Ethnographic Descriptive Analysis of Mechanism Curanderismo

Curanderismo has been documented as a form of physical therapy that has capacity to manage diseases (Luna, pp.326-42) falling under various categories for instance physical, mental, emotional, spiritual and supernatural. Literature on curanderismo (Luz, 2005, pp.146-8; Avila & Parker, pp.34-9) claims diseases arise from traumatic event or accumulation of trauma that may be categorized as physical, mental, psychological, physiological and emotional. Trauma blocks body energy by restricting (Maduro, pp.858-9) or limiting flow of energy hence the rationale of physical therapy is to remove, enhance or improve flow of energy (Applewhite, pp.248-50).

Statement of the problem

Implementation of spirituality care as a holistic approach in nursing care requires determination of context through which spiritual healing takes place and variability of healing modalities (Kreisman, pp.82-3). Health has been defined to incorporate physical, emotional, mental and spiritual state. The rationale through which physical therapy could be integrated into medical system as a function of cultural, social and psychological health has not been qualitatively been documented (Fishman et al, pp.161-2). It is important to determine rationale physical therapy is conducted in order to identify rationale physical therapy as a function of curanderismo could be integrated into medical setting and facets of physical therapy that need amendments to enhance quality of care. Health and healing process therefore present varieties of facets (Alegria et al, pp.1355-6). This ethnographic study seek to identify processes involved in delivering curanderismo healing in order to determine if curanderismo healing process could be integrated into healthcare systems.

Goals and objectives

  1. To investigate mechanism through which curanderismo is carried out and processes involved in curanderismo healing
  2. To investigate capability of curanderismo to deliver physical, emotional, mental and spiritual health

Theoretical and conceptual framework

Health and illness is culturally defined as structural flow of energy (Trotter & Chavira, pp.2204). Health is status of balance or equilibrium in the flow of energy hence diseases, as deviation from health is characterized by imbalance of flow of energy. Ayurvedic theory (Trotter, pp.130-1) claims that diseases are a resultant outcomes emerging from imbalance or stress in the flow of energy that affect person’s consciousness. Traditional approaches recognize lifestyle interventions to be instrumental in Ayurvedic preventive (Tafur et al, pp.82-5) and therapeutic approaches. Curanderismo has been identified to be descriptive term that denotes positive or negative outcomes of hotness or coldness (Neff). Based on Ayurvedic theory, health is a sustained balance between extremes of temperature thus hotness and coldness. An extreme of an element is reversed by its opposite element for instance hot stress is managed through cold stress. Physical therapy depends on animal magnetism theory (American Psychiatric Association, pp.6-11). Animal magnetic theory claims stars influences human behavior where every individual radiates magnetic force that influences other individual. Accordingly, human body has two halves that function like magnetic poles (Luz, pp.61-7) hence; diseases arise from imbalance of magnetic power distribution.

Expected outcomes

The study findings would result into determination of mechanism through which curanderismo could be applied into medical settings through determination of processes, and procedures involved in curanderismo. Upon understanding of procedures used in curanderismo healing, the findings would provide capability of determination of safety of acupuncture and its effectiveness in healing.

Literature review

The healing ability of physical therapy is based on utility of forces and energies known as “Chi” or “Qi” in Chinese or “Ki” in Japanese (Hess, pp.181-5). The force that forms basis of physical therapy is two sided with capacity to radiate energy from both ends that have opposite impact depending on the end that radiates the energy (Hess, 187-9). The functionality is derived from need for sustainable awareness level with regard to meant potential, emotional capacities, development of wisdom and knowledge that serves humanity needs (Portela et al, 2004). Qi utilizes the power within a patient, power of the mind and power of consciousness and constructive elements that define limits of wisdom. Communication is achieved through polarity that forms foundation for eradiation of energy between the practitioner and the patient (Avial & Parker, pp.65-72). The foundation of Qi is based on five elements that define healing based on Yin and Yang that are derived from Chinese terms (Alegria et al, pp.1355-6). Thus, Curanderismo functionality is based on functionality of the five Qi elements namely Fire, Earth, Metal, Water and Wood and integrates patient’s internal organs and meridian system.

Deficiencies however have been cited in the rationale for conceptualizing functionality of the Qi elements and mechanism they impact on human psychological function (Hess, pp.18-9). A creative conceptualization has arranged the Qi elements into a creative cycle namely Fire, Earth, Metal, water and Wood (Kovacs, pp.116-20) while in a destructive cycle, the Qi elements are arranged as fire, metal, wood, earth and water. the yin and yang principles of physical therapy (Kovacs, pp.125-9) conforms to meridian systems of healing by recognizing that the creative cycle of Qi elements is meant to enhance patient’s energy through tonification (Applewhite, pp.250-1). However, the Qi destructive cycle is structured towards decreasing patient’s energy or dispersing energy.

The flow of energy abides by meridian system of healing that is delivered through use of acupuncture points which are also conventionally termed as pressure points. In practice, human body exhibits electrical conductance (Briones et al, pp.17-8). In patients, electrical conductance of the body is higher and influences on consciousness level of the patient. The acupuncture points provide information of functionality of internal organs through simulation and reflection (Fishman et al, pp.164-5). The acupuncture points are classified into groups depending on functionality of internal organ (table 1).

Based on Curanderismo, an organ refers to energy meridian component and energy flows from the ground through the front into the body and back to the ground through the back of the body as yang (Kreisman, p.82). The acupuncture points are bilateral. The human body has other meridians points whose role is to act as energy reservoirs. Increase of energy via accumulation in the energy reservoir or decrease in energy reservoir causes a disease. The energy reservoir however lacks systematic energy flow (Kovacs, pp.150-5). This is because the functional role of the energy reservoirs is to supply the main meridians (table 1). This implies, excess of energy in reservoirs is managed by draining off the excess energy while deficiency is managed by filing in energy into the reservoirs. The flow of energy from reservoir occurs through yin-yin thus negative to negative cycle or yang-to-yang thus positive to positive cycle hence satisfying diurnal cycle (Fishman et al, pp.164-5). Acupuncture is applied in medical environment through stimulation of nerves and treatments that involve counter irritation.

Methodology of the study

The study was conducted through ethnographic technique. The process involved visiting a curanderismo practitioner in order to get information on the way curanderismo is carried out. The study used participant observations and interview as the main method of data collection. The study used open ended questionnaires as study instruments (appendix 1). The study satisfied ethical issues by complying with principle of anonymity, principle of informed consent and beneficence.

Results and discussion of the findings

The respondent indicated that the Curanderismo is carried out by folk healers for instance erbero that translates into herbalists, sobador that translates into message therapist; partera that translates into midwifery; espiritualistos that translates into psychi medium of healings and curandero that translates into a practitioner that uses varieties of physical therapy to administer healing.

The respondent claimed that curanderismo is used to manage common-folk illnesses in brazil and Mexico for example susto that translates into soul loss disease, empacho that translates into problems associated with digestive system, mal de ojo that translates into problems associated with bad spirits or evil eye disorders; brujeria that translates into witchcraft; ataque de nervios that translates into nervous diseases and disorders, bilis or colera or muina that translate into rages and frights associated disorders and locura that translates into diseases and disorders associated with chronic psychosis.

The respondent indicated that curanderismo is delivered through varieties of methods like hot and cold balance, balancing material and spiritual body, use of vibrating energy and flow of energy management, conducting massage, use of biofeedback and regulation of biofeedback, use of hypnotherapy and use of acupuncture and acupressure.

Balancing energy

The respondent claimed that curanderismo is used towards achievement of relaxation that is delivered through meditation, deep breathing and aromatherapy.

Etiology of the illness

The respondent suggested that “mind and body cannot be separated” because of inadequacy of “dichotomy between emotional and somatic disease”. The predisposing factor to ill-health emerges from “imbalance between physical and emotional health” with increased tendency of “increased emotional state as causative agent”. The respondent noted that emotional illnesses might be predisposed by “susto” that translates into “fright”, and manifests itself through “envidia” that translates into a “scare of soul out of the body” hence “distorting state of emotional equilibrium”. The feelings of “envidia” may be resultant outcome of “distressing influence of abandonment”. This gives implication that “emotional states that upset an individual” increase “bilis” and “susto” that predispose “reckless impulses” and clinically diagnosed through patients presentation of “interpersonal and intra-psychitic distress”. Influence of “susto”, “envidia”, “tristeza” and “bilis” result into functional incapacity of bile.

The setting of healing session

The respondent indicated that the healing process of curanderismo is achieved through combinative approaches for example “limpia” that translates into spiritual cleansing of the patient, conducting rituals for example “prayer”, “massage” as well as “herbal therapy”. The respondent claimed that the practitioners use varieties of tools and ingredients to stimulate healing process for example “herbs”, “spices”, “eggs”, “lemons”, “flowers”, “fruits”, “holy water”, “pictures of saints”, “candles”, “incense” and “oils”. The respondent noted that every ingredient has its own symbolic value and plays a specific role in the patient healing process. For example the respondent indicated that “holy water is used to protect the patient from impact of “negative spirits” that the respondent classified as “evil spirits” which means “holy water” is selective in healing process by allowing “positive spirits” or “good spirits”. The respondent indicated that ingredients like eggs and lemons are smeared on the patient body in order to absorb any present negative spirits and negative energies. The respondent further indicates that candles can be burned. The burning of candle to absorb negative energy depends on the color of the candle. For example, burning red candles has potential to strengthen the patient, while burning blue candles enhance patient harmony. Burning of pink candle is associated with development of good will. The respondent further claimed that incense is adopted towards purifying the room of the patient. Garlic and oils are similarly used like eggs and oils to protect negativity and bad spirits on the patient.

Setting of curanderismo practice

The respondent noted that curanderismo can be practiced in any environment either for instance at patient home or in a hospital setting. The respondent claimed that men who practice curanderismo are called curanderos while women who practice curanderismo are called curanderas.

Acquisition of curanderismo knowledge

The respondent claimed that curanderismo skills are inherited or can be acquired through apprenticeships that arise from practitioner living with experienced practitioners. The skills are inborn or developed through training. The healing power is sacred and is empowered by acquisition of mystical gifts during the life of a practitioner. In some instances, curanderismo capability to heal a patient may require divine energy that is channeled into the practitioner spiritually and transferred into the patient to remove the source of illness. The practitioner argues that curanderismo follows normal medical system recommendations for sustaining health through balancing extremes of conditions that predispose ill-health for instance hotness and coldness that influence on patient physical, social, mental, emotional and spiritual order of wellbeing.

Process of diagnosis

The respondent claimed that categorizing disease is the first step in curanderismo. The classification is structured towards meeting medical system “24 hour recall” of activities that could have predisposed the disease. Curanderismo categorization criteria seek to identify physical activities of the patient, type of food that patient had eaten, previous medicines that patient had been prescribed, previous illness that patient had suffered and possibilities of evil eye that could have resulted into patients clinical signs of susto that translates into fright, empacho that translates into blockage of patient digestive system. The respondent indicated that treatment may involve ritual cleansing that is meant to achieve state of equilibrium and balance of patient physical health, spiritual health, and biopsychosocial health.

The mode of treatment advanced during Curanderismo healing

The physical therapy that is administered to the patient may include rituals, or use of counter magic depending on the nature of patient disease. The healing may involve patient prescriptions to drink water at specified time intervals. In the event a spiritual cause is identified, the practitioner may spiritually negotiate the bad spirits to leave the patient or failure to cooperative abandonment of the patient by the evil spirits, the practitioner may resort to force the bad spirits out. Magical elimination of the evil objects may be done through influence of the practitioner powers. However, the respondents indicated different practitioners have different levels of power to remove bad spirits or objects like lizards or worms. The healing process recognizes that the practitioner ahs overall autonomy over healing of the patient which conform to principle of autonomy for nursing care and practice. The respondent claimed that practitioner seeks permission from patient when they conduct healing which satisfies the principle of informed consent. The respondent further claimed that the practitioner should abide by principle of malfeasance and beneficence by not causing harm to the patient.

Tools and healing

The respondent indicated that the tools that are used in healing depend on the type of the disease. For instance in limpias that translates into spiritual cleansing, practitioners sweep the patient’s body by using herbs that have been bounded together. Eagle feathers may also be dipped into cleansing liquor to remove negative energies in the patient’s body. The cleansing liquor penetrates into the skin through skin pores. The process of cleansing body involves breaking the egg into a glass of water. The egg yolk makes it possible for the practitioner to psych reach the patient hence making it possible to understand the energies that need to be input into the healing process via cleansing. If a patient is suffering from soul loss, the cleansing process involves retrieving the soul. The respondent claimed that soul loss arises from abandonment of the patient, cases of rape that fail to be forgotten, divorce or separation of the patient from a loved one. Through soul retrieval cleansing, the cleansing is meant to integrate the patient such that the patient gains from soul parts that had been lost. The healing process initiates with burying a symbolic articles to represent the lost love. Fasting prayers may be done that are followed by feasting to bring back good omen. The patient is fed on a specially prepared liquor or infusion.

Dietary role in healing

The respondent argued that dietary regimen is recommended towards accelerating healing. The respondent claimed that some food delivery element of hotness while others deliver element of coldness as extremes that contribute into development of a disease. Herbs like penicillin are hot and are used to manage cold predisposing elements to disease. The hot herbs for example penicillin cannot be used to manage diseases characterized as hot. Cilantro which is a cold food is used to manage diseases characterized by hotness element. In healing, the diabetes is classified into sugar diabetes and water diabetes. The respondent claimed that healing process satisfies safety rules and the procedures for healing involved are considered safe. The respondent indicated that as a medical process, curanderismo meets ethical concerns with regard to patient medical care.

Spiritual healing

The respondent claimed that curanderismo involves spiritual healing that forms basis for spirituality care in medical setting. Spiritual curanderismo healing involves conducting prayers and mental healing techniques that are meant to achieve spiritual health. The respondent claimed that curanderismo spiritual healing involves two types of healing namely type I spiritual healing and type II spiritual healing. The respondent claimed that type I healing occurs when the practitioner engages in prayers. Through prayer, the practitioner and the patient should achieve single entity or be spiritually unified in order to achieve success. During type I spiritual healing, the practitioner and patient may engage in physical contact. The practitioner doesn’t give patient anything but contact ensures unification with universe, God or Cosmos. The respondent further claimed that in type II curanderismo spiritual healing, the practitioner transfers energy into the patient. In an instant, the respondent argued that a practitioner can offer type I and type II spiritual healing.

Patients culture, beliefs and traditions

The respondent claimed that healing process is dependent on the patient beliefs, culture and traditions. The respondent further indicated that practitioner doesn’t need to impose healing to the patient but should involve the patient family in the ehaling process. The patient family members ought to have clear understanding on the outcomes of the healing intervention in order to ensure they are informed on healing procedures to be used.

Application of curanderismo in healthcare

The respondent indicated that curanderismo could be integrated into healthcare systems although different cultural beliefs could impact on its acceptance, capacity of patient to comply with treatment and capability of the patient to accept the outcomes of the healing. The respondent indicated that practices that can be adopted by physicians should first seek to identify traditions of the patient. The patient should not be forced to accept a specific mode of curanderismo or physical therapy because healing process depends on cooperation of the patient. The respondent further claimed that physicians ought to understand rationale of delivering spirituality care. The respondent however indicated curanderismo is not efficient for all diseases but can support patient capability to recover fast through management of patient’s beliefs, customs and traditions that might affect effectiveness of medical intervention. The respondent further claimed that lack of regulations in the use of curanderismo has resulted into some practitioners claiming they have knowledge and wisdom to implement curanderismo healing which results into use of inappropriate herbs and teas towards managing patient diseases. The respondents affirmed that curanderismo that incorporates use of acupuncture may be associated with risks of infection in the event the piercing tools used are not appropriately sterilized.

Conclusion

The study achieved its goals and objectives by determining procedures, processes and mechanism curanderismo is carried out and implemented. Curanderismo was determined to be structured on philosophical theories. The study determined that diseases occur as a result of emotional imbalance and distortion of equilibrium of health that predisposes clinical signs like fear, rage, envy, mourning, isolation, loss of appetite and general loss in the quality of life. Healing therefore is structured towards bringing about balance and harmony of the patient with its environment which reduces opportunities for envy, fear, hatred, isolation and improved appetite or management of malicious forces that act on the patient. The study determined that curanderismo is used to manage patients whose souls has been separated from the body. The study determined that application of curanderismo requires participation of family members of the patient which helps to improve social factors that are associated with diseases. Curanderismo therefore brings family together increases sense of belonging and ensures increased capability of the patient to respond to healing through patient open interaction with the practitioner.

Recommendations

Curanderismo could be applied and adopted into medical settings.

References

Alegria, D., Guerra, E., Martinez, C., Jr., et al. El hospital invisible. A study of Curanderismo. Arch.Gen.Psychiatry 1977; 34(11):1354-1357.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: American Psychiatric Association.

Applewhite, S. L. Curanderismo: demystifying the health beliefs and practices of elderly Mexican Americans. Health Soc.Work 1995; 20(4):247-253.

Avila, E., Parker, J. Woman who glows in the dark. A curandera reveals traditional Aztec secrets of physical and spiritual health. NY: Jeremy P. Tarcher/Penguin, 1999.

Briones Gomez, R., Garcia de Sola Marques, A. Curanderismo y trance. Curanderas de Kazajistan.Gazeta de Antropologia. No 17. Texto, 2001; pp.17-18.

Fishman, B. M., Bobo, L., Kosub, K., et al. Cultural issues in serving minority populations: emphasis on Mexican Americans and African Americans. Am.J.Med.Sci. 1993; 306(3):160-166.

HESS, D.J. Disobsessing disobsession: religion, ritual, and the social sciences in Brazil. Cult. Anthropol., v.4, n.2, p.182-93, 1989.

HESS, D.J. Spirits and scientists: ideology, spiritism and Brazilian culture. Pennsylvania: The Pennsylvania State University Press, 1991.

KOVACS, M.J. Bioethics concerning life and death. Psicol. USP, v.14, n.2, p.115-67, 2003.

Krajewski-Jaime, E. R. Folk-healing among Mexican-American Families as a consideration in the delivery of child welfare and child health care services. Child Welfare, 1991; 70(2), 157-167.

Kreisman, J. J. The curandero’s apprentice: a therapeutic integration of folk and medical healing. Am.J.Psychiatry 1975; 132(1):81-83.

Luna, E. Las que curan at the heart of Hispanic culture. J.Holist.Nurs. 2003;21(4):326-342.

LUZ, M. Contemporary culture and complementary medicine: new paradigm in health in the end of the century. Physis, v.15, supl, p.145-76, 2005.

Maduro, R. Curanderismo and Latino views of disease and curing. West J.Med. 1983; 139(6):868-874.

Neff, N. Folk Medicine in Hispanics in the Southwestern United States; n.d. Web.

PORTELA, M.C. et al. Characterization of assistance among philanthropic hospitals in Brazil. Rev. Saúde Pública, v.38, n.6, p.811-8, 2004

Tafur , M. M., Crowe, T. K., & Torres, E. A review of curanderismo and healing practices among Mexicans and Mexican Americans. Occupational therapy International, 2009; 16(1), 82-88.

Trotter, R. T. Curanderismo: A picture of Mexican- American folk healing. The Journal of Alternative and Complementary Medicine, 2001; 7(2), 129-131.

Trotter, R.T., & Chavira, J. A. Curanderismo, Mexican American folk healing (2nd ed.). Athens, GA: University of Georgia Press, 1997

Appendices

Appendix 1: the study instrument

The Setting open ended questions

  1. Where are the characteristics of the site of the healing?
  2. What are characteristics of the physical setting of healing?
  3. How is the place of healing arranged?
  4. Who is present during healing?
  5. What types of patients visit this healer?

Illness Etiology open ended questionnaires

  1. What are the beliefs of illness causation that the healer deals with?
  2. What is the belief of illness causation that the healer espouses?
  3. Are the views different or similar from your understanding of illness?
  4. How is anatomy and physiology viewed?
  5. What is the symbolic anatomy the healer refers to in healing, if any?

The Context of Healing open ended questions

  1. What is the worldview in which this form of healing fits?
  2. How does the healer’s view of illness causation relate to the larger understanding of how the body is situated in the world?
  3. How is the body viewed?
  4. Is it viewed as part of a larger collective?
  5. Is the body viewed as part of individual?
  6. How is the body or person seen in relation to the larger cosmos?

The Healing Method open ended questions

  1. How does healing take place?
  2. What are the various methods employed in healing?
  3. What are various tools used?
  4. What are characteristics of the place where the healing takes place?
  5. How long does the treatment last?
  6. Is there expectation that the patient should return for is the treatment ongoing?

The Healer’s Training open ended questions

  1. How did the healer become who he/she is today?
  2. Did she/he receive formal education in a university or as an apprentice?
  3. Was the modality of information exchange oral or written?
  4. Did he/she have a “calling”?

The Healer’s Reason for Becoming this Form of Healer questions

  1. Why did the healer select this form of healing over others?
  2. Is the reason related to training, to calling, to upbringing, to relationships in the past?

The Healer’s View of His/Her Relation to the Patient questions

  1. Does the healer see him/herself as a superior to the patient?
  2. Does the healer see him/herself as a component of the healing process, in which the patient is equally important?
  3. Does the healer see him/herself as a facilitator in the healing process?

The Healer’s Relation to or Role in the Biomedical System questions

  1. How does the healer view the biomedical realm of healing?
  2. Does he/she see his/her form of healing as opposing biomedicine or as a complement to it?
  3. If the latter, when does he/she recommend biomedical treatment to the patient?