Culture, Emotions, Confession

Notes from Chapter 2 - A Cultural and Historical Perspective on Confession

• The disclosure of deeply personal topics as a therapeutic technique is an entrenched and long-standing feature of Western culture
• Cross-culturally, as well, confession-as-therapy is found in a widely diverse array of societies
• However, in other cultures, confession is absent -- even actively discouraged -- on the premise that the disclosure of intimate thoughts and feelings would compromise health and well being
• There is meaning attached to confession in cultures that rely on the practice to effect healing, as well as in those that explicitly proscribe it in order to maintain health.
• Confession as symbolic healing
• From the perspective of medical anthropology, disclosure is usefully categorized as a form of symbolic healing:  a therapy that is based on the ritual use of words and symbols.
• Ritual can be secular as well as religious, and here it refers simply to a repetitive, patterned and symbolic enactment of a cultural belief or value.  The efficacy of symbolic therapies is contingent on a shared symbolic universe that ensures that a given therapy carries culturally specific meaning.  In other words, a symbolic therapy is meaningful and can be said to "work" insofar as it is related to the theories of illness-causation of a particular culture and, more broadly, to the other aspects of that culture.
• The central anthropological insight here is that historically determined cultural values and social processes give meaning to a symbolic therapy and, in doing so, facilitate its ability to heal within a given context.  Early socialization into this symbolic system, through the acquisition of language and culture, provides the framework that enables people to make sense of their interior experiences.
• Disclosure as a method of self-knowledge can be traced at least as far back as the Stoic philosophers of the first two centuries A.D. For the Stoics, daily inscription of one's thoughts and actions in diaries, journals, and letters was a means of knowing one's self in order to overcome flaws and refashion the self according to a specific ethos or model.  The objective of this reflective process was both moral and medical well-being, and ongoing attention to health maintenance was one of the significant features of contemplative self-disclosure (Foucault, 1988 via Pennebaker).
• The identification of the pastor-confessor as a "physician of souls" is probably traceable to the notion of Christ as a healer and to the medical ministrations of early Church Fathers
• Although obligatory confession to a priest was rejected by the Protestant revolution, the practice of confessional self-inspection nonetheless persisted.  For the Puritans in the seventeenth century, for example, daily writing in confessional diaries was a technique for monitoring one's state of sin.
• Confession in the West has a long history as a culturally authorized "idiom of distress" that is associated with some benefits to body and soul
• In American English, anger is metaphorized as heat or fluid that can dangerously accumulate in the bodily container, causing physiological damage if not allowed to exit.
• Folk understanding clearly mark "letting off steam," "getting something off your chest," and the like as salutary processes
• Among the unacculturated Ojibwa living in the 1930s and 1940s in Canada, it is clear that confession was an important technique used to effect healing in cases of serious illness
• Healing was believed to occur after a healer elicited a confession from the sick person.  However, in contrast to much of the Western tradition, confessions were not private, dyadic transactions, and patients were not isolated.  On the contrary, confessions were public statements of transgression, made to the group.  They were also in a real sense compulsory, for even if the patient wanted to withhold the disclosure of her or his transgressions, the healer would find out anyway through the assistance of his "other-than-human" helpers ("grandfather" spirits who routinely interacted with humans).  In essence, serious illnesses forced the sick person to accept responsibility for culturally disapproved conduct in full public view.  Ritual confession thus provided a recurrent public forum for stating and restating the core values of Ojibwan culture to members of the group as well as a venue for the socialization of children.
• For the Ndembu of West Africa, confession is also an important technique for effecting the healing of serious illness and is also publically performed
• The Ndembu healer orchestrates the confessions of not only the patient, but also of relatives, neighbors, and other members of the community who must all confess in order that the sick person get well
• The Ndembu, like the Ojibwa, believe that individual illness is an indication that something has gone awry in the social body
• The Ndembu doctor heals by tapping into the various streams of affect associated with conflicts and inter-personal disputes that have built up in the community over time
• Confessions are thus used as a mechanism (along with other cultural practices) for transforming ill-feeling into well-wishing, for restructuring relationships to restore social harmony, and for reintegrating the sick person into the social group
• For the Ndembu and the Ojibwa, as for many Westerners, there is a clear and positive association between the disclosure of personal events and the restoration of health
• While for Westerners the goal of disclosure is enlightenment through the process of self-reflection or alleviation from the "work" or "burden" of containing negative emotion, for the Ojibwa and the Ndembu the goal of therapy is collective: to restore social relations to a harmonious keel
• In other cultures disclosing negative emotions and one's "deepest thoughts and feelings" is believed to be directly responsible for poor health, illness, and general misfortune
• Balinese are socialized from infancy not to disclose negative emotions such as sadness and anger.  Children are taught that such emotions can be conquered by the strategies of "not caring" and "forgetting" as well as by laughing and joking, even in the most somber of circumstances.
• For the Balinese, "not caring" and "forgetting" are explicitly linked with the preservation of sanity and health.  Balinese do not disclose emotional difficulties often, even to family and close friends, for two reasons.  The first is compassion for others, since it is believed that sadness spreads when it is verbally and nonverbally expressed.  The second is to maintain their own mental calmness, since by not disclosing emotion and "forgetting," it is thought possible to shape inner feeling itself...The only appropriate technique for their elimination is to try not to think about and not to care about the experience that aggravates the feeling.  In this effort, laughter is regarded as especially effective.  It is important to stress that Balinese acknowledge that these strategies involve much emotional work, effort, and struggle...Disclosing negative emotions and experiences is thought to increase susceptibility to illness by weakening one's life force...Black magic is believed to be an omnipresent potential threat to well-being.  Because strong emotions such as sadness or anger can blur judgment, they can result in a person offending, disappointing, or hurting others and provoking their magical attacks.  Under these circumstances, disclosure could threaten an individual's very survival.
• Emotions for the Chinese are private and embarrassing, or shameful, events, with polluting qualities.  Thus, they are best left unscrutinized and are almost never disclosed to others.  What would be called psychological insight in the United States, the Chinese regard as self-absorption.  Thus, children learn from an early age not to attend to their emotional states.  When feelings are expressed, it is generally in somatic terms, using idioms of bodily organs and their functioning...the Chinese did not think in terms of the intrapsychic qualities of these emotions and lacked a language for their expression.  Finally, like the Balinese, the Chinese believe that the excessive expression of feelings will disturb the harmony of the body and lead to illness.
• A psychiatrist (from the People's Republic of China) advises a female patient suffering from depression and anxiety that "You must contain your anger.  You know the old adage:  'Be deaf and dumb!  Swallow the seeds of the bitter melon!  Don't speak out!'"  Chinese values affirm an understanding of the self that is more sociocentric, more attuned to and resonant with relational and situational contexts than to inner, private states.
• It becomes evident, within a framework of culturally and historically specific contexts, that no single, universal meaning or function can be attributed to the institutionalized disclosure of intimate thoughts and feelings...both disclosure and nondisclosure are related to particular cultural expectations of health and of cure.  Furthermore, the fact that both disclosure and nondisclosure are deployed to therapeutic ends in a wide variety of cultures suggests the possibility that a range of habitual strategies exists for dealing with negative emotions, and that the specific strategy chosen may vary according to a culture's understanding of emotions, the self, and the maintenance of health.

Pennebaker, J.W. (1995)  Emotion, Disclosure, & Health. Washington, D.C.: American Psychological Association.