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CT for a curse?
Jim Pretzer · 3/3/99 at 9:32 PM ET
I can almost hear Albert Ellis' response (imagine a gravelly voice saying "A curse??? That's BULLSHIT!"). However, I try not to stage a frontal assault on the client's belief system and not to argue with their priest if I can help it.
Medical anthropologists emphasize the value of developing and understanding of the individual's "explanatory system" as a first step towards intervening effectively when the practitioner and the patient have incompatible understandings of the problem being treated. To do this I would start with questions such as:
- "What do you call this problem?"
- "How does someone get _______________?"
- "If someone gets _______________ what happens then?"
- "How serious is ________________?"
- "If someone gets _________________ what should they do?"
- "Is there any way to cure _______________?"
The medical anthropologists argue that once you understand the individual's beliefs about the problem, you have a better chance of negotiating a shared understanding and being able to intervene effectively.
Once I know that the individual believes that the problem is due to a curse and that their priest (and possibly members of their family and their community) supports this view, I have a number of options. For example:
- I could use guided discovery to identify other possible explanations of the problem and then help the client consider whether the available evidence is most consistent the idea that the problem is due to a curse or is more consistent with my understanding of the problem. We could even use "behavioral experiments" to test which explanation is most consistent with day-to-day reality.
- I could find out what sort of intervention approach is supposed to work for a curse (i.e. prayer, rituals, exorcism, or whatever) and find out how well that has worked so far. I could then outline the intervention approach that I would suggest. The client could try each approach and see which works best. (If an exorcism or whatever really solves the problem, I'll be happy that the problem is solved. However, the person probably wouldn't be talking to me in the first place if the exorcism had worked.)
- I could find out if there is any harm in trying the intervention approach which I would recommend in addition to their doing what the priest would recommend. If not, why not try both approaches? Perhaps there are even some ways in which the person's religious practices can be useful in accomplishing some of the goals I have in mind. With a depressed individual, increasing their attendance at religious services can be a useful way to increase their activity level and this is likely to improve their mood somewhat. With a socially anxious individual, taking a more active role in services can be a useful way for them to face their fears. For an individual who is plagued by guilt, talking with their religious leader or attending confession can sometimes be useful in alleviating the guilt. Of course, these options are less risky if I know that their religious leader is fairly reasonable.
Generally, I prefer option three. If that's not an feasible, I try option two. If possible, I avoid option number one. I'm pretty good, but if I directly challenge their priest or their family, I may well not win.
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