La therapie traditionnelle des troubles mentaux chez les wolof et les lebou (senegal): Principes

Abstract

The article is taken from a systematic study of the traditional interpretation and therapy of mental disorders among the Wolof and the Lebou. Its aim is to bring up to date the therapeutic approach, common to different varieties of traditional cures, which the author has observed in the field. The fundamental principles of the cure and the clinical and diagnostic activity of the healer receive special attention. The Wolof and the Lebou obviously know neither the descriptive method nor the nosology. They do not name and do not classify mental disorders on the strength of their clinical manifestations. They consider pathological behaviour as the result and visible sign of aggression coming from outside, either from the rab and the tuur (ancestral spirits) or from the jinne and the seytaane (Islamic spirits) or from the dömm (sorcerer or witch) or from ligêêy (magic: sorcery). The etiology formed from these 4 categories of interpretation provides the criterion for the classification of mental disorders. The patterns of persecution which this etiological system offers the Wolof or Lebou patient are general and commonplace in his society. The result of this is that the interpretation of the mental disease is a collective discourse on the illness: therapist, family and patient use a common language, thanks to which the pathological experiment is completely seen through, taken over and manipulated by the others. The patient is never a lunatic, and the process of interpretation leads him of necessity towards therapy. The different types of cure associated with each of the 4 levels of interpretation must be analysed, starting from these principles. Five successive stages may be isolated in the therapeutic process which is common to them: 1. (1) Primary consensus of the family: therapy begins before the therapist is consulted. The act of consultation assumes in fact that there has first been a consensus among the family, however vague and tenuous, concerning the interpretation of the disorder and the kind of healer to be approached. The therapeutic scope of this previous agreement of sections of the family varies according to the cures. The healer pays great heed to it, for he is aware that the cure is effected in the triad formed by the patient, the family and himself. 2. (2) Consultation, and the search for etiological signs: during consultation the therapist undertakes to reduce the disquieting strangeness of the pathological experiment to an experiment which can be formulated collectively. In conformity with this objective, he shows little interest in the emotions, symptoms and individuality of the patient. He does not explore, nor does he make a systematic reference table of the manifestation of the morbid state, as does a Western practitioner, but he seeks to establish immediately its cause, and from there the therapy. His examination is centred on every observable or reported fact (appearance, behaviour of the patient, time when and place where the trouble started, dreams, previous gestures and words…) which could provide information about the identity and the intentions of the persecuting agent. (3) Procedure for divination and clairvoyance: their function. This examination, rich though it may be, gives no authority for making a diagnosis. To do this, it intentionally does without the patient and his own knowledge. In fact, the divination and clairvoyance which bring the final answer take place outside of the patient and exclude the subjective influence of the therapist. They seem to have as their function the affirmation of the primacy of the collective utterance over all experiment or individual thought in discovering the true nature of the disorders. By his psychosomatic and omiric (omirique) experiments the therapist gives proof of his position as active mediator in this process of transmission of messages. 3. (4) Secondary consensus and interrogation of the family. The diagnosis inaugurates a new stage, which may be characterised by the following: induction of an ambiguous and specific figure of a persecutor by a deliberately imprecise indication by the healer; family interrogation about this figure, by means of the language of collective representations guaranteed (cautionnées) by the therapist; restructuring of the pathological experiment into an imaginary collective speech, a sort of network formed by the alternatives inherent in the pattern of interpretation previously induced; formulation of a coherent therapeutic question and a secondary consensus. 4. (5) Symbolic action of the cure: it bears upon the factors thus set out. It consists of a setting to w work differentiated from the therapeutic myth. The essential mechanics of the cure, properly so called, seem to be the passing from an imaginary speech, knowingly kept up by the therapist up till then, to a symbolic speech which assumes submission to the collective law and to institutional mediations.