Recognition and Treatment of Psychotic Symptoms: Spiritists Compared to Mental Health Professionals in Puerto Rico and Brazil

Abstract

This article expands psychosocial and cultural perspectives on the experience and expression of psychotic symptoms and the treatment of schizophrenia by exploring how Spiritism, a popular religion in Latin America, provides healing to persons with severe mental illness. Beliefs and treatment by Spiritist healers of persons with psychotic symptoms, some diagnosed with schizophrenia, are described. Reactions by mental health professionals (psychologists, mental health technicians and psychiatrists) to this alternative treatment are described. Qualitative data have been collected through in-depth interviews with 49 Spiritist mediums in Puerto Rico, and case histories of 22 patients and their family members, all of whom gave informed consent. In Brazil, interviews were conducted with a sample of 115 Spiritist mediums, with their informed consent. These mediums responded to semi-structured interviews and standard measures of social adjustment and mental health. As expected, beliefs and practices of Spiritist healers regarding psychotic symptoms, whether manifested by themselves or by clients diagnosed with schizophrenia or other disorders, differ substantively from conventional psychiatric constructs and treatment approaches. According to patients' self reports and researchers' observations, spirit healers often achieve positive results with persons manifesting psychotic symptoms or diagnosed with schizophrenia in that symptoms become less frequent and/or social adjustment improves. We suggest psychosocial mechanisms to explain these findings and raise questions for future research.

Searching for reintegration: life experiences of people with schizophrenia

“…However, participants who were not Buddhist had also consulted a tâng‐ki (shaman) for help. The explanation that one was possessed by a ghost indicated that one was being manipulated by an external evil power, rather than succumbing to personal flaws (Moreira‐Almeida & Koss‐Chioino ).…”

“…Attributions in relation to possession by a ghost or the influences of karma are widely reported in Taiwan, Thailand, Puerto Rico and Brazil (Lin et al . , Loue & Sajatovic , Moreira‐Almeida & Koss‐Chioino , Sanseeha et al . , Yang et al .…”

Social Support and Religion: Mental Health Service Use and Treatment of Schizophrenia

“…Such sources included traditional and spiritual practices provided by spiritual/traditional/faith healers in eight articles and/or Western treatment methods provided by mental health professionals in five articles. Examples of treatment methods by spiritual/traditional healers included use of alternative medicines, ‘dissuading the obsessing spirit of its purpose to do harm,’ spiritual cleanses, and communication with ancestral spirits (Furnham & Igboaka, 2007; Furnham & Wong, 2007; Moreira-Almeida & Koss-Chioino, 2009 ; Mzimkulu & Simbayi, 2006; Teuton et al, 2007). In the five articles that preferred treatment methods by mental health providers, services included psychotherapy, medication, and hospitalization (De Toledo Piza Peluso & Blay, 2009; Harland et al, 2009; Kim-Goh, 1993; Milstein et al, 2000; Motlana, et al, 2004).…”

An exploration of how psychotic-like symptoms are experienced, endorsed, and understood from the National Latino and Asian American Study and National Survey of American Life

“…Many of these themes fell into the context of spiritualist belief systems which are prevalent in many Latino cultures and are not considered “abnormal” or “uncommon.” In some cases, these beliefs may actually represent a spiritual gift as opposed to a clinical disorder. (Gaviria & Wintrob, 1976; Moreira-Almeida & Koss-Chioino, 2009). …”