This book is a revision and development of a doctoral dissertation directed by Willem Saayman at the University of South Africa. Between 1980 and 1990, mainline church membership (Anglican, Methodist, Catholic and Dutch Reformed) declined by 25 percent, while membership in churches offering religious and faith healing increased by 23 percent. The author determined to study healing churches in an effort to understand the reason for their appeal and to seek an answer for the recurring debate about whether healing did or did not occur there in each instance.
He coined the phrase "coping-healing" to describe the subject of his study. This concept refers to healing apart from scientific western medicine and includes all that is involved in healing through prayer, faith, and other spiritual means. Coping was added as a qualifier because some realities subjectively experienced as healing might not necessarily be healing at all.
Bate used a participatory phenomenological method to gather data about those who heal and are healed in the Natal region, particularly the Durban - Pietermaritzburg axis. Then he analyzed the data from five "mediations" or perspectives: psycho-medical, anthropological, sociological, philosophical, and theological. Each perspective highlighted distinctive features of the coping-healing phenomenon and helped construct a rich -- if still only partial -- understanding of this complex reality. Each perspective also exposed the positive and negative dimensions of the phenomenon. For instance, the theological perspective observed that coping-healing churches tend to place more emphasis on the spirit and much less on Jesus but in either case believe that supernatural intervention suspends natural law. This simplistic perspective is an inadequate explanation of the event.
At this point, Bate begins to make a theological judgment about the coping-healing phenomenon. He accepts and refines Robert Schreiter's approach to culture in theological anthropology and inserts this as a key element in his inculturation model. In Schreiter's terms, coping-healing practices are "culture texts" operating within various "semiotic domains" of healing. Bate believes that the value of using an inculturation model to explore the coping-healing phenomenon lies in its historical orientation. Such a model helps to identify stages in the establishment of Christianity in a new culture different from the Mediterranean culture of origin or the European-Western culture of transmission. The model suggests that the coping-healing strategy emerged in South Africa as a response to believers' frustrations with apartheid, racist society and to the disillusioning realization that mainline churches may have been part of the problem rather than the solution.
To explore coping-healing more specifically, Bate considers to what extent this strategy is solely "cultural" and to what extent is has been or can be "christianized." He concludes that it is "a partially inculturated ministry in which culturally mediated needs are being responded to by empirically based culturally mediated pastoral responses" (p. 283), though individual coping-healing practices themselves need to be evangelized and purified. The phenomenon ought to be accepted, refined and incorporated into the Church's praxis.
Bate has accomplished a praiseworthy pioneering theological study that deserves careful attention. Readers unaccustomed to reading this kind of multidisciplinary investigation will discover intellectual "muscles" of which they had previously been quite unaware. Like all exercise, this one too may cause this muscle temporary pain. Once strengthened, however, the intellectual "muscle" will function effectively, facilitate interpretation of reality and texts, and render theologizing an even more rewarding experience.
As a theologian, he deserves enormous credit for venturing into diverse disciplines -- even if not formally trained in some of them -- in order to gain the broadest possible understanding of his topic. Happily he is not deterred by the academic prejudice that one dare not enter into any field in which one has not earned another graduate degree. His willingness to employ and adapt models is especially commendable. Models help to gather data and to interpret it. Bate's use of models is a good example for other theologians to imitate. The basic theological methodology in this (observe-judge-act) is executed adroitly. A variation on this which might be useful in future investitations is the "life-lore-life" approach, whereby one examines a slice of life (coping-healing), searches the lore for illumination (scripture and/or tradition; other mediations), and returns to re-interpret life.
Is there room for improvement in this study? Of course. Like every pioneering effort, so too does this one have its shortcomings. To point these out in some detail will not detract from the value of Bate's work. The aim is to encourage him and others who might be interested in adopting his approaches to refine and sharpen basic concepts, models, and the inculturation model he uses. The viewpoint of this reviewer is that of a trained biblical scholar who employs the social sciences (cultural, Mediterranean, medical, psychological, and political anthropology among others) in the interpretation of biblical texts and contemporary society and who has held a clinical appointment on the preventive medicine faculty of a medical school for thirteen years.
What impact does it have on the research if the researcher is a white male, a Roman Catholic, a cleric, a religious, a member of a missionary group, a native (or non-native) South-African? As a white male, Roman Catholic, Western, lay-person, trained biblical scholar who employs social science methodology in interpreting the Bible and modern society. By neglecting to tell the reader the significance of his social location on his research, the author forces a reader to read between the lines. Such reading may well have been entirely false or it may have had some merit. Here are three examples which suggests to me that Roman Catholicism played a significant but entirely implicit role in the research.
At the very beginning of his study, Bate voices concern about the implication of 5,000 (and still growing number of ) Christian churches for Christian unity, or for the mark of Oneness of the true Church. While pre-Vatican II Ecclesiology generally considered the Roman Catholic Church as the one true church (One, Holy, Catholic, and Apostolic), post conciliar Ecclesiology teaches that the Church embraces Catholics, Orthodox, Anglicans, Protestants, and Oriental Christians alike. Other Christian communities are somehow related to the Church. The four marks of the Church are a Roman Catholic belief. Does Bate's concern for unity stem from his Roman Catholicism? If so, a reader would appreciate more information about the ideal and the problem.
From a social science perspective, a researcher would examine this plurality in terms of the collective orientation (group-centeredness) that anthropologists ascribe to African culture in general. In other words, this apparent plurality seems to offend against the culture (as much as against Christian unity). Yet each church is a group and seems to behave according to the patterns of group behavior identified by social scientists. And the groups appear to have this in common, that they resist mainline churches. Is there perhaps a unity or solidarity here after all? Reading between the lines (always a risky procedure) suggests the concern about unity stems from the Roman Catholic social location of the researcher. At least ten of the nineteen abbreviations of documents regularly quoted in this book refer to Roman Catholic documents. This perspective is quite legitimate but ought to have been made more explicit.
On a few occasions, he seemed interested in finding a specificity for Christian healing, that is, a dimension other than the cultural. Does Christian healing have to be distinct? Is it? This interest in a specificity for Christian healing reminds me of a similar concern in the United States among Catholic hospitals. Is health care (healing) a business or a ministry or both? If both, which element receives priority? If both are equal, why are pastoral ministers so minimally included in the management of each patient's condition? They are usually summoned only after the medical personnel play their roles. Who in the hospital heals as Jesus heals? What makes a hospital Catholic? (or Lutheran, for that matter?) What takes place in county or state-owned hospitals when the majority of health care personnel on staff are Catholic or Christian? How did the healing activity of Jesus differ from that of contemporary Asclepeian priests or from that of contemporary Hebraic holy men like Hanina ben Dosa? Questions like these appear to stem from a concern for specificity, uniqueness, distinctiveness. As is evident, they are not easy to answer.
Finally, theological anthropology is a major element in Bate's study. Theological anthropology is not a social science but a theological enterprise. It is a favorite interest of the phenomenological philosopher, Pope John Paul II and some other theologians. One encounters it in some older theological studies. For the most part, it describes a biblical rooted, theological outlook on human beings. How does it or does it not mesh with social scientific anthropologies? This item too deserves fuller treatment than it receives in this study.
Reading between the lines, this white, male, Roman Catholic reviewer concludes that the three example just listed suggest Bate is using his Roman Catholicism as a "mediation," that is, a particular standpoint that attempts to render reality or aspects of reality intelligible within the categories of that standpoint (p. 64). If this is so, the mediation ought to have been made explicit and evaluated along with the other mediations in Part III.
Bate also has missed some opportunities to expand upon insights surfaced by the mediations. For example, in the psycho-medical mediation, the experience called amafufunyane in the Zulu world-view (p. 69) is very similar to the Middle Eastern experience of the "evil eye" with which Jesus and his cultural world were quite familiar (see Matt 20:15; Mark 7:22; Prov 23:6; 28:22; etc.). This should not be a surprise since the basic experience is common to sixty-seven cultures of the world, about 36% of a total world sample. Each culture, of course, shapes it into a distinctive syndrome, or a culture bound syndrome which Bate discusses in the anthropological mediation. Comparing amafufunyane and evil eye cross culturally might have provided a new and interesting point of entry into the coping-healing phenomenon which in turn might have promising results for missiology.
This leads to a third observation. The contours of the coping-healing phenomenon could become sharper if at least three of Bate's mediations would have been recognized and treated as complementary. He often speaks of overlaps, but this three-fold complementary perspective is more than an overlap. A rather broad picture of health, sickness, and related strategies in any culture emerges from a combination of psycho-medical, medical-anthropological, and medical-sociological perspectives. This is standard procedure in some specialties of western medical practice, viz., family medicine and preventive medicine. In other words, it would be helpful to broaden the horizon of "mediations" and relate them more closely.
Thus, from a psycho-medical perspective, amafufunyane is a psychosis (a disease) caused by response to intolerable stress. From a medical anthropological perspective, it is a Zulu culture-bound syndrome constructed as a response to stress in that culture. The medical-sociological perspective highlights the social aspect (animosity or jealousy of another person experiencing good fortune) of the condition. This is certainly not a private affair but rather a social or communitarian experience. The philosophical mediation highlights the important and integral place of spirits in the Zulu (and African) world-view. Studies have demonstrated that the Western distinction between "supernatural" and "natural" reflect categories peculiar to Western culture. Such a distinction doesn't exist in Zulu or many cultures in which the spirit world is an integral ("natural") part of ordinary ("natural") life. Finally, the theological mediation -- if rooted in the Bible -- relates amafufunyane to the evil eye and its consequences. Both the Old and New Testaments make references to the evil eye and its effects and discuss strategies for dealing with it. Clearly the mediations don't overlap. Each reveals another dimension of a complex reality. Correlating the data provided by the mediations helps form a richer understanding of the problem at hand.
Finally, the definitions and distinctions in medical anthropology between disease (organic and objective) and illness (social and subjective) and curing (restoring or maintaining organic integrity) and healing (providing human meaning to the sickness experience) would have sharpened Bate's discussion if he had adopted and applied them throughout the book rigorously and consistently. Bate (p. 102) understood and correctly reported them from Kleinman in the anthropological mediation but did not adopt them as guiding definitions in his study. Since healing by definition includes coping, it would not have been necessary to coin the tautological phrase "coping-healing." Neither is it correct to say that some ways and means of coping with reality "may not necessarily be [healing]" (p. 15). According to medical anthropology (e.g., Kleinman), healing takes place all the time, infallibly, in 100% of the cases. Healing results from finding new meaning in life whether the condition improves or not. Improving or remedying the actual condition is curing, and it happens very rarely. In the Unites States, in this century, major threats to health peaked and were subsiding before scientific medicine found the cure. Thus, "theologia crucis," redemptive suffering, the will of God, turning the other cheek, and offering it up for the souls in purgatory among other strategies all reflect this medical anthropological understanding of healing. Healing helps ill people get on with life.
From this perspective, amafufunyane is not a disease but rather an illness, that is, a socially constructed interpretation of a loss of meaning in life. It is the western scientific psycho-medical perspective that erroneously and unfortunately would turn it into a disease. H. Bame Nsamenang of Cameroon, West Africa (Human Development in Cultural Context: A Third World Perspective (London: Sage, 1992) has demonstrated that modern Western psychiatry and psychology is monocultural and for all practical purposes useless in diagnosing or dealing with non-Western situations, particularly those in [West] Africa. Medical anthropologists are in general agreement that before so-called scientific, western, bio-psycho-medicine can be imported or applied to any other culture it has to be stripped of its peculiar western cultural accretions. If Bate is a native South African, I would encourage him to omit insights from Western psychology from his study except to critique them or demonstrate their inapplicability to the South African situation.
It is insufficient simply to identify something as "biblical" (laying on of hands, p. 259; demons, p. 263) or to state that the coping-healing praxis is "closer to the biblical cultural framework than to the Western cultural framework" (p. 269) when the first century, Middle Eastern, cultural world of the New Testament is nowhere explained in this study. The challenge to coping-healing, mainline, and all churches is to conduct a study of the healing activity of Jesus in its cultural context similar to the study Bate has conducted on the contemporary South African coping-healing phenomenon.
What does it mean to heal like Jesus heals? In Jesus' Mediterranean, high-touch culture where people touch one another freely, press against each other without apology, speak to one another with as little as six to ten inches between each other, what is the significance of "laying on of hands?" How was it done? How was it experienced? What did it signify culturally? David Flusser ("Healing through the Laying-on of Hands in a Dead Sea Scroll," Israel Exploration Journal 7 (1957) 107-108) concluded from his study of the [1st Cent BC/AD] Genesis Apocryphon XX:29 that Jesus was not the first to heal by the laying on of hands, and that this practice was current in some Jewish circles.
Specialists in proxemic behavior caution against thinking in monolithic terms when considering things like touching behavior. Variations occur between and within cultures according to many factors such as sex, age, relative status, among other variables. Given the diverse modern interpretation and practice of laying on of hands inspired by biblical narratives, why does Bate suspect that "God's healing would probably not be communicated to the mainline church member in a Zionist Service and the converse would probably also be true" (p. 259)? Is this a conclusion from his participatory phenomenological observation? Is it informed by one or another mediation?
It may not have been available to him before he completed preparing this book for publication, but for his future reflections on the coping-healing phenomenon Bate would profit from consulting the Pontifical Biblical Commission's publication, The Interpretation of the Bible in the Church (Rome: Libreria Editrice Vaticana, 1993). Though the publication date is 1993, the document did not become available until 1994. Of particular interest would be the section on interpreting the Bible with the Human Sciences (sociological approach; cultural anthropological approach; psychological and psychoanalytical approaches), and the section on Actualization and Inculturation.
A cultural study of Jesus' healing activity and cross-cultural comparison with South African cultural strategies conducted according to the Biblical Commission's guidelines might well uncover commonalities hitherto unnoticed. Such a study would provide fresh insights about the coping-healing phenomenon in widely diverse Christian churches and perhaps inspire mainline churches to review their theological traditions and enlarge and enrich their repertory of healing strategies.
John J. Pilch
Georgetown University, Washington, DC 20057 USA