Shortly after completing my training in family therapy at the Ackerman Family Institute, I returned to Kisii, Kenya for a few months after being there ten years earlier as a Peace Corps volunteer. What I learned from my time in these villages was that the traditional approach to medical and psychological treatment was complex, consisting of herbalists prescribing compounds from locally grown herbs, good and evil witches, and surgeons removing part of the skull from fully awake patients as well as grafting goat ribs to humans. In a previous blog postI wrote about observing the operation of clocks under a tree; the patient was without anesthesia and antiseptic.
Visit a fortune teller in Kenya
On my second visit to Western Kenya, I witnessed another part of the traditional approach to disease control – this time not as an observer, but a client, if you will. I went to a fortune teller, a person who diagnoses personal problems and prescribes remedies.
As anthropologist Sarah LeVine writes, in Kisii fortune teller’s job “determining (the cause of) calamities and determining the appropriate ritual reversal or counterattack.” A friend of mine, who was my translator, arranged for me to meet a middle-aged woman who practiced fortune-telling. We waited outside Kemunto’s hut as he prepared himself for my visit. I heard unusual noises from inside. It was a fortune teller, my friend said. He speaks in a different voice during the fortune-telling.
After waiting for a while, he invited us into a windowless, unlit room filled with smoke from a three-stone fire in the center of the dirt floor. She sat on a stool wearing a beaded cap and asked me questions.
Kemunto misunderstood my intention, so instead of interviewing me, he asked me questions. He would often throw millet straw on the three-stone well placed in the ground, which would catch fire. I could hardly see that more smoke filled the bright room. He continued using his amazing voice, speaking while breathing in, not out.
Through his constant questioning, he found out that I have children who occasionally have nightmares, that my wife once had a bicycle accident, that I sometimes have an upset stomach, and that there are thunderstorms around my house on Long Island. After about half an hour, she offered her analysis of the causes of my various afflictions: Living among those not of my tribe. It was stupid because I was vulnerable to alien magic. His solution was to gather my extended family and offer a black goat for a sacrificial feast. (When I told him that it was not my custom to sacrifice to my ancestors, he looked at me with pity, as if that explained everything.)
Placebo effect
Did Kemunto’s fortune telling work? He made me express some, admittedly minor, problems. Maybe someone who believes in this process will immediately express his problem. I don’t know. However, divination must have some influence; otherwise, its appeal is lost. Perhaps it is considered a cultural practice because of its potential effectiveness that can be placebo effect. As in a article in Michigan Medicine, “Research shows that placebo effect formed by positive expectations, the provider-patient relationship, and the rituals associated with receiving medical care.”
Those who employ fortune-tellers bring to this trip positive expectations and confidence in the person performing the fortune-telling. They are focused on a healing ritual that brings the community together. This is consistent with a family systems approach that focuses on strengthening relationships rather than on individual feelings and understanding. In this case, it is the basic act of getting people around food without criticism or blame.
I am not aware of any research that looks at the effectiveness of divination in Kisii. But this approach is consistent with factors that contribute to placebo effectiveness. Of course, I don’t know how many people followed her instructions, but I suspect most of them did.
If so, how is it effective? psychotherapy? One meta-analysis Randomized controlled trials of psychotherapies have concluded that their overall effectiveness is relatively small. My experience in Kenya leads me to believe that if one believes in the power of diviners, established remedies such as Western psychotherapies can be successful in solving client presenting problems.
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