Since the dawn of time indigenous, cultural, folk and traditional healing practices have been a part of health and mental healthcare, as humans found ways to alleviate or tolerate pain and suffering using the knowledge, resources and skills they possessed at the time.

Gradually a set of complex practices evolved, involving religion, magic and supernatural healing. These practices were designed to appease the gods and goddesses, who were believed to have the power to relieve mankind of their pain and suffering, and to heal them of their illnesses and diseases.1 Defiance of the gods and goddesses was thought to bring disharmony, disequilibrium, distress and, eventually, death.

In the West, the Enlightenment battles waged between religion and science led to the suppression and denial of healing and magic practices, which moved underground as science dominated. The move towards modernity shifted the discourse of healing from the supernatural to contemporary medicine and, it seems in more recent times, back again. Today, more than half the population of the US uses alternative and complementary medicine.2 Many of these healing practices are being integrated into conventional medicine, psychology and counselling – for example, mindfulness in CBT.

The growth in the use of alternative healing is paralleled, particularly in the West, by a growing interest in ethno-cultural and traditional healing practices as alternative solutions to psychological and physical problems.

From 2006 to 2010 I led a research project, sponsored by the Social Sciences and Humanities Research Council of Canada, to examine how traditional healers living and practising in greater Toronto provided counselling, healthcare and education to several ethnic minority communities. The study interviewed healers from Caribbean, South Asian and African cultural groups and looked at their reasons for becoming a healer, the patient or client groups they treated, the process of healing, their training and practice, and their relationship to practitioners of Western approaches to healthcare.

I was drawn to this research for both personal and professional reasons. My family history appears to be rooted in healing: my paternal great grandfather was a Hindu priest practising in South Africa, and my father, after spending a year in solitary confinement for anti-Apartheid activities as a Young Communist, became a pastor in his local church. My early childhood experiences of being in the company of Pentecostals got me used to the idea of ‘laying of hands’ and ‘speaking in tongues’ as part of the healing process. During my own exile in England during the Apartheid era, and in my early days as a counsellor and therapist working with Deaf people in Derby, and eventually through my own Jungian analysis, I came to understand that the ‘spirit’, ‘spirituality’ and the metaphysical are a profoundly complex and creatively imaginative ‘essence’ that is available to doctors and patients alike.

In this article, I will explore the idea of the spiritual, to show that the notion of the spirit is a critical space in counselling and psychotherapy. As part of this discussion, I will draw from the Toronto research, focusing particularly on the work of Caribbean healers and their healing practices.3

Gods and unholy spirits

Healers, wounded or not, have been part of the landscape of all cultures and communities, from family members who practise folk medicine to shamans in religious and non-religious settings. Many of these folk healing treatments have been tried and tested over centuries, proving that they are beneficial to those who use them appropriately. In time, many evolved into more complex treatments. In some cases these traditional healing processes have undergone dramatic changes as a result of social, economic and political conditions, in some instances producing new forms of healing, such as the healing traditions of the Caribbean, South and North America. These healing practices evolved in an environment of slavery, oppression and pain: for example, Voodoo healing was a direct response to slavery and racism.4

Voodoo (Vaudou, Voudoun) emerged as a spiritual healing and religious tradition in Haiti. It combines French Catholic practice and African spiritual tradition, and is now practised in many parts of the Caribbean and the diaspora.5 It is understood as spiritual magic involving divination, animal sacrifice, conjuring and herbalism. Patients or clients are attended to by a Houngan (priest) or Mambo (priestess), and invited to engage in ritual dancing, the offering of gifts and animal sacrifice to the spirit (Loa), a fusion of the African gods, spirits of the ancestors and Catholic saints.6 The initiation ceremonies are intended to imbue patients with the belief that the Voodoo spirit will protect them from harm and suffering. In Haiti, Voodoo acted both as a spiritual healing process and as a subversive political force that played a key role in the Haitian revolution against French colonial occupation in 1804. In 2003, the Haitian Government passed a law recognising Voodoo as an official religion.7

Another spirit-based healing practice is Shango (Sango, also known as Xango or Chango), which is practised particularly in Latin America and in the Caribbean, in Trinidad, Haiti and Cuba. Shango combines spiritual and healing traditions from the Yoruba region of Nigeria with Catholicism and the Baptist faith. Prayers and dreams are seen as ways of communicating with the spirit.3 Another form of folk healing that arises out of a fusion between Christianity and West African gods is Orisha (also know as Spiritual Baptist). It employs music, dancing, jumping and shaking as its healing ritual. This practice is sometimes known as spirit-filled Christianity. Other spirit-filled Christian groups (such as Pentecostal or Apostolic) practise ‘speaking in tongues’ and the ‘laying of hands’ for healing work.

To the Pentecostal and Spiritual Baptist healers in the Toronto research, spirit is the primordial presence of God, or the divine spirit, whom we sometimes know and experience as the holy spirit. Alongside, spirit can manifest in other ways: the Pentecostal healers encounter spirits in demonic possessions, in which they intervene; the Spiritual Baptist healer encounters spirits as spiritual (spirit-form) mothers and fathers, who help train and guide him/her in the practice of healing. For the Santeria healer, spirit is a pantheon or collectivity of Orishas or Yoruba deities to whom one can appeal individually and in turn, using one’s own spiritual power. This healer also practises Lucumi, where spirit also refers to the spirits of people who have passed – ‘spirits of the dead’ – including ancestral spirits, with healing and transformation facilitated by the transmission of supernatural powers from the spirits of the ancestors to living humans.8

The notion of spirit also takes centre stage in the healing practice of Espiritismo (Spiritism), found particularly in Cuba and Puerto Rico, where the belief in good and evil spirits is (dis)engaged with through dancing, drumming and exorcisms. And last, but not least, the healing practice of Santeria (also known as La Regla de Ocha/Lucumi) is a syncretic Afro-Cuban religion evolving from Yoruba slaves. Spirit-based, it uses a variety of healing methods such as cleansings, baths, herbs or sacrifice. In contemporary Cuba the religion has undergone a revitalisation and resurgence, partly due to governmental support.3

In essence, all of these practices are a synthesis, a mélange of African gods and practices of Animism, Christianity in various forms and the spiritual and folk healing traditions of Amerindians. All have infused to produce a unique set of religious and spiritual practices that form the backbone of healing and wellness for Black people in the Caribbean, Africa and the diaspora.

Traditional healing today

Traditional healing practices for singular health complaints are often multi-axial, involving cultural and indigenous rituals, herbs, prayer, meditation, sacrifices, spirit dances and, on occasion, even a referral to a Western healthcare professional. In the Toronto study, for example, a Spiritual Baptist healer treats high blood pressure with medical advice, exercise and keeping the head wrapped to restore balance in the head as well as with the body, heart and spirit, alongside prayer and meditation as channels of direct access to spirit. Treatment may involve more than one practitioner working on the same, seemingly single health complaint.

The post World War II period saw an increase in immigrants from the Caribbean Islands to the UK and Canada. Among these were traditional healers, whose presence offered hope and wellness in an environment of racism and exclusion. Many were forced, as a result, to practise deep in the heart of the inner city and out of the gaze of mainstream culture. Yet today, in the large urban metropolises around the globe, practitioners of Voodoo, Santeria and Orisha and many other shamanistic healers are in the business of healing bodies and spirits through consultation with ancestors, interpretation of floor x-rays (the throwing of bones or shells to reveal the shadows and silhouettes of a troubled self), rhythmic fire dances, ritual animal sacrifices and exorcisms.

Perhaps we are in the era of the post-enlightened where questions of the spirit, spirituality and religion are once again coming to the centre of city life? In the Toronto research we found that the Voodoo healer works out of a modern office (a room in her or his apartment), takes notes in an initial interview, schedules weekly or monthly sessions, and makes referrals to Western healthcare practitioners where appropriate. Many Voodoo healers themselves will be in full-time employment and will see patients in the evenings and at weekends.9 The research also revealed that as many Jewish people visited the Voodoo healers as did people from the Caribbean; that the Orisha (Spiritual Baptist) healer was frequented by Black, White and Asian people, and the Pentecostal healer saw African, Caribbean, Indian, French Canadian and European clients.3

Yet, while these modern enactments of age-old traditional ceremony and ritual can give the impression that they have undergone a postmodern change, not much has changed in terms of their basic rituals since their evolution in the Caribbean. Indeed, many in the Black and non-African and non-Caribbean communities see these practices as frightening, dangerous, immoral and grotesque. Negativity towards Caribbean healing traditions has become deeply engraved into the Western psyche and has been reinforced historically through their Eurocentric representations in literature, art, popular culture and film, particularly in the Hollywood movie industry’s depictions and bizarre renditions of zombies and the walking dead.

Spirit-based knowing and healing

The fact that African and Caribbean traditional healing and religious practices remain relevant, despite the hegemonic influence of centuries of sustained colonisation, is a testament to the strength of the intergenerational transmission of traditional healing practices.10 The concept of the spirit is an excellent medium through which the healers come to know something about another person’s health problems. Insight comes directly from the spirit through some physical or material artefact. Direct insight is achieved through prayer, meditation and invocation, in which the healers establish a connection to the spirit with their own spirit(s). Insight is rendered as a knowing, a felt sense, an image or ‘seeing’. As the Spiritual Baptist healer indicated in the Toronto research: ‘That’s the third eye… that’s the one you go way back [to], to your ancestors or to the holy spirit… the divine spirit… a lot of meditation… and you get that insight and as soon as you feel the person, you could feel their pain… if you have a headache I could just pick it up so I could feel it and automatically I lay a hand on your head.’

Insight from the spirit may come from reading holy scriptures (the Bible) by candlelight, where an image might appear in the flame that gives insight into what someone is facing. Or, as the Santeria/Lucumi practitioner described, it may be done by casting cowrie shells that disperse in a pattern that associates with particular proverbs and bodies of knowledge held by the Orishas. Finally, the Spiritual Baptist healer uses the rhythmic sound of drums to help her call and receive messages from spirit. The healers in the Toronto research also spoke repeatedly about a ‘laying of hands’ through which the healing power from spirit is transmitted.

Acquiring the ability to read and access spirit involves intensive learning, often over several years, and a lifetime’s commitment to maintenance and renewal of the spirit through inter-generational mentoring and accountability. This process is dedicated to developing the spirit(s) within and, through them, the ability to attain insight directly or indirectly from spirit.

The orientation towards healing might be innate, a destiny that is predetermined before birth. This innateness might be ancestral or it might be decided directly by a spirit. Once pre-determined, as the Houngan (Voodoo healer) said, ‘…you’re born with that spirit, you continue your life with that spirit, that spirit just gives you knowledge on your dream, in your feeling, it tells you what to do’. For other healers, the orientation towards healing comes as a calling later on in life.

These manifestations of the spirit through the work of the healers are profound and transformative for patients and their families. Traditional healers act as conduits of the spirit world and protectors of the ‘divine’. In this way they mediate the relationship between the natural world and the supernatural for these communities. Through traditional rituals and ceremonies they establish a convergence of shared ontological and epistemological trajectories of cures within which African and Caribbean people can fulfil their desire for health, wellness and spiritual healing.

Dual interventions

A key aim of the Toronto research was to find out how traditional healers felt about counsellors, psychotherapists, psychologists and psychiatrists. We learnt that patients seek out healers from their own and other ethno-cultural communities while also consulting GPs and hospital specialists. Such dual interventions8 are now becoming accepted practice among minority patients. If they perceive our current Western healthcare practices as culturally insensitive, discriminatory or even racist, they have no hesitation in visiting one or more traditional healers to sample their healing methods. This of course makes it critical for counsellors and other mental health practitioners to be aware of these traditional healers and their practices, and to ascertain from clients if they are pursuing dual interventions.

In the Toronto research, healers often recommended that clients seek Western medical assessments and treatments, recognising that a client might need interventions that were beyond the scope of their own practice and training. However they also seemed to feel that Western counsellors and psychotherapists might not recognise the spiritual aspects of a client’s presenting issues, or a client’s therapy might be limited as a result of not connecting the spiritual to the process.

It may not be possible to bridge the gap between Western medical sciences and the spirit-based epistemologies of African and Caribbean traditional healing, or to integrate the core components of African and Caribbean healing traditions into counselling and psychotherapy. But there are many ways in which therapists can learn about the varied healing practices and their practitioners across all ethno-cultural communities and, through this process, become aware of the charlatans and bogus community healers whose dangerous methods lead to life-threatening situations. Such knowledge will eventually lead to an acceptance and a healthy critique of cross-cultural epistemological paradigms, so that Voodoo health is no longer feared, traditional herbs or plants are recognised as part of indigenous pharmacy, and healthcare institutions and practitioners include traditional healing in patients’ treatment choices, as is increasingly the case in countries such as China, Brazil, India and South Africa.9 The big concern among traditional healers is the issue of expropriation and commercialisation of indigenous and traditional healing methods; these, they argue, along with herbs, and even their own roles, can disappear in time, in the same way that yoga and mindfulness practices have become commercialised.


The fear of African and Caribbean healing practices illustrates the complex relationship between Africa, the Caribbean and the West. Clearly, the history of slavery, the nationalist struggles for independence and the current neo-colonial relations between Africa, the Caribbean and the West are riddled with myriad and plural signifiers and meanings. It is in this context that African and Caribbean healing traditions are organised and performed.

Not all traditional healing modalities are regarded as acceptable in the West; indeed, several are seen as unnatural, dangerous or, at worse, evil. Yet, in spite of their negative portrayals in the media, there is a growing awareness that age-old traditions of healing are becoming part of our contemporary modernist culture.

Traditional healing practices are a way of keeping indigenous knowledge alive and current; they are also a way of recording psychosocial and illness experiences of the community and, through the healing of individuals’ bodies and minds, they have established a dictionary of illness, health and wellness for African and Caribbean people in the diaspora. In this way traditional healing tends to become the oral and embodied historical archive of a culture/ethnicity undergoing transformation. Traditional healers, by becoming the carriers of African and Caribbean culture and theology, are the guardians of indigenous knowledge and spiritual practices against the onslaught of colonialism, oppression, racism and capitalism.

Roy Moodley PhD is Associate Professor of Counselling Psychology at the University of Toronto, Canada and director of the Centre for Diversity in Counselling and Psychotherapy. His research interests include critical multicultural counselling/psychotherapy; race and culture in psychotherapy; traditional healing practices; and gender and identity. Caribbean healing traditions: implications for health and mental health, co-edited by Roy with Patsy Sutherland and Barry Chevannes, is published this month by Routledge.


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