Obeah and myal

Domain XI · Traditional medicine & indigenous healing · Jamaica and the Caribbean

What it is

Obeah and myal are not one therapy. They are Afro-Caribbean spiritual and healing traditions, and they have no single text, founder or governing body. What follows describes them for the psychotherapist who works with clients for whom they matter. It does not teach them.

Format

• Phase A: Engagement and cultural assessment (sessions 1-3, individual; family or informant if the client wishes).
• Format: APA says the CFI can be used "by any clinician providing services to any individual in any care setting." How long the core CFI takes is. In the DSM-5 field trial, later administrations took less time.

Who practises it, and how they are trained or regulated

• Who holds authority. No regulator, licensing body or council governs obeah, myal or balmyard healing. Authority has rested with individual healers, mediums and Revival leaders whom their own clients and congregations recognise. Oral tradition, for example, traces one historical balmyard healer's authority to a calling in a vision. Historically the state appears as the prosecutor, under obeah, vagrancy and…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• reluctance to tell the prescriber, and new physical symptoms. It is working when the prescriber has a complete list.
• language such as "superstitious" or "lacks insight" used about cultural belief. It is working when the client agrees the summary is accurate.
• guarded politeness; missed appointments after spiritual topics come up. It is working when the client says what they are afraid you will think.
• accusations naming a person, plans for revenge, or social withdrawal. It is working when fear and avoidance ease, even if the explanation stays the same.
• brokers whose own views on obeah, Revival or Rastafari are partisan. It is working when the broker's input changes or confirms your formulation in a specific way.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.