Puerto Rican spiritism. Part I--Description and analysis of an alternative psychotherapeutic approach.

Spiritism is a multifunctional institution which serves in the Puerto Rican community as a religion, a voluntary organization, a way of ordering social relationships, a source of personal identity, and a form of psychotherapy. This paper, based on participant observation in 79 Puerto Rican households and 6 spiritist centros in a low-income area of New York City, describes this institution and examines its contributions to a broader understanding of psychological healing as well as its practical implications for community health. In discussing spiritist psychotherapy, the paper outlines the conditions which lead clients to consult spiritists and examines its system of diagnosis and treatment. A comparison of the therapeutic goals of spiritism and mainstream psychiatric therapies reveals fundamental premises in both that provide the symbolic means by which certain behaviors may be bracketed off and rendered ego-alien for clients. While spiritism distances the client from unwanted behavior by attributing it to intrusive spirits and then removing the spirits, many psychiatric therapies accomplish distancing by attributing behavior to remote social causes which are then relearned or 'worked through'. What spiritism accomplishes symbolically by removal in space, psychiatric therapies handle through removal in time. The practical import of spiritist psychotherapy for community health is examined under the following rubrics: (1) spiritism as a treatment of choice, (2) implications of spiritist procedures for psychiatric treatment, and (3) interrelations between spiritists and community health programs.