Special Issue: Religion, Healing, and Public Health

Between Patient and Healer

Four anthropological observations

By Peter J. Brown, Professor of Anthropology, Center for Health, Culture, and Society


What Do You Believe In?
Special, Guest-Edited Issue on Religion, Healing, ad Public Health

"You can't hide from religion in Georgia. If you don't go after it with a positive agenda, it will come after you."
Gary Gunderson, Director, Interfaith Health Program

"To understand our patients fully, we need to understand their beliefs, or we will not be effective as their healers."
Lori Arviso Alvord, Assistant Professor of Surgery and Associate Dean for Student Affairs, Dartmouth Medical School

New Perspectives on Health and Healing
Can Science and Religion Work Together?

An integrated exploration
A three-pronged approach to health, healing, and spirituality

A cross-cultural perspective
P. Venugopala Rao, Associate Professor of Physics

Mrs. Bradley's body
Carla Gober, Registered Nurse and Doctoral Candidate, Graduate Division of Religion

Spirituality and Modern Medicine
Science on a wing and prayer?

Between Patient and Healer
Four anthropological observations

Return to Contents

As a medical anthropologist, I teach about such topics as cross-cultural medical care, the social constructions of biomedicine, and “ethnomedical” systems, or medical systems of non-western cultures. The connections between religion, healing, and health are, therefore, not a new area of intellectual inquiry for me. With my interest in biocultural evolution, I tend to think that religion, as a cross-cultural universal, must have old and adaptive functions in our species’ prehistoric past.

In many societies, it is impossible to separate religion from medicine (or ethnomedicine) because they intertwine beliefs and practices aimed, in large measure, towards curing and maintaining health. Indeed, hidden within the center of the modern and scientifically sophisticated edifice of biomedicine is the ancient and powerful social interaction of patient and healer, which is based on knowledge, trust, and the ritual manipulation of symbols of curing. The anthropologist and physician Arthur Klienman has called this therapeutic interaction between healer and patient “medicine’s symbolic reality.” No matter how complex the science of biomedicine becomes, from the patient’s point of view there is nothing quite as powerful as his belief in the doctor’s knowledge, experience, and connections.

With that background in mind, I was aware as a participant in last fall’s faculty seminar on Religion, Healing, and Public Health of the cross-cultural narrowness of much research on religion and health (and the opportunities for medical anthropological research in this regard). It was therefore a pleasure to explore critically the current research along with faculty and graduate students from a wide
variety of fields. Our discussions inspired me to think about four related topics: the problems of definitions, the material conditions of health, the creation of meaning for our existence, and the taboo on personal spiritual issues in the academy.

I was not surprised that academic discussions of the problems of definitions—particularly of health and of religion—were central to the seminar. The definitions of both religion and health are slippery. Each re-search project we considered could be subjected to strong criticism of the compromises of operational definitions. Can church attendance be used as a measure of religiosity? Is survival time after a diagnosis a measure of health? One theologian in the seminar proposed, “health is really the ability to accept the situations that have been given us,” and that it had little to do with objective medical conditions. Part of the research question is whether there should be a dose-effect in the religion-health connection. Members of the seminar agreed that sometimes people carry religion to unhealthy extremes, often under a charismatic leader. But the response to historical examples was that they were perversions of religion. As an anthropologist, I sometimes suspected that questions of the definitions reflected unconscious ethnocentrisms.

Perhaps in part because of these problematic definitions, the material prerequisites for health often went unmentioned in the research we considered (most of which involved particular types of societies in the United States), and the relationship between inequality and health was taken for granted. In approaching these topics, it is important to reiterate continually the necessary material conditions for health. These conditions include secure access to appropriate food, clean water, adequate housing and hygiene, and basic health services and knowledge (both preventive and curative). Because ours is such a rich society, we easily take these things for granted. But high levels of disease are correlated everywhere with poverty, socioeconomic inequality, and “structural violence.” As such, the quest for improved population health must first involve the struggle for social justice and human rights. Historically, religious institutions have played a variety of roles (both helpful and harmful) in efforts to decrease poverty and increase social justice—prerequisites for health.

One reason for this historical involvement of religious institutions may be that humans need to create meaning for their existence. Since this need is universal, it is probably evolutionarily old and genetically driven. We share our systems of meaning with our social group, and we pass them down to our children. An old-fashioned anthropological definition of religion is the “belief in supernatural beings or forces and the rituals associated with those beliefs.” These beliefs help us explain, understand, and survive through misfortune, illness, and death. They benefit society in terms of cohesion and cooperation. At the same time, these beliefs and rituals provide an outlet for personal anxiety, as well as a source of hope and optimism, which have biological benefits. It is not surprising to read research results that say it is unhealthy to be without a raison
; such individuals are socially isolated, psychologically depressed, and vulnerable to disease. We as humans need to create an illusion of control over our lives and environment, and rituals allow us to create such illusions. The question is, does it matter what we believe in? Does it matter which social groups we belong to? Are religion and faith communities better in regard to the promotion of health and hope than corporations, bowling leagues, fan clubs, or even the Ku Klux Klan?

Finally, hearing the personal narratives—of intellectual trajectories and life experiences—that seminar members shared (see examples in this issue) provided some of the most interesting moments in the seminar and made me reflect on our own social group in the academy. These statements explained “how I came to this seminar table,” and I realized how little I knew about the religious beliefs, backgrounds, and practices of my colleagues. It is almost as if in the culture of the modern academy (or at least my little corner of it) discussions of personal spiritual issues are taboo. There is an assumption that most of us working in the university are atheists or agnostics—and certainly not regular church-goers. In this regard, academic work has an assumed secular culture, which might influence our epistemologies in unrecognized ways. Personally, I was surprised by my own lack of introspection about how my religious upbringing and socio-spiritual experiences had influenced my academic career and my current intellectual worldview. The topic “Religion, Healing, and Public Health” is a low prestige area of medical and health research because investigators are assumed to have an ideological agenda. The research is suspect; the operational definitions difficult; and funding agencies are not necessarily supportive. The situation is unfortunate, because this is a rich and important area for exploration into the intersection of health, culture, and society.