Littlewood - Mental Illness As Ritual Theatre
Littlewood - Mental Illness As Ritual Theatre
To cite this article: Roland Littlewood (1998) Mental Illness as Ritual Theatre, Performance Research: A Journal of the
Performing Arts, 3:3, 41-52, DOI: 10.1080/13528165.1998.10871625
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Mental Illness as Ritual
Theatre
Roland Littlewood
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How do healing • This paper draws on material from regarded as functional, or 'instrumental': 'In situ-
practices 'heal'?* It has 'The Butterfly and the Serpent', ations of deprivation or frustration where recourse
published in 1987 in Culture, Medicine
recently been suggested and Psychiatry, 11: 289-335. to personal jural power is not available, the
that it is through their principal is able to adjust his or her situation by
aesthetic and dramaturgical idiom (Kapferer 1979; recourse to "mystical pressure" ' (Lewis 1971 ), that
Laderman 1991; Desjarlais 1992). This paper is, by appeals to values and beliefs that cannot be
examines certain relatively discrete patterns which questioned, because they are tied up with the most
appear, historically and geographically, to be specific fundamental concerns and political organization of
to industrialized cultures, especially to the United the community. How 'conscious' the principal is of
States and Britain, and which are generally referred pragmatically employing the mechanism as a
to as mental illnesses. Can they be seen in a dra- personal strategy is debatable , but it may be noted
maturgical idiom? The psychiatric term 'culture- that observers frequently describe the reactions as
bound syndrome' has usually been taken to refer to: 'dissociative'; Turner (1969) aptly calls this
(I) local patterns of time-limited actions, specific to sideways recourse to mystical action 'the power of
a particular culture, which, while regarded as the weak'; the popular medical or psychiatric term
undesirable, are recognized as discrete by inform- is perhaps 'manipulation'.
ants and observers alike; (2) few instances of which
have a biological cause; and (3) in which the indi- 'Wild Man behaviour'
vidual is not held to be aware or responsible in the Let us start by considering in more detail some
everyday sense; (4) the behaviour usually has a non-western examples. 'Wild man behaviour' (negi-
'dramatic' quality, in the popular sense. negi, nenek) is the term given to certain episodes of
aggressive behaviour in the New Guinea
SYMBOLS AND SYMPTOMS Highlands. The affected man rushes about errati-
Such reactions frequently articulate a personal cally, threatening people with weapons, destroying
predicament, but they also represent public their property, blundering through the village
concerns, usually core structural oppositions gardens tearing up crops. Episodes last for a few
between age-groups or the sexes. They have a hours or, at most, a few days; during them the wild
shared meaning as public and dramatic represen- man fails to recognize people and, on recovering,
tations in an individual, whose personal situation claims amnesia for the episode. This behaviour is
demonstrates these oppositions, and they thus locally attributed to possession by spirits, and
occur in certain well-defined situations. At the treatment may include pouring on of water or
same time they have a personal expressive meaning exorcism, although observers have felt these
for the particular individual and have been measures were applied 'half-heartedly' (Newman
41
Performance Research 3131. pp.41-52 © Routledge 1998
1964). The incipient wild man's announcement pay-off for the survivor of a suicide swim includes
that he no longer wishes to eat and his rejection of enhanced status together with a renegotiation of
his share of the prepared food advertise that his the original problem. Thus an adolescent girl who
performance is about to begin. This is always is rebuffed or censured by parents reacts by exag- ro
>::
public. 'It would be possible for a man to run wild gerating this extrusion, detaching herself further 0
0
in seclusion but no-one does' (Newman 1964: 3). from the community, and the resolution restores 0..
The audience participate by feigning terror or the equilibrium. For the community, the tension
attempting to mollify the principal, or alternatively between parental authority and filial independence
pouring water over him and ostentatiously hiding is presented as dramatically as the account of a
weapons. To observers he retains a high degree of lovers' suicide pact in the American popular press.
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QJ
c: as revealed to the expert therapist' (Lewis 1971 ). In FUNCTION AND
,..... patriarchal Islamic society, where women are OPPOSITION
QJ excluded from the public realm, the outrageous To summarize: this pattern of reaction appears to
,..... '--
111 ..... behaviour of possession coerces husbands into occur where major points of political and cultural
..... 111 gestures of reconciliation and consideration, while opposition are represented in a particular situation
c: QJ
QJ .&:; at the same time the formal public ideology of male and thus, not surprisingly, where the everyday
::E I-
dominance remains unchallenged. The cost of sar articulation of power relationships is not appropri-
ceremonies may be such as to preclude the ate as solution to a perceived problem. Employing
purchase by the husband of additional wives. The our western psychological categories, these
typical situation is a ambiguous points may be represented as 'tensions'.
Turner (1969) says such tensions do not imply that
hard-pressed wife, struggling to survive and feed her
society is about to break up; they 'constitute strong
children in the harsh nomadic environment, and liable to
unities ... whose nature as a unit is constituted and
some degree of neglect, real or imagined, on the part of
bounded by the very forces that contend within it.
her husband. Subject to frequent, sudden and often
[The tension becomes] a play of forces instead of a
prolonged absences by her husband as he follows his
bitter battle. The effect of such a "play" soon wears
manly pastoral pursuits, to the jealousies and tensions of
off, but the sting is removed from certain troubled
polygamy which are not ventilated in accusations of
relationships.' As Harris (1957: 1064) comments
sorcery and witchcraft, and always menaced by the pre-
about the saka attack, it 'allows a round-about
cariousness of marriage in a society where divorce is
acknowledgement of conflict, but in the saka dance
frequent and easily obtained by men, the Somali women's
there is again peace, dignity and festivity'. Indeed
lot offers little stability or security.... Not surprisingly
individual components of this key institution are
the sar spirits are said to hate men.
included as parts of other rituals of the community.
(Lewis 1971: 75, 76)
The performances appear characteristically to have
Diagnosis of the performance as sar possession is in three stages. In their course, the individual is
the hands of women and the treatment groups extruded out of normal social relationships in an
provide an organization for women in opposition to extension of the usual devalued or marginal social
the public ritual oflslam dominated by men. The status. This is followed by a prescribed role, deviant
participation of women in such healing groups may but legitimate, which represents further exaggera-
be said to 'allow the voice of women to be heard in a tion of this dislocation (frequently suggesting a
male-dominated society, and occasionally enable direct contravention or 'symbolic inversion' of
participants to enjoy benefits to which their status common social values) to unbalance the social equi-
would not normally entitle them' (Corin and Bibeau librium to such an extent that it is succeeded by
1980). Such self-help groups may partially maintain restitution back into conventional and now unam-
the stigmatized ('sick') identity in opposition to biguous social relationships. 'The saka dance turns
43
the saka attack on its head' (Harris 1957: 1060). The The audience is placed between distress and safety,
suicide voyager's 'attempt at detachment has failed, the position of 'optimal distancing' and balanced ...,.
but he has succeeded in resolving his problem. He is attention reserved for group catharsis (Scheff 1979). ...,.
once again absorbed and an effective catharsis has To describe the behaviour as a 'performance' is not ro
X:
been obtained' (Firth 1961: 15). to say that the 'actors' do not fully identify with 0
0
A similar three-stage model of separation, tran- their parts. Even in the more stylized display of the c..
sition and reintegration has been postulated for Balinese theatre, the actor portraying the witch
those psychosocial transitions usually glossed as Rangda may disrupt the performance by running
'rites of passage' (Van Gennep 1960), such as amok and the audience follow suit (Geertz 1966);
shamanic trance possession and women's cults in but some observers remain unentranced and direct
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Africa (Turner 1969). While medical convention the activities of the 'spectators'. For the community
divides such patterns into 'symptoms' and as a whole, social contradictions are demonstrated
'treatment' I should prefer to consider them a but shown to be susceptible to a solution, albeit a
single ritual complex. 'Attack and dance are two temporary and restricted one (for these contradic-
manifestations of a single situation ... [they] can tions are not ultimately resolved). The performance
be translated into one another' (Harris 1957: 1061). articulates these social oppositions for all members
Leach (1961: 135-6) suggests that ritual is 'normal of the audience, but also permits individual identifi-
social life ... played in reverse' and offers the cation with the protagonist. That sex-specific per-
terms 'formality', 'role reversal' and 'masquerade' formances are appreciated equally by both sexes
to represent the equivalent of our three stages. The suggests that individual identification is perhaps
prescribed deviant role amplifies the rejection by less important than psychodynamic writers have
the community, frequently taking the form of suggested: ritual derives its efficacy and power from
behaviour which contravenes the core values of the its performance.
society, female modesty or decorum. During this
period, the principal is regarded as the victim of THE 'MYSTICAL PRESSURE'
external mystical forces (which must be placated) OF MEDICINE
and is not accountable. In negi-negi 'a man does not My model of culture-bound reactions thus involves
have a name'; he is an animal escaped from non-dominant individuals, who display in their
everyday social control (Newman 1964). Whilst I personal situations the basic structural social con-
am emphasizing here the instrumental, rather than tradictions, expressed through the available intel-
the expressive, aspect of this behaviour, I may gloss lectual tools, with recourse to 'mystical pressure'
the personal experience for the principal (and permitting personal adjustment of their situation
audience) by the western term 'catharsis', similar to by a limited contravention of society's core values.
the collective experience of social inversions found Each reaction involves dislocation, exaggeration/
in carnivals, licensed rituals of rebellion and con- inversion and restitution. An attempt to look for
travention of norms in certain specific and tightly equivalent 'western' reactions would appear quite
controlled situations. In large-scale societies (with a straightforward apart from the notion of 'mystical
linear rather than a cyclical notion of time; Leach pressure'. What unquestionable 'other-worldly
1961 ), individual culture-bound reactions of 'hys- authority', standing outside everyday personal
terical conversion' may succeed the periodic and relations, might serve to explain and legitimate
collective rites of role-reversal practised in smaller them?
and more homogeneous groups. For small-scale traditional communities,
Sociological explanations of symbolic inversion social organization and normative principles and
stress both group catharsis and the social marking of the categorization of the natural world and human
a norm by its licensed and restricted contravention. relations to it are articulated through an
44
intellectually tight system of cosmology, which we some means of exculpation, usually through
usually refer to as 'religion'. Religion is an ideology; mechanisms of bio-physical determinism. 'When
it both describes and prescribes, binding the indi- faced with a diagnosis for which he has equally
vidual into society and into the natural order. convincing reasons to believe that either his client
ru
::> Through its other-worldly authority it legitimates is sick or he is not sick, the physician finds that the
+-
personal experience and the social order. By professional and legal risks are less if he accepts the
0:::
contrast, in the secularized West, Christianity has hypothesis of sickness' (Young 1976). To question
ru
lost its power of social regulation and competes the medical scheme itself involves questioning
both with other religions and, more significantly, some of our most fundamental assumptions about
V>
with a variety of alternative ideologies, moral and human nature and agency. Because of its linking of
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QJ
c political. Where then can we find an equivalent personal experience with the social order, its stan-
'mystical' sanction that integrates personal distress dardized expectations of removing personal
QJ into a shared conceptualization of the world? responsibility and initiating an institutionalized
...... '--
I would suggest that the legitimation of our response, and its rooting in ultimate social values
ru +-
+- ru present world-view lies ultimately in contemporary through science, biomedicine offers a powerful and
c QJ
QJ ..c science, which offers core notions of individual unquestionable legitimate inversion of everyday
l: I -
identity, responsibility and action. In its everyday behaviour. It will thus not be surprising to find
context as it relates to our personal experience, many of our 'culture-bound syndromes' already
science is most salient in the form of medicine. In all included in psychiatric nosologies. Others we may
societies illness is experienced through an expres- suspect lie hidden in the fringes of general
sive system encoding indigenous notions of social medicine. Lee ( 1981) shows how the symbolic
order. Whilst serious illness 'is an event that chal- inversions of Malay amok, latah and possession
lenges meaning in this world .... medical beliefs states continue, although the attribution of
and practices organise the event into an episode responsibility has been transferred from super-
which gives form and meaning' (Young 1976). This natural agencies on to a notion of illness.
obligation to order abnormality is no less when it is
manifest primarily through unusual behaviour. BUTTERFLIES AND
Professional intervention in sickness involves SERPENTS: THE
incorporating the patient into an overarching MEDICALIZATION OF
system of explanation, a common structural pattern WOMAN
which manifests itself in the bodily economy of In all societies, women are 'excluded from partici-
every human being. Social accountability is trans- pation in or contact with some realm in which the
ferred on to an agency beyond the patient's control. highest powers of the society are felt to reside'
Becoming sick is part of a social process leading to (Ortner 1974). They are excluded by a dominant
communal recognition of an abnormal state and a ideology which reflects men's experiences and
consequent readjustment of patterns of behaviour interests: 'The facts of female physiology are trans-
and expectations, and then to changed roles and formed in almost all societies into a cultural
altered responsibility. Expectations of the sick rationale which assigns women to nature and the
person include exemption from discharging some domestic sphere, and thus ensures their general
social obligations, exemption from responsibility inferiority to men' (La Fontaine 1981: 347).
for the condition itself, together with a shared The core aspect of the female role in western
recognition that it is undesirable and involves an society is reflected in the ideals still held out to
obligation to seek help and co-operate with women: concentration on marriage, home and
treatment. Withdrawal from everyday social children as the primary focus of concern, with
responsibilities is made socially acceptable through reliance on a male provider for sustenance and
45
status. There is an expectation that women will Women are closely identified with psychotropic
emphasize nurturance and that they live through medication. Whilst more women than men go to '
...I,
-+
and for others rather than for themselves. Women physicians and receive prescriptions, there is an -+
are expected to give up their occupation and place of even greater disproportion in the number of Ill
:c:
residence when they marry and are banned from the women receiving psychotropic drugs. During the 0
0
direct assertion and expression of aggression. Their year preceding a national sampling of American 0..
lack of power is attributed to their greater emotion- adults, 13 per cent of the men and 29 per cent of
ality and their inability to cope with wider social the women had used prescribed drugs, especially
responsibilities, for dependency and passivity are minor tranquillizers and daytime sedatives. These
expected of a woman; her psychological image is of a American rates are consistent with other western
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person with a childish incapacity to govern herself industrialized nations. Physicians expect female
and a need for male protection and direction. Con- patients to require a higher proportion of mood-
temporary western women are permitted greater altering drugs than do less expressive male patients.
freedom than men to 'express feelings' and to These are perhaps the 'attractive healthy women
recognize emotional difficulties, enabling the woman who thoroughly enjoy being ill' (Daily Express
to define her difficulties within a medical framework 1984). That we are not dealing simply with a 'real'
and bring them to the attention of her doctor. gender disparity in psychological distress is
Through childbearing, every woman in the West suggested by the symbolism of medical advertising.
becomes a potential patient: Jordanova ( 1980) Women outnumber men by 15:1 in advertisements
suggests that medicine and science are character- for tranquillizers and anti-depressants. One adver-
ized by the action of men on women; women are tisement depicted a woman with a bowed head
regarded as more 'natural', passive, awaiting male holding a dish-cloth and standing beside a pile of
('cultural') organization. In the heraldry of the dirty dishes represented larger than life-size; the
British Royal College of Psychiatrists, as sported on medical consumer is told that the drug 'restores
the neckties of its members, they continue this perspective' for her by 'correcting the disturbed
tradition as the Butterflies of Psyche, awaiting the brain chemistry'. Psychotropic drug advertisements
Serpents of Aesculapius. Serpent and Butterfly are emphasize women as the patients; they are repre-
in an opposed but complementary relationship; sented as discontented with their role in life,
action by one engenders the opposed complement dissatisfied with marriage, with washing dishes or
in the other (Bateson 1958). There is a close his- attending parent-teacher association meetings.
torical relationship between the psychiatric notions Advertisements for psychotropic drugs tend to
of 'woman' and 'patient', and there is a similarity picture women as patients, while those for medi-
between neurotic symptom patterns and normative cations show men; within the psychotropic drug
expectations of female behaviour. category alone, women are shown with diffuse
emotional symptoms, while men are pictured with
OVERDOSES discrete episodes of anxiety because of specific
A contemporary reaction which offers close pressures from work or from accompanying organic
parallels is parasuicide with medically prescribed illness.
drugs. As in hysteria, in this type of ritual theatre 'Overdoses' of medical drugs are up to five times
the normative situation of active male (husband, more common among women than men, especially
doctor) and passive female (wife, patient) is in the age group 15-19. Among girls of this age in
reflected in the drama of the hospital casualty Edinburgh, more than one in every hundred take
department. The unease and anger which it evokes an overdose each year. Half of the episodes involve
in the medical profession reflect its 'perverse' interpersonal conflicts as the major precipitating
transformation of the clinical paradigm. factor. Only a minority had made definite plans to
46
prepare for death and avoid discovery or subse- or psychiatric illness. 'Expressive' explanations
quently regretted not having killed themselves. (communicating despair and aiming at withdrawal,
Suicidal intent and risk to life appear to be low, escape or death) are more acceptable and evoke
especially as overdoses are usually taken with more sympathy or readiness to help in both doctors
somebody close by: 59 per cent of attempters and nurses than pragmatic motives. Doctors tend to
commit the act in the presence of or near other distinguish acts as either suicidal or 'manipulative',
0:::
people. and are more accepting of the 'wish to die' motive.
ro
While the reasons given by the individual for Women who take overdoses still gain access to
taking overdoses may be expressive (explaining the hospital, despite the physician's antipathy, since the
"' overdose as a result of a personal predicament and popular conception of suicidal behaviour is as a
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QJ
<= associated feelings at the time of the act), they are discrete event, 'something that happens to one',
frequently pragmatic- that is, they are consciously rather than something one intentionally brings
QJ conceived in terms of the desired consequences of about. Relatives accept that the patient's problems
..-
ro
L.
~
the act, usually increased support or understand- are outside her direct personal control, and
~ ro ing. Overdoses can be interpreted as a transaction responsibility is thereby attributed to some agency
<= (I)
(I) ..c between the woman and her intimate group. A beyond the patient's volition. The official trans-
l:f-
study of adolescent overdosers suggested they lation of the performance into symptoms takes place
viewed their act as a means of gaining relief from a under socially prescribed conditions by the
stressful situation or as a way of showing other physician who alone has the power to legitimate
people how desperate they felt. Medical staff who exculpating circumstances (Young 1976). As with
assessed their motives both regarded them as nineteenth-century hysteria, the resolution of the
expressive but also noted that adolescents took reaction involves a 'mystical pressure', which repli-
overdoses in order to punish other people or change cates the social structure in which the reaction
their behaviour. Typically, a teenage girl took occurs. The drama of the scene in the casualty
tablets after a disappointment, frustration, or department replays the male doctor I female patient
difference of opinion with an older person (usually theme without questioning it, but it does afford a
a parent); many patients afterwards reported that degree of negotiation for the principal, who
the induction of guilt in those whom they blamed induces a mixture of responses, mainly sympathy
for their distress was a predominant motive for the and guilt, in close relatives and friends.
act. Thus, while overdoses can be seen as strategies
designed to avoid or adjust certain specific situ- MENTAL ILLNESS AS
ations, the self-perception of the principal is of THEATRE:
social dislocation or extrusion: the reaction exag- PSYCHOPOLITICS,
gerates this extrusion, offering a threat of refusing OPPOSITION AND
membership in the human community altogether - INVERSION
an inversion of normal life-seeking norms. As in Reactions like overdose, agoraphobia, shoplifting
Tikopia (Firth 1961), attempted suicide is, among and hysteria cannot necessarily be taken as
other things, a dangerous adventure. phenomenologically discrete. Many similar
The conventional resolution of the inversion patterns occur in non-western societies and
involves its complement: medical intervention occured in the past in the West. Anorexia nervosa is
returns the patient into everyday relationships. Not arguably an 'internalization' of the nineteenth-
surprisingly, the overdose meets with little pro- century corset, similarly controlling female
fessional sympathy, particularly when it is inter- sexuality by giving it an increased but restricted
preted as an instrumental social mechanism rather salience. The spread of industrialization and its
than the sign of underlying individual hopelessness associated tendency to individualize, psychologize
47
and assign pragmatic motives (and hence perceive seen, already in an inverted and socially extruded
socially standardized behaviours as 'only' ritual or position and the reaction is an extension of this
.....
theatre) might suggest that 'Western' variants will accessible to the principal and her audience. Exag- .....
become more universal. Whatever the origins of geration of behaviour provokes a reciprocal ro
>:::
pibloktoq ('arctic hysteria') in European/Inuit response in men. The parody of gender-specific 0
0
relations (Murphy 1982), the reaction is being behaviour in women may be perceived as inversion 0..
'replaced' by parasuicide (Harvey eta!. 1976). of those values which, at another level, men and
I have emphasized the specific social and women hold in common. Anorexia, like obesity (its
symbolic meaning of certain performances in apparent reverse), has a close subjective relation-
Britain and America which show similarities with ship to male/female relations; for many partici-
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my model of Third World culture-bound pants, both are phases in the same reaction. The
syndromes. While social meanings and behaviour ambiguity and 'overdetermination' of anorexia
may be superimposed on a variety of existing bio- reflect a current ambiguity over female sexuality
logical patterns- as in premenstrual syndrome, and child-rearing, which is not characteristic of the
adolescence, biological psychoses, drug intoxica- role of the woman as housekeeper (agoraphobic) or
tions - I have restricted my discussion to reactions patient (overdoser). Coherence of the matured
not primarily associated with human pathophysiol- syndrome is shaped by interaction between the pro-
ogy. These are public and dramatic presentations of fessional and the principal.
core social issues; in a word, theatre or, to be more Particular elements of the 'Serpent/Butterfly'
precise, ritual theatre, which offers a specific relationship thus appear to be employed distinc-
pragmatic tool for the principal actor and one tively in different reactions: doctor/patient in
which may at times end in her death. overdoses; public/private in agoraphobia; produc-
The application of 'inversion' is not to imply tion/ consumption in shoplifting. They are not dis-
that each gender simply adopts a role more directly cretely related, however, and each reaction partly
opposed to the other. In the case of the male articulates the total complex, out of which other
equivalents, domestic sieges and flashing, the ritual situation-specific patterns can be generated.
pattern is an exaggerated ritual reassertion or Thus, a bank manager's widow, faced with
parody of dominant (male) norms rather than their insoluble debts, attempted to rob a bank, where she
obvious inversion. Although they are clearly extra- was a well-known customer, undisguised and using
ordinary behaviour relative to everyday articulation her perfume spray as a gun. After a suspended
of the same symbolism, it would perhaps extend court sentence facilitated the adjustment of her
the notion of 'inversion' too far to include them. finances, she commented: 'I must have had a brain
In obesity, running amok, or parasuicide, it is the storm.' The popular notion of a brain storm affords
ritual threat that provides bargaining power. Sieges exculpation as an overriding and irrational but
(separated or divorced men kidnapping their excusable impulse, clearly aligned with the medico-
children) certainly take place in situations where legal concepts of 'diminished responsibility' and
the principal is excluded from full participation in 'disturbed balance of mind'. This coexists with the
dominant values. But the consequent performance professional and lay idea that at some unconscious
is an assertion of such values. I have seen a number level the reaction is 'understandable'.
of husbands who became agoraphobic after a period The mystical power of biomedicine as 'external'
of compulsory redundancy, during which the wife justification for individual action, and the negotiat-
continued as the wage-earner. The female reactions ing 'space' it affords, seem relevant to those other
also appear to be an exaggeration or reductio ad performances in which patient enacts a pas de deux
absurdum of normal sex roles, but in certain cases with doctor: Ganser Syndrome, compensation
(agoraphobia, overdosing) women are, as we have neurosis, irritable bowel, Munchausen's Syndrome,
48
Munchausen's Syndrome by Proxy, and chronic thus not be taken to mean that individual personal-
pain or loss of energy syndromes, apart from the ity or biology are irrelevant in the choice of
many situations (such as non-compliance) where reaction. It is not surprising that agoraphobic
different explanatory models employed by doctor patients are anxious people or have 'phobic person-
"':::J and patient afford the latter some control over the alities' or that anorexics were overweight as
..... social drama. The mystical sanction of medicine children. The final path is polysemous and over-
oe: seems less relevant to the two specifically male determined: 'The efficacy of ritual as a social
"' reactions, sieges and flashing (or other similar mechanism depends on this very phenomenon of
"' patterns such as the ritual stealing of cars by male central and peripheral meanings and on their
adolescents), presumably because of the allusive and evocative powers .... All symbolic
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QJ
women's groups in the Third World, actually difficult to distinguish pragmatic from 'uncon-
develop into alternative political structures scious' participation, even in such clearly iatrogenic
('counter-cultures') (Turner 1969) is unlikely. It is reactions as the recent vogue for multiple posses-
interesting that these reactions are often 'resolved' sion. In the case of work disability symptoms
through psychiatry: the psychiatrist, relative to ('compensation neurosis') the symptoms are now
other doctors, is more passive, more empathic, believed to continue longer after financial settle-
more 'feminine'. The inversion can, however, be ment than was formerly believed. In most instances
institutionalized, either as an undesirable identity it is more appropriate to talk of identification or
in relation to dominant norms (Open Door phobic 'fit' with models than 'intent'; but a complete
groups) or as valued identities in their own right description of the transformations of participant
(the American Big Beautiful Woman [BBW] experience and reflexive self-perception by cultural
network). The irony of affirming a stigmatized typification lies outside the scope of this essay.
identity is that this identity remains determined by Whilst the precipitating event would appear on our
the dominant culture. model to be some type of excessive 'stretch'
between the oppositions, this may be no more rep-
STRUCTURE, FUNCTION resentative of the central symbolic relations than a
AND ACTION relative loss of self-determination.
If, as Gregory Bateson claims, 'data from a New A related issue is that of 'functioning' to
Guinea tribe and the superficially very different preserve social homeostasis, emphasized by many
data of psychiatry can be approached in terms of a scholars: rituals are taken as adjustment reactions
single epistemology' (Bateson 1958: vii), a variety for a society, allowing repressed impulses and
of explanatory problems still remain. Thus, we have potential rebellions to express themselves in
argued that many of these reactions can be inter- harmless 'rituals'. As Kapferer (1979: 121) points
preted as instrumental (function for) as opposed to out, 'rituals [may] function to paper over and to
the medical and semiological perception of them as resolve conflicts and tensions'. This is often the
reflections of'stress' (functions of). Where is such case, but it is not necessarily so. To arbitrarily
instrumentality (which retains its symbolic isolate individual institutions as 'functional' is often
dimension) located? In many instances of overdoses little more than seeing how the total field of data
there is a clear pragmatic intention to alter personal under the observation of the fieldworker must
relations; in anorexia nervosa functionality lies in somehow make sense. Indeed, it is only a disguised
the therapist's explanations in family therapy; in form of description. Certainly, if our reactions may
other instances it can be located in our own, more be glossed by the observer as 'rituals of rebellion' or
distanced, method of analysis. It is difficult to even parodies, this is not the participants' exegesis:
assign a uniform 'meaning' to any behaviour, par- nineteenth-century hysterics do not seem to have
ticularly one which, once established, is available been conscious of their part in what De Swaan
for fresh situations. 'What is instrumental for some (1981) calls a 'revolt enacted as mental disease'.
so
Standardized rituals can always lead to the The same phenomena are susceptible to a variety
development of new tensions. Thus, a common of theoretical explanations: reflection of social
experience of family therapists working with status or of stress; social catharsis; social homeo-
neurotic patients is that therapy leads to marital stasis; cultural loophole; individual catharsis; role
ru
::::1 separation. We cannot assume that the illness reversal; ritual theatre; entertainment; ritual
+-
simply 'masked' an inevitable separation, for thera- reaffirmation of gender relationships; genesis of
peutic assumptions and techniques carry their own sorority or sodality; rite of passage; revolutionary
VI
ru
models and implicit goals. To what extent can the prototype; resolution or expression of symbolic
reactions themselves be regarded as the direct rep- ambiguity; manifestation oflay or professional
VI resentation of communal tensions rather than some explanatory model of sickness; not to mention the
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QJ
c: relatively discrete and less central adjustment expression of such basic impulses as distress,
reaction? Functionalist and structuralist models parody, play, adventure or revenge. Western
QJ have the advantage of a hierarchy of causality, neuroses may be represented simultaneously as all
..- '- allowing us to differentiate 'core' from 'adjustment' these. Claims to the primacy of a particular theory
ru +-
+- ru patterns. Functionalist explanations assume that are ultimately arbitrary and are grounded in the
c: QJ
QJ .s::: rituals are occasioned by social tensions and that particular perspective of the observer.
l:l-
they are merely occasions when their tensions find
expression, with the assumption that the precipitat- REFERENCES
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