Entre zelar e cuidar: sentidos sobre saúde-doença em dirigentes da Umbanda / Entre celar y cuidar: significados sobre salud-enfermedad en los líderes de Umbanda / Between watching over and caring: meanings about health-disease in Umbanda leaders

RESUMO Por meio da antropologia da saúde, podemos compreender o terreiro de umbanda como parte de um sistema popular de cuidado. Este estudo teve por objetivo investigar as concepções de saúde e doença produzidas por zeladores de terreiro de umbanda. Participaram dez zeladores de terreiro da cidade de Uberaba (MG/Brasil), sendo três mulheres e sete homens, com idades entre 40 e 76 anos. O tempo médio de atuação como dirigente foi de 18,4 anos, variando de cinco a 43 anos. Os terreiros chefiados por esses participantes atendem entre 15 e 280 pessoas por dia de funcionamento. Pela análise das entrevistas, destaca-se que o cuidado em saúde oferecido pelos zeladores ultrapassa os limites rituais, nas cerimônias públicas, sendo prestado de modo contínuo nos terreiros. As posturas assumidas pelos entrevistados envolvem ações de escuta, acolhimento e proximidade física no momento da urgência. Pelas narrativas, pode-se concluir que o zelar, no sentido de gerenciar o espaço do terreiro, espiritual e materialmente, não pode ser dissociado do cuidar, significando os zeladores como importantes agentes populares de saúde.

RESUMEN A través de la antropología de la salud podemos entender el terreiro de umbanda como parte de un sistema de atención popular. Este estudio tuvo como objetivo investigar las concepciones de salud y enfermedad producidas por los cuidadores del terreiro de umbanda. Participaron diez cuidadores de terreiro de la ciudad de Uberaba (MG/Brasil), tres mujeres y siete hombres, con edades comprendidas entre 40 y 76 años. El tiempo promedio como gerente fue de 18.4 años, que van de cinco a 43 años. Los terreiros encabezados por estos participantes atienden entre 15 y 280 personas por día de operación. Del análisis de las entrevistas, se destaca que la atención médica ofrecida por los cuidadores va más allá de los límites rituales, en ceremonias públicas, que se brindan continuamente en los terreiros. Las actitudes asumidas por los entrevistados implican escuchar, acoger y proximidad física en el momento de urgencia. A través de las narrativas, se puede concluir que el cuidado, en el sentido de administrar el espacio del terreiro, espiritual y materialmente, no se puede disociar del cuidado, lo que significa que los cuidadores son importantes agentes de salud populares.

ABSTRACT Through health anthropology we can understand the umbanda terreiro (specific place for the religious ritual) as part of a popular system of care. This study aimed to investigate the conceptions of health and illness produced by saint keepers of umbanda terreiro. Ten leaders of the terreiros in the city of Uberaba (MG/Brazil) participated, being three women and seven men, between 40 and 76 years old. The average time of performance as a manager was 18.4 years, ranging from 5 to 43 years. The terreiros led by these participants attend between 15 and 280 people working day. The health care offered by saint keepers exceeds ritual limits in public ceremonies and is provided on a continuous basis in the terreiros. The postures assumed by the interviewees involve actions of listening, welcoming and physical proximity at the moment of urgency. From the narratives, it can be concluded that care, in the sense of managing the space of the terreiro, both spiritually and materially, can not be dissociated from caring, meaning saint keepers as important popular health.

Cross-cultural, transnational or interdisciplinary? Eric Wittkower's psychosomatic medicine and transcultural psychiatry in historical context.

This article traces the career, scientific achievements, and emigration of the Berlin-born physician, psychoanalyst, and psychosomatic researcher Eric Wittkower. Trained in Berlin and practicing internal medicine, he became persecuted by the Nazi regime and, after fleeing Germany via Switzerland, continued his professional career in the United Kingdom, where he turned to psychosomatic medicine and worked in the service of the British Army during World War II. After two decades of service in the UK, Wittkower joined McGill University in Canada. His increasingly interdisciplinary work contributed to the establishment of the new research field of transcultural psychiatry. Finally the paper provides a detailed history of the beginning of the section of transcultural psychiatry at the Allan Memorial Institute.

Hard antler extract inhibits invasion and epithelial-mesenchymal transition of triple-negative and Her-2+ breast cancer cells by attenuating nuclear factor-κB signaling.

ETHNOPHARMACOLOGICAL RELEVANCE: Hard antler extract (HAE) is a traditional Chinese medicine and has potent antitumor, antioxidative, anti-inflammatory, and immunomodulatory activities. Previous studies have demonstrated that HAE can inhibit human prostate cancer metastasis and murine breast cancer proliferation. However, the effect of HAE on human breast cancer cells has not been clarified. AIM OF THE STUDY: To investigate the effects and underlying mechanism of HAE on self-renewal of stem-like cells and spontaneous and transforming growth factor (TGF)-ß1-enhanced wound healing, invasion and epithelial-mesenchymal transition (EMT) in breast cancer cells. METHODS: HAE was prepared from sika deer by sequential enzymatic digestions and the active compounds were determined by HPLC. The effects of HAE on the viability, mammosphere formation, wound healing and invasion of MDA-MB-231 and SK-BR3 cells were determined. The impact of HAE treatment on spontaneous and TGF-ß1-promoted EMT and the nuclear factor (NF)-κB signaling in breast cancer cells was examined by quantitative RT-PCR and western blotting. RESULTS: Treatment with HAE at varying concentrations did not change the viability of breast cancer cells. However, HAE at 0.25 or 0.5 mg/mL significantly reduced the number and size of formed mammospheres, and inhibited spontaneous and TGF-ß1-enhanced wound healing, invasion and EMT in MDA-MB-231 and SK-BR3 cells in a dose-dependent manner. TGF-ß1 treatment significantly decreased IκBα expression and increased NF-kBp65 phosphorylation in breast cancer cells, indicating that TGF-ß1 enhanced NF-κB signaling. In contrast, HAE treatment attenuated the spontaneous and TGF-ß1-enhanced NF-κB signaling in breast cancer cells. CONCLUSION: Our data indicated that HAE inhibited the self-renewal of stem-like cells and spontaneous and TGF-ß1-enhanced wound healing, invasion and EMT in breast cancer cells by attenuating the NF-κB signaling in vitro.

Influence of Spiritual Dimensions on Suicide Risk: The Role of Regional Differences.

The field of suicide prevention has been enriched by research on the association between spirituality and suicide. Many authors have suggested focusing on the various dimensions of religiosity in order to better understand the association between religion and suicidal risk, but it is unclear whether the relationship between spirituality and suicidality differs between countries with different cultures, life values, and sociohistorical experiences. To explore this, the aim of this multicenter study was to investigate the possible relationship between suicide and spirituality in Italy and Austria. In the two countries, two different groups of subjects participated: psychiatric patients and university students. The patients were evaluated with the Mini International Neuropsychiatric Interview. In addition, the following measures were used: a sociodemographic questionnaire, the Columbia-Suicide Severity Rating Scale-B, the Symptom-Checklist-90-Standard, and the Multidimensional Inventory for Religious/Spiritual Well-Being. Our results confirmed the multifactorial nature of the relation between suicide risk and the various religious/spiritual dimensions, including religious/spiritual well-being and hope immanent. However, regional differences moderated this relationship in both the clinical and nonclinical samples.

Mate wareware: Understanding 'dementia' from a Maori perspective.

AIM: To investigate Maori (Indigenous people of Aotearoa New Zealand) understandings of dementia, its causes, and ways to manage a whanau (extended family) member with dementia. METHOD: We undertook kaupapa Maori research (Maori informed research) with 223 kaumatua (Maori elders) who participated in 17 focus groups across seven study regions throughout Aotearoa New Zealand and eight whanau from the Waikato region. We audio recorded all interviews, transcribed them and then coded and categorised the data into themes. RESULTS: Mate wareware (becoming forgetful and unwell) ('dementia') affects the wairua (spiritual dimension) of Maori. The findings elucidate Maori understandings of the causes of mate wareware, and the role of aroha (love, compassion) and manaakitanga (hospitality, kindness, generosity, support, caring) involved in caregiving for whanau living with mate wareware. Participants perceived cultural activities acted as protective factors that optimised a person's functioning within their whanau and community. CONCLUSION: Whanau are crucial for the care of a kaumatua with mate wareware, along with promoting healthy wairua for all. Whanau urgently need information to assist with their knowledge building and empowerment to meet the needs of a member affected by mate wareware. This requires collaborative healthcare practice and practitioners accessing the necessary matauranga Maori (Maori knowledge) to provide culturally appropriate and comprehensive care for whanau.

Traditional Chinese Medicine Explanatory Models of Depressive Disorders: A Qualitative Study.

Traditional Chinese medicine (TCM) is an alternative medical system utilised by many Chinese. However, the knowledge of TCM concepts of depression is limited amongst clinicians with training in Western biomedicine. The purpose of this study was to obtain a better understanding of the conceptualisation of depression from a group of TCM practitioners. Semi-structured interviews in Chinese were carried out with 10 TCM practitioners in Hong Kong. A case description of major depression disorder (MDD) was used as a basis. Interview texts were transcribed, translated and analysed using qualitative content analysis. Most informants identified the case as a depression pattern, a term that lacked clear definition and standardised criteria. The mechanism of disease for MDD symptoms were regarded to be liver-qi dysregulation and an imbalance of yin and yang. The TCM practitioners implemented individualised diagnosis, treatment, and a holistic concept without clear distinction between the mind and the body. This contrasted with the biomedical tradition of separating psychologisation and somatisation. The meanings given to the concept of depression did not correspond with current DSM or ICD definitions, and the TCM normativity can result in variations in explanatory models.

Blood, Sweat, and/or Tears: Comparing Nervios Symptom Descriptions in Honduras.

With the aim of advancing the cross-cultural investigation of the folk illness nervios, I conducted a dual-sited comparative study of symptom descriptions among two diverse research settings in Honduras. Baer et al. (Cult Med Psychiatry 27(3):315-337, 2003) used cultural consensus modeling (CCM) to confirm a core description of nervios among four Latino groups in the US, Mexico, and Guatemala, but observed that overall agreement and average competence in a shared illness model decreased along a gradient from presumably more-to-less economically developed sites. This has left unresolved whether such variation extends to other Latin American regions. This paper is an exploratory analysis of inter- and intracultural variation in nervios symptom descriptions by 50 Hondurans from the market town of Copán Ruinas (n = 25) and city of San Pedro Sula (n = 25). I performed CCM using a combination of free-listing, pile-sorting, and rating activities to establish if respondents across sites share a single model of nervios. I found consensus for the San Pedro Sula subsample, but not for Copán Ruinas or for the overall sample. Results suggest nervios is constitutive of differing forms of distress ranging from chronic illness to acute suffering, as well as anger- and panic-based manifestations that overlap with biomedical ideas about depression, anxiety, and panic disorder. This variation derives in part from demographic factors such as age, gender, and residence, but may also result from ethnic and regional diversity among subsamples. However, consensus only being present among San Pedro Sula respondents suggests their greater awareness of cultural distinctions between biomedical and folk medical knowledge, which is likely due to their exposure to manifold health frameworks in those settings.

[Brua and psychiatry: A pilot study among Dutch-Antillean patients in the Netherlands]. / Brua en psychiatrie: een pilotstudie onder patiënten in Nederland afkomstig van de voormalige Nederlandse Antillen.

BACKGROUND: Individuals native to Aruba, Bonaire, and Curaçao, the abc islands of the former Netherlands Antilles, often attribute their complaints to brua, although they seldom discuss this with health professionals. This may have a negative influence on the therapeutic relationship and diagnostic processes.
AIM: To explore the role of brua in the illness perception of psychiatric patients in the Netherlands who were originally from the abc islands.
METHOD: A random sample of patients under treatment at Parnassia Psychiatric Institute in The Hague were interviewed with the aid of a semi-structured questionnaire.
RESULTS: Of the 18 psychiatric patients interviewed, 10 (56%) believed in brua, and 3 (17%) considered it the cause of their disease. Although none of the interviewees admitted to an active involvement in brua, 8 (44%) had been in touch with a traditional healer and 9 (50%) possessed artifacts meant to provide protection against evil. Regarding the usefulness of discussing brua with health professionals, opinions were divided.
CONCLUSION: Psychiatric patients in the Netherlands native to the abc islands are all knowledgeable of brua, with more than half of them believing in it. Despite the fear and shame that people often experience, making brua fit for discussion in clinical practice would improve the relationship between health professional and patient, yielding further opportunities for diagnosis and treatment.

Exploring the East-West Divide in Prevalence of Affective Disorder: A Case for Cultural Differences in Coping With Negative Emotion.

Lifetime rates of clinical depression and anxiety in the West tend to be approximately 4 to 10 times greater than rates in Asia. In this review, we explore one possible reason for this cross-cultural difference, that Asian cultures think differently about emotion than do Western cultures and that these different systems of thought help explain why negative affect does not escalate into clinical disorder at the same rate. We review research from multiple disciplines-including cross-cultural psychology, social cognition, clinical psychology, and psychiatry-to make the case that the Eastern holistic principles of contradiction (each experience is associated with its opposite), change (the world exists in a state of constant flux), and context (the interconnectedness of all things) fundamentally shape people's experience of emotions in different cultures. We then review evidence for how these cultural differences influence how successfully people use common emotion regulation strategies such as rumination and suppression.

The Flexibility Hypothesis of Healing.

Theories of healing have attempted to identify general mechanisms that may work across different modalities. These include altering expectations, remoralization, and instilling hope. In this paper, we argue that many forms of healing and psychotherapy may work by inducing positive psychological states marked by flexibility or an enhanced ability to shift cognitive sets. Healing practices may induce these states of cognitive and emotional flexibility through specific symbolic interventions we term "flexibility primers" that can include images, metaphors, music, and other media. The flexibility hypothesis suggests that cognitive and emotional flexibility is represented, elicited, and enacted through multiple modalities in healing rituals. Identifying psychological processes and cultural forms that evoke and support cognitive and emotional flexibility provides a way to understand the cultural specificity and potential efficacy of particular healing practices and can guide the design of interventions that promote resilience and well-being.

Com a licença de Oxalá: a ética na pesquisa etnopsicológica em comunidades religiosas / With the licence of Oxalá: the ethics in the ethnopsychological research in religious communities / Con la licencia de Oxalá: la ética en la investigación etnopsicológica en comunidades religiosas

O objetivo deste estudo é discutir as especificidades da pesquisa etnopsicológica em comunidades de terreiro à luz dos dispositivos da minuta de 2016 do Conselho Nacional de Saúde (Resolução 510/2016). A pesquisa em terreiros envolve métodos que preveem a possibilidade de fotografar, realizar vídeos e audiogravação de rituais, consultas mediúnicas e demais atividades que ocorrem em terreiros, bem como observações participantes, entrevistas com consulentes, médiuns em transe de possessão, bem como seus diferentes adeptos. A partir da nova minuta, o processo de esclarecimento do participante não deverá passar, necessariamente, por um termo formal. Essa alternativa contempla a possibilidade de que a autorização para a pesquisa (envolvendo diferentes métodos de coleta) passe pela anuência do responsável pela comunidade não necessariamente pela via escrita, de modo a valorizar a "palavra" do sacerdote, dada como selo de concordância e que possibilita que a comunidade, de fato, abra-se à ação mais direta do pesquisador e suas intervenções. Considerar essas especificidades garante o respeito à dimensão ética do sujeito e sua comunidade de referência.

The aim of this study is to discuss the specificities of ethnopsychological research in the religious communities based on Resolution 510/2016 of the National Health Council. Research in terreiros involves methods that allow the possibility of photographing, making videos and audiotaping of rituals, médiumistic consultations and other activities that take place in terreiros, as well as participant observations, interviews with consultants, mediums in possession trance, as well as their different followers. From the new draft, the process of clarification of participants must not necessarily go through a formal term. This alternative contemplates the possibility that the authorization for the research (involving different methods of data collection) will pass through the consent of the person in charge of the community, not necessarily through the written way, in order to value the priest's "word", given as a seal of agreement and makes it possible for the community, in fact, to open it self to more direct action of the researcher and his interventions. Considering these specificities guarantees respect for the ethical dimension of the subject and his community of reference.

El objetivo de este estudio es discutir las especificidades de la investigación etnopsicológica en comunidades de terreiro a la luz de los dispositivos del borrador de 2016 del Consejo Nacional de Salud (Resolución 510/2016). La investigación en terreros involucra métodos que prevean la posibilidad de fotografiar, realizar videos y audiograbación de rituales, consultas mediúmnicas y demás actividades que ocurren en terreros, así como observaciones participantes, entrevistas con consultores, médiums en trance de posesión, así como sus diferentes adeptos. A partir del nuevo borrador, el proceso de esclarecimiento del participante no deberá pasar, necesariamente, por un término formal. Esta alternativa contempla la posibilidad de que la autorización para la investigación (involucrando diferentes métodos de recolección) pase por la anuencia del responsable de la comunidad no necesariamente por la vía escrita, para valorar la "palabra" del sacerdote, dada como sello de concordancia y que permite que la comunidad, de hecho, se abra a la acción más directa del investigador y sus intervenciones. Considerar estas especificidades garantiza el respeto a la dimensión ética del sujeto y su comunidad de referencia.

[What do Interpreters Cost? - A Retrospective Analysis of the Costs for Interpreters in Treatment of Refugees in a Psychiatric Outpatient Clinic in Berlin]. / Was kosten uns Dolmetscher? ­ Eine retrospektive Analyse der Dolmetscherkosten in der Behandlung von Flüchtlingen in einer Psychiatrischen Institutsambulanz in Berlin.

Clinical diagnostics of mental disorders especially among refugees and asylum seekers come with unique difficulties: language barriers, different forms of expression and concepts of the understanding of mental illness as well as a different cultural background. Therefore professional interpreters are needed but associated with a higher effort related to costs and time. We conducted a retrospective analysis of costs, which incurred by the use of professional interpreters in our outpatient clinic in Berlin, Germany, in the first quarter 2016 for the treatment of refugees and asylum seekers. The sample consisted of 110 refugees and asylum seekers; the highest costs in the use of interpreters incurred among Neurotic, stress-related and somatoform disorders (53.04%), especially Posttraumatic Stress Disorder (39.04%), as well as affective disorders (38.47%), especially major depressive episodes (25.23%). Our data point out the crucial need of a regulation of costs with regard to the service of professional interpreters in Germany.

Cultural humility: The cornerstone of positive contact with culturally different individuals and groups?

Comments on the original article by Christopher et al. (see record 2014-20055-001) regarding cultural and folk psychologies. As noted by Christopher, Wendt, Marecek, and Goodman (2014), "U.S. psychology remains not only overwhelmingly U.S.- centric but also largely unaware of how its cultural roots shape theory and research.

Traditional healing practices originating in Aruba, Bonaire, and Curaçao: A review of the literature on psychiatry and Brua.

Brua is an Afro-Caribbean religion and healing tradition from the southern part of the former Netherlands Antilles. Like other Caribbean healing traditions, it plays a significant role in shaping how individuals experience and express disorders which Western health professionals consider to require psychiatric care. Because little has been published on Brua, and because patients from Aruba, Bonaire, and Curaçao are often reluctant to discuss their commitment to this tradition, they are often misdiagnosed and either over- or undertreated by biomedically trained health professionals. The present paper provides a review of the literature on Brua and its relation to psychiatry. A systematic search was carried out in PubMed, the Ovid database, Google Scholar, and the historical literature. Our search yielded 35 texts on Brua, including three peer-reviewed scientific papers and eight academic theses. From those texts Brua emerges as a holistic patchwork of creolized beliefs and practices which are considered to be both cause and remedy for a wide variety of ailments. Despite the fact that tension between the Brua discourse and Western-oriented psychiatric practice is significant, adherence to Brua does not seem to cause much patient delay in help-seeking. However, belief in Brua as a possible source of mental and physical complaints, as well as patients' frequent recourse to Brua practices, including the use of hallucinogens, may affect the diagnosis and treatment of mental disorders.

Research by Psychiatrists of Chosun Chongdokbu Hospital and Keijo Imperial University in Korea during Japanese Colonial Rule / 신경정신의학

Eighty-three of 114 original articles and abstracts of research published by neuropsychiatrists of Chosun Chongdokbu Hospital (the Japanese colonial government hospital in Korea) and Keijo (Seoul) Imperial University Hospital during the Japanese colonial period (1910-1945) in journals including Shinkeigaku-zassi (Neurologia), Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica), and The Journal of Chosun (Korea) Medical Association were reviewed. Most articles were on clinical research based on descriptive and biological psychiatry while only 4 articles were on dynamic psychiatry, probably because Japanese pioneers in psychiatry had introduced German psychiatry into Japan during the 1880s. The first paper was written by Dr. Shim Ho-sub. Professor Kubo of Keijo (Seoul) Imperial University published most articles, followed by Dr. Hikari, Dr. Hattori, and Dr. Sugihara. There were more articles on symptomatic psychosis and morphine addiction, followed by general paralysis, schizophrenia, neurological diseases, narcolepsy, epilepsy, and neurasthenia. The meaningful articles even for today were comparative studies between Japanese and Koreans and articles on opioid use disorder in Korea. Authors reported a markedly lower rate of psychotic inpatients in the population of Koreans compared with Japanese. Japanese researchers argued that, because of simpleness in social life in Korea and less violence or excitement in symptoms, Korean mental patients could be cared for by family or members of the community, or be treated by shamanism rather than bringing them to a public mental hospital, and poverty also prohibited hospital care. Finding of higher ratio of schizophrenia to manic-depressive psychosis among Koreans than Japanese was discussed in relation to delayed cultural development of Korea compared to Japan. In addition, traditional customs prohibiting marriage between relatives in Korea was related to low prevalence of manic-depressive psychosis, local endemic malaria was related to low prevalence of general paresis, and poor general hygiene was related to high prevalence of epilepsy. Unclear (undifferentiated) form of psychotic symptoms including hallucination and delusion was reported in more Koreans than Japanese. Also Korean patients showed a more atypical form in diagnosis. Authors added that they had found no culture-specific mental illness in Korea. However, no Korean psychiatrists were included as author in such comparative studies. Comparative studies on constitution between Koreans and Japanese mental patients and prisoners were also unique. However, no Korean psychiatrists participated in such comparative studies. In studies on morphine addiction in Koreans, Japanese researchers argued that such studies were necessary to prevent introduction of morphine-related criminal phenomena to Japan. Meanwhile, Dr. Kubo had left a notion on adaptation problems of Japanese living in the foreign country, Korea. Nevertheless he reported nothing about psychosocial aspects of mental illness in relation to political, cultural, and economic difficulties Koreans were experiencing under the colonial rule of Japan. These general trends of studies based on German biological and descriptive psychiatry and policies of colonial government to isolate "dangerous" mental patients in hospital appeared to reflect colonial or ethnopsychiatry of those days. These policy and research trends seem to have worsened stigma attached to mental disorders. Japanese tradition of psychiatric research was discontinued by return home of Japanese scholars with the end of WWII and colonial rule.

Critical cultural awareness: contributions to a globalizing psychology.

The number of psychologists whose work crosses cultural boundaries is increasing. Without a critical awareness of their own cultural grounding, they risk imposing the assumptions, concepts, practices, and values of U.S.-centered psychology on societies where they do not fit, as a brief example from the 2004 Indian Ocean tsunami shows. Hermeneutic thinkers offer theoretical resources for gaining cultural awareness. Culture, in the hermeneutic view, is the constellation of meanings that constitutes a way of life. Such cultural meanings-especially in the form of folk psychologies and moral visions-inevitably shape every psychology, including U.S. psychology. The insights of hermeneutics, as well as its conceptual resources and research approaches, open the way for psychological knowledge and practice that are more culturally situated.

Deep pharma: psychiatry, anthropology, and pharmaceutical detox.

Psychiatric medication, or psychotropics, are increasingly prescribed for people of all ages by both psychiatry and primary care doctors for a multitude of mental health and/or behavioral disorders, creating a sharp rise in polypharmacy (i.e., multiple medications). This paper explores the clinical reality of modern psychotropy at the level of the prescribing doctor and clinical exchanges with patients. Part I, Geographies of High Prescribing, documents the types of factors (pharmaceutical-promotional, historical, cultural, etc.) that can shape specific psychotropic landscapes. Ethnographic attention is focused on high prescribing in Japan in the 1990s and more recently in the Upper Peninsula of Michigan, in the US. These examples help to identify factors that have converged over time to produce specific kinds of branded psychotropic profiles in specific locales. Part II, Pharmaceutical Detox, explores a new kind of clinical work being carried out by pharmaceutically conscious doctors, which reduces the number of medications being prescribed to patients while re-diagnosing their mental illnesses. A high-prescribing psychiatrist in southeast Wisconsin is highlighted to illustrate a kind of med-checking taking place at the level of individual patients. These various examples and cases call for a renewed emphasis by anthropology to critically examine the "total efficacies" of modern pharmaceuticals and to continue to disaggregate mental illness categories in the Boasian tradition. This type of detox will require a holistic approach, incorporating emergent fields such as neuroanthropology and other kinds of creative collaborations.

Masters of their Conditions III: Clinical applications of theater anthropology in cultural psychiatry.

Body learning gives actors basic structures and references that enable them to codify their actions in a script or score. With this score, acquired through training, performing and transmitting, actors who work with theater anthropology methodology offer strategies and tools that healers can use with their patients. This actor's score has inspired a mode of working with patients both to understand the case history and guide the course of therapy. In this approach, patients are like authors who want to act out their dramaturgy, but who need a director-healer to organize the story and help them build their healing process. Together, patient and therapist work on stage to advance the treatment, at the same time enhancing their strategies and methods for collaboration.