The Barking Man: A Case Study of Rootwork in Psychiatry

Cultures and sub-cultures attempt to describe illness in ways that are most understandable to the people who live in that community. These groups may differ when describing the etiology, course and treatment of any given ailment. Mental illness is just as susceptible to being explained in a manner which differs from group to group. Not surprisingly, psychiatrists trained under the auspices of "mainstream America"-that is, where the Western Judeo-Christian paradigm reigns, may find themselves dismissing symptoms of other sub-cultures. Some patients may have manifestations of true mental illness; others may have symptoms which are culturally sanctioned but which we label as mental illness. We may even misdiagnose behavioral variation among cultural groups as serious disease.This paper is specifically concerned with the phenomenon of rootwork, a magical system of explaining sickness and health among some people in the United States. More specifically, a case is described where the severe symptoms of one patient went misdiagnosed as a result of cross-cultural confusion. Such misunderstandings can become clearer for those able to think about how mental illness crosses cultures and may become a new entity to that different group of people. Cross-cultural psychiatry is interested in the interface between such different groups. Additionally, difficulties with treatment of one culture's disease by another culture's remedies are discussed.