introduction 21
Along with these exalted goals of therapy are the more common, modest
results of treatment that are not captured by the usual understandings of cur-
ing or healing. Th us people struggling with mental problems in Kerala talk
of achieving māram (“change”), bōdham (“improvement”) and abhivriddhi
(“prosperity”) through therapy. Th e attention to the process of therapy also
makes us aware of ways of approaching time and teleology in therapy that
also complicate the ideals of curing. For example, some people with chronic,
recurring problems have found ways not of curing or healing, but of coping or
living with their problems by residing in the aesthetically engaging environ-
ment of a temple, mosque or church. Th ese people have been unable to rid
themselves of their mental affl ictions, but they have found a way of improv-
ing the quality of their experience as a person living with mental problems by
choosing to reside in the aesthetically engaging setting of a religious center
rather than pursue healing in the sterility or aesthetic adversity of a hospital
environment.
Th is study also hopes to revive medical anthropology’s concern with med-
ical pluralism. Th is feature of the world of healing, which is indeed the norm
of medical environments around the globe, was the focus of research going
back to some of the earliest investigations in the fi eld of medical anthropol-
ogy, yet this topic has waned as a central concern in recent decades. Certainly
numerous contemporary studies in medical anthropology continue to be set
in medically plural environments, and the insights of some of these earlier
works have been canonized in reviews of the fi eld of medical anthropol-
ogy (for example, Baer, Singer and Susser 2004). Nevertheless, the fact that
most people in the world have the opportunity to “shop around” and com-
pare medical systems could be more central to our analyses. Early studies of
medical pluralism looked at how people navigate multiple healing systems,
focusing on decision-making and cognitive, rather than experiential, orienta-
tions (Romanucci-Ross 1969, Janzen 1978, Young 1981). Later work looked
at how people’s interactions with multiple healing systems relates to socio-
economic change and social relations (Mullings 1984, Crandon-Malamud
1993), concerns about morality (Brodwin 1996), and, in my own earlier
work, how medically pluralistic environments enable people suff ering psy-
chopathology to fi nd a healing system that fi ts their personality and identity
(Halliburton 2004). But the ability to compare medical systems also leads to
insights into the aesthetic experience of healing and off ers novel understand-
ings of health and curing. By investigating these topics, this study reminds us
of the fundamental importance of attending to the insights and experiences
people develop from living in environments where multiple healing systems
are widely available.