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Article 39

Cultural Awareness

Understanding Curanderismo

Nigel Torres & Janet Froeschle Hicks

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The ACA Code of Ethics (American Counseling Association [ACA], 2014) states that competent counselors “gain knowledge, personal awareness, sensitivity, disposition, and skills pertinent to being a culturally competent counselor in working with a diverse client population” (p. 8). According to Salazar and Levin (2013), “Curanderismo is an integral part of Mexican American culture, encompassing religious, spiritual, and health related beliefs and rituals.” If counselors are to demonstrate cultural competence with Mexican American clients who value curanderismo, they need an understanding of the unique culture, spiritual beliefs, and values of the practice. This article provides counselors with a brief overview, personal account, and insight into the practices of curanderismo. This insight may enhance counselors’ understanding, acceptance, and multicultural awareness when working with clients who adhere to the practices of curanderismo.

Description of Curanderismo

Curanderismo is a type of holistic folk medicine traditionally used in Mexican and Mexican American cultures. Followers of this healing system define disease as having both biological and spiritual causes and, therefore, utilize curanderos who treat on three levels—material, spiritual, and mental (Texas State Historical Association, 2015). These material, spiritual, and mental processes are integrated within healing rituals and result in a type of insight termed actualization. This actualization results in individual growth.

To assist clients from this culture, counselors must be aware and open to the expression of these elements (physical, mental, and spiritual components of a person) and approach the diversity of these systems through the spirit of respect and acceptance (Faver & Cavazos, 2009). Arredondo et al. (1996) stated that counselors establish awareness and sensitivity to client issues, are aware of their own biases and limitations, gain knowledge of personal and others’ social impact, and seek skills to better understand culturally different populations. To aid in this awareness, knowledge, and skill formation, the diverse nature of curanderismo, a description of types of curanderos and curanderas, nosology, and treatment approach in curanderismo follows.

Types of Curanderos and Curanderas

When looking at the word curanderismo, one can see the base word curar. This word, curar, is a Spanish word that means to heal. Individuals who practice curanderismo are called curanderos (male healer) and curanderas (female healers). According to Johnston (2008), curanderismo has specialists, including: hierbero (herbalist), sobadoro (massager), partera (midwife), consejero/consejera (counselor), huesero (bone setter—less common), and espiritualista (spiritualist). Curanderismo works with the individual on the physical (hierbero, sobadoro, partera, and huesero), mental (consejero and consejeras), and spiritual (espiritualista) levels (Eugenia, 1990; Perrone, Krueger, & Stockel, 2012;Texas State Historical Association, 2015; Trotter, 2001). In treating illnesses, curanderos/as do not treat the mind and body separately, but rather simultaneously treat both in their healing practice (Salazar & Levin, 2013).

Nosology of the Curanderismo

Traditional diagnoses and those described in curanderismo often overlap. For example, the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) and curanderismo both describe diagnoses such as depression (melarchico), posttraumatic stress disorder or emotional shock (susto), and mood disorders or nerves/nervous stomach (latido or munia; Salazar & Levin, 2013; Zacharias, 2006). Another psychological illness treated by curanderismo that co-occurs with traditional diagnoses includes billis (also known as bile or suppressed anger). According to Salazar and Levin (2013), curanderismo is used to treat not only psychological disorders but also with general medical disorders such as empacho (intestinal obstruction), mal aire (bad air or exposure to cold wind), and mollera caida (fallen fontanel).

Curanderismo goes beyond traditional diagnosis, however, in that it also treats illnesses that fall into the supernatural category. For example, curanderismo treats disorders such as enoco (festering wounds caused by another), mal ojo (evil eye or envy, jealously, strong admiration by another), and maleficio (witchcraft; Salazar & Levin, 2013; Zacharias, 2006). These supernatural disorders may cause confusion between clients and counselors if awareness of curanderismo, its rituals, and beliefs are misunderstood.

Treatment Approach in Curanderismo

The curandero or curandera views the person holistically (Texas State Historical Association, 2015). Curanderismo believes that the mind and body are inseparable and that no dichotomy exists between emotional and somatic illnesses (Salazar & Levin, 2013). Curanderos understand health and illness as a manifestation of an interactive process between three main dimensions of regulatory process: the religious and/or spiritual dimensions, the affective-emotional dimension, and the somatic processes of health and illness (Zacharias, 2006). Employing this position, curanderos and curanderas seek to provide treatment or interventions that include the whole person. All of the senses and psychological resources of the person are utilized to bring about a cure or improve an illness. To create this movement, the curandero or curandera employ the use of symbols, objects, rituals, and herbs. By the mixing these components, the curandero or curandera invokes internal processes of the person that support the overall goal of healing. Although these elements are helpful, they are not necessarily required for growth to occur. Unlike Western medicine’s tendency to focus in on one area of healing, the methods of curanderismo pull in all areas, allowing the individual’s physical, mental and spiritual elements to create growth (Texas State Historical Association, 2015).

The use of symbolism or symbolic gestures and symbolic objects is also used. This symbolism parallels many techniques used in modern counseling. For example, the writing of a “good bye letter” to a loved one to facilitate closure or even the use of the “empty chair” technique is much like a common technique called barridas. A barrida consists of having a person lay down or stand up as the curandero or curandera prays over the individual. While conducting prayers, the curandera or curandero begins to sweep the top of a person using a broom-like object made of different types of herbs or materials. An herb broom traditionally consists of herbs containing purposed properties of cleansing or protecting. The physical act of sweeping symbolizes removing the unwanted.

In order to assist counselors in fully understanding the rituals, beliefs, and holistic treatment processes utilized in curanderismo, a case study follows. This case study describes the treatment and experiences of a cultural insider, Manuel. This account is shared to enhance counselors’ knowledge and understanding of the multicultural issues inherent when treating individuals within the curanderismo culture.

Case Study

Manuel is a 40-year-old Mexican American male who offers a personal phenomenological perspective describing his experience growing up in the curanderismo culture. Identifying information such as name and age have been changed to ensure anonymity.

Manuel states, “As a child, I recall times where my mother, father, and grandparents utilized curanderismo, an approach taught to them by their elders. These methods assisted in times of struggle (physically and mentally), yet the inherent meaning of these methods were a mystery for some time. As I aged, my parents instilled more information regarding these processes. Further, education and religious understanding helped me gain greater understanding of the processes behind curanderismo. My personal religious experiences, along with studies in psychology, created connections between self-exploration and accepted theoretical teachings. The more I examined this mixture, the greater my desire became to understand curanderismo.

I remember personal skepticism regarding the benefits of curanderismo. Those outside the culture ridiculed my family’s beliefs and values. They made comments such as, “this is nothing more than foolery or nonsense.” As a result, I often withheld my cultural beliefs for fear of being ridiculed or even accused of exhibiting unchristian behavior. I was conflicted between my cultural beliefs and those who viewed curanderismo superficially and, therefore, had little understanding of the beliefs.

As I matured, I experienced greater understanding, less conflict, and acceptance of this cultural heritage. With time, I came to understand the essence of the belief system. The connection between the curandero or curandera’s approach and the power of the belief one has in their own abilities is tied to a belief in a higher power. An example of this connection can be seen when examining my experience through a barrida.”

Barrida Experience

“After years of utilizing different tools acquired through curanderismo, I decided to overcome a personal struggle and the accompanying stress and anxiety through a barrida. I went to the curandera and explained my negative life situation. She actively listened and acknowledged my presence. After a brief discussion and overview of my situation, she asked that I stand up so that she could conduct the barrida. As I stood there, she began to pray over me. She utilized familiar prayers. As she said these prayers, she gently waved a candle around my person. As I watched the candle, I recalled a number of times when I previously used candles as a calming mechanism. Next, she grabbed a grouping of bound herbs. She gently brushed my body, from head to toe, with these herbs. As she performed this sweeping action, she continued to state a number of familiar prayers. I could smell the pleasant aroma of herbs and it conjured up a number of pleasant memories. As she ran the herbs on areas such as my arms, I could feel the brushing more intensely. She made sure that her sweeping motion moved from my person to the outside and she brushed toward the end of my arms, legs, and head. This ensured a symbolic understanding that unclean forces were being removed from my person.

Incense burned throughout the process and, at times, I found myself focusing on the smoke created by the incense. It gently burned and the smoke curled in a number of beautiful patterns. Eventually, the pattern of smoke dissipated and was no longer observable. My attentions would vacillate between the smoke patterns, the brushing actions, the smell of herbs, and the light and heat of the candle.

As an additional bonus, the curandera stated, “all is well,” at the end of the process. She informed me that she would continue to pray for me and the candle would continue to burn for me. After the session, I offered her a small donation and thanked her for providing me with this experience.”

Reflection of Barrida Experience

“As I reflect on this experience and the many other experiences I have had with the curandera, I often ask myself, “why does this work?” There is nothing extraordinary occurring during this experience. The items used are not particularly special in any way. Nonetheless, I walked away with an improved sense of well-being. The aforementioned question has come to mind many times and I process it by viewing it through mental, physical, and spiritual life filters.

As someone who grew up immersed in this cultural phenomena, perhaps my explanation clarifies the event for counselors. During this barrida, the curandero or curandera utilizes as many of the five senses as possible. In the aforementioned experience, four senses were utilized. This invoking of the senses stirs conscious and unconscious memories and restores memories from times of comfort. For me, these recalled memories were from my childhood and earlier adulthood. The process helped me to call upon times when things were better, challenged the current negative mind frame, and eliminated unhealthy feelings and thoughts. Affirmations received during the process improved my sense of self-efficacy, and I was allowed a type of catharsis.”

Implications

Curanderismo can be effectively incorporated into counseling sessions as part of a cultural practice. Following are suggestions to help counselors gain knowledge, awareness, and skills toward being multiculturally competent counselors (ACA, 2014). First, counselors must learn more about the cultural practice of curanderismo. Trainings, readings such as this, and courses can enhance knowledge and understanding of specific cultural practices.

Second, counselors need to overcome biases and personal fears about the practice of curanderismo. Hoogasian and Lijtmaer (2010) stated that “working with clients who participate in Indigenous healing systems, like Curanderismo (Mexican traditional healing) presents Western therapists with heightened levels of uneasiness” (p. 297). Curanderismo is viewed by many individuals as archaic and outdated, where others may even see the practice as a complete farce and nothing more than a group of charlatans preying on the needy.

Third, counselors must understand curanderismo and assess it based on its cultural contributions. Counselors competent in their knowledge of this multicultural group and its beliefs and values are better able to provide care for clients functioning within the cultural domain encompassed by curanderismo For example, counselors who understand cultural practices avoid improper diagnosis of mental disorders and have the ability to integrate healthy thought processes and beliefs into counseling sessions.

Finally, counselors can integrate counseling skills with helpful cultural practices. For example, counselors can work with curanderos to benefit clients just as they might work with physicians or other mental health providers. Additional skills that integrate with curanderismo include Rogers’ (1961) core conditions. Carl Rogers maintained that three therapist attributes create a growth-promoting climate in which individuals can move forward and become what they are capable of becoming: congruence (genuineness or realness), unconditional positive regard (acceptance and caring), and accurate empathic understanding (an ability to deeply grasp the subjective world of another person; Rogers, 1961). Curanderas convey each of these conditions through words, actions, and interactions. As such, the therapeutic relationship created in curanderismo is much like that created in counseling sessions. Counselors who understand these multicultural practices can describe overlaps to clients, thus, potentially accelerating the creation of the therapeutic alliance.

Conclusion

Curanderismo is a Mexican American healing art that infuses physical, spiritual, and supernatural facets. Counselors who understand the practice, are aware of personal biases and fears, and integrate counseling skills with cultural values and beliefs are better equipped to assist clients. Proper diagnosis, an improved therapeutic alliance, and adherence to ethical guidelines are positively impacted when counselors gain cultural competence in this area.