introduction 31
standard defi nition that transcended the various therapeutic contexts I was
examining.
Meanwhile, allopathic psychiatrists I discussed my work with, both in
Kerala and in the United States, were concerned about whether I was compar-
ing problems of similar severity in my research. When I said that some people
reported their condition had improved after their stay at Beemapalli mosque,
psychiatrists suggested that this was probably because there were no seriously
psychotic people at Beemapalli. Th ey suspected that the mentally affl icted
people at the mosque were only mildly neurotic and thus easily treatable by
suggestion. Th is was a valid concern, but ultimately it did not refl ect the kinds
of people who frequented Beemapalli. Many of the patient-devotees at the
mosque would be, or already had been, diagnosed by allopathic psychiatrists
as psychotic. Several exhibited symptoms such as hearing voices, outbursts
of laughing, crying, or screaming, tearing off clothes, fl at aff ect, disordered
speech, and outbursts of violence, and several had previously been inpatients
in allopathic psychiatric hospitals.
Th e concern voiced by these psychiatrists did, however, refl ect the need
to interview people with problems of varying severity to obtain a more com-
plete picture of the experience of psychiatric healing in Kerala. Fortunately,
most research sites had something like a distinction between inpatients and
out patients based on the severity of the patients’ problems, and I worked to
balance my interviews along these lines. Both the allopathic and ayurvedic
healing centers had outpatient and inpatient facilities, and the religious heal-
ing sites had similar distinctions. Some patients visited Beemapalli mosque
on occasion and then went home whereas others lived at the mosque. Some
people with serious diffi culties who were violent or who were believed by their
accompanying family members to be at risk of running away were locked in
cells behind bars.^27 After reviewing the patient interviews, I found that a sub-
stantial portion of interviewees in each of the three therapies had problems that
would meet the defi nition of severe mental disorder used by the World Health
Organization in international epidemiological studies of mental illness.^28
A related issue is whether states of possession and illnesses as understood by
allopathic psychiatry or ayurveda are comparable or whether an illness category
used by one healing system can be translated into the terms of another system.
Is spirit possession a form of dissociative disorder? Is the ayurvedic diagnosis
kaphotmada understandable as a type of depression, or vice versa? Th e relations
between diff erent forms of affl iction have been discussed and debated, but I
think the diff erences between these types of distress are impossible to discern
fully—we may never completely comprehend how the existential experience
of being possessed compares to the experience of coping with dissociative