Use of Ifa as a means of addressing mental health concerns among African American clients.
In part, because of the aforementioned barriers, African Americans often rely on informal networks of support in lieu of seeking counseling (Harley & Dillard, 2005; Parham, 2002). These networks typically include family and community resources, religious leaders, and indigenous healers (Yeh, Hunter, Madan-Bahel, Chiang, & Arora, 2004). In fact, African Americans are more likely to seek religious or spiritual experiences rather than admit to mental health concerns (Harley & Dillard, 2005). Spiritual and mental health concerns are often viewed as interconnected; therefore, religious institutions have an extensive history of providing both spiritual guidance and counseling services (Harley & Dillard, 2005). Within the African American community, indigenous African spiritual systems also have a long history of providing mental health services (Clarke, 2004). In fact, African Americans may rely on indigenous African spirituality as an alternative to Western forms of counseling (Boyd-Franklin, 2003). Although the scholarly literature has explored the therapeutic use of religion, little attention has been given to African-based spiritual systems used by African Americans as a mental health intervention (Boyd-Franklin, 2003; Constantine et al., 2004).
To assist counselors in increasing their level of cultural competency, this article explores historical factors prompting African Americans to choose African-based spiritual systems when addressing mental health concerns. Specifically, an overview of Yoruba-based Ifa is presented. This article places specific focus on Ifa because it is the largest indigenous African spiritual system practiced outside of its country of origin, Southwestern Nigeria (K. Abimbola, 2006; Falola & Genova, 2005). Ifa and its diasporic manifestations are currently followed by an estimated 100 million people worldwide (K. Abimbola, 2006). Diasporic manifestations of Ifa include Candomble in Brazil, Santeria in Puerto Rico, Lucumi in Cuba, Shango in Trinidad, and Yoruba within the United States (K. Abimbola, 2006; Falola & Childs, 2004). Scholars additionally note the increasing popularity of Ifa among African Americans as a healing modality (Boyd-Franklin, 2003; Clarke, 2004; Falola & Genova, 2004).
Finally, the conceptual, diagnostic, and treatment practices of Ifa are reviewed. Understanding this information will result in counselors gaining a broader knowledge base from which to work with African American Ifa adherents. This will enable clinicians to provide intervention strategies consistent with the client's beliefs regarding the etiology and treatment of mental health concerns. Providing culturally congruent interventions can result in improved treatment adherence among this population.
* Factors Influencing Selection of Indigenous African Spirituality as a Healing Modality
Sussman (2004) suggested that historical, social, and cultural variables influence the culturally constructed health care
systems developed by members of a particular society. These cultural healing systems include collectively held knowledge and beliefs regarding the cause, manifestation, and mitigation of mental health concerns among members of that group. Scholars posit that many Western intervention strategies fail to consider historical factors or the worldview of the client (Duran et al., 2008; Sussman, 2004). This approach toward care can result in the therapist misinterpreting a client's low treatment adherence as resistance rather than a culturally constructed means of managing and healing mental health concerns. However, within Western counseling, there is a growing trend toward the delivery of culturally competent counseling services (Constantine et al., 2004; Myers et al., 2005). This approach includes an examination of historical, social, and cultural variables influencing the client's worldview and treatment utilization patterns. The following example outlines the ways in which historical, social, and cultural variables influenced the use of Ifa as a mental health intervention among African American clients.
* Historical Interactions Within the American Mental Health Care System
Historically, within the mental health field, African Americans have been misdiagnosed and improperly treated for psychological concerns (Harley & Dillard, 2005; Parham, 2002). Studies suggest that African Americans are disproportionately diagnosed with psychotic disorders (Neighbors, Trierweiler, Ford, & Muroff, 2003; Trierweiler, Muroff, & Jackson, 2005) and underdiagnosed and inadequately treated for mood disorders (Jackson et al., 2007; Trierweiler et al., 2005). The authors further suggested that racial profiling in the therapeutic exchange has historically resulted in African-descended people being characterized as hypersensitive regarding issues of race, unable to meaningfully engage in counseling (Moodley & West, 2005; Parham, 2002), and excessively paranoid (Whaley, 2001). Such characterizations of African Americans by mental health professionals have resulted in members of this population being apprehensive toward engaging in treatment and may account for lower mental health utilization rates. Furthermore, these factors provide a context within which to understand treatment-seeking patterns among this group.
* Affirmation of an African Identity
The efforts of Black nationalists and cultural anthropologists in the early part of the 20th century also affected treatment-seeking patterns among African Americans. These two groups ignited an interest in those who sought to reclaim their African cultural and spiritual heritage (Clarke, 2004). African-based spiritual systems brought to America by immigrant practitioners of Santeria, Candomble, and Vodou redefined religious practices (Falola & Childs, 2004). Some students of these African cosmologies sought to use African-derived religions as a tool for political organization and social empowerment. Adherence to African-based spiritual systems became an affirmation of Black nationalist ideology and of African cultural identity (Clarke, 2004). This affirmation of a political and ethnic identity, coupled with a historical distrust of Western mental health care, meant that adherents of African-based spiritual systems began relying on indigenous healers to address mental health concerns.
* Cultural Congruency of Treatment Approaches
In addition to historical patterns of racism within the mental health field and efforts to reclaim a lost cultural heritage, writers suggest that indigenous healing strategies appeal to the values, beliefs, and worldview of many African Americans (Harley & Dillard, 2005; Parham, 2002). Indigenous healing methods are defined as those interventions developed and used by individuals of a particular society (Constantine et al., 2004; Yeh et al., 2004). Within indigenous African healing concepts, mental, physical, and spiritual well-being are integrated. This approach encourages familial and community interconnectedness, key values within the African American community (Parham, 2002). Mental health concerns are managed via holistic approaches addressing mind-body-spirit connections, in addition to kinship bonds that extend beyond biological relations (Boyd-Franklin, 2003). One of the most common indigenous African healing systems used within the Americas and Caribbean is the Yoruba-based system of Ifa (K. Abimbola, 2006).
* Ifa in the African Diaspora
Although Yoruba more accurately describes the language spoken by people occupying the southwestern region of Nigeria, parts of Benin and Togo, the term has become a moniker representing the group's indigenous spiritual practices within the United States (Clarke, 2004; Falola & Genova, 2005). A more accurate descriptor is Ifa (K. Abimbola, 2006). Like many words in the Yoruba language, the term Ifa has multiple meanings. In addition to denoting the spiritual practice, the word is used to identify a spiritual divinity, the divination process (communication with supernatural forces), and the sacred body of knowledge (Ifa Sacred Literary Corpus) used by priests of the tradition (W. Abimbola, 1997).
During the introductory stages of Ifa in America, African Americans primarily adhered to versions of the spiritual system that syncretized or blended Ifa with Catholicism. Later, devotees (adherents to the spiritual system) who adopted a Black nationalist ideology attempted to remove the African religion from its Catholic shield (Clarke, 2004). Recently, a new generation of African American devotees has emerged. This group follows orthodox Ifa teachings through initiation and ritual practices as observed by devotees in current day Nigeria (Clarke, 2004). Distinctions among Ifa practitioners still exist within the United States; however, this is not unusual since regional variations of the spiritual system are also found throughout Nigeria (Falola & Childs, 2004).
* Ifa as a Mental Health Intervention
Ifa devotees often seek the services of a priest to address problems described as mental health concerns in Western counseling (Boyd-Franklin, 2003; Elebuibon, 2000). These individuals may use a pluralist approach toward healing, which includes seeing both a priest and Western-trained therapist for the same issue (Sussman, 2004). A full overview of Ifa spiritual practices is beyond the scope of this article. However, the summary outlined as follows assists readers in understanding how the etiology, diagnosis, and treatment of Western-defined mental health concerns are conceptualized within this spiritual system.
* Etiology of Mental Health Concerns Within the Spiritual System of Ifa
Within Ifa, mental health is not typically distinguished from physical or spiritual well-being (K. Abimbola, 2006; Elebuibon, 2000). With this approach, a set of culturally established beliefs and values defining emotional and behavioral norms are applied to recognize an individual as being ill. Through violation of these cultural norms, an individual may be labeled as sick rather than healthy (Sussman, 2004). Within Ifa, these violations are not labeled as mental health concerns, although the emotional and behavioral presentation can be consistent with Western conceptualizations outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000). For the purposes of clarity, violations of cultural norms are labeled as mental health concerns for the remainder of this article. This is not meant to suggest that such a clear distinction exists within Ifa; rather, it is to assist the reader in understanding this complex system of culturally shaped beliefs regarding the cause, diagnosis, and management of what, from a Western perspective, would be viewed as mental health concerns.
Ifa practitioners believe that mental health concerns emanate from three sources: (a) supernatural forces, (b) natural causes, and (c) personal choice (identified as Ori and Iwa Pele). When mental health concerns arise in an individual, a priest is consulted to determine the source of the problem and to obtain an appropriate prescriptive remedy (K. Abimbola, 2006).
Belief in supernatural forces causing illness is a widespread concept throughout the world (Sussman, 2004). Ifa devotees believe that anxious, depressive, and more severe psychotic symptoms may originate from supernatural forces (Prince, 2004). Resulting symptoms include alterations in behavior, speech, affect, and perceptual reality. Social relationships are also adversely affected. Ifa devotees believe that humans activate most negative supernatural forces, resulting in psychosomatic and other mental health concerns (Elebuibon, 2000). For instance, one person can create supernatural problems for another individual by wishing bad experiences on him or her, spreading harmful gossip, or engaging in negative magic designed to hurt the person (Falola & Genova, 2005). A client exhibiting symptoms of depression may be told by an Ifa priest (through communicating with supernatural forces) that one source of her or his ailment is a friend who is spreading negative gossip.
Failure to propitiate or offenses against one's ancestors and other divinities can also trigger consequences resulting in mental health concerns (K. Abimbola, 2006; Adekson, 2003; Prince, 2004). This is often the case when a child experiences ongoing behavioral difficulties such as hyperactivity or social withdrawal after the death of a parent. In such a case, the priest determines how the spirit of the deceased parent can be appeased in order to alleviate the child's symptoms (Prince, 2004).
According to Odejide's (1979) seminal work, Ifa devotees perceive two natural causes of mental health concerns: use of mind-altering substances and eating foods taboo or restricted for that individual (Elebuibon, 2000). In Ifa, substance use is recognized as causing mental health concerns paralleling those outlined in the abuse and dependence categories of the DSMIV-TR (APA, 2000; Odejide, 1979). For instance, symptoms of cannabis dependence are attributed to the consumption of marijuana rather than supernatural forces.
Noncompliance with dietary restrictions is also believed to result in mental health concerns. These restrictions are identified when problems arise for a client or can be predetermined during a spiritual ceremony (Elebuibon, 2000). Consultation with a priest can result in the client being advised to make dietary changes, and this includes the addition or elimination of certain foods in order to regain or sustain optimum health (Elebuibon, 2000).
The Yoruba worldview emphasizes the notion of personal responsibility for one's own choices (K. Abimbola, 2006). Although the majority of mental health concerns are perceived as emanating from sources outside the individual, personal choice is also believed to affect one's well-being (Prince, 2004). The concepts of Ori and Iwa Pele illustrate this point.
Ori. In the Yoruba language, the concept of Ori has multiple meanings. Ori refers to the physical head and a spiritual divinity (K. Abimbola, 2006). When the term is used to represent the spiritual divinity, it can be loosely compared with a guardian spirit influencing human behavior (Elebuibon, 2000). Ifa devotees believe that each person chooses an Ori before being born. It is believed that the individual's choice of Ori affects the quality of one's life. A client who is constantly facing difficulties in life can be perceived as having chosen a poor Ori. Adequately caring for one's Ori is used as a preventative measure against mental health concerns (Falola & Genova, 2005).
Iwa Pele. Maintaining Iwa Pele (good character) is also considered an important tool in the maintenance or restoration of mental health (Elebuibon, 2000). Iwa is roughly translated as character or the essence of being. Pele is translated to mean gentle or good (Falola & Genova, 2005). The term Iwa Pele is therefore translated in English as good character. Ifa devotees believe that individuals who forgo Iwa Pele risk developing mental health concerns (K. Abimbola, 2006). In Yoruba theology, sacrifice must be coupled with good character in order for a devotee's concerns to be resolved (K. Abimbola, 2006). Therefore, a client seeking to address mental health concerns may be counseled to make character improvements (Elebuibon, 2000). For example, rather than prescribing a spiritual intervention, a priest may advise parents to make improvements in their own character (behavior) in order to resolve their child's behavior problems.
* Labeling and Diagnosis
Indigenous healers tend to address the gamut of human dysfunction from a holistic orientation (Constantine et al., 2004). Priests are consulted for a variety of issues without specifically separating out mental health concerns. This holistic approach generally eliminates the need for mental health labeling categories. The introduction of Western psychological methods into Nigeria brought about the practice of distinguishing and labeling mental health concerns as separate from other conditions. At least one author makes limited labeling categorizations for acute psychotic disorders in the Yoruba language (Odejide, 1979). Were, disease of the mind, is similar to a diagnosis of schizophrenia in the DSM-IV-TR (APA, 2000; Odejide, 1979). Symptoms of Were include poor appearance and hygiene, disorganized speech patterns, and auditory and visual hallucinations. However, the etiology of the illness differs from Western psychology. The origins of Were are described as being caused by malevolent supernatural forces. Another diagnosis that parallels Western categories is Were Abga. This is similar to a diagnosis of dementia in Western mental health (Odejide, 1979). Although these few labels exist, priests generally emphasize the etiology of a problem rather than classification of the symptoms. Therefore, extensive information regarding symptom indicators or standardized intervention protocols does not exist.
In Ifa, diagnosis of mental health concerns begins with a violation of cultural norms, resulting in impairment of social relationships (Adekson, 2003; Prince, 2004). Once a problem is identified, a priest is sought out to determine its source and a prescriptive remedy. The priest uses the spiritual system of Ifa as a diagnostic tool through the process of divination (Falola & Genova, 2005). Divination is a method of connecting with supernatural forces to obtain information regarding the cause and treatment of the problem (K. Abimbola, 2006; Boyd-Franklin, 2003). The client seeking divination does not reveal the problem to the priest. This helps to ensure that the resulting information is not influenced by the subjective opinion of the diviner (K. Abimbola, 2006; Prince, 2004). The client is provided an object on which to pray quietly, returning it when finished. A series of invocations are performed, opening the lines of communication between the priest and the supernatural world. The priest casts the divining tools (shells or seeds) until a set of four binary symbols are obtained. These symbols relate to specific chapters of the Ifa Sacred Literary Corpus (i.e., sacred text; Falola & Genova, 2005). The priest explains the message in the chapter by relating relevant stories and proverbs to the client. In the process, the etiology of the problem is ascertained, the client's questions are answered, and the intervention is prescribed.
When mental health concerns arise, Ifa devotees typically use interventions prescribed through divination to alleviate the issue (K. Abimbola, 2006). Priests treat clients through a variety of methods, including spiritual baths, talismans (healing symbols), chanting Odu Ifa--The Sacred Ifa Literary Corpus, and sacrifice (Prince, 2004). Use of these intervention strategies is a method of healing the symptoms, while also addressing the underlying spiritual problem (K. Abimbola, 2006). Family members of the client often participate in therapeutic healing ceremonies, assisting with the administration of prescribed Ifa medications and helping to maintain special dietary restrictions (Boyd-Franklin, 2003; Vontress, 199 I).
Water is used in spiritual baths prepared with medicinal herbs for a variety of client concerns. Spiritual baths are often prescribed for clients with concerns believed to be the result of a curse (Oyelade, 1997). Clients experiencing psychotic symptoms are also given spiritual baths using a medicinal soap and sponge. In preparation of the bath, a priest recites specific prayers relevant to the client's presenting concern onto the mixture. The bath is then given to the client who is instructed in its use.
Another intervention tool used by priests to ameliorate or guard against negative forces is a talisman or charm (Falola & Genova, 2005). Talismans are small medicinal pouches prepared specifically for the client. A talisman is worn on the body or displayed in a distinct area within the home (K. Abimbola, 2006). Some are worn for healing and others are used to ward off malevolent spirits, manage behavioral concerns of children, or provide luck during pregnancy (Elebuibon, 2000). For people experiencing acute mental health concerns, talismans are also used as a sedative (Oyelade, 1997). Making talismans is a highly specialized field requiring additional instruction beyond the normal priest training.
Chanting Odu Ifa--The Sacred Ifa Literary Corpus
The Sacred Ifa Literary Corpus is a knowledge base composed of 256 chapters known as Odu (Falola & Genova, 2005). These chapters contain solutions to problems encountered in daily living and are used to express advice during divination. This body of knowledge is composed of stories, proverbs, and metaphors used for divination, in addition to being a therapeutic intervention (K. Abimbola, 2006). As an intervention, verses relevant to the client's concerns are chanted to invoke the medicinal properties embodied in the words (Falola & Genova, 2005). In Nigeria, when a client experiences mental health concerns, a group of Ifa priests gathers to chant Odus that return the person to a state of well-being. Chanting verses from the Ifa Sacred Literary Corpus for healing is primarily used in Nigeria and with less frequency throughout the diaspora because devotees have a more limited knowledge of the Yoruba language (K. Abimbola, 2006).
Among the Yoruba, the act of sacrifice is considered an integral link in the relationship between the physical and spiritual worlds (Clarke, 2004; Falola & Genova, 2005). The process of sacrifice entails giving up or forgoing something in order to gain positive changes in one's life (K. Abimbola, 2006). People perform sacrifices in order to continue receiving blessings from benevolent divinities and to remove and keep away destructive malevolent forces (Elebuibon, 2000). Ifa devotees believe that sacrifice must be performed for individuals to achieve success in personal endeavors. Sacrifices include personal commitments (e.g., time, money, and individual belongings), plants, herbs, and cooked foods. Ceremonial sacrifice is also used as an intervention on a more limited basis in Nigeria than in the diaspora (W. Abimbola, 1997). Once the sacrifice is received, the devotee's concerns are considered spiritually resolved. Devotees believe that failure to complete a prescribed sacrifice results in additional problems for the client (Elebuibon, 2000).
* Illustrative Case Example
Today, adherents of indigenous spiritual systems often consult with their spiritual leader when addressing mental health concerns (Boyd-Franklin, 2003; Sussman, 2004). This holds true among a growing number of African Americans drawn to indigenous healing systems and in particular Ifa (K. Abimbola, 2006; Clarke, 2004). Considering that clients may use Ifa in conjunction with Western interventions, counselors would benefit from understanding the conceptual framework underlying this healing modality. It is also necessary for counselors to form therapeutic alliances with indigenous healers, incorporating knowledge gained from these practitioners into the counseling session. The following case provides an illustrative example.
The Case of Ade Cotton
Ade Cotton (a pseudonym used to describe several clients) is an 8-year-old African American boy referred to counseling by his pediatrician. Mr. Cotton, Ade's father, expressed concern that his son has experienced attention difficulties, poor academic performance, and a failure to maintain peer relationships in school. During the intake session, Ade appeared visibly anxious. Mr. Cotton is an engineer who noted raising Ade alone after his wife died 6 years earlier. He became concerned after Ade's second-grade teacher suggested that he be evaluated by the school's psychologist. Mr. Cotton discussed his concerns with Ade's pediatrician, who suggested a counselor specializing in working with children.
Although Mr. Cotton did not indicate any religious preference on his initial paperwork, the counselor followed up by asking about interactions with a spiritual community and prior use of indigenous healers. Mr. Cotton discussed his previous use of Ifa priests when addressing personal concerns. Boyd-Franklin (2003) noted that many African Americans treat religion and spirituality as separate concepts; therefore, counselors should ask clarifying follow-up questions. Counselors should also consider that individuals use the services of an Ifa priest without being a devotee. Therefore, the counselor should ask whether the client has used the services of an indigenous healer, received divination, or participated in spiritual rituals.
Etiology of the Problem
During the initial interview, the counselor maintained awareness of her own Western training influencing her assessment. The counselor considered how her own conceptualization of Ade's concerns was informed by her theoretical orientation and how that differed from his father's. She asked Mr. Cotton to share his beliefs regarding the origins of Ade's concerns. Mr. Cotton conceptualized his son's problems as being linked to the death of his mother.
The counselor shared her assessment that Ade could benefit from psychodiagnostic testing by the school psychologist. She also noted Mr. Cotton's interest in pursuing divination from an Ifa priest. The two agreed that divination should occur first and coincide with family therapy. However, Mr. Cotton did not have access to a local Ifa priest. The counselor had established relationships with local priests, the child's school counselor, and school psychologist. She assisted the family in coordinating care for Ade.
The counselor made initial contact with the Ifa priest, having obtained a release of information. The counselor and the priest had a long-standing professional relationship, which included a mutually signed nondisclosure confidentiality agreement. Ade and his father made an appointment to receive divination. The Ifa priest identified the origins of Ade's problems as a need for him to engage in activities in remembrance of his mother (e.g., propitiation of one's ancestors). The priest also counseled Mr. Cook on a need to set clearer boundaries and change his rigid disposition toward Ade (e.g., change in dad's behavior--Iwa Pele).
The priest provided Ade with a spiritual bath to use daily for 1 week. She also prescribed activities that Ade and his father were to complete weekly in remembrance of his mother. After discussing the results of the divination, the counselor worked with Mr. Cotton to establish clear boundaries and soften his interpersonal style with Ade. The counselor also encouraged Mr. Cotton to monitor Ade's academic progress through regular contact with his teacher and school counselor. The two agreed to continue monitoring Ade for 6 months before reconsidering a referral to the school psychologist.
Within this illustrative case example, family participation in healing activities is highlighted. However, the choice to embrace a non-Western religion can cause conflict within families (Adekson, 2003; Boyd-Franklin, 2003). This may mean that family members decline to take part in healing activities or pressure clients to discontinue participation in Ifa. When treating an Ifa devotee, clinicians should evaluate family dynamics by assessing for stressors in this area.
It is important for counselors to consider the underlying historical, social, and cultural variables that shape a client's beliefs regarding illness etiology, diagnosis, and intervention. Although the professional literature has begun to explore the use of indigenous healing modalities, little attention has been given to African Americans seeking these services (Moodley & West, 2005; Myers et al., 2005). The growing popularity of such healing modalities necessitates that counselors become better equipped to deliver services consistent with the client's beliefs (K. Abimbola, 2006; Boyd-Franklin, 2003). Considering that little is known about Ifa within the counseling field, future research should focus on understanding the ways in which priests of this spiritual system conceptualize and treat Western-defined mental health concerns. This will enable counselors to better comprehend the factors compelling some African Americans to seek this healing system either exclusively or in conjunction with Western mental health care.
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Ifetayo I. Ojelade, Jeffrey S. Ashby, and Joel Meyers, Department of Counseling and Psychological Services, Georgia State University; Kenja McCray, Department of Social Sciences, Atlanta Metropolitan College. Ifetayo I. Ojelade is now at A Healing Paradigm, LLC, Atlanta, Georgia. Correspondence concerning this article should be addressed to Ifetayo I. Ojelade, A Healing Paradigm, LLC, 950 Dannon View, Suite 4201, Atlanta, GA 30331 (e-mail: Ifetayo@AHealingParadigm.com).
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|Author:||Ojelade, Ifetayo I.; McCray, Kenja; Ashby, Jeffrey S.; Meyers, Joel|
|Publication:||Journal of Counseling and Development|
|Date:||Sep 22, 2011|
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