The man laying on the rich carpet welcomed me into the the Hamadcha zaouia in Essaouira.   After determining my nationalty he proceeded to tell me in English about the psychological and spiritual healing role the Hamachda confrere traditionally enjoys within Moroccon folk ethnology.

Just several hours before he had been one member of a collective of musicians and dancers performing in the Place de l’Horlage as part of the 2019 Gnaoua Musiques de Monde festival in Essaouira, Morocco.  In the small square under the old clock tower the ensemble performed for forty minutes in front of a enthralled mostly Moroccan audience.  Approximately 2 minutes of the early part of the performance is captured below.



The Hamadcha are members of a loosely and diversely organised religious brotherhood, or confraternity, which traces its spiritual heritage back to two Moroccan saints of the late seventeenth and early eighteenth centuries.  These saints are Sidi Ali ben Qamdush and Sidi Ahmed Dghughl. They are considered to be part of the cult of saints, or maraboutism, which has been generally regarded as a feature of Maghrebian Islam,  ie the idiosyncratic development of the Islamic faith in north Africa integrating both local pagan and sub-saharan religious influences . The French word ‘marabourisme’ is derived from the Arabic rnurabit, which describes a man attached to God — the root itself means “attach” or “fasten” — and has been used for any of the warrior-saints who brought Islam to Morocco. “Maraboutisme” has become in French a catch-all expression for all sorts of activities associated with the worship of saints. It defines two basic institutions: the cult of saints and the religious brotherhoods which continue to spread the tariqa,  or pathway, of the more famous saints.

Their practices do not only encourage,  in the Sufi tradition, a closer personal union with God but also provide cures  for the devil-struck and the devil-possessed. They are essentially healers and believe they have received their power (baraka) to cure the jinn-possessed from Allah,  channelled through the saint they follow and  the music, rituals and procedures they perform.

The man who greeted me in the zaouia post- performance can be seen in the video.  He is the dancer with his back mostly to my lens,  dressed in green and communicating with the other 3 dancers in front of him.   He was articulate about the ethnic provenance of the Hamachda,  and without too much prompting suggested that many people who approach them have symptoms of anxiety,  depression, low confidence and poor self-esteem which affect their behaviours and ability to function within Moroccan society.  He explained that the role of the Hamadcha was to listen to people when they are distressed,  help with their distress and to aid their functioning within their families and other social groups. He clearly described a psycho-therapeutic and counselling approach to their role,  a role which seemed at face value to be client centred.

He also described a civic and functional role where the musicians were requested to play at important local events, ceremonies and anniversaries,  such as marriages and circumscisions..

I revealed to him that I was formerly a Community Psychiatric Nurse and had worked with emotionally distressed people for most of my working career.  I tried to elicit more symptomatology and specific psycho-therapeutic practice the Hamachda undertook with little success.  I tried to establish whether more formal psychiatric treatments were also used,  such as medication and supportive interventions by medical and associated professional staff. There was little response.  I finally tried to  discuss the alternative interventions for which the group is traditionally better known, that of treating illnesses believed to have an aetiology of spirit possession, but he was equally non-committal..



We were standing in the courtyard of the Hamadcha zaouia in the narrow back streets of the medina of Essaouira.  This was a large enclosed space which contained,  just off centre,  a set of small clay drums laying on an animal skin.  Several doors led to a functioning mosque,  a rest and social room for the members of the brotherhood ( from which came the occasional high resonance of a ghaita being played ) and a large room where the group practised music.  The flooring was a pattern of dark green and white tiling and the surrounding walls were tiled waist high in a geometric almost floral display.  Some  basic furniture and bicycles rested against the brown and orange wall-tiles and otherwise white walls. Several banners stood furled up beside a green door and adjacent to the flags and by the entrance an incongruous poster announced the confrere’s name in both Roman and Arabic calligraphy.  Stairs led up to an extensive terrace area looking both down into the zaouia and away over the medina’s jumbled rooftops and adjacent buildings. .

He said I could remain in the zaouia,  was free to take some photographs and enjoy the atmosphere of the sacred building.

I had previously described how I regarded the contrasting sacred and profane roles of another brotherhood with a similar ‘healing’ tradition,  the Gnaoua confrere,  here.  I had suggested that,  in order to be viable, and congruent with modernity,  Gnaoua music must develop into a more socially inclusive art form which appeals to a wider,  potentially international audience.  The Gnaoua has mostly achieved that,  with links with both jazz and rock genres in America and Europe and an annual festival in Essaouira attracting both musicians and spectators from across the world.  In reaching out from its origins to establish wider cultural acceptability it has markedly developed its profane role.  Its sacred form continues to conist of a complicated series of ancient musical and dance rituals developed over millenia to treat both physical and emotional illnesses believed to be caused by spirit possession.  These rituals have no public entertainment or social attainment value,  are functionally attuned to an innate belief in spirit possession and can involve ritual sacrifice of animals as part of mediating with that spirit and bringing relief to the afflicted.  I reflected, whilst talking with the dancer in the zaouia, that the brotherhood was apparently caught in a similar cultural double-bind.

Despite whatever personal feelings may be held about the belief systems of other cultures, the development of the Moroccan jinn traditions and belief in possession has caused considerable anthropological interest.  American and French anthropologists and ethnologists have spent time with both individuals and communities in Morocco studying trance,  possession and the healing roles of the three main confraternities,  the Gnaouia,  Aissouia and the Hamachda.  In a world of increasing migration and multi-ethnic cultural integration it seems important that the ethno-centric roots of morbidity and pathology are better understood.  Studies in Holland and Israel suggest that migrants from Morocco to those countries bring culturally sensitive patterns of Jinn belief and pathology which makes assessment and treatment of health problems difficult.  A study of Muslim migrants in 2018 to a ‘specialized, psychiatric, transcultural outpatient setting in the Netherlands 17.7% of Muslim patients attribute their mental health problems to jinn’ interference.



In psychiatric terms it maybe convenient to describe symptoms of possession in terms of conventional depression,  anxiety, hysteria, dissociation or even psychosis with attendant symptoms of passivity and delusions of persecution. Regarding formal classification of disorders, The DSM and the International Classification of Diseases incorporate specific categories of dissociative trance and possession disorders and regard them as  transient involuntary states of dissociation causing distress or impairment. The disorders,  when experienced in western countries, may more specifically concern people from ethnic minorities for whom acculturation difficulties may play a key role  To rely exclusively on traditional assessment models and treatments of medication and psycho-therapy of various descriptions may not be the most appropriate or clinically propitious way to treat people from another culture. A culturally integrated approach reflecting the cultural normalcy of the experience and tolerance of indigenous treatment models seems respectful. In the Dutch trial involving Jinn belief within Muslim patients a major conclusion was ‘This underlines the importance of the need for culturally sensitive interviewing techniques for this patient group, including proper attention to attribution styles, religious matters, and system dynamics, as well as the further development of tailor-made therapeutic strategies, preferentially in close collaboration with Islamic counselors’.

An article called ‘Dissociative trance and spirit possession: Challenges for cultures in transition’ published in the December 2016 PCN Psychiatry and Neuro Sciences magazine written by 2 Indian psychiatrists addresses the dichotomy between anthropology and psychiatry and suggests ‘The limitations to current diagnostic definitions of possession and trance states relate both to psychiatry’s underlying theoretical viewpoint and to the historical development of Western psychiatry. Likewise, the distinction between psychiatric definitions and the anthropological concept of spirit possession lie in the historical context of both disciplines, and their respective interests. Among social scientists, possession states invite, but arguably resist, categorization along multiple lines, including sought/unsought, real/fabricated, pathological/normative, and distressing/non‐distressing’.

In 2017 a report issued by the Ministry of Health for Morocco in Rabat suggested that one out of every two Moroccans,  an astonishing 50 percent of the population, had psychiatric or psychological disorders. There were only 297 psychiatrists in the country, representing an average of 0.63 psychiatrists per 100,000 inhabitants, compared with the world average of 3.66 psychiatrists per 100,000 inhabitants.  There were only  5 child psychiatrists, and 1,069 nurses trained in psychiatry. Some 41.3 percent of the population lived in rural areas with unstable income and no mental health facilities locally.   A  2017 report from the World Health Organization suggested that cases of depression increased by 18.4 percent and cases of anxiety by 14.9 percent in only 10 years.  Psychiatrist Dr. El Baroudi confessed that he had seen a dramatic increase in instances of peadophilia, receiving approximately five victims of peadophilia per day at the Souissi Children’s Hospital in Rabat.   In 2017, over 600,000 Moroccans were addicted to substances. As many as 16,000 were addicted to hard drugs, such as heroin and cocaine according to study conducted by the Biochemistry, Nutrition, and Cellular Biology group in affiliation with Casablanca’s Faculty of Medicine and Pharmacy. Over 70 percent of those addicted to hard drugs were young people aged 18 to 28.  According to psychiatrist Hassan Kisra, the most common cases he treated at the mental health hospital were children with Attention Deficit Hyperactivity Disorder (ADHD), schizophrenia, bipolar disorder, depression, anxiety, and phobias.

A mausoleum dedicated to the marabout saint Bouya Omar,  located in El Kelaa des Sraghna, some 70 kilometres from Marrakech in central Morocco,.had been used to supplement deficient numbers of beds in psychiatric hospitals.  Statistics issued in 2015 by the Ministry of Health showed that 99% of the patients voluntarily accommodated there suffered from psychological and neurological disorders, an unknown percentage suffered from psychosis, 9.4% from affective disorders and 2.9% from personality disorders, while the rest were said to be have dependency issues.  A vast majority were said to be  “haunted” by evil spirits and whose relatives had brouight them there, believing proximity to the saint Bouya Omar’s ‘baraka’ would bring a cure. Described as Morocco’s Guantanemo, reports suggested that patients there did not receive any health care, lived in miserable conditions, were chained and handcuffed to the wall and often shared a room with four other patients. It was described as a prison where some patients were kept until they died.



In June 2015 the Ministry of Health in Rabat,  after a year and a half of studying the conditions of the mausoleum and its inmates, decided to close the Bouya Omar Mausoleum concluding that its continued operation would constitute a flagrant violation of human rights and humanitarian law.  It seems in Morocco,  despite the explosion of cellphone and other technology, and increased interest in western culture and values,  modernity in terms of its infra-structural development and provision of services comensurate with notions of civilisation,  is coming slowly.

In Moroccan.culture, perhaps due to this paucity of health care,  reliance on foqahers ( spiritual faith healers who use Koranic verse to treat malady often in combination with herbs and exorcism ) remains popular,  though their ministrations are plaintively not always successful.  Spirits that refuse to be exorcised,  and often illnesses which will not improve with a Koranic faith healer,  are considered more pathological and require more ‘industrial’ intervention.  This may be analogous to being referred to secondary,  or even tertiary,  health services within the UK; in these circumstances people in Morocco have historically been directed to the confreres of Gnaoua,  Hamadcha and Issaouia.  A combination of music, religious ritual and animal sacrifice,  infused with the spiritual energy of Allah channelled through the  ‘baraka’ of their long dead saint, seeks to negotiate with the recalcitrant spirit,  often over a long period of times,  perhaps even years.  Psychological and physical symptoms believed to be secondary to that possession may or not heal.

As alluded to above, the work of anthroplogists and ethnologists,  whose practices embody a range of social sciences, have brought considerable understanding and interpretation of these and other Moroccan belief systems.   Vincent Crapanzano,  an American anthropologist,  made two particular studies of Moroccan ethno-psychiatry in the last century.  He firstly studied the Hamadcha confraternity and its rituals of healing, and,  some 10 years later,  studied the phenomenolgy of the possession of a Moroccan male by a female jinn.  The latter study,  which also comprehensively explored and reflected upon Crapanzano’s relationship with his subject,  had far reaching consequences within anthropological/ethnographic data collecting, reflecting on how traditional means of collecting life stories and other culturally and ethnologically relevant information was adulterated by pre-existing academic and literary conventions.



‘Women’s intrigues are mighty

To protect myself I never stop running

Women are belted with serpents

And bejeweled with scorpions’


Words by 16th century poet Sidi Abderrahman El Mejdoub used in Tuhami : A Portrait of a Moroccan by Vincent Crapanzano :

Vincent Crapanzano is Distinguished Professor of Anthropology and Comparative Literature at the Graduate Center of the City University of New York.  Relatively early in his career he spent time in Morocco and produced 2 well considered ethnographic studies.  The first,  The Hamadsha: An Essay in Moroccan Ethnopsychiatry,  printed in 1973, remains the most comprehensive study of the Hamadsha produced  and is considered more fully below.  The second  study,  Tuhami: A Portrait of a Moroccan,  was printed in 1983.  Both explore the concept of spirit possession,  associated illnesses and Ethnocentric treatments available within Moroccan society at that time.

Tuhami: A Portrait of a Moroccan, is a description of a man from Meknes who had an extraordinary well developed belief system of spirit possession.  Such was the richness of the Tuhami’s pathology and personality, Crapazanzo found difficulty maintaining an objectivity and avoidance of preconceived notions expected of anthropologists.  Rather than maintaining a conventional distance,  he developed a closeness with Tuhami  and,  utilising an interest in a number of other social scientific disciplines including philosophy and  psychodynamic psychotherapy,  began developing interpretations of and interventions in Tuhami’s complicated presentation.

Tuhami was an illiterate, Moroccan Arab tilemaker…..He lived alone in a dank, windowless hovel beside the kiln where he worked and his privacy was entirely respected.  He was often humoured,  and with his acquaintances – they were many – he had a sort of joking relationship. But he was also treated with awe and a certain deference;  he was not considered dangerous like the outcasts believed to be sorcerers or said to have the evil eye. Tuhami was married to a capricious, vindictive she-demon – a camel-footed jinniyya called A’isha Qandisha who kept a firm control over his amorous life. His arrangement with A’isha was rare but by no means unique. Lalla A’sha,  or Lady A’isha,  as Tuhami always called her, was a jealous lover and demanded absolute secrecy in their marital affairs.  In her other relationships with human beings – she could strike them or take possession of them – she made no demands of secrecy …. these other relationships were public and had to be mediated through the curing ceremonies,  the trance dances of such exorcistic brotherhoods as the Jilala,  the Gnawa and especially the Hamadcha.  Unlike her husbands,  the victims in these relationships led more or less normal family lives.

Tuhami was not,  however,  a Hamdushi,  a member of the brotherhood……and could not participate in their rituals or undergo their cure.  He was an outsider.

Extract from Tuhami : A Portrait of a Moroccan by Vincent Crapazanzo



pathology perhaps represented the apogee of the Moroccan delusional folk-lore manifestation, and it was a belief that the Hamachda confrere considered they had a specialty in treating through their rituals.  Tuhami’s belief was that he was possessed by, and married to, a well known and feared female spirit called Lalla Aisha Kandisha ( in Arabic : عيشة قنديشة , ʿĀʾisha Qandīsha , and in French Aicha Kandicha ) who demanded total submission to her willAisha is a Jinniyya,  a female Jinn, that manifests herself often as a beautiful woman with red or black hair, dressed in a light white dress.  At other times she presented as an old woman without teeth. In all cases  she has camel or goat legs instead of feet and legs. She usually appears at night in empty or half-empty places.





Tuhami waa a villager, orphaned aa a boy, and obligated to support his mother and sister. The author describes him as middle-aged, gentle, dark skinned, and illiterate. Yet Tuhami waa obviously exceptional even by indigenous standards, since in a society demanding strict segregation of the sexes, he was trusted to be among the women. His most outstanding characteristic was mamage to a spirit, ‘Aisha Qandisha, who demanded total submission to her will. It was this feature in particular that attracted the initial interest of the author. Crapanzano sham with us his attempts to understand how Tuhami came to his present circumstances in the city of Meknes. his sentiments towards women, mystic orders, spirits, and his social/economic condi- tion. Throughout his many, sometimes intricate disclosures, the reader is troubled by contradic- tions and exaggerations. The author points out that Tuhami’s tales are often structured likefairy tales. As a reader, I would often find myself asking why I needed to read these far- fetched creations. As an anthropologist, what was I learning about Moroccan society from such an apparently confused person? Fortu- nately, the author shares like sentiments with the reader, sensitively interposing himself be- twem the narrative and audience at the crucial junctures. He too wrestles with the “real” and “imaginary,” “truth” and “fiction.” As the author puts it: I did not then understand that the real was a metaphor for the true-and not identical with it. Tuhami had been speaking the truth from the very start . . . but I had been listen- ing only for the real, which I mistook for the true. The truth was for me the real masked by the metaphor. Such wapl my cultural bias [p. 1301. What ultimately happens to Tuhami is less im- portant than the evolving relationship between informant and anthropologist. As the pieces of the jigsaw puzzle emerge from the encounters and are placed in their proper relationship, as the multidimensional human being takes life with our (and the author’s) increasing compre- hension, as Tuhami becomes more than a source of data, empathy with and sympathy for him grow. In the last sections of the book, the author concedes: I knew that I could no longer maintain ethnographic distance.



It was Crapanzano’s experience in Morocco, working with the spirit possessed, that led him to question some of the fundamental presuppositions of psychoanalysis. In describing his interviews with an illiterate Moroccan tile maker, Tuhami, after whom he named one of his books, considered by many to be his most important, he came to realize how life stories and by extension other ethnographic findings are reformulated by the anthropologist in accordance with literary genre and conventions, rendering them more familiar but losing their unique cultural framing. This led him to consider the role of writing in anthropology generally and was one of the founders of what came to be known as the writing culture school of anthropology. It also led him to a close reading of several of Freud’s case histories from a linguistic point of view, demonstrating how, for example, attributions of transference and countertransference were refractions of such linguistic functions as the pragmatic and the metapragmatic, that is the way speech figures its context and itself. Many of these articles were collected in Hermes’Dilemma and Hamlet’s Desire.

Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.Tuhami is an unusual and provoking portrait of a Moroccan informant. It is also a venture in self-discovery, but its real intent is to question the assumptions about the nature of the rela- tionship of an anthropologist to the object of study. Thia self-examination is more than an ex- tmsion of the “new ethnography” and action- anthropologiata’ premises about the advantages of subjectivity in the promotion of the subject society’s goals. Crapanzano instead follows the path embarked upon by Rabinow (Refections on Fieldwork in Morocco, 1977) and othen who have attempted to clear the air about the discipline’s earlier naive proposition that an- thropologists aa outsiders can maintain a sem- blance of objectivity by social distancing and avoidance of preconceived notions about the society being studied. The author attempts both philosophically and psychologically to come to grips with perspectives of society as “subject” m. “object” and informant as automaton of infor- mation m. informant aa human being-whose needs reach out and engulf the anthropologist in a web of personal and emotional entangle- ments. Tuhami emerges as a most interesting yet ir- ritating and perhaps wen exasperating per- sonality, whose reliability aa an informant must be constantly questioned. Tuhami waa a villager, orphaned aa a boy, and obligated to support his mother and sister. The author de- scribes him as middle-aged, gentle, dark ski~ed, and illiterate. Yet Tuhami waa ob- viously exceptional even by indigenous stan- dards, since in a society demanding strict segre- gation of the sexes, he was trusted to be among the women. His moat outstanding characteristic waa mamage to a spirit, ‘Aisha Qandisha, who demanded total submission to her will. It was this feature in particular that attracted the initial interest of the author. Crapanzano sham with us his attempts to understand how Tuhami came to his present circumstances in the city of Meknes. his sentiments towards women, mystic orders, spirits, and his social/economic condi- tion. Throughout his many, sometimes intricate disclosures, the reader is troubled by contradic- tions and exaggerations. The author points out that Tuhami’s tales are often structured likefairy tales. As a reader, I would often find myself asking why I needed to read these far- fetched creations. As an anthropologist, what was I learning about Moroccan society from such an apparently confused person? Fortu- nately, the author shares like sentiments with the reader, sensitively interposing himself be- twem the narrative and audience at the crucial junctures. He too wrestles with the “real” and “imaginary,” “truth” and “fiction.” As the author puts it: I did not then understand that the real was a metaphor for the true-and not identical with it. Tuhami had been speaking the truth from the very start . . . but I had been listen- ing only for the real, which I mistook for the true. The truth was for me the real masked by the metaphor. Such wapl my cultural bias [p. 1301. What ultimately happens to Tuhami is less im- portant than the evolving relationship between informant and anthropologist. As the pieces of the jigsaw puzzle emerge from the encounters and are placed in their proper relationship, as the multidimensional human being takes life with our (and the author’s) increasing compre- hension, as Tuhami becomes more than a source of data, empathy with and sympathy for him grow. In the last sections of the book, the author concedes: I knew that I could no longer maintain ethnographic distance. Tuhami’s appeal was too great, and I myself too much of an acti- vist, to accept what I understood then to be his pamivity before forces externalized in ‘Aisha Qandisha, the saints, and ultimately Allah. I was a doer, and I came from a culture of doers. . . . His beliefs, I was con- vinced at the moment, held him back; they hindered his self-expression and impeded his self-reliance; they precluded the poanibility of self-overcoming. They were a sanctioned ground for rationalization. There was, I realized, a limit to my relativism. Z became a curer [p. 133, emphasis added]. Crapanzano’s intervention as a therapist is alluded to in the briefest of terms and was in fact only a short-term effort. As such, its effects were quite predictable. This slim volume, offered as an “experiment” (p. ix), succeeds in evoking numerous questions, the sine qua non of good scholarship. The author, Wisely avoiding any psychologically de- fined diagnosis (it would have complicated the prcacntation enormously), nevertheless admits to engaging in cross-cultural psychotherapy. Was he competent to have done so? Had he cal- culated the relevant factors correctly? Why was a local curer not engaged? Was not the effort too little and was it not too late in the field study to have commenced such an undertaking? After exposing the “patient” to the source of his prob- lems, was it fair then to abandon him? The ethical implications of this kind of questioning will no doubt be debated by many scholars in the years to come, but I, for one, am beholden to the author for having the temerity to present what has no doubt occurred in other field con- texts and has at the least crmd the mind of every anthropologist with the least modicum of human sympathy. Other questions concern the implications of such a narrowly defined work for the under- standing of Moroccan society as a whole. Is Moroccan life as dull and boring as the author suggests (e.g., pp. 34-35)? Are the kinds of ex- periences related by Tuhami, whether real or imaginery, shared widely among Moroccan men? Do Tuhami’a ideas and action fall within the range of acceptable Moroccan behavior or is he considered sick? This book is well written, appropriately in- dexed and, best of all, disturbing. It may well be a landmark in ethnographic candor, of in- estimable value to field-workers and humanists alike


he came to realize how life stories and by extension other ethnographic findings are reformulated by the anthropologist in accordance with literary genre and conventions, rendering them more familiar but losing their unique cultural framing. This led him to consider the role of writing in anthropology generally and was one of the founders of what came to be known as the writing culture school of anthropology. It also led him to a close reading of several of Freud’s case histories from a linguistic point of view, demonstrating how, for example, attributions of transference and countertransference were refractions of such linguistic functions as the pragmatic and the metapragmatic, that is the way speech figures its context and itself.

n the past ten years, the field of French-speaking social sciences has witnessed the emergence of a new paradigm: ethnopsychiatry. Clearly, it had already happened that within ten to twenty years after the massive arrival of immigrants, Western psychiatry produced a sub-discipline crossbreeding anthropology and psychiatry. Indeed, comparable research programs appeared after World War Two, in the 50’s and 60’s, in the US and Canada, in the 70’s in Britain, Germany and Holland, and are flourishing today, in Italy, Switzerland, Belgium etc…
In the United States, both empirical and classifying orientations were adopted, sign of the times or locally inspired: first, Folk Psychiatry, then Transcultural or Cross Cultural Psychiatry, and Medical Anthropology. In France, yet another sign of the times or local inspiration, as soon as ethnopsychiatry was developed in its clinical aspects it became the object of violent conflict, as if one aimed to force the discipline into a political debate rigged from the onset – pitting communities against the Republic, culturalism against universalism. Yet nothing is farther from the spirit of ethnopsychiatry than this imposed state of war. For almost twenty years, since the creation of the first ethnopsychiatry clinic at Avicenne Hospital, and for five years now at the Georges Devereux Center (2), part of the Psychology department of the University of Paris 8, the discipline has consistently provided a space for experimenting mediation. Now, in order to mediate one must first acknowledge misunderstandings, oppositions, conflicts, good or bad reasons to hold each other in contempt – in other words: recognize conflict, define it, and then take diplomatic action.
To act according to this philosophy of mediation amounts to putting confidence in an acceptable peace, in the possibility of learning to live with others. But the political situation in France doesn’t account for everything and the contradictions inherent to the field itself must be considered, as well as the personality of the man who introduced these questions: Georges Devereux.


n the past ten years, the field of French-speaking social sciences has witnessed the emergence of a new paradigm: ethnopsychiatry. Clearly, it had already happened that within ten to twenty years after the massive arrival of immigrants, Western psychiatry produced a sub-discipline crossbreeding anthropology and psychiatry. Indeed, comparable research programs appeared after World War Two, in the 50’s and 60’s, in the US and Canada, in the 70’s in Britain, Germany and Holland, and are flourishing today, in Italy, Switzerland, Belgium etc…
In the United States, both empirical and classifying orientations were adopted, sign of the times or locally inspired: first, Folk Psychiatry, then Transcultural or Cross Cultural Psychiatry, and Medical Anthropology. In France, yet another sign of the times or local inspiration, as soon as ethnopsychiatry was developed in its clinical aspects it became the object of violent conflict, as if one aimed to force the discipline into a political debate rigged from the onset – pitting communities against the Republic, culturalism against universalism. Yet nothing is farther from the spirit of ethnopsychiatry than this imposed state of war. For almost twenty years, since the creation of the first ethnopsychiatry clinic at Avicenne Hospital, and for five years now at the Georges Devereux Center (2), part of the Psychology department of the University of Paris 8, the discipline has consistently provided a space for experimenting mediation. Now, in order to mediate one must first acknowledge misunderstandings, oppositions, conflicts, good or bad reasons to hold each other in contempt – in other words: recognize conflict, define it, and then take diplomatic action.
To act according to this philosophy of mediation amounts to putting confidence in an acceptable peace, in the possibility of learning to live with others. But the political situation in France doesn’t account for everything and the contradictions inherent to the field itself must be considered, as well as the personality of the man who introduced these questions: Georges Devereux.

“Go find a master…”

In the course of my formative years, I encountered schoolteachers, educators, professors, guides… Towards them, I experienced admiration or anger – often indifference – before them, I felt fear or pride; at times they rewarded me; often they scolded me, sometimes they humiliated me – most often they ignored me and that was how it should be! Only once did I experience the pain of having a master. In his presence, I felt suspended, as though any personal thinking were interrupted. This experience somewhat resembles entering a convent – in fact for a long time, a very long time, I felt cloistered within his thinking. I traveled the spaces, theories, beings and yet I remained confined to the very spot where he had left me since our last meeting. My ideas followed the strict progression of what he accepted to entrust me with. I must point out that this wasn’t deliberate on his part, rather, it was a mechanism, a sort of machinery. Actually, I didn’t like meeting with him; I avoided those one on one encounters during which he confidently purred away… reminiscing, uttering sentences which were sometimes profound, sometimes merely reasonable, dispensing advice or criticism, which he gave out generously. Our work meetings were long – lasting four hours, twelve hours… I would come out crushed. He dislocated me, as one takes apart a puppet ; he broke my shell as one shells a walnut, he stoned me like an olive, throwing my naked flesh out to the world… And it was like a new beginning: I was left with the courage and recklessness of newborns.
I was fascinated by his intelligence – the kind of intelligence I prefer, agile, sharp, loathing boredom above all else, skipping over explanations without ever becoming sibylline, mystic, or sophistic… Yet he left me dumbfounded by contradiction… He endlessly spoke of humanity, comprehension, reason, friendship yet only abstract theories interested him; he stated that the only true value was mature love within a stable couple and repeatedly praised the radiant bawdiness of the Mohave Indians; he idealized psychoanalysis, described it to us as the only true therapy, yet he despised flesh and blood psychoanalysts whom he considered garrulous show-offs. I met him in 1969 – he hated Marxists, leftists, protesters, agitators, all those he referred to as « social negativists », and in fact any thought remotely inspired by Marxism; yet he consistently behaved as a rebel, a fundamental anarchist. (3) He owned a single tie, a plaid tie, which he wore every Saturday afternoon, the day of his seminar. In private conversations, he described all ethnologists as jokers – except Marcel Mauss – all psychologists as eccentrics – except Freud, and only up until 1915. He praised the pursuit of progress yet claimed that there had been none in the Humanities for the past fifty years. He sometimes acted as if he were inviting me to share fragments of his private life, immediately denying me any authentic knowledge of him. Such was Georges Devereux, my master. Today, I know a master leads one to the hidden but never reveals it, never points it out, never explains it – he is the path leading to it… for one cannot all at once be the container and the content.
I worked with him for ten years – from 1971 to 1981 – first under his direction, and then more and more with him, like an apprentice: together, we founded the first ethnopsychiatry journal (Ethnopsychiatrica), we often discussed together the concrete extensions his teachings should include. He endlessly complained about not having a laboratory or research funds for his students, of not receiving attention from administrative authorities. Yet he carefully avoided all contact with officials of any kind representing the administration. (4) In the last days of our relationship, he acted towards me as towards a future heir, asking me to teach his seminar when he couldn’t because his respiratory insufficiency made it difficult for him to breathe. He insisted that I obtain a course at the Ecole des Hautes Etudes which I taught for a year in 1977-1978. At the time, I was too little to know that one doesn’t inherit from a master; one is merely transformed by him! I learnt this to my cost one day! On a Saturday of 1981, we were four of his students gathered together to start the first ethnopsychiatry consultation – four clinicians, psychiatrists, psychologists, with psychoanalytic training. Indeed, we had theoretical knowledge of what was then already referred to as ethnopsychiatry – the study of specific manifestations of disorders in certain cultures, the analysis of traditional treatment systems – but no idea of the real practices that such knowledge could produce. That same evening, he ended all relations with me. I like to think that by acting in this way, he was simply taking once again his true place, that of a master, to guide me one last time; teaching me to leave: I’d like to keep thinking that, in fact, he wished to pass on to me the rage to go on. In any case, it is the lesson I think I learned: I’ve mostly worked on clinical issues.

The contradictions of theoretical ethnopsychiatry

The ethnopsychiatry which Georges Devereux taught us was theoretical, descriptive and explanatory. He made out index cards sorting out thousands of anecdotes of all kinds, field notes, short clinical observations. This is how he constructed his books; he also taught in this fashion. His rare lectures – he didn’t like giving talks, and preferred to debate, argue, discuss – were a long list of small observations. For over thirty years, he had patiently accumulated unusual, contradictory, paradoxical facts. Though he was always attempting audacious conceptual breakthroughs, original constructions, his true passion was that of the scholar, his ambition, knowledge. Yet his theory of complementarism, inspired by Jordan, Bohr and Heisenberg isn’t that of a practitioner of physics designing experimental set ups to try to capture the electron, but rather it is that of a creator of general theories of matter. His writings are peppered with general statements on the nature of beings : humans are like this; culture is that; the superego is made up of this, stress of that.
I wish here to examine two fundamental impacts of Georges Devereux’s thinking on psychoanalysis and psychotherapy.

1. The first was to compel the clinician to take into consideration facts he didn’t know about, whose existence he never even suspected, to whom he therefore gave no importance a priori – for example that one can read psychological disorders through the lens of specific cultural determinants. In other words : the statement (number 1) : B, son of A, himself the head of a Fon lineage of Benin, was driven mad by the voduns because he refused to take on the ritual responsibility incumbent upon him since his father’s death is as true as the statement (number 2): B was overcome by a profound melancholic sadness following the death of his father, A, to whom he was strongly attached by bonds both deep and ambivalent. This first blast still hasn’t been metabolized by the field of clinical psychotherapy which, up until now, hasn’t been able to take it into consideration technically, forever trying to be rid of the first statement.

2. The second impact is methodological. For Devereux, psychoanalysis creates the phenomenon it observes.

« The psychoanalytic experiment not only elicits the behavior which it studies, it actually creates it – exactly as the opponents of psychoanalysis have told the psychoanalyst all along, though he refused to listen. » (5)

It is therefore the task of the psychoanalyst to always create fruitful material, open to elaboration, to new productions, to life. For, just as a biologist can set up experimental designs which, taken too far, can destroy the very object of his experiment, a psychoanalyst is always at risk of creating a clinical situation turning the patient into a vegetable.(6)

« The behavior so produced also includes the patient’s specific responses to the existence of the therapist and to the physical and formal setting of the analysis. It includes, above all, responses to the experience of being analyzed and it is this experience which is unique and altogether unlike ordinary life experiences. It is even probable that it is this which elicits transference. »(7)

Thus, as early as 1966, Devereux had reached crucial methodological formulations regarding psychoanalysis – formulations in which he attributes the entire responsibility of the process to the psychoanalyst who provokes, triggers, creates, who, in the end, generates and interprets his own productions. This also underscores the responsibility of the therapist and the intellectual dead-ends in which the interpretation of possible therapeutic failures inevitably get stuck.
Such are the two essential methodological points based on which I will attempt to describe what ethnopsychiatry has developed into, at least the ethnopsychiatry we practice at the University of Paris 8.


As I said earlier, as early as 1981, we seized upon the methodological premisses of ethnopsychiatry in order to develop new practices. I must point out that, for ten years, Devereux’s seminar was attended by young psychiatrists and psychologists, who were all faced with new clinical problems that were starting to appear in France. From then on, ethnopsychiatry was redefined by force of circumstance, moving beyond its status as a descriptive theory towards the invention of therapeutic settings for the treatment of immigrant populations. This ethnopsychiatry was first and foremost a research approach to clinical work, but it also constituted a theoretical and political experiment. For, if it prompted us to rethink the practice of psychoanalysis, I believe it also led us to think in an radically new way about the place we are willing to give to immigrant populations and their cultures in the modern societies we are contributing to build.

In fact, I would gladly define the Georges Devereux Center as an experimental space for mediation between scientific systems of thought, and thought systems brought with them by immigrant populations. At a time of what is referred to as globalization, it seems impossible for us to consider actual social practices – as well as political action, in fact – without addressing the question of the place we attribute to systems from other worlds.

Languages versus language (langue et langage)

But let us return to clinical considerations. Changes in settings which stem from the questioning of doctrine often result in fruitful innovations. I can say today that simply introducing a translator in the psychotherapeutic setting sufficed to turn upside down the pleasing theoretical construct that was ours at the beginning. First, the patients’ statements were no longer « interpretable » – or more precisely: the interpretation – and namely psychoanalytic interpretation – appeared oddly superfluous. Indeed, what place was to be given to slips of the tongue, or to specific arrangements of signifiers when the primary urgency first resided in the literal comprehension, then in the necessary comparison of the systems thus brought together – and first of all the languages! I claim that the diffidence my psychoanalyst colleagues generally display towards languages – and not language – stems from the fact that introducing a second language and its necessary representatives (translators, family, friends) makes it impossible to « listen », according to the usual sense we give that word in our profession. An then, we gradually discovered that it wasn’t merely a matter of speaking the language of the patient, but also of speaking about languages. In the end, this is a considerable advantage because speaking about languages, publicly discussing the translation of the patient’s and his family’s statements ipso facto turns the patient into an expert, a necessary partner, an ally in an enterprise of exploration, knowledge and especially of acting on negativity. Indeed, the mediator’s translation, immediately submitted to the patient, becomes debatable, invites contradiction. He or she can discuss the subtleties, the intention; comment on the partiality of the translator. For if the words of the patient become questions about his world, and as such about the world, these questions, quite understandably, are of interest not only to the therapist. As soon as they appear, the patients join the debate, contributing to the translation, to the discussion of etymologies, the exploration of the thousands of mechanisms at work in the making of possible statements, the choices allowed by the language and those it prohibits.(8)
From time to time, when the exploration of the meanings of a word became too problematic, too conflicting, a proverb would appear. “Why does she say « God blessed me when he gave me this son »? Hasn’t she experienced so many problems because of his illness?” Is this a mere figure of speech?” “Custom” one might say? The husband answers: “At home, we often say: el kerd fi ‘en ommou gha-zal.” How should this proverb be translated? Probably literally, first: “In the eyes of its mother, the monkey is a gazelle.” And it sounds just right… For isn’t this mother forever praising her drug abusing son who has been plaguing her for the past five years? Someone in the gathering explains… Is it the patient, a family member, the therapist, a co-therapist? What does it matter? Talking about languages can bring everyone to agree; the meaning of a proverb as well. “The proverb means that in general, one tends to find only qualities among one’s close relations”… Yes but… How are we to understand it in this case? Does it mean that she doesn’t dare complain about her son, for fear that the words of a mother might put a curse on him? Or only that she is partial? Does she wish to ward off fate, she who has suffered so much from a cruel destiny? Is it merely a complaint worded in a coded form? All this is open to discussion, commentary, argumentation, initiating reminiscences, attempts at demonstrations and theoretical constructions.
Treating language as a thing – more precisely as a system of things – suddenly opens the psychotherapeutic space to real debate in that it henceforth contains a means for the speakers to reach an agreement, instead of finding themselves confined yet again within the closed field of dual conflict where the question is always to determine which of the two better understands the meaning of what is said. This is why clinical ethnopsychiatry takes place within a group – a group of therapists who come from different worlds, who practice multiple languages, a group thus containing a multiplicity of interpretations. The multiplicity of possible statements creates and stabilizes a space which can thus avoid degenerating into an arena of dual confrontation. The innovation of clinical ethnopsychiatry has been to consider this transformation of the clinical setting as specifically worthy of interest.
The growing experience we acquired in the handling of translations gradually led us to adopt languages as a comprehension model, in an attempt to resolve the contradictions inherited from theoretical ethnopsychiatry. Let me try to explain in what way. I would first define every language as an object manufactured by a group which in turn manufactures one by one the individuals belonging to this group. Indeed, it is clearly absurd to wonder who created the French language – absurd because the answer is obvious! The speakers manufacture the language every day – any one of them being capable of modifying in a durable way a word, an expression, a pronunciation, a rule of syntax, provided the modification is accepted by the group. The creation of new expressions by present day second generation North African immigrants in our suburbs or by rap music groups demonstrates that the French language isn’t manufactured only in the Académie française but mostly in the streets. And since it is obvious that language is one of the systems that most strongly contributes to the development of the individual, one can conclude that the group manufactures an object which, in turn, manufactures the individuals of the group.
Again, the model of language provides us with a logical, reasonable and robust solution. There is no difference, from this perspective, between let’s say a Malinke speaker and a French speaker. There is no doubt that each of them has been “manufactured” by a language, itself manufactured each day by their group. It is precisely because the Malinke person and Frenchman are identical that they are both manufactured by a language. One could also say that the fact that they are both manufactured by a language proves that they are identical. The problem is that the objects by which they’ve been manufactured are different : the Malinke language isn’t the French language. It thus becomes absurd to discuss a possible opposition between universalism and relativism. This is mere common sense: the universal nature of man is obvious, it is not worth discussing. If humans are the same, the objects manufactured by groups of humans are different. The difference worth studying is located in objects, not in humans -not in their biology, nor their social structure, nor their psyche. I will try to demonstrate how this notion solves a series of contradictions and opens the way to original and effective technical settings.

The question of recovery

This notion also solves the old problem posed by recovery and the endless question: can one consider recoveries obtained by cultural therapies as being of the same nature as those obtained through “scholarly” therapies? What I refer to as “scholarly” therapies are those psychotherapies claiming to proceed from the scientific observation of “nature.” It goes without saying that I am in no way taking a stance on their scientific value. The question of recovery is crucial because if, on the one hand, therapeutic systems are radically heterogeneous, and, on the other, recoveries obtained by these different systems were all of the same nature, we would then have to abandon the claim of theories of psychopathology to a general explanation, both of disorders and of action upon the disorders. Yet, to think in this way clearly seems too difficult – professionals’ resistances are huge! This explains why most authors who have attempted conceptualizations in the field of ethnopsychiatry have always proposed Western-based explanations of the therapeutic effects of cultural systems, effects which have been routinely observed. They ascribe the improvements observed in patients either to “transference” (Roheim), to “suggestion” (Freud and many psychoanalysts after him), to the “placebo effect”,(9) to “beliefs” (Levi-Strauss) or to “social reorganizations” (Zempleni, along with many anthropologists). Some, like Devereux, do not recognize any real effect other than palliative:

« Thus, one cannot consider that the shaman accomplishes a “psychiatric cure” in the strict sense of the term; he only provides the patient with what the Chicago School of Psychoanalysis would call a “corrective affective experience” which helps him reorganize his defense system but does not allow him to reach the genuine insight without which there is no real cure. »(10)

Transference, suggestion, placebo effect, belief… these are all “Western” concepts which make it possible to reject cultural explanations by interpreting them. Of course, the days are over (yet it wasn’t so long ago) when the thought of “primitive” peoples was considered prelogic,(11) magical or infantile .(12) But today, interpretation – be it sociological, structuralist or psychoanalytic – is the principal instrument used to disqualify theories belonging to groups and communities, and, consequently, to disqualify their therapeutic practices(13). Those who from the start deny actors in a system the capacity to totally account for the system they manage, are doomed to interpret these actors’ theories, their results, the entire system. As a result we have a psychiatrist, a psychoanalyst, an ethnographer feeling at home everywhere he (or she) goes. Such a nomad will tend to annex any cultural therapy he approaches, translating it into ready-made theoretical tokens. Having become an expert, he won’t learn anything of substance about the people with whom he comes into contact. Isabelle Stengers has perfectly described this problem:

“As I have already emphasized, only those who see themselves as purely « nomadic », are irreparably destructive and/or tolerant, those who can no longer be frightened or distressed by anything; and the group which identifies as such can only send out experts The psychoanalyst, when he views himself as a « modern practitioner » also views himself as « nomadic », freed from the illusory bonds that attach others. Henceforth, the analyst can consider himself « at home » wherever he is, since his practice defines any « territoriality », any sedentary way of life as open to « analysis ».”(14)

So, we must take a stance: do cultural therapies cure patients? Or, even worse, do they cure them for the “wrong reasons”(15)? This is the first question we will have to answer seriously. In any event, it is always in the name of recovery that the Senegalese patient continues to consult the marabout, the Moroccan to consult the fkih and the patient from the Limousin the magnetic healer. Since, justifiably, it is by way of this criteria that patients allow the persistence – and even the development(16)– of such systems, making it possible for the objects of their worlds to continue manufacturing new cases, new beings, we must pay attention to their arguments. The Moroccan has usually experienced that amulets heal; the Senegalese that sand speaks, and the person from the Limousin that hands convey a fluid. They don’t believe in the healer, as is generally claimed, they respect the objects of the professional: an amulet, sand, a fluid – and the mastery he has acquired.

The question of the validity of cultural theories:

How should we consider the concepts which organize cultural therapeutic systems? As “representations,” “beliefs” or genuine theories? If we think of them as “representations,” we deny them, in effect, any claim to describing objects of the world: they speak of things, we, of representations; they, of the action of the fetishes, we, of the belief in the action of the fetishes; they, of the demands of the dead, we, of mourning feelings; they, of the constraints imposed by the gods, we, of “paternal complexes” If we could find a way to respect their claim of describing the world, then we should consider cultural therapeutic systems as genuine theories. And if theories they are, it becomes necessary 1) to learn them; 2) to experiment with them concretely; 3) to compare their clinical efficiency, or at least their concrete effects, with the efficiency of “scholarly” therapies. This is a challenge, in as much as these theories often aren’t taught but rather they are transmitted through initiation. Moreover, these theories are rarely explicit, never presented as systems of ideas. Rather, they inform the technical actions of the therapist and can only be re-constructed. Finally, to consider them as genuine systems of thought would require of those who decide to learn them that they more or less adopt the professional identity of those who practice them. Yet it is socially impossible for a Western clinician to take on the identity of a Colombian shaman, a Moroccan fkih, a Nigerian baba-lawo – not to mention that of a magnetic healer from the Limousin! Here again, we come up against professional resistances. This is why, to avoid the problem, most authors(17) consider cultural theories, as “pre-notions,” “fantasies,” “beliefs” and sometimes even as the survival in adults of infantile sexual theories.(18) As was often the case, G. Devereux recognized the problem and expressed himself vividly on the subject:

« This is why we can never be certain data of primitive “psychiatrists” represent authentic scientific intuitions or if they are mere fantasies derived from a model of cultural thinking »(19)

It should be noted that for Devereux, should the theories of traditional therapists prove to be of interest, they would be so only in terms of intuition. Thus, he writes further-on in the same text, referring to the Sedans in Viet Nam :

« …These are merely people who are inclined towards speculation, but whose insights remain sterile in as much as they are not integrated within a scientific context and are not correlated with other insights of the same order, but only with mythology. »(20)

Yet cultural theories are perceived by those who make use of such therapeutic systems as being as genuine as « scholarly » theories. Patients, and we have all experienced this, do not oppose the two worlds. Rather, they try to take advantage of both. Indeed, it is the « scholars » who are at war, not the clients! At war with each other, in the first place,(21) but also with those they designate as “charlatans.” Again, the ethnopsychiatrist should follow the users’ example when constructing his concepts, taking seriously cultural theories – approaching them not as “representations”, but as genuine theories the specific rationale and necessity of which he will have to explicit. In brief, he will have to explain how the phenomenon apprehended by these theories is apprehended correctly and how these theories permit an effective grasp of the world.

What to do about groups?

Ethnopsychiatry needs the concept of “culture”, or at least a concept acknowledging the existence of groups. French anthropologists and especially sociologists have an increasing tendency to do without such a concept (often with good reason), preferring the more vague notions of « worlds » or « universes ». Moreover, the increasingly active processes of globalization of information, habits, laws, commodities, tend to make this notion seem out-of-date, perhaps somewhat prematurely obsolete. Yet at the same time, a series of new elements have emerged reminding us that in psychopathology, groups cannot be done away with – whether such groups are referred to as “ethnic groups” or as “communities.” Indeed, more and more frequently “therapists” appear who re-invent “cultural” treatment systems. For example, a Tahitian Tahua who, in the wake of an existential crisis, suddenly decides to seek initiation among the New Zealand Maori and is tattooed there from head to toe;(22) or a woman healer in a Mali village who organizes (invents? re-invents?) new rituals to the djinnas claiming all the while that she is merely re-instating a timeless tradition; (23) or a female nganga, a healer from Northern Congo, settled in Brazzaville, who creates a new method of extracting malignancy.(24) And what of this healer from a social housing development in the northern suburbs of Paris who reads the cards for the depressed unemployed on the dole?(25) These people all gather around them numerous patients. They present and see themselves as “cultural” therapists. It seems to me that, today, if the social sciences are to be innovative, they must imperatively conceive of methods allowing for these « subjects » to be considered as competent and creative, in no way puppets or robots! For, after all, these people haven’t chosen to be initiated in just any old trade but in the art of healing. Our observations in ethnopsychiatry have increasingly led us to a somewhat strange hypothesis: It may be that psychopathology and culture entertain stronger bonds than was once suspected. For if it turned out that nowadays, in this period of globalization, it were mostly through an illness – or one of its most pernicious forms, the obligation to heal others – that “culture” might suddenly invest a person, then illness – and especially mental illness – and culture would form a couple more closely linked than ever before, though such an alliance would remain as mysterious as ever.(26)
First, it must be said that any social science is the science of groups. Even clinical psychology, based on the study of individual cases, necessarily leads to the creation of groups – admittedly artificial groups, the only expert of which is the researcher. Indeed, what social reality might a group have, for example made up of all the people classified by psychologists and psychiatrists under the heading of Paranoid Schizophrenia? These are simply statistical groups, “homogeneous groups of patients,” people whose only common characteristic is of having been classified in a given category by professionals. In this case, how could one possibly construct the truth by way of a real debate taking on the patients as partners?
In the modern world, social groups are often formed in a battle opposing specific interests to experts. Recent examples: people with AIDS, united in associations, succeeded in imposing their expertise, thus upsetting the perspectives and priorities of researchers in the field.(27) The pressure of gay movements compelled the American Psychiatric Association to delete homosexuality from the list of mental disorders. Sometimes, isolated researchers help to constitute such groups through their brilliant personal efforts. Oliver Sachs, for instance, has succeeded in imposing the idea that modern research in neurology consists in investigating the actual experience of patients, who are the only ones capable of describing the unique strangeness of their world.(28) Thus, recognition by groups is sought after by an increasing number (though still to few) of modern researchers in social sciences in order to acquire partners able to question the validity of their hypotheses.(29)
Ethnopsychiatry can be practiced only in this manner. Indeed, the ethnopsychiatrist always has a double who incessantly questions him on the legitimacy of his perspectives, methods and results, namely the healer or the “natural” therapist of the populations he treats. The good fortune of the ethnopsychiatrist, his asset, is merely epistemological: among all clinicians, he is the only one to have a necessary contradictor. We must also remember that in other universes, groups of “patients” are also often genuine social groups. For example, in Morocco, the group made up of all those who have been possessed by a certain djinn is possible and constitutes a reality of experience. Such a group can be found in certain zaouias (30) in which the followers can devote themselves to the ‘hadra, the ritual trance.
In other words, the question of ethnopsychiatry necessarily calls forth actual social groups which, nowadays, have lost the distant, literary and somewhat imaginary nature conveyed in yesterday’s ethnology. We meet Bambaras, Dogons, Mandingos… every day, in the street, in the subway, in our offices. Such cohabitation requires managing relations with different communities, given that, as all groups, these tend to produce representatives. We are in the urgent need of a theory which will allow us to recognize and call upon these groups and their representatives. Thus, the ethno part of the term “ethnopsychiatry” is a reminder to the ethnopsychiatrist of his own methodological requirement: to appeal to actual constituted groups and their representatives in order to validate his (or her) propositions and hypotheses.
Today, however, there is an added complexity. Sometimes, it turns out to be concepts constructed by practitioners that end up generating genuine social groups.
First example: The description of a neurological syndrome by Gilles de la Tourette led, several decades later, to the creation of an extremely active association (especially in the United States), the Tourette Syndrome Association.(31) Here, the group is defined by the disease. While keeping close ties with the doctors and neurologists who created it, the association challenges them incessantly, prompting them to actively pursue research, propose new etiologic hypotheses, discover new treatments.
Second example: It is reasonable to consider that Freud’s definition of homosexuality as a “psychic structure” allowed people with homosexual practices who saw themselves as “deviant,” to imagine they were members of a particular category, then constitute a social group: the gay movement. Today, the movement questions the experts – psychiatrists, psychoanalysts, endocrinologists, biologists, who created them – having designated itself as their unavoidable partner.
Third example: The description by Benjamin, followed by Stoller, of “transsexuals” gradually brought individuals to first create a social group then a pressure group requesting surgery from doctors and identity changes from administrative authorities… Here, the group originally defined by a bio-psychoanalytic concept – they refer to themselves as Benjaminites, inspired by the name of their “creator” – has become a pressure group compelling professionals to adopt new ethical standards, a new moral code, indeed a new philosophy.
Thus, we must face the evidence: social practices, which are always the applications of social sciences, generate the creation of new social groups which in turn question their creators.

Therapeutic settings

Attempts in this field – ethnopsychiatry, transcultural psychiatry, comparative psychiatry, folk psychiatry – always started from the acknowledgment of differences, but then got bogged down in an endeavor to recapture universality. This is what renders them “soft,” fragile and, of course, questionable. Most of the time, the authors adopt the hypothesis according to which the psychological or psychopathological structure is universal, merely “colored” by culture. Jilek, for example, quite rightly points out that the usual position in “comparative psychiatry” has been to consider culture as having a pathoplastic rather than pathogenic influence on psychopathological symptoms.(32) Some authors, considering the strangeness of pathologies referred to by Anglo-Saxons as culture bound syndromes, venture a little farther, though quite timidly. Michael Kenny, for example, proposes the idea that certain morbid entities, such as smallpox or the measles are unequivocally universal, whereas the Malaysian latah would be a sort of “social theater”.(33) It remains to be seen, however, in what way a “social theater” might make up a psychopathology. Georges Devereux was perhaps alone in noting that this constituted a true epistemological problem calling for the creation of a full-fledged discipline. Yet it must be said that his works are replete with the same type of contradictions I have indicated. For instance: if there is an irreducible specificity to Mohave psychopathology,(34) through what miracle could psychoanalysis possibly account for it? Indeed, even reduce it to something already known elsewhere? Unless we consider this psychopathology to be in no way specific; or rather that its specificity is nothing but an illusion. Here we find ourselves almost insulting the Mohave, sympathetically considering them poor theoreticians, barely capable of naïvely approaching – and only “symbolically” – Freud’s thinking.
To put an end to this type of contradiction, my proposition is to apply to therapeutic settings the conception drawn from our experience with languages and translation. Groups manufacture therapeutic settings; and it is these therapeutic settings that manufacture, not human beings, of course – and here they differ from languages – but patients. This proposition solves a series of problems, creates new ones and entails technical and theoretical consequences.
First, this proposition is rational, materialistic, and rejects any compromise with mystico-philosophical positions, in good keeping with rationality.
It has the advantage of being perfectly congruent with what is known about traditional therapeutic systems. In many African groups, for example, people don’t refer to a person as a treatment specialist but as someone who has touched things – not knowledge but things, objects. I believe these systems know – or, more precisely, they postulate – that patients are manufactured by things, those things that the therapists belonging to the group have learned to handle. On the other hand, it fits rather well with traditional theories that have so far been considered mythical and/or symbolic, according to which humans manufacture fetishes, look after them, feed them, all the while receiving sustenance from them – in no way impeding that fetishes in turn manufacture humans.
This proposition makes it possible to once and for all rid ourselves of those vague, catch-all notions such as “belief” or “conviction” – notions which can only generate attitudes of tolerance, indeed even condescension.
This proposition also makes it possible to understand why people from non-Western societies expect from a therapist that he (or she) manufacture them from their own objects, yet are also prone to accepting other types of manufacturing, agreeing to go along with, in a sense to try out, other types of patient-manufacturing. We are thereby afforded a new perception of a curious fact that has ceaselessly bewildered clinicians, namely the paganism, the sort of spontaneous therapeutic polytheism of patients all over the world, who never hesitate to straddle the so-called metaphysical opposition between “natural” and “supernatural,” between “rational” and “irrational,” seeking help successively, sometimes even simultaneously, from a psychiatrist, a psychotherapist, but also a healer, a charismatic church, etc. Finally, feeble and contradictory reasoning can thus be avoided, such as the “either, or” argument – either Western reason or traditional irrationality – as well as the postmodern logic of juxtaposition, the “why not?” stance – why not both the psychiatrist and the healer – this vague crossbreeding rightly criticized by Devereux in his 1968 preface to The Psychotherapy of a Plains Indian. The very fact that patients so willingly accept the ethnopsychiatric setting demonstrates that any true therapy should always strive to reach the level of complexity of which are capable those it is intended to serve.
It also allows us to understand why, when we consider traditional therapeutic objects, in the course of an ethnopsychiatry consultation, patients willingly accept to take part in the discussion with us. When we demonstrate some competence, certain statements can make the entire gathering agree, just as the discussion around the meaning of a word or a proverb can make everyone agree. Formulations such as the following: the jnoun throw stones at noon; or every person has a rab of the opposite sex; or this child spends each night talking with the spirits which is why he hasn’t been able to learn the language of humans, etc.
But the theoretical implications are considerable:
In terms of psychopathology, according to this proposition, the core of a person is no longer located inside him (or her), but in a public space, within the objects invented by the group and manufactured by professionals. I must make it clear that I am referring to patients and not persons as such.
In order to account for what ethnopsychiatry brings to light, we need to change the very object of psychopathology. It would no longer be a matter of studying symptoms, syndromes, structures, even illnesses, but of describing and then learning the use of therapeutic objects such as they are invented and manufactured by human groups. When I speak of objects, I mean all kinds of objects: theories, prayers, songs, but also things – plants, statuettes, calabashes, skulls, etc.
And there is no reason to think that what has just been said holds true only for non-Western groups. On the contrary, I think such a theory is just as useful with our native patients. In other words we are much closer to the reality of our clinical work when we consider our patients as “manufactured” – rather than spontaneous – manufactured by our own theory, of course, but also by the successive theories of those professionals who inevitably preceded us.
In a word, the ethnopsychiatry we practice is not relativistic: it is constructivist.

Ethical consequences

If ethnopsychiatry is constructivist, then the patient loses his status as an object, a strange and feeble being to be probed until interesting elements come to light. It is no longer possible to “interpret” her functioning with a theory. She becomes a necessary partner, an indispensable alter ego in a common research enterprise. Ethnopsychiatry has developed the habit of rethinking with the patient both his personal suffering – as do talk therapies – as well as the theories which have informed this suffering, which have, as we have seen, constructed and elaborated it… To generalize the logic of ethnopsychiatry to all patients, regardless of their origin, would lead us never to hesitate in considering them as “constructed” as “cases;” to postulate that this manufacturing concerns and interests them; and that they are the privileged recipient of what the theory thinks about them. Thereby promoted informant, the patient is invited to discuss the observations of the therapists, to argue their hypotheses, and finally to share the responsibility of the treatment thereby worked out in common.
Thus conceived, ethnopsychiatry generates an ethical rigour through a sort of natural process since any information concerning her is necessarily and systematically submitted to the patient’s attention. The obligation to share interpretations with the patient, the construction of “truth” in the course of a genuine debate in which she truly participates, are part of its theoretical postulates and thus of its routine clinical practice. In fact, such a therapy truly achieves the ideal of psychoanalysis – to allow the patient to grasp part of what constituted her.


Although Georges Devereux probably would’ve disagreed – but can the dead be made to speak? – both technically and politically with the practice of clinical ethnopsychiatry – I am firmly convinced that his inspiration has been passed on. His continuous strive towards scientific rigour and specialization; his never-ending interest in related disciplines, biology, ethology, physics, what wasn’t yet referred to as cognitive psychology, considered as practices and not results, constitute, in my opinion, the most innovative aspect of his work. It is for this reason that we chose to name after him the university centre I have directed for the past five years. And it is this perspective, which we can qualify today as materialistic, constructivist and research-oriented that the ethnopsychiatry I practice attempts to take as far as clinical work will allow.


Finally, to conclude, I would now define ethnopsychiatry as follows:

1. A clinical discipline taking as its object the analysis of all therapeutic 
          systems, viewed as systems of objects; all systems without exception 
          nor hierarchy, those claiming to be "scholarly" as well as 
          those purporting to belong to a specific collective or community - be 
          it ethnic, religious, or social. Ethnopsychiatry sets out to describe 
          these systems, to extract their own rationality and especially to demonstrate 
          their necessary character. This discipline claims a specific scientific 
          rigour stemming from the fact that, considering therapeutic systems 
          as the property of groups - according to the aforementioned formula: 
          groups manufacture objects which in turn manufacture persons - it seeks 
          to demonstrate its hypotheses through the development of methods allowing 
          representatives of these groups to take a stance on their validity.
          2. A discipline which sets out to test the concepts of psychiatry, psychoanalysis 
          and psychology in light of theories belonging to the groups whose therapeutic 
          systems it studies. It creates situations, imagines settings, invents 
          methods intended to test these theories in light of the cultural and 
          clinical realities it observes.
          A clinical practice which considers that the processes and results of 
          points (1) and (2) are of concern primarily to the patients; a practice 
          interested in engaging in a true debate with them; finally, a practice 
          deliberately setting up spaces prohibiting on the part of therapists 
          the practice of insulting(35) patients, 
          their families or their groups- by this I mean that it isn't satisfied 
          with simply leaving the respect of this rule up to the moral value of 
          the therapist, but rather it actively engages in constructing a setting 
          which concretely precludes such a practice.

The ^amadsha are members of a loosely and diversely oigamzed 
leligioiis brotherhood, or oonfrateroity, which traces its sptritnal herit- 
age back to two Moroccan saints of the late seventeenth and early 
dghtseenth centuries, Sidi ^AU ben Qamdush and Sidi Ahmed DghughL 
E>espite a certain notoriety due to their head-^hing and other prac- 
tices of self-mutilation, tiie lElamadsha have receii^ comparative^ 
little attention in the literature, ethnographic or other, on Morocco and 
North Africa.^ This has probably resulted less from any secretiveness 
or lack of cooperation on their part than from their political insignifi- 
cance and from the fact that they have been overshadowed by larger, 
more spectacular brotherhoods like the Isawiyya. 

The Qamadsha have been classified by French scholars as an extreme 
example of the coTifrerie populaire, a sort of degenerate form of the 
Sufi brotherhoods of the Muslim high tradition, corrupted by the base 
imagination of le peuple, by survivals from the ancient religions of the 
circum-Mediterranean culture area, and by pagan influences from sub- 
Sahaian A^ca. They are considered, then, to be part of the cult of 
saints, or ?naraboutism, which has been generally regarded as the hall- 
mark of Alaghrebian Islam. The French word **marabourismc" is derived 
from the Arabic rnurabit, which describes a man attached to God — the 
root itself means "attach" or "fasten" — and has been used for any of 
the warrior-saints who brought Islam to Morocco. "Maraboutisme" has 
become in French a catch-all expression for all sorts of activities asso- 
ciated with the worship of saints. It may, for our purposes, serve to 
define two basic institutions: the cult of saints and the religious brother- 

The saints of Morocco — ^they are referred to as siyyid, salib, or nvaU 
^The most complete study u a aidde fay Heiber, pnblidied in 1923. 


— may be descendents of the Prophet, founders and sheikhs of religious 
brotherhoods like the Hamdushiy) a,^ political heroes of the past, 
scholars reputed for their piety and religious learning, holy fools, or 
''simply vivid Individuals who had tried to make something happen" 
(Geertz 1968:8). Associated with the tribal structure of Morocco, they 
run a gamut of importance frmn the purely local saint about whom all 
but his name is forgotten, and who is perhaps visited by half a dozen 
women each year, to a saint like Moulay Idriss, to whom all Moroccans, 
Berbers and Arabs alike, pay homage (Dermenghem 1954:11-25). 
Some^ like Moulay Abdeslem ben Me^hish, Sidi Hamzam, or Sidi Said 
Ahansal, were hi^rical figures of considerable fame; while others, as 
Wcstermarck (1926 (I):49) put it, seem to have been invented to 
explain the holiness of a place. 

The object of the cult of saints is the saint's tomb — usually a squat, 
white cubical building with domed roof (qubba). These dot the Mo- 
roccan countiyside and are cared for by the saint's descendants — 
celibacy is not a prerequisite for sainthood in the Islamic world^-or by 
a caretaker (muqaddim) who lives on part of the alms received from 
pilgrims. The tombs are visited and venerated by men, women, and 
children anxious to obtain ^m their saint some favor such as a male 
child, a cure for a bout of rheumatism or a case of devil-possession, a 
favorable verdict at court, political asylum, or simply good fortune. 
A particular behavioral set designed to enable the pilgrim to obtain 
the saint's blessing or holiness (baraka) is associated with each tomb. 
Its components may vary from the offering of a candle to the sacrifice 
of a bull or even a camd; from kisang the four sides of the tombstone 
to chanting long litanies; from rolling a holy stone over aching parts 
of the body to receiving massages from descendants of the saint. Sacred 
springs and grottos, trees, stones, and animals believed to contain 
baraka, and spots to which the jnuny or devils, are said to gravitate, 
are often found near the tombs. These too have their behavioral dic- 
tates which are linked to the veneration of the saint (Basset 1920). 

The brotherhoods are associated with the cult of saints, for their 
members follow the path (tariqa) of a spiritual leader, or sheikh j who 
is usually considered to be a saint. There is considerable variation in 
the organization, function, degree of theological sophistication, and 
ultimate aim of the brotherhoods. The members of die more sophis- 

'Thc Hamadsha brotherhood is referred to as at-tariqa al-Havidushiyya, or 
siniplv as l-Haindushiyya. A male adept of the brotherhood is a I^aindiishi; a 
female adept, a ifrnidusMyya, The juural for both male and female adq>t8 is 
Ifrnnadsbttf whicfa I also employ as an adjecdve; 

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ticated are lecruited, as might be expected, from the wealthiest, best- 
educated strata of Islamic society; the members of others, like the 
](Jamadsha, come from the illiterate masses. Ail of the orders involve 
certain ritualized acts: the mechanical recitation of supernumerary 
prayers, reminiscent of the Sinaitic and Anthonic prayers of Jesus or 
the chants of mantra yoga; listening to music; dancing. The popular 
orders tend to be extreme: wild dances inducing ecstatic, frenetic 
trances; drinking boiling water; eating spiny cactus and other defile- 
ments; charming poisonous snakes; and innumerable acts of self-mutila- 
tion. All of them attempt to produce some sort of extraordinary psy- 
chic state which may be interpreted as union with God or possession 
by a demon. 

Unlike the members of the more sophisticated orders, who consider 
their founding saint as a spiritual master who has provided them w^ith 
a path to God, the members of the popular orders often consider their 
saint as an object of devotion in his own right and the source of power 
for their miraculous feats. Some of the orders have an extensive net- 
work of lodges located not only in Morocco but as far East as Mecca 
and deep into sub-Saharan Africa; others are limited to a few members 
who meet when and where they can. Some have close tics with die 
descendants of their founding saint, to whom they must give their 
complete allegiance and all of the alms they collect each yeai^ others 
have almost no contact with the families of the saint. Some have a very 
elaborate hierarchy of initiates; others no hierarchy whatsoever. Some 
meet in well-constructed lodges, others in the open or in private houses. 
All of them arc firmly convinced that they are faithful members of the 
Orthodox Muslim community. Some of these confraternities still flour- 
ish today, others are moribund, and still others defunct. 

The Hamadsha are, in fact, members of two distinct brotherhoods 
which are closely related to each other and often confused. The ^Alla- 
liyyin are the followers of Sidi *Ali ben Hamdush, and the Dghughiyyin 
follow Sidi *^Ali's servant, or slave, Sidi Ahmed Dghughi.^ Both saints 
are buried and venerated some 16 miles by road northwest of the city 
of Meknes on the south face of the Zerhoun massif — Sidi 'Ali, whose 
tomb is one of the largest in Morocco, in the comparatively wealthy 
village of Bcni Rachid, and Sidi Ahmed about a mile farther up the 
mountain, in the much poorer village of Beni Ouarad. The inhabitants 
of Beni Ouarad are much darker than those of Beni Rachid. Roughly 

*I diall use die tenn J^amaisba to refer to bodi orden and to pncdoes oooi- 
mon to bodi. ^AltaUyyin and Dgbugbiyyiu will refer to die q;»ecuSc offden and 
dieir specific pracdoes. 

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a sixth of the population of each village claims agnatic descent from 
their respective saints. 'Fhev are collectively referred to as the mmlad 
siyyid, the children of the saint. As the "children" of both saints claim 
descent not only from their saintly ancestors but from the Prophet as 
well, thcv may also be called shurfj, the Moroccan Arabic plural for 
sharif, a dcsccndent of the Prophet Muhammad through his daughter 
Fatima and his son-in-law 'Ali. Since the children of each saint are all 
able to trace their descent back to a single ancestor, they constitute, in 
anthropological terminology, a maximal lineage. Each of the two maxi- 
mal lineages, which are in turn divided into a number of smaller patri- 
lincages, is governed by a headman, or 7mzwar. A descendant of Sidi 
*Ali or Sidi /\hmed has the option of becoming a member of his an- 
cestor's brotherhood, but rarely takes this option. 

The members of the Hamadsha brotherhoods — they are most com- 
monly called foqra — are divided into teams. A team (taifa) may have 
a specific meeting place, or lodge, called a zawiya. Although the word 
"zawiya" refers, strictly speaking, only to the meeting place of a par- 
ticular taifa, I will follow common Moroccan usage and use it to refer 
to members of a particular lodge as welL The taifa must also be dis- 
tinguished from the taruia, which is either a brotherhood or the "path" 
or 'S(ray"-^hat Is, the teachings— of a particular saint. 

Although the I^amadsha may be related historically to the mystical 
tradition of Islam, they do not usuaUy conceive of the goal of their 
piactices as union or communion with God, but rather as the cure of 
the devil-struck and the devil-possessed. They are essentially curerSi and 
it is in this spirit that I propose to examine them. This is not to say 
that the l^amadsha would consider such an investigation appropriate or 
even desirable. They have received their power (baraka) to cure itoxsk 
Allah by way of I£s servant, their saint and intermediary to Him, and 
they are content with their lot. The ways of Allah are not to be 
questioned. To ask whether they concdve of their cures as essentially 
religious in nature, however ''religious" may be defined, is to ask a 
question which has no meaning for them. All activities are religious 
insofar as they are contingent upon the will of Allah, and this very 
contingency is brought home to them with particular poignancy by this 
fact tlmt the cures diey effect are extraordinary, outside the tone and 
content of everyday life. 

The ^lamadsha are not just curers but successful curers at that, in 
terms of the standards theur society sets and, in some instances, in terms 
of the standards set by modem medicine. They are able to effect, often 
dramatically, the remission of symptoms— ^Mralysis, mutism, sudden
blindness, severe depressions, nervous palpitations, paraestfaesias, and 
possession — which led the patient or his family initblly to seek their 
hdp. The sympttmis th^ treat aie freqaently expressions of the com- 
mon anxiety reaction found in many primitive societies (Wittkower 
1971) or expressions of more severe hysterical, depressive, and even 
schizophrenic reactions. The Jtiamadsha are, in their own fashion, su- 
perb diagnosticians and generally avoid treating those illnesses which 
are regarded by Western medidne as organically caused. They seldom 
treat epilepsy. 

The Hamadsha complex is to be regarded here, then, as a system of 
therapy. Therapy is considered to be a structured set of procedures for 
the rehabilitation of an incapacitated individual — an individual who is, 
from a sociological perspective, unable to meet role expectations and 
effectively perform valued tasks (Parsons 1964). Therapeutic pro- 
cedures effect changes in the ailing individual's social situation as well 
as in his physical and psychological condition. He is moved through 
the roles of sick person and patient back, in the case of successful treat- 
ment, to his original role. If the treatment is not completely succ^ful, 
he may be regarded as "a chronic case," or as handicapped. The ideal 
is of course full restoration to his "old self." 

Certain therapies, however, of which the Hamadsha is but one of 
many examples, may often be incapable of, or do not even aim at, re- 
storing the distressed individual to his previous condition. Rather, they 
introduce him to a new social role and concomitant tasks. The individ- 
ual may become a member of a cult like that of the Hamadsha. He is 
provided thereby not only with a new social identity but also with a 
new set of values and a new cognitive orientation — that is, with a new 
outlook. This new "outlook" may furnish him with a set of symbols 
by which — in the case of psychogenic disorders, at any rate — he can 
articulate and give expression to those particular psychic tensions which 
were at least in part responsible for his illness. This symbolic set is 
closely related to the cult's explanation of illness and theory of therapy. 

Aside from techniques designed to alter the physical and psycho- 
logical condition of the patient and his social situation, a therapy must 
provide the distressed individual, the curer or curers, and other mem- 
bers of the society with an explanation of the illness and a theory of 
cure.^ In the case of cure by incorporation into a cult, such explana- 
tions may be considered the ideology, or belief system, of the cult. 
Berger and Luckmann (1967:113) have written: 

*ln what follows T am indclMsd to Beiger and Lwckmaim'a Tlie Social Con- 
struction of Reality (1967). 

Copyriyliiou iiiatciial 



Snce therapy must concern itself yndi deviatkm firom the "official** defini- 
tions of reality, it must develop a conceptual machinery to account for soch 
deviations and to maintain the realities challei^ed. This requires a body of 
knowledge that includes a theory of deviance, a diagnostic apparatus, and a 
conceptual system for the "cure of souls.** 

To die extent to which such explanations are commonly known, or at 
least known to the ailing individual, they tend to formulate the illness 
and furnish, thereby, a ground for therapeutic procedures. This is 
particularly true of psychogenic disorders. 

In therapies like tluit of the Qamadsha the elements of explanation 
consist, as we shall see, of symbols which represent both social and 
psychic realities for the ailing individual (and other members of his 
milieu). These elements-Hmages, in Godfrey Lienhardt's term— serve 
not only to ardculatc but to interpret the individual's experience imme- 
diately, and must be at once congruent with both psychological needs 
and sodo-cultural realities. They are not individual projections. They 
are givens m the world into which the individual is bom and, as such, 
serve from the start to mold his reality and to realize themselves in his 
psychic life. They provide a schema for the interpretation of his expe- 
riences and make liiem congruent with the realities of his world and 
that of other members of his culture. Their locus, which may be sought 
within the recesses of the soul or without— in the worid, say, of samts 
and demons-^nay reflect the chaiacteiisdc stance of an individual 
within a particular cultural tradition to others within his world (Crapan- 
zano 1971). Such explanarions— they may be calkd symbolic-interpre- 
rive— are characteristic of many so-odled primitive therapies and cannot 
be divorced fit>m the curing practices themselves. Therapy, in such 
cases, involves the manipuladon of symbols not only to give expression 
to conflicts withm the individual, but also to resolve them (Livi-Straoss 

It is suggested here that the I4amadsha effect their cures by incor- 
porating their patients into a cult which provides them with both a 
new role— one which is probably more in keeping with their individual 
needs-^md an interpretation of their illness and its cure. This inter- 
pretation permits during the curing ceremonies the symbolic expression 
of incapacitating conflicts and the consequent discharge of tensions 
which may impede social behavior. This discharge of tensions is not 
merely an emotional outburst, which may be of little therapeutic im- 
port, but a highly structured process which involves the symbolic 
resolution of such tension-producing conflicts. The process of resola- 



tion serves not only to ''resocialize the deviant into the objective reality 
of the symbohc universe of the society," as Berger and Liickmann 
(1967:114) mainrain, but to reestablish or reinforce his motivation. 

It must be emphasizx-d that the practices and, to a lesser extent per- 
haps, the beliefs of the Hamadsha and the members of other similar 
brotherhoods are not characteristic of "Moroccans'' in general. The 
Hamadsha complex is a fringe phenomenon, peripheral but by no 
means unrelated to the mainstream of the Moroccan socio-culturai 
tradition. Many Moroccans, especially Berbers and the educated Arabs, 
look askance at the practices of the Hamadsha; they consider them to 
be uncouth, unorthodox, disgusting even, and are often embarrassed 
when reference is made to them by foreigners. Still, it has been my 
impression tliat even among the better-educated — though perhaps not 
among the best-educated — disapproval is tempered by a certain awe 
which results, if for no other reason, from the dramatic quality of the 
Hamadsha performance and the "spectacular" nature of the Hamadslia 
cure. These performances, and these cures, are after all the will of God. 

The Hamadsha, who are almost exclusively Arabs, consider them- 
selves to be members of the Orthodox (Sunni) Muslim community and 
follow — or, perhaps more accurately, believe they follow — the laws and 
traditions of that community which find their inspiration, if not their 
very source, in the Koran and in the Prophetic tradition (hadith). 
Indeed, they find the very ground not only of tlieir rehgious belief and 
worldview but of their social organization in the Koran — or, again 
more accurately, in what they impute to the Koran. The Hamadsha 
are in this respect not dissimilar to the millions of ilhterate or quasi- 
Hterate Muslims of North Africa and the rest of the Middle Elast. As 
heterodox as their behefs and practices may be, they do recognize the 
fundamental importance of the "five pillars" of Islam — profession of 
faith, pra)'er, almsgiving, fasting, and the pilgrimage to Mecca — and 
attempt to lead their lives accordingly. 

Like Arabs throughout the world, the Hamadsha are patrihncal and 
patrilocal; that is, they trace their ancestry through the male line and 
live, if not under the same roof as their fathers, then in the same village 
or neighborhood. People in the newly created shantytowns, however, 
often live tens if not hundreds of miles from their fathers' homes; but 
even thev^ still hold patrilocality as an ideal which thcv have had to 
abrogate force of circumstance. Although the nuclear family tends 
to be the basic residential unit in the shantytowns — and to a lesser 
extent in the city and country — the extended family is perhaps the 

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basic social unit. Extensions beyond the extended family do not play an 
important xole in the shantyto\i^ and among the Hamadsha of the 
old quarter of Meknes; they do of course play an important zole for 
the descendants of the lE^lamidsha saints. Genealogies of die fbimer are 
shallow, seldom exceeding &n generations^ those of the latter are yery 
extended, theoretical^ all the way back to the Prophet himsdf by way 
of his daughter. PaiaUel-cousin marriage, considered the ideal marriage 
among Arabs, is rate in all the l^jhmadsha settings. 

The lather, or grandfather, as head of household, is all-poweifiiL 
He has strong and direct jural control over his wife or wives, and his 
sons (and daughters) must remain subservient to him until the very day 
of his death. No hostility whatever can be expressed toward him in Us 
presence— or, for that matter, in his absence. Sons who are already 
middle-aged, for example, will not smoke in front of their father. His 
rule is ateolute, and to foreign observers often appears arbitrary and 
harsh. There is considerable rivalry between brodiers— often directed 
against the dominant one, who is usually but not necessarily the eldest 
— and this livaliy receives its fullest expression in disputes over in- 
heritance. (According to the Koran, all sons inherit equally; daughters 
inherit a half of what their brothers receive.) Sons were traditionally 

economically d^>endait upon and respcmsible to thdr fathen, who 

foovided them with the bride-price necessary for marriage. Although 
this economic dependence is breakmg down with wage-work in Ac 
cities and in Europe, economic responsibility is not. Sons still send home 
to their fathers much of what th^ earn. 

Women are considered inferior to mesL Fathers— and mothers too 
— desire sons and not daughters, in ^te of the fact that th^ receive a 
bride price upon their daughters' marriages. Women are considered 
weak, defenseless, treacherous, and untrustworthy. They must be con- 
stantly watched, locked up even, by their husbands or male kin, and 
must always remain submissive to the aggressive dominance of their 
menfolk. (Sons at a very early age will b^|in to demand such a sub- 
missive attitude from thieir mothers.) Women are considered sexually 
insatiable by Moroccan men, at least by those of the Hamadsha's milieu. 
The virginity of an unmarried girl— a symbol of her family's honor — 
must be preserved at all costs. Wives must be prevented from amorous 
adventures. Fear of adultery is rampant. Lone women are always fair 
game. Although women are veiled and sequestered whenever possible, 
housiDg conditions in the Z'l^omn^^— shantytowns which have grown 
up on the outskirts of most Moroccan cities, in the years following the 

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arrival of the French— give at least the iUnaon that they have more 
freedom than do the womea of eitiier the old quarter or the ZediOQiL 
Polygamy is rare in all the l^^amadsha settings. Often it is desired by a 
wife who wants help in household matters, Usoally there Is rivdty 
between co-wives for then: husband's favor. Older sons are often re- 
sentful of their fathers^ second wives, or their stepmothersi who plot, 
they dmn-^ot without justification— for their own children to inherit 
at die sons' expense. 

Men must demonstrate no overt emotional d^iendence upon women; 
thi^ must show no signs of femuunity. They must strive contmuaily 
to live up to die ideal of male behavior: domination; extreme virility; 
great sensitivity to matters of honor, independence, and authority; not 
to mention, of course, adherence to the canons of Islam. These ideals 
are embodied, realistically or not, in thehr image of their fsthers. Indeed, 
the Arab male of the Qamadsha's milieu is caught in a dilenuna be- 
tween the dependence, the submission, the obsequiousness, even the 
passivity that he must show for years, often for more than half his 
lifetime, toward his father, and the independence, the dommation, the 
authority, the aggressiveness that he must demonstrate to his sons and 
womenfolk. From the conceptual point of view, he must be at once 
both male and female. It is tins dilemma that receives symbolic expres- 
sion, as we shall see, both in the hagiographic legends and in the Qa- 
madsha cures themselves. 

A few words on the nature and organization of this study are m order 
here. It is an attempt, on the one hand, to present the not-ahogether- 
taken-for-granted world of the Igbmadsha and, on the other hand, to 
uncover and make explidt the stmctnres and symbds of that wcdd. 
Its final ann is to offer an eq>lanation, albeit l^pothetical and incom- 
plete, of how the Qamadsha ^ect their cures* Substantivdy, the stady 
is necessarily biased. My interest in die Jgbmadsha as essentially curers 
not only influenced my own perception of them and the questions I 
asked them but also the manner in which I have chosen to present the 
collected material. Naturally I have tried whenever and wherever pos- 
sible to compensate for this bias, but it would be foolish to daim that 
I have overcome it. The Boasian ethnography must always remain in 
the realm of the ideal. I was fortunate enough, however, to have had a 
view of the Hamadsha which was not altogether alien to their own 
view of themselves. Certainly in the shantytowns, and to a lesser extent 
in the old quarter of Meknes, the ^^bmadsha considered themselves to 

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be primarily curers and were proudest of all of this activity. Their 
devotees were most taken with their extraordinary cures; and I am 
certain that I too was captured by their enthusiasm. 

Fiddwork itself was conducted in the standard anthropological fash- 
ion, with perhaps more than an average amount of material collected 
by free-association, imaging, and fantasizing techniques. My field a$» 
sistant, a Berber, not a member of die Qamadsha brotherhood and not 
a permanent resident of Meknes or its environs, was present at many 
of my interviews. He was very gifted, endowed with a fine ethno- 
grapl^c cnriosity and imagination and with that rare mobtrustve qual- 
ity that makes for a supofo ethnographer. He did not serve as an in- 

This study is divided into three main parts. Part One is concerned 
with the Qamadsha's past, both in historical and legendary terms. 
Chapter One treats the Sufi tradition from which the (faniadsha are in 
part derived and with which at least the most knowledgeable ^iamadsha 
recognize an affinity. It is a background chapter for the nonspedalist, 
and makes no new contribution to the study of the Islamic mystical 
tradition. Chapter Two relates what little of die history of the l^amad- 
sha is known. Chapter Three is concerned with the hagiographic leg- 
ends of the order, legends which are accepted by the ^^ainadsha and 
other Moroccans of dieir background as historically true. Indeed, it is 
the historical facticity of the legendary events that **charters** the 
madsha worldview and ritual acdvity. The legends are r^arded here 
as givens in their world and provide the Ijjamadsha with a set of sym- 
bob, or perhaps more accurately with a justification for a set of 
symbols, by which they organize and give expression to at least part of 
their life situations, the most notable being of course their ritual activ- 
ities. The analysis of the legends is carried out from a combined struc- 
tural and psychoanalytic perspective which reveals, it is hoped, not 
only underljnng themes, perhaps indicative of tensions within Moroc- 
can society and personality, but also the possible symbolic significance 
of certain elements that recur in the Hamadsha's therapeutic theory 
and receive symbolic enactment in their rituals. 

Part Two is concerned with the component institutions of the 
Hamadsha complex and their intricate interrelationships. Descriptions 
of the order in the saintly villages of Beni Rachid and Beni Ouarad, as 
well as of the teams in their urban and shantytown settings, are given 
in Chapters Four, Five, and Six. The diverse personnel of the C(Hnplex 
are described sociologically, and their relationship to one another and 
to the saints they worship is examined in detail in Chapter Seven. The 



logic of barakuy or blessing, already found to be of singiular impoitaiice 
in the legendary material, is related to the social and economic organi- 
zation of the order. A digression, not properly speaking part of the 
phenomenological orientation of this study, describes how the tjamad- 
sha serve to integrate newcomers to the city by providing them widi 
an enlarged social field and more complex interpersonal relations. 

Part Three is devoted to ^amadsha therapy. Chapter Eight, on the 
theory of therapy, attempts to present—in a manner comparable to the 
presentation of Western therapeutic practices — ^thc Hamadsha's own 
explanation of their cores. It is again concerned with the givens of their 
world. Particular attention is paid to the way in which members of the 
order, and other Moroccans, relate to the fnunj or demons, and how 
the jnun themselves are related to the saints. Baraka is found to be the 
curative element par excellence, but is in itself insufficient to effect a 
cure. Chapters Nine and Ten are devoted to a description of the coring 
rituals — the pilgrimage and the trance dance — both from the perspec- 
tive of an outside observer and from that of the actors themsdves. 
"Elements" which occur in both the legends and the theory of therapy 
arc given symbolic enactment in the rituals themselves. 

The final chapter of the book, Chapter Eleven, attempts a synthesis 
of the diverse components of the ^amadsha complex. It is predicated 
on the fact that every therapeutic system functions at all levels of 
human existence: the physiological, the psychological, and the socio- 
logical. Apart from whatever effects the Hamadsha*s rituals have on 
the physiological condition of their patients and themselves, they pro- 
vide them with a symbolic set, historically justified and socially and 
ritually reinforced, which is integrated with their social organization 
and expressive perhaps of tensions inherent in at least that segment of 
Moroccan society from which the Hamadsha are recruited. This sym- 
bolic set, it is suggested, serves to articulate and give expression equally 
to the Hamadsha's experience of their physical and social, if not their 
physiological, environment. It enables them to act out, albeit s)Tnboli- 
cally, the scars of their past, and may indeed be of therapeutic import. 
How exactly the structured synibohc set functions for the individual is 
relegated to a sequel to tliis work.