Soc. Sci. Med. Vol. 24, No. I, pp.

I-I1, 1987

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HEALTH AND THE HOLY IN AFRICAN AND
AFRO-AMERICAN SPIRIT POSSESSION
THOMAS J. CSORDAS
Department of Social Medicine and Health Policy, Harvard Medical School, 25 Shattuck Street, Boston.
MA 02115, U.S.A.
Abstract--The difficulty of reconciling religious and medical dimensions of ethnopsychiatric phenomena
is discussed with respect to spirit possession cults. The paper documents a trend toward medicalization
of the phenomenon in the Anglo-American literature, and points out the lack of such a trend in the French
literature. Extended discussion is presented of the Afro-Brazilian candomblb, a cult not well represented
in the Anglo-American literature. Case vignettes are excerpted from key informant interviews with a
Brazilian psychiatrist who is also an initiated elder of the candombl~. It is concluded that a balanced
approach that attends to both religious and medical motives of cult participants is essential for an
adequate understanding of the phenomenon, and that such an approach is intrinsic to the goals of
contemporary medical anthropology.
Key words--religion and health, ethnopsychiatry, spirit possession, candombl~

The relation between medical and religious
definitions of human experience is of long-standing
concern for the cross-cultural study of illness and
healing. The importance of this relation stems from
the following empirical circumstances: (1) many
forms of religion are essentially concerned with
health and healing; (2) many religious phenomena,
and at times religion as a generic entity, have been
interpreted as pathological; (3) many forms of healing can simultaneously be interpreted as forms of
religion [1-3]. These circumstances raise a methodological dilemma: while it is possible to generate
accounts of certain phenomena from either the point
of view of comparative religion or medical anthropology, the two accounts may not be of great relevance to one another, and may not necessarily even
be mutually intelligible.
This is not simply to say that certain forms of
healing can be interpreted as religious in an 'emic'
sense and as medical in an 'etic' sense. It is instead to
recognize that scientific accounts can be formulated
of religious phenomena qua religious, as well as in
clinical terms. Thus, it cannot be assumed a priori
that an adequate account can be given by focusing
only on the 'medical aspect' or 'clinical implications'
of a phenomenon that also has an overt 'religious
aspect' or 'spiritual-aesthetic implications.' Given the
cross-cultural prevalance of religious healing, the
ubiquitous interrelation of religion and healing, and
the fact that both religion and medicine address basic
existential problems of life and death, it can be
argued that the category of the 'sacred' may be just
as fundamental to our understanding of health and
healing as are the categories of 'disease' and 'illness.'
A complete account of religious healing, then, must
not only examine the construction of clinical reality
with respect to medical motives, but also the construction of sacred reality with respect to religious
motives.

The phenomenon of African and Afro-American
spirit possession trance (distinguished from possession belief without trance or trance behavior without possession belief, both of which are more typical
of other world culture areas) [4, 5] is a prime locus of
the relation between health and the holy. Yet within
the literature on this topic, there has been in recent
decades a trend toward emphasis on pathology and
therapy, with increasing neglect of the religious
definition of the situation. When an earlier debate as
to whether spirit possession is pathological or normal
was largely resolved in favor of its normality, the
occasion was not taken to explore the religious and
everyday meanings of this normality and its connections to health and illness. Instead, the medical
question was reformulated in persistently medical
terms: if spirit possession is not pathological, then
how is it therapeutic?
This trend can be traced at least as far back as
1958, when Messing [6] published his analysis of the
Ethiopian zar cult as an equivalent of the 'group
therapy' that was then achieving popularity in the
United States. In 1960 Margaret Field [7] published
her landmark study of Ashanti shrines operated by
spirit-possessed healers. The theoretical impact of
this book can best be assessed in contrast to Field's
1937 study of the Ga people [8], in which traditional
medicine and spirit possession were examined against
the background of the religious system. In the intervening years Field received medical training as a
clinical psychiatrist, with the result that the later
volume is analytically focused against the background of major categories of psychopathology.
Given that not all shrine supplicants suffered from
mental illness as opposed to problems of everyday
life, and that it was the healers rather than those
afflicted with psychopathology who experienced possession trance, it is yet the case that a major conceptual transition had occurred in Field's work. Rather
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' This work helped to crystallize the trend identified here. based largely on familiarity with the zar material. He describes two cult initiations from Nigeria which are indeed those of psychotics. nor discounted. among several articles concerned with psychotherapeutic aspects of possession. and that indeed it would be possible instead to emphasize religion or folk theology. and thus deserves extended comment. but the focus shifts exclusively onto socially marginal settings of possession and affectively negative possession the culturally appropriate response to which is ethnomedical treatment. Bourguignon's [22] phenomenologically sensitive account of vodou dwells neither on medical implications nor on manifestations of the sacred. The dichotomy also implies a willingness to recognize a religious element only in the social sanctioning functions of central cults. His rationale for adopting the medical framework was that cult adherents see its role not as mystical union but as cure. he observed that psychotic patients were at times initiated for therapeutic purposes. focuses on instances in which the possession is aberrant and negative [18]. namely Brazilian Umbanda [17]. Prince [13]. which includes. The discussion of the zar cult by Young [15] in 1975 opens with an acknowledgment of a trend toward concern with peripheral over central cults. and which may or may not emphasize therapeutic goals. whereas the peripheral cult indicates a lack of social integration. but in two additional initiations described from the Yoruba candombl~ cult of Brazil. also blurs this distinction. most often serving as a response through which women as a socially oppressed group can obtain limited redress as a 'secondary gain' of spiritinduced illness. or 'ritual. The religious meaning of the cults is neither discussed as relevant to mental health. In his 1973 account of the North African Hamadsha. The central possession cult is defined as part of the institutional apparatus upholding a society's moral order.' possession is a kind of defense mechanism that acts in a therapeutic capacity. introduced the polar classification of possession cults as 'central' or 'peripheral. Young accepts the trend. The central cult is 'normal' in that it supports a moral status quo. This precludes addressing the relation of medical and religious meanings in either type of cult. Finally. The trend continued in 1980 with Ward's [19] elaboration of the central/peripheral distinction as applied specifically to mental health. of the hypothesis that the preponderance of women in possession cults is correlated with nutritional deficiency. in his 1974 discussion of Yoruba possession cults as psychiatric treatment. it is simply not considered. Beginning with an interest in psychiatric disorders in the Yoruba population. Even the single contribution dealing with a cult in which possession is positively valued. 189]. By the time of the second major collection of papers edited by Crapanzano and Garrison [16] in 1977. Deren's [21] early work on Haitian vodou highlighted spiritual and aesthetic dimensions of the dances executed by devotees in possession." He acknowledged this as a bias. Crapanzano [12] expressed a methodological tension in his choice of a "framework familiar to readers of Western medical and psychiatric literaure. emotional. only one that specifically addresses its religious meanings. and hysteria-prone persons" [7. Crapanzano's own notion of a symbiotic cure in which the patient merges with a cult calls into question any easy distinction between mystical union and cure. Whereas in 1937 Field stressed the 'fundamental difference' between the conceptions and premises of African and European medicine. and the fact that informants see everything as religious does not necessarily grant that the anthropologist leave to make the distinction for them between religious and medical dimensions of their experience--at least not without some careful methodological critique of the distinction. stating that his informants would not agree. which he generalizes as the primary concern for members of possession cults. in 1981 Kehoe and Giletti [20] published their controversial formulation. acknowledging little if any relevance for religious motives and meanings. non-mainstream individuals and possession is usually regarded as a form of illness. This paper concludes that central. there is no indication that the initiates are 'patients' in any sense. which while socially marginal constitute the dominant reli~on of specific segments of their respective populations. and accordingly proposes a methodological shift that substantially narrows the relevance of his argument. p. and possession is usually regarded as a positive experience. since for them everything is religious. not only has the central/peripheral dichotomy persisted. while the meaning of peripheral cults is essentially restricted to issues of personal and social pathology. but anthropological attention has been focused with increasing exclusivity on the peripheral. low-status. Lewis' [14] influential cross-cultural study of 1971. CSORDAS than possession and healing being treated as subtopics under religion. not only does the religious element disappear. Yet a psychological interpretation is offered that lumps together situations the actors in which may have been 'possessed' of very different motives. and replaces it with illness. Instead. which also used the zar as an examplary case. while peripheral possession is a cultural explanation of individual pathology. but demonstrates the everyday reality of spirit possession . That this is a tend and not a unanimous conclusion in the literature can be highlighted by mentioning certain exceptions. The trend continued with the first major collection on possession trance. he rejects the phenomenon of possession as the focus of analysis. In spite of its weakness. That is. This distinction introduces an implicit notion of social pathology to that of individual illness and therapy. In 1967 Kennedy [11] published an account of the zar cult as a form of psychotherapy. and that the question of whether these cures are religious is meaningless for them.THOMASJ. The dichotomy is weak insofar as it stumbles over instances such as Haitian rodou and the Brazilian candombl~. but makes no attempt to balance this concern. in 1960 spirit possession was part of the 'ideological background' for an analysis of psychopathology. possession was now a subtopic in a discussion of psychopathology. including the hypothesis that the core participants of the cult "Tend to be rather unstable. edited by Prince [9] in 1966. however. Peripheral possession cults are the refuge of marginal. and then primarily with regard to Asian traditions [10].

bori is a significant opportunity for the social advancement of women. whereas in Cuba it was predominantly a religious institution. thus pointing to the overlap of existential concerns at the boundary between religion and medicine. the Ethiopian zar. She points out that while adepts are frequently recruited as the consequence of an illness. it should also be recognized that social change may alter the religious and therapeutic needs of a community. who suggests that the zar is in fact unique among African and Afro-American possession cults: "The Zar cult is considered a healing cult for disturbed people whereas the other possession cults in question are actually religious institutions for the worship of the gods of the community" [25. and demonstrate an interest in correlations of possession beliefs with social structure or in the role of spirit activities as articulations of social change processes. and insofar as for Hausa people all illness has a spiritual dimension. as writers like Neher [35] have . activity. Leiris' [34] monograph on the zar cult demonstrates that even this paradigm case for the predominantly medical approach can be analyzed as a form of ritual drama as well as a form of ethnomedical therapy. dominance. Other works of note in this tradition include those of M~traux [32. Hence they would not only differ in their personal research stances. Bourguignon [29] clearly delineates some of the issues raised here by juxtaposing two accounts of the bori cult among Hausa women. trance and non-trance behavior. and as having their indwelling souls displaced by a spirit during trance. bori participants enact roles from the male domains of public life and officialdom. denied to them in real life. Such inordinate weight given to a single example might be suspect in any case. which include discussion of the nature of the soul in that religion. While medical and therapeutic elements are prominent. Possession trance is seen as a normal. Rouget's [5] outstanding recent work on the role of music in possession trance gives prominence to spiritual and aesthetic dimensions of the experience. She demonstrates that the bori is not marginal. Music is not simply a psychological triggering mechanism for trance. It appears more serious in light of a comparative study from the disciplinary perspective of the history of religions by Walker [25]. about relations of power. they may also inherit a position within the cult. A second and likely more relevant factor is that the former is a man and the latter a woman. or seek to join of their own free will and because of the prestige associated with membership. she does not neglect the pantheon of bori deities and the spiritual relation between devotees and their guardians. Exactly what has changed? In a recent article. 1 I. Monfouga-Nicolas [31] work is a case in point of the balanced approach prevalent in the French works. and plays a significant role in articulating social interaction in everyday life. the ritual activities can thus be understood as a metacultural commentary on the existential conditions of social life that transcends the 'battle of the sexes. Yet a third factor is a cultural difference between scholarly traditions.28]. the recent incarnation of the Afro-Cuban Shango cult (Regla Lucumi) as 'Santeria' among Cuban immigrants in Miami has been described as a therapeutic response to social malaise and personal crisis generated by the stresses of immigration and acculturation [27. insofar as cult adepts are respected healers consulted by both men and women. as being 'wives' of the spirits. on Haitian vodou. At the same time. Leacock's [24] study of the Brazilian Batuque emphasizes that the term cura has a connotation that includes problems such as obtaining employment or regaining the affections of a wandering spouse as well as healing illness. 33]. 19. the account by MonfougaNicolas [31] gives a much more balanced view of the social position of bori and its devotees. 160]. p. 15. also largely avoids the debate as formulated here.African and Afro-American spirit possession as it is imitated in children's games and as it is called into play in interpersonal relations between the anthropologist and her informants. but would have access to different types of informants and data. The account by Onwuejeogwu [30] portrays the cult from the perspective of social pathology. Thus they escape in fantasy from the role of oppressed female to that of dominant male. Bori is both a religious institution and a therapeutic institution oriented around women. but provides a power base for women vis-a-vis traditional Hausa religion and Islam. and passivity and about sexuality and motherhood. while examining the important work of cult leaders as healers. and thus transform the cultural profile of possession trance cults. the two anthropologists worked with different populations: Onwuejeogwu with Hausa in northern Nigeria and Monfouga-nicolas with Hausa in Niger. Several authors elaborate rather broad repertoires of possession types and functions in the societies they discuss. Rather than a hysterical imitation of men. as a paradigm case in establishing the dominant trend in the literature [6. in that the former writes in English within the Anglo-American tradition and the latter writes in French within the French tradition. The predominantly British volume edited by Beattie and Middleton [23]. These images indicate that possession trance is ultimately about identity.' The existence of contradictory accounts of bori can have several possible explanations. there is in Batuque a distinction between public ceremonies which the deities attend in order to 'have fun. For example. both of which are male-dominated. cathartic behavior in a sacred context.' and curing ceremonies which the deities attend in order to 'work. First. perusal of the French literature on African and Afro-American spirit possession does not reveal a pronounced trend toward medicalization. 20]. Finally. Within ethnographic instances. valued. While this statement may go too far in asserting the uniqueness of the zar [26]. Indeed. covering both spirit mediumship and possession. 14. it legitimately argues for the necessity of more careful empirical determination of the relative contribution of medical and sacred interests across ethnographic instances. or an overly great concern with social pathology/marginality.' What is noteworthy in the foregoing review of a medicalized discourse on spirit possession is the prominance of a single cult. Bourguignon concludes by adding a symbolic analysis of devotees' conceptualization as being 'mounted' as 'mares' of the spirits. On the other hand. or structural flaws in the relation between men and women: in possession.

the festivals of which only partially overlap with the feastdays of Catholic saints. Angolan deities. and contrasts substantially with the better known zar cult. The impact of this religion extends even to diet. In Afro-Brazilian culture as a whole the Angolan influence is strongest. but on the contrary once again separated. or orixas of the traditional Yoruba pantheon [39]. native Indian spirits. there is the classic monograph by Bastide [36] on the Afro-Brazilian candomblO.4 THOMAS J. was fortunate to have as guest the Brazilian psychiatrist Dr Alvaro Rubim de Pinho. what is the relation between statements like Young's that " . Participants honor the gods and goddesses. ~ith former slaves as members [42]. Angolan candombl~s. was founded by a priestess from Africa in 1830. Interestingly. linked to therapeutics. . it is these sickness episodes.. and represent various syncretisms of orixas. and Caboclo [31]. Dr Rubim attributes his personal interest in candomblO to three sources. Terreiros participate publicly in the carnival. together with the therapies and rituals they entail. 40. While a comprehensive comparison of the French and Anglo-American literature would doubtless confirm the relative trends identified here. has largely displaced or assimilated other deities. the orixa patronness of the waters. complementary.. and annually stage a public festival for Yemanja. however. or can they be reconciled? The question is large. Macumba. The first Bahian congregation. CSORDAS suggested. It is within the dynamic of the ceremony that we must consider the relations of music and trance" [5. and initiated elder of the eandombl~ terreiro of Ax~ Op6 Afonja. notably Nina Rodriguez [45] and . and its members include people of European as well as African descent. where the sociological and psychiatric were no longer identified. the latter being referred to medical or psychiatric issues. for it continues a trend begun by liberal intellectuals in the 1930s and 1940s. at least very often. Bastide stated that this approach had been necessary to countervail the medicalization of his time that saw possession trance as hysteria and neurosis. the problem remains of the interrelation of medical and sacred realities in this phenomenon. Do they contradict one another. 56 and 57. This work emphasizes the relation between myth and ritual. Batuque. in the domain of religion the Yoruba pantheon. Catimbo. and treats possession trance as a form of religious mysticism. CANDOMBLI~ Candombl~ in Brazil is essentially Yoruba (in Brazil Yoruba = Nag6 = Quetu) religion transplanted from West Africa. my translation]. or terreiro. in a retrospective some 15 years later. Periodically repressed by the predominantly Catholic authorities. At the same time. although they appear to emphasize religious ideology and participation in ritual over experiential dimensions of religion. 24. p. each orixa is paired with a Christian saint who is its counterpart with respect to shared attributes. my translation]. . It was necessary to lay the foundations for a unified discourse. In summary. It is also not intended to deny the recognition of religious elements by most Anglo-American authors. if not always. the Nag6 candornbl~ of Bahia is said to be the most orthodox. that dominate the interest of many devotees" [15]. to the life of the adept and to the unfolding of the ritual event: "A possession ritual is an architecture of time composed of different phases to which different musics are attached. with the publication of books on preparation of the ritual cuisine honoring the orixas----each deity having his or her favorite dish [43]. This review is not intended to be comprehensive. In any case. introduced in the Nineteenth Century. Umbanda. what must be explored are the implications of starting from a 'medicaltherapeutic' orientation as opposed to a 'comparative religion' orientation. 41]. These cults are prominent in different regions. First was his reading of works by an earlier generation of anthropologically concerned Brazilian psychiatrists. but that ultimately an approach more balanced between religious and medical meanings would be necessary: "'In the end. Finally. In the summer of 1979. Other cults with varying degrees of Yoruba influence include Xango of Recife and Rio de Janeiro." [37. In a series of intensive interviews coordinated by the present author and historian Linda Guthrie [44]. it was necessary to incorporate from it that which could be of value to what I was calling the sociology of trance. who found in Afro-Brazilian culture a focus of populist concern with folk culture in response to discouragement of activist politics by an authoritarian right-wing government. the African and AfroAmerican Studies Program at the University of North Carolina. after having repudiated the psychiatrists" interpretation as a unilateral interpretation. not only of madness but of all illnesses of psychosomatic origin or nature. the problem is that they tend to be made as generalizations across the field of possession trance studies. Within the spectrum of Afro-Brazilian possession cults. This participation is not as astounding as it may first seem to non-Brazilians. Candomblk has an established liturgical calendar. and be valuable in its own right. due to its presence since the Sixteenth Century. it has been only since 1976 that Bahian terreiros have not been required to register with the police. and again there are important exceptions within the French literature. For in Africa possession is. Dr Rubim offered a valuable key informant perspective based on his unique dual position as chairman of the Department of Psychiatry in the Faculty of Medicine at the University of Bahia in Salvador. pp. and spirits of the two found in Kardecist spiritism [17. Chapel Hill. Many Brazilians make use of the spiritual resources of the candombl~. such as Zempleni's [38] work focusing on the therapeutic dimension of possession trance rites among the Lebou and Wolof. but is integral to the trance experience. and the present paper will take only a first step by presenting some material on the Afro-Brazilian candombl& This major possession trance cult is poorly represented in the Anglo-American literature. 64. examines the cosmological structure of the candomblO universe. and a statement like Bastide's that "The structure of ecstasy is the structure of myth" [36]? Admittedly these statements are taken out of context--Young is a student of the zar and Bastide of the candombl& Beyond the issue of whether such statements are true for specific ethnographic instances.

in the course of 10 years this anticiwomen of higher social status than the yafs. All are consecrated to the orixa not for an illness. rituals. also influential were the works of The obas are organized hierarchically among themRene Ribeiro [47. The more usual process is rank. who is invariably a woman of African de. None of patients frequently submitted themselves to religious these male cult participants experience possession treatments without being open about it to him. and this is a possible indication that she is this office. On the day of initiation he was given of the Saints) who constitute the remainder of female a necklace sacred to Oxala as a sign of his office. experience did not bear this out. and rites of purification and Santo until a successor is chosen. his ritual obligations. When one room) are a larger group that may vary in number. are eight obas. and office. talks about authentic mental illnesses--psychoses--she genthere are slightly more than 20 in Ax6 Op6 Afonja. y a f s consecrated to the same orixa. They also act as general supporters of the terreiro. e. His initiation ocSaints). 721. which led him to attend acquired his patron when. the drummers or players of the atadecided that it should be a responsibility of baque are generally young men responsible for cerepsychiatrists of his own generation to resume these monial music. and in certain instances financial support as well. Third orixa that serves as his or her guardian. There are seldom more anticipated access to valuable ethnopsychiatric data. serve as auxiliaries in charge of coordinating decorative and aesthetic aspects of terreiro festivities. On occasion an uninitiated indiA x 6 0 p 6 Afonja a small but significant group of vidual attending a public ceremony will become artists and intellectuals of European ancestry occupy possessed. the sacred color of Oxala. and devotees who experience possession by the orixas. especially those of a more social and less sacred "At the time of my initiation. She also directs the strengthening by means of the animals' blood and initiation of the ya6s or Filhas-de-Santo (Daughters cooked meat. he was levantado para group of colleagues participating in the transcultural ser ogan (raised up to be ogan) by an entranced psychiatry symposium sponsored that year in Bahia Filha-de-Santo who was possessed by the deity Oxby the World Association of Psychiatry. conflict in life. it looked like the circumstances which led me to be an ogan would give me the character. It is organized of the religion. problem.48] and Edison Carneiro selves: first oba on the right of Xango. or Xango. who is also the principal deity of the terreiro.through consultation with the Mae-de-Santo. including Dr Rubim. but for some difficulty. They pation was disappointed. and serving the M8e-de-Santo as direct advis. at the culmination of a 3 week cycle of ceremonies that constitutes the scent. while attending his second his first candombl~ ceremony in 1968. and not with the advance intention . [49.bath. From this time Males seldom experience possession. Having achieved the status of ogan.African and Afro-American spirit possession Arthur Ramos [46]. Through this reading Dr Rubim was choosing a new Male-de-Santo on the death of one in self-instructed about issues of ethnopsychiatry. and who is was punctuated by rituals that included a sacred the temporary replacement for a deceased Male-de. because participants. animal sacrifices. Finally. it is not strictly speaking an episode of defray the cost of an orixa's expensive ritual costume. again ors.required to keep vigil before Oxala's altar. Four ceremonial offices are available to male opportunity to study what I wanted: the treatment of mental illnesses. Male cult heads (babalorixa or Pai-de-Santo) have been known. 50]--few of these works are available in English second on the right. which is either moral advice or sacrificial animals. and standing involvement with the affairs of the terreiro. Dr Rubim was the matter of curiosity. their primary responsibility is as patron to the purposes of research I have preferred to take another route. This group is responsible for translation. The ogan de quarto (ogans of the advice about how to fulfil religious obligations. but for orixa. undergo a series of interviews with the Mae-de-Santo.g. etc. and they are typically As he states. than three ekeide in a terreiro. and treatments. a ritual name in the Yoruba language. There are far more religious practices than there are must be present in all public and private rituals. but are infrequent in the Nag6 festival of Oxala. illness that indicates initiation as a ya6 capable of They are typically both black and white men.attend all public ceremonies of the terreiro. and how to around an ialorixa or M~e-de-Santo (Mother of comport himself during rituals. There are eight ogan de faca (ogans of in the Nag6 candombl~ few treatments of mental illnessesare the knife). whose responsibilities in. The night before the initiation. His trance. erally recommends going to a doctor. and Pequeno (Little Mother). Ax~ Op6 Afonja is one of three daughter terreiros during which she instructed him about the structure of the original Nag6 terreiro of Bahia. along with a candombl~ ceremony in 1969. Dr Rubim Finally among female participants. I continued as an ogan Aside from attending festivals of their guardian to frequent the terreiro and attend the rituals. each participant is consecrated to a single psychiatric hospital where he was employed. full-time officiants of the terreiro who applied. producing the sacred rhythms that studies.curred at the end of this period. in Ax~ Op6 he was entitled to attend private as well as public Afonja the relation of male to female y a f s is 1:I0. In fact. they may help In general. and in possession trance. chance discovery of these visits led him to explore Whether or not a person experiences possession their consequences for his patients at a private trance. first on the left. Above the ogans in chosen by an orixa. A second influence was the discovery that his indicate the presence of particular orixas. The night clude directing the music at ceremonies. the ekeide is a kind of general protectress. These ogans offer using questionnaires [in general population surveys]" [44. p. The Nag6 M8e-de-Santo makes appointments who are the only persons ritually consecrated to kill in which she gives advice. advice and support to the yafs. he candornbl& Second in rank is the iaquerere or Mae was dressed in white. During the following year he was required to encounter with the cult leader evolved into a long. His initial ala.

I judge the process of initiation to be mainly a process of conditioning. I imagine that the conflict the M8e-de-Santo talks about as possession by more than one orixa has a connection with what I would think to be resistance of the person to adopting that pattern of behavior which is being induced as the pattern of behavior of that particular orixa.Side-de-Santo talks do not concern situations of personality but moments of possession--the conflict between two orixas possessing the same body. and that it does not allow the person to work for too long a time. Another ceremony. Bastide [36] recounts that one of Xango's wives. often flies into a rage during ceremonies. enabling a person to confront life's difficulties. During initiation the novice Filha-de-Santo is secluded in darkness in a twilight state of semi-trance characterized as one of childlike suggestability or regression. in which latter case it is perfectly normal. For example. Inside the peji the environment is shadowy. where the Filha de Santo is prepared to be a person who dances in a certain way. and referred to in Y o r u b a as ~r& While totally absorbed in the sacred presence. the identification of the ya6 with the orixa is perfectly defined" [44. Dr Rubim described the following process of initiation: "It is very different from the initiation of an ogan. In a situation in which a w o m a n is required to become a yar. but its effects perdure for only a limited period. But even now the process of initiating a ya6 in A x 6 0 p 6 Afonja is never shorter than three months. Thus. attending particular religious ceremonies. Many years ago in Ax~ Op6 Afonja the period of initiation extended to nine months of seclusion in the peji [initiation house]. where the parts of deities are not played by humans. While all ogans and yars receive a necklace of color and composition specific to their guardian orixa at their initiation. In contrast to some possession cults. initiates make the elaborate costume characteristic of their patron. and even for initiated members must be renewed after several years. in which one is strengthed by 'feeding the head' with cooked meat and blood from a sacrificial animal. they talk to the iaquerere only for essential things. and possession occurs only 'in religious situations. But I have the impression that the conflicts about which the . 48-50]. spirit possession in candomblb can be seen as a pure form of ritual drama. since they will be responsible for incarnating their deity in human form. Also according to Bastide. the mystical relation in this instance takes precedence over features of social pathology or marginality that are often invoked in . offering a sacrificial animal to an orixa. The effects of this training are seen not only in the carefully stylized behavior of the deities during ritual possessions. and which is included as one part of the initiation of organs and yars. necklaces may be given to anyone in consultation. A part of the formation is specific to each orixa.' This suggests caution in concluding that spirit possession in candomblk is a cultivation of the multiple personality phenomenon.' This is a simple rite consisting of a series of prayers uttered by the Mre-de-Santo while the supplicant performs predetermined gestures. but rather a selective suggestibility based on cultivated sensitivity to the interweaving of musical themes in the ceremonies [cf. size and shape of beads. Becoming a ya6 or Filha-de-Santo is only one of his possible recommendations. there is no uniform susceptibility to sonic driving [35] as a mechanism of trance induction. and that the process of conditioning makes it possible to overcome this and adopt the proper behavior. But the Mac-de-Santo says that when the work of initiation is done correctly. The M~e-de Santo used to tell me that it is possible before or during the initiation that more than one orixa would try to possess the same daughter. During this period. and sometimes the same ritual is performed simultaneously for more than one. the Male-de-Santo seeks advice from Xango through the technique of Ifa divination [51]. and offering a meal of a particular orixa's favorite dish (ebo or fazer um despacho). the relation of the individual to her possessing orixa is essentially one o f mystical communion. 5]. or has certain personality traits in c o m m o n with the guardian orixa: it is c o m m o n to say that a person is 'for Oxala' or 'for Oxun' in the same way that a North American might say that a person 'takes after her grandmother. On an interpretive level. The person may need the ritual of bori (not to be confused with the Hausa bori cult). The initiates don't talk to one another. I imagine that this could be comprehensible to us as personality traits that appear to be in disagreement. and must be restrained by assistants from beating her malefactress in revenge. pp. Yet another prophylactic measure is bestowal of a necklace made in the terreiro with ritually prepared beads. She is the one who coordinates the ambience of the place. But if the process occurs correctly there is a definite link established between a ya6 and only one orixa. Xango indicates the cause of the problem and tenders advice. but where the deities in effect play themselves. quiet. I imagine that this is purely personal. This raises the issue of the separation of pathological processes from possession in the religious context. It can be a group of initiates.6 THOMAS J. but in interactions among orixas that reflect their relations in myth. C$ORDAS of becoming a member of candomblO. A person often resembles. and isolated. Sometimes they are in different rooms performing different rituals. each participant in candomblb has only one guardian spirit. This ritual fortifies spirit and mind. In such a consultation. Those who are initiated into the possession experience undergo a careful process of training over a period of several months. and learn both the complex mythology associated with that divinity and its t?pical patterns of behavior and speech as manifested on ritual occasions. wherein repressed or unrecognized motives are acted out [52]. Other prescriptions made by Xango through medium of the Mre-de-Santo include taking sacred herb baths. mimics certain characteristics of the orixa. and on certain occasions the ialorixa (Mac de Santo) visits to supervise and give directions. Thus. once tricked in myth by her co-wife. semi-dark. and has certain ways of behaving socially. but there are different rooms. so that on ritual occasions her possession experience is initimately tied to a particular musical experience. is 'cleansing of the body. meant to prevent misfortune. though they vary in color. This time has been greatly diminished. the novice is sensitized to the drum rhythm sacred to her orixa. instead of therapeutic acting out. I imagine that during this process there can arise resistances or duplicities to the adoption of a kind of conduct. The iaquerere (Mae Pequeno) enters daily and directs the works. I suppose because the process is expensive. In a situation of conflict.

The situation would be tense.. After two weeks of frequenting the house and fulfilling religious obligations. even though the-woman had travelled a long way to do it. The police were alerted. The initial conflict was between daughter-in-law and mother-in-law. In this case a conflict arose within her marriage because she wanted to participate in the Afro-Brazilian cults. T h e following is an e x a m p l e o f such a situation. I know this family very well. who does not have any children himself. and soon after they sold it to get cash. it will not do any bad. She did have relatives in Bahia. I think that the consultation had been made with many doubts.African and Afro-American spirit possession the e x p l a n a t i o n words: o f p o s s e s s i o n cults. On returning she became a Professor of Literature at a university. in an Afro-Brazilian terreiro--another place. The variations of social solidarity are finally only the reflection. the following is o n e w h e r e religious p a r t i c i p a t i o n itself is an issue in the conflict b e t w e e n spouses. Her orientation towards this had come through contact with a house of Umbanda in Rio. I advised them to take her to the cult whose address she had brought back from Minas. Then she got married. she had confidence in the J. So the daughter-in-law tried to avoid seeing the older women too m u c h . as of now. A prayer was given to her and she was told to continue to use it. made some recommendations. A lady. but the problem was not with me---she wanted a religious solution. in the city of Mariana. I do not know if this indication was . it is still necessary in a b a l a n c e d e t h n o p s y c h i a t r i c a p p r o a c h to view it as a resource for the h e a l t h a n d well-being o f a c o m m u n i t y t h r o u g h the m e a s u r e s o f ritual p r o p h y laxis p r e s c r i b e d by the M ~ e . had for more than two years submitted herself to psychoanalysis. A l t h o u g h o n o c c a s i o n p e o p l e with v a r i o u s m e d i c a l illnesses c o n s u l t the M d e . and the young women would be demanding.S a n t o in c o n s u l t a t i o n . She had gone to Europe when very young. N o t e also D r R u b i m ' s role as a p s y c h i a t r i s t in this instance. She was from Ceara State in the north of Brazil.d e . She had simply fled from the hotel room in Guarapari and gone to Minas. She was a white woman about thirty years of age. (T)he social can only inscibe. Case 2. She did not accept me. pp. 73-75]. I told her about my contacts with candombl& I just used my position as ogan in order to be well accepted.. in perpetuity. If this case is an e x a m p l e o f religious m e d i a t i o n o f i n t e r p e r s o n a l conflict. mother of one child. so the lady went to Bahia to have an appointment with the M~e-de-Santo. but I do not know which ones. However. completely different. because although my information is that the ambience improved quite a lot. She did the diagnosis. It was a neurotic state. It concerns a family that lives in the Amazon region. and once she demanded a car. because if it does not do any good.. Her husband suggested that they go on vacation to take her away from her anxiety. The devees of participation in the group can only follow those of the identification of a person with the orixa. and the consequence. One morning the husband woke up and did not see her--she had disappeared. She went to the Mac-de-Santo daily. and spent six years there pursuing her education. of the variations of solidarity established between the person and the world of the gods . though her family moved to Bahia when she was an adult. Even though the husband is a lawyer he agreed to wear it.b u t she still wanted to profit materially and financially from her in-laws. but the older women's husband took a position of solidarity with his wife against their daughter-inlaw. talking with her and participating in the cult. m o s t c o n s u l t e e s are p e o p l e with p s y c h o s o c i a l issues such as m a r i t a l p r o b l e m s . Now this mother always had great affection for her only son. In this case it was my Mac-de-Santo in Ax6 Op6 Afonja. because this happened only a few months ago and many factors can influence the situation. saying it was a very good one. She would agree to leave only if she could go to Bahia to consult another house of religion. In trying to get her to accept me. having heard very little of the story. After two consultations with her.Ide-de-Santo and the necklace. and the Mac-de-Santo completed her description of the family situation with absolute fidelity.S a n t o . But she refused psychiatric treatment. my translation]. in the domain of interpersonal relations. and decided upon the use of the necklace for the lady and a smaller necklace for her husband [44. The mother-in-law gave her the car. 27 and 28. the laws of the mystical life. has a conflict with her daughter-in-law. as we say in psychiatry.d e . another state. besides having lived in Europe and being a professor at the university. the situation seems to have become better. She was having a possession. and they found her in Minas Gerais. saying that when intellectuals go to candombl~ it's out of curiosity. But it was indicated to her that she should not become a yar. financial difficulties o r p r o b l e m s with d r u g s a n d alcohol. I decided that a psychotic condition did not exist. someone in Minas gave her the address of the terreiro there. This in turn had repercussions for their son. since they are from my hometown. But the mother-inlaw's confidence in the MSe-de-Santo improved because the Male-de-Santo described the facts as they happened.. as r e c o u n t e d by D r R u b i m : . her anxiety disappeared. as well as his t e n d e n c y n o t to c o n s u l t directly with his religious c o u n t e r p a r t . but the daughter-in-law began to think that the mother-in-law was overprotective of her son. The anxiety disappeared. In Bahia I was called to help this lady. Another necklace was prescribed for the lady's husband. the address of which she had obtained in Minas. and her husband did not let her. . aggravated by her reaction to the situation--the condition was psychogenic. but on the contrary the mystical that commands the social" [36. I found her in a very a~tated and anxious state. This was a very curious case that concerned a lady who was not a participant in the cult of candornblk. who. Then I surprised the family. The conflict grew worse and became aggravated. She received the indoctrination and fulfilled obligations. but not in the same house. CASE VIGNETTES If illness is n o t the p r i m a r y c o n c e r n o f candombl~ p a r t i c i p a n t s . She continued to refuse me. Case 1. All four live in the same city. pp. a n d the cult's existence is n o t a d e q u a t e l y e x p l a i n e d as a r e s p o n s e to social m a r g i n a l i t y . She tried to ask for jewellery. The situation became very difficult. It is not social morphology that commands religion or explains it. From what she told me. . the orientation given by the Male-de-Santo was for the lady to use. they share a lot. she gave very little information to the Mac-de-Santo. saying that it didn't matter. In this case. and not because they believe. it is still too early to judge. The lady believes that the relationship is much better. a necklace prepared and made sacred by the M~e-de-Santo. The difficulties grew worse for the family. So the couple spent several weeks at the beach of Espirito Santo in Guarapari. I do not want to judge the consequences of all this as it evolves. to the point that they did not see each other unless the daughter-in-law would go to ask for something. so she consulted me and I recommended this one for her. In Bastide's " . who was their only child. What seems curious to me in this case is not the situation's development. I tried to get another psychiatrist. But it seems that she acquired a lot of trust--after all. The marriage was well accepted. w h i c h a p p e a r s typical o f his self-described o p e n n e s s to religious t r e a t m e n t as long as it is c o m p a t i b l e with t h e r a p e u t i c goals. the lady wanted to go to a M~e-deSanto.

to a conception o f Latin American psychiatry as limiting its scope to 'psychiatric p h e n o m e n a in the strict sense. and felt the incapacity of psychoanalysis to understand the problem. In the Peji there were some days when she submitted herself in a disciplined way to the determinations of the Male-de-Santo and fulfilled her rituals. In this case. Very simply. for him. This behavior would cause disturbances in the environment. Let me tell you about a case in which I was involved that illustrates the capacity of the Mile-de-Santo to separate what comes from the religious side and what comes from the medical side. I remember this because. on returning to Rio de Janeiro. From the description. Later on. and stayed in the eamaria (the room where the MSe-de-Santo stays) for two months. After her ~aduation she went to New York for a time. in this instance the prescribed level o f religious participation goes well beyond that observed in the first case. My contact with the M?te-de-Santo wasn't good enough to know why she thought as she did. the area o f 'neuroses' is no more the privileged d o m a i n o f psychiatry than it is o f religion. That was the major conflict with her husband. after she interrupted her psychoanalytic treatment. As a psychiatric instrument I would not have been able to resolve it. So there she was. and thought it necessary even in that moment to obtain medical intervention. pp. The evolution of the situation was quite normal. a treatment which she interrupted. playing--but that is proper to these manic syndromes. It concerns a recently graduated medical student. who had been an excellent student. Second. an ogan of this candombl~ had been an attendant in a psychiatric hospital. I think she was neurotic. she had consulted an Umbanda house. although the ceremonials described were ofcandombl~ type. but the Mae-de-Santo did not accept her for initiation again. but she told me that there were situations of mental illness that were considered to be natural illnesses. and that the action is done without any reflection or inhibition. She would have episodes of agitation and accentuated insomnia. Thus.S a n t o . and was told that her problem was a religious one. she experienced certain perturbing reactions while she was in New York. There she was advised to have initiation. I have the impression that the cult had to do with black magic. What I find curious about this is that the Male-de-Santo did not attribute the agitation to religious causes. she burned sacred objects. she was very primitive in her knowledge. The treatment a p p r o a c h o f both Dr R u b i m and the M a c . but she advised that. and we were in total agreement. So there must already have been some reasons to motivate the consultation and treatment. hysterical crisis. but one characterized by a syncretism of candombl~ and the beliefs of Kardecist spiritism. because she thought that the existence of a medical problem made a contrary indication. and the M8e-de-Santo identified it as not being proper within possession. The Male-de-Santo felt uneasy. and he knew me becasue of this. When she was back in Bahia she decided. She continued to attend the house. conditions were not right to proceed with the initiation. and told them that she suspected that there was a medical problem in addition to the religious one. and she accepted. This Mile-de-Santo with whom I have been associated knows how to differentiate trance by possession of an orixa. I explained this diagnosis to the M~e-de-Santo. The present M~e-de-Santo in my Terreiro was a public functionary who left that work when she was chosen as Mile-de-Santo. she told me she was having fun. actually reaching the initial stages o f initiation. Case 3. He is critical o f the trend in American psychiatry since A d o l p h Meyer toward increasing medicalization o f h u m a n life to the point o f presumed omniscience for psychiatry. Nevertheless. and simulated . He informed the M~e-de-Santo about this. this girl was cured. First. the woman told me it was Irm~o Basa--Spirit of the Brother Basa ('Irm~o' is the Kardecist term for 'spirit'). According to what she told me later. D r R u b i m ' s simultaneous ability to diagnose a neurosis and willingness to declare the p r o b lem not a psychiatric one is directly related to his own conception o f psychiatry's p r o p e r boundary. She consulted a religious cult. In the third case. It would have been that she sensed a problem intuitively in Rio. talking too much during times when she should not have been speaking. In Rio.b e t w e e n w h o m there was apparently no direct c o n t a c t . CSORDAS proper through religious means or because it coincided with the wish of her husband. u n e m p l o y m e n t and communality will ultimately be frustrated. I understood that it was not a traditional terreiro.a p p e a r s to have been aimed at c o m p r o m i s e between the w o m a n ' s perceived spiritual needs and her h u s b a n d ' s a d a m a n t opposition to her cult participation. Although the family of the girl was opposed to her initiation. but it stops short o f full initiation as a cult devotee. the Mae-de-Santo asked her relatives to come. and diagnosed that the young woman was in a psychotic episode. although this M~e-de-Santo looked like a very intelligent woman. and the relation between medical and sacred realities becomes critical. Later on. she didn't have the higher level such as does the M~e-de-Santo in Ax6 Op6 Afonja. I don't know if in the past this would have been regarded as the correct procedure for a Mde-de-Santo--it may be a consequence of some awareness of psychiatric subjects on the part of contemporary Males-de-Santo. It was a manic-depressive psychosis. I have heard that everything is now going well in this case. By coincidence. In one of the nights when she could not sleep. Two points must be made in c o m m e n t a r y on this case. despite the fact that we knew that the process of becoming a Filha-de-Santo included modification of one's level of consciousness. the woman should not frequent the cults. The spirit who advised through the medium was not an orixa. or is inappropriate to the feeling. The M~e-de-Santo concluded that while she was ill. because it was not a psychiatric problem [44.. He knew that I was an ogan of another candombl~. It is common that an ecstasy of happiness is associated with an activity that does not correspond to. She would be very talkative. because according to the rule of candomblk she could not call a stranger or uninitiated person--a doctor-to help her in the private area of the house. in the middle of an agitation. on the indication of a Mde-de-Santo. I have reason to think this because she submitted herself to psychiatric treatment for two years. but there were some days when she interrupted the rituals with her behavior. The M~e-de-Santo observed that there was a different disturbance that aggravated her to such an extent that one day she burned certain sacred objects. She initiated the process. and that in such cases Xango did not think that initiation was convenient. But it seems to me that this was funny behavior on the part of the Male-de-Santo: she gave religious orientation and obligations. Religion was an alternative solution. but she then had other episodes.d e . demonology.8 THOMAS J. His willingness to acknowledge 'informal psychiatry' is tied to a critique o f the lack o f limits between pathological and normal socially conditioned p h e n o m e n a in N o r t h American psychiatry.' and to a view that those who are waiting for a solution through p r o g r a m s o f mental health to societal problems o f poverty. it was an Angolan candornblk.. But what was said was that there had been an orientation from a superior entity. So I was called to give my opinion. to submit herself to the process of initiation and become a Filha-deSanto. the degree o f ritual participation is greater still. 75-79].

then. that one cannot a priori deny the psychiatric aspects of candornbl~. Each side accused the other of being one-sided. though it must be used with care. When she decides it is a hysterical crisis she does not use that term. She passed through a period of several days during which she had a problem with fixation of memory. the 'new cross-cultural psychiatry' [53] combines the sophistication of epidemiological method with the sensitivity or hermeneutic method. or abandonment of the subdiscipline's important move toward clinical relevance. When she commented to me about this period. diversity in types of trance behavior and experience available in adherents' behavioral environment. The ability to experience possession by an orixa is a highly valued religious skill and a serious ritual responsibility. These judgments by a Male-de-Santo are apparently based both on observation of more or less subtle behavioral cues and on evaluation of states of consciousness entered by devotees. the saint does not manifest itself in that way. It is also curious in this case that the Mac-de-Santo knew how to separate the infantile behavior of ~r~ [preparatory trance---see above] from the euphoric behavior of mental disease. but I have seen my Male-de-Santo observe trances even in the initiated ya6s of her terreiro. I don't know how she can do it. Would it not be wiser to pose the issue at the outset rather than to let it arise in a post-facto polemic? What are the implications of observations that some people appear to make no distinction between the spiritual domain and the domain of health. 82-90]. A situation in which a variety of modes of possession are possible may be significantly different from one in which only a single form is recognized. which is common among people who receive electric shock. and which she interpreted as a supernatural situation. even now she does not know that she underwent electroshock treatment. Careful empirical study and ethnological comparison along these lines are essential for a balanced approach to the relation between ecstasy and illness. all three cases described by Dr Rubim involved individuals who were marginal not to their society--all were professional class women of European ancestry--but marginal to the religious milieu. But she herself told me that the M~e-de-Santo listened to the narration of this period and did not confirm the possession. even initiated ya6s will be referred to a doctor if their possession behavior becomes inappropriate. if implicit. Likewise in the previous case. she said she had the impression of having passed through several days which she remembered only as if it were a dream. And there was another episode in which the young woman was hospitalized and it was necessary to use electrical shock treatment--a treatment done in few cases. Finally. Ecstasy as a category of cultural experience is elaborated to a degree alien to Western science. this is a case in which initiation was denied precisely because the novice was discerned to be mentally ill. pp. As Dr Rubim noted. In that case it was administered under anaesthesia. but the patient didn't know about it. In this account of direct collaboration between psychiatrist and religious specialist. and hence not considered as viable candidates for initiation. cultural definitions of which health resources are appropriate for which illnesses. it is unlikely that the opposition of her husband was the only factor affecting the Mde-de-Santo's decision to limit her participation. while others. CONCLUSION Using the example of African and Afro-American spirit possession. a context in which 'possession" is a manner of speaking about an emotional attachment [55] may not have much in c o m m o n with one where 'possession' implies mystical communion with a deity [36]. but which in certain ones can be necessary. and variations of symbolic structure within the repertoire of possessing spirits. attention to local contexts of interpersonal power. it has been argued here that certain religious or health-related phenomena can be adequately understood only by examining both their medical and sacred dimensions. distinctions between normal ecstasy and pathological ecstasy. the medical expert is impressed by his counterpart's intuitive and practical ability to distinguish pathological from sacred experience. as evidenced by the frequent accounts of initiatory illness. such that there are definite. and each claimed even-handedness [56]. the different levels of participation and identification attained by individual supplicants. and tell them to see a doctor. indicating that the cult experience itself is not primarily a form of therapy. but told her that what she described was not a possession. The Mac-deSanto does not know what happened. Specific issues that must be addressed in the study of possession trance include the degree to which existential problems are defined in religious or medical idioms. She simply decides it is a case for the psychiatrist by excluding possession by an orixa and simulation. The family was informed and authorized the treatment. Kleinman and G o o d ' s [41] recent outline of a research program for an anthropology of emotions specifies the need for detailed phenomenological description. The controversy between Leacock on the one hand and Crapanzano and Garrison on the other over the latter's edited volume on possession in the end came down to the relative emphasis given to medical and religious features in defining the nature of the phenomenon. Contrary to the c o m m o n generalization that individuals are initiated into possession cults as a form of psychotherapy for mental illness. such as the Mac-de-Santo described here. or can illness in some cases by an idiom for a certain type of encounter with the sacred [cf. She knows how to make the differential diagnosis [44.African and Afro-American spirit possession trance----something we psychiatrists do not know. of course. and that one is remiss in denying the religious aspects of the zar cult. Indeed. Dr Rubim notes that this conforms to an observation made decades earlier by Ribeiro [48]. To argue for the inclusion of the holy as a factor in the discourse of medical anthropology is not to advocate a return to older paradigms. She confused the effect of electroshock with a possession. 57]? Is there a religious . entrusted only to those regarded as stable enough to function appropriately. Her evidence is that the Santo does not know what she is doing. and recognition of the basic somatic dimension of culturally conditioned activity. The present work argues. a neurotic individual was deemed an inappropriate candidate for initiation. analysis of relevant semantic domains. are able to make surprisingly subtle distinctions? How and under what circumstances are the boundaries drawn? Is spirit possession predominantly an idiom for illness.

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