The location of madness---Spiritist psychiatry and the meaning of mental illness in contemporary Brazil

This dissertation investigates how religious belief influences professional medical ethics and choices, and the cultural adaptations of bio-medicine in non-western contexts. It is based on ethnographic research at the "Spiritist psychiatric Hospital Andre Luiz," in Belo Horizonte, Minas Gerais--Brazil and interrogates the moral underpinnings and cultural construction of psychiatric diagnosis.;Spiritist psychiatry is a professional psychiatric system that is unique to Brazil and distinctly different from secular psychiatry by integrating standard neuroscientific practice with spiritual treatment modalities. Spiritists, followers of a "modern spirit possession religion" with Euro-American origins, administer one third of private psychiatric hospitals in Brazil.;Spiritist psychiatrists claim to not only treat mental illness more successfully and effectively than standard biomedical psychiatry, but to also elucidate the causes of mental illness that originate from the moral failure of the mad person (in this or a previous life) and follow an ethic of individual responsibility. They believe that the soul cannot bear the weight of its own guilt over past wrongs, a condition that is aggravated by "obsessing spirits" (meaning disincarnate souls who attach themselves to the living to perturb them). Biological, structural and social vectors in the etiology of mental illness are regarded as secondary and as a consequence of patients' moral state.;Spiritism's spiritual etiology appears to be in contrast with contemporary neuroscientific psychiatry, which locates mental illness in the body and psychoanalytic theory, which locates mental illness in the mind. This dissertation demonstrates that in the medical practice of the Spiritist psychiatric hospital these competing and opposed epistemologies coexist and imbricate each other.;This dissertation further contextualizes Spiritist psychiatry by exploring its contingencies, conflicts and affinities with the history of psychiatry, social medicine, the imaginary of the nation and the recent democratizing proposal of the psychiatric reform movement in Brazil.