This paper examines a Brazilian spirit medium's multiple treatment-seeking strategies that have culminated in an orientation to both biomedical and spiritual understandings, which in turn, shape embodied experiences and notions of selfhood. Implications about the relationship between medical pluralism and subjectivity are discussed.
Paper long abstract:
In medically plural environments clinical and religious ideologies and interventions have the power to differentially shape experiences of illness and selfhood. How do social actors select from and make sense of multiple meanings, practices and frames of reference that are available to them? I address this question by drawing on a case study of Paulinho, a young research informant from my ethnographic fieldwork in the Brazilian Amazon. Paulinho is a practicing spirit medium in the Kardecist tradition who has suffered from epilepsy and episodic psychosis. In this paper I trace his life history and highlight important aspects of his psychosocial experience and help seeking strategies that led him to simultaneously utilize clinical and spiritist therapeutic modalities. I discuss how Paulinho has internalized cultural messages from both domains and how they jointly inform his understanding of illness, spirituality, and moral identity. Additionally, Paulinho makes distinctions between, peculiar sensations and imagined voices and visions that are psychotic symptoms on the one hand, and those that are manifestations of spirits on the other. I illustrate this by examining his use of different metaphors of embodiment that register subtle distinctions in perceptual attunement. Paulinho's 'experiential dualism' is a compelling example of how 'flexible selves' are cultivated in medically plural social ecologies. Implications for the role of person-centered ethnography in the study of medical pluralism are also discussed.