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The woman who chose the terreiro. Lay care and medical landscapes in mental health care in Rio de Janeiro.

Manuela R Müller, Francisco Ortega, Angel Martínez-Hernáez

Anthropology & medicine December 1, 2022 DOI: 10.1080/13648470.2022.2144131 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population A patient in Rio de Janeiro who used ayahuasca in the Afro-Brazilian religion of Umbanda for mental health care
Intervention ayahuasca in the context of the Afro-Brazilian religion of Umbanda
Topics Ayahuasca
Keywords Cultural determinants Self-care Mental health treatment Traditional healing practices Cultural healthcare Afro-brazilian spirituality Alternative medicine
Citations 13
Key findings Recognizing sociocultural differences and therapeutic negotiations is key to making mental health care more inclusive, as illustrated by a patient who chose ayahuasca in Umbanda over standard treatment.

Abstract

Brazilian mental health care reform understands mental health as a complex social process. There is a large literature production within the country focused on deinstitutionalization policy, social determinants of mental health and human rights, however, with little recognition beyond Latin American borders. In addition, cultural dimensions of mental suffering have been neglected in Brazilian debates which limits an expanded understanding of health care and users' inclusion. This paper aims to discuss the role of cultural determinants in mental health care in Brazil. We followed a patient in the city of Rio de Janeiro who opted for therapy based on her religious beliefs-using ayahuasca in the context of the Afro Brazilian religion of Umbanda-over the treatment-as-usual in mental health. We draw on the notions of autoatención (self, domestic, and group-care in lay contexts) and medical landscapes to examine how therapeutic negotiations reflect embodied cultural traits and both social and political determinants shaping therapeutic spaces. We argue that recognizing sociocultural differences and therapeutic negotiations are key elements in making a more inclusive health practice. Moreover, this recognition enables identifying and reasoning the broader social processes framing health practices. This debate is relevant to the Brazilian mental health context and to other scenarios, especially those where local and global knowledge and practices in mental health are entangled.

Comparable studies

Other case reports and case series on ayahuasca, most cited first.

Study Year Design Participants
A fatal intoxication following the ingestion of 5-methoxy-N,N-dimethyltryptamine in an ayahuasca preparation. 25-year-old white male 2005 Case study n = 1
The Diaspora of Brazilian Religions 2013 Ethnographic case studies
EEG Gamma Coherence and Other Correlates of Subjective Reports During Ayahuasca Experiences Experienced ayahuasca users 2005 Exploratory case series n = 2
Reply to “Ayahuasca turned on my mind’s eye”: A case of acquired versus congenital aphantasia, as evidenced with DMT use? Individual with apparent congenital aphantasia 2018 Case study n = 1
“Ayahuasca turned on my mind’s eye”: Enhanced visual imagery after ayahuasca intake in a man with “blind imagination” (aphantasia) A man self-diagnosed with long-lasting aphantasia 2018 Case study n = 1

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