lunes, enero 26, 2009

Finkler (1994). Sacred Healing and Biomedicine compared

Kaja Finkler (1994) Sacred Healing and Biomedicine compared.
In this article the author contrasts two healing systems, the “Sacred Healing” system with the “Biomedical” system. And she does this comparison with the aim of highlighting both differences and similarities not only in the ways they diagnose and treat patients but also in how they engage with people’s experience of illness and healing. The main point Finkler made is that in the “sacred healing” what is at stake is the treatment techniques and the persona of the healer is less important (she is only a medium of a spirit) whereas in the biomedical encounter the persona (and the need of assuring patient’s compliance) is important because the treatment itself is more uncertain. The first distinction Finkler suggests between these two systems is that one is secular (biomedicine) and the other sacred (sacred healing) and one wonder if her use of “sacred” permit or preclude understanding of this phenomenon. It is “sacred” because it is health care system and it is associated with a religious movement and lacks what medicine has (professional system, made by trained professionals, and legitimated by the state). Furthermore, these two systems have an epistemological difference (although people use them in many cases at once judging their success by the their treatment effects).
One central point in this analysis is that sacred healers are usually women (and though not mentioned biomedical professionals are usually men) who have experienced sickness before, have been cured with spiritism and then became healers themselves with the help of spirit protectors. The gender issue is not considered in Finkler’s analysis but I think should be highlighted more. One of main difference that I’ve found compelling is how different both systems consider the role of the “patient”. In biomedicine, it has a passive role in relation with the doctor constant pursue of finding right diagnosis and treatments, needs to comply (“adhere” is the usual term) with the treatment and is seen in isolation as an individual (usually as at the physiological level). In “sacred healing”, in contrast, patients are active and engage in their own healing processes trying to re-organize themselves and their families lives although the diagnosis in itself is less relevant. Finkler even says that a certain “passive catharsis” occur when “the healer tells the patient what the patient is experiencing, eliminating the need for patients active verbalization of their discomfort” (182). The healing processes in both cases are dissimilar: in biomedicine the physician uses his clinical judgments to change the image of the body (for instance, change diet under the physician’s perception of patient’s obesity) whereas in the sacred medicine the engagement with the “community of sufferers” work as support and produce a change in the experience of the body in itself. And there is another difference in that doctors tried to situate the cause of the malady chronologically and in a specific site of the body, whereas the sacred healers is expected to know what the patient is having since she already suffered similar conditions and because the spirit helping her “knows everything” as usually tells patients. There are other differences too, the sacred healing is supposed to be a progressive reordering of person existence, a gradual transformation of his/her life and of their families (many men after the healing quit drinking, or abusing their wives and kids), in fact they are changing the social relation in which patients live emphasizing in the congregation as part of the cure. Whereas biomedicine, instead, treats individuals’ bodies but fails to transform peoples’ lives.
One problem that I see in this article is certain essentialization of both sides. It is clear the analytical distinction the author made between both systems, but we keep thinking what else is going on between the sacred healers and the doctors. Finkler mentioned that patients were seeking for cure in both systems but then she does not say anything or bring more lights to these more pluralistic use of the patients of both types of healing.

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