The Cultural Context of Therapeutic Choice

Abstract

The intent of the following chapter is to present data on religion, cosmology and concepts of morality among the Bariba that will serve as a foundation for explaining the bases of therapeutic choices made by Bariba women. The central hypothesis of the chapter is that decisions regarding the utilization of alternative medical services are largely derived from the diagnosis of the sickness or disorder that is presenting a problem to the sufferer and significant others. Thus, the logic of therapeutic choice must relate problem identification to therapy techniques and specialists’ roles — only then do actions taken in response to sickness begin to make sense (Janzen 1978:127). The determination of a diagnosis is necessarily related to beliefs and assumptions regarding sickness causation; as Maclean noted “treatment is always related to explanation since, in the absence of some idea of causation, the response to symptoms is arbitrary or irrational” (Maclean 1976:290). This chapter then, seeks to discuss Bariba concepts of causation of sickness in the broader context of beliefs regarding the causes of misfortune, assumptions regarding human nature, and conceptions of a “general order of existence” (cf. Geertz 1966:8–12) in Bariba culture. In general, the chapter will attempt to sketch the range of beliefs, values and expectations that comprise major assumptions upon which therapeutic choices are based.