Women and affliction in Maharashtra: a hydraulic model of health and illness.

The anthropological literature on spirit possession cults offers a distinction between voluntary possession or mediumship and involuntary possession or illness. Fieldwork was carried out in a Mahanubhav healing temple. Contradictory interpretations of trance and affliction were found to be held by the different temple inhabitants. Beliefs about the nature of spiritual affliction, its epidemiology and aetiology vary according to gender, family structure and position within the family. One manifestation of affliction is thought to be madness. However, the experience of mental affliction is very varied, for example, the number of family members accompanying an afflicted person, the amount of money made available for treatment, the length of treatment, as well as the less tangible but equally important aspects of treatment such as the degree of empathy and concern felt, all vary according to the afflicted person's gender and status within the family. The inferiority of women's position in society and their precarious belonging in their husband's family comes to the fore in cases of mental illness. The greater shame attaching to women's mental illness means that more women seek temple treatment alone and that the level of family support and involvement is less for women. Recently married women and older childless women fare particularly badly in the division of concern and responsibility for the afflicted. In Maharashtra the recognition and experience of mental affliction varies according to the stage of family development and, most importantly, according to the gender of the patient.