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Updated: Aug 15, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Abstract:
This paper argues that discourse is culturally recognized as powerful and dangerous, significantly informing both the illness experience known as daño (magical aggression) and its traditional cure in North-coastal Peru. Words are viewed as a type of symbolic currency which negotiate and "transact" identity in an economic, social, and psychological environment in which self-esteem is generally viewed as a scarce commodity and tied to the opinions of others. In the case presented, gossip is a verbal mode of daño that is perceived as a threat to the victim's constructed identity: the physical and emotional symptoms of daño directly relate to the anxiety about what people will say (que dirán). I examine the symbolism of the mesa or traditional healing ceremony in terms of this "economy" of discourse to illustrate how the patient's personal experience is linked to a culturally powerful metaphor and then transformed in order to effect the cure.
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