The Canon - 6

Editorial note. Each A&M issue will contain (in no particular sequence) a reappraisal of a past text of what may be considered (unfashionably) canonical, classical or at least of continuing interest in medical anthropology or cultural psychiatry. The sixth is by Hora-cio Fabrega and Daniel Silver. Piggy-backed onto the existing Harvard University Chiapas Project in SouthWestern Mexico, Fabrega and Silver initially attempted a rather wider survey in Zinacantan using sociological and psychological theory, but were forced to restrict themselves to looking at just one occupational group – the h'iloletik or shamans. They continued to use quantitative data recorded in many tables and projective psychological tests, and the book may be seen as on the cusp between the earlier American Culture and Personality School and the newer cognitive and medical anthropologies that emerged from that position. They start by contrasting two ways of looking at medical issues in 'isolated and non-literate groups': (i) the first is the epidemiological approach to biomedical disease (and a derivative of this – the study of local biologies); (ii) and what they term the ethnomedical, an examination of local subjectivities and recourse to healing, which they argue is properly part of anthropology. They attempt to follow the latter but recognise that this is still to be anchored in biomedical frames of reference rather than, say, in local cosmology; this seems to be in part as a consequence of a rather particularised method of individual specific studies such as population surveys, questionnaires and the psychological tests (p. 12). (Whether this is their choice or else part of the constants of the Harvard Chiapas Project we do not learn, but they do not stray very far from the biomedical starting point, constantly urging that biomedical disease has to be the departure point.) They warn against the assumptive that the cultural variables the anthropologist is interested in will themselves all stem from 'culture', and note that the effective healer may well be familiar with the signs of good or bad prognosis in the biological domain – for their efficacy will be greater when dealing with the former. Following Frank and Kiev they argue that healing is 'persuasion' in a heightened emotional setting. They survey the earlier assumption that healers such as shamans are conspicuously deviant or have an 'underlying psychotic personality. .. somehow protected and concealed by the behavioural requirements of their role' (see Canon – 2). The h'iloletik …