ABSTRACT
In surveying the ethnomedical literature on illness aetiologies one thing immediately arrests our attention: such systems look to orthodoxy rather than orthopraxy for the basis of classification. Psychoanalytic psychotherapy, like certain forms of biomedical intervention, is a predominantly mono-directive, internalising system. Beyond altering the ‘inner world’ of patients, psychotherapeutic intervention has little to say: there is no direct intervention in the patient’s social world, there is thus no ‘social work’, no suggestion or advice. Whether or not therapists make sense of phenomena perhaps better understood from other interpretative standpoints is not much considered in training. Therapists are not taught to question whether they are simply ‘recasting’ phenomena in psychological terms, and instead learn that they ‘unearth’ them: unearth their roots and their shrouded meaning, which are concealed behind the brute incidences of life. Trainees often perceive trainers as they do their therapists—as endowed with special dexterity to uncover faults of which they themselves are unconscious.
