Voodoo healers, spirit mediums, rootworkers, charismatic faith healers -- they have no licenses and many don't even have a grade school education. But now psychologists are beginning to accept them openly as colleagues.
In New York, Miami, Sacramento and other cities, mental health clinics have brought in spiritists, magic users and other mystical folk healers to help treat patients, and an increasing number of psychologists advocate using them on a regular basis.
Folk healing by magic and spirits "is widespread, and is in all ethnic groups, in rural areas as well and inner cities, the great Midwest as well as the coasts," said Vivian Garrison, a psychologist at the New Jersey Medical School who has worked with folk spiritists in New York and New Jersey clinics. She said that among Hispanics, a third of the entire population consults spiritists for cures.
Rough estimates put the number of folk healers of all sorts in the tens of thousands. About 80 percent of all episodes of mental or physical illness in America are handled not by MDs, but with home remedies or folk cures regardless of whether they contradict medical knowledge, Garrison said.
Virtually every one of the many cultures in America has one or more varieties of folk healing tradition, including the voodoo of the Haitians, the santeria of the Cubans, the espiritismo of the Puerto Ricans, the charismatic faith healers among different white groups, the rootworkers and other spiritists among different black groups and dozens of others.
Beginning more than a decade ago, psychiatrists discovered the existence of these networks of traditional healers among ethnic groups in America. Soon after, psychologist began to report that these folk healers shared certain approaches with mainstream therapists.
Then, they noted that the folk healers also had considerable success in curing their patients of psychological troubles.
Jerome Frank, a psychiatrist at Johns Hopkins University says, "There is no question that psychotherapy and folk healing have features they share. They provide patients with acceptance. . . . They create hope."
In the current issue of the American Psychologist, Herbert and Margaret Rappoport of Temple University put forward a proposal to link the folk healing systems with orthodox mental health care.
"It would make little sense for a Gestalt therapist who advocates 'doing your own thing' to be in a setting such as . . . Nigeria," the article says. "An African shaman would be just as out of place advocating . . . confession and atonement in a Western setting." The article recommends changing the technique-oriented therapy of orthodoxy with a more person-oriented therapy that would allow a therapist to call in a voodoo doctor or a faith healer if it would help.
"I think that theoretically, the orthodox and folk healing systems may have equal potential, Vivian Garrison says. "But because they are generated within different cultures, each is apt to be more effective in the culture in which it was developed." The patient's belief in the treatment he is getting is the most important of all factors in success, she continues.
Minority and lower income patients frequently have such different ideas about sickness that they have no understanding of what psychologists expect of them in treatment. Many such difficult patients are marked down as "inappropriate for psychotherapy."
In a large study of attitudes in Miami, researchers found that attitudes toward medical and psychological treatment were totally different among minorities than in middle class white culture, to the point that many ailments exist among the minorities that do not exist in the mainstream culture.
Symptoms are named and located differently, and they are organized into syndromes that have no counterpart in orthodox medicine. Some black cultures believe that "low blood" or "high blood," the migration of the blood to the lower or the higher parts of the body, can cause a number of symptoms, from weakness to fainting. The array of symptoms leave orthodox physicians without effective treatments. But folk healers recognize the ailments and cure them quickly with potions and rituals.
In the culture of middle America, there are also contradictions between tradition and orthodox medicine, though the differences are less pronounced. For example, it is believed that standing in a draft or getting wet and chilly can cause colds and even pneumonia, an idea long ago disproved, and remedies such as castor oil and chicken soup are used alongside orthodox medicine.
Hazel Weidman, anthropologist at the University of Miami and the chief researcher in the study, said that orthodox medicine has put many people of different cultures into a bind. "We have tried to socialize all our patients to turn away from their traditional beliefs. We have said they are nonsense, and mere superstition." But the same people haven't the means to use the orthodox medical system for all but a few of their ailments.
She recalled a man who was losing weight rapidly, and was distraught. Doctors could find nothing wrong, and after working with him for some time a psychologist began to ask the man what he thought the cause of the trouble was and whether he thought someone had "rooted him," that is, through "rootwork" or black magic, worked some spell upon him.
"He is a devout Baptist and was trying hard not to believe in the that stuff," said Weidman, "But finally he said, yes, he thought his wife had gone to a rootworker and the two together were working to get rid of him, to take his house. . . . " So the psychologist recommended a few quick folk remedies -- putting pots of lye in the four corners of his house because the evil spirits are frightened by lye; leaving the Bible open because when it is open its words can help purify a room; drinking a vitamin tonic, and going to find a rootworker who could rid the man of the evil root work.
The cure worked quickly, where orthodox therapy might have been useless.
In Miami a large-scale city project has been set up to bring folk healers into the orthodox medical system, not only for psychological treatment but to help resolve the conflicts between the medicine of the streets -- which is personal and strongly believed -- and the medicine of the hospitals which is more impersonal and of another culture. About a hundred reliable folk healers were found and are used as consultants in the system.
The folk healing systems are not limited to minorities. A large number of spiritualist groups, with memberships ranging from a few thousand and tens of thousands, exist around the country. Melinda Wagner, a sociologist from Radford University, joined one for a year to research their practices.
"The group called the Spiritual Frontiers Fellowship I was in was middle class, middle-aged, mostly women," she said. They were clerks and accountants and belonged to mainstream religions as well as the spirit fellowship. They held seances, and healed by "laying on of hands."
She said the group's smorgasbord approach was apparent from the room in which they met, the living room of the woman who was the chief healer:
"On one wall was Christ, beatific and smiling. There was another picture of Christ with a crown of thorns and blood. There was a string-picture of one of the four-armed Hindu gods. In the corner was a black Buddha with a candle in his hand and slips of paper under the candle names of people she was praying for . There was a North American Indian bust, two little Chinese Confucian figures, a madonna and a crystal ball under a velvet cover. The woman is also an elder in the Presbyterian church."
Though there are outward conflicts between orthodox therapy and folk healing, it is possible that the same psychological principle may be operating behind the success of both, Jerome Frank said.
"We have proved that reduction of symptoms with placebos is just the same as with psychotherapy," he said. The key to placebos working is "postive expectancy" --the belief that it will work. Because of that, Frank said, the folk healer "may do just as well in his own group, his own culture," as orthodox therapy does within its milieu.