "queen" affixed
to them,
them
，孤
as in
in "crowned watchman." Although
Al由ough
the "spiritual
"ψiritu过 name"
name"
becomes a tenn
of address,
addres
币， as in for instance,
instance , "Nurse Smith
Smith,"
," the
the 适应
affixes
es are not nonnally included in
addressing the individual.
148 W. W. Zane
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Th
is page intentionally left
Zφ blank
blank
This
PART III
111
Spirituality,, Religion
Religion,,
Spirituality
and Cultural Healing
Th
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This
12
CHRISTIAN SPIRITUAlITY
SPIRITUALITY,,
RElIGION
HEALING
RELIGION,, AND HEAllNG
IN THE CARIBBEAN
E. Anthony Allen and Abrahim H. Khan
Introduction
The Caribbean Christian Church traditions of healing and understanding of
Biblical teachings implicate the hegemony of Western culture and thought.
Rationalism, a hallmark of that culture,
Rationalism,
culture , has brewed suspicions over claims about
ichardson , 1969). The suspicion is compounded with a
miraculous healing (R
(Richardson,
culture-bound Cartesian compartmentalizing of spiritual and medical science based
healing, and an engendering of a denigration of non-Eurocentric cultural realities
healing,
(Allen,
Thus,, the hegemony has either 飞jected
rejected outright or at the least
(All
en, 1995).1 Thus
Biblical interpretation and related
created a divisive ambivalence around aspects of
ofBiblical
healing practices having any resemblance to non-European religious worldview
and practice. The ambivalence has hardened to yes/no dichotomy around which
has been formed a plurality of spiritual healings within the structure of the
Caribbean Church.
ambivalence , the Caribbean
Consequendy , on account of its own cultural ambivalence,
Consequendy,
victor, it has a historical
Christian Church has become both victor and victim. As victor,
role in the total development and resilience of the people in the former
fon 丑er British
time , it is an institutional victim
victit
丑 of
of cultural and
Caribbean region.
region.22 At the same time,
philosophical contradictions born of imperial and neo-imperial designs. That
duality is undermining
undennining the availability
av 组lab 血ty of the full benefits of Christian healing and
contributing to dysfunctional distortions of the reality of the situation. For
example , there is interdenominational prejudice with respect to aisle crossing by
example,
Mainline and Evangelical Church members seeking healing to Pentecostal
(Allen,
en, 2003) or
denominations (Cole,
(Cole , 2007) and the secretive use of folk healers (All
even those from other faith traditions. Further,
Further, there is denial of the benefits of
integrating medicine and health promotion with spiritual teachings and practices
154 E. A. Allen and A. H. Khan
in
a primary
system,, especially inJamaica
inJamaica,, the first
inaprima
巧 health
health
care system
fìrst country in the region
to become free of
ofBritish
British colonialism. However,
However, within the past 40 years
years,, a new
integrative or "Whole Person Healing Ministry" movement has developed,
developed ,
denominations across the Caribbean. The challenge now is for
embracing most denorninations
health care providers and trainees to help Caribbean clients engage meaningfully
with Christian healing and to utilize its health promoting advantages in working
through any dysfunctional ties related to cultural contradictions.
Recognition and social acceptance of healing practices outside medical
treatment were not without trauma
traurna for the Caribbean Christian Community. By
th century
20 出
century
social and political movements were gaining a
the second half of the 20
momentum that would throw into sharp relief the ambivalence and cultural
A 丘ocentric
worldview to a Eurocentric one,
one ,
conflict created by resistance of an Afrocentric
with implications for the interpretation of scripture and the understanding of
oflife.
life.
The latter worldview was undermining
underrnining the very presupposition of healing
practices,
namely, the non-rational notion of God's revelation beyond nature and
practices , namely,
(Richardson,
chardson, 1969). But by the mid-20
rnid-20 th
His supernatural involvement in healing (Ri
century,
centu
町， resistance to it was increasing as a result of a sociopolitical and cultural
synergy in connection with at least four factors: a) the rising tide of national
independence across British Caribbean territories,
territories , 2) a sense of racial pride and
belonging associated with Garveyism in the 1930s and later heightened by the
nationalism, 3) the ripples ofBl
Black
ack Power movement spreading
impulses of Mrican nationalism,
among the younger generation wanting to define
defìne their identity for themselves,
themselves, and
4) the emergence and spread of Rastafarianism in Jamaica3 and across the MroCaribbean region.
Aligned with a Eurocentric view,
view , Mainline Protestant and Catholic Churches
Aligned
were stressing social outreach
outreach,, along with Evangelical Churches that opted to preach
"Word."
ord." These denominations
denorninations appealed more to the cultured,
cultured ,
the scriptural "W
Westernized educated classes whose members are mostly of white or lighter
black, and belong to upper and middle
rniddle income level
complexion, as opposed to black,
complexion,
people (Lowenthal
(Lowenthal,, 1972). Their critique of
ofbelief
belief in healing rituals is that it is due
ofthe
the Bible (Cole,
(Cole , 2007).
largely to lack of education and a simplistic interpretation of
By contrast,
contrast, aligned with an Afrocentric
A 仕ocentric
view
view,, is the Pentecostal Church along
withReviva
with
Revivalist and Spiritual Baptist movements4 that have healing rituals as a main
characteristic. They attract largely the lower income, rural, and inner city poor,
mainly of African ancestry. The latter movements tend to merge recollections of
African realities with Christian ideas. That is, the healing methods combine
Christian beliefs (Trinity, angels, and anointing) with beliefs that rely also on the
assistance of ancestral spirits, and that include the engagement of strong musical
and dance rituals and the use of herbal baths. However, though the Pentecostal
denominations unambiguously promote miraculous healings, the supernatural gifts
of the spirit, and the ministry of deliverances, they are not to be confused with
spiritualism or Mro-Caribbean movements that employ a mix of Christian beliefS
and folk healing ritual practices. For the Mrocentric Christian beliefs movements
Christian Spirituality 155
the issue was not to prove the divinity of Christ on earth or to establish certitudes,
certitudes ,
but to live life before a spiritual presence with the conviction that the creator God
has provided all that is needed to be a healthy person. That is,
is , there is a continuous
interaction between the physical and spiritual realm,
realrn, an interaction that can be
disrupted by the reality of evil forces from which one must be protected. These
beliefS
fS are common to both an Mrocentric worldview and a Biblical cosmology.
belie
The resistance to a Western
Westem worldview increased following W
World
orld War 11
II to
the point that healing practices gained not only sociopolitical recognition but also
came
car 丑e to characterize Mrocentric Christianity in the Caribbean. This latter form
forrn
of Christianity gained the upper hand in the ambivalence,
arnbivalence , largely as a result of
of1)
1)
declining viability
viab 血ty and growth of European originated Mainline and Evangelical
2007) , some of it brought on by members seeking healing
churches (Cole,
(Cole , 2007),
rniddle class
cla 岱 Protestant,
Protestant
，
choosing to cross over to the Pentecostal churches or to middle
charismatic,
charismatic , independent churches having similar
sirnilar beliefs and practices to the
Pentecostals , 2) members openly consulting local/native healers without having
Pentecostals,
so , 3) the educating of misguided
rnisguided
later any internal
intemal conflict and guilt from doing so,
thinking that belief in the miraculous
rniraculous means that treatment by modem medicine
is unnecessary,
unnecessa
巧， and 4) the absence of promotion of a healthy lifestyle,
lifestyle , psychological
counseling, and medical screening in churches,
counseling,
churches , and that may mean the members
su 岳r emotionally and die prematurely. All these factors helped in
unnecessarily suffer
the emergence and receptivity of a new integrative approach to or model of church
ministry
rninistry that would accommodate also healing practices and practitioners.
healing,
This chapter identifies traditional principles and practices of Christian healing,
correlating practices with prayers and discussing the intercessors along with their
training and formation.
forrnation. It is then followed by a postcolonial critique of Christian
healing. Next
Next,, it presents the new integrative healing paradigm,
paradigrn, including how the
possibility
血ty for research. The model of the
staff is trained and supervised and the possib
healing ministry
rninis
位y discussed opens up possibilities for a close working relation with
ofhealth
health to the infirmed.
i 吐血丑ed. However,
However, the health
medicine , in healing and restoration of
medicine,
care professional needs to understand any client's
client' s core beliefs about health
health,, disease
disease,,
and healing. This is even more relevant when working with Caribbean clients
holdingaa Christian belief systemin a population comprising a plurality of ethnicity
holding
and culture.
Principles of Christian Healing
Central to the healing practises and theology of the Christian religion is an
is , according to its adherent,
adherent , God-inspired. As a
understanding that the Bible is,
literary source,
source , it has two main parts: the Old and the New Testament. The
forrner , narrating the creation story and the prophetic tradition,
former,
tradition , is a salvation
history of God's relationship to a people whom he/she has chosen. The relation
is marked by disobedience or sin and evil
ev 且 as
as the cause of sickness and suffering.
Healing and health are possible only through repentance and divine forgiveness.
156 E.
E. A. Allen and A. H.
H. Khan
God's promise
prollÚse is to care and to heal of disease. 5 The New Testament,
Testament, situating
眈 of
of the prophetic tradition of Judean culture,
culture , depicts his activities as
Jesus as papart
being healer and exorcist: enabling the lame to walk,
walk, the blind to see,
see , and casting
out demons. 6 His saving and healing activity is not just from physical infirmities
infirnúties
and afBictions,
afBictions , but primarily from spiritual sickness and death. He advocates for
the marginalized and those oppressed by the religious-political establishment of
the day. More interesting is that health and healing are linked not
notjust
just to sin,
sin, evil,
evil ,
and repentance but also to his compassion for the aillicted.
a 值icted.
His followers and
Christianity carried his combat spirit against sin and evil along with a show of
compassion to new and different
di 岳rent
cultural situations (Porterfield,
(Po 眈erfield
， 2005). The apostle
example , tells the Corinthians that healing was infrequent among them
Paul , for example,
Paul,
because of their intolerant divisiveness?
Further , the history of Christianity is marked by transformative healing
Further,
experiences: St. Ignatius describing the Eucharist as medicine of immortality and
the healing
heali
吨 powers
powers of St. Cyprian and St. Agatha (Porterfield,
(P 。此erfield
， 2005). Other
examples
ex 组nples
include anointing with oil
oil,, belief that the relics of saints have curative
powers,
(Wilhelmi,
and,, in
ilhelnú , n.d),
n.d) , and
powers , healing in monastic hospitals in the Middle Ages (W
the modem period,
period, the healing water of the shrine at Lourdes. These are indicative
also of the idea that the vision of healing is unquestionably central to the history
of Christianity and specifically
spec 面cally
connected to crucial concepts in Christian theology:
evil , repentance,
repentance , forgiveness,
forgiveness , and redemption. As papart
眈 of
of that history,
history , the
sin, evil,
sin,
Caribbean Christian Church with its healing activity shares the vision that can be
set out in terms of principles.
Four principles,
principles , at the least,
least, encompass divine healing according to scripture.
One that is cosmological in scope,
scope , affirms briefly that God is the source of all
creation,
oflove , or goodness. 8 Dialectically related to the good,
good, evil
creation, created out oflove,
is understood as that which lacks the good,
good, is manifested as sickness and death,
death , and
(Buttrick
Satan, a fallen angel in cosmic
COSllÚC struggle with the good (B
uttrick et
personified by Satan,
al. , 1963
creation, God is not limited
lillÚted in his ability
al.,
1963,, pp. 226-227). As the source of creation,
to heal and to overcome evil.
Another principle relates to health or wholeness. That is,
is , God has created
Thus , the human is more than a material or
humans in his/her own image. 9 Thus,
llÚ
mind-body
nd-body being,
being, but also one that is infused with spirit. T
The theological
implication is that each individual is a whole or complete being, having capacity
to be to be rational, creative, and relational. As part of their wholeness, individuals
are able to sustain a spiritual relation with God and fellow creatures. An I-thou
relation, it empowers humans to transcend all sufferings connected with being
finite, and survive even physical death. By God holding together our wholeness,
health then is not just the absence of disease or infirmity but is also a harmony of
mind, body, and spirit. Hence, health is a positive quality of life, the creature
sustaining the right relation to the Creator and to the other creatures, including
the natural order of life. The New Testament injunction to love God and
neighbour10 is a summary of healthy living that encompasses various lifestyles.
Christian Spirituality 157
A third principle relates to disease and the healing process. A core Christian
is that the human potential for wholeness
wholene
岱 is
is subject to disruption and hence
beliefis
belief
defìance against the relationship
dis-ease on account of ego-centric rebellion or defiance
with God and hence neighbour and environment (B
(Buttrick
uttrick et al.
al.,, 1963). The term
tenn
for this defiance
defìance or misuse of the
the 丘eew
freewill
诅1 is sin,
sin, understood as a state in which we
are rendered vulnerable to human,
human, natural,
natural , and demonic evil. In that state,
state , humans
a 臼iction
on others and the environment. They inflict on
become perpetrators of affiiction
themselves negative lifestyles,
lifestyles , ignore the moral order by which human existence
is meaningful,
meaningful , assault the natural order that sustains human existence,
existence , and thus
bring on themselves illness and aflliction. But through acceptance of God's
forgiveness , their restoration of wholeness and hence healing of dis-ease is possible.
forgiveness,
According to Buttrick et al. (1963) salvation is the saving power by which that
e 证ected.
restoration is effected.
A final
fìnal and fourth principle relates to the modality of divine therapeutic
intervention. Accordingly,
Accordingly, divine healing may occur through different pathways:
miracles
miracles,, having faith
faith,, or having knowledge in the medical arts and human sciences
such as counseling,
counseling, psychotherapy,
psychotherapy , and social intervention. Mi
Miracles,
racles , of
ofwhich
which the
Bible gives many examples,
examples , are signs of God's providential intentions for
humanity.ll
humanity.
11 Faith as a healing mode implies an attitude of faithfulness that accepts
the forgiveness of sins understood as a means of grace that correlates with a spiritual
transfonnation of our being. The human sciences pathway correlates with the
transformation
tradition of the Biblical prophets in their advocacy for the marginalized and
oppressed. In the modern context it may include making accessible to the poor
and oppressed medical and health resources: medical knowledge relating to
prevention and available cures,
cures
，由lprovement
improvement of personal hygiene,
hygiene , and seeking
treatment for afllictions. This kind of advocacy may have psychological and
individuals , fanlliies
families,, and communities.
spiritual implications for the healing of individuals,
Altogether,
Altogether, the four principles presuppose that human self is more than a
afHi ctions that are not always
physical body. It is spiritual as well and susceptible to affiictions
occasioned by sin. Affiictions
A 臼ictions
may result from chance circumstances that include
one'
nature , old age,
age , or from
one'ss ignorance or negligence with respect to the laws of nature,
God testing and strengthening us to reach an even greater
g
level of wholeness
(Buttrick et al., 1963). Further, it does not follow that divine healing removes all
infirmities, to recall Biblical narratives: the healing of Sarah's womb was not until
old age, Isaac was blind for many years, and Jacob in his old age was both blind
and sick. Still further, the greatest of all healings is God's calling home the faithful,
through death, to acquire an immortal body and thus to end the pain and sorrow
that mark our mortality.
Christian Healing Practices
Healing practices among English speaking Caribbean Christians have central to
them prayers that are Biblically based and are in keeping with the tradition of the
158
E. A. Allen and A. H. Khan
Christian Church. Prayers vary,
vary, but fall in one of three broad categories and may
be integrated as needed,
needed , rather than used separately. Further,
Further, they are relatively
mini 日lUm use of personal charisma,
charisma , ritual
ritual,, or sacred objects. Still
Sti1l
simple,
simple , with minimum
further,, they incorporate Biblical passages appropriate for healing
from the Gospels
further
healing
丘om
in the New Testament,
Testament, or the Psalms in the Old Testament,
Testament, but are by no means
眈s of the Bible.
limited to those paparts
The first
fìrst category,
category, prayers for miraculous healing or formal healing prayers,
prayers , are
an integral papart
眈 of
of congregational or special worship services. They may be said at
evangelistic prayer crusades,
crusades , in private homes,
homes, and at health care or other residential
Theyare
are comprised roughly of three steps,
steps , involving the intercessor
intercessor,,
institutions. They
or prayer leader,
leader, and the affiicted
afflicted person. The intercessor is either a priest,
priest, church
member with special gifts,
gi 缸， or lay reader. The first
fìrst step is for the intercessor to
prepare the afllicted for healing by providing encouragement through Biblical
to heal. Next,
exhortations to recognize God's desire and ability
ab 且ity
Next , the afllicted
Or, sometimes through the gift
individuals state their ailment or health concerns. Or,
of "a word of knowledge,"
knowledge ," God may give the intercessor a revelation of the
fìnally to the third
complaint and a confirmation
confìrmation of the healing to come. This leads finally
step: the healing prayer or activity itself that may be just a simple word of revelation
that indicates restoration is occurring. The steps apply also to prayer for the healing
of memories,
memories
，也
forr past hurts or trauma followed by counseling,
counseling, and for the casting
out of demons or spirits. The latter prayers belong to the ministry of deliverance
in the work of Pentecostal or Charismatic non-denominational churches. In the
deliverance , someone on the prayer team
te 缸丑 whom
whom
God has
healing activity of this deliverance,
given the gift of discernment of spirits invokes the authority and name of Christ
as the power that enables the casting out of the demons.!2
demons. 12 Altogether,
Altogether, in healing
prayers the intercessor and the afflicted
affiicted recognize that God in Christ is the healer
who operates through humans as agents. Thus,
Thus , in standard church practice,
practice , the
authority, or name of Christ,
Christ,
Christian seeks healing by calling direct upon the authority,
rather than invoking perceived power,
power, resident in any person
person,，。随ject
object,， or ritual.
afllicted , consists of two healings that
Second, prayers with touching of the afllicted,
Second,
involve the act of touching the afllicted accompanied by Biblical exhortations.
f
of the afflicted, or the thumb of
Hands of the intercessor are laid on the forehead
the priest-intercessor is dipped in oil and then used in making the sign of the cross
on the forehead of the afflicted.!3 Each activity is done with words spoken in the
name of God, for both activities symbolize the touch of God and the bestowing
of His spiritual power. In conjunction with either one, the Eucharist or Holy
Communion may be administered, or Confession made. Both are sacramental
means of God's grace and hence channels of healing. The act of Confession
involving the acceptance of the assurance of God's forgiveness is itself a powerful
therapeutic aid to healing. Though not a sacrament, fasting by the intercessor may
be a potent facilitator in preparation to become a tool of God's power. These
rituals, accompanied by prayers, may require repeated performance.
Christian Spirituality 159
The third category consists of prayers that are supplemental to knowledge of
medical and human sciences. Christ expressly stated that it is not the healthy but
the sick who need a doctor. 14 By the 4th
4 由 century
century
the Church had started infirmaries
infìrmaries
and hospitals-monastery hospitals to care for the sick (Horden
(Horden,, 2005). Today
Today,,
medical rnissionary
hospitals , provide doctors,
doctors ,
missionary movements of the Church build hospitals,
(Koenig, McCollough,
McCollough , & Larson,
Larson, 2001). Catholics
Catholics,,
and staff medical schools (Koenig,
Anglicans , and Seventh Day Adventists all run Caribbean hospitals. The healing
Anglicans,
setting,
prayers , considered part of pastoral care during visitation in an institutional setting,
prayers,
are an adjunctive
a 句 unctive
to medical treatment or therapy. They consist of reading Biblical
hands,, and anointing,
passages,
ofhands
anointing, as the occasion might
rnight accommodate.
passages , laying on of
More specifically,
specifically, the healing act in certain cases may
m 町 require
require
follow-up with
psychological counseling,
counseling, and social work with the family
fami1y to encourage patience
afBicted and give interpersonal
emotional, and concrete support
suppo
眈 to
to the
with the afBicted
interpersonal,, emotional,
tirnid
chaplain, church priest,
priest , or trained
timid and weak. 15 In an institutional setting a chaplain,
lay reader may serve as intercessor.
Spiritual Healing Practitioners,
Practitioners, Their Training and Formation
The Caribbean Christian Church accommodates intercessors who pray for healing
of the infirm.
infìrm. Intercessors belong to one of three levels. The Clergy is one level
此 of
of their pastoral care and spiritual counseling,
counseling, may
rnay include
whose members,
members , as papart
priests , trained at a serninary
seminary or
healing for specific concerns. They are pastors or priests,
theological school and ordained by a Church. Another
Another level consists oflay leaders
in the Church or congregation. They pray for others as part of their various
ofhealing
healing,, whether pastors,
pastors , lay
responsibilities. A third level are ones with the gift of
leaders,
leaders , or other members,
members , to particular ministries
rninistries of
ofhealing.
healing. Some gifted persons
have become healing evangelists
evangelists,, often operating through para-church organizaaddition, the Bible exhorts all members of the Church congregation to
tions. In addition,
pray for one another,
another, and for those outside the congregation
congregation,, as papart
时 of
of the healing
community of Christ. Each individual is also encouraged to take personal
comrnissioning individuals
responsibility for his or her healing prayer. Training and commissioning
to a ministry
rninistry of spiritual healing is in keeping with Biblical as well as Church
traditions. The Apostle James encouraged the New Testament Church to send
forth elders to pray for the sick and anoint them with olive oil to restore their
health and have their sins forgiven. 16 The Gospel Mark reports that Jesus
J esus called
together his 12 disciples and gave them power and authority to drive out evil spirits
comrnissioned them to preach and heal the sick. 17
and cure diseases,
diseases , and commissioned
All who pray formally
fon 丑ally
for the sick are usually required to be Christians of
exemplary character,
character, making no claims
clairns to personal or intrinsic ritual power
power,,
operating ethically within congregational structures and not for personal gain.
There is always the danger of factionalism,
factionalism , of cultic mind
rnind control
control,, and of
forbidding medical and psychological interventions due to over-enthusiasm
or inadequate experience and training. Usually there is the corrective ideal of
160 E. A. Allen and A. H. Khan
appropriate training and practical supervision for each of the three levels of
intercessors,, including areas relating to Scripture,
growth,, moral
life,, and
intercessors
Scripture , personal growth
morallife
rninis
位y.
approaches to ministry.
Collaboration and an Integrative Healing Model
The task,
task, if the church is to play
playaa significant role in the lives of the Caribbean
di 岳rent
healing approaches and strategies
people, is to bring together and integrate different
people,
so as to relieve afflictions
a 但ictions
and promote health and well-being. Already,
Already, training in
understanding and assessing spirituality has been introduced to medical,
medical , theological , and psychology students at the University of the West Indies,
logical,
Indies , Mona
campus with good initial reception (All
(Allen
en & Paul,
Paul , 2003). It is a first step for
training, and supervision of professional
Caribbean students and clergy,
clergy , for more training,
development , which overworked clergy in a congregation can hardly provide,
development,
provide , are
areas requiring attention. Further
Further,, ethnographic research
research,, along the lines of the
Baptists , is needed as is research on
recent work by Griffith (2010) on the Spiritual Baptists,
clinical expressions of issues,
issues , phenomena,
phenomena , and inner conflicts surrounding the
W esternlMrican indigenous interface.
Western!
inte 出ce. Still further
further,, the measurable health assets of
churches , best practices,
churches,
practices, and public health impact in the Caribbean and its diaspora
research , and professional development
are also areas requiring research. Training,
Training, research,
task , and thus
go hand in glove with an approach that seems to be addressing the task,
model.
becorning
becoming an adopted model.
The Whole Person Ministry is offered as a model that incorporates different
healing approaches
Integrative,, it is congregationally based,
approach
臼 and
and
strategies. Integrative
based, takes
into consideration the whole person
person,, and is guided in its understanding by Biblical
paradigms.
inJamaica, comprises
paradigrns. This model adopted by the Bethel Baptist Church in]amaica,
medical services,
counseling, prayer and spiritual care,
care , social care,
care , and outreach
services , counseling,
activities (All
(Allen,
en, 2005). Medical services are community based and comprehensive,
comprehensive ,
promotive , preventative,
preventative , curative,
curative , and rehabilitative.
meaning that they are promotive,
Curative services are integrated with the aid of a Wholistic Assessment
As sessment Questionquestionnaire , patientsl
patients! clients are then assigned to the
naire. On the basis of the questionnaire,
counselors , prayer counselors,
counselors , conflict
appropriate medical doctors,
doctors , psychological counselors,
resolution counselors,
counselors , or the church's social worker. Preventative and divine
hands , special healing
healing services include the spontaneous laying on of hands,
services
services,, invitations for healing in regular services,
services , and a prayer "hot line."
The healing and spiritual assessment approach is open-ended to assisting both
counselors and clients. It enables counselors
c
to become culturally competent in
understanding the relationship of the client's possible ethnic and social classinfluenced culture and the culture conflicts (if any) with their healing worldviews
and expectations. The assessment elicits the client's self-understanding offaith and
lived experiences: practices, crises, ego strengths and weaknesses, and desire for
change. It provides an opportunity for clients to share their spiritual worldview!
cosmology and their understanding of health, illness, cure, and living, and to relate
Christian Spirituality 161
them to their own situation or dis-ease for which they seek remedy. Further,
Further,
clients may gain clarity as to whether the healing modality is to be one that is
mental,
social,, spiritual
spiritual,, or other. Still further,
men 时， physical,
physical, social
further , the approach is instrumental
for clients with problems conceming
concerning any cultural conflict that may exist (All
(Allen,
en,
2005).
Counselors and volunteer assistants of the Whole Person Healing Ministry try
to discover the available relevant "functional" and ethical healing resources within
reference , and
the Christian belief system. They try to understand the terms of reference,
denominational
denorninational and cultural nuances of the client's
client' s situations as disclosed in the
assessment. They network to leam of available culturally sensitive religious clergy
who might
rnight assist specific
specifìc clients. They encourage the client to reflect on self-help
selιhelp
healing, and to take advantage of
approaches that are auxiliary to prayer for healing,
wholistic peer support
suppo
眈 in
in their home congregation. Counselors do not seek to
influence the client's
client' s beliefS
beliefS through coercion or use of a spiritual healer. Rather
Rather,,
they understand their approach as co-participatory and ethically responsible. As a
healing congregation,
congregation, Bethel church provides over 15 non-professional volunteers
who work with 17 paid staffers to render multidisciplinary services.
The integrative model allowing for spiritual healing,
healing, or some other aspect of
Whole Person Healing Ministry
Ministry,, has been adopted elsewhere in Jamaica and in
other Caribbean countries. Among
Arnong the island's capital of over 500,000
500 ,000 persons
persons,,
Copeland (1992) listed at least 46 such ministries
rninistries run by 13 denominations,
denorninations , most
poverty-stricken
町-stricken
areas. A healing ecumenism encompassing Mainline,
Mainline ,
being in pove
Evangelic
址， and Pentecostal churches is forming
forrning around the wholistic needs of
Evangelical,
Caribbean people and out-shadowing culture-conditioned doctrinal debates. In
Jamaica , for example,
Jamaica,
example , there have been many joint workshops sponsored by
ecumenical faith and health coordinating and capacity building agencies and the
Ministry of
ofHealth.
Health. Trinidad,
Trinidad, Barbados,
Barbados , and the Leeward Islands and Haiti are also
1s The Caribbean Conference of Churches (2008) has been facilitating
involved. 18
AIDS , substance abuse and violence. In a
initiatives in churches related to HIVI AIDS,
transnational and metropolitan world,
world, Caribbean imrnigrants
immigrants have taken with them
culture conflicts and solutions about healing. Apart from a continuance of
Pentecostal healing,
healing, some evangelical and mainline leaders have set up aspect
aspects of
new integrative healing programs for Caribbean diasporas in England and America.
The Whole Person Healing Ministry is not without challenges. One is the need
for more members' presence and participation in low income communities, and
for integrating healing practices and wholistic evaluations (Allen, 2003). Another
is that the Mainline churches, having opted for the integrative model, have been
content to practice a health ministry that combines insights gained from
psychology, medicine, and sociology, and to abandon for the most part the practice
of miraculous healings to Pentecostal and Charismatic churches (Henlin, 2006).
162
E. A. Allen and A. H. Khan
Conclusion
The Whole Person Healing Mi
Ministry,
nistry , as an integrative model,
model, offers Caribbean
healing, while
Christian clients the opportunity to engage meaningfully with biblical healing,
A丘ocentric
matrix , and utilizing
taking into consideration a traditional and Mrocentric
cultural matrix,
the insights from medicine and the human sciences. Tried and tested for almost 40
years , it is being embraced by different
di 岳rent
Christian denominations in the Caribbean
years,
However, there are challenges to it as mentioned above. Still,
Still, there remains
region. However,
one challenge that as an integrative healing model it can least afford to overlook.
For to present oneselfbefore God for healing
healing,, in the cultural context of Caribbean
Christians , it would make no sense to embrace all aspects of Mrican culture,
culture , to
Christians,
ofWestem
Western thought
thought,, or to dismiss the insights
insigh
岱 about
about
wholeness of
oflife life 丘om
from
reject all of
cultural neighbours in the population: Chinese, East lndians,
Indians, Amerindians,
Amerindians, and
Caribbean, and make up its Christian community.
other ethnicities. They too are Caribbean,
Notes
cen 脏乱1 influences of formal
fon 丑al
1. Traditionally the village or urban church has been one of the central
aspects
aspec
臼 of
ofCaribbean
Caribbean mores and community life (Austin-Broos
(Austin-Broos,, 1997).
2. The Pentecostal movement originated during a 1906 revival in a black church in the
USA. A black preacher, W.J. Seymour, was their main
rnain pioneer (Hollenwager, 1974,
pp. 18-19).
3. Rastafarianism holds that the Messiah is the Emperor of
ofEthiopia
Ethiopia,, Haile Selassie,
Selassie , that
出e
Ethiopia, and
and 由at
that modem Babylon is Western
Westem culture. It takes as
the Promised Land is Ethiopia,
biblical authority Psalm 87: 4-6,
6, and has its roots also in the Back to Africa
A 丘ica movement
of
Marcus Garvey in 1920s and 30s.
ofMarcus
4. The history of
ofthe
the Baptists inJamaica
inJarnaica
山ustrates
illustrates a culture clash in Caribbean spirituality.
The Baptist movement,
movement, begun by
by 丘eed
freed US slaves,
slaves , experienced in the 1860s a revival
and spiritual fervor that initiated an outbreak of
ofPentecostal
Pentecostal manifestations
m 扭曲 stations
that included
出e
the spiritual gift
gi 丘 of
of healing (Bisnauth,
(Bisnau
出， 1996,
1996 ， pp. 175-176; Gayle,
Ga) 此 1982).
1982).
Partly due to
the strong opposition of the relatively new British missionaries,
missionaries , several thousand
members left the Baptist Church to form
fon 丑 their
their
own indigenous Mrican-Jamaican
Mrican-Jarnaican
1997,, p. 62). Today these movements
Ssyncretistic
严lCretistic
religious movements
movemen
臼 (Austin-Broos,
(Austin-Broos
， 1997
and their offipring which thrive among the West
W创 Indian
Indian
underclass include Revivalists
and Pocornania
Pocomania in
inJarnaica
Jamaica and the Spiritual Baptists in Barbados and Trinidad. The first
two mix Christian beliefs,
beliefs , veneration of the Trinity and angels with employing
employing
由e
the
services of ancestral and other spirits. Healing methods are a main feature of these
Typically
，由ey
rituals ,
movements. Typically,
they combine prayer with strong musical and dance rituals,
herbal baths,
baths , and medicines. Most of these groups are described by Bisnauth (1996,
(1996 , pp.
165-184).
5. For example,
example , see Exodus 23:25-26; Deuteronomy 7:11-12,15;
7:11-12 , 15; Genesis 20:17-18.
6. For example see Matthew 4:23-24; Matthew 9:20-22,
9:20-22 , 27-30al; Acts 3:16.
7. Corinthians 11:29-30.
8. For the creation myth see Genesis,
Genesis , Chapter 1,
1, in the Bible.
9. Genesis 1:26-31; 1 Corinthians 26; and 1 Timothy 4:4.
10. Luke 10:27.
11. See John
Jo1m 9:3,
9:3 , Jesus' response when queried about healing the congenitally blind man.
rnan.
12. Mark 1:34 and 6:13.
13. Mark 6:5 and 6:13; Acts 5:16; and
andJames
James 5:14.
Ma 时lew
14. Matthew
9:12 and Luke 5:31.
•
Christian Spirituality 163
•
15. Thessalonians 5:14.
James 5
5,, pp. 1
14-16.
16. ]ames
16.
9,, pp. 1-2.
17. Mark 9
18.
lS. These are based on person communication by Rachel Vernon
Vemon (2000); and Oral Thomas
Thornas
(2010).
References
Allen,
Allen, E. A. (1995). Caringfor
Ca 何如 the
the whole person. Monrovia,
Monrovia, CA: MARC Publications.
Allen, E. A. (2003). Capacity building for healing
healing,, faith and reconciliation in mission
rnission
Allen,
through biblical wholism: A Caribbean case study. World Council qf Churches'
Consultation on Faith,
Faith , Healing and Missions. Santiago de Chile.
Allen, E. A. (2005). The congregation as a healing community: The story of
ofBethel
Bethel Baptist
Allen,
Church,, ]amaica.
Jamaica. lndianjournal
Church
IndianJournal qfPallative Care,
Care, 11(1),37-43.
11(1) , 37-4 3. (adapted)
T. J. (2003) Spiritual health assessment in the undergraduate
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Allen,
Allen, E. A.,
A. , & Paul,
Paul, T.].
unde 您raduate
medi ωl
α4rriculum
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UWI,, Mona. Presented at
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Austin-Broos,
D. J. (1997).
(1997).jamai Jamaica
ω genesis
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Religion
忽ion and the polia
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]amaica:
Jamaica: lan
Ian Randle Publishers.
History
religions in the Caribbean. Kingston,
Jamaica: Ki
Kingston
Bisnauth,
Bisnauth, D. (1996). His
ωryqf qf 陀ligions
Ki n 呈阳on ， ]amaica:
ngston
Publishers Ltd.
S., Knox
Knox,,].,
J., May,
S., & Bucke,
(Eds.)
Buttrick,
A.,, Kelper
KeIper,, T.
Buttrick, G. A.
T. 忌，
May, H. G.,
G. , Terrien,
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，忌，
Bucke , E. S.
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(1963).
(1963).
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The interpreter'ss dictionary qfthe
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Nashville,
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， TN: Abingdon Press.
Pres 唱.
(200S) About CCC: lntroduction.
Introduction. Retrieved
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丘om
from
Caribbean Conference of Churches. (2008)
Caribbean Conference of Churches at http://www.ccc-caribe.org/eng/intro.htm.
Cole , R.].
Cole,
R. J. (2007). What can the Euro-Christian churches in the Caribbean learn
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Copeland,
Copeland, S. (1992). An analysis qf churches related clinics
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(1982). George
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Gri 岳出， E. H. (2010). Ye shall dream a dream. Mona,
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(扩Jesus
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Hollenwager,, W. (1974). Pentecost between black and white. Belfast: Christ
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13
RASTAFARI
Cultural Healing in the Caribbean
Kai A. D. Morgan
Introduction
RastafarI
Rastafa
rI 1 was born
bom out of a need to challenge the ever-prevailing Eurocentric
ideology and restore the Caribbean's African
A 丘ican
history and identity in order to restore
us to our traditional greatness (Mari,
(Ma 口， 2007).
2007).
Africans,
A 丘lcans
，丘om
from the beginning of time,
time ,
(i.e.,, fire
fire,, water,
air, and earth)
earth),, and
have always respected nature and its elements (i.e.
water
，拙，
thereof,
the plants thereo
f, and have always utilized nature in its ritualistic processes of
maintaining health and healing sickness (Some,
(Som 层， 1998). With Eurocentric ideology
came the stripping of these practices as primitive and worthless. RastafarI
RastafarI has
evolved
from these beginnings
beginnings,, endorsing the spirit of peaceful revolution,
evolved
丘om
revolution, attempta 忧empt­
ing to build
b ui1d institutions,
institutions, and respecting rituals which honor our Africanness,
A 丘icanness
， and
expanded
丘omJamaica
from Jamaica to the wider Caribbean and the
today the movement has expanded
world, speaking to its globalization (B
world,
(Boxill,
oxill, 2008).
With the Rastafarian culture comes the absorption and the glorification of the
African
A
臼can heritage of
ofblack
black people
people,, and with it the many practices that are aligned
with nature and an intuitive spirit. This belief system encompasses the Rastafarians
altemative approach to general health (i.e.,
alternative
(i.e. , Mricentric and natural/herbal
natural/he
血1 medicines) and represents a perspective that has broadened into mainstream practice
today.
In the area of mental health in particular,
particular, the oppressive history of the
Rastafarians inJarnaica
inJamaica and the ensuing personality patterns
pattems detected also calls into
question the existence of a "healthy paranoia,"
paranoia," against Babylon2 system,
system, much like
the "healthy paranoia" that has been identified and described amongst Mrican
Americans,
Americans , against white supremacy. Therefore the issues of psychosis,
psychosis , delusions
delusions,,
paranoia,, in the area of mental health,
and paranoia
health , become salient topics of discussion.
Rastafarian ideology equally applies to healing; however,
however, like any other culture,
culture ,
RastafarI
RastafarI continues to evolve.
Rastafarl
165
After
After almost 500 years of colonialism,
colonialism, erasing the blueprint ofEurocentrism is
almost impossible. However,
However, very often
often,, the answer lies within our awareness of
our
ourA African
丘lcan
ancestry,
anc 臼try ， the establishment of our personal and collective identity
identity
丘om
from
which an acceptable,
acceptable , possibly integrative model can be generated. Rastafarl
RastafarI
currently struggles with this issue as some isolate themselves from Western
influence as much as is possible,
possible , while others live amongst the Caribbean community
munity
位ying
trying to combine the two with the strengths of each. The debate about
whether this is a weakening of Rastafarl
RastafarI philosophy or a strengthening of a
reality, we must
combined and new cultural identity continues. In this postcolonial reality,
understand,
understand, as Chevannes (2006) articulates,
articulates , that we stand "betwixt and between"
these two worlds,
worlds , therefore,
therefore , finding our path is dependent upon this very truth.
In this chapter,
chapter, the original tenets regarding health and mental health
health,, and the
process of evolution and how this has altered these tenets will be explored. 1I begin
with looking briefly at the origins and development ofRastafarI,
ofRastafarI, outlining some
ofthe
of
the major
m 习 or tenets. This is followed by an account ofRastafarI
ofRastafarI beliefs regarding
health,, then more specifically addresses practitioners and their
health and ill health
approaches to RastafarI.
RastafarI. Finally this chapter concludes with a discussion of the
integration between Rastafarl
RastafarI beliefs and contemporary medicine and the
recommendations of
ofhow
how to approach this group from a health care perspective.
Rastafarl: Origins and Development
RastafarI began in Ki
Rastafarl
Kingston,
ngston, ]amaica
Jamaica,, in the 1930s with Leonard Howell,
Howell ,
Dunkley , Claudius Henry,
Henry , ]oseph
Joseph Hibbert,
Hibbert , and much later Vernon
Archibald Dunkley,
Carrington (Hickling,
(Hickling, Matthies
Matthies,, Morgan & Gibson,
Gibson, 2008) who with their
Bome out of political strife,
strife ,
contributions shaped Rastafarl
RastafarI into what it is today. Borne
racial and classicist oppression
oppression,, the movement espoused black consciousness and
A 丘ica
and her children,
children, a
identity, the strength and sacred nature of Mother Africa
identity,
ofHis
His
reverence and respect for Marcus Garvey and the divinity and/or greatness of
Imperial Majesty
Ethiopia
但
(Barrett,
arre 扰， 1997). Several
Majesty,, Emperor Haile Selassie 1I of Ethiopia
rel 粤ous
denominations) of Rastafarl
RastafarI exist which advocate
mansions (much like religious
varying principles and these include the Nyabingi House
House,, The Bobo Shanti or
Ethiopian
Ethiop
山1 National Congress,
Congres
币， and The Twelve Tribes
T 曲es 但aηett，
(Barrett, 1997). However
However,,
some basic principles abound: Haile Selassie as ]ah
Jah (God),
(God) , Zion (Ethiopia) as
heaven on earth,
ea 眈h ， an orientation towards Mrican culture,
culture , spiritual use of cannabis,
cannabis ,
restrictions , and the wearing of dreadlocks (Zips,
(Zips , 2006).
dietary restrictions,
In the years that followed the origins of RastafarI,
RastafarI, the culture has developed
resistance , with alienating dogma,
dogma, fearfrom one in the 1930s of passive/peaceful resistance,
inducing responses and ostracism,
ostracism, to the late 1960s when there became a greater
ofRastafa
Rastafarl
rI by the wider society,
society , until 2012 where attitudes,
attitudes , ideals,
ideals ,
acceptance of
(e.g. , language,
language , dress,
dress , eating habits) are being embraced. This
and even practices (e.g.,
is a time and place where Rastafarl
RastafarI commands respect.
166 K. A. D. Morgan
The Rastafarian culture has evolved and though some of the core principles
have shifted,
shifted, the Rastafarians have indefatigably shaped the rhetoric on Mrican
identity through their convictions. This concept has guided many youth in a
positive way toward an understanding of their Africanness. The ideology and
in Jamaica,, the Caribbean,
Caribbean, and its diaspora with the
practices have been on the rise inJamaica
Rastafarians globally estimated at 1 million
million,, with about 200
200,000
,000 in
population of
ofRastafarians
J amaica alone
Jamaica
alone
但
(Barnett,
arnett
， 2008). This major
m 习 or global impact is due to several
Marl 町， as well as the social and
figureheads such as Marcus Garvey and Bob Marley,
political consciousness,
love,, and unity which have appealed to the masses (C.
consciousness , love
Campbell,
C
缸npbell
， personal communication,
communication, February 2,2010).
2 , 2010).
Principles and Practices of Rastafarl
The principles and practices of Rastafari including those regarding illness and
ofHis
His Imperial Majesty,
Majesty , Haile Selassie 1I born
health are based in the philosophy of
Tafari Makonnen,
Makonnen , a figure of central importance to RastafarI,
RastafarI, and his Empress
Menen Asfaw (see Selassie & Ullendorff,
Ull endor
筐; 1976 for a discussion). In addition,
addition, the
(Lewis
1991),, the emotional and spiritual
ewis & Bryan,
Bryan, 1991)
teachings of Marcus Garvey (L
richness ofKemet (now Ethiopia),
Ethiopia) , and the beauty that Mrica brings forth
fo 眈h for its
RastafarI. Furthermore,
Furthermo
时， Africa,
A 丘ica ， the
people has been an abounding concept in RastafarI.
alignrnent with
Motherland,
Motherland , and its value and respect for the power of nature and alignment
creation and healing into its reasonings,
reasonings , is also critical to the RastafarI
RastafarI rhetoric.
rhetori c.
The mind
rnind and the promotion of a good "livity" (natural way of
oflife
life or totality of
Oone's
町、 being
being in the world) form the unique
uniq 时 rituals
rituals
that have become associated with
derived
丘om
practic
臼. These include such
RastafarI and are also closely derived
RastafarI
from Mrican practices.
meetings , ceremonies
ceremonies,, and reasonings. The "Nyabingi" or "Bingi" is the
things as meetings,
functions , of which music,
music , drumming
drumming,,
most important and recognized of such functions,
prayers,, smoking
smoking,, and singing are integral activities (B
(Barrett,
prayers
arrett, 1997).
There are also various guidelines for what one consumes. Food must be as "ital"
(derived from vital; meaning natural,
natural, pure,
pure , and clean) as possible. Some
dairy, nor poultry) or vegetarian
Rastafarians endorse a purely vegan (no meat,
meat, fish
fish,, dairy,
poultry, some fish) diet,
diet, while others endorse or include the eating
(no meat,
meat, or poultry,
of poultry (K. K'nife,
communication,, 2010). What is standard across
all
K'nife , personal communication
acros
唱 d
mansions ofRastafarI
ofRastafarI is that the ingestion of pork is forbidden. Salt is avoided,
avoided, no
chernicals
chemicals,, no alcohol
alcohol,, no cigarettes,
cigarettes , and no drugs (herbs are not considered drugs)
is endorsed (Barrett,
(B arτett， 1997). Cooking in a clay pot is popular among Rastafarians
alurninum pots (c.
due to the metals that can sometimes be disposed from aluminum
Campbell,
Campbell , personal communication,
communication, February 2,
2, 2010). In general,
general , Rastafarians
perceive food as a way to be one with nature and also as medicine for the body.
The herb known scientifically as Cannabis sativa
sativa,, and affectionately as ganja
(cultivated Indian hemp
from the female plant),
hemp
丘om
pla 叫， marijuana (of Mexican-Spanish
Mexiαn-Spanish
roots) and many other terms
di 岳rent
forms of
ofthe
the herb
herb,, has been
terms,, all representing different
a source of great debate amongst scientists,
naturalists,
herbalists,
Rastafarians,
scientists , naturalists , herbalists , Rastafarians , and
Rastafarl
167
non-Rastafarians. While it is a herb and therefore one of the healthy food sources,
sources ,
illegality in]amaica,
it has been the source of much controversy due to its
its 血egality
inJamaica, yet it is
an important facet of Rastafarl
RastafarI cultural practices. It becomes integral to this
discussion relating to health and mental health.
Rastafarl IIIness
Illness and Health Beliefs
Rastafarians,, like our Mrican ancestors and compatriots,
Rastafarians
compatriots , believe in the monistic
concept of mind and body and have rejected the idea of Cartesian dualism,
dualism, which
mind
丘om
from the body and therefore
has sought to divide the elements of the human mind
juxtaposing us against ourselves,
ourselves , providing an imbalance which at its extremities
su 班èring.
Therefore
，丘om
causes pain and suffering.
Therefore,
from the Rastafarian perspective of universal
oneness , one's diet (vegetarian or vegan) and livity become critical in maintaining
oneness,
a totally healthy system (mental,
(Boxill,
(men 时， physical,
physic
址， and spiritual)
spiritual)
但
oxill
， 2008; Chevannes,
Chevannes ,
2006).
In Rastafarian culture,
culture , the body is regarded as a temple and must be treated
with care. The rules which govern how the body is attended to somewhat depends
on the mansion to which one belongs. However,
However, the sacredness of the body goes
beyond mansions. Both the outer and the inner bodily systems are revered.
Therefore one usually applies natural products (e.g.,
(e.g. , shea butter,
butter, black soap,
soap , essential oils etc.) to the outer skin and nourishes the inner organs with essential foods
(e.g.,
fruits, legumes etc.).3 The body has a direct connection to
nuts , vegetables,
vegetables
，丘阳，
(e.g. , nuts,
the mind. If the body is pure,
pure , then it is a perfect conduit for the energy that will
w血
intertwine with the mind
mind,, also aiding its purity.
The mind is a source of great energy. All Nyabingi reasonings are exercises for
the mind
mind,, assisting the process of energizing the mind-body connection to its
ultimate for the good of the Rastafarian community and for the good of the entire
nation. Preservation of the mind is achieved through utilizing herbs,
herbs , including
meditation," reading certain
marijuana
marijuana,, which allows one to reach the "heights of meditation,"
books,
books , prayi
praying,
吨， and by being disciplined with observed rituals (A. Amen,
Amen , person
personal
址
communication
3 ， 2010 创). The principle and strength of mental exercise
exercαlse
communication,, February 3,2010).
i扫
issd由
duly
ul 坊
y recognized and 叩P
appreciated
伊re町町c1山
a挝te叫
db 树
by
yRaωstafa
Rastafarians.
缸nans
ARaRastafarian
衍stafarian
who is in the best of optimal
op严t 由lal health 扫
is
i s phy
physically
严sically
and mentally
A
sound. There is no separation between the mental and the physical. "Finnness"
"Finnness"
(p
hysical strength) is a must and one must be sure about what one's position is in
(physical
the global scheme of things,
things , one's
0 时 's position and understanding
understandi
吨 of
of RastafarI,
RastafarI, and
s 严nbols
of mental soundness (A. Amen,
Amen, personal
one's environs; these are all symbols
3 , 2010). Likewise,
Likewise , symbols
s 严nbols
of an unhealthy "livity"
communication,
communication, February 3,
dancehall , alcohol drinking
drinking,, sexual promiscuity
include over-involvement in the dancehall,
or casual sex
se (A. Amen, personal communication, February 3,2010).
The etiology of ill health can be explained in a number of ways. Kadamawe
K'nife explains that Rastafarl began as an intuitive system of knowledge, especially
because of the low level of literacy-the original elders started a largely oral
168 K. A. D. Morgan
tradition with the Bible as a guiding principle. The "ones" (Rastafarian people)
knew intuitively what to eat and what not to eat. The "irations" (l
(logic
ogic or
reasonings) surrounding such ideology were very simple.
sir 丑ple.
For example
example,, one may
not eat food from under the ground as one is seeking spiritual upliftment; or one
may not eat anything that grows on a vine because it causes sexual energy to rise
(as the vine rises) and sexual energy is not a focal point of one's purpose on Earth4
(K. K'nife,
K'nife , personal communication,
communication, 2010). Nevertheless,
Nevertheless , what ensued was certain
defìciencies in one's
0 肘's diet,
diet, especially B12,
B12 , which could cause a multitude of
ofillnesses.
illnesses.
deficiencies
Over the years,
years , RastafarI
RastafarI has learned about these deficiencies
defìciencies and are relying more
on scientific
scientifìc findings
fìndings to counteract them. RastafarI
RastafarI firmly
fìrrnly believe that one can
maintain a healthy lifestyle through one's nutritional habits,
habits , which is the beginning
of one's spiritual cleanliness.
In the Caribbean,
Caribbean , illness is often believed to be caused by spiritual forces or
violation of cultural taboos. This is no different
di 班汪rent
for the beliefs of the Rastafarian
ofunhealthy
unhealthy nutritional practices (consumppopulations; however,
however, the addition of
tion of table salt,
meat,, animal-based products,
products,
salt, red meat
products , processed produc
仿， white flour,
flour ,
and white sugar) can also lead to some of the common chronic illnesses such as
diabetes and hypertension. Livity also refers not only to spiritual cleanliness,
cleanliness , but
to personal cleanliness/hygiene,
cleanliness/hygiene , good moral standards/highly ethical behavior,
behavior,
good nutrition,
nutrition , and a reverence for nature and truth (C. Campbell,
Campbell , person
personal
址
communication,
is
communication , February 2,
2 , 2010). All these factors intertwine-"cleanliness
intertwine
一"cleanliness
next to Godliness"-to
Godliness"
一to ensure total spiritual cleanliness and therefore strong
immunity against the disease process. Clearly,
Clearly, these belief systems affect healthforces , then
seeking behaviours; if one believes that illness is caused by spiritual forces,
one will seek remedies that connect with the spiritual realm.
The rhetoric on the etiology of mental illness has not been clearly defined
defìned or
established by the Rastafarian community,
community , thus this is classified
classifìed based on one's
communication, February
beliefsystem
Campbell, personal communication,
personallindividual belief
system (C. Campbell,
2,2010).
Therefore,, one may become ill due to demon po
possession
岱ession
(e.g.
(e.g.,, Obeah)
Obeah),,
2 , 2010). Therefore
illne
岱 brought
brought
on by stressors and exacerbated by
due to predisposition to mental illness
smoking marijuana or taking hard drugs (e.g.,
(e.g. , cocaine) or due to an unnaturallivity.
Kadamawe
damawe K'nife (K. K'nife, personal conununication, 2010), mental
According to Ka
illness is derived from possessing a "superactive brain" and there must be certain
genetic predispositions to same. By the same token, the curative agents for mental
illness are as varied as their etiological factors and may consist of medicinal herbs,
traditional medicine, psychotherapy and the reduction or cessation of marijuana and
hard drugs, and finally calming techniques (yoga, relaxation, and exercise) to soothe
the "superactive brain." It is thus apparent how with the evolution of RastafarI,
members of the conununity have begun to merge their ideology and will utilize
the traditional approaches to healing. Rastafarians are not so separate and apart from
the population that they do not recognize the dictates of mental illness, and what
it may take for healing to occur.
Rastafarl
169
The typical profile
profùe of the Rastafarian youth who enters the psychiatric ward for
treatment is a male in his early 20s who smokes marijuana and is inevitably
treatrnent
disorder, including
diagnosed with either schizophrenia or other psychotic disorder,
cannabis-induced psychosis (i.e.,
(i.e. , ganja-induced). The initiation into RastafarI
RastafarI is
often wrongly interpreted by many youths as the smoking of
ofmarijuana
marijuana O. Niah,
Niah ,
personal communication
Februarγ3
3,2010;
， 2010;
L. Moyston,
Moyston, personal communication,
communication,
communication,, February
February 33,, 2010). Many Rastafarian
Rastaf
泣如1 youth,
youth , ignorant of the totality and the
foundation principles ofRastafarI,
ofRastafarI, begin
begi 川heir
their "trod" Gourney) into RastafarI
RastafarI with
the heavy smoking of marijuana. This sometimes lands them into problems with
contrary,
their reality testing and they end up on the psychiatric ward. On the contrary,
marijuana is not a mandatory practice of all Rastafarians. In fact,
fact , Mutabaruka,
Mutabaruka, dub
poet and renowned Rastafarian,
Rastafarian, has always espoused that he has never smoked
marijuana. Nevertheless,
Nevertheless , many immerse themselves into the practice of smoking
marijuana, a practice that is,
marijuana,
is , as most Rastafarians will indicate,
indicate , not for everyone
and has varying effects for each individual,
individual , sometimes based on dosage. Most
Rastafarians understand that the relationship between ganja and self is an individualistic one.
Healing Practitioners and Practices
Caribbean people use a mix of traditional and biomedical healing practices. The
degree of use of traditional means,
means , including spiritual healing
healing,, is inversely related
Consequendy , most
most
血nesses
illnesses are treated holistically. When
When traditional
to class status. Consequendy,
means fail,
fail , modern medicine is tried (C. Campbell,
Carnpbell , personal communication
communication,,
February 22,, 2010). This is no different from RastafarI
RastafarI who sometimes utilize a
quasi-folk healing approach. There is a well-known physician and Rastafarian,
Rastafarian, Dr.
Carlton "Pee Wee" Fraser,
Fraser, who is trusted and frequendy accessed by the RastafarI
RastafarI
community including infamous
infarnous Mortimo Planno,
Planno , the late Bob Marley,
Marley, and many
others in their times of ill health. This individual is favoured by the community
because he espouses a natural healing tradition and a holistic concept of livity,
livity ,
combined with his Western medical training (L. Moyston,
Moyston , person
personal
址 communicommulli­
cation, February
cation,
Febru
町 3,2010).
3 ， 2010).
There are other practitioners,
practitioners , who despite their Western
W侃ern
training, have adapted a more holistic approach,
approach , some with naturopathic/
training,
regirne that a
homeopathic training also
also,, which are more suited to any treatment regime
Rastafarian would employ and be compliant with. These practitioners in the
Caribbean setting are few and far between
between,, and are typically general practitioners.
rI who utilize mental health services (p
(particularly
articularly inpatient services)
Most Rastafa
RastafarI
involuntarily, though this is not very different
di 岳rent
from the motivation ascribed
do so involuntarily,
the 勾rpe
type of mental
to other members of the population. This is also dependent on the
fac 出口es to the psychiatric wards on
health service. From the institutionally-based facilities
a general hospital to the general wards at a hospital and private psychiatric and
worker, the perception and stigma
psychological care to the attendance of social worker,
is different. At one extreme,
extreme , the Rastafarian who wants nothing to do with the
170 K. A. D. Morgan
Babylon system,
system, will
wi1l fight
fìght against the usage of not only the mental health services,
services ,
but also any medical or health service. Some will
wi1l utilize a combination of
medications , prescribed by the medical doctor as well as additional herbs and
medications,
supplements to treat any disease process he or she may observe.
In a preliminary
prelirninary assessment of a number of mental health professionals,
professionals , very
few had in-depth knowledge of the needs of Rastafarian individuals as they had
not been exposed to them as outpatients,
outpatients , neither psychiatrically nor psychologifìt the profile
profùe previously mentioned and these
cally. Inpatients on the other hand fit
youths are brought in by family
fami1y members and loved ones who are concerned
concemed about
pa 忧ems
(S. Longmore,
Longmo
时， personal
the drastic shift in their behavioral and cognitive patterns
communication
communication,, 2010).
Compliance is a difficult challenge for mental health professionals who manage
patients with chronic illnesses such as schizophrenia and bipolar disorders (S.
Longmore , personal communication,
Longmore,
communication, 2010). With the complexity andlivity of
ofthe
the
Rastafarian
Rastafarian,, that challenge is multiplied. With the reality that there are no
Rastafarian or
or,, at the very least
least,, holistic psychiatric practitioners
practitioners,, that challenge is
magnifìed further,
magnified
further , as the first
fìrst line of treatment for such chronic mental illnesses is
indeed conventional medicine,
Risperdol)
medicine , such as antipsychotics (e.g.,
(e.g. , Seroquel or Ri
sperdol)
and mood stabilizers (e.g.,
(e.g. , Epilim or Depakote).
In the Rastafarian community,
community, the importance and healing properties of
ofherbs
herbs
and nature in general is espoused in a folk herbalist tradition. "Ganja" is a plant
that is termed the "healing of the nation." For some Rastafarians,
Rastafarians , ganja is essential
to bring the heights of reasoning and is an important herb for medicinal purposes
and mental development. For these Rastafarians,
Rastafarians , there is no place for psychotropic
medication,
diminish
faculties
，也rninish
medication, which allows one to further lose control of one's faculties,
one's personality,
personality, while becoming
becorning dependent on the prescribed drug and ignoring
the causative factors (C. Campbell,
communication,, February 22,, 2010).
C缸npbell
， personal communication
While for other Rastafarians,
Rastafarians , mental or psychological development is more suited
to the therapeutic realm,
realm, where the etiology of the symptoms
s 严丑ptoms
are explored and
real healing can begin and maybe there can sometimes be a place for psychotropic
(巳 Campbell,
Campbell
， personal communication,
communication, February
Februarγ2
， 2010).
In addition
medication (C.
2,2010).
to this,
this , exercise,
exercise , nutrition,
nutrition, and meditation become critical to the healthy sustenance
nanc of the whole person.
Some approaches to mental health wellness espouse the eradication of the
smoking habit, while others espouse a reductionist perspective. In other words, an
attempt to compromise is utilized with the reduction in the amount of the herb
ingested being encouraged and focus on the clear relationship (usually how the
herb exacerbates the illness) that may have been established between the herb and
the psychosis. When that rapport between practitioner and patient is established,
this methodology appears to work best.
Healing through music is an important factor in the Rastafarian tradition. From
Count Ossie (a Rastafarian musician) to the drumming at a Bingi to the reggae
tunes of Peter Tosh and Bob Marley, to the genre of roots reggae (Rastafarian
Rastafarl
171
reggae music),
music) , music has been integral to the foundation ofRastafarI.
ofRastafarI. Reggae was
RastafarI across the world. Drumming utilizes the
the avenue that promoted Rastafarl
natural power of rhythm and music and
and 叩plies
applies it to an individual or group for the
purpose of healing. Group drumming breaks down social barriers,
barriers , promotes
expression, nonverbal communication
communication,, unity,
unity , and cooperation. It
freedom of expression,
decreases depression,
depression
，组lXiety
anxiety,， and stress,
stress , boosts the immune system functioning,
functioning,
and benefits physical health.
Collaboration and an Integrative Healing Model
Mental health professionals generally utilize Western
Westem approaches to medicine when
confronted with Rastafarl
RastafarI in their midst;
rnidst; however,
however, there are a few practitioners
who very skillfully cross the barrier and successfully
success
也lly interweave the traditions and
cultures of Rastafarl
RastafarI into the healing process. These professionals not only
understand the Rastafarian tradition and the current struggles and issues related to
its formation
forrnation and development,
development, but they also understand the terrain that they must
maneuver in order for compliance and healing to take place. What the average
mental health professional may term
terrn grandiosity (delusions of grandeur) can
sometimes be explained as the reasonings of the "normal"
"norrnal" Rastafarian. In order to
best deal with Rastafarians,
Rastafarians , one must have a general understanding of the tradiRastafarians , and to formulate
fon 丑ulate
tions; some find it easier to reason and talk with Rastafarians,
comprornises
compromises such as those discussed earlier with the herb.
Another
Another consideration in clinical practice is the concept of "healthy paranoia."
Rastafarians are well-reputed for their lack of trust in anything that belongs to
Babylon' s system. It is therefore not unusual for a sense of mistrust
Babylon's
rnistrust to prevail for
outsiders and typically one has to liaise with a member of the Rastafarian
Rastafàrian community
in order to enter the community. This sense of mistrust
rnistrust must not be mistaken
rnistaken
amongst mental health professionals as a clinical,
clinical, pathological paranoia as it serves an
Morgan, n.d.).
adaptive function and is based on reality of experience (Anderson & Morgan,
The use of psychology,
psychology, as an important part of the mental health profession,
profession,
also becomes a salient point of discussion. Psychological approaches become
important in how one orients to the cultural needs of such individuals. Psychotherapy is more about "reasoning" and it is here that perhaps the Rastafarian
Rasta
缸ian would
be more willing to engage in rhetoric about his or her healing,
healing, given that,
that, again,
again,
the understanding of his or her traditions can be carefully considered and
interwoven into the fabric of treatment.
Mental health professionals must also recognize the evolutionary process that
econornic , racial,
racial, technological
technological,, and
RastafarI has undergone with a shift in the economic,
Rastafarl
social environments; the challenge always exists to explore and understand culture
as a stable yet dynamic
dynarnic entity,
entity, paying special attention to issues such as gender roles,
roles ,
sexuality,
sexuality, and age to name a few. A holistic approach incorporating psychiatry,
psychiatry ,
psychothera
psychotherapy, nutrition, exercise, meditation, and other possible facets of healing
can be critical to the "buy-in" of any Rastafarl to the healing process.
172 K. A. D. Morgan
•
The use of cognitive-behavioral
cognitiv behavioral therapy,
therapy, music therapy,
therapy, and psychological
rnind is more amenable to RastafarI
RastafarI
processes to the end point of strengthening the mind
pa 眈 of
of
than are the practices of psychiatry. The psychologist can be perceived as part
the community,
community, an elder,
elder, the replacement for that person in the community who
would usually listen to one's woes and burdens and assist one with solving them
(A. Payne,
Payne , personal communication,
communication , February 55,, 2010; K. Banton,
Banton , personal
Febn 町y 5,
5 , 2010). The techniques of the health psychologist,
psychologist ,
communication
communication,, February
developmental psychologists
psychologists,, clinical and counseling psychologists are in line with
strengthening the mind
rnind and are therefore more in line with RastafarI
RastafarI (c.
Campbell,
communication,, February 2,2010;
C
缸npbell
， personal communication
2 , 2010; A. Amen,
Amen, personal communication , February 3,
munication,
3 , 2010). It is abundandy clear that a Rastafarian clientl
client!
patient would feel more comfortable with a Rastafarian practitioner. This is not
unusual in the literature on multicultural competencies and preferences of clients
in multicultural settings. They feel more open and trusting with ones who they
However, the reality is that the existence
believe understand them more keenly. However,
of
ofsuch
such practitioners is not sufficient (I
(1 know only of
oftwo
two inJamaica),
inJamaica) , and so the
emphasis is on cross-cultural understanding and how best our practitioners can
bridge this gap that so evidendy exists.
The Rastafarian community in its evolutionary process currendy has a few of
its believers who are mental health professionals. This is no doubt an important
Western and traditional approaches. The
gap in bridging the divide between the Westem
evolution ofRastafarI
ofRastafarI is an important concept in the rhetoric on the mental healing
of the nation. There are glaring differences between the elders and the youth
developing the culture,
culture , the way of
oflife
life,, the entire livity
livity,, with the youth being more
integrative into the Babylon system which allows them to be more open to
accessing mental health services,
services , but serves as double-edged sword as it is this same
"Westem"
integrative , evolutionary factor that allows the youth to wear more "Western"
integrative,
garb,
garb , eat salt,
salt, misconstrue
rnisconstrue the boundaries of sexuality,
sexuality, and in general to stray from
ofRastafarI.
strict adherence to the doctrine ofRastafarI.
Future hopes lie in having Rastafarian hospitals and more Rastafarian-based
schools (e.g.,
the nation's
ofthe
(e.g. , Bunny Wailer's Solomonic school) as an integral part of
marijuana , which has so many healing
healing. The further exploration of marijuana,
p
seeds that this earth produces
properties , is crucial. It is one of the most powerful
properties,
and one of the most environmentally- friendly plants in the world. We know very
lillie about the cannabis plant, only knowing about three to four properties of the
450 plus that exist (A. Amen, personal communication, February 3, 2010). Why
are we not investigating these properties more carefully instead of trying to focus
on its role in mental illness and as a gateway drug?
Indeed, the prevalent use of marijuana in the Rastafarian community brings
about a conundrum of concerns regarding the interplay between marijuana and
psychosis and the differential diagnoses of cannabis-induced psychosis and any
other psychotic process (e.g., schizophrenia). The literature is replete with
warnings about the linkage between ganja smoking in adolescence and psychosis
Rastafarl
173
in adulthood (Andreasson,
Engstrom,, & Rydberg,
(Andreasson, Allebeck,
All ebeck, Engstrom
R ydberg, 1987; Arseneault
Ars eneault et
al.
al.,, 2002; McGrath et. al.
al.,, (2010). However
However,, there has been much debate about
studies
例ORML
(NORML,， 2010); about the cross-cultural
the conclusiveness of such studies
relevance of such studies (D
(Dreher,
reher, Nugent,
Nugent , & Hudgins,
Hudgins , 1994); the lack of
comparative data when one reviews the rising trends in marijuana usage which do
not concur with the rates of schizophrenia; the lack of clarity in determining which
use , and the ensuing ambiguous
actually comes first,
fìrst , mental illness or cannabis use,
relationship between cannabis and psychosis. These individuals and groups (e.g.,
(e.g. ,
Coalition for Ganja Law Reform,
Reform, National Organization for the Reform of
Marijuana Laws 例ORML))
(NORML)) recognize the possible health risks and therefore call
for legal regulation,
regulation, much in the same way that ibuprofen and other drugs that
(NORML,
have particular and potentially damaging side effects are regulated
re 伊lated
例
ORML ，
2010).
Research is necessary to further explore the issues of RastafarI
RastafarI within this
ofbooks
books and articles about Rasta are not Rasta
postcolonial reality. Most authors of
Jamaican. Although
Although this can have its advantages
advantages,, for example
and are not even ]amaican.
encouraging objectivity
objectivity,, it also has its drawbacks due to a lack of cultural
understanding. The Mro-Caribbean has mainly espoused an oral tradition,
tradition, so we
have failed
fai1ed to articulate and document our own Caribbean history. The issues of
RastafarI and health,
RastafarI
health , RastafarI
RastafarI and mental health,
health , RastafarI
RastafarI and personality,
personality,
identity, and politics all need to be researched and incorporated into the training
identity,
of our practitioners.
rninority groups (i.e.,
(i.e. , Mrican Americans,
Am e 配ans ，
Currently, cross-cultural studies of minority
Currently,
Native Americans,
Americans , Asian
Asian Americans,
Americans , and Latin Americans)
Americans) are a mandatory part
of American
American Psychological Association (APA)-approved doctoral psychology
programmes,
programmes , as mandated by the APA in its role in curriculum development.
Likewise , Rastafarian practices and belief systems should be made mandatory for
Likewise,
our Caribbean people to understand. This is a critical training issue.
Conclusion
A present challenge for mental health professionals is to deal with this conundrum
of Rastafarl.
Rastafarl. This is critical because of the growing number of people,
people , especially
youth,
youth , that are being drawn into such a livity at varying levels,
levels , and are being
affected by ganja smoking; because of the high rates of non-compliance with
current treatment
treatrnent regimes; and,
and , fìnally
finally,, because of the resonance of RastafarI
RastafarI as
something fundamentally
fundamentally]amaican/Caribbean.
Jamaican/Caribbean. We must therefore speak to all its
story, as articulated by us. The
aspects appropriately from our own Caribbean story,
ideology that surrounds mental
mental
山ness
illness is not clearly defined
defìned from a Rastafarian
approach , release stereotypes
stereotypes,, and
perspective and so one must be flexible in one's approach,
listen to the voice of the individual.
174 K. A. D. Morgan
Notes
1. RastafarI
Rastafarl is spelt throughout this chapter with a capital 1I at the end of the word to
emphasize the central concept of empowerment through words,
words
，呻ecially
especially with "I."
"1."
2. Babylon is a name given to the establishment,
establishment, represented by the police
police,, governmental
organizations and so on and hails
hails
丘om
from the experiences of Rastafarians with these
systerns , which indeed did oppress them,
them, and attempted to destroy the foundations of
systems,
出e
the Rastafarian uprising back in the 1960s.
ofthe
the evolution ofRastafarI over the past 70 years,
years
，由e
the originally endorsed livity
3. As part of
is not always stricdy
stric
由 adhered
adhered
to. For example,
example , consumption of substitute meats
mea 臼 made
rnade
from wheat gluten (e.g.
(e.g.,, veggie chunks
chunks,, veggie steak) and soy products (e.g.,
丘om
(e.g. , tofu) are
an acceptable part of a Rastafarian diet. While still others include live foods,
foods
，豁出e
as the
consumption of cooked food destroys the enzymes that promote healing and
nourishment for the body.
4. This ideology mainly belongs to some Boboshanti peoples
peoples,, the most orthodox of the
RastafarI mansions.
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14
HINDU HEAllNG
HEALING TRADITIONS
IN THE SOUTHERN CARIBBEAN
History and Praxis
Keith E. McNea/
McNeal,, Kumar Mahabi
Mahabir,r, and Pau/
Paul Younger
Introduction
Hinduism found its way to the Caribbean in the hearts and minds of
ofSouth
South Asian
of"indentureship"
"indentureship" devised by the British-and soon
migrants under a new system of
followed by the French and other colonial powers-to supply West Indian planters
with alternative sources of labor in the aftermath of slavery. Indenture was
contract , often renewed one or more times,
times , and
characterized by a five-year contract,
criminallegal
legal sanctions. Recruits were unfree
un 丘ee while indentured,
indentured ,
maintained by criminal
and-by the late 19th century-return passage to India had to be self-paid should
one decide to quit the West Indies upon completion of servitude. Halted in 1917
India, over two and a half million Indians emigrated
due to political agitation in India,
migration, though
from the subcontinent under this transoceanic system oflabor migration,
less than a quarter of them returned to the subcontinent after
a 丘er serving their
Clarke , Peach,
Peach , & Vertovec,
Vertovec , 1990;
indenture (see Brereton & Dookeran 1982; Clarke,
Lai , 1993; Mangru,
Mangru , 1987; Vertovec,
Vertovec ,
Jayawardena
Jayawardena,, 1968; La Guerre
Guerre,, 1985; Look Lai,
Younger, 2002: 2010). Colonial discipline saturated the lives of indentured
1992; Younger,
laborers , with frequent prosecution by employers and wretched living conditions
laborers,
fami1y life in addition to the maintenance
presenting serious challenges to stable family
of
health and psychological well-being. Enslaved Mricans had faced these problems
ofhealth
as well,
well, thus indentureship has been described as a "new system of slavery" (Tinker,
(Tinker,
1974).
What happened from the mid-19 th century onward was the gradual reorganization and consolidation of diverse beliefs and practices brought
brought 丘om
from various parts
of
ofSouth
South Asia into a more standardized type of
ofHindu
Hindu sociocultural system: "from
village
vi11
age and caste beliefs and practices to wider,
wider, more universalistic definitions of
Hinduism that cut across local and caste differences"
di 岳rences"
Oayawardena 1968
1968,, p. 444).
Hindu Healing Traditions
177
This chapter therefore outlines the development of Hinduism in the southern
southem
Caribbean and considers the ways varied healing traditions stemming from South
Asia have adapted to and been reconfigured by their experience in the West Indies.
We focus on Guyana and Trinidad since they are home to some of the most
dynamic Indo-Caribbean healing traditions,
traditions , which have also had the greatest
America. Our discussion
impact throughout the region as well as abroad in North America.
sitt 阳
u山
a筑te臼s 伊
ppractices
raκctice
臼s of
ofre 时
eli ♂O 山 and
and
popul
由
la盯r healing within changing
d
religious
popular
political and
situates
t由
heological
prorninen
川tc ∞
contemporary
on川temporar
巧
yfo fonns
口ns s
theological
contexts in order to analyze the most prominent
of
o fI Indo-Caribbean
n叫
d也
o-Ca 红扭
曲
n1也
bbea 扭
n therapeutic praxis: a psychosomatic healing prototype known
asjharay,
asjharay , as well as practices of cathartic,
cathartic , trance-based psychotherapeutic treatment
treatrnent
and devotional exorcism offered by heterodox Shakti
Shaktí temples. The colonial
coloniallegacy
legacy
and postcolonial transfonnations
transforrnations are examined with regard to their implications
for health and mental health.
Hinduism in the Southern Caribbean
The first indentured Indians arrived in British Guiana in 1838,
1838 , and almost 239,000
239 ,000
Indians were brought to this tiny coastal strip of northeast South America
America by the
time the system was abolished ry ounger,
ounger, 2010). They likewise arrived in Trinidad,
Trinidad,
th century,
which Britain had taken from Spain at the tum of the 19
19 由
century
， except the
144,000
there,, in 1845,
1845 , and involved approximately 144
,000 people.
process began later there
The
Them majority
司jority
hailed from the Gangetic plains
pl 组 ns of northeast India,
India, having sailed
Americas. A mix
through the Bengali port ofKolkata (Calcutta) en route to the Americas.
of people from varied caste backgrounds arrived,
arrived, though Brahmins
Brahrnins were few and
lower castes likely represented a larger percentage than in the regions from which
they came. The experience of radically novel economic
econornic routines and power
relations spawned a range of modified,
modified, as well as new,
new, sociocultural fonns.
forms. Though
the
them majority
司jority
was Hindu-with a small,
small , but significant number of Muslims in the
mix-an
mix -a nimpo
important
眈:ant early distinction concemed
concerned whether one was a northemer
northerner who
had sailed through Kolkata or a southerner
southemer via the port of Madras (Chennai) on
the coast ofTarnil Nadu,
Nadu , i.e.
i.e.,, a Kolkatiya
Kolkatíya versus Madrassi
Madrassí (La Guerre,
Guerre , 1985).
civilization, thus
Indians were seen as hailing from an inferior Oriental civilization,
Islam, a
condescension animated the official colonial position on Hinduism and Islam,
stubbom local tendency to refer to people of South
legacy that translated into a stubborn
Asian descent as East-rather than West-Indians,
West-Indians , thereby framing them as
"outsiders" and complicating their political claims on the state in both colonial and
Se 酬， 1989; 1993;
postcolonial incarnations
incamations (Khan,
(Khan , 2004; Munasinghe
Munasinghe,, 2001; Segal,
W血iams ， 1991). Given conventional assumptions about the
1994; Sheller
Sheller,, 2003; Williams,
Asia , it is ironic that
"essential" relationship between caste and Hinduism in South Asia,
growth of mainstream Hinduism was in fact facilitated by attenuation of the caste
system in the West Indies,
Indies , where caste could not be transplanted as an integrated
structure , econornic
economic relations
relations,, and ritual hierarchy 01an der Veer
system of social structure,
& Vertovec,
1991).
Vertovec ,
178 K. E. McNeal,
McNeal, K. Mahabir,
Mahabir, and P. Younger
The result was a "leavening" process (Haraksingh,
(Haraksingh , 1986; 1988) in which beliefs
and practices from varied localities and communities in India were submerged and
reformulated in relation to one another. Hinduism and caste ideology were
simplified under the oppositional principles of
ofhigh/low
highII ow,, pure/impure,
pure /impure , Brahminl
Chamar, and North/South Indian: protean categories mediated by the continChamar,
gencies of local power relations. 1 Structural transformations reflected by these
categorical modifications enabled aspiring Indians to take advantage of the overseas
experience by shedding connections with previous status and elevating themselves
as New World higher "castes" of a sort. To the extent that the discourse of caste
persisted at all
all,, it became a cipher deployed in the negotiation of new class relations
within the changing political economy of capitalism (see Jayawardena,
Jayawardena , 1968;
Schwartz,, 1967; Younger
Younger,, 2010).
Schwartz
The process of social leveling fostered by indentureship meant that the
expansive number of those claiming Brahmin status were able to establish
themselves as leaders of
ofthe
the "North Indian" community. Their leadership was as
much sociological as it was religious,
religious , and a thriving new temple tradition evolved
needs.
一including
in the wake of indentureship to meet the emergent needs-including
health and
psychological-ofthe
Hindu community. These mandir
psychological
一-ofthe
mandír (temple) traditions became
the locus for congregational communities that met on Sundays for worship typified
by devotional singing and listening to the Brahmin give a "sermon,"
"sermon," or katha.
Pandits (p
(priestly
riestly Hindu specialists who oversee and direct ritual observances and
life cycle rites) also provided pastoral care to families throughout the week. This
ofHinduism
Hinduism is strongly Vaishnavite-i.e.,
Vaishnavit i.e. , oriented to Vishnu-in
Vishnu
一in theological
form of
orientation and characterized by an emphasis on bhakti devotionalism (V
(Vertovec,
ertovec ,
1992). Drawing support from conservative
conse
凹ative
Hindus
Hindus,, the development of
standardized West Indian Hindu accelerated in the 1920s under the canopy of
Sanatanism in response to the provocation of Arya Sarna}
Samaj reformism emanating
from India. A "Sanatanist" is a follower of Sanatan Dharm
Dharma-known
阶-known
as "Eternal
"Etemal
Order" or "Traditional Religion"-and
Religion" -and Sanatanism had already begun to consolidate in the subcontinent in response to the Samajjist
Sama.üist challenge (Y
(Younger,
ounger, 2010).
The overall point here is that a dominant form of Hinduism emerged in the
th century
20 由
century
West Indies under the neo-traditionalist sign of
ofSanatan
Sanatan Dharma. The
20
waxing and waning of an internal Samajjist-Sanatanist dialectic was overdetermined by the fact that Christianity retained hegemony as the dominating cultural
barometer of social status and moral legitimacy throughout the colonies, putting
Hindus on the defensive. Thus the Indo-Caribbean community internalized values
espoused by colonial elites and adopted them as their own terms of reference in
an effort to forge a "respectable" Hinduism. This orthodoxy is predominantly
devotional and Vaishnavite in orientation, identified with "North Indian"
tradition, proctored by a transculturated Brahmin ceremonial elite, has become
standardized as well as centered upon a limited set of "high" Sanskritic deities, and
is as much sociological as it is religious in practice. Though the apical position of
Brahmins is hardly watertight-especially in the postcolonial era-Hinduism may
•
Hindu Healing Traditions
179
be understood as having become progressively ethnicized under their stewardship
in the Caribbean. Van der Veer and Vertovec (1991,
(1991 , p. 158) observe that West
ways , achieved an even more central social
lndian
Indian Brahmins have
have,, in important ways,
position than in lndia
India itsel
itself
f.
Yet the other side of this homogenizing Brahmanical coin has been the
marginalization of ostensibly "low" or "impure" folk practices falling outside of
the alleged "orthodox" orbit. Most Brahmins relaxed their attitude toward lower
"castes" and took on a role comparable to that of a parish pripriest,
臼t ， multiplying their
functionality in diaspora while closely guarding the sanctity of the office through
secrecy and some degree of endogamy. Caribbean Brahmins widened their purview as proletarian Hindus progressively embraced their vision,
vision, thereby
In negative terms,
tenns , mainstream West
consolidating the hegemony of Sanatanism. ln
lndian
Indian Hinduism has distanced itself from "heterodox" healing practices
practices,, as well
as actively marginalized ostensibly "primitive"
"prirnitive" ritual modalities such as animal
fire-walking, trance performance,
perfonnance , and spirit mediumship signifying
sacrifice , ritual fire-walking,
sacrifice,
飞ject
aspec
岱 of
ofthe the lndian
Indian past (McNeal
(McNeal,, 2011).
abject aspects
/haray
jharay and Shakti: Hindu Caribbean Healing Practices
This process of orthodoxification is reflected in curricula for the training of pandits
th century,
20 由
century
， which are not especially focused upon healing,
healing,
developed late in the 20
per se. They do focus on astrology; however,
however, this is only indirecdy relevant to
therapeutic praxis in that identifying
identi
马Ting
auspicious times
tir 丑es for doing important things
or
or 也lfilling
fulfilling various ritual obligations is pertinent for the general pursuit of wello fI汪ring
to jharay them,
them, discussed further
being. Pandits may treat sufferers by offering
below
below,, which they often leam
learn to perform
perfonn by observing their gurus or growing up
in a family
farni1y of pandits,
pandits , rather than fonnal
formal didactic training. Mantras (mystical chants)
and yantras (talismans)---of
(talismans)
一斗。f which there are two local types: tabij (amulets) and totka
(apotropaic magic)-are
magic)
一-are
also commonly used among Hindus for spiritual
protection, yet they are increasingly
protection,
i 配reasingly
looked down upon as "superstitious" by
higher-clas
在 Hindus.
Hindus.
educated or higher-class
Anthropologist Steven Vertovec (1992) observed
obse 凹ed that the system of folk Hindu
Anthropologist
magic known as ojha overlaps and intermingles
interrningles extensively with the 尬。
Afro-Creole
-Creole
tradition of Obeah,
clients of all ethnic
Obeah , and that ojha-men-or
ojha-men
一or "seer-men"--serve
"seer-men"
一→erve
Juanita Niehoff
and religious backgrounds. lndeed
Indeed,, anthropologists Arthur and ]uanita
(1960) earlier concluded that lndo-Caribbean
Indo-Caribbean incorporation
inco 叩 oration
of black ritual and
religious forms was historically much greater than usually imagined. Ojha specialists
0 岳red a number of services--sometimes
services-sometimes for significant
si 伊ificant
prices
prices--such
-such
traditionally offered
as casting spells or protecting people from them,
them, counteracting cases of the evil
nown as ωjar
najar in patois Hindi,
Hindi , or maljo in the more predominant
predorninant Creole
eye (k
(known
tongue) , soothsaying
tongue),
soothsaying,, concocting love potions
potions,, and locating lost items. Ojha was
used to deal with various culture-bound syndromes that have become progressively
recessive among lndo-Caribbeans
Indo-Caribbeans of
ofthe
the late 20 th and early 21 st centuries,
centuries , such as
180 K. E. McNeal,
McNeal, K. Mahabir,
Mahabir, and P. Younger
aaffliction
fRi ction by rakas (dastardly infant demons),
demons) , patnas (which attack only unmarried
jumbíes (wayward ghosts),
ghosts) , and other folk spirits (Mahabir,
(Mahabir, 2010). It is clear
girls) , jumbies
girls),
1950s, if
that ojha had already begun to be seen as a "lower" status activity by the 1950s,
not
notbeforebefore 但lass
(Klass,， 1961; Niehoff & Niehoff,
Niehoff, 1960).
Jharay
One of the most prominent types of healing within the local Hindu repertoire is
known as jharay,
jharay , the only component of the folk healer's therapeutic armamentarium that continues to be used while the rest of the ojha tradition has dissipated.
The term "jharay"
"jha 町" is used in the West Indies as both verb and noun
noun,, e.g.
e.g.,, "the
pujarijharays" and "I
"1 got ajharay." It refers to purification administered through
ritualized "brushing" or "sweeping" of the seeker by a mystical specialist. Healers
supplicants-commonly
-commonly cocoyea broom
use various implements in order to jharay supplicants
(palm frond) straws,
straws , but also sometimes peacock feathers,
feathers , doob grass,
grass , or vibhuti
pinched within one's fingers or held in hand-and
hand 一-and utter mantras that empower
their work. One may be jharayed for conditions as varied as insect stings or snake
bites,
jaundice,, or cases of maljo,
aches , jaundice
maljo , as well as anxiety or
bites , head and stomach aches,
depression, or for good fortune during trying
depression,
trying
由丑es.
times.
The efficacy ofjharay as a therapeutic ritual technology varies depending upon
the circumstances at hand. We see psychosomatic
psychosomatic
血nesses
illnesses as more amenable to
ofjharay,, but
religious cure than organic diseases. There is no one singular form ofjharay
the underlying model recurs across a range of popular modalities. Thus a masseuse
may jharay at times,
tir 丑es ， but only if they are sufficiendy adept. Jharaying is widespread
women,, yet it is unclear how much
among Hindu Obeah men or ojha men and women
pandits employ this technique-some
technique
一亏ome do,
do , but many do not
not,, as a result of dominant
trends in both orthodox religion and biomedicine oudined above.
Shakti
Jharaying is itself embedded at the heart of the other main form of
ofHindu
Hindu healing
in the contemporary southern Caribbean-known as Shakti
Shaktí PiPuja,
帜， or Kali
Worship-which
W orship-which takes place in temples dedicated to therapeutically-oriented
trance performance and spirit mediumship. This practice of healing is widely
considered a "Madrassi" tradition; yet,
yet , such a characterization is more apt for
Guyana, than Trinidad (McNeal,
Guyana,
Younger,, 2002; 2010). Shakti refers to the
(McNeal , 2011; Younger
complexity, and is
cosmic energy activating the universe in its polymorphous complexity,
associated with the devis-or
devís-o r goddesses-in Hindu cosmology. Puja
P ‘ ja refers to ritual
worship directed towards a deity. West Indian Shakti Worship revolves around
to 一-and healing received from-deities
from-deities conjured through spectacular
devotion to-and
trance performances by spirit mediums,
mediums , all of which now takes place within
temples under the overarching aegis of
ofMother
Mother Kali (in Trinidad) or Mariyamman
Ma 町amman
(in Guyana),
Guyana) , even though it also traffics in masculine deities. The tradition is
Hindu Healing Traditions
181
deemed "heterodox" from the Sanatanist perspective since it is predicated upon
practices of popular mysticism considered "primitive"
"prirnitive" and less than "respectable,"
"respectable,"
m 町 be
although this bias may
be relatively lesser in Guyana than Trinidad.
A reconstituted Madrassi ritual tradition coalesced early in the 20 th century in
British Guiana due to the substantial number of south Indians living in the
compacted coastal colonial society. In contrast to the north Indian-inflected
"Hindu" tradition,
tradition , Madrassi ritual praxis was less political and more mystical,
mystical ,
centered on devotions to the goddess Mariyamman and other flanking deities.
Guyanese Madrassi religion became temple-based and premised
prernised upon regular
re 伊lar
oofferings
岳rings
to the gods-including live animal sacrifice
sacrifìce in addition to
to 丘uits
fruits,， flowers,
flowers ,
coconuts,
coconuts , lit flame,
flame , and so forth-in
fo 由一in order to cultivate devotional relationships
perforrnances
with them and seek their healing interventions through the trance performances
of ecstatic mediums.
mediurns.
In Trinidad a much smaller percentage of
ofMadrassis
Madras sis in colonial society became
more encompassed by the evolving tradition of
ofSanatanism.
Sanatanism. Their lively wedding
and funerary traditions-as well as devotions to Mariyamman and a spectacular
tradition of firewalking--were
fìrewalkin g--were practiced throughout the period of indentureship,
indentureship ,
but more or less eclipsed by the mid-20
rnid-20th century.
centu
巧. There were also north Indian
traditions ofKali Puja involving animal sacrifice
sacrifìce and trance performance
perforrnance as papart
眈 of
of
community devotions to Mother Kali in colonial Trinidad,
Trinidad , as well as Dí
Di Puja
(p
ronounced "Dee"),
"Dee") , in which the spiritual "Master of
ofthe
the Land" is entreated for
(pronounced
agricultural fertility or protection of the household. All of these practicesMadrassi and otherwise-were deemed "heterodox" by the muscular Sanatanism
1. Yet links were made by several
that gained such traction 放er
after World War 1II.
aspiri
吨 Indo-Trinidadians
IndoTrinidadians with Pujari Naidoo in Guyana,
Guyana, who helped establish
aspiring
the first
fìrst postcolonial mandir dedicated solely to shakti healing
heali
吨 in
in Trinidad. This
schisms ,
fìrst temple community was followed by a series of extensions and schisms,
first
producing a set of temples that continues to proliferate to this day.
Shakti Puja is often observed on a weekly basis in temples that range in size
from makeshift shacks to compounds capable of
ofholding
holding hundreds of people. Most
murtí (sacred statue) ofMariyamman or Kali,
Kali , around
are oriented around a central mUTti
which-in turn-are positioned her accompanying gods and goddesses at
concentric levels of remove. Divinities of "orthodox"
"orthodox north Indian provenance
are also present in these temples, but they are secondary to the "heterodox" deities
that operate as the most central sacred personae within these ritual precincts.
Devotees arrive early before the puja armed with flowers, milk, fruit, and other
items offered to any or all of the deotas before the formal service begins. The
general structure of the temple puja consists of pujaris (ritual leaders and their
assistants) and an attending group of devotee-observers moving to each and every
deota "stand" (location of the murt!) in order to make offerings of fruit, flowers,
green and dry coconuts, incense, lit flame, and possibly install a jhandi (spiritual
flag representative of each divinity). Ritual performance is accompanied by
devotional songs and musically driven by the rhythmic percussion of typically three
182
K. E. McNeal,
McNeal, K. Mahabir,
Mahabir, and P. Younger
or five or more tappu (special goat-skin) drums. The round of puja offerings to the
deities culminates
cu1minates climactically in collective devotion to the great central goddess
murti as well as her performing spirit medium. If the temple makes
herself, via her murtí
herself,
blood offerings
0 班èrings
via live sacrifice
sacrifice,, it is at this point that the animals are beheaded
0 岱red.
for whomever they are being offered.
People bring all sorts of issues and problems to be dealt with by deotas. These
"consultations" are conducted openly within the space of the mandir; however,
however,
everyone except those direcdy involved stands back in order to create a buffered
space of semi-privacy
seuú-privacy for the divine interchange. The entranced "manifestation"
of the deities through experienced adepts is the highpoint ofShakti Puja and many
people visit such temples on puja days with the specific purpose of consulting with
the deotas via their ecstatic oracles about a wide range of existential problems such
as
as 山ne
illness,
队 domestic
dome 唱tic or work conflicts,
con 血侃， infertility,
i 吐』由且ty ， sexual dysfunction
dysfunction,, or tabanka (l
(love
ove
depression). As one devotee put it: "Yuh go to Kali when you have to,
to , not when
you want to!" The end of the ppuja
可 a is also a time when especially severe cases of
illness or spiritual afRi
affliction
ction may be dealt with more privately by the primary healers
of the temple. Leaders of some temples may also be available during other days of
the week in order to "see about people" with special concerns
concems or urgent therapeutic needs. There are also cases of practitioners who run private healing centers
out of their home without holding public puja.
p 归. The more involved or complicated
expands , often leading to long-term
the case,
case , the more the pujari's pastoral care expands,
social relations with the primary healers and temple community more generally.
One senior pujari observed that his temple "come like a clinic,"
clinic ," continuing:
We can heal the sick with shakti. But it is not we that is doing it
it,, it is God.
So the divine Mother Kali and all the deities - they are using the bodies of
these people,
sick.
people , of these pujaris,
pujaris , to cure and heal the sic
k.
Trance perfon
丑ance
within these temples is conceived as the activation of shakti
performance
energy within the human body.
This temporary "elevation" of shakti in a spirit medium makes the practice of
jharaying with neem leaves-a sacred Indian plant closely associated with devi
worship-especially powerful during ecstatic consultations in temple ppuja.
叮 a.
Jharaying in shakti praxis is conducted with a bundle of ritually prepared neem
fronds , which are brushed all over the head and body of the supplicant or devotee.
fronds,
This is a potent gesture transmitting
transuútting the healing power of the god's
god' s shakti to those
who seek it. Jharaying in shakti temple ppuja
归 is
is usually accompanied by an
interchange with the deity through its ecstatic votary,
votary, such as making a confession
or seeking advice,
advice , receiving instructions about how to focus one's devotions in
order to "get through" difficult
di 面 cult
times. Ecstatic mediums
mediu
日lS take flanúng
flaming cubes of
camphor into their mouths,
mouths , or hold them in their hands,
hands , as a performative sign of
authentic mystical activity taking place,
place , the logic being that only superhuman
power can withstand the heat and avoid getting bumed.
burned.
Hindu Healing Traditions
183
Lay members as well as visitors to shakti temples also commonly become
entranced by shakti "vibrations,"
"vibrations," but this form of "catching power" is a lowerlevel , more generic type of mystical energy not identifiable as any specific divinity.
level,
forr 丑 of
of ecstasy experienced by lay devotees or spiritual seekers may
This baseline form
be intensely cathartic,
cathartic , as it offers the opportunity to phenomenologically transcend
retrospect, such experiences may
oneself within a supportive,
supportive , ritualized context. In retrospect,
come to be seen as the beginning of one's
0 肘 's career as a medium
medium,, if one ends up
graduating to the higher level of performance and much more complex register of
experience. These experiences feed reciprocally into prayer and personal devotion
outside the ritual arena,
arena , creating a ramifying
chain of experience that may gain
rami 马ring
transformative momentum over time-what psychotherapy refers to as the
"expanding circle of mental health."
su 凹ey data demonstrate that people involved in Kali
William Guinee's (1990) survey
su 岳d 吨， with nowhere
W orship in contemporary Trinidad are often poor and suffering,
Worship
else to turn. They have attempted to relieve their distress through more
conventional routes without success. Thus they become open to an alternative
community that welcomes them and their problems. Once meeting with success
through ecstatic temple puja-accessing the healing power of the Mother and her
associates via trance performance-their motivation shifts and they may become
more deeply affiliated with the temple community. They may even themselves
become involved in care-giving for others over time. The clientele of templebased Shakti Puja is also considerably more ethnically and religiously heterogeneous than that of orthodox Hindu mandirs.
su 岳ring
and healing in one of the
Guinee's (1992) extraordinary study of suffering
largest Kali Temples in Trinidad shows how the practice of ecstatic Shakti Puja
operates as an embodied theodicy,
theodicy , forging new attitudes and transformative
successful. Spiritual diagnoses of problems made at the
relations over time when successful.
mandiro
岳r hope and an explanation for misfortune or suffering,
suffering, as well as provide
mandir
offer
a devotional recipe for bringing about relief and change. The supplicant participates
in a series of exchange relations with deotas (deities) mediated by both mediums
community, fostering cathartic devotional praxis that alleviates
and the temple community,
grounded,
one's
O
肘 's sense of helplessness-and
h 句lessness
→ nd thereby fosters
fo 阳s a more buoyant,
buoyant, 罗
g roωun
伊 叫
d叫
participating in procedures that
do something
proactive sense of self-through
selι一through
t
concrete and compelling about it. There is much more nuanced research to be
done on the psychospiritual complexities and self-transformative "magic" of such
healing practices.
One important difference between the practice of shakti healing in Trinidad
and Guyana is that Guyanese practitioners are much more committed to appeasing
and soliciting the gods through live sacrificial animal offerings, as compared with
Trinidad, where the dominance of Sanatanism has been amplified by greater
socioeconomic mobility. More than in Guyana, this sphere of religious practice
has progressively abandoned live animal sacrifice as part of orthopraxy in Trinidad,
184
K. E. McNeal,
McNeal, K. Mahabir,
Mahabir, and P. Younger
although several "holdout" temples continue to resist the switch to the wholly
vegetarian approach to puja known as sada.
Ecstatic Shakti Puja is important not only because this complex practice is one
of the most prominent
prorninent forms of healing in the contemporary
contempora
巧T West Indian
Hinduism
Hinduism,, but also because it is the therapeutic practice that has traveled most
extensively among Indo-Caribbeans throughout the north Adantic world.
W orship have also spread further afield in
Extensions of Trinidadian-style Kali Worship
several major
m 习 or metropolitan centers of the United States.
Yet, it may be Trinidad that has recendy taken the lead in spreading the gospel
Yet,
ofShakti Worship
W orship within the Caribbean region itself Ri
Ritual
linkages have recendy
tuallinkages
been forged between a prominent
prorninent Trinidadian temple and a small,
small , but symbolically
significant community
comrnunity of Hindu-identified Martiniquans of Mrican and mixedA
臼can descent. Mahabir (2011) observes that people ofIndian
o fI ndian descent in Belize
African
and Guadeloupe also look towards Trinidad for inspiration and support
suppo
眈 in
in recent
attempts at reclaiming
reclairning their history and culture. Trinidad and Tobago has
substantial oil and natural gas resources that make it the industrial and financial
Indies , thereby able to project national cultural power
powerhouse of the West Indies,
throughout the region.
In addition,
addition, the proliferation of new digital media as well as the continued
circulation of Caribbean people throughout the Adantic world foster dynamic
dynarnic
patterns of cross-fertilization and reciprocal influence among varied healing
modalities and nationally inflected temple traditions that have yet to be adequately
documented and analyzed.
Collaboration and an Integrative Healing Model
It is important to note that the forms of therapeutic engagement and spiritual
healing discussed here
here-especially
-especially jharaying and Shakti Puja-may involve
pa 眈 of
of the healer that a supplicant,
supplicant, or "patient,"
"patient," would
conclusions reached on the part
be better served by a biomedical doctor,
doctor, and thereby make such a "referral."
"referral. " We
We
(especially McNeal) have encountered such assessments in collecting the life
devotees , and witnessed these referrals made on the part
pa 眈 of
of
histories of various devotees,
shakti mediums dealing with people in search of healing power. Hindu hospital
patients are sometimes jharayed by ritual healers while their doctors turn a
blind eye.
Kumar Mahabir (2012) considers all of the dtherapeutic forms discussed above
along with other 岛
folk
f ülkhe healing
忧
ealing
practices
pract 位ices
such aωs
as herbalism,
her 由
balism
， midwifery,
rnidwifery, massage,
massage , and
Trinidad, seeing them as sorely
chiropractics in his typology of ethnomedicine in Trinidad,
ofhealth
health care. Indeed
Indeed,, Mahabir
under-appreciated within the local infrastructure of
argues these ethnomedical traditions represent "untapped development potential"
in the late modern era of neoliberal globalization and structural adjustment
a ‘ justment
programs,
prograrns , which downsize the public health sector and scale back formal health
regard, since its benefits
care. Indo-Trinidadian massage especially stands out in this regard,
Hindu Healing Traditions
185
span a wide range of conditions and there were as many practitioners on the island
in the mid-1990s as there were doctors and nurses. While biomedicine is
dominant, largely militating against whatever legitimacy ethnomedicine might
dominant,
otherwise gamer
gamer,, the relationship between bio- and ethnomedicine is complex,
compl
旺，
including the persisting relevance of some traditional therapeutic traditions at the
fùtering down into ethnoproletarian level,
level , as well as aspects of biomedicine flltering
medicine in less
les 在 overt,
overt
， yet nonetheless significant ways.
vemacular Caribbean Hindu healing
It must be emphasized that practitioners of vernacular
do not view their traditions as inherendy or necessarily in competition with
biomedicine despite the fact that most biomedical practitioners see popular healing
practices as "primitive" holdovers destined to eventually die out. Yet such theratimes,, and under certain
peutic practices are successful in certain ways,
ways , at certain times
conditions. They are especially efficacious when used to deal with psychological
illnesses and psychosomatic conditions. Healers recognize this with distinctions
such as differentiating between "Mother Work" and "Doctor Work,"
Work," for example.
However, the line between ethno- and biomedical therapy is neither static nor
However,
distinct in personal experience or ritual practice. Indeed,
Indeed, according to Singer,
Singer,
Araneta,
Araneta, and Naidoo (1976) it was Pujari Naidoo's years of observing psychiatric
intake assessment and clinical interviews conducted between doctors and patients
in Guyana's
Guyana' s colonial-era mental hospital that inspired his dispensing with liturgical
1960s, effecting
e 岳cting
a
pidgin Tamil
T ami1 speech by ecstatic mediums in his mandir in the 1960s,
as w
叫
well
ell aωs
as 附
exert
e xe 眈 r叫
ramifying
m 马阳
11
change that would better approximate psychotherapy,
psychotherapy , 衍
Eeffects
丘岳
ecωt
岱s throughout the region.
re咱
g lO n ..
Conclusion
The understanding and experience of spiritual illness-as
illness-as well as its treatment and
various therapeutic outcomes-change over time in dynamic interrelations with
healers , family members
healers,
members,, and other factors. The idiom of "spirit" affiiction is a
protean one that may obliquely express a multifarious range of conflicts and
life , making it an elusive object,
object, yet also meaningful precisely
problems in one's life,
because of this ineffability. The operation of spirits in oneself may reflect
conflict, yet also provide a fulcrum for spiritual
intrapsychic pain or interpersonal conflict,
intervention and vehicle for self-transfonnation.
selιtransformation. Indo-Caribbean Hindu healers
understand this. Their therapeutic engagements are geared toward cultivating and
hamessing the sacred power of trance praxis in order to care for others and
harnessing
su 岳ring
or alienation.
ameliorate their suffering
Their interventions are not always successful,
successful , but in this regard they are akin
infallible , but contingent
with biomedicine and psychotherapy,
psychotherapy , neither of which is infallible,
upon person,
person, problem
problem,, and circumstance as well. Indeed,
Indeed, Indo-Caribbean Hindu
healing traditions are resilient and respond to the times. Biomedicine may be
ascendant, but it coexists with these practices that express the soul as much as the
ascendant,
body-and for this reason,
body-and
reason, they are unlikely ever to be wholly superseded. The
186 K. E. McNeal,
McNeal, K. Mahabir,
Mahabir, and P. Younger
question is what sorts of new complex configurations the future holds. Much
research remains to be done.
Note
1.
Chamar refers to a demographically large,
large , low-caste group in India who worked
traditionally as cobblers in leather-working trades and therefore considered ritually
unclean. However,
However, the term has been broadened throughout much of the diaspora ω
as
a derogatory gloss more generally.
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in Trinidad. Ithaca,
Ithaca, NY: Comell
Cornell University Press.
Niehoff,
A.,, & Niehoff,
Nieho
ff, A.
Nieho ff, J. (1960). East !ndians
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Museum Publications in Anthropology,
Anthropology, 6.
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Schwartz,, B. M. (E
Schwartz
(Ed.).
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Chandler.
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Se 酬， D. A. (1989). Natio
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in a colonial state: A study qf Trinidad and Tobago (D
(Doctoral
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K. Yelvington (E
(Ed.),
d.) , Trinidad ethnicity (p
(pp.
p. 81-115). Knoxville
Knoxville,, TN: University of
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Segal,
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(Ed.),
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(pp.
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，如1.
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扎1acrr
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Younger , P. (2002). Playing host to deity: Festival religion in the South !ndian
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Younger, P. (2010). New homelands: Hindu ωmmunities
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升ica. New York: Oxford University Press.
Pre 臼.
15
ISLAMIC
ISlAMIC INFLUENCE
INFlUENCE
IN
IN THE CARIBBEAN
CARIBBEAN
Traditional and Cultural
Healing Practice
Abrahim H. Khan
Introduction
Islam came to acquire a recognizable presence in the Caribbean from 1837 with
waves ofIndians
ofI ndians arriving to supply the labor force for British sugar plantations. Its
culturallore
lore of the region is reflected in at least
influence on the traditional and cultural
one healing practice known by dam
dam 阳rna
karna,， an Urdu expression that means roughly,
roughly ,
occurring,, the practice is papart
"blowing breath." Still occurring
眈 of
of religion "as it is lived,"
lived," or
of vernacular
vemacular religion that American
American folklorist Primiano (1995) distinguishes from
"。但cial"
"official" or elite religion understood primarily with respect to philosophictheological doctrines or group rituals. It belongs also to the genre in the history of
understanding oneself with respect to hurnan
human survival and well-being
well-being,, in countries
眈 of
of the British colonial Caribbean sugar plantation and political
that once were papart
economy and relied on indentured Indians for its labor force.
Health care provision in the harsh indentureship conditions was a bare
minimum
obligations , according to Mangru
minimum,, planters defaulting in the contractual obligations,
ai1ments was on local practices informed by the
(1987); reliance for remedying ailments
culturallore
cultural
lore shaped by religion. Despite the comparative ready access of modem
medicine in Guyana and Trinidad,
Trinidad , the persistence of dam karna is an indication of
continued belief in its efficacy,
efficacy, and thus is a reason to consider it as an adjunctive
a 句 unctive
therapy and treatment in existing or primary health services in the Caribbean.
In scholarship the medical literature shows signs of a correlation between
religion and health,
health, especially in the area of mental health and well-being (B
(Bhut,
hut ,
King
Koenig, 2001; Cinnirella & Loewenthal,
Loewenthal, 1999).
King,, Dein
Dein,, & O'Connor 2008; Koenig,
At a primary health care level,
level , religious beliefs and practices are increasingly
accorded recognition in North American
American medical practice as a resource for coping
with trauma from life's adversity and suffering (Newberg & Lee,
Lee , 2006). But this
Islamic Influence
189
recognition has yet to be extended to the ro1e
role of religion in Caribbean traditional
karna would assist at the 1east
least in better
and cultural healing. A discussion of dam kama
ideas and research projects appropriate to health care in the region.
forrnulation of
formulation
ofideas
This chapter has for its underlying argument that dam kama
karna belongs originally
life,, aspects of which have to be recovered for the practice to become
to a form
forrn of
oflife
exp1ains how the expression dam kama
karna
an adjunct to existing health care services. It explains
gained currency in the vernacular of the English Caribbean colonies
co1onies and hence
Indo-Caribbean diaspora in North America.
America. This
remained in use even among the 1ndo-Caribbean
is then followed by an exposition or recovering of the healing practice relative
re1ative to
1s1amic
Islamic princip1
principles,
战 practitioners,
practitioners
， and remedies. Finally
Finally,, considerations are offered
0 岳red
for its acceptance as an 叫junctive
adjunctive therapy in a prim
primary
町 health
health
care system.
Methodo1ogically
Methodologically,, the study proceeds along ethno1ogical
ethnological and humanistic lines
in the academic
acadernic study of religion. It
Itss explanation
exp1anation and analysis presuppose that dam
阳rma
karma is intelligible
intelligib1e in the context of vernacular religion. According to Prirnianio,
Prirnianio ,
the concept of vernacular religion allows for recognizing religious beliefs as
invo1ving a complex
involving
comp1ex of conscious and unconscious negotiations of and between
religious believers in unequal power relations,
re1ations , and as having a bidirectionality
influence in relation
re1ation to the environment,
environment, each affecting
a 岳cting
and being affected
a 岳cted
by the
other.
Though official
0 伍cial
1s1am
Islam and Hinduism eschew recognizing the interactional
phenomenon,, a widening (see
(see,, for examp1e
example,, Bowman
Bowman,, 2003; Khan,
phenomenon
Khan , 2004: Smith,
Srnith ,
acadernic study of religion makes it possible
possib1e to consider the
1967) in the academic
phenomenon "vernacular religion." The exposition on dam kama
karna is based on first
hand acquaintance with the associated form
forrn of life while growing up in Guyana
and augmented by conversations with Caribbean Muslim diaspora members in
Toronto and Orlando. Archival materials are employed
emp10yed as further checks and
balances-travelogues,
historical,, 1iterary
literary,, cultural studies (sociodiaries , and historical
balances-trave1ogues , diaries,
Guyana,, Trinidad
Trinidad,, and ]amaica
Jamaica,, with respect
political) and newspaper reports from Guyana
to factors coming
corning into play
p1ay to form
forrn a unified and organic system of belief for
religious individuals.
Presence of Islam in the Caribbean
From 1838 to 1917,
1917 , 1ndia
India under British rule dispatched to the Caribbean 619,988
619 ,988
mm 让grants
as indentured workers to the sugar plantations
p1antations that faced a sudden
immigrants
shortage of 1abor
labor force due to the abolition of slavery. The plantation
p1antation workers
went primarily to four countries: Guyana received the 1argest
largest number 238,909;
238 ,909;
Jamaica,, 36,420.
143 ,939; Guadeloupe,
Guade1oupe , 43,326;
43 ,326; and ]amaica
36 ,420.
followed by Trinidad 143,939;
Roughly 13% of the total immigrants
imrnigrants were Muslims and Urdu speaking. The
remainder was considered to be 1arge1y
largely Hindus
Hindus,, and mainly Hindi speaking.
Today,
Today , however,
however, the majority
m 司jority
of Muslims are in two countries. Guyana has
800 ,000 population,
popu1ation , and Trinidad 8% of its
approximate1y 13% of its estimated 800,000
approximately
1 ,400 ,000 population.
1,400,000
popu1ation. With their arrival,
arrival , 1s1am
Islam gained its footho1d
foothold in the
币
90
190
Ä.
A. H. Khan
Caribbean region,
region , and dam karna became
becarne transplanted (Birbalsingh,
(Birbalsingh , 1989; Lal,
Lal ,
1983; Seecharan,
Seecharan, 1997).
Not unexpected,
unexpected, a fluidity in customs,
customs , religious practices,
practices , and beliefs at the
quotidian level in that indentured situation existed between Islam
Islarn and Hinduism as
forms of life. That is,
is , conscious and unconscious negotiations between the two
religious traditions were occurring to form a unified and organic system at the
vemacular level that helped to deal with the harsh living conditions. The fluidity
vernacular
hhelped
句ed at a communal or neighborly level to deal with harsh living conditions
associated with indentureship and plantation life. With respect to relief from
aih 丑ents
mental/psychical , dam karna is a case in point about the
ailments
that seemed mental/psychical,
fluidity. This was not peculiar to the diaspora,
diaspora, for it has its antecedents in areas
areas
丘'Om
from
where more than 90% of the immigrants had come,
come , and what is today the State of
Utter Pradesh (Fl
(Flueckiger,
ueckiger, 2006; Sengupta,
Sengupta, 2009). The search for health and wellbeing clearly seems to trump religious strictures associated with orthodoxy in Islam
Islarn
or Hi
Hinduism
nduism and that define the identity of many of the adherents of each religion,
religion,
especially in Guyana and Trinidad
Trinidad
但han
(Khan,， 1998; 2004). In those two countries today
Islamic culture thrives alongside that of Hi
Hinduism
nduism and Christianity to the point that
it is recognized in the form of national holidays by each county.
Before the Indian indentureship,
indentureship , Islamic influence had reached the Caribbean
through the slave trade that brought Mrican Muslims. Even prior to British slave
Jamaica through Moorish mariners,
trade,
Islarn may have had a presence in
inJarnaica
mariners , and
trade , Islam
later through
through
仕ee
free Muslim Moors or Maroons,
Maroons , according to Afroz (2008).
Religious gatherings and practices were done secredy by Maroons working as
slaves , but under supervision
slaves,
supe 凹ision
of
ofkinfolks
kinfolks considered as spiritual guides,
guides , or
or 丘iends
friends
of Allah
n.d.).! The awliya' are pious one
one,, making
Allah (Awliya'
(Awlíya' Allah) (Solairnan,
(Solaiman, n.d.).l
intersession to God on behalf of those requesting divine assistance. The dominance
dorninance
of Christian conversion and influence in the plantocracy led to erosion and erasure
of Islamic gatherings and practices.
However, recent archival and anthropological work in Trinidad (Kh
(Khan,
an, 2004)
However,
is showing Islamic
Islarnic influences and suggesting cultural fluidity or blending with
Hinduism. Remnants of Islamic practice are being identified by the academic
acadernic
A 丘。z (1999; 2001). In
InJarnaica
Jamaica,, one example
exarnple of
ofaa remnant is the use
research of Mroz
of the term bucra by Maroons and slaves to characterize the animal
anima attitude of a
fellow human. According to Afroz (2008), the term is a corrupt form of the Arabic
baqarah meaning cow, and the name for a chapter of the Qur'an-Surah al
Baqarah. Verses 67-71 about self-sufficiency and obstinacy reference a type of
individual, notes Mroz, whose human development is arrested and with loss of the
ability to recognize that he or she is no longer spiritually alive. When used by
Maroons and slaves, the term bucra was meant as amusing, in mockery of the
oppressors or sugar planters that they were that type of individual-spiritually dead.
Muslims account for 0.15% ofJamaica's estimated 2.4 million people. Reports
on Friday prayers puts the attendance at 100, though festival celebration days may
see as many as 10,000 according to Dawes (2005). Given the comparatively small
Islamic Influence
Influence
币
91
191
size of the community,
community, it is not surprising that for Muslims in Jamaica there is a
similar cultural fluidity to Guyana and Trinidad. That fluidity extends to treating
the sick or to traditional healing practices correlating with beliefs that define a
Muslim or Islamic
Islarnic view of
oflife.
life.
Islamic Principles and Belief System
The interplay between religion and health is by no means exclusively
exclu
盯ely associated
with an Islamic
Islarnic context. According to its over 2,000
2,000 year history
history,, Mesopotamian,
Mesopot
组ruan ，
Persian
illne
岱 befalling
befalling a person to the
Persian,, and Egyptian civilizations linked disease or illness
actions of a demon or evil
ev 且 deity
deity
(R
(Reynolds
eynolds & Tanner,
Tanner, 1983; Tempkin,
Tempkin , 1973).
ex 缸nple
， evidence the
Greek and Hebraic-Christian religious traditions,
traditions , for example,
intermeshing. Religions seek not only to relieve suffering,
suffering, or to heal,
heal , but offer
as well an explanation for the human condition. They explain the prevalence of
disease,
disease , sickness,
sickness , and evil as human failings to live in truth-be it through
disobedience , defiance
disobedience,
defiance,, or forgetfulness as in monotheistic religions; or by
ignorance and unmindfulne
unmindfulness
岱 as
as in non-theistic religious traditions. In this respect,
respect,
Islam is no different.
di 岳rent.
It
Itss sacred text,
text, the Qur'an
Qur'an,, especially the last Surah,
Surah, Chapter
115
115,, known as An-Naas,2
An-Naas ,2 is a call to trust in Allah
Allah as protection from evil
e 白1 or the
karna , sometimes
practice of witchcraft. In the healing practice known as dam kama,
fluidity) ,
confused or identified with jharay (and hence evidencing cultural fluidity),
Qur'anic verses come to play an important role,
role , as do the pious ones or awliya'
awlíya'
mentioned earlier.
Islam has central to its
its 胎
life view
view
the notion offaith (iman)
(ima 份 that
thatis is adumbrated
adun 由ated
by
也
expres
时 here
here
briefly as beliefin
belief in 1) the unity or oneness
six basic
basic articles. They are expressed
of Allah/God,
Allah/God, 2) angles of God
God,, 3) the Qur'an as a revealed book or God's
Torah,, Psalms,
Psalms , and Gospels comprising the Christian Bible,
Bible , 4)
guidance as is the Torah
prophecy-Muhammad is another prophet in the tradition of the Hebrew or Old
Testament prophe
prophets,S)
俗， 5) the day of
ofjudgment
judgment in the afterlife,
afterlife , and 6) divine decreedecre eGod having decreed for human kind
kind
丘ee
free choice remains the creator and knower
of all. They,
They, in one way or another,
another, are presupposed by dam
dam 阳rna.
kama.
At the very heart of human life according to Islam
Isl 缸丑 is
is the idea that guidance is
Q 町、n. Practicing and especially God-fearing
from God alone through the Qur'an.
(taqwah) Muslims know by heart the Qur'an as a holy book (Kh
(Khan,
an, 2004). Those
who know and practice its commands,
commands , and live a devout life are perceived as potent
in healing. They are the intercessors (awliya~,
(awlíya~
， having become friends of God by
purifying their hearts through dhikr or remembrance of God. They in fact impart
to healing its Islamic
Islarnic influence.
Healers and Healing Remedies
The traditional and cultural folk healing practice we are discussing is sometimes
referred to colloquially by different
di 岱rent
names: dam kama,
ka 仰， maangna du'ij
du 、ã' "， and
andjharay.3
jharay. 3
币
92
192
Ä.
A. H. Khan
Etymologically,
or action. The first,
Etymologically, each alludes to performance
perfon
丑ance
first , dam karna,
karna , an
Urdu expression,
expression, is derived
derived
丘om
from the Persian damiidan
damíídan which is to blow or breathe,
breathe ,
"damlblood." This associative meaning,
meani
吨， in
and associated with the Arabic "dam/blood."
connection with healing,
healing, is intensified by the meaning of the noun dam = breathe,
breathe ,
air, life,
life , scent,
scent, and stewing over a slow fire (Al
avi , 2008; Steingass,
Steing
脯， 1892). These
air,
(Alavi,
meaning ranges are suggestive of spreading over the whole that which is essential
or life giving.
givi 吨. The Urdu verb,
verb , karnaa,
karnaa , derived from Persian,
Persian, means "to do"; hence
karna is the act of doing,
doing, and dam
dam 阳rna
karna is to do the blowing after making the
supplication that includes reciting a passage of
ofthe
the Qur'
Qur'an
an,, which for adherents is
a life-giving or affirming
affinning book. In this connection,
connection, it is important to note that the
Qur'an is received by Muslims as a miracle,
rniracle , the only miracle
rniracle associated with
Muhammad when asked by his detractors to show one,
one , as proof that he is a
messenger of God.
The expression,
expression , maangna
maat 忽na du
du 'a'
、ã' is an Urdu one meaning "supplication,"
"supplication," but
often rendered as prayer,
prayer, and used here as such. It is clearly different from the
salãt or prayer done five times daily. The word maangna written also as
liturgical salat
matigna,
mãtig 时~ is to ask or beg as in knocking from door to door for alms;4 the Arabic
Arabic
du
du 'a'
、ã' is a humble supplication/prayer of which there is a different
di 岳rent
one for each
occasion or circumstance (Platts,
(Platts , 1884). Hence,
Hence , the expression works out to
"asking humbly with hands held out to receive a blessing/healing by God." The
hands , at the end of the petition may then be wiped over the face as token of
hands,
having received blessings,
blessings , according to Padwick (1969). In Toronto,
Toronto , Jamaican
tenn du
du 'a'
、r
Muslims at rehabilitation institutions with an imam as chaplain use the term
in requesting the imam to say on their behalf a fitting Qur' anic prayer and to do
breath. However
However,, used colloquially by Guyanese and Trinidadians,
Trinidadians ,
the blowing of
ofbreath.
the expression refers to a performative
perfon
丑ative
act-that of praying as in pleading with
God for health,
health, to dispel dis-ease or infirmity
infinnity
Central to the perfon
performative
丑ative
act are Qur'anic recitations as prayers. They include
verses
丘om
al-Fatíhah , the open surah of the Qur'an (seven verses),
verses) , followed by
verses
from al-Fatihah,
other verses. Qur'anic verses used as prayers are
are 丘om
from the surah al-Fatihah,
al-Fatihah , quite
114 , respectively; and the
likely surahs al-Falaq and al-Nas
al-Nas,, Chapters 113 and 114,
versel
verse/ ayat al-Kursi or 2:225 as may be fitting. Other verses appropriate to the
request may be in order. Though not ppart
狂t of the performative
perfonnative act,
act, the treatment
treatm
may include the ill person wearing a tabeejlamulet (in Arabic ta'wiz), or a yellow
dress for a number of days, or facing the sun and saying a mantra or prayer, as the
healer may consider appropriate. For the sick or seeker of remedy, knowledge of
the source or content of the recitation matters not at all. Rather, it is belief in the
efficacy of the performance or healing act that counts.
As a healing act, dam karma has at least two components. One is the supplication
or prayer/ du 'a' that involves the reciting of the appropriate verses for the Qur' an.
The other is the blowing of breath over the affected area of the person. It is not
the breath itself that has the efficacy, but the spoken words of God, given by the
Qur'an. Those words are spread over the body or infirmed part by reciting the
Islamic Influence
Influence
币
93
193
verses and immediately blowing on the body or infinned
infìnned area. Sometimes,
Sometimes , instead
of
ofblowing
blowing on the body,
body, the blowing is done over a cup of water and given to be
drunk by the sick. The 优
tenn
t enn
岛
for
f or requesting the pe
perfonnative
丘onnat 位ive act is maangna
mηtaω
al咆您n
仰
1ω
a du'ii'
du 万
aωs
as 正
if
i fi 此
itt ，references
r e臼f岳汪祉
r臼
en配
ce创s the two ∞
components,
c omponent
队
s趴， but in fact
fa汪Cαt 扰
it
i t literally
lit让terall 忖
y means "asking
"aωsk
挝ing
岛
for
f or
supplication."
Sometimes tωO
too,
Qur'anic
supp 抖lica 扭
tion."
∞
O叽， the Qur'
anic verses are written in digits on a piece
of
ofpaper
paper,，也lded
folded and given to be kept in the pocket or carried in a tabeejlamulet
tabeejl amulet
wom on the body,
worn
body , either ann,
ann ，也oulder
shoulder,， or waist,
waist , using a string. Digits are used
to represent the syllables of the verses of the Qur'an,
Ql 町、n ， whose words are considered
sacred,
life-giving, and requiring reverence and ablution before opening the book
sacred, life-giving,
itself. The digitalized fonn mediates the reverence for the text and the reality that
itsel£
one is inescapably
in 创capably
exposed to pollution in daily living but must nonetheless have
penneated
丑eated
with the word of God. It may
rnay even be the case that
the self become pen
du 、3 、' is
is put in water
the paper with Qur' anic verses written by the maker of the du'ii
to dissolve as much as possible and drunk.
example , those for a continually crying child,
child,
Remedies sought are,
are , for example,
ev 且 eye
eye or gaze (U
(Urdu-Hindi:
rdu-Hindi: nazar) cast on the
presumed to be suffering from an evil
child or from a seemingly
seerningly unexplainable pain or dis-ease. Sometimes the gaze or
stare is cast innocently,
innocently, that is,
is , the person may
rnay not be aware of having the gaze,
gaze ,
and casts it through an innocent comment or praise about a child's good looks.
Ailments in individuals would
Sometimes it occurs when there is envy or jealousy. Ailments
include pains that are abdominal,
abdorninal, limbic
limbic,, or elsewhere on the body,
body, and might
rnight be
accompanied by diarrhea,
diarrhea, or refusal to take food and drink. Sometimes the cure
condition, or one associated with an evil spell and
sought is for a mental health condition,
spirit possession. Sometimes the condition is connected with dreadful dreams.
remedy, or have
Conditions are often ones that medical prescriptions have failed to remedy,
not been medically diagnosed correctly. Thus they tum to alternative
altemative medicine or
forrns of healing.
forms
To be sure,
sure , in connection with dam kama
karna there is no healer but only a person
perfonning or doing it-reciting the texts and blowing the breath. Such persons
performing
are regarded as living a morally exemplary and religiously devout life,
life , reputed to
be learned
leamed about matters of healing,
healing, or known to be the head of a brotherhood
brotherhood,,
and may be perceived as having karamaat/ charisma (b
(blessed)
lessed) by being a friend of
Allah,
All
close to God. Whether male or female, that person is often in the
community or village and presumed to have the knowledge of what to say and
do. Sometimes a family member, considered spiritually and morally upright and
who has seen it done frequently in his/her own family may be called upon, in
urgency, to do dam kama. Generally an older person, he or she is addressed
respectfully in the vernacular by names such as sadhu, babu, maiya ji, shaykh, didi,
mamu, that are customarily used in the village or life situation. Further, persons
doing the recitation and blowing are knowledgeable about the Qur'an, can read
and know what verses to recite and are often imams (Khan, 2004). Some imams
in conversation with me were reluctant to acknowledge that they are approached
for healing purposes. But one indicated that as many as 90% of the imams known
币
94
194
Ä.
A. H. Khan
to him would read and do the blowing. In short,
short, the infinned
infirmed seeks out assistance
Qur'an, and knows how to read or
from one who is knowledgeable about the Qur'an,
recite by heart this Arabic text,
text, especially the verses appropriate for the situation
for which healing is being sought. In all of this,
this , the reciter is not a healer nor
pretends to be one,
one , for the presumption is that it is Allah
Allah through the Qur' an by
which healing is effected.
etfected.
ob 优凹ances
are often
0 丘en considered
Sacred-secular intersections or religious observances
petition
狂y prayers. It might be expected that
auspicious for healing and making petitionary
the 10th of Muharram or the first month in the Islamic calendar is one such point.
For Shi'ite Muslims in Trinidad and ]amaica
Jamaica that day is observed as the Hosay
ffestival,
创t1 v 址 , and in Guyana is identified as tadjha day,S
d 町 ,5 ∞
commemorating
C ornn 时mora 低叩
t位ln吨
gt 由
the
hemarmartyrdom
町
t巧y叫om 1
a刽
d 町， commemorating the day Adam
att Karbala. For Sunni Muslims it is a joyous day,
created, Noah's ark landed,
landed , and Solomon received his kingdom.
and Eve were created,
During the indentureship period the Hosay festival became widely popular,
popular, with
all ethnicities participating to the point that it ceased to be a heartening and lifean, 2004). By the mid-20 th century,
century , it had fizzled out in
affirming occasion (Kh
(Khan,
Guyana , but continues to be observed in Trinidad in a carnival-like style or
Guyana,
spectacle , and to a very lesser extent in ]amaica.
spectacle,
Jamaica. Neither archival research6 nor
conversations with knowledgeable members of the community give any indication
elsewhere ,
that the Hosay festival functions in the Caribbean as it does in Mrica and elsewhere,
as a sacred-secular intersection for divine healing to occur.
Collaboration and an Integrative Healing Model
Contextualized and described,
described, dam karma as a healing practice is not unique to the
Caribbean. It has cultural variations and is fairly widespread in the Muslim world.
healing practice among some Bangladeshis
Bangla
企业is in England,
England, and Muslims
Case studies of
ofhealing
in Pakistan,
Pakistan, South Mrica,
Mrica , Palestine,
Palesti
肘， and the US offer
0 岱r evidence and are
Further, in a
comparatively more detailed in their social science methodology. Further,
study of
ofBangladeshis
Bangladeshis in England,
Engla
叫 Rozario
Rozario
(2008) distinguishes
disti 吨uishes
between two kinds
of
illness: one that is medical,
medical, and another that is caused by evil spirits or bhuts,
bhuts , and
ofillness:
requiring remedy by a spiritual practitioner.
In Palestine,
Palestine , the majority
m 可 ority
of folks find no contradiction,
contradiction , according to
anthropologist and folklorist Sharif Kanaana (2004),
(2004) , between folkloric daily
practices and the practice of official Islam. Though official religion condemns their
folkloric practices,
practices , they seem unaware of each practice belonging to a different
di 岳rent
system, or where one ends and the other begins. SharifKanaana's
SharifKanaana' s description
(sub) system,
of one subsystem is that of holy men,
fasting,, reading
men, engaged in prprayer,
町er ， fasting
readi
吨 the
the
Qur'an , and able to do karamaatlmiracles.
Qur'an,
karamaat/miracles. They are the vehicle through which
Al together
，丘om
remedies are effected.
etfected. Altogether,
from those studies mentioned
mentioned,, the pattern of
healing practice bears striking family resemblance to that of dam karna in the
Caribbean. Based on my conversations with Caribbean Muslims in Toronto and
Orlando,
Orlando , that practice continues among diaspora members today. What is
Islamic Influence
195
important to note is all the variant healing
he a1ing modes associated with Islam,
Islam, whether
in the Caribbean,
Caribbean, Asia,
Asia , the Middle East
East,, or Mrica,
Mrica, clearly rely on the centrality
centra
且tyof of
the word of Allah
Allah or Qur'an (see,
(see , for example,
example , Abdulla,
Abdulla , 1992; Mason,
Mason , 2002;
Naidoo,1985).
Naidoo , 1985).
The persistence of dam karna in the Caribbean region has also to be understood
quality
a1ity of medical care in the region,
region, especially
relative to the accessibility and qu
among former British colonies. Reasons for its persistence are fairly intuitive. Use
of prescription medication would sometimes fail to take into consideration
sociocultural conditions that hinder properly following medicinal instruction.
Another
An other is the lack of urgency in updating the medical practitioner's
practitioner' s training,
training, a
consequence of which is incorrect diagnosis,
diagnosis , prescription,
prescription, or techniques in caring.
Other contributing factors to the lack of urgency include inadequacy in
methodology of the science and the availability
availab
血ty of refined
refìned techniques and!
and/or
or state
of the art equipment. These factors,
factors , not all empirical knowledge related,
related , are
deterrninants of
connected with socioeconomic
socioeconornic and political priorities. They are determinants
accessibility to medical treatment for rural area people,
people , and especially those having
to eke out a bare daily existence. In times of crisis or when health is at risk,
risk, the
individual sufferer
su 岳rer tums to what is available and known to bring relief,
relief, regardless
of whether it is folk or modem medicine. In short,
short , there is an altemative to
interpreting or understanding the reality
re a1ity of suffering
su 岳ring
or impediments to health and
well-being, not readily accommodated always by the practice or paradigm of
well-being,
modern medicine.
Unlike rural folks,
folks , urban people are less constrained from gaining access to
health care services. Yet
Yet,, they also tend to rely on traditional and cultural healing
he a1ing
practices such as dam karna and consider that one kind of practice complements
the other. In fact,
fact , one professional in Trinidad
Trinidad
丘om
from the Muslim community
indicated that there was no need to rely on such healing
hea1ing practices when everyone
inhis
in
his country
coun 位y could have access
acce 岱 to
to medical services. Further along the conversation
sti1l seems to linger.
he began relenting when asked why dam karna still
A likely and important insight about dam karna may have been overlooked by
As gara1i, personal
the community member in his zeal for modern medicine (Y. Asgarali,
communication
communication,, 2010). It is that dam karna may at one level have therapeutic value
or significance,
signifìcance , namely that physiological processes are influenced by emotions and
stress
stresses that are reducible through religious beliefs and rituals. This mind-body
connection is one that modern medicine, psychiatry, and psychotherapy are
beginning to more readily acknowledge and, where appropriate, to integrate or
modifY the medical paradigm regarding the nature of the reality that is called
suffering, health, and well-being (Abruzzi & McGandy, 2003). In other words,
there is more awareness of drawing a distinction between disease and illness, and
for that matter curing and healing, and of acknowledging that traditional healing
practices may correlate with etiology that is related to a humoral pathology, or
bodily energy disequilibrium (see, for example, Foster, 1976; Hisham & Kabbani,
1997). Efforts to explore alternative conceptions of reality with respect to illness
币
96
196
Ä.
A. H. Khan
and in fact just what is meant by objectivity with respect to medicine is relatively
just after World War II (Hi
(Hisham
Kleinman,
recent,
beginningjust
sham & Kabbani,
Kabbani , 1997; Kl
einman,
recent, beginning
1995; Koenig
Koenig,, 2001).
A strong warrant
sh 。此， exists for considering dam kama
karna
部呻
as adjunctive
unctive
therapy
warrant,, in short,
in a health care delivery system. That is,
is , while some health disorders are culture
bound, it is equally clear that some others have a non-naturalistic etiology. Their
bound,
causes are personalistic,
personalistic , traced or imputed to the intrusion of a spiritual entity and
thus the disorders or ailments do not fit neatly the disease patterns normally
correlating with the diagnostic categories of
ofWestern
Western medicine. Such are some of
the cases that have received,
received, for an intervention,
intervention, dam kama,
karna , where Allah/God
Allah/God is
understood as the healer. Included in that genre are the well documented cases of
miracles,
rniracles , one of the criteria in the Christian tradition,
tradition , for canonization by the
Vatican (Duff,
(Du 筐: 2008).
Conclusion
To continue withholding recognition of dam karma when it is clearly efficacious
for certain disorders makes little sense in light of emerging interests in the
connection between healing religion and medicine. There are antecedents
antecedents,, if not
good reasons
reasons,, for considering how it and similar
sirnilar healing practices might
rnight contribute
to health and well-being in the cultural and political economy of the Caribbean.
Such consideration does not mean an abandonment of the quest for intelligibility
in becoming
becorning an adjunctive therapy to existing health care services. For without
that quest no human science is possible nor,
nor, for that matter,
matter, the academic
acadernic study of
the interplay between religion and medicine.
Clearly,
Clearly, dam kama
karna provides another investigative area in medicine and mental
health. In particular,
particular, it opens up opportunities
oppo 时unities
for exploring further connections
between areas such as counseling psychology and spirituality
spirituality,, or Islamic
Islarnic hospital
chaplaincy. It is at this level that its practitioners can be annexed by a mainstream
health care system to be in dialogue with health care workers and thereby begin
a process towards regularizing the healing practice.
Notes
1. Solaiman (n.d.). Chapter 2 discusses the spiritual influence of this brotherhood or
Tariqah
Tariqah
丘omWestA
from West Africa.
丘ica.
Chapter 3 discusses the coming oofIndian
fI ndian Awlyia to Guyana.
2. Especially verse 44,, referring to
to 由e
the mischief of those practicing secret arts or witchcraft.
In fact the last three chapters are quite important for warding off evil
ev 过 and
and
becoming
protect
丘om
healed. Surah 114 is also with respect to protect
from evil and witchcraft.
3. Derived
Derived
丘om
from the Hindijhara to sweep away
away,, remove,
remove , clean ooff,
ff, or
or 命ive
drive away
away,, either
fire,, bush brush
brush,, or a bramble broom. Jhadu is to cast off eevil
vi1 spirit (Shakespear,
(Shake
唱pear ，
with fire
th century
1834)
Arabic jharrah
19 由
1834),, and is phonetically similar to Arabic
jharrah,, used in 19
century north India to
refer to the local doctor/hakim or barbe
barber.
r.
bhtkh4. Platts (1884),
(1884) , for dar-dar maftgna
mat 飞gna is knocking/beating door to door asking. See also bhlkhmangain Platts (1884).
Islamic Influence
Influence
币
97
197
5. An etymological deviant of the Arabic ta'ziya
ta 注iya that means mourning
mouming or consolation,
consolation ,
tadjha refers in general to the gathering for commemorating the martyrdom of the
grandsons of the Prophet Muhammad at Karbala,
Karbala, and is marked by a day of Atonement
called ‘'Aashura,
Aashura, that is the 10th day of
ofMuharram.
Muharram.
scholar
百 familiar
fam 血 ar with and who have published on
6. No evidence is found in studies by scholars
the community: Bisnauth (1993); Ferguson (2006); Khan (1998); Koram
Korom (2003);
Mangru
Man 伊1 (1993); and Thaiss (1994; 1999).
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This
PARTIV
PART IV
Traditional Healing and
Conventional Health
and Mental Health
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This
16
COMMUNITY MENTAL
MENTAl HEALTH
HEAlTH IN
THE ENGLISH
ENGllSH SPEAKING CARIBBEAN
Gerard Hutchinson
Introduction
The development of mental health services in the English speaking Caribbean has
occurred in parallel with the training of mental health professionals in the region.
The philosophy of this process has always been community service driven and has
been influenced by the growth of the training opportunities in mental health
ofthe
the West 1ndies.
Indies. The vision of
ofthe
the university to train
offered by the University of
professionals to serve the region (Sherlock & Netdefo
Netdeford,
时， 1990) has been integral
to the community mental health treatment services that are currendy being provided. However,
However, these services have struggled to fully meet the needs of the
communities they serve because they have been thus far unable
unab1e to fully reconcile
peop1e with
the complex
comp1ex health related traditions and belief systems of Caribbean people
mode1s of science based illness models
mode1s that have been imported
the imported models
though adapted from the dominant
dorninant EuroEuro-American
American cultural axis.
As the poet Martin Carter (1977) wrote
wrote,, "I
"1 walk slow1y
slowly in the wind,
wind, watching
myse1fin
myself in things 1I did not make" (p. 58).
The Caribbean constitutes one of
ofthe
the world's most mobile societies exporting
popu1ation in the world. 1ntemal
Internal rural to
the 1argest
largest percentage of its constituent population
urban migration,
to the USA,
rnigration, and continued migration
m 耶ation
USA, England,
Engla
叫 and
and Canada has
farni1y fabric
also tampered with the social and family
fabric,, already challenged by the sense of
pove
poverty
眈y and dissatisfaction with the possibilities
possib
血ties
of
oflife
life in perceived backward and
is1ands. This has created among other phenomena the concept of
underdeve10ped islands.
underdeveloped
barre1 children,
barrel
children , referring to children who are nurtured through the contents of
barre1s sent to them by their parentis
barrels
parent/s who live abroad. The reparation of money
to the region by relatives
re1atives living abroad is also a great source of income in some
island economies
(Bakker,
econornies
但
akker
， Engils-Pels,
Engils-Pe1s , & Reis,
Reis, 2009). This 10ss
loss of direct nurturing
204 G. Hutchinson
by parents and the dependence on the financial
fìnancial and material support
suppo
眈 from
from
abroad
suppo
眈 has
has been partly blamed for the rise in
alongside the decline in community support
delinquent and criminal
crirninal behaviour among adolescents in the region. The pervasive
cultural influence
from the metropolitan centres in the United States and Britain
influence
丘om
has also been thought to contribute to an increase in maladaptive behaviour such
as self-harm,
self 二harm ， drug use
use,, and a range of developmental disorders including Attention
Defìcit Hyperactivity Disorder (ADHD) (Crawford-Brown,
Deficit
(Crawford-Brown, 1999).
Additionally
Additionally,, the geographic location of the West Indian islands have facilitated
cocaine , moving between its production base
their use as transshipment points for cocaine,
in South and Central America
America to its main demand bases in North America
America and
rnajor mental health and social problems including cocaine
Europe. This has led to major
crime , and the psychosocial problems associated with
addiction
addiction,, escalating gun crime,
drug dependence,
dependence , in some instances permanently scarring communities and
rnaterial progress within Caribbean society (p
(pan
an
farnilies and eroding the effects of material
families
American Health Organization,
Organization, 1986; Reid,
Reid , 2005). In this way,
w 町， mental health in
American
the region has developed primarily along a socially conscious needs based
However, there is still
sti1l a pervasive perception that mental health probtrajectory. However,
lerns are caused by supernatural
lems
supematural or spiritual factors rather than by changes in brain
or central nervous system functioning. As much as 30% of medical students in
Trinidad for example believe that mental health problems are caused by superdorninating cultural view as many
rnany
natural practices or influences. This reflects a dominating
supematural
people continue to believe that mental health problems are caused by supernatural
if not spiritual forces (Hutchinson,
(Hutchinson , Neehall
Neehall,, Simeon &
& Littlewood
Littlewood,, 1999). This
has inexorably led to a conflict between traditional religio-magic thinking and the
more recently embraced Western
Westem empirical tradition from which the training of
the mental health professionals has been drawn.
The shifts in Western
Westem philosophy about psychiatry and mental health paradoxically still
sti1l provide the intellectual guidance for the training of our psychiatric
practitioners in the region in the absence of a clear philosophical ethos to guide
the practice of Caribbean mental health treatment
treatrnent (Hutchinson,
(Hutchinson, 2005). The
Diagnostic and Statistical Manual (DSM) system of the American
American Psychiatric
Association has become the diagnostic standard in the region although there is
ongoing debate about the cultural applicability of some of its categories (Thakker
&Ward, 1998).These issues have implications for the expectations that are placed
on mental health service delivery and the ways in which services have developed
to meet these expectations.
This chapter discusses the evolution of training as a means of community mental
health provision and assesses the particular mental health concerns that affect the
region. Issues such as religion and the role of traditional healers in the context of
adapting the services to the needs of the people are also discussed. Finally, it
addresses the need for adjunctive mental health service providers from the private
sector as well as non-govemmental organizations.
Community Mental Health
205
History of Mental Health Provision
Community mental health treatment in the English speaking Caribbean has been
evo1ving in theory and practice over the past 45 years and has grown in parallel
evolving
paralle1
psycho1ogy at the University of the West Indies
with training in psychiatry and psychology
队用(1);
(UWI); however the embrace of formal community mental health care has not
been comprehensive (B
(Beaubrun,
eaubrun, 1992). An appreciation of the need for educating
extensive1y in psychiatry was first articulated by
medical professionals more extensively
Michael Beaubrun in a paper entitled "Psychiatric education in the Caribbean"
但
eaubrun
， 1966). At that time (the rnid-1960s),
rnid-1960s) , Beaubrun noted that mental
(Beaubrun,
asy1um type mental hospitals in the 1arger
larger
health treatment was concentrated in asylum
islands
is1ands of the Caribbean,
Caribbean, Jamaica,
Jamaica, Trinidad,
Trinidad, Barbados,
Barbados , and Guyana,
Guyana , and in some
of the smaller ones as well. He advocated for an expansion and extension of mental
health services that would provide better community care and for increased public
education about mental illness. He wrote that the existing situation did not
adequate1y meet the needs of the West Indian population
adequately
popu1ation and directed the
establishment of a 25 bed psychiatric unit at the University Hospital in Mona,
Mona ,
Jamaica
甜ists
by the end of that decade to
Jamaica,, and eventually began training psychi
psychiatrists
serve the needs of the West Indian community. This was a 1andmark
landmark initiative
because it was the first public attempt to bring mental health care into the
mainstream health domain and by extension out of the mental hospital.
hospit
在1. He also
nurses , psychiatric social workers,
workers , and
identified the need to train mental health nurses,
psychologists.
psycho10gists. The psychiatric unit in a general hospital was seen by Beaubrun as
a prototype and the first step toward the development of community mental health
led to the eventual establishment of Psychiatry Units in most of the
services. It 1ed
m
习 or general hospitals in the 1arger
larger islands of the West Indies and served to predict
major
the expansion of mental health services into the community. Beaubrun (1977) also
pioneered the training of community mental health nurses who provide the
backbone of the community mental health care by traveling into the communities
and providing mental health support.
paralle1ed and reflected an increasing awareness in the metropolitan
This of course paralleled
岱 with
with
mental health disorders could function effectively
e 岳ctive1y
in the
world that patien
patients
synon
严丑ous with a lifelong
community and that a mental health diagnosis was not synonymous
mode1 for the
th development of mental health
stay in a mental hospital. It provided a model
services within general hospitals and to locate psychiatry in this context. It also
encouraged the process of moving the diagnosis and treatment of mental health
disorders closer to the community in both literal and figurative senses, demystifying
the closed door sensibility of a mental hospital/asylum. However, this is a pendulum
that has swung back and forth over the course of the history of mental health
treatment (Sumathipala & Hanwella, 1996).
206 G. Hutchinson
Mental Health Training in the Caribbean Context
Beaubrun (1966; 1992) implied that the cultural focus on training in psychiatry
should be in the environmental setting in which practice was to take place (as
compared to the previous practice of
oftravelling
travelling to Britain or the USA). This was
consistent with the philosophy of the independence era in the West Indies at that
time (Trinidad and Tobago and]amaica
andJamaica were granted independence from Britain
in 1962,
1962, and Barbados in 1965). This also inadvertendy nourished the notion that
the most effective mental health care in particular should be sensitive to the
sociocultural context of the people it was designed to serve. This anticipated the
ideas of multiculturalism and cultural sensitivity in mental health practice.
The growth of community mental health services has therefore been facilitated
by a supply of psychiatrists and more recendy psychologists in the region through
campus
臼 in]
inJamaica
amaica,，
the development of training programs at the three regional campuses
Trinidad,
Trinidad, and Barbados which serve the English speaking Caribbean. Postgraduate
psychiatry now occurs at each of these sites. Training in psychiatrγm
psychiatry in
training in psychiatrγnow
the region has to be reconciled with the principles of training as espoused by the
Psychiatrists and the American
Arnerican Psychiatric Association (Horwitz,
(Horwi
钮，
Royal College of
ofPsychiatrists
2002; Moller
Moller,, 2001). These principles while rooted in the biopsychosocial model
emphasize the biology of the brain as the main focus of psychiatric interest. This
s lt 阳
ua筑ted the individual as the site of 伊
ppathology
at 由
hology
and the 岛
f ocαus of
ofint intervention,
优
er 凹
ven 川
lt由
tion 风
focus
has 缸
situated
1,
t he ∞
c ommunity
∞
c on时te四延 in which he 臼
0 rs 如
hefu functions
缸阳
mct
1江
thereby diminishing 配
the
community
context
or
she
(Novas
&
&戈 Rose,
Rose
， 2000). This has in tum led to an emphasis on biological interventions as
being the preferred options for clients of mental health.
Definitions regarding the nature of mental health have therefore mosdy focused
on
onmental
mental 山ness
illness,， and mental health perceived as the absence of this demonstrable
山ness.
treatrnent in mental health
illness. This has probably occurred because the focus of treatment
predominandy psychiatry driven in the region until this new decade. In
has been predorninandy
some islands,
islands , however,
however, there are no psychiatrists and care must be delivered by
psychologists with referral to general physicians and surgeons when necessary.
Psychology has become the undergraduate degree with the highest demand at the
ofthe
the West Indies (Hickling
(Hickling,, Mathies,
Mathies , Morgan
Morgan,, & Gibson,
Gibson, 2008)
200 and
University of
there are now postgraduate training programmes in each of the campuses for
clinical and counselling psychology. This is suggestive of a greater sensitivity to
the need to understand the behaviour of Caribbean people in the context of greater
access to information and the exposure to the globalized world. The impact of
eroding community supports that had hitherto been taken for granted, such as
supervision of children, community sport, and cultural activities, has resulted in a
renewed attempt to establish a sense of psychological well-being in the context of
overall wellness (Williams & Griffith, 2005). A study in]amaica suggested that the
mediators of psychological well-being and life satisfaction in the community were
related to perceptions of physical health and social status in terms of religion and
marriage (Hutchinson et al., 2004).
Community Mental Health
207
The Mental Health Clinic and the Community
The public perception of mental health care remains almost entirely derived from
m 司jor mental
the pattern of mental health service development that focuses on a major
hospitals , and satellite clinics
hospital,
hospital , perhaps small psychiatry units in general hospitals,
geographically dispersed throughout each island. These clinics are located usually
in health centres that devote specific
specifìc days to mental health treatment. In islands
rare , psychiatric nurses and
where there are no psychiatrists,
psychiatrists , a situation now that is rare,
lor
input,, and the medical management
/ or psychologists provide the mental health input
would come
from general physicians and surgeons This pattern is the standard for
come
丘om
mental health care in the English speaking Caribbean.
Community clinics have been instrumental in bring a greater awareness oflocal
needs to the attention of the wider mental health services while also making the
delivery of mental health care more personal. Since these clinics are conducted in
the primary care health facilities,
facilities , they reinforce the medical model as the basis for
problems
丘om
treating with mental health problems
from a purely biological medication based
this , there is sorely lacking a
perspective. While there is a place and need for this,
more whole person approach and interventions that focus more specifically
specifìcally on
psychological and social issues rather than medical and psychiatric ones. Since the
base for these services remains the hospital,
hospital, genuine community outreach is often
a result of the instinctual cultural orientation of the practitioners rather than an
d E臼V而町
巾
e叫
l lop 阳
me圳
n时t 阳
p ara
缸叫硝
di 箩伊伊
n (Hickling
(Hi阳
f诅lC妹耐
ωck
喇创
恤
kl lin 吨
g &
& Maharajh,
Ma山
ha叫
a盯r
institutionalized service 的
development
paradigm
2005;
Maharajh
Ma油
har 飞叼‘习jh& &戈 Parasram,
Pa 缸ra挝sr阳缸丑风， 1999).
1999 刽). In this way,
w 町， the philosophy of training has created
the existing awareness of the value of mental health care and has largely followed
the trends that have taken place in the metropolitan world.
The concept of sectorisation,
sectorisation, which refers to the use of geographically defined
defìned
a 忧empted
to
units to locate mental health teams,
teams , appeared early in the 1970s and attempted
establish services in as close a proximity
pro 刀rnity
to where people lived as possible (Hickling
&
& Gibson
Gibson,, 2005). However,
However, the axis around which care turned remained the
inpatient treatment facility. These facilities have continued to be large asylum type
ofJamaica
Jamaica,, Trinidad
Trinidad,,
mental hospitals which have persisted in the larger islands of
and Barbados as well as some of the smaller islands
islan such as Grenada and St Vincent
for example.
This has led to the maintenance of the pervasive belief systemthat mental health
problems only require significant intervention when the affiicted are demonstrably
a risk to themselves or others as evidenced by aggressive or violent behaviour or
consistently inappropriate socially disruptive behaviour. Roland Littlewood (1996)
described this as a kind of benign stigma which posits a general tolerance of
aberrant behaviour until it becomes threatening and/or embarrassing. The problem
is that because it has been psychiatry led, it has remained rooted in a medical
model.
In addition, the use of substances both licit and illicit remains the most
frequently utilized response by people experiencing stress in the population,
208 G. Hutchinson
particularly those in rural areas who are not well served by the community health
Sogren , & Cameron-Padrnore
Cameron-Padrnore,, 2006). This then leads to a
(Valtonen , Sogren,
system (Valtonen,
treatment gap which is partially addressed by services being provided by churches
and other religious organizations,
organizations , non-governmental
non-governrnental organizations providing
trauma, and the healers of the
services to families and victims of various kinds of trauma,
religio-magic variety. Interestingly there has been a resurgence of interest in this
type of approach paralleling the rise in the West of interest in alternative treatment
acupuncture , yoga
yoga,, meditation,
meditation, and a range of other interventions
strategies such as acupuncture,
including those directed specifically at the spirit (Aarons,
(Aarons , 1999). There is,
is , however,
however,
growing suspicion about the use of medication for these kinds of problems as
perpetrated by the medical and pharrnaceutical
pharmaceutical industry which champions the
medical model of psychiatry. This has been partly due to a lack of
ofbalance
balance because
of a relative shortage of other mental health professionals such as psychologists,
psychologists ,
psychiatric social workers
workers,, and occupational therapists. As these services have
become more accessible,
accessible , there has been a growing demand for counseling type
also
丘om
from churches and other
services not just from mental health practitioners but also
community groups (All
(Allen,
en, 2001).
Nevertheless,
Nevertheless , the inability to further the community mental health agenda has
been partly due to a lack of resources,
resources , and to the stigrna
stigma and perception that those
rnad are permanently
perrnanently afRicted
a:但icted and likely to be eventually violent.
deemed to be mad
However, many non-governmental
However,
non-governrnental organizations provide community mental
拍ons ，也r
health initiatives
initiatives,, although these are usually for specific popul
populations,
for example
VIC t1日15 ， trauma affected
a 岳cted
families
rape victims,
families,, alcohol and drug abusers
abusers,, and activity within
non-governrnental
also , in some
non-governmental organizations varies across the islands. There are also,
islands,
(EAPs) which are funded by the
Assista
配e Programmes
Progr
a:mm es 但APs)
islands , Employee Assistance
employer in order to provide psychological and social services to their workers
who may
rnay be experiencing these kinds of problem (w
(World
orld Health Organization
Organization,,
2011).
Community Mental Health and Traditional Healing
The initial aims
a:ims have therefore not entirely been met and the evolution of the
provision of mental health treatment has continued to be primarily housed in the
mental hospital in a firmly
firrnly grounded medical perspective. This perspective has not
fully or successfully endeared it to the communities it seeks to serve in the way it
was perhaps first envisaged. In other words,
words , it remains apart
apa 眈丘om
from the community
and has not become an integral component of community psychosocial health
(Maharajh
(Maha
飞jh & Parasram,
Paras
ra1丑， 1999).
Selιharrn behaviour is increasing and in some countries suicide rates are high
high,,
Self-harm
homicidal behaviour is a cause of concern throughout the region,
while hornicidal
region, with
particular issues related to gang formation
forrnation in deprived communities and the ever
trade
但lumet
(Blum et 址，
al., 2003).
2003).
Interest in the effects of alcohol
popular but sinister drug trade
dependence and more recently cocaine has been necessary because both are the
Community Mental Health
209
consequences of geography and history. The West Indies were the major
m 司jor
producers of sugar in the New World
W orld 何咀山田，
(Williams, 1970) and one of the by-products
of this industry was the rum industry. Drinking alcohol
alcoho1 excessively
excessive1y has 10ng
long been
one of the major
rnajor community health problems,
prob1ems , contributing to poor physical health
as well as a number of psychosocial problems
prob1ems which directly or indirectly impact
on mental health. The use of cannabis and cocaine are also problematic
prob1ematic in the
context of transshipment issues described in the Introduction and the widespread
availab
出ty of cannabis which continues to attract young urban users.
availability
Although
Although there is increasing secondary and tertiary education,
education, many
rnany children
unti1 their teenage years and some for their
with 1earning
learning disorders go undiagnosed until
lifetime , because of the absence of trained mental health professionals who can
lifetime,
a 岳cted
the psychosocial fabric of the West
conduct these assessments. This too has affected
deve10pment and affecting
a 岳 cting
the behavioural norms that
Indies , hindering societal development
Indies,
are consistent with community deve1opment.
ab1e to
to 也lfill
fulfill
development. Individuals who are not able
their potential because of these minor
rninor cognitive deficits become targets for the
drug trade and other non-progressive activities. Another recent hypothesis is that
some of the behavioural problems
prob1ems in the Caribbean population
popu1ation are a consequence
of personality issues which are negatively
negative1y impacting interpersonal and intimate
relationships,
parenting, family
farni1y nurturing,
nurturing, and responses to authority (Hickling et
relationships , parenting,
al. , 2008). Among
Among young West Indians,
Indians , there seems to be a disconnect with both
al.,
authority and history,
history , 1eading
leading to a sense of disenfranchisement and consequent
antisocial behaviour at worse and at best a 1ack
lack of commitment to personal
deve1opment. This nihilism may be
deve10pment in the context of regional development.
development
contributing to the escalating problems
prob1ems of criminal behaviour,
behaviour, drug use
use,, and selfself 二
harm (United Nations Office of
ofDrugs
Drugs and Crime,
Crime , 2007).
There has also been a shift in the psychosocial organization of communities in
the West Indies,
Indies , where there has been a rise in individualism and a consequent
loss of collectivism. This focus on personal benefit has seen a decline in many
10ss
community activities beneficial to mental health such as community based sport
and cultural endeavours. Community supervision of children,
children, insistence of
standards of social conduct,
conduct, and nurturing of socially positive values have all given
philosoph to acquire material and/or
way to a pervasive by any means necessary philosophy
social prestige even in the midst of profound deprivation (Girvan, 1997). It has
also fostered the transformation of gangsters into community leaders who have
acquired their status by providing material community support through the
dispensation of largesse principally obtained from their drug and gang related
criminal activities (Mathies, Meeks-Gardner, Daley, & Crawford-Brown, 2008).
They also act as role models perpetuating the romanticized notions of violence
and social intimidation as the vehicle of leadership and material success
(Chevannes, 2001).
Gender relation is the other area which is impacting significantly on community
mental health and is in a state of flux. Greater empowerment of females has led to
a declining tolerance for domestic abuse and an increased presence of women in
210
G. Hutchinson
the traditional male dominated areas of education and employment.
emplo
严nent.
A difficulty
with adjustment
adjustrnent among males is creating
cre 拍 ng increasing relationship and gender related
Jamaican educationist Errol Miller (1991) wrote several years ago
conflicts. The ]amaican
that men were at risk and the evidence supporting this assertion is growing
significandy and spreading throughout the region where girls are outperforming
outperforrning
violence , drug
boys at every turn while boys continue to be overrepresented in violence,
use
use,, and criminal activity. Interestingly women are greater utilizers of mental health
services and indeed all health facilities and it may be this willingness to seek help
that has cemented their ongoing drive for improvements in their psychosocial
envIronment.
environment.
i 吐on 丑 help-seeking
help-seeking
A greater understanding and sensitivity of the processes that inform
behaviour in postcolonial multiethnic developing societies is necessary given the
distrust of institutions and a suspicion about the benefits and side effects of
psychotropic medication. There must be a direct investment in the further
sk 血 base
base
in mental health to ensure that
development and expansion of the skill
adequate and relevant training informs
infonns best practice. Wider public education to
facilitate a better and faster recognition of mental health problems throughout the
lifespan, and active and constructive partnerships between the various elements of
lifespan,
community treatment must be established. There have been some attempts
a 忧empts
to
realize this through training in psychology for ministers of religion and perhaps
there should also be exposure to the practices of the dominant religious and faith
en, 2001).
based communities for mental health practitioners (All
(Allen,
Religion is a powerful force in the negotiation of community mental health.
There has been an increasingly collaborative relationship between religious and
mental health practitioners,
practitioners , though the borders of this collaboration remain blurred
both for clients and for practitioners themselves. In ]amaica
Jamaica,, there is one
psychiatrist/psychotherapist who is also a trained pastor and marries the two
ideologies in his practice (Hickling & Gibson,
Gibson, 2005). Psychology education has
also become an integral part of training for those undertaking theological training
and the first postgraduate programme in counselling psychology was in fact
ofTheology
Theology in Mona,
Mona, ]amaica.
Jamaica.
established by the School of
Still
Still,, these two have not always been merged successfully or satisfactorily and
tensi
There is still widespread use
remain independendy functional with some tension.
of an assortment of healers, pundits, priests, and Obeah men as the population seeks
to deal with the problems of their existence and their relationships with others.
However, research among the Mrican American and Caribbean community in the
USA has demonstrated the psychological value of the Baptist church in the
ongoing negotiation of psychological distress among its membership and there is
also emerging vindication of the social support role of membership and
participation in church related activities as a protector against the conversion of
psychological distress to mental illness (Griffith, 1995).
Religion therefore has a pivotal role to play in the process of preventative
mental health and treatment. The Caribbean remains a place where religious belief
Community Mental Health
211
and behaviour play significant roles in community perceptions of itself
itself. I have
already alluded to the belief in the supernatural and the spiritual and these are
fuelled by the growing evangelism and even in the growth of Islam in the region.
Bridges must be constructed to create working alliances between mental health
practitioners and the religious establishment to ensure the creation of common
agendas and mutual support
suppo
眈 in
in the management of psychological distress in the
communities which they serve. Many religious organizations host health clinics
for the treatment of physical illness in their congregations and the next step would
be to incorporate mental health clinics into this process. It has been shown that up
to 25% of those patients utilizing primary health care facilities have either primary
or concomitant
concornitant mental health problems (Maharaj,
(Maha
坷， Reid
Reid,, & Misir,
Misir, 2010) and it is
conceivable that avid participation in religious activities may also be a sign of
underlying physical distress.
Many people seeking help from the mental health clinics also engage in a
herbalists , alternative health practitioners
practitioners,,
parallel system of help-seeking with herbalists,
religion
religion,, and spiritual and supernatural supports. There is clearly a need to work
together with traditional healers and religion to mount an effective response to the
mental health needs of the region.
Indeed, holistic healing should be the goal; however
Indeed,
however,, the way in which this can
be achieved must be explored more fully. This should be informed by a better
understanding of our unique history which demands a true multidisciplinary and
muti-sectoral approach to engage and incorporate indigenous knowledge and
instinct. There is some evidence that in the pre-colonial Caribbean community
mental health care was informed by communalism and the community did in fact
Gibson ,
care for their mentally ill using a community perspective (Hickling & Gibson,
2005). The more recent indigenous support systems
systerns such as community activism,
activism,
sport
sport,, and cultural activity have been undermined by globalization and access to
images from the dominant
dorninant North American
American culture. Consonant with this,
this , there
churches , all preaching a
has been an exponential growth in evangelical Christian churches,
gospel of prosperity and well-being as being a direct result of Christian faith and
participation. This has reinforced the idea that psychological phenomena such as
depression are really a result of a lack of faith rather than inherent disorders of
ofbrain
brain
function
retarde the desire to seek treatment except through
function,, and further retarded
reinforcement of the religious paradigm.
It has been estimated that mental health problems and substance use are fast
becoming the number one health problem in the region of the Americas (periago,
2005). There is also a pressing need to articulate and catalyze a research agenda in
mental health, an issue acknowledged in the documentation of a health research
agenda in the Caribbean. The priorities identified include reviews of mental health
legislation and policies, the epidemiology of mental illness, and the relationship
between mental health and chronic disease (Caribbean Health Research Council,
2011). It is suspected that more than 50% of those needing community mental
health services are not accessing them, therefore amplifying the negative effects
212
G. Hutchinson
and care giving burden in the communities where they live. Therefore
Therefore,, the
treatrnent
nurnber of untreated individuals
treatment gap rernains
remains wide and it is likely that the number
(periago,
eriago , 2005).
exceeds the number that is being treated (p
Conclusion
The people of the Caribbean are becoming
becorning an increasingly savvy and well
1informed
世on 丑ed pop
u1ation and therefore require responsive and proactive mental health
population
atfected by the
service delivery. This population is also more aware that they are affected
stress and psychological challenges of daily
d ai1y life and will demand support for this.
It is to Beaubrun's
Beaubrun' s (1966) credit that he introduced mental health training to the
region in anticipation of this development. This was done also with a view to
catering specifìcally
population
u1ation in terms
tenns of having
specifically to the needs of the Caribbean pop
homegrown culturally sensitized psychiatrists able to respond to the needs of the
popu1ations they served. However,
However, more work needs to be done to create a
populations
training environment that better reflects the reality of Caribbean life. This will
certainly require an incorporation of the models of care currendy practiced by the
more indigenous traditional and spiritual healing methods so that uptake of services
will be improved. This will undoubtedly
undoubte d1y improve the mental health of the region
platform for hurnan
and establish a more supportive platfonn
human development.
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17
PSYCHOLOGY,
PSYCHOlOGY, SPIRITUAlITY
SPIRITUALITY,, AND
WEll-BEING
WELL-BEING IN THE CARIBBEAN
Omowale Amuleru-Marshall,
Amuleru-Marshall, Angela Gomez,
Gomez,
and Kristyn O'Rita Neckles
Introduction
Recently,
Samuels,, Cummings
Cummings,, Gallop,
Recently, two important publications (Hospedales,
(Hospedales , Samuels
Gallop ,
& Greene,
Greene , 2011; Samuels & Fraser,
Fraser, 2010) documented that the Anglophone
Caribbean, with a population of mainly Mrican-origin people,
Caribbean,
people , is the worst affected
atfected
by chronic non-communicable diseases-the so-called lifestyle diseases-in
diseases
一in the
America and the Caribbean. These authors make the following
region of Latin America
observations which should be arresting to anyone who is involved in the practice
of counseling or healing in the Caribbean. In Barbados,
Barbados , the prevalence and
mortality rates of diabetes-related lower extremity
extrernity amputations are reported to be
among the highest in the world. Diabetes mortality in Trinidad and Tobago and
in St. Vincent and the Grenadines is 600% higher than in North America,
America, and the
Tobago , Guyana
Guyana,, and
cardiovascular disease mortality rates in Trinidad and Tobago,
, 62% and 56% higher
respectively , than in North America.
America. In
Suriname are 84%
84%,62%
higher,, respectively,
Trinidad and Tobago,
Tobago , obesity and overweight among females are 50-60% higher
than most countries and cervical cancer rates are 3-12 times higher. It should be
noted that these are highly preventable diseases,
diseases , the prevention of which require
changes in personal,
personal , familial,
familial , communal,
communal, and societal behavior. Behavioral changes
are the domain of counselors and other psychologists presumed to have the science
and practice to intervene to effect
e 岱 ct cultural
cultural,, social
social,, and personal behavior change.
Yet their interventions will not be effective
e 岳 ctive
unless they are informed by the
historical and social circumstances out of which Caribbean cultures are formed.
The countries in this region were established by violence,
violence , with epic dehumanizing campaigns of colonialism,
colonialism, genocide
genocide,, slavery,
slave
町， and indentureship condihealth ,
tioning the psychology of the people. Any analysis of Caribbean behavioral health,
therefore,
therefore , must take this history into account (Sutherland,
(Sutherland, 2011; Ward & Hickling,
Hickli
吨，
216
O. Amuleru-Marshall
Amuleru-Marshall,, A. Gomez,
Gomez, K. O'Rita Neckles
2004). This is not intended to distract attention
attention
丘om
from more contemporary psychoi 配 reasingly
widening condition of
logical stressors and oppressors. Indeed,
Indeed , an increasingly
poverty,
pove
町， unemployment,
unemplo
严nent ， and socioeconomic
socioeconornic decline endangers the psychological
and overall well-being of large segments of these populations (Lewis,
Joseph,
(Lewis , J
oseph , &
Roach , 2009; Girvan,
Roach,
Girvan, 2001).
ve 巧 little
little
individuals , or to their collective forNonetheless,
Nonetheless , very
has happened to individuals,
mations , in these Caribbean places that can be disconnected from the enslavement
mations,
and traumatization of Mrican persons. Despite the attainment of political independence , the postcolonial experience provided neither the time nor the policies
pendence,
psychocultural
cultural damage to the region's Mrican-origin
and programs to repair its psycho
m
与 ority.
Afi 缸口眈
Cωan American
Am丑肘
1四
enωn 咆
Slav 而
e
Byrd and Clayton's (2000) analysis of the African
"Slave
majority.
Health Deficit
," illustrates 由
t ha 刽t even if corrective interventions were attempted,
a 忱empt 优
ed ，
Deficit,"
that
available
time
the 汩
a va 组
ail 且la站
ble 由
ti me would have been grossly
gros 岱sl忖丁
y inadequate.
Placing the earliest arrival of enslaved Mricans in the Caribbean between 1630
(Murdoch , 2009»,
2009)) ,
and 1640 (although their arrival has been dated as early as 1517 (Murdoch,
the entire period of Mrican life in the Caribbean would be at least 372 years by
2012. Fifty-three
Fi 丘y-three
percent of that time was spent in a horrific and unrelenting assault
on the Africans'
A 仕icans'
physical and psychosocial health (Murdoch
(Murdoch,, 2009; Sheridan
Sheridan,,
1985). Given different
dates of independence,
di 岳rent
independence , another 33 to 39% of the total
to 时 time
time
was spent
spent,, following emancipation
emancipation,, in colonized arrangements which delivered a
psychocultural
cultural damage and
protracted series of booster shots to reinforce the psycho
slaverγ 但ulhan
distortions installed during slavery
(Bulhan,， 1985). While political independence
count
町 's population enjoyed the
was forrnally
formally attained at different points
points,, no country's
relative self-determination
self-detennination of independence for more than 13% of the total
historical experience. Even if concerted efforts to repair the psychocultural
defonnities were being consciously attempted,
attempted, 13% of the total
malforrnations or deformities
malformations
psychocultural
cultural pathology engineered
exposure is patently insufficient to repair the psycho
over 87% of the total period of cultural deracination and human degradation
violence , often quite horrific in nature and
imposed with multiple forrns of violence,
consequence (Sheridan,
(Sheridan, 1985).
In this chapter,
chapter, we review some of the complex range of psychosocial maladies
en 伊lfing
the region's people
circurnstances out
ou
engulfing
people,, consequent to the dehumanizing circumstances
of which these societies emerged. This is followed by a consideration of professional groups who might potentially engineer the repair of Caribbean individuals,
and their communities, with some attention paid to their availability and
accessibility. A brief discussion of selected elements of counseling or psychotherapy
which appear to be appropriate to Caribbean cultural conditions is provided
before, finally, the incorporation of spiritual systems and healers of different
Caribbean stripes and popularity is discussed as a necessary enhancement of
whatever is created or refined to heal Caribbean psyches.
Psychology,
Spirituality,, and Well-Being 217
Psychology, Spirituality
Sun,, Rum
Rum,, Fun
Fun,, and the Coexisting Psychic Trauma
Sun
The Caribbean has a cultural brand as being a space for fun-loving,
fun-loving , pleasandy
inebriated,, easy-going people who see and have "no problem,
problem , man." Yet
Y et an
inebriated
reveals , in addition to the prevalence
analysis of mental health needs in the region reveals,
of conventional psychopathological states,
states , a rather broad range of behavioral
problems which demand attention (Kohn et al.,
al. , 2005
2005,, cited in Maass,
Maass , Mella,
Mella, &
Risco,, 2010; Morgan &
& O'Garo
O'Garo,, 2008). While the rates of
ofpsychosis
psychosis,, depression
depression,,
Risco
anxiety disorders
disorders,, and dementia appear to be within the range that is reported in
other countries,
countries , the incidence rates of affective disorders appear to be sketchier
& Hickling
Hickling,, 2005; Maharajh &
& Rampersad
Rampersad,, 1999).
(Hutchinson &
Some ethnic and gender differentiation has been noted. For example,
ex 缸nple
， the
prevalence of suicide,
suicide
，臼pecially
especially among women in the Caribbean
Caribbean,, presents certain
patterns,, disfavoring Indian-origin women,
women, while homicide is
unavoidable ethnic patterns
distributed in patterns that suggest increased risks for African-origin men
(Hutchinson &
& Hickling,
Hickling, 2005; Maharajh
Mahar
句 h&R
& Rampersad,
组呻 ersad
， 1999). There
There
叩pear
appear to
be increases in suicides,
suicides , as well as substance abuse,
abuse , child abuse
abuse,, gender violence
violence,,
and veiled personality disorders in some Caribbean countries and emerging rates
of anxiety-based and stress-related problems have also been noted (Maharajh
(Maha
呵 h&&
Rampersad , 1999). Sutherland (2011) identified a range of psycho
Rampersad,
psychocultural
cultural
A 臼can Caribbean people which included excessive
pathologies developing among African
individualism,, disrespect for elders,
elders , women and children
children,,
materialism,, wanton individualism
materialism
violence
dev 址uing
of
ofblackness.
blackness. Moreover,
Moreover, the increasing
violence,, hopelessness
hopelessness,, and the devaluing
lif 臼 tyles
， which predispose chronic diseases
diseases,,
patterns of unhealthy behaviors and lifestyles,
complicate the array of psychobehavioral problems
problems,, associated with ".
" ...
. . slavery
. . . that we are sstill
ti11 dealing with . . . [as] very
[and] ...
. . . the degradation of the soul ...
(Mo 耶n &
& O'Garo
O'Garo,, 2008,
2008 , p. 11). These are gravely unmet needs
real issues today" (Morgan
and the relative unavailability of professional helpers makes matters worse (Maass,
(Maass ,
Risco,
Mella,
Mella, &
& Ri
sco , 2010).
Current Mental Health Resources in the Caribbean
There is a variety of professionals who are trained to intervene in the development
and progression of psychobehavioral problems and all employ talk therapy or
counseling exclusively or with medication. Psychologists
Psychologists,, psychiatrists,
psychiatrists , different
counselors , and social workers are among the professional groups that are
types of counselors,
normally expected to be engaged in therapeutic activities to remediate psychopsychologists , their comparative unavailability
unavailab
出w
behavioral conditions. In the case of psychologists,
presents challenges as countries seek to monitor and respond to the needs of
vulnerable groups,
groups , locked in pockets of poverty (Maass,
(Maa 民 Mella,
Mella
， &
& Ri
Risco,
sco , 2010).
The presence of professional psychologists varies widely across the Caribbean
(Lefley,
Rico
Martinique,, have rela(L
efley, 1981). Some countries,
countries , such as Puerto Ri
co and Martinique
proportions
tively large propo
眈ions
of them while in other places,
places , especially in the Eastern
218
O. Amuleru-Marshall
Amuleru-Marshall,, A. Gomez,
Gomez, K. O'Rita Neckles
Caribbean, professionally trained psychologists are virtually invisible
Caribbean,
invisible
何Tard
(Ward &
Hickling,, 2004; World
Hickling
W orld Health Organization,
Organization, 2011). In the larger Caribbean states
particularly, there have historically been more psychiatrists than psychologists
particularly,
(Lefley,
Maharajh
1999),, but social workers are often as scarce
(Lefl 町， 1981;
1981;
Maha 均 h & Parasram,
Parasram, 1999)
as psychologists in many Caribbean places.
Even when helping professionals are available,
available , their deployment can often
present financial and geographical inaccessibility. They tend to be more typically
located in cities and towns and offer services to individuals or families in fee-forservice , private practice arrangements which betray their class allegiances. The
service,
bourgeois aspirations of the available psychologists,
psychiatrists,, counselors
counselors,, and
psychologists , psychiatrists
social workers would seem to exacerbate problems caused by their inadequate
numbers.E
也 rts to launch wider-reaching and effective
e 岳ctive
models of
ofhealth
health care have
numbers.
Efforts
been seen to threaten the "proletarization of
ofprofessionals"
professionals" (Maass,
(Maass , Mella
Mella,, & Ri
Risco,
sco ,
2010,
2010 , p. 397). Counselors must come to recognize how their privileged position
in society often blinds them to many of the injustices that underlie clients'
uran, Fi
rehammer, & Gonzalez,
Gonzalez , 2008). Indeed
Indeed,, the ways
psychological distress (D
(Duran,
Firehammer,
in which professional helpers understand the problems
problerns which they are seeking to
confront do not only inform how and where they offer
0 岳r their services but ultimately
what these services,
services , themselves
themselves,, are conceptualized and planned to accomplish.
Effective Psychological Counseling and Healing
Counselors' ability to work effectively with Caribbean persons raises questions
about the types of psychological or counseling interventions that are appropriate
in this historicultural context. A culturally-appropriate healing experience would
require that the impact of the people's
people' s history
historγand
and social circumstances is brought
into the clinical narrative (D
(Duran,
Firehammer,
Sutherland,,
uran , Fi
rehammer, & Gonzalez,
Gonzalez , 2008; Sutherland
2011). This is precisely why the importation of a "culture-bound" diagnostic
person, rather than the situation,
situation,
nosology that focuses on the examination of the person,
is viewed as an alienating approach to psychology in the Caribbean (Hickling &
Paisley,
Pai 世y ， 2011).
2011).
Caribbean
叩proach
Hickling (2007) proposes that a Caribbean
approach to psychotherapy
"psychohistoriography"
historiography" of the region and not on ahistorical,
ahistorical ,
must focus on the "psycho
culturally-dislodged ideas of individual pathology. Building on a protracted
Jamaica,
experience of teaching,
teaching, research,
research, and service in community psychiatry in J
amaica ,
he distilled,
disti1l ed, with interdisciplinary influences,
influences , culturally-based
culturally-based,, indigenized therapeutic strategies. Adequate training of psychological counselors for the Caribbean
of, and prepared to confront,
con 丘ont ， various forms of
must include making them aware of,
cultural oppression and social injustice that impact the mental health of
ofhistorically
historically
therapy, proposed by the
disenfranchised groups. The master's degree in cultural therapy,
Caribbean Institute of Mental Health and Substance Abuse at the University of
the West Indies,
Indies , Mona
Mona,, is a vanguard step in this direction (Gibson,
(Gibson, Matthies
Matthies,, &
Hickling,
2007).
Hickling,
Psychology,
Spirituality,, and Well-Being 219
Psychology, Spirituality
The work of
ofHickling
Hickling and his associates,
associates , drawing heavily
heavi1y on cultural therapy,
therapy,
is somewhat similar
sinúlar to the classic efforts
e 班orts
of
ofPaulo
Paulo Freire (1972) and his notion of
conscientization , or a change in consciousness,
conscientization,
consciousness , constructed on clients' deconstruction of their historical and cultural experience to inseminate
inserninate a psychology of
liberation (D
(Duran,
uran, Fi
Firehammer,
rehammer, & Gonzalez,
Gonzalez , 2008). What is needed are more
sociogenic approaches which would cultivate a professional willingness to examine
exarnine
sociohistorical factors that contribute to the psychological oppression of individu 埠， their families,
farnilies , and communities in the Caribbean (D
(Duran,
uran , Fi
Firehammer,
rehammer, &
viduals,
Gonzalez , 2008; Sutherland,
Gonzalez,
Sutherland , 2011). The focus must shift from intrapsychic
" ...
. . bloodthirsty and pi
pitiless
ti1ess atmosphere,
atmosphere , the generalization of
dynarnics to the ".
dynamics
inhuman practices,
practices , and the firm impression that people have of
ofbeing
being caught up
in a veritable Apocalypse" (Fanon,
(Fanon, 1968
1968,, p. 251).
Serious attempts to construct an appropriate psychology for the Caribbean
cultural experience must revisit the work of this iconic Martinican psychiatrist.
Several decades ago,
ago , he posited that Caribbean societies-colonial societiesdamage psyches and leave them devoid of the requisite psycho
psychocultural
cultural framework
to even understand,
understand , much less to dismantle,
dismantle , the violent forces and systems that
shape and condition their humanity.
hurnanity. According to Fanon (1967
(1967
纱，
a), "Psychologists,
"Psychologists,
who tend to explain everything
everγthing by movements of the psyche,
psyche , claim to discover
this behavior on the level of contacts between individuals . . . Such attempts
deliberately leave out of account the special character of the colonial situation" (p.
Clearly, etiological primacy must be placed in the sociocultural situation in
33). Clearly,
which individuals are involuntarily sequestered as " ... every neurosis,
neurosis , every
abnormal manifestation
manifestation,, every affective erethism in the Antillean
Antillean is the product of
his cultural situation" (Fanon,
1967b,, p. 152).
(Fanon, 1967b
identi
町，
Fanon asserted that the goal of psychotherapy must be to rebuild the identity,
culture , and a progressive sociopolitical trajectory of people in these former
culture,
colonies through a liberating praxis (Fanon,
(Fanon, 1967b). His legacy is the quest for a
instead, to nurture sociality
psychology that de-emphasizes individualism and seeks,
seeks, instead,
and collective liberty (B
(Bulhan,
ulhan, 1985). It is noteworthy that this perspective is finally
finding a place in the discourse of effective clinical skill sets for psychologists
working with historically-marginalized
historically-mar
groups. Ecological, sociopolitical, and
historical forces delivering differential effects on individuals and groups must not
be minimized any longer (Fouad & Arredondo, 2007).
An example of drawing on the historicity of Caribbean populations is offered
by Dudley-Grant (2001). Recognizing the preponderance of African heritage in
the Caribbean, she offers family therapy as an important" ... means of intervening
in the social decay that is rapidly taking hold in the Virgin Islands and Caribbean
community and that is manifested in the antisocial behavior of young people"
(p. 48). Despite the infancy of family psychology, associated with the limited
development of the science and profession of psychology in the region, the urgent
need for family therapists capable of applying treatment approaches that are
constructed on the extended family and communal traditions of the region is
220 O. Amuleru-Marshall
Amuleru-Marshall,, A. Gomez,
Gomez, K. O'Rita Neckles
highlighted (D
(Dudley-Grant,
al.,, 2008). While acknowledging
udley-Grant, 2001; Ramkissoon et al.
that there were striking differences between Mrican Caribbean and Mrican
American
(Duran,
American experiences of chattel slavery,
slavery, the soul wounding (D
uran, Firehammer,
Fi rehamr
丑er ，
& Gonzalez,
Gonzalez , 2008) was common as were some historical causes of the consequent
multi-systerns family therapy,
therapy , which
disintegration of their families. Adaptations of multi-systems
American families,
families , especially in the
has enjoyed some success among Mrican American
southem
States , is proposed to hold good promise
prornise as a culturally-approsouthern United States,
ofintervention
intervention in the Caribbean (Brondino et al.,
al. , 1997; Dudleypriate model of
Grant, 2001). This is an example of the adaptation of a treatment system that has
Grant,
been demonstrated to be useful in another context.
Cultural adaptations,
this , are being encouraged as the field of counseling
adaptations , such as this,
Norcross ,
embraces evidence-based psychological practice (EBPP) (Morales & Norcross,
2010).
The relationship of potentially adaptable,
adaptable , evidence-based treatments to
Caribbean people's history and culture must be carefully explored,
explored, however. There
must be suspicious and careful adaptations given the fact that there is incontrovertible evidence that culture and context are in almost every aspect of the
diagnostic and treatment process (B
(Bernal,
Jimenez-Chafey & Rodriguez,
emal, ]imenez-Chafey
Rodriguez , 2009).
The notion of epistemological hybridity,
hybridity, or the ability to become "enmeshed in
the cultural
culturallife-world
life-world of
ofthe
the person or community seeking [or needing] ...
. . . help"
2008,, p. 291)
291),, emerges to be of grave impor(Duran,
Firehammer,, & Gonzalez,
(D
uran, Fireharnmer
Gonzalez, 2008
tance as Caribbean psychologists complement their consideration of the best
available research from more Eurocentric contexts with a more critical consideration of
oftheir
their client's
client' s characteristics,
characteristics , culture,
culture , and preferences (Morales & Norcross,
Norcross ,
lirnitations of the Eurocentric pro2010). One of the increasingly recognized limitations
fessional perspective is its relegation of spirituality beyond the reach of professional
helpers.
Spirituality,
Spiritualit
弘 Traditional
Traditional
Healing Practices,
Practices, and Mental Health
The
Thein infusion
也 sion
of spirituality into our systems
systerns of conceptualization and intervention
would likely augment their appropriateness and efficacy as well as their reach. The
advocacy is mounting that spirituality should not merely be subsumed within
mental health,
health , one of the three pillars of biopsychosocial health. It has,
has , in fact,
fact ,
been proposed that the World Health Organization's classic definition of
ofhealth
health
be expanded to explicitly include spirituality so that health is promulgated to be a
mental,, spiritual
spiritual,, and social well-being and not merely
state of complete physical,
physical , mental
i 吐1m 世ty (Kwan,
(Kwan, 2007). Indeed,
Indeed, some psychologists have
the absence of disease or infirmity
emphasized the critical buffer that spirituality provides in contexts of historical
trauma (D
(Duran,
Firehammer,, & Gonzalez,
Sutherland,, 2011).
uran, Fireharnmer
Gonzalez , 2008; Sutherland
Comprehensive discussions of the types of spiritual practices extant in the
Caribbean, including the ways in which they are or may be used to shore up health
Caribbean,
in the region,
region, are quite timely. It has been suggested that traditional healers are an
Psychology,
Spirituality,, and Well-Being 221
Psychology, Spirituality
ever-present resource that Caribbean clients have always used in the absence of,
o f,
and even in preference to
to,, mental health professionals. The latter may only be an
altemative treatment option
alternative
option,, used as a first or last resort
reso 眈 or
or in tandem with a native
Maha 均 h & Parasram,
Parasram, 1999; Ramkissoon
R 缸nkissoon
et al.,
al. , 2008).
healer (Lefley,
(Lefley, 1981; Maharajh
Irrespective of the rates of utilization across the diversity of extant practices,
practices , that
spirituality should be situated in efforts to indigenize a psychology for the Caribbean
is clearly recommended (Hickling,
(Hickling, 2007; Sutherland & Moodley,
Moodl
町， 2010).
2010).
Obviously,
Obviou
吻， there will have to be much closer collaborations between the
professional counseling community and religious practitioners if spiritual belief
systems are to be incorporated into the efforts of professional counselors. Some
collaborations are easier than others (Griffith,
(Griffith , Mahy
Mahy,, & Young,
Young, 2008),
2008) , but broadbased collaborations are,
are , nonetheless
nonetheless,, encouraged if counselors are to improve the
efficacy of their treatment strategies (Sutherland & Moodley,
Moodl
町， 2010).
2010).
It is the client's
client' s
experience rather than the counselor's preference which should dictate the range
and nature of collaborative efforts. Yet engaging a full range of spiritual practices
introduces competing epistemological constructions and related tensions. Yeh,
Yeh ,
Hunter, Madan-Bahel,
Hunter,
Madan-Bahel , Chiang
Chiang,, and Arora (2004)
(2004)
组织led
argued that indigenous forms of
healing follow a collective and holistic approach,
approach , which is largely absent in Western
Westem
practices. They further note
note,, "most Western
W estem helping practices remain within the
mental and the physical boundaries of human experience. Often ignored in
Westem psychological thought and practice is that domain
Western
dornain considered to transcend
the mental and the physical ...
. . . the realm of spirituality" (p. 414). The other
significant difference is the linearity emphasized by the scientific method,
method ,
associating human behavior with a "discrete cause-and-effect-framework"
cause-and-e
岳 ct-framework"
(Y
(Yeh
eh
et al.,
al. , 2004
2004,, p. 414).
Developing or tolerating a more holistic concept of human health,
health , with
increasing attention to spiritual functions and a more multifactorial and interactive
e 岳 ct ， can be challenging. However,
However, greater
ecological understanding of cause and effect,
tensions are encountered when different
di 岳rent
and largely incompatible notions about
the Divine,
Divine , and the nature of transcendental relations surrounding and including
human beings,
beings , collide as counselors seek to incorporate alienating ideas about
spiritual phenomena into their own frameworks.
fÌ'ameworks. When counselors
coun
are generally
contemptuous of, or indifferent to, spiritual beliefs, or hold a complacent ecumenicism or diunital flexibility (Dixon, 1976), collaborations are more easily
established. However, professional counselors who hold personally-significant,
crystallized cosmological convictions would find it much more difficult to develop
what might be called cosmological hybridity. Nonetheless, when working with
individuals and communities from cultural backgrounds with cosmological
constructions that shape their perception of mental health in ways that are different
from the perception of mainstream psychological counselors, pathways have to be
found if effective efforts are to be launched.
Traditional healing practices, embedded within Caribbean cultural traditions,
provide contextual meanings for understanding and addressing health concerns,
222
O. Amuleru-Marshall
Amuleru-Marshall,, A. Gomez,
Gomez, K. O'Rita Neckles
including mental health problems,
problems , a fact that is finally influencing psychologyJames,, 2008; Ramkissoon et al.
al.,, 2008).
(Hickling
ckling & ]ames
based helping professionals (Hi
Indeed
Indeed,, even those counselors who place primacy on a sociogenic analysis of the
etiology of psychological problems recognize the indispensable instrumentality
ins 仕umentality
of
sharing the client's
client' s cultural construction of his or her experience. Despite an
sequestered ,
understanding that the sociostructural conditions in which people are sequestered,
such as extreme pove
poverty
此y or lack of access to basic education and health care,
care , rather
than spiritual explanations,
explanations , are the basis of their psycho
psychocultural
cultural stultification,
stultification ,
transformations will
required transforrnations
wi1l be elusive if clients' phenomenology cannot be
accessed as the platfon
platform
丑 on
on which therapeutic relationships are constructed.
Collaboration and Integration
The delivery of culturally accessible health services requires that collaborative
bridges are built between the traditional and the professional healer. This would
be facilitated if each category of therapist becomes more informed
inforrned about the other.
Attempts have been made to organize traditional healers into different typologies
to facilitate their demystification among psychotherapists (McKenzie,
(McKenzie , Tuck,
Tuck , &
Noh,
Noh, 2011; Vontress,
Vontress , 1991)
1991),, and systerns
systems of comparisons have also been presented
(Krippner,
(Kri
ppner, 1995; Wing,
Wing, 1998). Among
Among other steps that have been proposed are
other' s practices,
practices , the awareness
the acceptance by both parties of the value of each other's
of the limitations of their respective practices,
practices , the willingness to help those
interventions , and the willingness
receiving services to understand the value of the interventions,
by both parties to share their philosophies,
philosophies , values,
values , and beliefS
beliefS as well as to recognize
sim 由rities
(Y
eh et
et 址，
Ultimate
坊， a cosmological and
underlying similarities
(Yeh
al., 2004). Ultimately,
epistemological hybridity-an
hybridity-an ability
ab 血ty to become "enmeshed in the cultural
culturallifelifecomrnunity seeking [or needing] ...
. . . help"-is going to
world of the person or community
have to be developed (D
(Duran,
Firehammer,, & Gonzalez,
2008,, p. 291).
uran, Firehammer
Gonzalez , 2008
McKenzie
Tuck , and Noh (2011) suggested that there are three types of
McKenzie,, Tuck,
interfaces that can occur between professional psychotherapists and traditional
inclusive , and tolerant,
tolerant, while expressing a clear preference for
healers: integrative,
integrative , inclusive,
quali
马T as merely inclusive is the
the integrative approach. An approach that would qualify
provision of a shared space in which traditional healers offer their services side by
side with professionally-trained providers. An example is provided in Suriname in
which professional practitioners are housed in a clinic that is next door to a clinic
in which shamanistic practitioners treat persons (O'Neill,
(O'Ne
血， Bartlett,
Bartlett, & Mignone,
Mignone ,
2006).
Wing (1998) argued
ar 伊ed for more integrative efforts
e 也rts by attempting to draw attention
to many similarities between traditional and more contemporary healing concepts,
concepts ,
while Nuñez-Molina
itselfhas
has
Nunez-Molina (1996) expressed the view that "the healing process itself
generic
genenc prope
properties
眈ies which can be found in several therapeutic systems" (p. 227).
Other ways of integrating the two systems of healing include training professional
therapists
from the same cultural background as potential clients so that they can
therapists
丘om
Psychology,
Spirituality,, and Well-Being 223
Psychology, Spirituality
Ssynthesize
严lthesize
cultural healing systems and the psychotherapeutic strategies with which
they have become equally familiar (Martinez-Taboas,
(Martinez-Taboas , 2005). A critical step towards
healers , with access and influence in their
integration is the need for traditional healers,
communities , to be recruited to work on preventing conditions which threaten
communities,
the health and longevity of community members. The penchant of traditional
healers to wait to respond to illnesses limits their potential role in health promotion
Archibald , 2011). Their influence
influe
配 e as
and disease prevention (Aarons,
(Aarons , 1999; Archibald,
community elders,
elders , cultural brokers,
brokers , and healers must be incorporated in the
cultural struggle against the strident erosion of the communal fabric and the
marching epidemic of diseases of
oflifestyle
lifestyle and privation (Sutherland
(Sutherland,, 2011).
Utilizing traditional healers and community leaders as informal helpers and
sociocultural mediators is a way to bridge cultural and socioeconomic gaps that
culturally-disen
丘anchised
and economically disadvantaged individuals and
keep culturally-disenfranchised
communities from accessing professional or formal mental health services. These
healers , and other elders and aficionados of social and cultural
religious advisors,
advisors , healers,
charisma, leadership skills
skills,, and cultural
activities in their communities possess the charisma,
knowledge to expand the reach of professional mental health providers in their
commurutles.
communities.
Conclusion
The critical and growing need for a cadre of psychological counselors in the
Caribbean region proportionately and paradigmatically adequate to meet the wide
array of psychobehavioral challenges,
challenges , including mental illnesses with some
transαùtural features
transcultural
features,, was discussed. Issues ranging from the prevention and control
of chronic non-communicable diseases,
diabetes,, hypertension
hypertension,, cancer
cancer,,
diseases , particularly diabetes
and obesity
e 岱ctive
changes in behavior and habits of diet,
diet , physical
obesity,, requiring effective
activity,
smoking,, and alcohol use
use,, to profound pathologies of
identity and culture,
ofidentity
culture ,
activity, smoking
including violence and gender-based maladaptations were elaborated. These issues
were presented as protracted consequences of the region's history of violence and
human degradation- a contemporary profIle
profùe of arresting psychosocial patterns
e 岳ctive
psychological responses to this assortment of
and a crying need for effective
behavioral , cultural,
behavioral,
cultural, and social maladies. The argument was made that a Caribbean
psychology, promising accurate analyses and effective
psychology,
interventions,, requires
e 任ective
interventions
(beyond
eyond slavery and colonialism)
colonialism),,
foundational grounding in the people's history (b
culture,, and social realities
realities,, including their spiritual reserves.
culture
unmet
These matters were raised in the context of a discussion of the dire and urunet
need for psychobehavioral service providers with a capacity to effectively respond
to the region's population. The available human resources to tackle these
conditions were presented as inadequate as are the ways in which services are
conceptualized and made available when they exist. Selected elements and
examples of a culturally-appropriate psychology were discussed to illustrate both
the special needs of this population and efforts that have been recommended or
224 O. Amuleru-Marshall
Amuleru-Marshall,, A. Gomez,
Gomez, K. O'Rita Neckles
tried to build or adapt promising systems of healing. Among
Am ong the innovations
spiritu a1ity into counseling. lndeed
Indeed,, the reportedly
recommended is the infusion of spirituality
ubiquitous nature of traditional spiritual practices across the region promises that
significant numbers of persons seeking,
needing,, interventions by professional
signifìcant
seeking, or needing
counselors will present with backgrounds and beliefs that mandate their
helpful.l. Professional helpers are being encouraged
incorporation into efforts to be helpfu
to establish ways in which their efforts
e 证orts
may be augmented by practitioners who
are more familiar with these practices. While illustrating some difficulties
di 伍culties
that may
be encountered in the process of establishing these pathways
pathways,, the chapter discussed
m 町 be
certain ways through which these collaborations may
be advanced.
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18
PRACTICAL
PRACTICAl MAGIC
MAGIC IN
IN THE
US
US URBAN
URBAN MILIEU
MlllEU
Botánicas
Botanicas and the Informal
Networks of Healing
Anahf
Anahí Viladrich
Introduction
The growing market of religious healing in the United States (U
(US)
S) has called
attention to the role of religion in American
Am erican society and to the multiplicity of
coexisting healing systems,
systems , as a cultural epiphenomenon resulting from the
country's ethnic and religious diversity. Folk healing practices have been
blossoming in recent decades along with the holistic health movement (developed
in the 1970s) and its successor,
successor , the New Age trend,
trend , followed by the newlyinstitutionalized field of complementary and altemative medicine (B
(Baer,
aer, 2001;
Hemandez , 2001). Nevertheless,
Nevertheless , there has been a paucity of research on
Baez & Hernandez,
the intertwining
intert
飞iVÍning
fields of religion,
religion, spirituality,
spirituality, and health
health,, particularly pertaining
to Caribbean healing traditions.
therapies , folk healing
Contrary to the popularity of New Age and holistic therapies,
Conversely, while
practitioners have remained an understudied universe in the US. Conversely,
years , the
the safety net for health services has become more unraveled in recent years,
li ncr
burden of health care has 口
increasingly
shifted to immigrant communities that
mostly
m
丑10ωsd
由
1句y片 serve the po∞
poor
O倪r and the undocumented
un时
1址
docum 丑1en 川
1芷ted
(Viladrich,
01飞
v 凡咀
il血
ladrich
， 2006a; 2007a). In this
context, traditional healing systems
context,
systems,, rather than being diluted by globalization and
Westem practices
practices,, have been blossoming more than
the ubiquitous presence of Western
ever before. Undoubtedly,
Undoubtedly, the popularity of Mrican and Caribbean traditions in
the US has been prompted by an increasing international
intemational clientele searching for
either traces of the Americas'
Americas' indigenous cultural forms,
forms , or for innovative versions
of transnational healing therapies (see Polk,
Polk, 2004).
botánicas in New
N ew York
Y ork City (NYC),
(NY C),
This chapter examines the presence of bocinicas
which are ethnic-religious stores that provide a physical and social space for the
reproduction of informal faith-healing networks on the basis of religious belonging
228 Ä.
A. Viladrich
Vì ladrich
(e.g. , Santeria
(e.g.,
Santer{a and Spiritism). Botanicas
Botánicas are main healing outlets serving a panethnic population of
ofLatin
Latin American
American and Caribbean immigrants in urban milieus.
núlieus.
ofNew
New York
Either in El Barrio of upper Manhattan or in "the United Nations of
City" (as the borough of Queens is often called,
called, see Tyree
Tyree,, 2005) or in the
Hollywood outskirts of Los Angeles,
botanicas' products and services unveil the
Angeles , botánicas'
which,,
overlapping fields of religious healing and community bonding in ways which
until recently
recently,, had mostly remained unexplored. Rather than opposing biomedicine,
medicine , the main argument of this chapter aims at underscoring botanicas'
botánicas'
contribution to providing unique responses to their clients' needs on the basis of
complementing what the former system of healing has to offer (see Moodley,
Moodl
町，
Sutherland,, & Oulanova,
Sutherland
Oulanova, 2008; Viladrich
Viladrich,, 2007b). It begins with an examination
of the literature on the role of botanicas
botánicas in promoting Caribbean and Latin
American folk healing traditions in the US,
US , and examines the social geography of
American
healing expressed in botanicas'
botánicas' changing locations due to the ongoing gentrificenters , such as NYC. This is followed by an
cation taking place in main urban centers,
analysis of informal healing networks that extend both within and beyond the
botánicas' premises.
botanicas'
prernises. Lastly,
Lastly, it highlights the need for developing conceptual models
that incorporate indigenous etiologies,
etiologies , including reliance on spirituality and
religiosity as holistic systems of healing.
Botanicas'
Botánicas' Religious and Spiritual Realm
Botarucas,
Bot 扭icas ， which literally means botany,
botany , are local dispensaries that offer spiritual
and religious goods to mostly a Latino and Caribbean clientele (Murphy
(Murphy,, 2010).
droguer{as (p
(pharmacies)
harmacies) that existed as early
While their origin can be retraced to the droguerias
as in the 1900s,
1900s, through time they evolved into becoming
becorning eclectic outlets that
(Long, 2001). Botanicas
Botánicas are
combine healing practices with religious traditions (Long,
found almost anywhere in the Americas,
Americas , and are named with a variety of terms
híerber{as , herbarias,
herbarías , and botanicos
botanícos in places such as Brazil,
Brazil , Colombia
Colombia,, and
including hierberias,
the French Caribbean. In fact,
fact , the presence ofbotánicas
ofbocinicas has become ubiquitous
in many urban regions,
regions , where they combine an uncanny financial enterprise with
a witty array of multicultural religious icons and products. In agreement with
Romberg (2003),
(2003) , in her study on religious healing practices in Puerto
P 时rto Ri
Rico,
co , rather
than witnessing the birth of homogeneous healing trends as a product of
globalization, bot
globalization,
botanicas
挝cas represent myriad healing influences that are dynamically
expressed (and transformed) into unique versions of religious faith.
botánicas' eclectic nature achieves an
Additionally, it is in the US where botanicas'
Additionally,
concornitant with
ultimate multinational and wide-ranging concoction. This is concomitant
imrnigrants relying on culturally familiar
immigrants
fanúliar healing practices (e.g.,
(e.g. , folk healers or
curanderos) while they are literally "crossing borders" to get services in different
di 岳rent
countries
但yrd
Law , 2009; Loera
Loera,, Munoz,
Muñoz , Nott,
Nott, & Sandefur,
Sandefur, 2009). In the US,
US ,
countries
(Byrd & Law,
botánicas can be found in most Latin American
American and Caribbean neighborhoods,
neighborhoods ,
botanicas
where they represent the main selling outlets of religious and spiritual objects
0 庐cts along
Practical Magic in the US Urban Milieu
229
with natural remedies (Anderson,
(Anderson , McKee,
McKee , Yukes
Yukes,, Alvarez,
Alvarez , & Karasz,
Karasz , 2008;
Pugh-Yi , 2011). Rather than being solely associated with one
Dearfield & Pugh-Yi,
particular national or racial group,
group , these stores have become multiethnic settings,
settings ,
since they are owned by (and serve)
se 凹e) a variety of
ofimmigrant
immigrant populations including
Haitians , Cubans,
Cubans , Puerto Ri
cans, Mexicans,
Mexicans, Colombians,
Colombians, Ecuadorians,
Ecuadoriar
毡，
Dominicans,
Dorninicans , Haitians,
Ricans,
and Guatemalans. With immigrant groups rising in numbers in the US' gateway
botánicas have begun to share their front doors with magic and fortunecities , botanicas
cities,
teller services,
services , while offering myriad products and services-from herbs to magical
potions,
Polk,, Fl
Flores-Pella,
potions , and from tarot reading to marriage
rnarriage counseling (Jones,
(J ones , Polk
ores-Peña,
& Evanchuk,
Viladrich,,
Evanchuk, 2001; Reyes-Ortiz,
Reyes-Ortiz , Rodriguez,
Rodriguez , & Markides,
Markides , 2009; Viladrich
2007c).
Furthermo
时， botanicas
botánicas combine a mosaic of ethno-religious practices that
Furthermore,
Santer
旬， Palo Monte
Monte,,
merge Mro-Caribbean religious beliefs and traditions such as Santeria,
Voodoo,, and Spiritism (see Gomez-Beloz & Chavez,
Voodoo
Chavez , 2001; Fernandez Olmos &
Paravisini-Gebert, 2011; Gelb,
Paravisini-Gebert,
Gelb , 2005; Romberg,
Romberg, 2011; Trotter & Chavira,
Chavira , 1981).
The transnational
transnationalliaisons
liaisons taking place between immigrants' country of origin and
of destiny,
destiny, as in the case of Santeria
Santer{a practitioners in Puerto Ri
Rico
co and NYC,
NYC , make
of their "spiritual capital" (Romberg
(Romberg,, 2011) a matter of ongoing religious and
commercial exchanges across nation-states. Among
Among botanicas'
botánicas' diverse products,
products ,
one can find aromatic candles named after Latin American
American saints
saints,, who are well
known for their healing powers,
powers , as well as herbs often imported
imported
丘om
from Puerto Ri
Rico
co
Dominican Republic. Botánicas'
Botanicas' staples also include oils
oils,, tinctures,
tinctures , and
and the Dorninican
candles aimed at cleansing both the physical and the spiritual environment (see
Reyes-Garcia , 2010).
Reyes-Garcia,
As a result,
result, most botánicas
botanicas have become vivid representations of transnational
faiths , as they offer
faiths,
0 班er every key charm revered and utilized in Mro-Caribbean
spiritual traditions-from necklaces (or Elekes de Santo) to caracoles (cowry shells
used for divination) and voodoo dolls for trabajos (used for spells and other magical
Americas as part of a
works). These religious practices,
practices , which evolved in the Americas
culture of resistance
resistance
组丑ong
among Mrican slaves
slaves,, are expressed through a syncretic blend
of
ofYoruba
Yo rub a and Catholic belie
beliefS,
fS, which find a common ground in the communication with and possession by an array of incorporeal spirits (McCarthy Brown,
Brown,
Garcia, 1989).
1991; Murphy
Murphy,, 2010; Singer & Garcia,
The Changing Social Geography of Botánicas
Botanicas
Social geography is defined in this chapter as a multi-level layered map that
interweaves physical location with the sociodemographic and cultural characofLatin
Latin and Caribbean immigrants in urban milieus. In any big US city,
city,
teristics of
it is easy to observe the large (and rising) number ofbocinicas,
ofbotánicas , mostly located in
neighborhoods where ethnic minority
rninority groups reside. Paradoxically,
Paradoxically , and despite
areas , these establishments seem to be
their outstanding presence in key urban areas,
catering to a diverse clientele in search for unique religious and healing products.
230
Ä.
A.
Vì
Viladrich
ladrich
Being unique aesthetic places that feed on transnational liaisons,
liaisons , the social
botanicas in NYC are embedded in immigrants' grassroots settings
geography of
ofbotánicas
in the barrios
(Latino
neighborhoods),, where they coexist along with bodegas
(Latino
barríos (L
atino neighborhoods)
bod 怨as (L
atino
grocery stores)
stores),, amid a variety of community organizations,
organizations , including Latino
churches and immigrant organizations (Solimar,
(Solimar, 2007).
In tracing the botanicas'
botánicas' physical and social settings in NYC,
NYC , Viladrich (2006a)
found that the largest location of these establishments correlated with the highest
Furthermore , the higher the density of
percentage of Latinos per neighborhood. Furthermore,
Latino residents,
residents , the bigger the number of bot
botanic
担icas-independent
as-independent of residents'
Conversely, most geographical areas that register the lowest
country of birth. Conversely,
percentage of Latinos also have the least number of botanicas.
botánicas. 1 By all means,
means , the
botanicas in NYC reflects both the current ethnic composition and
presence of
ofbotánicas
the ongoing changes taking place in the city's urban fabric. Viladrich's study
showed that the shifting patchwork of bocinicas
botánicas symbolizes the paradigmatic
rninority populations from NYC's gentrified neighborhoods,
neighborhoods ,
displacement of minority
areas ,
marked by their disappearance of ethnic stores from most upwardly mobile areas,
vis-a-vis their slow (b
(but
vis-à-vis
ut steady) emergence in others.
For example,
example , botánicas
botanicas found in the Manhattan neighborhoods of
ofWashington
Washington
Heights and Inwood are mostly located within the Dominican
Dorninican enclave,
enclave , while the
Rican
can presence in that area as a
ones in East Harlem reflect the vanishing Puerto Ri
product of ongoing gentrification. Finally
Finally,, the botánicas
botanicas scattered around
ofLatinos
Latinos,, as it is the
Manhattan represent spotted vestiges of the former presence of
case with the neighborhoods of the Lower East side and Morningside Heights
(Viladrich,
(V
iladrich, 2006b). In sum,
sum, the distribution ofbotánicas
ofbocinicas in NYC is living proof of
the demographic shifts that have lately taken place in many large cities in America.
America.
Latin and Caribbean immigrants typically tend to have less access to health care
coverage , and due to the many barriers (e.g.,
(e.g. ,
because of their lack of health coverage,
financial,
financial , linguistic,
linguistic , and logistic) that deter them
them
丘om
from seeking and obtaining
(飞Tiladrich
， 2007a). According to the Community
adequate medical care in the US (Viladrich,
Health Survey 2002 (N
(New
ew York
Y ork Department of Health and Mental Hygiene,
Hygiene ,
2002)
level, suggesting that
2002),, the density ofbotánicas
ofbocinicas does not change by insurance level,
una
their use is a matter of cultural affinity more than a surrogate for the unavailability
of insurance. Furthermore, a strong correlation was found between the high
presence of botanicas and the large percentage of Latinos reporting no personal
doctor, which suggests that botanicas are more likely to be placed in areas where
Latinos mostly lack a regular source of care.
Nevertheless, rather than using botanicas as the only point of entry, it seems
that their customers combine services with those of allopathic medicine.
Concomitantly with the literature on immigrants' healing practices, botanicas
provide unique products that complement those offered by other local businesses
including the selling of herbs and other botanical products (Menard et al., 2010;
Vandebroek et al., 2010). Moreover, the fact that bocinicas tend to share the front
space with drugstores, pharmacies, and other health-related outlets located on main
Practical Magic in the US Urban Milieu
231
commercial avenues,
avenues , further supports the idea that these diverse businesses coexist
coexist,,
rather than compete
compete,, with each other. For instance
instance,, studies on ethnobotany suggest
that botanicas
botánicas are key points of entry for immigrants' access to plants and herbal
infusions for the treatment of specific
specifìc health problems,
problems , as in the case of women's
women' s
(Balick
alick et al.
al.,, 2000;
health conditions such as infertility and menstrual dysfunction (B
al, 2010; Reiff et al.,
al. , 2003).
Menard et al,
botánicas (including
Therefore,
Therefore , it appears that the services provided by botanicas
personal
址 doctor,
doctor
，
counselors working on site) are somehow surrogates for the person
particularly among those oflower socioeconomic
socioeconornic status who lack health insurance
and/or are undocumented. Finally
Finally,, and in agreement with research on the
nonmedical sources of prescription drugs (see Vissman et al.,
al. , 2011),
2011) , botanicas
botánicas also
vein , the
sell allopathic medicines,
medicines , particularly non-prescription drugs. In this vein,
literature usually defines
defìnes botanicas
botánicas as affordable
a 也 rdable
and culturally competent "invisible
pharmacies,"
pharmacies ," where clients are treated by those speaking their language and sharing
alick & Lee,
Lee , 2001; Gomez-Beloz & Chavez,
Chavez ,
their cultural and religious beliefs (B
(Balick
Pignataro , 2009; Polk,
Polk, 2004; Tafur,
Tafur, Crowe,
Crowe , & Torres,
Torres , 2009).
2001; Pignataro,
Botánicas'
Botanicas' Informal Healing Networks
Regardless of the specific
specifìc products they offer,
0 岳飞 the
the
success of botanicas
botánicas greatly
inforrnal social webs held by those working in their premises
prernises on
depends on the informal
the one hand,
hand, and by those who regularly visit them as either providers or clients
on the other. Although
Although the owners and employees ofbotánicas
ofbocinicas do not usually call
themselves "healers,"
"healers," they are actually key players in the informal economy of care
(V
iladrich, 2007c). Comparable to the figure
fìgure oftheJarmacista
ofthejarmacísta (pharmacist)
(p harrnaci
叫 in
mmany
many
(Viladrich,
Latin American
cultures,, botanicas'
American cultures
botánicas' employees are pivotal in helping their
ointments ,
customers navigate a complex pharmacopoeia
pharrnacopoeia of herbs and natural ointments,
along with the provision of referrals and the prescription of home remedies. As
noted by Dearfield
Dearfìeld and Pugh-Yi (2011): "Botanico staff are a primary or influential
source of medical advice for some clients,
client
丑， and therefore are an important potential
referral source to clinical practice as well as potential educator for clinicians who
want to reach their clientele"(p.21).
bocinicas and religious healers do not
clientele" (p .21). In fact,
fact , botánicas
claim to be biomedical experts,
experts , and they usually refer their clients to conventional
medical care when dealing with health conditions they cannot treat.
Botánicas' owners and folk healers are known by word of mouth; therefore
Botanicas'
they build their reputation at face value on the basis of the esteem and popularity
of their clientele (see Reiff et al.
al.,, 2003; Viladrich
Viladrich,, 2006a; 2006b). As immigrants
ímmígrants
treating
treatí
咆 immigrants
ímmígrants
(Viladrich, 2006b) botanicas'
(Viladrich,
bot 扭icas'
employers are seen as cultural
se 凹 e ，
brokers par excellence that are acknowledged by the community they serve,
including members of hidden populations (e.g.,
(e.g. , unauthorized imrnigrants)
immigrants) who
are unlikely to be beneficiaries
benefìciaries of the health system's
system' s safety net. From tarot readers
to
"lay injectionists"
(Rahill,
botamcas
to 咀y
injectioni
归" (R
ahill, Dawkins,
Dawkins , & De La Rosa,
Ro 毗 2011),
2011)
， bot
扭icas
help their
clients deal with specific
specifìc health ailments,
ailments , such as diabetes and high blood pressure
232
A. Viladrich
Vì ladrich
as well as emotional and family issues (Caban & Walker,
Walker, 2006; McNeill &
Cervantes,, 2008; Ransford,
Cervantes
Ransfo
时， Carrillo,
Carr 诅0 ， & Rivera,
Rivera, 2010).
Not only do botanic
bot 扭icas as offer
0 班er a physical and a social space for the exchange of
inforrnation and resources,
information
resources , but they also support informal
inforrnal faith-healing networks
on the basis of
ofreligious
religious belonging (V
(Viladrich,
iladrich, 2006b). Bocinicas'
Botánicas' back rooms are
typically turned into offices where healers regularly greet and treat clients seeking
sarne alternative
informal
inforrnal counseling and health advice. As participants of the same
model of cure,
cure , customers and providers are linked by social relationships that
become alive in the many religious ceremonies that often take place at the
botanicas'
spaces. In fact,
baseme
时s ， waiting rooms,
rooms , and adjacent
a 句 acent
fact , the communal
botánicas' basements,
aspects
aspecωof
of ritualistic healing is one of the most conspicuous elements of Santerfa
and other Caribbean-religious systems,
systems , in which surrogate families
farn 血es of parents and
Oríshas (e.g.,
(e.g. , deities
godchildren remain tied to a spiritual house led by particular Orishas
such as Shango or Obatala).
Within healers' faith networks,
networks , reciprocity becomes a shared trait that rests on
a system of redistribution in which key resources (material and symbolic) are
exchanged between godparents and their followers. Overall,
Overall, disease is understood
as the result of the combined effect
e 岱ct of the natural,
natural, social,
social, and supernatural realms,
realms ,
which overlap in convivial
convivialliaisons
liaisons toward creating a balance in the sufferer's
su 岱rer's
life.
lif 马.
Illnesses
diagnosed,,
Ill
nesses expressed through biological and organic symptoms
s 严nptoms
are often diagnosed
treated
example , via Y oruba
treated,, and cured through divine intervention-for example,
ab 出ty to both harm
harrn and cure. In their study on religious
protectors who have the ability
Caribbean, Fernandez
Fernández Olmos and Paravisini-Gebert (2011) point
healing in the Caribbean,
out the following:
Mro-Cuban religious practices focus on the relationship of devotees with
the deities and the spirits. Those who require balance and harmony
harrnony in their
lives due to a physical or emotional illness or a life crisis seek out the help
of a priest of Ocha who will undoubtedly consult the oracle to hear the
spiritual solution proffered by the deities. The remedies can range from a
cleansi
吨， a resguardo
re. 毯uardo
or protective charm,
charrn, to more advance initiatory
spiritual cleansing,
steps.
(p..59)59)
。
One of
ofthese
these Orishas,
Oríshas , Babaluu
Babaluú Aye,
Ay 是， embodies the Santeria
Santer{a representation of the
Catholic Saint San Lá
Lazaro.
zaro. He is highly respected among
arnong religious healers as one
who not only can cure but also cause illness
illness-a
-a duality found in many of the
divinities composing the Mro-Caribbean pantheon. Pugliese (2010) notes that:
"He is an Orisha that is respected but at the same
sarne time highly feared. These two
extremes exist because as he cures he can simultaneously bring sickness and disease
upon you" (p
(pp.
p. 4-5).
5). Furthermore,
Furtherrnore , rather that opposing biomedicine,
biomedicine , Or
Orishas
íshas (or
Santos , saints in the Catholic faith) and other spiritual beings actually represent the
Santos,
ultimate biomedical allies,
allies , particularly by warning and protecting the living
•
Practical Magic in the US Urban Milieu
233
regarding organic ailments which,
which , even if latent,
latent, may be waiting to arise. For
example , surrounding envies may weaken the physical body by making a person
example,
more vulnerable to common diseases-from the common cold to chronic asthma
or allergies. Fi
Finally,
nally, rather than being passive observers of their own maladies,
maladies ,
patients tum into active participants in the healing process by following the Santos'
prescriptions through offerings and cleansing ceremonies (Fernandez
(Femandez Olmos &
Paravisini-Gebert, 2011; Viladrich & Abraido-Lanza,
Paravisini-Gebert,
Abraido-Lanza, 2009).
Botánicas and Community Mental Health
Botanicas
Despite the findings presented above,
above , not all voices are as optimistic when it comes
Botánicas have been labeled
to assessing botanicas'
botánicas' impact on the clients they serve. Botanicas
with offering produc
products
岱 that
that
have dubious curative powers (see Long
Long,, 2001) and
that may even be dangerous,
dangerous , as in the case of their alleged selling of mercury for
spiritual-religious purposes (Masur,
(Masur, 2011). The literature also questions the labeling
of
ofbotánicas
botanicas as "unlicensed clinics" vis-a-vis
vis-à-vis the unclear distinction between folk
and complementary
compleme
时ary medicine (Holliday,
(Hollid
町， 2008a; 2008b). Critical perspectives have
botánicas' folk healing practices have been swept away from their
also noted that botanicas'
authentic ethnic and cultural roots,
roots , at the expense of turning into samples of petty
hermeneutic practices (see Jacobs,
capitalist enterprises,
enterprises, or as new representations of
ofhermeneutic
Jacobs ,
2001).
There is still much to be learned
leamed in terms
terrns of understanding the liaisons between
religious faith and immigrants' physical and mental health,
health , along with the efficacy
of non-biomedical systems on health outcomes. Future work should shed light on
the actual therapeutic effect claimed by botanicas'
botánicas' products and services,
services , while
promoting community-based strategies toward educating the public about the use
of potentially dangerous substances. From a research perspective,
perspective , religion and
spirituality are often seen as frozen concepts that miss
rniss the dynamic
dynarnic fluxes of the
healing experience along with the subjective meaning of transcendence (Viladrich
(飞Tiladrich
& Abraido-Lanza,
Abraido-Lanza, 2009). This speaks to the importance of developing conceptual
models that incorporate the beneficial impact of indigenous etiologies of health
holistic /integrative
and disease,
disease , including reliance on spirituality and religiosity as a holisticlintegrative
way of healing.
In many ways,
ways , the chasm between folk practices and Western
Westem medicine has
possibility
血ty of learning from indigenous healing forms,
forms , while
dissociated the possib
minimizing
rninirnizing the contributions of the latter to Western
Westem models of thought. Health
researchers should consider the multidimensional and complex influence of
religious practices on both physical and mental health,
health , including the importance
of collective healing
(Broad,， 2002; McKenzie,
healing
但road
McKenzie , Tuck,
Tuck, & Noh,
Noh , 2011). Among
Among the
positive therapeutic outcomes of these practices,
practices , the literature suggests the power
of group support
suppo
眈 and
and the self-reliance in the positive help of others (Hoogasian &
LLijmaer,
司 maer ， 2010).
234
Ä.
A. Vì
Viladrich
ladrich
As it was sought in the past (see Koss,
Koss , 1980; Koss-Chioino; 1992),
1992) , health
services that work with community-based organizations and folk practitioners
fonnal and informal
infonnal mental health services,
services ,
could lead to forging bridges between formal
while providing care in less structured contexts. Recent efforts in countries like
road , 2002; Hoogasian & 闯
Lijtmaer,
tmaer
， 2010; McKenzie et al.,
al. ,
the US and Canada (B
(Broad,
2011) stress the need to include traditional medicine into integrated health care
systems. This body of research shows that service organizations are key in linking
institutions ,
botánicas with both grassroots organizations and broader social institutions,
botanicas
(Motta-Moss,, 2008). On
including government agencies and biomedical services (Motta-Moss
this line,
li 肘， the religious-healing practices that take place during ritualistic and
collective ceremonies,
ceremonies , often in botanicas'
botánicas' premises,
prernises , have remained an unexplored
area of research from a Western psychotherapeutic perspective. Future studies
healing, including the
should provide an in-depth understanding of religious healing,
influence (b
(both
oth positive and negative) of the social environment in promoting
physical , mental,
physical,
mental, and spiritual health.
Conclusions
Botanicas constitute the visible entry
Botánicas
en 位Y to the concealed world of
ofimmigrant
immigrant healers'
botánicas'
practices in urban milieus. This is supported by studies that emphasize botanicas'
care , given the financial and cultural barriers
role as a viable substitute of health care,
us. These establishments provide alternative
that minority
rninority populations face in the US.
storefronts , which are
sources of care by making their products highly visible in storefronts,
run by their owners or employees,
employees , many of whom are healers themselves.
thernselves.
products ,
Despite the rising of international trade of spiritual and religious products,
botanicas (and the healers associated with them) have remained loyal to their Latino
botánicas
clientele,, which find in their premises
prernises unique answers to both their
and Caribbean clientele
organic and spiritual ailments.
ai1ments. Botanicas'
Botánicas' customers are mosdy drawn
drawn
丘om
from
disadvantaged populations that have little access to formal
fonnal health care,
care , and for
whom religious healing offers
0 任èrs
an available oudet to both their physical and
extent , these ethnic businesses have become an
emotional needs. To a certain extent,
ci 町's iinformal
吐出nal networks of healing as they offer personalized
integral part of the city's
spiritual, mental
mental,, and organic conditions that would probably remain
attention to spiritual,
unattended otherwise.
As part of the urban fabric,
fabric , botánicas
botanicas function as informal
infonnal hubs for the
dissemination
dis 吕ernination
of information
infornIation about community resources:
resources:
丘om
from where to obtain a
furniture to the newest treatment for children's empacho
cheap second-hand piece of
offurniture
(indigestion). As discussed in this chapter,
chapter, Latino and Caribbean folk healers
healers,, and
fanúliar surroundings through communal practices
their followers
followers,, tend to recreate familiar
supp 。此， while building
that promote emotional bonding and interpersonal support,
relational buffers against social stress
stress,, discrirnination
discrimination,, and isolation in urban settings.
NYC , Los Angeles,
Angeles , or Miami
Miarni are mosdy
Botánicas found in cities such as NYC,
Botanicas
located in areas where Latino and Caribbean populations live,
live , by offering
0 班èring
products
Practical Magic in the US Urban Milieu
235
not
not 句rpically
typically available
avai1able in other health stores and services.
se 凹ices.
Nevertheless,
Nevertheless , slowly but
steadily,
steadily, botanicas
botánicas have been moving away from places that have experienced deep
gentrifìcation. As a result
result,, they tend to be
ethnic and social transformations due to gentrification.
either concentrated in transitional areas or in neighborhoods where immigrants
m 习 ority
(e.g. , Jackson Heights in Queens).
have increasingly become the majority
(e.g.,
Botánicas may continue changing their locations in years to come
come,, but they are
Bocinicas
meant to stay as long as they keep offering
0 岳ring
unique products and therapies sought
by a growing Latino and Caribbean clientele residing in urban milieus.
rr 咀ieus.
The
unsolved health and social problems oflow-income immigrants,
immigrants , along with the
impo 时ance
of religiosity and spirituality in their lives,
lives , prorrúse
promise to keep botánicas
botanicas
importance
thriving in most American
American cities in decades to come. In their pivotal role as main
bonding, botanicas
botánicas are called to stay as long as they continue
outlets for community bonding,
emotional, and spiritual responses to their clients' unmet needs.
providing practical
practical,, emotional,
Note
1. The neighborhoods where the correlation between the high number ofbotánicas
ofbot:inicas and
Hei 挡ts ，
the density of the Latino population was the strongest included: Washington Heights,
Inwood, and East Harlem
Inwood,
Harlem,, in Manhattan; the middle and southem
southern Bronx; Jackson
York, East Williamsburg
Williamsburg,, Bushwick
Bushwick,, and Sunset
Heights , Queens; and in East New York,
Heights,
Park,, Brooklyn.
Park
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19
CARIBBEAN TRADITIONAl
TRADITIONAL
HEAllNG
HEALING IN THE DIASPORA
Roy Moodley and Miche
Michel'e
l'e Bertrand
Introduction
Caribbean traditional healing has been a papart
眈 of
of the social,
social, cultural,
cultural, and geopolitical
slavery , a process that has taken several
landscape of the West since the time of slavery,
decades to evolve and develop to the degree that many are now regarded as part
of the mainstream in the Caribbean and rapidly becoming accessible in the
diaspora. Religious and healing practices such as Voodoo,
Voodoo , Shango,
Shango , Spiritual
Baptist,
Baptist, Santeria,
Santer
旬 ， Espiritismo
Espírítísmo and others that are a unique blend of Mrican Animism,
Animism,
Christianity,
Christianity, and the healing modalities of the Amerindians
Am erindians have been reconceptualized in ways that are relevant to modern metropolitan urban living in the
West. As a result these healing practices have become deeply engraved into the
frightening, dangerous
dangerous,, and grotesque
grotesque,, and reinforced
psyche as something that is frightening,
through its Eurocentric representations in literature,
literature , art,
art, popular culture,
culture , and fUm,
fùm ,
particularly in Hollywood's depiction of some of these practices
practic
臼 (e.g.,
(e.g.
， voodoo) as
immoral, violent
immoral,
violent,, and evil. The fear and trepidation of
ofCaribbean
Caribbean healing practices
illustrates the complex relationship between the Caribbean and the West. For
example,
the
t he history of slavery,
sla 盯
ver 巧吼】 the struggles for liberation and independence, and
example , 趾
the current neocolonial
neoc ∞
olonial
relations between the West and the Caribbean
Ca 红扭
ribbean
are riddled
with numerous signifiers 由
that
t ha刽t ∞
construct
c onstrucαt Caribbean
Ca 红扭
ribbean
people aωs
as inferior and
liberal hurnanism
humanism within a postcolonial
postcolonial,, multicultural
multicultural,,
uncivilized despite the rise of
ofliberal
and diverse environment.
The post-World
post-W orld War II period saw an increase in immigrants from several
sever
址
America and Europe from economic depression
Caribbean islands to rescue North America
industry, transport,
transport, social,
social, and health
through cheap labour in various sectors of industry,
care services.
Amongst
se 凹ices.
Amongst these new Caribbean immigrants were many traditional
healers whose healing practices offered
0 岳red
hope and wellness in an environment
240
R. Moodley and M. Bertrand
where they felt alienated
disavowed,, resulting in stress,
a1ienated and disavowed
stress , psychological distress,
distress ,
and psychosomatic responses to racism. The limitations
lirnitations of conventional medicine
ofhegemonic
hegemonic meanings
became apparent not for want of trying but a consequence of
embedded in colonialism. The research and literature demonstrating racist and
psychiatry,
町" psychotherapy
psychotherapy,, and counseling are explicit about
oppressive practices in psychia
the dehumanizing ways in which Caribbean and other black people are treated in
Western mental care (see,
(see , for example,
example , Fernando,
Fernando , 1988; 2010; Moodley,
Moodl
町， 2011;
2011;
Palrn
吨 2005).
2005).
Moodley & Palmer,
Indeed,
Indeed , the lack of awareness of Caribbean culture and wellness practices by
health and mental health practitioners led many new Caribbean immigrants to seek
help from traditional healers in their midst. The traditional healers were forced
forced
部
as
a result to practice deep in the heart of the inner city and out of visual gaze of
mainstream culture; indeed,
indeed , while remaining "underground" these practices were
responding to the sociocultural and political reality
re a1ity of the time alongside other
cultural healing practices undergoing similar
sirnilar challenges,
challenges , amongst them the
Charter, 2005),
200 日， the new immigrant
Aboriginal communities (see,
(see , Poonwassie & Charter,
communities from the Asia continent (L
(Laungani,
aungani, 2005),
200 日， Mrica (Vontress,
(飞Tontress
， 2005;
Bojuwoye & Sodi,
Sodi , 2010),
2010) , and South America
Am erica (Hoogasian & Lijtmaer,
L 单位naer ， 2010).
Individuals and groups from mainstream dominant cultures too were seeking
complementarγhealth
a1ing strategies outside the framework
alternative and complementary
health and he
healing
of conventional medicine. Acupuncture,
meditation,, Ayurveda
Ayurveda,, qigong,
Acupuncture , yoga,
yoga, meditation
qigong,
Chinese traditional medicine and many others were in vogue and becoming
acceptable as treatments for health and mental health care (see Moodley & West,
West ,
Consequendy,, research and training evolved and developed
developed,, indicating that
2005). Consequendy
a1ing practices appeared to have a proven
proven,, and even
healing
traditional healers and their he
superior,, efficacy with some patient groups (W
(Wessels,
Moreover,, traditional
essels , 1985). Moreover
superior
healers and their healing
he a1ing practices were becoming critical spaces within which
larger questions of social justice,
justice , anti-racism and anti-oppression were being
interrogated. In addition,
addition , the role of the healers and their healing
he a1i ng practices were
shifting the discourse of an essentialist
essentia1ist and positivistic Western medical science.
Moreover, the traditional healing
he a1ing practices are a way of keeping indigenous
Moreover,
a1ive; by recording psychosocial and illness
illnes experiences of the
traditions alive;
community, and through healing individual's bodies, a dictionary of illness, health,
and wellness for Caribbean people in the diaspora is established. In this way
traditional healing tends to become the oral and embodied historical archive of a
culture! ethnicity (race) undergoing transformation. Traditional healers and healing
by becoming the carriers of culture and Caribbean theology and by acting as
guardians of indigenous sociocultural, economic, and political spaces against the
onslaught of colonialism, oppression, racism, and capitalism constructs a significance in the diaspora that appears to be greater than the one that it played in the
Caribbean.
In this chapter, we discuss how the Caribbean traditional healers and healing
practices are configured and reconfigured in the diaspora. We explore the
Traditional Healing in the Diaspora 241
underlying philosophical and psychological constructs that underpin these changes,
changes ,
and how it has changed our illness representations and perceptions as a result. We
discuss the role of traditional healers as conduits of the spirit world and protectors
of the "divine,"
"divine," and how traditional rituals and ceremonies converge upon shared
ontological and epistemological trajectories of cures within which Caribbean
health , wellness,
wellness , and spiritual
people in the diaspora can fulfill their desire for health,
healing.
Caribbean Philosophy of Healing in the Diaspora
For many who were transported to the Caribbean during slavery and
indentureship,, and for those people indigenous to Caribbean lands
indentureship
lands,, the philosophy
of health and healing evolved during the course of slavery,
slavery, the resistance to
oppression, and the fight to gain
oppression,
gain
丘eedom
freedom for oneself and the community. In a time
when the body and mind
rnind were shackled through Westem cultural,
cultural, socioeconornic
socioeconomic,,
and political ideologies
ideologies,, Caribbean people were able to understand and heal
themselves through their own construction of
ofhealth
health and wellness. From the very
beginning the concept of health meant freedom from oppression and slavery,
slavery,
resisting the representations of the body and mind
rnind as inferior by pseudo-scientific
ideologies , and engaging the spiritual in ways that were culturally specific to
ideologies,
Caribbean experiences. In combining Western
Westem religions and Mrican gods they
developed spiritual and healing institutions that required them to speak
tongu臼， worshipping at the feet of statues of
simultaneously in multiple opposed tongues,
Christian saints,
saints , and emotionally eulogizing the spirits of Mrican deities while at
Indeed, this created the
the same time planning to escape oppression and captivity. Indeed,
possibilities
possib
且ities
of accommodating several cognitive and emotional schemas with much
dissonance in their psyches. They lived on the edge of
ofhyperconsciousness;
hyperconsciousness; it is no
wonder that Frantz Fanon (1952) argued that the black man has no time to make
expenence unconscious.
experience
unconsclO US.
The capacity to code,
code , mask
mask,, and integrate various indigenous worldviews with
an increasingly Westernized approach came to define how Caribbean people
deterrnined and treated physical,
determined
physical , psychological
psychological,, and spiritual problems. While the
Cartesian body-mind
body-rnind determinism
deterrninism constructed the way in which Caribbean
historically, with a racist emphasis of the (working,
(working, or
people were perceived historically,
exotic/erotic) black body and an inferior mind,
rnind, the Caribbean people themselves
were less interested in what the "whites" thought of them but rather concerned
concemed
with their relationship with the Mrican,
Mrican, Asian,
Asian, and indigenous gods. However,
However,
body-rnind discourse was the place of
for Caribbean communities this polarized body-mind
tension and illness,
illness , while the place of spirit provided an avenue for solitude and
an integration of the self The notion of spirituality then becomes a strong
foundational construct for Caribbean communities to assert and validate their
health , and well-being in the West.
West The idea of the spirit is embodied
presence , health,
presence,
and enacted through membership of spiritual communities, such as the charismatic
242
R. Moodley and M. Bertrand
Christian churches,
churches , the Voodoo
V oodoo health centers,
centers , and community mental health
groups. A philosophy emerges with spirit as its center point that ontologically
configures the self and other. An ensuing spiritual worldview then evolves to
replace the body-mind
body-rnind division and its racist constructions.
In evolving a philosophy of spirit,
spirit, Caribbean healing traditions conceptualize
larger, undifferentiated realm,
real 日1 ， as
an understanding of spirit that involves spirit as a larger,
wel1 as a differentiated and localized spirit that is specific to an individual. For the
well
Pentecostal and Spiritual Baptist healers of the "Spirits of a drum beat: Mrican
Caribbean traditional healers and their healing practices in Toronto" research
Bertra
时， 2011),
2011)
， spirit is the primordial presence of
ofGod
God,, or the divine
(Moodley & Bertrand,
spirit,
spi 时， whom we sometimes know and experience as the holy spirit.
spi 时. Alongside
Alongside this,
this ,
spirit can manifest in other ways. The Pentecostal healers encounter spirits in
demonic possessions into which they intervene. Psychoanalytically,
Psychoanalytically, it seems that
the racisms,
racisms , tensions,
tensions , and oppressions of day to day living in the West are
embodied in the possession and exorcised through a Pentecostal healer's
lnterventlO n.
intervention.
The Spiritual Baptist healer encounters spirits as spiritual (spirit-form) mothers
and fathers who help train and guide them in the practice of
ofhealing.
healing. The spirit is
then the center of the healing process. For example,
example , a Spiritual Baptist healer
would treat high blood pressure with medical advice,
advice , exercise,
exercise , keeping the head
wrapped to restore balance in the head,
head, as well
wel1 as with the body,
body, heart,
heart, and spirit,
spirit,
alongside prayer and meditation as channels of direct access to spirit (Moodley &
Bertrand,
Bertra
时， 2011). For the Santerfa healer,
healer, spirit is a pantheon or collectivity
col1ectivity of
Orishas or Y oruba deities,
deities , to whom one can appeal individually and in turn,
turn, using
one's own spiritual power. These powers of course differ for each traditional
healing tradition. For some it's
it' s direct ancestry or being claimed by a spirit,
spi 时， between
life , and between families
farnilies of
innateness itself and receiving a calling later in life,
biological origin and chosen families;
farnilies; some converge and others are divergent
divergent
丘om
from
each other,
other, but for the healers the ontological dialectic is between the spirit and
the self as a manifestation of
ofbeing
being human. This in turn outlines the contours of a
medicine , health,
health, and illness.
particular philosophy of medicine,
Where spirit also refers to the spirits of people who have passed,
passed, "spirits of the
spiri 包， this concept then becomes the guiding philosophy
dead" including ancestral spirits,
of Caribbean traditional healing. Acquiring the ability to read and access spirit
involves intensive leaming,
learning, often over several years,
years , and a lifetime commitment
comrnitt
丑ent
to maintenance and renewal of the spirit,
spi 时， through intergenerational mentoring and
within, and
and,,
accountability. This process is dedicated to developing the spirit(s) within,
through them,
them , the ability to attain insight directly or indirectly from spirit
Bertra
时， 2011).
2011).
No doubt these constructions are a response to the
(Moodley & Bertrand,
ways in which Caribbean people are attempting to answer ontological and
existential questions in the West. It seems that healing and transformation are
transrnission of supernatural powers from the spirits of the
facilitated by the transmission
ancestors to humans to help them "to come into harmony with problem-causing
Traditional Healing in the Diaspora 243
spirits,, to forgive them
them,, and in so doing regulate emotions,
lifestyles,, physical
spirits
emotions , lifestyles
complaints and destiny" (Moodley & Sutherland,
Sutherland, 2009,
2009 , p. 18).
The concept of
of"being"
"being" is derived
derived
丘om
from spirit as a universal configuration
confìguration which
manifests itself in the situated spirit enacting through the various dimensions of the
mental , and physical. The state of equilibrium of
individual: spiritual,
spiritual , emotional
emotional,, mental,
the self is manifested through the condition of alignment or relationship with spirit;
problerns and healing occurs when the spirit is
disequilibrium results in health problems
restored to its harmonious and aligned place within the individual and the universe.
In this way,
w 町， traditional healing practices for singular health complaints are often
dimensions , and in terms
tenns of realigning with
multi-axial within a dimension,
dimension, across dimensions,
spirit,
prayer,, meditation
meditation,,
rituals , herbs,
herbs , prayer
spirit, involving a cultural and indigenous rituals,
sacrifices
Western health care
sacrifices,, spirit dances
dances,, and on occasions even a referral to a Westem
Santer{al Lucumi
Lucumí practitioner channels direct connections with an
professional. The Santeria!
Orisha to prescribe a pathway for action in life,
life , and also prescribes herbal cleanses
intersecting
胆es
to prepare and maintain openness to that connection along the intersecting
axes
of body,
body , mind,
rnind , and spirit. Multi-axial treatment may involve more than one
practitioner working on the same,
same , seemingly
seerningly singular health complaint (Moodley
& Bertrand,
Bertrand , 2011).
Reconfiguring Traditional Healing Practices in the Diaspora
Caribbean traditional healing practices have been undergoing a metamorphosis
West, responding to sociocultural and political events that
since arriving in the West,
confronted them as new immigrants,
imrnigrants , as well as the varied ways in which Caribbean
people represented and presented their illnesses and psychological distresses.
Throughout this period cultural and traditional healing practices have
reconfìgur
叶， "reconstituted and modified to suit current contexts" (Moodley,
(Moodl
町，
reconfigured,
2011,
2011 , p. 74),
74) , for example,
example , Voodoo healing has been a direct response to slavery
(Chireau , 2003)
Maat , an Mrocentric
A丘ocentric
method ,
and racism (Chireau,
2003),, while Maat,
healing method,
empowers individuals and groups to resist the racial discrimination
discrirnination and cultural
Graham, 2005,
2005 , for discussion).
d 肌ussion).
marginalization in the inner cities (see Graham,
In any engagement in reconfiguring
reconfìguring healing philosophies in the diaspora,
diaspora, the
protagonists of these traditions were invariably pitted against each other; transfonnations were undertaken in an environment in which there were competing,
formations
competing,
contesting, and complex interests,
interests , motivations,
motivations , and ideologies at play. For
contesting,
example , the Caribbean Christian charismatic churches portrayed non- Christian
example,
e 址， uncivilized,
uncivil
因
and illegal, clearly a reflection of
healers and healing traditions as evil,
a colonial mentality.
men 时talit 句
y. The enduring strategy for these non-Christian healing
V oodoo , Santeria,
Santer
旬， and many others
traditions was to go underground. For example,
example , Voodoo,
were the enterprise of many subversive healing communities in the larger metropolitan inner cities. Others of course flourished. For example,
example , the Charismatic
Charismatic,,
Pentecostal , and other denominations
denorninations of
ofblack
black churches with the unique blend of
Pentecostal,
existential theologies and survival strategies in the face of racism in the US,
US ,
244
R. Moodley and M. Bertrand
England,
central
healing and worship.
Yet,, others
others,,
England, and Canada are still the cent
ra1 places of
ofhealing
worsrup. Yet
such as the Caribbean Islamic and Hindu healing traditions while not quite
underground appear to be invisible or silenced by the new immigrant
imnúgrant healing
traditions
from the Middle East or South India.
traditions
丘om
Clearly, the diasporic space presents each healing tradition with challenges and
Clearly,
world , and indeed
opportunities for transformations and reconfigurations in a new world,
changi
吨 contexts
contexts
within which
wruch their
continues to do so in relation to the changing
particular communities find thernselves
themselves in. During the process of reconfigurations
of traditional healing
healing
丘'Om
from slavery days to the diaspora many of these practices took
on a more Eurocentric version in their enactments. For example,
exar 丑ple ， a Voodoo healer
may work out of a modern office (a room in her or his
rus apartment),
apartment) , schedule timely
sessions
sessions,, and make referrals to Western health care practitioners where appropriate.
Voodoo healers themselves could be in full-time employment (e.g.,
(e.g. , a school
teacher) during the day and see patients at night and on weekends. While these
modern enactments of an age-old traditional ceremony and ritual give the
impression that they have undergone a postmodern change,
change , not much has changed
at some levels since their evolution in the Caribbean. For example,
exarnple , V
Voodoo
oodoo wruch
which
evolved as a spiritual healing tradition combines Catholic practice and Mrican
spiritual traditions and still maintains at its core this integration and belief system
cOllÚng to the West where Christian traditions are strong and are
even after coming
However, since Voodoo is an integrated system
strongly opposed to Voodoo. However,
supernatura1,
concerning human activities between the natural world and the supernatural,
fusing Mrican aninúsm
Christianity , it bridges the body / llÚ
mind/
nd/ spirit
animism with Western Christianity,
complex. The healing for many patients is through the rituals of dancing,
dancing, offering
worsrup , deification of material artifacts,
artifacts , and inebriation from herbs
gifts,
gifts , ancestor worship,
and plants; ritualized and sacred drumming
drumnúng and dancing,
dancing, and animal sacrifice are
also an
important
animpo
眈antpa part
眈 of
of the healing practice
practice,, particularly when animal sacrifice to
appease the spirits and gods is performed (see Courlander
Courlander,, Bastien
Bastien,, & Schader,
Schader,
Paravisini-Gebert, 2003; Gomez-Beloz & Chavez,
Chavez ,
1966; Fernandez-Olmos & Paravisini-Gebert,
2005; Moodley & Bertrand,
Bertrand, 2011).
rituals , such as animal sacrifice,
sacrifice , in the West is always
Undertaking some of these rituals,
problematic and may lead to contravening metropolitan city health and
environment bylaws; moreover,
moreo
mainstream cultures not familiar with these rituals
can and do object to these practices being performed in their neighborhood,
meaning that ritual animal sacrifices need to be toned down, modified, or even
removed from some healing practices. These modifications take place to then
appease the mainstream culture at the expense of tradition and possibly one's own
healing. Clearly, as the newer forms of healing emerge they intersect, converge,
collide, and/or compete with the older forms, they invariably change the way in
which we represent and present health, illness, and wellness (Moodley, 2011).
While these processes and practices are continually changing and transforming
according to the dynamic cultural, geopolitical, and socioeconomic terrain of the
Caribbean and the diaspora, the function and purpose of the spiritual, religious,
Traditional Healing in the Diaspora 245
hea1i ng practices remain the same,
and healing
same , i.e.
i.e.,, to connect people with the "divine",
"divine" ,
more so in the diaspora against competing healing discourses within Western
Westem
multicultura1ism. The importance,
multiculturalism.
importance , relevance
relevance,, and revival of Caribbean healing
he a1i ng
practices have been gaining ground not only amongst Caribbean people but
amongst other cultural and ethnic communities as well (see Moodley,
Moodl
町， 2011).
Caribbean Healing and Western Health Care in the Diaspora
The fact that Afrocentric
A 丘ocentric
religious practices remain relevant despite the hegemonic
influence of centuries of sustained colonization is a testament to the strength of
the intergenerational transmission
transrnission of traditional healing
he a1ing practices (Gibson,
(Gibson,
this,, Caribbean communiMorgado,
Morgado , Brosyle,
Brosyle , Mesa,
Mesa, & Sanchez,
Sanchez, 2010). Alongside
Alongside this
ties deem their traditional healing
he a1ing practices to be outside the framework of
conventional Westem
Western medicine and mental health care. In addition,
addition, many see the
insensitive , discriminatory
discriminatory,, and
current Westem
Western health care practices as culturally insensitive,
West, 2005).
even racist (see Moodley & West,
A core asymmetry
as 严nrnet
巧T exists where Caribbean healers and people who seek them
would also tum to Western
Westem practitioners for complementary points of entry into
the same problems,
problems , but on the whole receive less recognition and referrals from
them even where these are vital. In "Spirits of a drum beat" (see Moodley &
Bertrand, 2011)
Bertrand,
2011),, for example
example,, healers often recommended clients to seek Westem
Western
medical assessments and treatments when and where it was necessary,
necessa
町， including
when the assessments
asses 在ments
and/or treatments required were beyond the scope of their
own practice and training. The healers were especially open to referring their
clients to Westem
Western health care professionals who either shared or respected the
healers' beliefs and practices,
practices , and received referrals from these professionals when
the client's
client' s concern
concem was believed to have a spiritual dimension. In the larger
framework , however
framework,
however,, this was often not the case. In the healers' perspectives,
perspectives , one
of the key recurring reasons for this is the dissonance between the beliefs of
Westem medical science,
Western
science , on the one hand,
hand, and spirituality
spirituality,, on the other. This
Westem medical approaches and
dissonance plays out in differences between Western
a1ity-based approaches to understanding client psychological difficulties.
di 伍culties.
spiritu
spirituality-based
Westem
rnight not recognize the spiritual aspects of a client's
client' s
Western professionals might
rnight be limited
lirnited because the appropriate spiritual
concern;
concem; a client's
client' s treatment might
healing interventions might
rnight not be undertaken,
undertaken , or referrals to spiritual healers
rnight not take place.
might
On the surface,
surface , the conflict between Western
Westem medical sciences and the spirithe a1ing might
rnight seem impossible to
based epistemologies of Caribbean traditional healing
bridge. Yet,
Yet, through the intersectionality
intersectiona1ity of the physical,
physical, emotional,
emotional , mental,
mental , and
spiritual
spiritual,, spirit-based epistemologies offer healers nu
numerous ways to be open to
scientific ways of knowing, and to integrate them into their own conceptions of
health and healing. Notwithstanding this, collaborating and networking with
Western health care practitioners continues to involve various obstacles, barriers,
246
R. Moodley and M. Bertrand
and skepticisms,
skepticisms , as well as perceived illegitimacy of their specific faiths,
faiths , cultural
ex 缸nple
， where Voodoo health is acceptable
beliefs
beliefs,, and healing practices. For example,
A 臼can
communities , it remains suspect to many
amongst many African
and Caribbean communities,
non-Mrican Caribbean communities,
communities , including Western medical practitioners.
structurallimitations
addressed, such
Additionally
Additionally,, there are current structural
limitations that need to be addressed,
as the legislation that forbids and creates systemic
systernic barriers to the referral systems,
systems ,
pharrnacy, and
the recognition of traditional herbs or plants as part of indigenous pharmacy,
the need for health care institutions to include traditional healers in patients'
w 町 that
that
health care practitioners are increasingly
treatment choice in the same way
countr
町， such as China,
China, Brazil
Brazil,, India
India,, and South Mrica. With these
doing in some countries,
barriers in place,
place , the holistic address of Caribbean healing systems comes to be
ruptured: interventions that are primarily spirit-based or those that cognitively and
口丑 are
are
engaged with while physical challenges are,
are , of
psychosomatically perfo
perform
necessity , referred to a regulated health professional in the Western system. In this
necessity,
W町，
assirnilation
way, the split of the Cartesian complex comes to be embodied through assimilation
thernselves
and integration,
integration , within which cultural healing practices situate themselves
(Moodley & Bertrand,
Bertrand, 2011).
There is still a long way to go in achieving respectful collaboration and
integration. The beliefs and practices of traditional healing and of
ofWestern
Western health
acknowledged , accommodated,
accommodated, and understood by all
care practices need to be acknowledged,
epiderniopractitioners within a framework of cross-cultural epistemological and epidemiological differences. The move towards getting more and more Western health care
practitioners to become more familiar and acquainted with indigenous,
indigenous , traditional
traditional,,
and cultural practices is gaining ground (see Moodley & Sutherland,
Sutherland , 2009;
West, 2005). However,
However, there still
stilllingers
lingers the pervasive issues of
Moodley & West,
expropriation and commercialization of indigenous and traditional healing
practices in the West. This raises key questions as to future trajectories for
Caribbean healing practices in the diaspora. If there are possibilities for these
professions ,
practices to be recognized by and implemented within Western health professions,
they bear much risk. Conscious of the ways that other traditional knowledg
knowledgeesuch as mindfulness
rnindfulness and yoga-have been taken up in Western health care
industries , Caribbean healers in the diaspora have raised concerns that their own
industries,
practices could be reformulated and repackaged without reference to their
ancestral, cultural and spiritual base, and that the healers themselves would be
replaced (Moodley & Bertrand, 2011). The uncertainty about the relationship
between these traditions and Western health professions bears the colonial echo
of rupture and recursive non-belonging.
Conclusion
For mainstream culture,
culture , as long as Caribbean traditional healing practices do not
threaten Western religious,
religious , cultural,
cultu
时， and health care ideas and ideologies
ideologies,, they
are left alone for the Caribbean people to indulge in. For Caribbean people
Traditional Healing in the Diaspora 247
the engagement with traditional healing was and still is a very complex and
confusing process
spirituality, and
process,, positioning them at the interface of Mrican spirituality,
the diaspora experience of acculturation,
acculturation , integration,
integration , and assimilation.
assirnilation. Many
would seek the services of a "witchdoctor" or Voodoo
V oodoo healer at night in
"borrowed robes" to avoid the European colonial gaze,
gaze , professional peers,
peers , and
farnily members.
even family
diaspora, the syncretism of Mrican or Asian or
For Caribbean people in the diaspora,
Islarnic spiritual and religious practices and the colonial gods and belief systems
Islamic
continues to enable a tentative
tentative,, shifting expression of indigeneity and ancestral
knowing that ruptures a contained and containing subject of the new world. This
process is geared to accommodate the ongoing condition in which ancestral origins
and ultimate destinations are psychically and physically withheld. At the 阳ne
same time,
time ,
it forestalls the kinds of densely rooted cultural self-articulations and self-assertions
selιassertions
that are necessary to resist fragmentation,
fragmentation , expropriation,
expropriation, and erasure by dominant
dorninant
structures , including those of health care
care,, in the West. Caribbean
discourses and structures,
systems of thought need to be sufficiendy theorized to discursively re-indigenize
Caribbean proce
processes
岱es and projects of
ofbeing
being,, but sufficiendy un-theorized so as to
allow Caribbean people to genuinely be able to recognize,
recognize , imagine,
imagine , and reinvent
themselves.
References
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咆吃怨
ψ
gω
r. uti 咆，咆您 t阳
traditional
radit 仰
iω
on阳
al 川
healing
heω
ali 饨
n咆~ practi
practices
ωE
Cl 臼's 仰
into
i nω ω
counseling
uω
n. selin 咆
~a 仰
and
n
p严
psychotherapy.
Isychot 仇
hera
， ψ
!J! Y. Thousand Oaks,
Oaks , CA: Sage.
psychiatry.
町. Australian and New Zealand
Wessels
Wessels,, W. H. (1985). The traditional healer and psychia
Joumal qf Psychiatry,
Journal
Psychiatry, 19,283-286.
19, 283-286.
GLOSSARY
Chapter 3 Traditional Medicine
caul. A person born with the placenta over the face (b
(born
orn with the veil/caul)
veil/ caul) is
considered to have special powers that allow hirn
him or her to be clairvoyant and
see into the spirit world.
etíology. Cause of disease.
etiology.
fallen angels.
a 咆els. Evil
E vi1 spirits; duppies.
Chapter 4 Herbal Medicine-Scientific and Common
Plant Names
Each plant is shown firsdy by its botanical name and is then followed by its
common names.
Abelmoschus moschatus:
gumbo musque
musque,, musk mallow
mallow,, musk okra
okra,, ambrette seeds
moschatus:
伊mbo
Achyranthes aspera:
a 华era:
devil's
de 世 's horsewhip,
horsewhip , prickly chaff-flower
Agave sp.: lechuguilla,
lechu
伊山a ， century plant
Ageratum conyzoides: Mexican agcratum,
agcratum, z'herbe aá femme
femme,, caringa de bode
Allium cepa: onion,
onion, zechalot,
zechalot, cebollin
Allium sativum: garlic,
garlic , áil
ail,, ajo
Aloe vera: aloes,
aloes , sábila
sabila
Ambrosia cumanensis: perennial ragweed,
ragweed, western ragweed
ragweed,, cumin ragweed
Ambrosía hispida:
Ambrosia
hispída: coastal ragweed
Anacardium
Anacardíum occidentalis:
occídentalís: cashew,
cashew , cashew apple,
apple , pomme cujou
Annona muricata:
murícata: soursop,
soursop , custard apple,
apple , guanabana
Annona reticulata: custard apple,
apple , sugar apple,
apple , bullock's heart
250
Glossary
Argemone mexicana:
mexíca
ω: Mexican prickly poppy,
poppy, goatweed,
goatweed, bird-in-the-bush
Aristolochia
Arístolochía rugosa: matroot,
matroot, anico
Arístolochía tri/obata:
Aristolochia
trílobata: Dutchman's
Dutchrnan's pipe,
pipe , pipevine
pipevine,, birthwort
Ar
Artocarpus
ωca ψus altílís:
altiUs: breadfruit,
breadfruit, breadnut
Bambusa vulgaris:
1 叫garís:
bamboo
Beta vulgaris:
vulgarís: beetroot,
beetroot, beet,
beet , remolacha
Bídens pilosa: Spanish needles,
Bidens
needles , begger's tick,
tick, amor seco
Bígnonía longissima:
Bignonia
10 咆íssíma:
French oak,
oak , ]amaican
Jamaican oak,
oak, mastwood
Bixa
tree,, anhiote
Bíxa orellana: roucou,
roucou , lipstick tree
Borreria
frade
Borrería verticillata:
vertícíllata: boton
botón blanco,
blanco , shrubby false buttonweed,
buttonweed, cardio de
de 丘ade
Cannabis
Cannabís sativa:
satíva: marijuana,
marijuana , ganja,
ganja, weed
Casearia
Casearía ilicifolia:
ílíc 份lía: holly-like-Ieaf,
holly-like-leaf, castor,
castor, casearia
Cassia
fistula: Golden shower,
Cassía
庐tula:
shower, Indian laburum,
laburum, purging cassia
Cassia
CassíaJ
fruticosa:
切 tícosa:
Christrnas bush,
Christmas
bush, drooping cassia
Catharanthus roseus: Madagascar periwinkle,
periwinkle , guajaca
gu 司Jaca
Chamaesyce hirta:
hírta: malomay
malornay
Chaptalía nutans: dandelion,
Chaptalia
dandelion, costa branca,
branca , bretonica
Chenopodium
Chenopodíum ambrosioides:
ambrosíoídes: worm grass,
grass , worm seed,
seed, bitter weed
Chiococca
Chíococca alba: West Indian milkberry,
milkberry, snakeroot
Chromolaena odorata: bitterbush,
bitterbush , ]ack-in-the-bush
Jack-in-the-bush,, agonoi
Cinnamomum
Cínnamomum verum: cinnamon,
cinnamon, canela
Císsus sicyoides:
Cissus
sícyoídes: possum grapevine,
grapevine , cow-itch vine
vine,, marine ivy
Cítharexylum spinosum:
Citharexylum
spínosum: spiny fiddlewood,
fiddlewood , fiddlewood
Cítrus aurantifolia:
Citrus
aurantifolía: limon,
limón, lime
lime,, citron
Cítrus sinensis:
Citrus
sínensís: sweet orange naranja dulce,
dulce , oranj
Cocus nucifera:
coco-tree,, cocotero
nuc 拆ra: coconut,
coconut, coco-tree
Cola nitida:
nítída: obie seed
Costus speciosus:
ginger,, cane reed
specíosus: crepe ginger,
ginger, malay ginger
Crescentia
Crescentía cujete: calabash tree,
tree , gourd
Cucurbita
Cu ωrbíta
maxíma: pumpkin
maxima:
Curcuma domestica:
domestíca: tumeric,
tumeric , hardi
Cymbopogon cUrates:
cítrates: lemongrass,
lemongrass , fevergrass
fevergrass,, molojillo criollo
Datura stramonium:
stramoníum: datura,
datura, jimson seed,
seed, thorn-apple
thom-apple
Eleusíne indica:
Eleusine
índíca: Indian goose-grass,
goose-grass , crows' foot-grass,
foot-grass , silver crab-grass
Eleutheríne bulbosa: dragon's blood,
Eleutherine
blood, lagrirnas de la virgen
Eryngium
fitweed,, bhandania
Eryngíum foetidum:
foetídum: spiritweed,
spiritweed, shadon beni,
beni , fitweed
Erythoxylum
havanense: barberry,
Eη
thoxylum
barberry, bracelet,
bracelet, tea bush
Eupatoríum macrophyllum: z'herbe chatte
Eupatorium
Eupatoríum triplinerve:
Eupatorium
tríplínerve: white snakeroot,
snakeroot, yapana
yapana,, pool root
Gomphrena globosa: bachelor button
Gossypíum barbadense: sea island cotton,
Gossypium
cotton, Creole cotton
cotton,, long staple cotton
Jatropha
]atropha gossypifolia:
gossypifolía: bellyache
belly ache bush,
bush , physic nut,
nut , Mrican coffee
Kalanchoe gastonis-bonnieri:
life,, donkey ears
ears,, good luck leaf
gastonís-bonníerí: leaf of
oflife
Glossary 251
Lantana
camara: red sage
sage,, kayakeet
kayakeet,, lantana
lantana,, graterwood
La
ntana
ιamara:
Le
Leonotis
onotís nepetifolia:
nepetifolía: shandileer,
shandileer, Christmas candlestick
candlestick,, lion's ears
Mangifera
Ma
咆拆ra indica:
índíca: Mango,
Mango , mangot,
mangot, mamuang,
mamuang, manguier
Mintha
peppermint,, garden mint
Míntha viridis:
vírídís: spearmint,
speannint, peppennint
Momordíca charantia
Momordica
charantía L.: cerasee
cerasee,, bitter gourd
gourd,, bitter melon
Myrístícaj
Myristica fragrans:
切rgrans:
nutmeg, neuz moscada
nutmeg,
Neurolaena lobata Syn. Pluchea symphytifolia:
symphytifolía: Jackass bitters,
bitters , zeb-a-pique,
zeb-a-pique ,
cure-for-all
Ocimum
basil,, basilik,
Ocímum basilicum:
basílícum: sweet basil
basilik, fon bazin
Ocimum
Ocímum gratissimum:
gratíssímum: wild basil,
basil , vane van
Pana
Panax
冗 gínset
ginseng:
您: ginseng
Parínarí campestris:
Parinari
campestrís: bois bandé
bande
Paspalum
Paspalum ω
conjugatum:
njuga
ωm: buffalo grass,
grass , sour grass
gras 唱
Peperomía pellucida:
Peperomia
pellucída: shiny bush
bush,, silver bush
bush,, man-to-man
Persea Americana:
Amerícana: avocado,
avocado , zaboka
zaboka,, aguacate
Phyllanthus urinaria:
urínaría: shatter stone,
stone , chanca piedra,
piedra , meniran
Pímenta racemosa: bay rum
Pimenta
rum,, wild cinnamon
cinnamon,, bwaden
Piper
plant,, hoja de Santa Maria
Píper auritum:
aurítum: bull hoof,
hoo f, root beer plant
Piper
wiwiri,, marigold pepper
pepper,, hinojo
Píper marginatum:
margínatum: anesi wiwiri
Portulaca oleraceae: little hogweed,
hogweed, pigweed,
pigweed , pourpier
Poutería sapota: mammee sapote
Pouteria
sapote,, sapote
Rhoeo spathacea: oyster plant,
plant, Moses-in-the-cradle
Moses-in-the-cradle,, wandering
wanderingJew
Jew plant
Ríchería grandis:
Richeria
grandís: bois band
bande,
层， mang blanc,
blanc , bwa bande
bandé
Rolandraj
Rolandra fruticosa:
切 tíc ω: yerba de plata,
plata, herbe argentee,
argentee , tete negresse
Roystonea regia
regía Syn. Roystonea reglia:
reglía: royal palm,
palr 丑， palmier
palrnier royal
Saccharum <ifficinarum:
officína
附n: sugar cane
cane,, canne
canne
主
asucre
sucre
Scoparia
dulcis:
Sι口'
paría
dulcís: sweet broom,
broom, broom weed,
weed , bitter broom
Sechium
Sechíum edula: chayote,
chayote , christophene,
christophene , Madeira marrow
Senna occidentalis:
weed,, bruca
occídentalís: coffee senna,
senna, septic weed
Serenoa serrulata: saw palmetto,
palmetto , dwarf palmetto,
palmetto , pan plant
Solanum torvum: prickly solanum,
solanum, devil's fig
fig,, turkey berry
Stachytarpheta cayennensis:
cayennensís: verbena,
verbena , blue snakeweed,
snakeweed , Brazilian tea
Stachytarpheta
Stachyta
ψ heta jamaicensis:
jamaícensís: vervine,
vervine , blue snakeweed,
snakeweed, worry
wo 町yvme
vine
Stemodía durantifolia:
Stemodia
durantifolía: white wooly stemodia,
stemodia , white wooly twintip
Swietenia
Indian mahogany
Swíetenía mahogoni:
mahogoní: mahogany,
mahogany, West lndian
Tagetes patula: marigold,
marigold , tall marigold,
marigold , French marigold
Tamarindus
asam,, celagi
Tamaríndus indica:
índíca: tamarind,
tamari
时， tangal asam
Thevetia
peruviana:
nut,, yellow oleander
oleander,, cabalonga
TI 与evetía
peruvíana: lucky nut
Vísmía macrophylla: wild plantain leaf,
Vismia
leaf, carachero,
carachero , shittin cloud
Xylopía
Xylopiafrutescens:
户耐'scens:
malagueto,
m 址agueto
， blister wood,
wood, malagueto chico
Zingiber
Zí
咆íber <ifficinale:
officínale: ginger,
ginger, jengibre
j er 粤bre
252
Glossary
Chapter 6 Haitian Vodou
dyab. Monster believed to eat people in the Haitian culture.
Erzuli.
purity,
Damballa,, Agwe,
Erzulí. Spirit oflove,
oflove , beauty,
beauty, puri
町， and romance; wife of
ofDamballa
Agwe , and
Ogou.
giyon. Equivalent of depression; clients with giyon present with a high level of
anxiety and also report
of weakness and vulnerability.
repo 眈 sensations
sensations
vulnerab
血可·
hunfo.
hu 价. Vodou temple; vodou clinic where healing takes place.
lwa. A vodou spirit.
的
les invisibles.
invisibles.
The spirits; those we cannot see.
lwa kenbe. Retaliation
Retaliation
丘om
from the spirits for unperformed duties or broken promises.
prornises.
manbo. A vodou priestess.
mèt tet.
met
tèt. Master of the head; Principal protective spirit. Big guardian angel;
consciousness or personality.
pase leson. First step of vodou healing where the vodou priest or priestess diagnoses
the nature of a problem or
or 迦ness.
illness.
Peristil! hunfo. Vodou temple; vodou clinic where healing takes place.
Peristillhunfo.
pitit卢'
fly.
pitit卢y;
fly; a vodou follower.
pitit
y. Little leaf; vodou priests (ess) call their clients pitit
Chapter 8 Santería
Santeria
Sp. = Spanish Yor.= Yoruban (many of
ofthe
the Yoruban words here are reproduced
in their Spanish translation/format.
Abakuá. A secret society ofEkpe origin (Nigeria),
Abakua.
(Nigeria) , open only to men. Abakua
Abakuá has
been present in Cuba since the 1830s.
abiku (y
(Yor.).
or.). "Bom
"Born to die"; usually refers to children/spirits who are born
bom on earth
only to return
retum within a short time to orun
0 阳1 (heaven).
(heave
叫.
aché (y
ache
(Yor.).
or.). Spiritual power/ energy; life force.
Át
Angel
忽el de Guardia (Sp.). Guardian angel; in La RegIa
Regla de Ocha refers to the guardian
spirit of ones' head.
apertura (Sp.). Refers to the era of political and cultural opening that occurred in
Cuba in the 1990s (the Special
Speci
址 Period).
Period).
babalawo (y
(Yor.)
lfa, in Cuba a position held only by males.
or.) a priest of
of 庐，
m 必es.
babalochas (y
(Yor.).
or.). A male priest of oricha; "father of the orichas."
Babalú-Ayé (y
BabaM-Aye
(Yor.).
or.). Or
Oricha
icha of smallpox,
smallpox, infectious diseases
diseases,, and leprosy; syncretized
in La RegIa
Regla de Ocha with the Catholic saint San Lazaro.
Lázaro.
brujeria
(Sp.). Witchcraft.
br 呢
， jeria
collares (Sp.). Necklaces; in La RegIa
Regla de Ocha refers to the beaded necklaces (each
representing a specific oricha) given as a first initiatory step in the religion.
diloggun (y
(Yor.).
or.). A Cuban adaptation of a Yoruban divinatory system using 16
cowrie shells. The highset form
fon 丑 of
of divination done by Oloricha.
dueño
dueiio (Sp.). Lord,
Lord, ruler.
ebbo (y
(Yor.).
or.). Offering or sacrifice designed to influence oricha,
oricha
， 组un
eggun,， or other
spiritual entities. A fundamental part
pa 眈 of
of La
La R
RegIa
号la de Ocha practice.
Glossary 253
egun (Y
(Yor.).
or.). Ancestors by blood.
eleda (Y
(Yor.).
or.). Head,
Head , inner being,
being, spirit that resides in one's
on 的 head.
head.
espírítísmo (Sp.). A branch of spiritual practice that is based on the teachings of 19th
espiritismo
century French educator Allan
Allan Kardec,
Kardec , who wrote several books on mediumship. A central belief of espiritismo
espírítísmo is that spirits need light and prayer to elevate
them spiritually. Espiritismo
Espírítísmo became very popular with the middle
rniddle classes of
ofLatin
Latin
America and the Hispanic Caribbean around the turn of the century. In Cuba,
Cuba,
America
espírít
位mo mixed with I.a
espiritismo
La Regla
Regia de Ocha so that today the two are intertwined.
Evidently,
espírítísmo replaced important
importa
时 egun
egun
rituals and worship which did not
Evidently, espiritismo
survive Mrican slavery.
espírítísta (Sp.). One who practices espiritismo.
espiritista
espírítísmo.
Guerreros (Sp.). Warriors; refers to the quartet of warrior orichas
oríchas Ellegua,
Elleguá , Ogun,
Ogun ,
Ochossí , and Osun,
Ochossi,
Osun , who are generally received together as a secondary step (after
(a 丘er
receiving collares) as an initiatory step in the religion.
伊(Yor.).
ifa (Yor.). Corpus of 16 major
m 习 or odu,
odu , which are further developed into 256 lesser
odu which is the central body of wisdom Y oruban origin. Priests of 伊
ifa are
are
known as babalawos.
íkín (Y
ikin
(Yor.).
or.). Nuts of the oil palm; used by babalawos in divination.
íle (Y
ile
(Yor.).
or.). House; spiritual family
farnily joined by initiatory lineage (godparents and
godchildren) .
ire
(Yor.).
íré (Y
or.). Good luck,
luck, blessing.
íré ariku
ire
aríku (Y
(Yor.).
or.). Blessing oflong life and victory over death.
íyalocha (Y
iyalocha
(Yor.).
or.). Priestess of
ofthe the 。优hω;
orichas; "mother of
ofthe
the orichas";
oríchas"; equivalent to sasantera.
仰ra.
letm
letra (Sp.). Letter; refers to the odu that falls in a divination.
limpieza
límpíeza (Sp.). Cleansing; in La RegIa
Regla de Ocha limpiezas
límpíezas may involve baths,
baths , flowers,
flowers ,
fruits,
丘ui
俗， and vegetables,
vegetables , animals,
animals , grains,
grains , alcohol,
alcohol, tobacco,
tobacco , etc.
Lukum{ (Y
(Yor.).
or.). Another
Another name for Yoruban that was adopted in Cuba and became
the common name for Mricans of that ethnic group as well as another name
La Regia
Regla de Ocha.
for I.a
maldícíones (Sp.). Curses.
maldiciones
malojo (Sp.). Evil eye.
malpensímíentos (Sp.). Bad thoughts of others; the sending of
malpensimientos
ofnegative
negative energy.
mísa (Sp.). Spiritual mass for the spirits of the dead.
misa
nervíos (Sp.). Anxiety/mental illness.
nervios
illnes
队
Obatala
(Yor.).
Oricha
bones,,
Obatalá (Y
or.). Or
ícha of white cloth,
cloth , wisdom,
wisdom, coolness; rules the head,
head , bones
insanity,, blindness
blindness,, paralysis.
nerves; punishments are insanity
odu (Y
(Yor.).
knowledge contained in the entire corpus
ifa,
or.). One of 16 bodies of
ofknowledge
co 叩us of
of 庐，
a compilation of verse and wisdom developed in the oral culture of the
Yorubans centuries ago. Each odu contains a wealth of allegories,
allegories , parables,
parables ,
advice
conduct , patakis
patakís or moral fables,
fabl and remedies.
advice,, examples of correct conduct,
Olofin (Yor.) Supreme God (of a trinity with Oludumare and Olorun).
Oloricha (Yor.). Collective name for both babalochas and iyalochas.
Olorun (Yor.) Supreme God (of a trinity with Oludumare and Olofin).
254 Glossary
Oludumare ry or.). Supreme God (of a trinity with Olcifin and Olorun).
omi tutu ryor.). Cool water.
omí
opele ry or.). A chain with eight coconut shell pieces which is used by babalawos to
divine odu.
Or
Orií ry
ryor.).
or.). Oricha
Orícha of
ofone's
one's head; one's
0 时 's personal oricha.
orícha.
oricha
the Yoruban pantheon; the most well known in La Regia
orícha ryor.). A deity of
ofthe
Regla
de Ocha include Elleg
Ellegua,
叫 Ogun,
Ogún ， Ochossi,
Ocho. 叫 Obatala,
Obatalá
， Chang6,
Chat 饭 ， Ochún
OchUn,, Yemaya,
Yemayá , Oy
Oya.
á.
osogbo ryor.). Bad luck; evil.
palero (Sp.). A practitioner of Palo Monte.
Palo Monte (Sp.). Mro-Cuban
A 丘。 -Cuban
religion of
ofBantu/Congo
Bantu ICon go origin.
pata
patakis
航 ryor.).
ryor.).
The stories/moral fables found in the odu.
resolver (Sp.). An expression used frequently by Cubans to refer to the day-to-day
of
life-food,, clothing,
struggle to meet the basic
ba 虹 needs
needs
oflife-food
clothi
吨， water,
water, work,
work, money.
mon 町­
Santeria (Sp.). Literally "worship of
ofthe
the saints"; another name for La Regia
Regla de Ocha.
santerolsantera (Sp.). Spanish name for bablochaliyalocha.
bablochalíyalocha.
Vodou
问dou (Kreyol).
(J王reyol).
Religion of Haitian origin which is a syncretism of Mrican and
Catholic influences; also found in the eastern part of Cuba.
voudouísants (Kreyol).
voudouisants
(J王reyol).
Devotees of vodou.
Chapter 9 Espiritismo
dis-obsession Therapy. A psycho-spiritual therapeutic technique that disrupts the
influence of an obsessed spirit over an incarnated person.
medium. A person (incarnated spirit) through whom spirits are able to commumcate.
municate.
obsession. A pervasive,
pervasive , persistent
persistent,, and intrusive spiritual entity who influences an
incarnated or disincarnated spirit entity.
radical empathy. Personal and spiritual identification between healer and supplicant
con 正ìdence
， understanding,
understanding, and support.
that fully bonds both within a realm of confidence,
spirit guide. Spiritual entity
en 咀ty that protects or guides those with whom it is identified.
Chapter 10 Revival
angels. Spirits that Revivalists "work" within
withinJamaica;
Jamaica; mostly Biblical figures.
Jamaica, generally operated by a
balmyard. A place of spiritual healing in Jamaica,
Revivalist.
in Jamaica.
bush. Herbal medicines used inJamaica.
duppy. A Jamaican
J amaican term
terrn for the spirit of a deceased person.
Kumína. A Jamaican religious tradition found principally in the parish of St.
Kumina.
Thomas that is associated particularly with funeral rites and has a strong Mrican
component.
inJamaica
Jamaica who is leader of a Revival group or a healer
modda. A revered woman in
with a balmyard.
Glossary 255
Myalism. A spiritual tradition inJamaica
in Jamaica that developed from Obeah in the 18th
century and is associated with a dance,
healing,, spirit possession ("myal")
("myal"),, and
dance , healing
opposition to "witchcraft."
Native Baptists. An indigenous religious tradition of 18th century Jamaica that
imbued Baptist missionary Christianity with Myalist practices such as visions,
visions ,
dreams , and spirit possession.
dreams,
ofmagic
magic inJamaica and the British West Indies.
Obeah. The practice of
Obeah doctor or Obeah man. Individuals with the power to intercede with spirits,
spirits ,
to practical ends: healing the sick,
sick, protecting crops from thieves,
thieves , finding lost of
stolen prope
property,
revenge,, predicting the future,
spells,, and
此y ， gaining revenge
future , casting spells
offering protection from spells.
Obía. Spiritual knowledge brought
Obia.
brought 丘omA
from Mrica
正Ìica to Jamaica and other parts of the
A
丘ican
African
diaspora.
Pocomanía. A religious tradition indigenous to Jamaica,
Pocomania.
Jamaica , also known as Pukkumina.
A derisive term
terr 丑 used
used
to refer to indigenous,
indigenous , particularly Mrican,
Mrican , spiritualism in
如naIca.
Jamaica.
exam
reading. A diagnostic
dia ♂lostic
eXal 丑 performed
perforrned
on a client or patient by a Revival healer,
healer,
using spiritual techniques or divination.
Revival. A religious tradition indigenous to Jamaica,
Jamaica , emerging in response to the
of1860-186
1860-1861.
1. Also
Also known as Zion or Zion Revival.
Great Revival of
terrn for Obeah in Jamaica,
Jamaica , particularly when it involves de
science. A modern term
Laurence.
Jamaican Revival religion. The term
terrn also
seal. A sacred shrine that attracts spirits in
inJamaican
refers to
sígíls. Distinctive occult signs or drawings representing the spirits to be invoked.
sigils.
A shrine must contain a sigil-seal,
sigil-seal, but a sigil-seal can be used without a shrine.
Chapter 11 Shango
doption. Vigorous dancing trance session that allows one to travel quickly to the
no rn1ally done in groups in a church meeting.
spirituallands
spiritual
lands,, normally
jumbie. An evil spirit.
jurnbie.
lock up. Soul
loss,, the belief that one's
body,, the symptoms
0 肘 's soul is outside of one's body
s 严nptoms
Soulloss
of which correspond to depression.
Harming someone supernaturally through envy
envy,, corresponding to many
maljo. Harrning
cultures' ideas of the evil eye.
meditation. Trance session consisting of quietly closing one's eyes and travelling
in the spiritual world.
mother. A female leader among the Spiritual Baptists,
Baptists, often a female pointer.
mourning. Long trance sessions while blindfolded.
c.
magic.
Obeah. Black magi
Yoruba-derived
rub a-derived religion originating in Trinidad,
Trinidad , "orisha" being the
Orisha. A Yo
Yoruba
Y
oruba term
terr 丑 for
for a god.
256 Glossary
pointer. The head of a Spiritual Baptist congregation who has the ability
ab 血ty to guide
spirituallands).
lands).
one in mourning (to point the way to the spiritual
Orisha , now often considered derogatory. Shango is
Shango. Aan older term for Orisha,
one of the chief orishas.
Chapter 13 Rastafarl
Babylon. Name given to objects of
ofWestern
Western society; represented by the police,
police ,
governmental organizations.
ganja. Cultivated Indian hemp from the female plant; also called marijuana (of
Mexican-Spanish roots) collie weed,
weed, grass,
grass , weed,
weed, hemp (Indian hemp origin).
Rastafari scholar E. E. Cashmore:
I and I is an expression to totalize the concept of oneness,
oneness , the oneness of
two persons. So God is within all of us and we're one people in fact. The
bond ofRas
Tafari is the bond of God,
God, of man. But man itself needs a head and the head
of man is His Imperial Majesty
M 司jesty
Haile
H ai1 e Selassie I (always pronounced as the
the firs
first')
t') of
ofEthiopia.
Ethiopia.
letter 飞，
'I,' never as the number one or ‘'the
The term
termis
is often
0 丘en used in place of
of"you
"you and 1"
I" or "we" among Rastafari,
Rastafari , implying
that both persons are united under the love ofJah.
irations. Creation; reasoning.
livity. Natural way of
oflife
life or totality of one's being in the world.
ones. People in general.
overstanding. Overstanding
Overstandí
咆 (also
(also
"innerstanding") replaces "understanding,"
"understanding,"
referring to enlightenment that raises one's consciousness.
Chapter 15
15 Islam
The list below is in the main either Urdu or Hi
Hindi
ndi terms but are not here identified
th to
as such. They are familiar to both Muslims and Hindus who are the 19
19 由
to llÚ
middth
20 century
centu
巧T diaspora from the Indian subcontinent,
subcontinent , a familiarity that is suggestive
of the cultural fluidity discussed in the essay.
'Aashura.
'A ashura. The 10th day of Muharram. For Shi' as it is day of mourning. For Sunnis,
Sunnis ,
it is a day of rejoicing for the glorious events with cosmic
COSllÚ C significance that
happened on that day.
Awlíya' Allah. Friends of God,
Awliya'
God, pious ones
ones,, interceding for divine assistance.
ayat. A verse of
ofthe
the Qur'an
Qur'an,, the holy text ofIslam.
o fI sl 缸丑.
babu. An older Hindu person,
person , term used as a form of respect.
Glossary 257
baqarah. Meaning cow
cow,, the name for a chapter of
ofthe
the Qur'an-Surah al Baqara.
bhuts. Evil
E 白1 spirits in Hindi.
bucra. Used in mockery to refer to oppressors,
oppressors , white sugar planters.
dam. Breath,
air,, life,
Breath , air
life , scent,
scent, and stewing over a slow fire.
fìre.
damiidan.
damíídan. To blow or breathe,
breathe , and is associated with the Arabic "dam/blood."
dam karna. To do the blowing after
a 丘er making the supplication or recitation of
pas
passages
吨es from the Qur'
Qu 巾n
an that for adherents is a life-giving or affirming
affirrning book.
dhíkr. Remembrance of God,
dhikr.
God , through repetition of
ofhis
his name as a way
w 町 of
of purifying
the heart.
didi.
dídí. Aunt,
Aunt, used as a tenn of respect.
du'ii'.
du 、ã'. Humble supplication to God or prayer using Qur'anic verses.
Friday worship in the mosque,
mosque , and a spiritual
spiritualleader
leader of the Muslim
imam. Leader of
ofFriday
commuruty.
community.
íman. Faith or belief
belie[
iman.
jhadu. Magic involving the idea of waving a wand or stick to expel evil spirit.
jharay. Hindi word for healing practice that drives out evil sprits.
阳ramaat.
karamaat. Charisma,
Charisma, blessed by being a friend of Allah,
Allah, close to God.
karna. The act of doing
maangna.
maal 忽na. To
T 0 ask or beg as in knocking
knocking
丘om
from door to door for alms.
maangna
maal 忽na du'ii'.
du γ. An Urdu expression meaning "supplication,"
"supplication," but often rendered
as prayer,
prayer, and used here as such,
such , humbly asking or begging God.
maíya jí.
maiya
ji. An older and respected
r 臼pected
person
person,, a tenn for the imam.
mamu. Uncle in Hindi,
Hindi , used as a fonn of respect to an older person.
nazar. An evil eye or gaze cast on a child.
sadhu. A Hindu revered or holy person,
person, used in showing respect.
salãt. Prayer done five
salat.
fìve times daily in Islam,
Islam, a ppillar
血ar of
ofIslam.
Islam.
shaykh. Head of a larger family,
family , and tenn
ten 丑 used
used
to show respect to the head.
Surah - chapter of
ofthe
the Qur'an.
Surah al Baqara. The name for a chapter in the Qur'an meaning "cow."
tabelj. Amulet.
Arnulet.
tadjha. A bamboo made
made
丘ame
frame decorated with colored paper to represent the tomb
of Prophet Mohammed's martyred grandsons at Karbala; a gathering commemorating the martyrdom
rnartyrdom and occurring on 'Aashura,
'Aashura, that is the 10th day of
Muharram, first
Muharram,
fìrst month in the Islamic calendar,
calendar, that in Guyana became festive
and riotous,
riotous , and is known as the Hosay festival in Trinidad.
taqwah. God-fearing Muslim; one watchful over oneself morally and spiritually so
as not to stray away
away
丘omGod.
from God.
ta'zíya. Mourning or consolation.
ta'ziya.
INDEX
Aarons , D. E. 70-1
Aarons,
slaves 15-16,17;
15-16, 17; controlof
control of
h眈血ty
fertility 56; emancipation 131; healers
19-22,, 30; health and medical care 16,
19-22
16,
42-3
42-3,, 53; mental health 23; postemancipation 43; religion 22; shamans
17; Slave Health Deficit 215-16,
215-16 ,
219-20; see also Yoruba religion
Afro-Saxon
Psychosis 3
A
丘。-Saxon
Afroz,
A
丘oz ， S. 190
Aizpurua, J. 116
Aizpurua,
alcohol 208-9
A
African
副can
Alleyne,~.41-2,44,49
All eyne ， ~.41-2
， 44 ， 49
alternative medicine 116,
altemative
116, 240
American Psychiatric Association 204
204,, 206
American Psychological Association 173
55,, 57
anthelmintics 55
Antigua: Obeah 74
Asgarali,
Asgarali , Y. 195
Ayorinde,, C. 102
Ayorinde
Babalawos 31
"bad blood" 55,
55 , 56
Bad Eyes 84
Baer,, H. A. 71
Baer
Baptists 131,
131 , 132,
132, 162n4,
162n4, 210; see also
a/s o
Spiritual Baptists
Barasch,
~.
I.
Barasch
，扎1.
1. 119n2
Barbados: community mental health
provision 207; diabetes 215; mental
health training 206; Obeah 69;
population 43; Wh
Whole
ole Person Healing
~inistry
161; see also
a/s o Spiritual Baptists
Barnet,
~.
110
Barnet
，扎1.110
Bar6,, F. 104
Baró
Barrett,
Barrett, L. 134
Barrett, Sr., L. E. 70
Beaubrun,~.H.
89,
206,, 212
Beaubrun
， ~.H.
89 , 98nl,
98n1 , 205,
205 , 206
Bedward,, A. 132
Bedward
behavioral health 215-16
Belize 184
Bergin, A. E. 2-3
Bergin,
Bertrand
Bertrand,~.242-3,245
， ~.242-3
， 245
Bibb,
79,, 81,
Bibb , A. 79
81 , 85
biomedicine 22,
37,, 41
41,, 46
46,, 47-8
47-8,, 208
22 , 37
"blood purifiers
purifiers":
飞 herbal
herbal
remedies 55
Bodin,, R. 78,
Bodin
78 , 80
botánicas in New York City 227-335;
botanicas
bot
扫icas:
definition 228; changing
botanicas:
social geography
geo 罗aphy
229-31; and
community mental health 233
-4;
233-4;
informal healing networks 231-3;
religious and spiritual realm 228-9
Bourgignon,
Bourgignon, E. 86
Brazil: Spiritism 122; see also Sango
British Honduras: Obeah 69
Brown,
84,, 86
Brown, K. ~. 82,
82 , 84
Bryan,
Bry 扭， P. 43
Burnharn,
Bun 巾m ， F. 70
"bush doctors/medicine" see herbal
medicine practices
Buttrick,
Buttrick, G. A. et al. 157
Byrd, W. ~. 216
Byrd,
Cabrera,
Cabrera, L. 109
Canizares,
Canizares , R. 105
Index
cannabis 166-7
166-7,, 169
169,, 170
170,, 172-3,209
172-3 , 209
cardiovascular disease 215
Caribbean Christian Church 153-63;
Christian healing practices 157-9;
collaboration and integrative healing
o-1; principles of
ofChristian
Christian
mode116
model
160-1;
healing 155-7; spiritual healing
practitioners 159-60; Whole Person
Ministry
扎1inis
位y 160-2
16 0-一2
Caribbean Conference of
ofChurches
Churches 161
Caribbean Institute of Mental Health and
Substance Abuse 218
Caribbean region: historical background
15-19,, 24; historical trauma
15-19
traurna 20;
worldview 3,
3 , 5,
5 , 19,
19 , 47-8
Carrington,
Carrington, V. 165
Carter,, M. 203
Carter
Cartwright,
Cartwri
酬， S. A. 23,
23 , 25n4
Caruth,
Caruth, C. 20
Casimir,
Casimir, G. 79,
79 , 81,
81 , 85
causes of illness 44-5
44-5,, 46,
46 , 53
Charismatic churches 158
158,, 161,241-2,
161 , 241-2 ,
Charisrnatic
243 -4
243-4
Charles , C. 81,
Charles,
81 , 82-4
Chevannes,
Chevannes , B. 165
child health: herbal remedies 57
Chinese medicine 54
Christianity 22,34,35;
22 , 34 , 35; Baptists 131,
131 , 132,
132,
162n4,
162n4, 210; hospitals 159; in
inJarnaica
Jamaica
130,
130, 132,
131;
132, 160; and Revival
Revival131;
Roman Catholicism 53,78,104-5,
53 , 78 , 104-5,
196; see also Caribbean Christian
Church; Charismatic
Charisrnatic churches;
Pentecostal Church; Spiritual
Baptists
Clayton,
Clayton, L. A. 216
Coalition for Ganja
Gania Law Reform 173
Cobbs,
Cobbs , P. M. 22
cocaine 204,
208,, 209
204 , 208
"cold" diseases
diseas
臼 and
and remedies 53-4
53-4
collaboration and integration 38,
38 , 222-3;
Caribbean Christian Church 160-1; in
the diaspora 245--6;
245 --6; Hinduism 184-5;
Islarnic influence 194-6; mental health
heal 由
Islamic
4-6; psychology,
psychology, spirituality,
sp 让itua 且ty ， and wellbeing 222-3; Rastafarl
RastafarI 171-3;
traditional medicine 47-9,
47-9 , 50
collectivism 3
colonialism 15-16,17,30;
of17,,
15-16, 17 , 30; effects of17
21-2,42,215-16,219;
and Obeah
21-2
，钮， 215-16
， 219;
67-9; traditional healing in 32-3
Columbus,
Columbus, C. 17
common cold: herbal remedies
remedie
唱 54-5
54-5
communication 46-7
259
community mental health 203-12;
233 -4;
botánicas in New York City 233-4;
botanicas
clinic and community 207-8;
20τ8; history
of
ofmental
mental health provision 205;
mental health training 206;
sectorisation 207; and traditional
healing 208-12
complementary
complement
红y medicine 240
comprehensive and alternative medicine
(CAM) 116
Conchado Juarbe,
Juarbe , M. 115
Copeland,
Copeland, S. 161
core spiritual experiences (CSE) 120
counseling 2-3,23,
2-3 , 23 , 129,
129 , 135,208,217,
135 , 208 , 217 ,
218,220
218 , 220
Csordas,, T. 121
Csordas
Cuba: herbal remedies 50,
55 , 56,
56 , 57,
57 , 58;
50 , 55,
see also Es
Espiritismo;
piritismo; Regia
Regla de Ocha
(Santerfa); Vodou
cultural awareness 37,
37 , 38n1
38n1,, 206
cultural therapy 218-19
Curtin,
Curtin, P. D. 132
Cushman,
Cushman, P. 85
Dawes,
Dawe 骂，如1.190
M. 190
De Vos,
Vos, E. L. 79-80
Dearfield,
Dearfìeld, C. T. 231
depression 82,
82 , 85
Deren,
Deren, M. 79
diabetes: herbal remedies 57-8;
prevalence of215
Diagnostic and Statistical Manual (D
(DSM)
SM)
23,204
23 , 204
divination 31,
94--6,
31 , 94
--6, 103,
103 , 106
dolls 96
55 , 57
Dominica: herbal remedies 55,
57,, 58;
Obeah 69
Dominican Republic:
Republic: herbal remedies 55,
55 ,
56; TRAMIL prograr
program
丑 58;
58; see also
Sango
Dow,].
Dow,]. 21
drapetomania
drapetornania 23,
23 , 25n4
drug use 2,
世ug
2 , 166-7,
16 7 , 169,
169, 170,
170, 172-3,
172-3 ,
207-8,209,211
207-8 , 209 , 211
Dudley-Grant,
Dudley-Grant, G. R. 219
Duncan,
Duncan, C. B. 143,
143, 147nl
147n1
Dunkley,
Dunkley, A. 165
Duran,
Duran, E. et al. 220,
220, 222
•
education 35-6
Employee Assistance Programmes (E
(EAPs)
APs)
208
Espiritismo see Puerto Rican Spiritism
Evans-Pritchard, E. E. 95
Evans-Pritchard,
260
Index
evidence-based psychological practice
(EBPP)
(E
BPP) 220
eevil
世1 forces 32
evolution of traditional healing practices
ofWest
West African
A 丘ican
29-38; influence
infiuence of
traditional healing 31-2; colonial
Caribbean 32-3; post-emancipation era
33-5; contemporary
contempor
红y sociocultural
dilemma 35-6; implications for health
and mental health 36-8
exorcisms 20,45,
20 , 45 , 83,
83 , 144,
144, 156
family therapy 219-20
Fanon,
Fanon, F. 3,22,
3 , 22 , 219,
219 , 241
Fernandez
Fernandez,].
, J. W. 94
Fernández Olmos,
Fernandez
Olmos , M. 19,232
19, 232
fever: herbal remedies 554-55
fiu: herbal remedies 554-5
4-5
Frankl,
Frankl, V. E. 121
Fraser,, Dr. C. 169
Fraser
Freire,, P. 219
Freire
Frye,, K. Y. 70
Frye
•
ganja see cannabis
Garey,].
,J. 84
Garey
Garvey,
154,, 162n3
162n3,, 165
165,, 166
Garvey, M. 154
gender relations 209-10
Glazier,
96,, 147nl
Glazier, S. D. 91,
91 , 96
147n1
glossary 249-57
González-Wippler, M. 110
Gonz:ilez-Wippler,
Govarrubia,
M. 108
Govarrubia
，扎1.
Greenberg, J. 81
Greenberg,].
Grenada: community mental health
provision 207; Obeah 69; Sango
Sango
日，
53,
90,, 92; see a
90
also
/s o Spiritual Baptists
Grenadines: diabetes
diabete
唱 215
215
Grier,, W. H. 22
Grier
Griffith,
Griffith, E. E. H. et al. 91,
91 , 98nl,
98n1 , 146,
146,
160
gris
bags 91,
岁'
Í sg gris
的 bags
91 , 98n3
Guadeloupe: Hinduism 184
184,, 189
Guinee,, W. 183
Guinee
Gullick,
C. J.扎1.
M. R. 143
Gullick, C.].
Guyana: cardiovascular disease 215;
indentured Indians 18,
18, 30,177,189;
30 , 177, 189;
Obeah 70; see also Hinduism; Islamic
infiuence
influence
Haile Selassie 162
162n3,
165,, 166
n3, 165
55,, 57; Whole
Wh ole
Haiti: herbal remedies 55
Minis
位y 161; see also
Person Healing Ministry
Sango; Vodou
Hale,
Hale , L. 95
Handler,].
Handler, J. 33,
33 , 53
healers 55,, 29,
Islamic
29 , 32-3,
32-3 , 35,
35 , 444-5;
4-5; Islarnic
healers 191
-4; Obeah men/women
191-4;
71-2; RastafarI
Rastafarl 169-71; RRegIa
怨la de Ocha
(Santeria) 104-6;
128,, 129-30
129-30,,
10 牛毛; Revival 128
132-3,
132-3 , 134-5; Sango 91-4;
91 -4; under
slavery 19-22
19-22,, 30; Spiritism 119-22;
SpiritualBaptists
Spiritual Baptists 143-5
143-5,, 147n4; Vodou
80- 1; see also mediums
80-1;
healing: definition
defìnition 124n2
124n2
definition 220
health: defìnition
Henry,
Hen 巧， C. 165
Henry,
Hen 巧T ， F. 145
Henry,
Hen 巧， F. S. 90
herbal medicine practices 43,
45,, 52-9; as
43 , 45
"blood purifiers"
purifìers" and anthelmintics 55;
for child health 57; for common cold,
cold,
fever,
fever , and fiu 54-5;
54-5; for diabetes
mellitus
me 血阳s 57-8; documentation and
preservation of 58; future of 59;
ganja
59; 织nJa
166-7,
170,, 172-3; glossary
166-7, 169,
169, 170
glos 阳y
249-51; Hinduism 54; for hypertension
58; Obeah 74; RRegIa
吃gla de Ocha (Santeria)
(Sante
巾)
107, 109; Revival129;
107,
Revival 129; Sango 96-7; for
sexual health 56; standardization of
48-9
48-9,, 50; traditional concepts of
ofhealth
health
and disease 53-8; for women's
reproductive health 55,
55 , 56-7; see also
botánicas in New York
botinicas
Y ork City
Hibbert, J. 165
Hibbert,].
Hickling,
Hickling, F. W. 218-19
Hinduism330-1,
Hinduism
0- 1, 176-86; caste 177-9,
177-9 ,
186n1; collaboration and integrative
186nl;
inte 罗ative
model 184-5; in the diaspora
healing mode1184-5;
herbal medicine
gloss
町 256-7;
256-7;
244; glossary
54; indentured workers 176,
176, 177-8;
jharay healing practices 179,
180,, 182,
179, 180
182,
magic
184,, 191
191,, 196
196n3;
184
n3; ojha
oj 加 folk
folk
179-80; Ramayan tradition 18;
Sanatanism 178-9,
178 斗， 181,
181 , 183; Shakti
healing 180-4;
180-4; in southern
Caribbean 177-8; Vaishnavite
Hinduism 178
Hobsbawm,
Hobsbawm, E. 18
156,,
holistic approach 33,, 55,, 19,46,
19, 46 , 97,
97 , 156
167,, 169,211,221
167
169, 211 , 221
homicide 208,
208 , 217
"hot" diseases and remedies 53-4
53-4
hothouses 42-3
42-3,, 131
Houk,].
Houk, J. T. 96
Howell,
Howell, L. 165
Hufford,
Huffo
时， D.].
D.J. 120
humoral concept of medicine 53-4
53-4
hypertension: herbal remedies 58
hysteria 83
Index
Ifa31,
95,, 96
96,, 101
101,, 103-4
Ifa31 , 92,
92 , 94,
94 , 95
103-4
representations 33,, 19,
19, 36; causes of
illness 44-5,
Rastafarl 167-9
167-9,,
44-5 , 46,
46 , 53; RastafarI
174n3; Regia
Regla de Ocha (Santeria) 106-7;
106-7;
Revival135-6;
Revival
135-6; Sango 990-1;
0- 1; Vodou
81-4
81 -4
inclusive approach 222
indentured Indians 16,
16, 17-18,21,
17-18, 21 , 189;
caste and Hinduism 176,
176 , 177-8; health
care 188; religion 22; traditional
healing 30-1,54
3 0-1, 54
individualism 209
integrative healing model see collaboration
and integration
intestinal worms 55,
55 , 57
Islarnic
Islamic infiuence
influence 188-97; in the
Caribbean 177; collaboration and
integrative healing model 19
194-6;
4-6; dam
karna 188,
189,, 190
190,, 191-6; in the
188, 189
diaspora 244; glossary 256-7;
healers
256 一7;healers
191-4;
and healing remedies 191
-4; Islam in
the Caribbean 189-91; principles and
belief system 191;
vernacular religion
191;
而macular
188,, 189
188
illness
迦ness
Jackson,, W.
w. A. 54
]ackson
]amaica:
Jamaica: Bethel Baptist Church 160; Bush
healers 96; community mental health
provision 205,207;
205 , 207; herbal remedies 50,
50,
554-5,
牛号， 57,
57 , 58; indentured workers 189;
189,, 19
190-1,
192,, 194; mental
0-1, 192
Islam 189
health training 206; Obeah
Obe 址1 38nl,
38n1 , 68,
68 ,
70,, 128
128,, 129
129,, 130
130,, 131
131,, 135
135,, 143;
70
population 43; religion
130-2;
re 且gion
13
0-2;
43,, 134-5;
socioeconomic issues 43
13 牛-5;
Whole
Wh
ole Person Healing Ministry
Minis
町 161;
161;
see also RastafarI; Revival
]ayawardena
Jayawardena,, C. 176
jharay healing practices 179,
180,, 182
182,, 184
184,,
179 , 180
191,, 196
196n3
191
n3
]ules-Rossette
Jules-Rossette,, B. 95
Jung,, C. G. 5
]ung
Kalin
ago 29
Kalinago
Kanaana,
Ka
naana, S. 194
Kardec,
114,, 115
115,, 116
116,, 117-18,
Kardec , A. 113,
113 , 114
117-18,
119
Kerr,
Kerr , M. 130
Khan,
Kh
an , A. 33
Klaus
Chaves,, A. 113
Kla
us Chaves
Kleinman,
Kl
einman, A. et al. 37
Knadler,, S. P. 20
Knadler
K'nife,
166, 167-8
K'nife , K. 166,
Koss-Chioino,J.
Koss-Chioino ,]. D. 4,119,120,122
4, 119, 120, 122
261
Lachataiiere,
Lachatañe
埠， R.
R.109
109
Laguerre,
La ♂le 盯e ， M.
M. S. 16
Laitinen,
Laitinen, M. 142,
142, 144,
144, 147nl
147n1
Lans,
Lans , C. 55,
55 , 56
learning disorders 209
Le
Leeward
eward Islands: Obeah 69; Whole
Whole Person
Minis
町T 161
Healing Ministry
Lewis,
Le wis ，如1.
M. G. 131
Lisle,, G. 131
Lisle
Littlewood,
Littlewood, R. 207
"lock up" 145
Long,J.
Lo 吨，]. K. 134
Lowe,
48 , 49
Lowe , H. et al. 48,
Lucumi see Regia
Regla de Ocha (Santer{a)
Lum,
Lum, K. 143
Maass , J. et al. 218
Maass,
Maat243
McClure,
McClure, S. A. 74
McKenzie,
McKenzie , K. et al. 222
McNeal,, K. 184
McNeal
Mahabir,
Mallabir, K. 184-5
Mally, G. E. 146
Mahy,
Makinde,
Makinde , A. M. 31
Mangru,
Man 箩u ， B. 188
Marley,
Marley, B. 166
materialism 209
Meance,, G. 86
Méance
mediums: Shakti 182-3; Spiritism 113,
113 ,
114,
116,, 118
118,, 119-20
114, 116
mental health 220-2;
220-2; African
A 丘ican
slaves 23;
current resources 217-18;
drapetomania 23,
23 , 25n4; and Espiritismo
122-4; failures of
122-4;
ofWestem
Western practices
2-4; integrating Caribbean healing
traditions 4-6;
6; perceived causes of204;
and Regia
Regla de Ocha (Santeria)
(San 化巾) 107-11;
and Revival
Revival136-7;
136-7; and Spiritual
Baptists
training 206; and
Baptis
臼 145-7;
145-7;
Vodou 85--6;
85-6; see also community
mental health
Mesa Blanca 116
Michel,
Michel, C. 80,
80, 81
Michie,
Michie , C. A. 57
migration 35
35,, 203-4,
日rigration
203 -4, 239-40
239-4 0
Miller,
M 诅er ， E. 210
Mills,
M 山S ， S.47-8
S. 4τ8
mind-body-spirit5,
mind-body pirit 5 , 19,32,46,97,156
19, 32 , 46 , 97 , 156
Moll,
Moll, L. 81
monotheism 4
Moodley,
Moodl
町， R. et al. 3,
3 , 55,, 242-3,
242-3 , 245
Moreira-Almeida,
Moreira-Almeida, A. 113
Morgan,
Morgan, K. 217
Morrish,
Mo 盯ish ， I.
1. 70
•
•
262
Index
Morrison,, E. G. 81
Morrison
Morton,]. F. 57
Murphy, ].M. 72,
Murphy,J.M.
72 , 73
Murray
Murray,, D. 67-8
Murrell, N. S. 73,
Murrell,
73 , 111n1
lllnl
Myalism 131-2
mythic world 21
Naidoo,]. 185
National Organization for the Reform of
Marijuana
Laws (NORML) 173
Mar 司 uana
Neezer,
Neezer, Pa 90
Newall,, V. 70
70,, 72
Newall
Niehoff,
Nieho
ff, A. 179
Nieho
Niehoff,].
ff,]. 179
Nodal,, R. 103,
104,, 110
110,, 111
Nodal
103 , 104
Norris,
Norr
毡， K. 66
Nunez-Molina,, M. 222
Nuñez-Molina
Obeah
Obe 址14444,65-76;
， 65-76; and conventional
medicine 75; European view of30
of30,, 33,
33 ,
34; evolution in colonialsim 67-9;
fortune-telling
fo 町une-telling
74; healers and
and 仕aining
training
71-2; herbal remedies
remedi
臼 74;
74; in]amaica
inJamaica
38nl,, 68,
129,, 130
130,, 131
131,, 135
135,
68 , 70,
70, 128,
128, 129
38n1
143; Myalism
My 址ism 131-2; and ojha folk
过 health
health
magic 179; for physic
physical
74;
poisoning for revenge 74; practitioners
73-4;
66; as psychological medicine 73-4;
resurgence of38nl,
of38n1 , 69-71; for
sociological problems 70-1,72-3;
70-1, 72-3;
terminology
53,, 67
67,, 69; uses 67
ten 丑inolo
臼T 53
Obe 址1 Acts 3
4-5
Obeah
34-5
obesity 215
obi 96
occult causes of illness 44,
44, 45
O'Garo,
O'G 红0 ， K.
K.-G.
-G. N. 217
ojha folk magic 179-80
Olupona,]. K. 94
Onisegun 31
Orisas see Sango
Orisha 34,
53,, 142,
34, 53
142, 147n2,
147n2 , 232-3,
232-3 ,
255-6
Ortiz,
Ortiz, F. 109
Orunmila see Onisegun
Otto,, R. 122
Otto
Pachter,
Pachter, L. 46
Padwick,
Padwick, C. E. 192
paranoid delusions 83
Paravisini-Gebert,, L. 232
Paravisini-Gebert
Paton,
Paton, D. 65,
65 , 68,
68 , 69,
69 , 70
Payne-Jackson,, A. 41-2
41-2,, 44,
Payne-]ackson
44, 49
Peek,, P. M. 94,
Peek
94, 95
Pentecostal Church 154,
158,, 162
162n2,
154, 158
n2, 242,
242 ,
243
philosophical hermeneutics 85
phobias 83
Plat 臼，]. T. 196n4
Platts,].
Pocomania see Revival
polytheism 4,
4, 22
possession 20
Pradel,
Pradel, L. 17
Primiano,
N. 188,
Primiano , L.
L.卜J.
188 , 189
205,, 206
psychiatry training 205
"psychic cause" 124
psychological imperialism 85
psychologists
psychologis
臼 217-18
217-18
psychology, spirituality,
psychology,
sp 让ituality
， and well-being
215-24; collaboration and integration
222-3; current mental health resources
217-18; effective psychological
counseling and healing 218-20;
psychocultural pathologies 217; Slave
Health Deficit
Detìcit 215-16,219-20;
215-16 , 219-20;
spirituality,
sp 让ituality
， traditional practices,
practices, and
mental health 22
220-2
0-2
psychology training 206
psychotherapy 85,87,219
85 , 87 , 219
psychotic disorders 23
Puerto Rican Spiritism (Espiritismo)
107,
107, 113-25; American
American colonial
influence 115; Christian oriented
Spiritism (Consejo Moral) 116;
comprehensive and alternative
altemative
medicine 116; glossary 254; and
healing process 119-20; history,
history ,
philosophy,, and belief system 117-19;
philosophy
Kardecian
Ka
rdecian movement 116; and mental
health
heal 由 care
care
practices 122-4;
122-4; Popular
ofhealers
Spiritism 116; relationship of
healers to
the "sacred" 12
120-2,
0-2 , 125n3; social and
political context 116-17; Spanish
influence 114-15;
11 4-15; Therapist-Spiritist
123-4;
-4; women
Training Project 123
practitioners 106
Regla de
Puerto Rico: psychologists 217; RegIa
Ocha (Santeria)
(Sante
巾) 116; socio-economic
issues 116-17; see a
also
/s o Puerto Rican
Spiritism (Espiritismo)
PUgh-Yi,
Pugh-Yi, R. 231
Pugliese , A. 232
Pugliese,
Ramos,, M. 103
103,, 104
104,, 110
110,, 111
Ramos
128,, 154
154,, 162n3
162n3,, 16
164-74,
RastafarI 128
4-74 , 174nl;
174n1;
collaboration and integrative healing
model 171-3; glossary
model171-3;
gloss
町 256;
256;
healing
practitioners and practices 169-71;
Index
illness and health belie
beliefS
fS 167-9,
167-9 , 174n3;
165--6;
origins and development 165--6;
principles and practices 166-7
Regla de Ocha (Santeria)
RegIa
(Santerfa) 30,
30 , 111nl;
111n1; in
Cuba 101-11; divination 103,
103 , 106; and
European medicine 102-3; glossary
252-4;
104-6;
252
-4; healers 10
4-6; herbal medicine
53
109;
山ness
53,, 107
107,, 109;
illness representation
106-7; and mental health practices
-4,
107-11; principles and practices 103
103-4,
242-3; in Puerto Rico 116; sacrifice
(ebbo) 103,
104,, 106
106,, 107
107,, 108-9
108-9,,
103 , 104
Lizaro 104
104,, 111n5
l11n5
111n4; San Lázaro
19,, 22,
46,, 48,
210-11;
religion 19
22 , 46
48 , 21
0- 11; see also
Caribbean Christian Church;
Christianity; Hinduism; Islamic
Islarnic
Regla de Ocha
infiuence; Obeah; RegIa
influence;
(Santerfa); Revival; Sango; Spiritual
(Santeria);
Baptists; V odou
Revival 128-37,, 154
154,, 162n4; "bush"
Revival128-37
(herbs) 129; church and balmyard
133-5; conceptualizations of illness and
health 135--6;
13 2;
135--6; emergence of 130-2;
glossary
254-5;
128,, 129-30
129-30,,
glo 岱ary 25
4-5; healers 128
132-3,, 13
134-5;
128,,
132-3
4-5; healing (Balm)
(B油丑) 128
129,, 133
133,, 134; legality of practice
129
heal 由 practices
129-30; and mental health
practices
136-7
Richard, P. S. 2-3
Richard,
Richardson,
Richardson, F. 68
Rivail,
Rivail, L. H. D. see Kardec,
Kardec , A.
Roast Breadfruit
Bread
丘uit Psychosis 3
Robinson,
Robinson , M. 67
Romberg,, R. 228
Romberg
Royal College of
ofPsychiatrists
Psychiatrists 206
Rozario,
Rozario , S. 194
•
sacrifice: in the diaspora 244; RegIa
Regla de Ocha
(Santeria)
108-9,,
(Santerfa) 103,
103 , 104,
104, 106,
106, 107,
107, 108-9
111n4; Sango 91
91,, 96
medicine 47
47,, 49
49,, 50
safety of
ofmedicine
Said,
Said, E. W. 21
Samaroo,
Sarnaroo , B. 18
San Lazaro
Lázaro 104,
104 , llln5,
111 币， 232
232
Sanatanism 178-9,
178-9 , 181,
181 , 183
Sandoval,
104-5,
Sandoval, M. 102,
102, 10
4-5 , 106-7,
106-7, 110
89-98 , 98n2; beliefS
beliefS and illness
Sango 89-98,
representations 90-1;
9 0- 1; and biomedical
practitioners 97; divination and spirit
4-7; gris ggris
仿 bags
bags 91
91,,
messengers 994-7;
98n3; healers and healing practices
91-4;
91 -4; herbal medicines 96-7;
9 7; Orisas
90-1,92,95,97;
90- 1, 92 , 95 , 97; sacrifice 91,96;
91 , 96; see
also Spiritual
Spiri
饥lal Baptists
•
263
Santerfa
Santeria see La Regla
RegIa de Ocha
Sartre,J.-P.20-1
Sartre ,J. -P.20- 1
Savory, E. 67
Savory,
Schiebinger
Schiebinger,, L. 56
schizophrenia 83
Scott,
Scott, L. 96
Seaga,
Seaga, E. 134
self-harm
208
selιharm208
sexual health: herbal remedies 56
Seymour, W.].
Seymour,
W.J. 162n2
shamans 15,
15, 17
Shango 255-6; see a
also
/s o Orisha
Sheridan, R. 42
Sheridan,
Sheridan, R. B. 131
Sheridan,
SSimpson,
扛npson
， G. E. 79,
79 , 92
sin 157
Singer, P. et al. 185
Singer,
Slave Health Deficit 215-16,219-20
215-16 , 219-20
slavery see Mrican slaves; indentured
Indians
Smith,
Srnith, M. G. et al. 128
Snow,
Snow , L. 46
social workers 218
socioeconornic issues 35--6,
35--6, 47
socioeconomic
47,, 49-50; in
Barbados 43; and botanicas
botánicas 230-1;
23 0- 1;
in]amaica 43,
caste
ca 眠 177-9,
177-9
， 186nl;
186n1; inJamaica
43 ,
134-5;
13 4-5; materialism 209; migration
rnigration 35,
35 ,
203-4,239-40;
203-4, 239-40; and Obeah
Obe 汕 70-1,
70-1
，
72-3; in Puerto Rico 116-17; and
Sango 97
spirit messengers 95
spirit obsession 118,
118, 124
83,, 84
84,, 86
86,, 134
134,, 144
spirit possession 83
Spiritism see Puerto Rican Spiritism
29,, 36
36,, 242-3
spirits 4-5,
4-5, 23,
23 , 29
Spiritual Baptists 140-7,
154,, 160
160,, 162n4;
14 0-一7 ， 154
belie
beliefS
fS and practices 142,
142, 147
147n3,
n3, 242;
healers and healing practices 143-5
143-5,,
147n4; history and development
141-2; and mental health practices
90,, 93
93,, 96
145-7; Sango 90
spiritual causes of illness 44,
44, 45
spiritual rituals 5,15,17,20-1,34,46,53
5 , 15 , 17 , 2 0- 1, 34 , 46 , 53
spiritual
spiritual
位ansformation
transformation 120
Spiritualism
114,
Spiri
饥lalism
114, 115,
115 , 117
spirituality 3,
3, 19,220-2,241-2
19, 220-2 , 241-2
St. Lucia: Obeah 69
heal 由
St. Vincent: community mental health
provision 207; diabetes 215; Obeah 69,
69 ,
90,, 92; see also Spiritual
70; Sango 90
Spiri
饥lal
Baptists
Stewart,, K. 146
Stewart
suicide 83,
83 , 208,
208 , 217
supernatural
44 , 46,
46 , 53
supematural causes of illness 44,
264 Index
Suriname: cardiovascular disease 215;
herbal remedies 56,
56 , 57; indentured
workers 18; integration of services 222
Sutherland, M. E. 217
Sutherland,
Sutherland, P. 3
Sutherland,
Swedenburg
Swedenburg,, E. 114
Sweeney
Sweeney,, C. 20
Tainos 29
22,, 249-57
terminology 22
Thomson,
Thornson, ]. 43
Thomton
Thornton,, K. A. 81
Tinker,
Tinker, H. 176
Tobago: cardiovascular disease 215;
cultural power 184; diabetes 215;
herbal remedies 55,
56,, 57;
55 , 56
69 , 70;
independence 206; Obeah 69,70;
obesity 215; see also Spiritual
Baptis
臼
Baptists
tolerance 222
Touloute,
Toulout
丘， P. 80-1
Tracy,
106,, 109
Tracy, E. A. 106
traditional healing in the diaspora 239-47;
Caribbean healing and Western
Westem health
care 245-6; Caribbean ph过osophy
philosophy of
healing 241-2; and community mental
20 8-一 12; reconfiguring
health 208-12;
traditional healing practices 243-5
traditional healing practices: definition
defìnition 15;
integration in mental health practices
4--6;
19-21,,
of19-21
4--6; philosophical basis of
241-2; rituals and ceremonies 220--1;
0--1;
also
transformation of21-4;
of21 -4; see a
/s o
evolution of traditional healing
practices; traditional healing in the
diaspora
traditional medicine 41-50; beliefS
belie fS and
practices 44-5;
44-5; Caribbean context
42-4;
definition 41; glossary 249;
42
-4; defìnition
implications for integration 47-9
47-9,, 50;
ssafety
拮ty 47,
47 , 49,
49 , 50; standardization 48-9,
48 斗，
50; tenacity of 45-7
TRAMIL (Traditional Medicine in the
Islands) 58,
58 , 59
trances 84
84,, 182
位ances
trauma 20
Trinidad: cardiovascular disease 215;
community mental health provision
50,,
207; diabetes 215; herbal remedies 50
54,, 55
55,, 56
56,, 57-8,
54
57-8 , 97; indentured
workers 18,
22,, 25n3
25n3,, 30
30,, 177
177,, 189;
18, 22
69 ,
mental health training 206; Obeah 69,
70; obesity 215; Sango 90,
90 , 92,
92 , 97,
97 ,
98n2; Shango cult 53; Whole Person
98n2;
Healing Ministry 161; see also
Hinduism; Islamic
Islarnic influence;
infiuence; Spiritual
Baptists
Trotman,
Trotrnan, D. 89-90
United States: Kali worship 184; La RegIa
Regla
de Ocha 107,
110,, 111
111,, 116; Obeah 69,
107, 110
69 ,
116,, 122; Spiritualism
70; Spiritism 116
114; Vodou 78; see a
also
/s o bot:inicas
botánicas in
New York City
ofthe
the West Indies (UWI) 203,
203 ,
University of
205
Van den Berg
Berg,].
,]. H. 85
Van der Veer,
Veer, P. 179
vernacular
vemacular religion 188,
188, 189
Vertovec,
Vertovec , S. 179
Viladrich, A. 230
Viladrich,
30,, 78-87,
78-87 , 87nl;
87n1; and Christianity
Vodou 30
78,, 81; and conventional mental health
78
care 85-6; in the diaspora 244,
244, 246;
glossary
glossa
巧T 252; healers and healing
practices 80-1; illness and wellness
practices 81-4;
81 -4; proactive/preventive
elements 84; reactive/protective aspects
84; religion and divinities 79-80
Voeks,
Voeks , R. 17
Vom Eigen,
Eigen, K. A. 134
Vontress,
C. E. 5
Vontres
吊， C.E.
Waldram,
Waldram, ]. B. 22
Walhouse, M.J. 67
Walhouse,
Weaver,
Weaver, S. R. 134
Weber,
Weber, M. 92
Wedel,].
103,, 104,
Wedel,]. 102,
102, 103
104, 107-8
Wedenoja,
Wedenoja, W. 96,
96 , 133
West
traditional healing 31-2
WestMricanMrican 仕aditional
Western
Westem health care practices
practic
创 2-4,
2 -4， 22,
22 ， 37
37
Wing
Wing,, D. M. 222
Winkelman,
94, 95
Winkelman, M.].
M.].
饵，
95
"witchdoctors" 21-2
W oessner, E. M. 20
Woessner,
women's reproductive health: herbal
remedies 55,
55 , 56-7
Wong, W. Y. 54
Wong,
W
orld Health Organization
World
Organization
同THO)
(WHO) 41
41,,
47,50,220
47 , 50, 220
Yeh,, C.]. etal. 221
Yeh
Yoruba religion 31-2,33,34,53,79;
31-2 , 33 , 34 , 53 , 79; see
aalso
/s o Ifa; Sango; Vodou
Zane,
Zane , W. W. 147nl
147n1
Zion see Revival