O outro lado: Candomble, psychiatry and discourse in Bahia, Brazil

In this thesis, I examine the ways in which the poor in the urban community of Salvador, Bahia, Brazil, resolve problems of mental health. I focus on the Afro-Brazilian religion, Candomble, and public care psychiatry as oppositional healing systems. These two healing systems produce opposing diagnoses but also complementary, parallel and overlapping practices, sharing clients and patients, metaphors, signifiers, practitioners, and sometimes spaces. I outline and analyze the complexities between frames of illness and wellness in Bahia as negotiated by local actors.; My thesis shaped itself into a challenge to notions of illness and to the discourse of global scientific healing processes. This thesis, therefore is also about discourse and how putatively "dominant" discourse is but one discourse among many. How "dominant" notions of illness and wellness may not be as effective as local notions. How the poor, even as they are excluded from the discourse of the higher classes and of adequate medical and psychiatric care, retain their own local ways of thinking about illness and wellness which are no less powerful and complex than the latest scientific theories about the mind's afflictions. How the "magical" can be rational while the discourse of the "rational" can assume the authoritative power of the magical in the context of structural and social inequality.; My thesis thus evolved into an analysis of the ways in which poor Bahians think and talk about illness and wellness, and the political and social economy of health-seeking behavior in a local economy of available choices. Crucial aspects of this analysis include an examination of racial politics in Bahia as well as socioeconomic correlations to racial realities. An entrenched class hierarchy, low social mobility, and poor educational opportunities combine to exclude poor Bahians from global discourse about psychiatric care, particularly biomedical psychiatric care, even when that discourse concerns their own case histories. On the other hand, the high value placed on religion and spirituality in Bahia in general opens a space in which spiritual meaning is granted a prominent position in local ways of understanding life events, coincidences, and illness. This thesis is about that space.