The embodiment of sorcery: Supernatural aggression,belief and envy in a remote Aboriginal community

Anthropologists have long attempted to come to grips with Indigenous Australian sorcery beliefs and especially with the idea that acts with no understandable efficacy bring about illness and death. In this ethnographic interpretation of sorcery beliefs in the remote community of Numbulwar, I follow those few who have attempted to find a link between these apparently harmless acts and real physiological consequences, arguing that the fear of sorcery that pervades Numbulwar contributes directly to the stress of daily life and indirectly to the premature morbidity and mortality of too many lives. Belief is posited as the mechanism whereby the human stress response is activated to a harmful extent, a process in which the projection of envious feelings may often be critical.     

Three days for weeping: dreams,emotions, and death in the Peruvian Amazon

Funeral customs and beliefs about the dead among the Matsigenka of Peru reflect great anxiety over the contagion of death and the power of the dead over the living. In this article, these beliefs and practices are interpreted in light of a native theory about emotion. For the Matsigenka, excessive displays of emotion, especially grief, anger, and aggressive sexuality, cause a vicious cycle of unhappiness, social disruption, illness, and death. Moving beyond a culturally particular, symbolic-interpretive perspective, the author also draws on personal experiences both in the field and at home to reflect on the phenomenology of grief across cultures.     

Interpreting Diabetes Mellitus: Differences between Patient and Provider Models of Disease and their Implications for Clinical Practice

Current medical literature suggests that Type 2 diabetes mellitus can becontrolled by diet and hypoglycemic agents or diet and insulin therapy.Nevertheless, adhering to a low glucose dietary regimen remainsproblematic for a majority of patients, and management of the disease isan ongoing source of frustration for physicians and other providers.While calling for more research on the physician's experience oftreating chronic conditions like diabetes, the authors argue that muchof the current frustration stems from the different frames orexplanatory models that physicians and patients use to understand thedisease. By comparing physician narratives collected in several clinicalcontexts (e.g., medical lectures, precepting sessions, patient caresessions and personal interviews) with patient stories obtainedprimarily through narrative interviews, the authors highlight crucialdifferences in the way physicians and patients experience and thinkabout the disease. In particular, the authors highlight differencesbetween physicians and patients across five dimensions: etiology,symptoms/signs, factors which affect blood sugar, ideal blood sugar,and future prospects. In concluding, the authors sketch out elements ofa theory of clinical practice involving diabetes care. Data for thestudy was collected at two family practice training sites in Chicago.     

Illness Beliefs Predict Mortality in Patients with Diabetic Foot Ulcers

BackgroundPatients’ illness beliefs have been associated with glycaemic control in diabetes and survival in other conditions.ObjectiveWe examined whether illness beliefs independently predicted survival in patients with diabetes and foot ulceration.MethodsPatients (n = 169) were recruited between 2002 and 2007. Data on illness beliefs were collected at baseline. Data on survival were extracted on 1^st November 2011. Number of days survived reflected the number of days from date of recruitment to 1^st November 2011.ResultsCox regressions examined the predictors of time to death and identified ischemia and identity beliefs (beliefs regarding symptoms associated with foot ulceration) as significant predictors of time to death.ConclusionsOur data indicate that illness beliefs have a significant independent effect on survival in patients with diabetes and foot ulceration. These findings suggest that illness beliefs could improve our understanding of mortality risk in this patient group and could also be the basis for future therapeutic interventions to improve survival.     

Social Capital, Narratives of Fragmentation, and Schizophrenia: An Ethnographic Exploration of Factors Shaping African-Caribbeans’ Social Capital and Mental Health in a North London Community

Recent research studies have proposed the concept of social capital—broadly defined as social networks, community cohesion, and participation—as a social risk factor for health disparities and the high rates of schizophrenia among individuals of Caribbean heritage in England. However, many of the existing studies lack sociohistorical contexts and do not capture the experiential dimensions of individuals’ social capital. This paper adds to the debate by examining the mechanisms and sociocultural processes that shape the understandings and experiences of social capital in a sample of British African-Caribbeans. Drawing on ethnographic and survey data collected over 2 years in a North London community, the paper focuses on participants’ every day experiences and the stories they tell about their community and social fragmentation. These stories suggest that social changes and historical forces interact to affect the social capital and emotional well-being of local African-Caribbean residents. I argue that my participants’ collective narratives about their social environment contribute to the emotional tone of the community, and create added stressors that may impact their mental health.     

Autobiologies on YouTube: narratives of direct-to-consumer genetic testing

Despite a growing personal genomics market, little is known about how people engage with the possibilities offered by direct-to-consumer (DTC) genetic testing. In order to help address this gap, this study deploys narrative analysis of YouTube videos posted by individuals who have purchased DTC genetic testing for disease. Genetic testing is said to be contributing to new states of illness, where individuals may become “patients-in-waiting.” In the videos analyzed, we found a new form of storytelling about this ambiguous state of illness, which we refer to as autobiology. Autobiology – the study of, and story about, one's own biology – concerns narratives of sense-making through forms of biological practice, as well as wayfaring narratives which interweave genetic markers and family histories of disease. These autobiologies – part of a broader shift toward public stories about genetics and other healthcare technologies – exhibit playfulness, as well as being bound with consumerist practices.     

Suffering, Frustration, and Anger: Class, Gender and History in Sri Lankan Suicide Stories

This paper explores competing stories of suffering, frustration and anger that shape the performance and reception of suicidal behaviours in contemporary Sri Lanka. Drawing from the results of 21 months of ethnographic fieldwork, I show how suicidal acts fit within broader narratives of class and gender experience and expression that draw from contemporary and historical 'folk' and 'state' discourses. Debates over whether suffering, frustration and anger are legitimate socio-effective states to exhibit come to determine the kinds of claims and counter-claims that suicidal people on the one hand, and those charged with their treatment and management on the other, can make with regard to the efficacy of suicide as a means of social action. Through such debates-not only what it means to be suicidal in Sri Lanka but also what it means to be middle class or working class, male or female, etc. are made and remade anew.     

Narrating Kidney Disease: The Significance Of Sensation And Time In The Emplotment Of Patient Experience

Drawing on research conducted among patients in Ireland, this article examines the narrative constructions of chronic kidney failure and explores the ways in which patient narratives cross-cut and subvert modernist medical constructions of transplantation as a therapeutic outcome, an endgame, a “gift of life.” In experience, patients dismantle this construction structure by emplotting their stories around the painful lack of an ending, ardently brought to bear by the lived realities of immunosuppressant drug therapy, the silent fears of graft rejection, and the isolation of recipiency. They articulate, instead, stories that disclose a multi-directional flow between past and future therapeutic interventions, between the altering nature of the renal body and personal experience. These storied dimensions are phenomenologically embedded in the sensory and temporal aspects of this condition as essential elements of chronic illness and as organizational properties of patient narratives.     

'What else do we Bengalis do?' Sorcery, overseas migration, and the new inequalities in Sylhet, Bangladesh

In Sylhet, Bangladesh, remittances sent home by sons and husbands working abroad have led to new inequalities conducive to the proliferation of sorcery accusations. In cases of illness, sorcery is often the preferred diagnosis. The virilocal rule of residence positions the son's wife as an outsider and, as such, she has been traditionally viewed as the prime suspect in cases of sorcery. This structural tension has been intensified by overseas migration as sons working abroad increase the isolation and vulnerability of their wives. Patients and their families do not passively act out structural contradictions but actively pursue a sorcery diagnosis. Through a detailed case study of one woman's struggle to come to terms with infertility, I show how a diagnosis of sorcery acts as a face-saving mechanism in situations of material inequality between kin.     

A Din of Whispers: The In-Group Manifestation of Sorcery in Rural Banyuwangi

In rural Banyuwangi, East Java, Indonesia, sorcery and the reprisals for it occur amongst neighbours, kin and acquaintances. When illness occurs following a dispute between these people, sorcery may be suspected. The people who identify and take action against the suspected sorcerer are usually the suspected sorcerer's own family members, neighbours or acquaintances. By describing an instance where malevolent magic occurs within rather than between social groups, I contribute to the documentation of instances of such in-group manifestations. I also analyse the implications of the fact that violence and suspicion, as much as solidarity and trust, may characterise relations among the people who are closest.     

Chikotsa--secrets, silence, and hiding: social risk and reproductive vulnerability in central Mozambique

In this article, I examine pregnancy narratives and patterns of reproductive health seeking among women of fertile age in central Mozambique. I map the interplay between gendered economic marginalization, maternal risk perceptions, and pregnancy management strategies. By interpreting my data in light of Shona illness theories, I illuminate the ways that embodied experiences of reproductive vulnerability, risk perceptions, and social inequalities are linked: women attribute the most serious maternal complications to human- or spirit-induced reproductive threats of witchcraft and sorcery. This construction of reproductive vulnerability as social threats related to material and social competition significantly influences prenatal health seeking. Data reveal the structural and cognitive gap between biomedical constructions of risk and lay social threat perceptions. Plural health care systems are strategically utilized by women seeking to minimize both social and biological harm. On-the-ground ethnography shows that maternal health initiatives must take this plurality into full and accommodative account to achieve viable improvements in reproductive care and outcomes.     

Controlling death--compromising life: chronic disease, prognostication, and the new biotechnologies

Within the modern culture of control, patients and physicians seek to actively shape the uncertainty of prognostications concerning the course of disease and the anticipated effects of therapeutic and surgical interventions. This article discusses the results of a three-year ethnographic study of persons with cystic fibrosis (CF) who undergo double-lung transplant. It draws on interviews with a difficult-to-access patient group, adult CF sufferers, and investigates their dilemmas with regard to having or not having a double-lung transplant. It situates their decisions within a complex framework: the denial of death and disability in technological modernity, the consequent emphasis on cure and saving life at any cost, rather than the management of chronic illness, the extent to which health and illness constitute identity, and the problems of CF patients conceiving their life narrative when life will be short. This framework produces two key questions: Do patient beliefs in the progress narratives of medicine overshadow other considerations, and are biotechnologies such as organ transplant a calculated gamble on a better life or an uncertain reliance on biomedical expertise? I argue that risk interpretation is heavily influenced by the constant introduction of new therapeutics that intersect with social technologies of normalization to strongly influence patient decisions concerning the pursuit of high-risk surgeries such as organ transplant, surgeries that sometimes hasten a patient's decline and death.     

Matsigenka myth and morality: Notions of the social and the asocial

This paper explores Matsigenka notions of morality as evidenced in central mythological texts. The focus is on myth since, it is argued, myths provide a means whereby fundamental conditions of everyday life as conceptualized by their conventional audience can be understood and interpreted. Although myth does not provide a uniformly accepted cultural blueprint of social reality, a certain intersubjective consonance is to be expected. It is argued that to the Matsigenka morality is primarily a means to maintain conditions of conviviality. Matsigenka moral considerations are thus context‐dependent and can only be reflected upon casuistically.     

Commodity Fetichismo The Holy Spirit,and the turn to Pentecostal and African Independent Churches in Central Mozambique

Pentecostal and African Independent Churches have rapidly spread throughout central Mozambique in the aftermath of war and in the midst of a recent structural adjustment program that has hastened commoditization of community life and intensified local inequalities. This extraordinary expansion signals a shift away from reliance on “traditional” healers to treat persistent afflictions believed to have spiritual causes. Survey data and illness narratives collected from recent church recruits and local residents during research in 2002 and 2003 in the city of Chimoio reveal that healers have increased fees and tailored treatments to clients searching for good fortune in ways that have alienated many other help seekers in this changing social environment. While traditional healing has been celebrated in the international health world, community attitudes are less generous; many healers are increasingly viewed with suspicion because of their engagement with malevolent occult forces to foment social conflict, competition, and confrontation for high fees. Church healing approaches offer free and less divisive spiritual protection reinforced by social support in a new collectivity. One vital source of church popularity derives from pastors' efforts to tap the already considerable community anxiety over rising healer fees and their socially divisive treatments in an insecure environment.     

Investigating the Barons: narrative and nomenclature in Munchausen syndrome

Recounting stories of the 18th-century Baron von Münchhausen, the unauthorized appropriation of his name into literature, and Richard Asher's subsequent medical use of the name Munchausen 150 years later, this article examines the narratives that are told about and through Munchausen syndrome that create meaning within medicine. By analyzing a half-century debate over the name of the illness, this article discusses how the medical literature invests meaning in names and how names create meaning through narrative with effects on the practice of medicine.     

Envy and egalitarianism in Aboriginal Australia: An integrative approach

The word ‘envy’ directs attention to feelings and cognitions that are especially important sources of information in our complicated sociality. As it is delimited by philosophers, economists, psychologists and others, envy is conceptually nested within a family that includes evil eye beliefs, inequity aversion, strong reciprocity and social comparison. Although the accumulation of work in these areas is substantial, anthropological treatments of envy are rare. Given repeated assertions of envy's universality and its potential importance for understanding widespread aspects of the human condition, a comparative eye seems essential. I present an account of ‘jealous’ in Aboriginal Australia via a framework that casts emotions as emerging from the interaction of psychobiological and sociocultural processes. According to this perspective, ‘envy’ should not be regarded as an invariant human condition but rather as a Western version of what, in a more generic human form, may both defend the individual and the larger sociality.     

Sorcerers,saints and charlatans: Black folk healers in urban America

Case histories of black Americans who believe their illness has been caused by sorcery have been reported with increasing frequency in the clinical literature. Such individuals often believe that their problems are not amenable to orthodox medical regimens and they may leave treatment to seek out a folk healer. Healers believed to be able to cure sorcery are viewed ambivalently as they are thought able to magically cause illness as well as cure it. There is little information available on such individuals or their modes of treatment, making it difficult to assess their abilities. This article reviews what is known about such individuals, including an attempt to learn more about those who have advertised in a large city newspaper. It is concluded that some of these individuals provide a useful service to their clients but that many others use their reputations as manipulators of occult powers to extract money from the poor and gullible.     

Sorcery and the dividual in Australia

In this article I present an analysis of Australian Aboriginal sorcery, applying concepts from the New Melanesian Ethnography. My starting‐point is Keen's approach to magic among the Yolngu, which engages Strathern's concept of the dividual, but which focuses on the extension of partible aspects of the person in space and time. Building on Keen's analysis, I draw on ethnographic material from Cape York Peninsula to argue that Aboriginal sorcery might be understood not only as the extension of partible aspects of the person, but also in terms of the interplay between the internal divisions and external connections of dividual personhood, linking that interplay to the various invasive techniques understood to be employed by sorcerers. On that basis, I argue that, in the central Peninsula, sorcery beliefs are best understood as forms of ‘indigenous analysis’ (Strathern) or ‘naïve critique’ (Kapferer) that simultaneously articulate and obscure the anxieties that inhere in postcolonial Aboriginal sociality.     

Five dramas of illness

First-person narratives of illness experience are dramatic: the narrator, who is also the sufferer, is caught in conflicts of forces that permit understanding more than control. Among the dramas of illness, five occur frequently in autobiographical accounts of illness. These dramas overlap and have varying emphases in different people's stories. They are the drama of genesis (what instigated the illness); the drama of emotion work (what emotional displays are required or prohibited); the drama of fear and loss; the drama of meaning; and finally, the drama of self. This five-drama framework can focus critical and clinical attention on which conflicting forces the ill person is working to reconcile, what makes that work difficult, and how conceiving of one's illness as a drama can be a source of meaning and value.     

Autism beyond pediatrics: why bioethicists ought to rethink consent in light of chronicity and genetic identity

Autism is a chronic neurodevelopmental disorder that presents unique challenges to bioethicists. In particular, bioethicists ought to reconsider pediatric consent in light of disparity between beliefs that are held about the disorder by parents and adults with autism. The neurodiverse community ought to be given some consideration in this debate, and, as such, there may be a role for autistic narratives in clarifying this problem.