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University Micr6films International 300 N INFORMATION TO USERS This was produced from a copy of a document sent to us for microfilming. While the most advanced technological means to photograph and reproduce this document have been used, the quality is heavily dependent upon the quality of the material submitted. The following explanation of techniques is provided to help you understand markings or notations which may appear on this reproduction. 1. The sign or "target" for pages apparently lacking from the document photographed is "Missing Page(s)". If it was possible to obtain the missing page(s) or section, they are spliced into the film along with adjacent pages. This may have necessitated cutting through an image and duplicating adjacent pages to assure you of complete continuity. 2. When an image on the fllm is obliterated with a round black mark it is an indication that the film inspector noticed either blurred copy because of movement during exposure, or duplicate copy. 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ZEEB ROAD, ANN ARBOR, MI 48106 18 BEDFORD ROW, LONDON we1 R 4EJ, ENGLAND SNYDER, PATRICIA J~AN 'OLK HEALING IN HONOLULU, HAWAII, UNIVERSITY O~ HAWAII~ PH.D" 191. COPR. 1979 SNYDER, PATRICIA JEAN University Micrc:iilms /rianationaJ 300 N. ZEEB ROAD, ANN ARBOR, MI 4Bl06 o 1979 PATRICIA JEAN SNYDER ALL RIGHTS RESERVED FOLK·HEALING IN HONOLULU, HAWAII A DISSERTATION SUBMITTED TO THE GRP~UATE DIVISION OF THE UNIVERSITY OF HAWAII IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN A1~THROPOLOGY }1AY 1979 By Patricia Jean Snyder Dissertation Committee: Richard W. Lieban, Chairman R. Warwick Armstrong Stephen T. Boggs William P. Lebra Thomas W. Maretzki iii ABSTRACT The research presented in this dissertation focuses on three primary areas of interest. The first is the phenomenon of folk healing within the urban United States context. The extent to which folk healers are functioning in the urban and suburban areas of Honolulu, the individual and ethnic group characteristics of the healers, and the types of services they offered are ascer­ tained. The second concern is with the role of folk healing as one aspect of the total medical system in Hawaii. The relationship of folk healing to the professional and popular sectors of the medical system, the healer's inter­ actions with clients, their processes of healing, and their sources of referral and use of other resources are examined. The third interest is in the ethnicity of the healers and the relevance this has to their work and to their clients. Thirty-five healers from eight ethnic groups are the subjects of this study. Four major sources of data are used: 1) interviews with healers; 2) observation and participation in healer-client interactions; 3) interviews with clients; and 4) interviews with people knowledgeable about ethnicity or healing and attendance at lectures and meetings on these subjects. Semi-structured interviews with healers and clients were based on specific categories of interest such as demographic characteristics, treatment methods, healer-client relationships, and beliefs about folk iv healing. The interactional processes occurring in healing encounters are delineated and include such events as the healers' handling of difficult clients and the clients' strategies for obtaining help. Folk healing as one sector of the medical system is seen as a cultural adaptation to ill health, and its adaptive efficacy is assessed. The adaptations made by individual healers to their social environment is viewed as an important means of maintaining their viability in the urban United States context. Evidence that folk healing in Hawaii is not a static condition, that there is considerable heterogeneity within anyone ethnic group, and that there is eclecticism and similarities across ethnic groups in the treatment and preventive services offered by healers, is presented. One hundred presenting complaints of physical problems and one hundred presenting complaints of psycho­ social problems are analyzed. This reveals that 90% of the clients with physical complaints had already consulted a physician, while 90% of those with psychosocial complaints went first to a healer. The majority of these psychosocial difficulties can be classified as everyday adjustment-type problems. The implications of these findings, including the evidence that the healers, despite a variety of styles~ have more personal involvement with their clients, are considered. v The finding that clients are crossing ethnic boundaries for preventive and therapeutic services is discussed in terms of individual behavior, cross-cultural counseling relationships, and ethnic identities. The strengths and weaknesses of folk healing as one sector of the medical system are analyzed. Its formal and informal relationships with the other two sectors are considered along with clients' and healers' views about the utiliza­ tion of folk healing. vi TABLE OF CONTENTS ABSTRACT ... iii LIST OF TABLES . viii CHAPTER I. INTRODUCTION Adaptation and the Medical System. 3 Components of the Medical System ... 7 Adaptation and Folk Healing. 14 Summation. 23 CHAPTER II. THE RESEARCH DESIGN The Setting. 25 Definition of Folk Healer. 35 Data Collection. 38 Other Methodological Considerations. 47 CHAPTER III. AN INTRODUCTION TO THE HEALERS Hawaiians..... 52 Caucasians .... 61 Chinese. ....... 66 Portuguese 71 Japanese. 73 Okinawans .. 79 Koreans. 81 Filipinos. 82 Samoans. 84 Vietnamese 86 Summation. 87 CHAPTER IV. THE FRAMEWORK FOR HEALING The Healers' Settings.... 91 Demographic Characteristics.. 97 Qualifications .... 106 Source of Referrals .. 113 Use of Other Resources ....... 118 Summation. ...... 123 CHAPTER V. THE PROCESS OF HEALING Criteria for Acceptance. ... 127 Establishment of a Therapuetic Relationship . 132 Diagnosis and Treatment. .. 138 Prevention .......... 150 vii Collection of Fees . 156 Summation. ...... 159 CHAPTER VI. THE CLIENTS Demographic Characteristics. 165 Visits to Healers. 170 Presenting Complaints: Physical. .. 174 Presenting Complaints: Psychosocial. 181 Relationships with Healers ..... ln6 Surrnnation. 193 CHAPTER VII. CONCLUSION: MAKING SENSE OF FOLK HEALING The Healers' Views. 197 The Clients' Views. 204 Folk Healing and Adaptation. 211 Folk Healing and the Urban Context . 219 Folk Healing and the Medical System. 225 Folk Healing and Ethnicity . 231 LITERATURE CITED . 236 viii LIST OF TABLES Table Page 1 Ethnic Groups on Oahu. 30 2 Ethnicity of Healers Interviewed . 40 3 Ethnic Group Representation of Oahu Population and Healers Interviewed . 89 4 Age and Sex of Healers by Ethnic Group . 98 5 Marital Status of Healers by Sex 99 6 Healers' Bases for Diagnosis and Treatment by Ethnic Group. .... .. ..... 139 1 CHAPTER I. INTRODUCTION Several years ago in Hawaii, a teenager with complaints of difficulty in walking was referred to a psychiatric clinic after a medical examination revealed no physical basis for the problem. The patient and parent, who were identified as being of Part-Hawaiian ancestry, described multiple recent family difficulties during the intial inter­ view, but a few weeks later reported considerable improvement in the patient's ability to walk. They also stated that they had gone to another island to consult a Portuguese healer who told them that a jealous person had cursed the family and that the evil influence would be removed by the healer's prayers. In the case of another Part-Hawaiian with long­ standing marital and family problems which were not respond­ ing to clinic treatment, it was suggested that Hawaiian therapeutic techniques be tried. The person refused on the basis that "if you don't believe, it won't work, just like counseling." As the therapist in both instances, I was presented with evidence of the concomitant use of conventional and folk healing, of the crossing of ethnic lines to obtain help, and of the parallels between the two types of healing which restricted their efficacy, at least in some instances, to believers. Although it was considerably more common for the clinic staff to hear about the use of popular advice from 2 family and friends of patients than about recommendations from folk healers, there was an awareness that other health practitioners were providing service. Little, however, was known about them except from occasional comments by the patients who volunteered information. There was a dearth of knowledge about the extent of folk healing in Hawaii, the services offered, the ethnicity of the participants, and the role it played as a resource of help for physical and psychosocial problems. A review of available literature suggests that the absence of data about nonprofessional health resources in the urban United States is not unf.que to Hawaii. Anthro­ pology, the primary discipline to have studied folk healing, has done so largely in rural and less technologically developed areas in keeping with its general focus on cross­ cultural studies. In such endeavors it has, as pointed out by Lieban (1974:1033), provided a means of tmderstanding not only aspects of health and illness but of society itself. Indeed, it is through an examination of health maintenance attempts that one can examine more closely a basic anthro­ pological question of how human beings adapt to their physi­ cal and social environments.
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