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Therapeutic Processes and Perceived Helpfulness of Dang-Ki (Chinese Shamanism) from the Symbolic Healing Perspective

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An Erratum to this article was published on 01 January 2010

Abstract

This study focuses on the therapeutic process and perceived helpfulness of dang-ki, a form of Chinese shamanistic healing, in Singapore. It aims to understand the healing symbols employed in dang-ki, whether or not patients find them helpful and whether their perceived helpfulness can be explained by the symbolic healing model (Dow, Am Anthropol 88(1):56–69, 1986; Levi-Strauss, Structural anthropology. Basic Books, New York, 1963). Although many researchers have applied this model to explain the efficacy of shamanistic healings, they did not directly provide empirical support. Furthermore, the therapeutic process of a shared clinical reality as proposed by the model may be achievable in small-scale traditional societies that are culturally more homogeneous than in contemporary societies that are culturally more diversified due to globalization and immigration. Patients may hold multidimensional health belief systems, as biomedicine and alternative healing systems coexist. Thus, it would be interesting to see the relevance and applicability of the symbolic healing model to shamanistic healing in contemporary societies. In this study, ethnographic interviews were conducted with 21 patients over three stages: immediately before and after the healing and approximately 1 month later. The dang-ki healing symbols were identified by observing the healing sessions with video recording. Results show that dang-kis normally applied more than one method to treat a given problem. These methods included words, talismans and physical manipulations. Overall, 11 patients perceived their consultations as helpful, 4 perceived their consultations as helpful but were unable to follow all recommendations, 5 were not sure of the outcome because they had yet to see any concrete results and only 1 patient considered his consultation unhelpful. Although the symbolic healing model provides a useful framework to understand perceived helpfulness, processes such as enactment of a common meaning system and symbolic transformation are complex and dynamic, and may be carried over several healing sessions.

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Notes

  1. One U.S. dollar is equivalent to 1.44 Singapore dollars (as of August 2009).

  2. In Singapore, English is one of the four official languages, including Chinese, Malay and Tamil.

  3. Given that health-related issues are the most common issues presented to dang-kis (DeBernardi 2006; Kleinman 1980), and to enable a systematic comparison across patients, only those presenting psychosocial and health-related issues were interviewed.

  4. The issue that the female patient presented during the prehealing interview was not the same as the issue she subsequently presented to the dang-ki. She also refused to take part in the posthealing interview, without giving a reason.

  5. Hokkien is the main Chinese dialect in Singapore. Although previous studies have shown that patients may need a translator to help them make sense of the unintelligible divine language used by their dang-kis (DeBernardi 2006; Kleinman 1980), that is not the case in this study. Even though the use of an unintelligible language may be symbolic proof of the presence of the divine force—dang-ki as a god incarnate—the use of a common language between the healer and the patient may also contribute to a positive healing relationship.

  6. In all excerpts, P refers to patient, R refers to researcher (the first author), and DK refers to dang-ki. Interviews in Chinese were translated into English.

  7. The dang-kis’ EMs were elicited during their consultations. It is impossible to directly interview them for their EMs because they claim to forget their experiences after the spirit possession. It is believed that during the possession the dang-ki’s soul has left for another realm or his soul remains but is inactive in his body. Since the entity conducting the healing is the god rather than the dang-ki, the dang-ki has no knowledge about the healing process.

  8. Jin, a TCM concept, refers to a fibrous cord extending from a muscle (Ou 1988, p. 475).

References

  • Ackerman, S. E. 2001 Divine Contracts: Chinese New Religious and Shamanic Movements in Contemporary Malaysia. Journal of Contemporary Religious 16(3):293–311.

    Article  Google Scholar 

  • Ahern, E. M. 1975 Sacred and Secular Medicine in a Taiwan Village: A Study of Cosmological Disorders. Pp. 91–113 in Medicine in Chinese Cultures: Comparative Studies of Health Care in Chinese and Other Societies. A. Kleinman, P. Kunstadter, E. R. Alexander, and J. L. Gale, eds. Bethesda, MD: National Institutes of Health.

    Google Scholar 

  • Atkinson, J. M. 1987 The Effectiveness of Shamans in an Indonesian Ritual. American Anthropologist, 89(2):342–355.

    Article  Google Scholar 

  • Balzer, M. M. 1996 Shamanism. Pp. 1182–1186 in Encyclopedia of Cultural Anthropology (Vol. 4). D. Levinson and M. Ember, eds. New York: Henry Holt.

    Google Scholar 

  • Baruss, I. 2003 Alterations of Consciousness: An Empirical Analysis for Social Scientists. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Beinfield, H., and E. Korngold 1991 Between Heaven and Earth: A Guide to Chinese Medicine. New York: Ballantine Books.

    Google Scholar 

  • Castillo, R. J. 2001 Lessons from Folk Healing Practices. Pp. 81–101 in Culture and Psychotherapy: A Guide to Clinical Practice W. S. Tseng and J. Streltzer, eds. Washington, DC: American Psychiatric Association Press.

    Google Scholar 

  • Chan, M. 2006 Ritual Is Theater, Theater Is Ritual. Tang-ki: Chinese Spirit Medium Worship. Singapore: SNP.

    Google Scholar 

  • Chong, S. A., Mythily, A. Lum, Y. H. Chan, and P. McGorry, P. 2005 Determinants of Duration of Untreated Psychosis and the Pathway to Care in Singapore. International Journal of Social Psychiatry 51(1):55–62.

    Article  Google Scholar 

  • Costantino, G., R. G. Malgady, and L. H. Rogler 1986 Cuento Therapy: A Culturally Sensitive Modality for Puerto Rican Children. Journal of Consulting and Clinical Psychology 54(5):639–645.

    Article  Google Scholar 

  • Csordas, T. J. 1994 The Sacred Self: A Cultural Phenomenology of Charismatic Healing. Berkeley: University of California Press.

    Google Scholar 

  • Csordas, T. J., and E. Lewton 1998 Practice, Performance, and Experience in Ritual Healing. Transcultural Psychiatry, 35(4):435–512.

    Article  Google Scholar 

  • D’Anglure, B. S. 1997 Shamanism. Pp. 504–508 in Encyclopedia of Social and Cultural Anthropology A. Barnard and J. Spencer, eds. London: Routledge.

    Google Scholar 

  • DeBernardi, J. 2006 The Way That Lives in the Heart: Chinese Popular Religion and Spirit Mediums in Penang, Malaysia. Palo Alto, CA: Stanford University Press.

    Google Scholar 

  • Desjarlais, R. R. 1989 Healing through Images: The Magical Flight and Healing Geography of Nepali Shamans. Ethos 17(3):289–307.

    Article  Google Scholar 

  • Dow, J. 1986 Universal Aspects of Symbolic Healing: A Theoretical Synthesis. American Anthropologist 88(1):56–69.

    Article  Google Scholar 

  • Elliott, A. F. A. 1955 Chinese Spirit-Medium Cults in Singapore. London: Athlone Press.

    Google Scholar 

  • Fidler, R. C. 1993 Spirit Possession as Exculpation, with Examples from the Sarawak Chinese. Pp. 207–232 in The Seen and the Unseen: Shamanism, Mediumship and Possession in Borneo. Borneo Research Council Monograph Series (Vol. 2). R. L. Winzeler, ed. Phillips, ME: Borneo Research Council.

    Google Scholar 

  • Finkler, K. 1980 Non-medical Treatments and Their Outcomes. Culture, Medicine and Psychiatry, 4:271–310.

    Article  Google Scholar 

  • Finkler, K. 1981 Non-medical Treatments and Their Outcomes. Part Two: Focus on Adherents of Spiritualism. Culture, Medicine and Psychiatry 5:65–103.

    Article  Google Scholar 

  • Finkler, K. 2004 Traditional Healers in Mexico: The Effectiveness of Spiritual Practices. Pp. 161– 174 in Handbook of Culture, Therapy, and Healing.U. P. Gielen, J. M. Fish, and J. G. Draguns, eds. Hillsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Frank, J. D., and J. B. Frank 1991 Persuasion and Healing: A Comparative Study of Psychotherapy. 3rd ed. Baltimore: John Hopkins University.

    Google Scholar 

  • Freeman, P. 1998 A Festival for the Dead in Japan. Transcultural Psychiatry 35(4):551–555.

    Article  Google Scholar 

  • Gaines, A. D., ed., 1992 Ethnopsychiatry: The Cultural Construction of Professional and Folk Psychiatries. Albany: State University of New York Press.

    Google Scholar 

  • Good, B. J. 1994 Medicine, Rationality, and Experience: An Anthropological Perspective. Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • Groleau, D., A. Young, and L. J. Kirmayer 2006 The McGill Illness Narrative Interview (MINI): An Interview Schedule to Elicit Meanings and Modes of Reasoning Related to Illness Experience. Transcultural Psychiatry 43(4):671–691.

    Article  Google Scholar 

  • Heinze, R. I. 1997 Trance and Healing in Southeast Asia Today. Thailand: White Lotus Press.

    Google Scholar 

  • Helms, J. E., and D. A. Cook 1999 Using Race and Culture in Counseling and Psychotherapy: Theory and Process. Boston: Allyn and Bacon.

    Google Scholar 

  • Holbrook, B. 1975 Chinese Psychosocial Medicine. Doctor and Dang-ki: An Inter-cultural Analysis. Bulletin of the Institute of Ethnology, Academia, Sinica 37:85–111.

    Google Scholar 

  • Jakobsen, M. D. 1999 Shamanism: Traditional and Contemporary Approaches to the Mastery of Spirits and Healing. New York: Berghahn Books.

    Google Scholar 

  • Kapferer, B. 2004 Ritual Dynamics and Virtual Practice: Beyond Representation and Meaning. Social Analysis 48(2):35–54.

    Article  Google Scholar 

  • Kirmayer, L. J. 1993 Healing and the Invention of Metaphor: The Effectiveness of Symbols Revisited. Culture, Medicine and Psychiatry 17:161–195.

    Article  Google Scholar 

  • Kirmayer, L. J. 2003 Asklepian Dreams: The Ethos of the Wounded-Healer in the Clinical Encounter. Transcultural Psychiatry 40(2):248–277.

    Article  Google Scholar 

  • Kirmayer, L. J. 2004 The Cultural Diversity of Healing: Meaning, Metaphor and Mechanism. British Medical Bulletin 69:33–48.

    Article  Google Scholar 

  • Kleinman, A. 1980 Patients and Healers in the Context of Culture. Berkeley: University of California Press.

    Google Scholar 

  • Kleinman, A., and J. L. Gale 1982 Patients Treated by Physicians and Folk Healers: A Comparative Outcome Study in Taiwan. Culture, Medicine and Psychiatry 6:405–423.

    Article  Google Scholar 

  • Kleinman, A., and D. Seeman 2000 Personal Experience of Illness. Pp. 230–242 in Handbook of Social Studies in Health and Medicine. G. L. Albrecht, R. Fitzpatrick, and S. C. Scrimshaw, eds. London: Sage.

    Google Scholar 

  • Kleinman, A., and L. H. Sung 1979 Why Do Indigenous Practitioners Successfully Heal? Social Science and Medicine 13B:7–26.

    Google Scholar 

  • Kreisman, J. J. 1975 The Curandero’s Apprentice: A Therapeutic Integration of Folk and Medical Healing. American Journal of Psychiatry 132(1):81–83.

    Google Scholar 

  • Krippner, S. C. 2002 Conflicting Perspectives on Shamans and Shamanism: Points and Counterpoints. American Psychologist 57(11):962–977.

    Article  Google Scholar 

  • Krippner, S. C., and J. Achterberg 2000 Anomalous Healing Experiences. Pp. 353–396 in Varieties of Anomalous Experience: Examining the Scientific Evidence E. Cardena, S. J. Lynn, and S. Krippner, eds. Washington DC: American Psychological Association.

    Chapter  Google Scholar 

  • Laird, J. 1984 Sorcerers, Shamans, and Social Workers: The Use of Ritual in Social Work Practice. Social Work March–April: 123–129.

  • Laufer, B. 1917 Origin of the Word Shaman. American Anthropologist 19(3):361–371.

    Article  Google Scholar 

  • Lee, B. O. 2002 Chinese Indigenous Psychotherapies in Singapore. Counseling and Psychotherapy Research 2(10):2–10.

    Article  Google Scholar 

  • Lee, B. O. 2006 Clients as Co-healers. Pp. 56–74 in Reflections on Counseling: Developing Practice in Schools H. W. E. Lui and S. S. Wong, eds. Singapore: Pearson Prentice Hall.

    Google Scholar 

  • Lee, R. L. M. 1986 Continuity and Change in Chinese Spirit Mediumship in Urban Malaysia. Bijdragen tot de Taal, Land-en Volkenkunde 142(2/3):198–214.

    Google Scholar 

  • Levi-Strauss, C. 1963 Structural Anthropology. New York: Basic Books.

    Google Scholar 

  • Li, F. Y. 2003 Shou-jing: A Magico-medical Phenomenon. Pp. 280–328 in Taoist Studies and the Religious Culture of China. Z. T. Li, ed. Taiwan: Zhong-Hua.

    Google Scholar 

  • Lin, K. M. 1981 Traditional Chinese Medicine Beliefs and Their Relevance for Mental Illness and Psychiatry. Pp. 25–111 in Normal and Abnormal Behavior in Chinese Culture A. Kleinman and Y. L. Tseng, eds. Dordrecht: D. Reidel.

    Google Scholar 

  • Lindquist, G. 2007 Beyond Meaning: Globalization and the Icons of Power. Anthropology and Medicine 14(3):307–320.

    Article  Google Scholar 

  • Littlewood, R., and S. Dein 1995 The Effectiveness of Words: Religion and Healing among the Lubravitch of Stamford Hill. Culture, Medicine and Psychiatry 19:339–383.

    Article  Google Scholar 

  • Miles, M. B., and A. M. Huberman 1994 Qualitative Data Analysis: An Expanded Sourcebook. 2nd ed. London: Sage.

    Google Scholar 

  • Moerman, D. E. (2002) Explanatory Mechanisms for Placebo Effects: Cultural Influences and the Meaning Response. In: H. A. Guess, A. Kleinman, J. W. Kusek, and L. W. Engel (eds) The Science of the Placebo: Towards An Interdisciplinary Research Agenda. BMJ Books, London, pp. 77–107

    Google Scholar 

  • Muhr, T., and S. Friese 2004 User’s Manual for ATLAS.ti 50. 2nd ed. Berlin: Scientific Software Development.

    Google Scholar 

  • Nguyen, T. H. 2008 Yin Illness: Its Diagnosis and Healing within Len Dong (Spirit Possession) Rituals of the Viet. Asian Ethnology 67(2):305–321.

    Google Scholar 

  • Obeyesekere, G. 1985 Symbolic Foods: Pregnancy Cravings and the Envious Female. International Journal of Psychology 20:637–662.

    Article  Google Scholar 

  • Obeyesekere, G. 1990 The Work of Culture: Symbolic Transformation in Psychoanalysis and Anthropology. Chicago: University of Chicago Press.

    Google Scholar 

  • Ou, M. 1988 Chinese-English Dictionary of Traditional Chinese Medicine. Hong Kong: Intellectual.

    Google Scholar 

  • Parks, F. M. 2003 The Role of African American Folk Beliefs in the Modern Therapeutic Process. Clinical Psychology: Science and Practice 10(4):456–457.

    Article  Google Scholar 

  • Peacock, J. 1984 Symbolic and Psychological Anthropology: The Case of Pentecostal Faith Healing. Ethos 12(1):37–53.

    Article  Google Scholar 

  • Quah, S. R. 1989 The Triumph of Practicality: Tradition and Modernity in Health Care Utilization in Selected Asian Countries. Singapore: Institute of Southeast Asian Studies.

    Google Scholar 

  • Schieffelin, E. 1996 On Failure and Performance: Throwing the Medium Out of the Séance. Pp. 59–90 in The Performance of Healing C. Laderman and M. Roseman, eds. New York: Routledge.

    Google Scholar 

  • Sherzer, J. 1983 Kuna Ways of Speaking: An Ethnographic Perspective. Austin: University of Texas.

    Google Scholar 

  • Sue, D. W., and D. Sue 2008 Counseling the Culturally Diverse: Theory and Practice. 5th ed. New York: John Wiley and Sons.

    Google Scholar 

  • Tseng, W. S. 1978 Traditional and Modern Psychiatric Care in Taiwan. Pp. 311-328 in Culture and Healing in Asian Societies: Anthropological, Psychiatric and Public Health Studies. A. Kleinman, P. Kunstadter, E. R. Alexander, and J. L. Gate, eds. Cambridge: Schenkman.

    Google Scholar 

  • Turner, V. 1973 Symbols in African Ritual. Science 179(4078):1100–1105.

    Article  Google Scholar 

  • Turner, V. 1977 Process, System, and Symbols: A New Anthropological Synthesis. Daedalus, Discoveries and Interpretations: Studies in Contemporary Scholarship 1(3):61–80.

    Google Scholar 

  • Turner, V. 1979 Frame, Flow and Reflection: Ritual and Drama as Public Liminality. Japanese Journal of Religious Studies 6/4:465–499.

    Google Scholar 

  • Vitebsky, P. 2001 Shamanism. Oklahoma: University of Oklahoma Press.

    Google Scholar 

  • Walach, H., and W. B. Jonas 2004 Placebo Research: The Evidence Based for Harnessing Self-Healing Capacities. Journal of Alternative and Complementary Medicine 10 (Suppl 1):S-103–S-112.

    Article  Google Scholar 

  • Waldram, J. B. 2000 The Efficacy of Traditional Medicine: Current Theoretical and Methodological Issues. Medical Anthropology Quarterly 14(4):603–625.

    Article  Google Scholar 

  • Welch, J. S. 2003 Ritual in Western Medicine and Its Role in Placebo Healing. Journal of Religion and Health 42(1):21–33.

    Article  Google Scholar 

  • Winkerlman, M. 2000 Shamanism: The Neural Ecology of Consciousness and Healing. London: Bergin & Garvey.

    Google Scholar 

  • Yeh, C. J., C. D. Hunter, A. Madan-Bahel, L. Chiang, and A. K. Arora 2004 Indigenous and Interdependent Perspectives of Healing: Implications for Counseling and Research. Journal of Counseling and Development 82(4):410–19.

    Google Scholar 

  • Young, A. 1976 Some Implications of Medical Beliefs and Practices for Social Anthropology. American Anthropologist 78(1):5–24.

    Article  Google Scholar 

  • Zhang, Y.Q. 1996 An Anthropological Study of the Holy Medicine Prescribed by Dang-ki in Taiwan. Unpublished Master’s Dissertation, Qinhua University.

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Acknowledgments

We are deeply grateful to the following people (in alphabetical order) for their help during the fieldwork: C. W. Chan, Margaret Chan, Aaron Choo, Timothy Pwee, Jave Wu, Victor Yue and members of the Singapore Chinese Heritage Group. We also owe a debt of thanks to all participants (dang-kis, helpers, patients and attendees), whose personal stories and healing experiences have enlightened and touched us. Without them, this study would not have been possible. Finally, we thank the anonymous reviewers for their invaluable suggestions.

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Authors and Affiliations

  1. National Institute of Education, Nanyang Technological University, No. 1, Nanyang Walk, Singapore, 637616, Singapore

    Boon-Ooi Lee

  2. McGill University, 845 Sherbrooke Street, West Montreal, QC, H3A 2T5, Canada

    Laurence J. Kirmayer & Danielle Groleau

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  1. Boon-Ooi Lee
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  2. Laurence J. Kirmayer
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Correspondence to Boon-Ooi Lee.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s11013-009-9168-9

Appendix

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See Appendix Table 3.

Table 3 Explanatory models, expectations, healing symbols and patients’ responses
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Lee, BO., Kirmayer, L.J. & Groleau, D. Therapeutic Processes and Perceived Helpfulness of Dang-Ki (Chinese Shamanism) from the Symbolic Healing Perspective. Cult Med Psychiatry 34, 56–105 (2010). https://doi.org/10.1007/s11013-009-9161-3

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