**For the purpose of distinguishing between Mexican American and Latino: Mexican American refers to individuals who are of full or partial Mexican descent and are a citizen or resident of the U.S. Latino refers to individuals with descent from Latin American countries including Mexico.**
Curanderismo is a traditional folk healing system used in Mexican American and Latino cultures. A curandero, which literally translates to “healer” in English, is a trusted individual from the community (often an elder) who performs curanderismo practices such as using herbal remedies, limpias (cleansings), prayer, energy forces, and rituals to cure various illnesses. Other forms of healing include manual setting of bones and massage therapy. Curanderismo uses a holistic approach to curing illness by coupling spirituality/religion with noninvasive healing of the physical and mental barriers to health. With curanderismo practices comes certain values and beliefs that should be understood by health care professionals to facilitate best quality of care for patients. So often, we meet individuals with completely different cultural practices from our own and it is easy to let our egocentric knowledge of health overpower their voice when it comes to providing healthcare services.
Occupational therapy practitioners are well-versed in providing services that are culturally competent, however, we should continue conversations about the role of spirituality in leading to health care decisions and beliefs such as those held from individuals in the lower Rio Grande Valley where modern-day curanderismo is still prevalent within the household and external providers. Within the Occupational Therapy Practice Framework: Domain and Process (3rd edition), spirituality is categorized in the client factors domain and is defined as “the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” (5). Spirituality goes hand-in-hand with curanderismo and is a respected alternative medicine within Mexican American/Latino communities. Spirituality in curanderismo practice does not always mean the inclusion of religion, but from personal experience, religious experiences in curanderismo gives individuals a sense of well-being and hope that their illness will fade.
The purpose of discussing the topic of curanderismo is not to dismiss the beliefs of those who continue to practice it today rather I hope to continue to raise awareness and understanding of this Mexican/Latino practice because the topic has rarely been explored since the 90s.
When I was completing my observation hours to apply to OT school, I shadowed at a privately owned OT pediatric clinic. The owner and only occupational therapist was white (and yes, she was an amazing therapist!). However, there was a family who was rarely able to make it in for therapy (they were Hispanic and spoke only Spanish). When I asked the therapist if perhaps there was an issue with transportation for them to make their therapy sessions, the OT responded with “The mom thinks their house is haunted and she is trying to find a different place to live” while simultaneously rolling her eyes. The therapist then explained that she was more than likely going to discharge the client because of their continuous absence.
This was an example of how two different cultures view a barrier to health because while the occupational therapist seemed annoyed by the family’s absurd claims, I was a bit more understanding because I grew up in a culture who believes firmly in supernatural forces. This brings me to my next statement: curanderismo practices include healing of supernatural illnesses (7). Individuals in Hispanic communities may value and continue to have faith in curanderismo because supernatural experiences that cause harm to health are taken seriously by their curandero/curandera instead of being dismissed.
From first-hand experience, I’ve seen how curanderismo has helped individuals feel more secure in their lives which has led to better health. While I am a firm believer of science, I am also able to understand how the belief in holistic alternative medicine such as curanderismo is able to heal the soul more than anything. Why is that a bad thing? As occupational therapy practitioners, there will be instances where we need to see beyond our own views and culture to help a patient “heal”; whether the healing is physical or spiritual. Understanding how differences in culture and beliefs could potentially become a barrier to health, such as in the example given before, is why I will be outlining a few of the beliefs and curanderismo practices that are still well-known and used throughout the Latino community.
Curanderismo in the Rio Grande Valley
The listed beliefs and customs of curanderismo are all based from personal experience and they have also been studied in the past by researchers. Currently, there is little research about the current curanderismo practices performed within the RGV. However, given the review of literature from the 90’s in which curanderismo was most extensively studied by researchers in smaller communities and the way I have come to know curanderismo practices today, it seems a shift has occurred from visiting a formally known curandero/curandera in their designated location to using curanderismo within the household. For example, usually the woman of the house (grandmother, mother, or sister) will perform curanderismo practices on their family; the examples listed below will highlight this.
El Mal Ojo
El mal ojo translates to the bad eye or evil eye. This might be one of the most common Mexican/Latino beliefs and is characterized by an occurring illness caused by another person’s envy. Mal ojo can happen to anyone, but is most commonly associated with children. When an individual is thought to have mal ojo, they are usually stricken by an illness that causes fever, fatigue, headaches, and inconsolable crying (4). In the Rio Grande Valley, it is not uncommon for strangers to approach you and ask to touch you, an object you are wearing, your hair, or your baby. While those who are not familiar with the culture in the RGV may feel their space is being violated (rightfully so), here, it is known that strangers do this to prevent giving you the mal ojo with their envy or appreciation for a part of you.
When a person envies or greatly appreciates something about you, it is thought that touching the person of envy or appreciation will limit the forces of the mal ojo. For example, while at the grocery store a person shopping with their young child is stopped by a stranger. The stranger compliments them and tells them that their child has the most beautiful curly hair they have ever seen. In this instance, the stranger asks to stroke the child’s hair because they don’t want to give them ojo. The parent of the child allows it and they simply go on about their shopping trip. In another example, the stranger never approaches the parent and child. Instead, they admire the child from afar. It is believed that the appreciation or envy from afar without touching the person will cause them to get mal ojo. This would result in the child feeling the symptoms previously mentioned by the end of the day and will continue on for days or weeks until it is eradicated with a curanderismo ritual using an egg and prayer.
The ritual can be performed by anyone who believes in curing the illness with curanderismo. The curandero/curandera rubs the egg all over the body of the individual affected by mal ojo in movements mimicking the holy cross. Simultaneously, the curandero/curandera recites a prayer. The egg is then cracked and the yolk immersed into a glass of water. After a few seconds, the reaction of the yolk and water reveals either a black color or multiple bubbles signifying the release of the bad energy from the body.
Limpias
Limpias or spiritual cleansings are performed by curanderos/curanderas for objects and people. Limpias are performed when wanting to clear someone of negative energy/thoughts, curses, hexes, or a supernatural occurrence (spirits, ghosts). One way a limpia can be performed is by using sage to rid a home of negative energy or bad spirits. My mother would often perform these limpias within our home. She was a believer in negative energy invading the home after family disputes, bad finances, and changes in mood among family members. So, she would burn sage all around the inside our home while reciting a prayer. Another technique used to cleanse the soul of negative energy is to sweep an aromatic plant such as rue or basil all over the person’s body. Typically, limpias are performed when a person is experiencing a phenomenon called susto. Susto is characterized by excessive fright resulting from a traumatic incident and may manifest symptoms such as physical weakness, depression, introversion, and apathy (2).
Yerberias and Candle Rituals
A yerberia is a Hispanic herbal shop or spiritual drug store that sells herbs, stones, ritualistic candles, religious amulets, healing oils, and other mystic tools used for home-made spiritual and physical healing remedies. Within these shops, services such as limpias are often offered by a self-proclaimed curandera. Herbal remedies are used in curanderismo to heal various ailments such as estafiate (white sage) for empacho, yerbabuena (peppermint) for stomach pains, and manzanilla for sleep disorders or anxiety/emotional discomfort (2).
Empacho: lodging of food within the digestive tract that causes symptoms such as bloating, constipation, and lethargy. Sobadores (masseurs) help to dislodge the bolus of food along with herbal supplementation (6).
Ataque de nervios, or ‘nerve attack’, is an emotional disturbance that occurs following a stressful circumstance which results in excessive crying, insomnia, anger, trembling, feeling of heat rising to the chest or head, and dissociative experiences (1). This is often treated with herbal remedies. Women are more likely to experience ataque de nervios and clinical studies have found that 76% of Hispanic patients seeking mental health services have reported experiencing ataque de nervios at least once in their life (3).
The use of ritualistic candles also known as “fixed” candles is common in the RGV. Ritualistic candles can be purchased within local grocery stores due to their high demand. Fixed candles have a catholic saint or a particular purpose “fixed” into them. An example of a fixed candle is the “Spirit of Good Luck” candle. This type of candle is used to bring about good luck and fortune. Religious candles can also be used for blessing the home, getting rid of negative energy, or to honor a family member who has passed. My mother frequently lights a candle of the Virgen De Guadalupe, a catholic saint who is revered in Mexico and other Latin American countries. She also lights white candles immersed in a bowl of water to help guide my father who has passed through his journey in the afterlife.
Complementary and Alternative Medicine (CAM) in Occupational Therapy
The American Occupational Therapy Association (AOTA) recognizes the value that complementary and alternative medicine (CAM) may bring when used by practitioners to enhance occupational engagement for clients (5).
CAM defined: “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine” — National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health
While it may not be expected for OT practitioners to necessarily adopt curanderismo practices, understanding the differences in cultural health beliefs and connection to spirituality for Latino populations will offer occupational therapists the opportunity to increase clients’ responsiveness and adherence to care. Additionally, viewing health through the perspective of Latino culture will improve quality of care by merging traditional health beliefs with occupational therapy and building trust through a much more intimate spiritual bond. Other CAM practices such as yoga, reiki therapy, energy healing, mindfulness, and massage are already being used by therapists to enhance occupational engagement for clients. Learning about curanderismo can help bridge the gap between a culture of Western medicine and traditional Latin American folk healing systems to improve overall health for Mexican American and Latino clients.
References
1. Glossary of Cultural Concepts of Distress. (n.d.). Retrieved July 31, 2020, from https://dsm.psychiatryonline.org/doi/10.1176/appi.books.9780890425596.GlossaryofCulturalConceptsofDistress
2. Lopez, R. A. (2005). Use of Alternative Folk Medicine by Mexican American Women. Journal of Immigrant Health, 7(1), 23-31. doi:10.1007/s10903-005-1387-8
3. Multicultural Series: Part One – Treating ‘Nervios’ in Hispanic Patients. (2014, November 12). Retrieved July 31, 2020, from https://www.healthcomu.com/2014/11/06/treating-nervios-hispanic-patients/
4. National Center for Farmworker Health. (n.d.) Folk medicine and traditional healing. [Fact sheet]. http://www.ncfh.org/uploads/3/8/6/8/38685499/folk_medicine_and_traditional_healing.pdf
5. Occupational Therapy Practice Framework: Domain and Process (3rd Edition). Am J Occup Ther 2017;68(Supplement_1):S1–S48. https://doi.org/10.5014/ajot.2014.682006
6. Torres, Eliseo. 2006. Mexican Folk Medicine and Folk Beliefs. [Powerpoint]. Retrieved from http://www.unm.edu/~cheo/LONG.pdf
7. Trotter, R. T., & Chavira, J. A. (1997). Curanderismo, Mexican American folk healing. Athens: University of Georgia Press.