RESUMO
Susto is one of the most common disorders referenced in the medical anthropological and cultural psychiatric literature. This article questions if "susto" as understood in cultural psychiatric terms, especially in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM), is in fact a single "cultural concept of distress." There is extensive cross-cultural and intracultural variability regarding fright-related disorders in the ethnographic literature. What is often labeled "susto" may be in reality a variety of distinct disorders, or lacking in the two signature components found in the cultural psychiatric literature: the existence of a "fright," and subsequent soul loss. There has been significant polysemic and geographical drift in the idiom label, the result of colonialism in Mesoamerica, which has overlayed but not necessarily supplanted local knowledge. Using data from fifteen years of research with Q'eqchi' (Maya) healers and their patients, we demonstrate how important variability in signs, symptoms, diagnosis, treatment, and prognosis of fright-related disorders renders any simple declaration that this is a singular "susto" problematic. We argue for a careful consideration of the knowledge of Indigenous medical specialists charged with treating fright-related disorders and against the inclination to view variability as insignificant. Such consideration suggests that Indigenous forms of fright-related disorder are not susto as presented commonly in the DSM and cultural psychiatric literature.
Assuntos
Medicina Tradicional , Transtornos Mentais , Humanos , Belize , Medo , Transtornos Mentais/etnologiaRESUMO
Q'eqchi' women's health is the product of inherent, acquired, and induced vulnerabilities that inform an idiom of "weakness" characteristic of women compared to men, reflecting both biological difference and gender-specific demands placed upon them within the context of village life. While women are understood to be uniquely vulnerable to sickness - their "weakness" - they demonstrate great strength and vigor to perform culturally prescribed roles, such as "backing" heavy loads. A framework grounded in Indigenous culture and ideology interprets Q'eqchi' understandings of women's health and broader position within society, arguing the need to take seriously Indigenous explanatory frameworks.
Assuntos
Formação de Conceito , Medicina Tradicional , Antropologia Médica , Belize , Feminino , Humanos , Masculino , Saúde da MulherRESUMO
Medical diagnosis is a process of illness discrimination, categorization, and identification on the basis of careful observation and is central in biomedicine and many traditional medical systems around the world. Through a detailed analysis of several illness episodes and healer interviews among Maya communities in southern Belize, we observe that the diagnostic processes of traditional Q'eqchi' healers reflect patterns of narrative 'emplotment' that engage not simply the individual patient but also significant spiritual and cosmological forces. Three diagnostic techniques of the Q'eqchi' Maya healers are described and their connections to Maya concepts of personhood and cosmovision are presented. This research fosters an appreciation of how Indigenous knowledge systems shape clinical encounters and healing dramas, widening the spheres of clinical narrative co-construction and dialogue beyond the material and physical contexts implicit within Western clinical encounters.
Assuntos
Medicina Tradicional , Terapias Espirituais , Antropologia Médica , Belize/etnologia , Humanos , ReligiãoRESUMO
Theory and research on the healing practices of Indigenous communities around the globe have often been influenced by models of "symbolic healing" that privilege the way patients consciously interpret or derive meaning from a healing encounter. In our work with a group of Q'eqchi' Maya healers in southern Belize, these aspects of "symbolic healing" are not always present. Such empirical observations force us to reach beyond models of symbolic healing to understand how healing might prove effective. Through the extended analysis of a single case study of rahil ch'ool or "depression," we propose to advance understanding of forms of healing which are not dependent on a shared "mythic" or "assumptive world" between patient and healer or where therapeutic efficacy does not rely on the patient's ability to "believe" in or consciously "know" what is occurring during treatment. In this we demonstrate how the body, as a site of experience, transformation, and communication, becomes the therapeutic locus in healing encounters of this kind and argue that embodied mediums of sensorial experience be considered central in attempts to understand healing efficacy.
Assuntos
Luto , Comunicação , Depressão/etnologia , Depressão/terapia , Cura pela Fé/métodos , Belize/etnologia , Feminino , Humanos , Indígenas Centro-Americanos , MasculinoRESUMO
Several Indigenous communities around the globe maintain unique conceptions of mental illness and disorder. The Q'eqchi' Maya of southern Belize represent one Indigenous community that has maintained, due to highly "traditional" ways of life and the strong presence of many active localized healers or bush doctors, distinct conceptions of mental disorders as compared to Western psychiatric nosology. The purpose of this ethnographic study was to understand and interpret Q'eqchi' nosological systems of mental disorders involving the factors--spiritual, cultural, social, historical, cosmological, or otherwise--implicated in their articulation and construction. Over a period of 9 months, and with the help of cultural advisors from several Q'eqchi' communities, 94 interviews with five different traditional Q'eqchi' healers were conducted. This paper demonstrates that the mental illnesses recognized by the Q'eqchi' healers involved narrative structures with recognizable variations unfolding over time. What we present in this paper are 17 recognizable illnesses of the mind grouped within one of four broad "narrative genres." Each genre involves a discernible plot structure, casts of characters, themes, motifs, and a recognizable teleology or "directedness." In narrative terms, the healer's diagnostic and therapeutic work can be understood as an ability to discern plot, to understand and interpret a specific case within the board, empirically based structure of Q'eqchi' medical epistemology.
Assuntos
Cura pela Fé/métodos , Medicina Tradicional/métodos , Transtornos Mentais/classificação , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Belize , Etnicidade , Humanos , Masculino , NarraçãoRESUMO
Traditional or indigenous healing is often assumed to involve rich forms of dialogical and symbolic communication between healer and patient that serve to explain its salience and efficacy. An ethnographic study of Q'eqchi Maya healing in Belize suggests, however, that communication in some forms of indigenous healing may also be minimal and peripheral to treatment and more akin to that of biomedicine than so-called traditional medicine. While communication may still involve symbolic, intercorporeal, and other forms of subtle intersubjective connection, anthropologists often overreach in an effort to portray such healing systems in contradistinction to biomedicine. It is argued here that Q'eqchi healing might best be thought of as a form of empirically based restorative medicine in which communication is purely instrumental to the healer's task of diagnosing and eliminating pathology and restoring the health of the patient.
Assuntos
Comunicação , Indígenas Centro-Americanos/etnologia , Medicina Tradicional , Relações Profissional-Paciente , Adulto , Antropologia Médica , Belize , Feminino , Humanos , MasculinoRESUMO
This paper presents a case study of the traditional treatment of a Q'eqchi' Maya man in southern Belize in 2011 who is suffering from AIDS-related sickness. The purpose is to detail the empirical nature of Q'eqchi' Maya medicine, distinguishing between manifest and latent empiricism, as evidenced in the healers evolving attempts to treat the patient in the absence of knowledge of his biomedical diagnosis. The paper argues for a more complete understanding of the empirical nature of much Indigenous healing, which parallels aspects of scientific medicine, and for better collaboration among traditional healers and biomedical practitioners in strongly Indigenous areas.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Empirismo , Medicina Tradicional/métodos , Fitoterapia , Belize , Humanos , Indígenas Centro-Americanos , MasculinoRESUMO
Studies of the efficacy of 'traditional' Indigenous healing often fail to consider the epistemologies that underlay specific healing traditions, especially intrinsic notions of efficacy. In this article, I critically engage the concept of efficacy by identifying two somewhat different approaches to the issue of outcome. In 'transformative' healing processes, healing is conceptualized as a journey in which the outcome goal is a transformed individual. Efficacy, then, is about incremental changes toward this goal. In 'restorative' healing processes, the goal is termination of the sickness and the restoration of health; efficacy is conceptualized as a return to a presickness state. These healing processes are illustrated with examples from the Q'eqchi Maya of Belize and Aboriginal peoples of Canada.