Therapeutic itineraries often unfold across different approaches to wellbeing posing new challenges to patients, healers and medical professionals. This panel explores the entanglements of spirituality and biomedicine in people’s experiences of healing, specifically asking: how do people make sense of and use different epistemologies of illness and healing in their therapeutic itinerary? How do they either draw, shift, or cross the boundaries between spiritual and medical approaches? How do they understand and apply notions of ‘efficacy’ and ‘evidence’ in their therapeutic experiences? How they deal with the power relations between the different approaches? How do they consider the relationships of negotiation and processes of decision implicated?
Researching these experiences, contexts and itineraries, demands that also ethnographers address particular methodological challenges. How could ethnographic knowledge approach the tension between different epistemologies of healing coexisting in people’s experiences? What kinds of methodological and ethical challenges arise in the ethnographic encounter with people in, or moving between, the fields of spirituality and biomedicine?
The panel combined papers discussing ethnographic research in groups practising spiritual healing, among patients following both biomedical and spiritual therapeutic itineraries, and health professionals using conventional and non-conventional therapeutic approaches to healing.
On 19 July 2018 panel participants visited the Núcleo Espírita Nosso Lar – Centro de Apoio ao Paciente com Câncer (CAPC) in Ribeirão da Ilha, a Spiritist Centre that offers support to patients with cancer. Participants visited the ambulatories and wards of the hospital and were introduced to the organization of the centre, the healing practices, and the Spiritist approach to illness and health.
The workshop was held as a post-event of the World Congress of the International Union of Anthropological and Ethnological Sciences at the Universidade Federal de Santa Catarina in Florianópolis, Brazil. It has brought together participants from Afro-Brazilian religions, Spiritism, Santo Daime, herbalists, a holistic therapist and parapsychologist, along with anthropologists working on Daime religions, Afro-Brazilian and Cuban religions, Vale do Amanhecer, Spiritist healing of João de Deus, public health and psychiatry. Participants shared their views upon health, illness and therapy. The debate included the participants’ views upon researchers and the role of anthropology in the field of health and spirituality. The workshop was conceived as a forum where participants led the conversation and raised the following issues:
EXPECTATIONS ON THE WORK OF ETHNOGRAPHERS
Participants of Afro-Brazilian religions noted that ethnographers should build a solid background knowledge of the practices they are going to research before accessing the field, so as to avoid asking questions that might be out of place and looking unprepared to understand their concepts. Likewise, anthropologists should also avoid cold descriptions of what for participant is “êxtase”, as expressed by Maxiamiano Araújo Gonçalves Neto, UFSC student in anthropology and herbalist: “sometimes the anthropologist of religion ignores that the object of his research is the subject of my life; I do not practice a religion, I am the religion. The anthropologist who enters the terreiro becomes the terreiro, becomes part of the network: anthropology should become contaminated with religion”. When working with religion, the production of ethnographic texts should be guided by particular ethical criteria.
The Yalorixá Mãe Fernanda de Iansã suggested that ethnographers planning to conduct research in a terreiro, in order to prepare themselves to understand the contexts and practices, could organize a pre-fieldwork meeting with participants of that religion and/or with other researchers working in that field. She also pointed out to the religious intolerance experienced by Afro-Brazilian religions and she reflected upon the importance of the role and quality of researchers, which is related to the expectations attributed to their reports: “we need to be heard, and for this reason we need good researchers”.
PERCEPTIONS OF BIOMEDICAL APPROACHES
The main difference that participants perceived in spiritual and biomedical approaches to healing is in the role of patients in the therapeutic encounter. Katerina Volcov, an anthropologist conducting postdoctoral research in public health, reported her experience as ethnographer in public health clinics, where patients attributed to her the role of listener: “In clinics there is no time for dialogue between doctors and patients, and these conversations are important to understand the relations and situations that cause illness”.
On the same line, Adilson and Tupijara Rodrigues from the Núcleo Espírita Nosso Lar (NENL), understand such a conversation as being at the core of the treatment of patients with cancer who need to identify the emotions that gave rise to the illness. Tupijara Rodrigues, who himself recovered from cancer, said that he learned from his experience in the NENL that “the entities will not take away your illness if you won’t change your behaviour”. Maxiamiano Araújo Gonçalves Neto, sees his role as herbalist as that of a mirror of the person who heals him/herself.
Alberto Groisman noted that since the doctor does not often share with patients, nor with other doctors, the same notion of healing, we should turn the notion of healing into a “mysterious matter” (drawing on the title of Diana Espírito Santo’s paper), as “multiplicity".