Social change and shifting paradigms: the choice of healer among black South Africans in psychological counselling

Social change in South Africa brings to light the multiplicity of world-views operating in our society, which individuals encountering a variety of social contexts are faced with. This raises questions about the choices black South Africans face in response to influences from Western and traditional African culture. This issue was approached through examining helpseeking choices made between different health care sectors that stem from different world-views. This would indicate whether individuals are drawing on a variety of belief systems. The sources of their beliefs are put into context by looking at the communities of practice that influence their local knowledge. Help-seeking is also influenced by the identities the individual may ascribe to, which are derived from the multiple positions held by them in different social contexts. In this research the use of health-care sectors by four black women attending psychotherapy is examined. Their use of these sectors reflects a potential multiplicity of world views. Semistructured interviews were conducted, focusing on participants' prior experience of different help options, and their current perceptions of traditional African healing and psychology. The texts were analysed using a qualitative hermeneutic method, the reading guide. Data was looked at through three main themes, the individual's relationship to the health care sectors, their knowledge of different world views, and the identities they adopted which may be influential in their choice of a healer. It was found that in two participants there was some movement away from traditional beliefs, with one rejecting the traditional healers who did not help her, once she has discovered therapy, and another identifying herself completely with Western medicine. In contrast, one participant illustrated a rediscovery of traditional healing, whilst still attending psychotherapy. This suggests that shifts in knowledge are not necessarily away from traditional beliefs. It was also found that the two participants who had experienced a broader variety of social contexts and identified with multiple belief systems, tended to use a variety of Western and traditional healing sources and selected the healing option they felt was most appropriate to a particular problem. It is argued therefore that having a variety of knowledge and beliefs places individuals in a more powerful position to determine their choice of action than those with a limited range of knowledge