Postert 2010 Moral Agency Identity Crisis Mental Health Hmong Laos

ORIGINAL PAPER

Moral Agency, Identity Crisis and Mental Health: AnAnthropologists Plight and His Hmong Ritual Healing

Christian Postert

Published online: 11 December 2009! Springer Science+Business Media, LLC 2009

Abstract During anthropological fieldwork, the author had a serious accident onthe outskirts of a Hmong village in the highland of Laos. However, this dramaticincident turned out to be the occasion of his ritual initiation into the local villagecommunity. An analysis of narratives of the incident reveals Hmong conceptions ofthe anthropologists physical, mental and moral affliction, its causative concomi-tants and his ritual healing. Hmong mental health and identity are situated in a moralspace of exchange relationships to significant others, challenging basic assumptionsof concepts of the person widely held in psychiatry and beyond. The healing ritualtransformed the authors being from indeterminate other, in a life-threateningstate of identity crisis, to a wholesome Hmong self, in a state of health and moralagency. This exemplary rite de passage highlights the affinity of ritual healing andconstitution of self in a moral space. The underlying relational concept of the personis in sharp contrast to psychiatrys concepts of the person, which are deeply shapedby values of individualism. Psychiatric services must accommodate substantialdifferences in the concepts of the person when treating Hmong migrants from Laos.

Keywords Hmong ! Self ! Mental health ! Identity ! Ritual ! Moral agency

Introduction

Constructing the other in anthropology is a creative process. In the analysis ofcultural data, the anthropologist has recourse to and chooses from establishedscientific models from the discipline. These models have been developed in onesown society to make the other intelligible. Insofar, an anthropological analysis is

C. Postert (&)Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, UniversityHospital Munster, Schmeddingstrasse 50, 48149 Munster, Germanye-mail: [email protected]

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inevitably an appropriation of the other in terms of ones own scholarly models(Postert 2004a).

There has been a long and heated debate in postcolonial theory about the practiceof appropriating the other (Gandhi 1998). Interestingly, scant attention has beenpaid to the fact that anthropological others are subjects, who on their part do nothesitate to appropriate fieldworking anthropologists. Indeed, analyzing the processof cultural appropriation of the anthropologist by his or her research subjects canteach us a lot about the respective cultural models and paradigms of what a person isbasically supposed to be from a native perspective. During my anthropologicalfieldwork in Laos from 2000 to 2002, a critical incident turned out to pave the wayfor my ritual incorporation into a Hmong descent group. An interpretation of thecourse of events from a Hmong perspective provides an exemplary case study ofmental health, identity construction and ritual healing. As the analysis will recount,strangers may be healed by ritual incorporation into Hmong village communityowing to a relational concept of the person.

The Hmong appropriation of my person performed in ritual healing challengedbasic assumptions of my Western socialization as an anthropologist and childpsychiatrist. The underlying relational concept of the person stands in sharp contrastto the cultural concept of the self prevailing in large parts of academic psychiatryand psychotherapy, which is deeply shaped by the values of individualism(Christopher 1999; Kirmayer 2007). For instance, psychiatric classification systemslike the U.S.-American Diagnostic and Statistical Manual (DSM) are explicit instating that mental disorders occur in a bounded self irrespective of socialrelationships and affect a central value of individualism, the ideal of self-mastery(Gaines 1992; Sadler 2004). The very notion that this self might constitute auniversal is itself integral to the foundations of this cultural model (Comaroff andComaroff 2001). In sharp contrast, the present case study of ritual healing amongthe Hmong in Laos stresses the moral, social and cosmological embeddedness of theHmong concept of the person. Hmong identity is relationally situated in a moralspace of exchange relationships connecting the social and the cosmological realm.

The Hmong

The Hmong are an ethnic group that lives primarily in mountainous regions ofsoutheastern Asia. Their area of settlement is scattered from southern China tonorthern Viet Nam, northern Laos and northern Thailand. In Asia, they numberabout 4 million people (Lemoine 2005). The Hmong are more widely known in theWest than other Laotian ethnic minorities because of their efforts on behalf of theUnited States of America during the war in Viet Nam, particularly after it spread toLaos and Cambodia. Thousands of Hmong were funded directly and secretly by theCentral Intelligence Agency to combat the Communist Pathet Lao (Quincy 2000).Communists gained control of Laos in 1975 and began persecuting the Hmong fortheir U.S. alliance, and many Hmong fled to refugee camps in Thailand. Since thelate 1970s, thousands of these refugees have resettled in Western countries,principally in the United States and France, but also in Australia, French Guiana,

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Canada and Argentina, adding a number of about 320,000 diasporic Hmong to thetotal Hmong population (Lemoine 2005). According to the 2000 U.S. Census,186,310 Hmong were living in the United States. This diasporic community is stillgrowing rapidly, due to an extraordinary birth rate and further waves ofimmigration. Finally, in December 2003, the U.S. State Department officiallyannounced the acceptance of roughly 15,000 Hmong refugees from Wat ThamKrabok, Thailand, into the United States (Grigoleit 2006).

The history of war between Laotian communists and Western powers has made itdifficult to conduct research among the Hmong in Laos, especially forU.S.-American researchers. Thus, whereas there are a good number of researchdata on the Hmong in the West, knowledge of the postwar situation of the Hmong inLaos is scanty (Postert 2004b). The Hmong in Laos are divided into big patrilinealclans whose exogamy connects them in affinal relationships. Poppy cultivation hasbeen partly replaced by shifting cultivation or the growing of vegetables for sale onLaotian markets. Most of the Hmong villagers practice ancestor rituals connectingthe living and the dead in manifold ritual exchanges. In cases of affliction andmisfortune, it is the shaman who restores equilibrium to unbalanced ritualrelationships. However, specifics are not known about the actual circumstances inwhich Hmong villagers lead their lives in Laos. One of the main topics during mylong-term anthropological fieldwork in a Laotian Hmong village community wasresearch on the construction of the person in life-cycle rituals. The analysis ofHmong birth, marriage, death and healing rituals suggests a continuous flow ofmaterial and immaterial resources connecting social and cosmological domains inexchange relationships (Postert 2003, 2004c). These exchange relationships aredeemed indispensable for reproducing the social order of the Hmong villagecommunity and the integrity of every single person. Afflicted individuals areconsidered to benefit particularly from ritual action. Rituals restore health byestablishing exchange relationships to significant others like ancestors or spirits andthereby render persons whole again. The self constituted thereby is a dialogical selfthat is, time and again, but invariably as a result of a crisis intervention,reconstituted in ritual exchanges between social and cosmological order (Postert2004c; cf. Carrithers et al. 1985). A relational and ritual constitution of the persontaking place in exchanges between the social and the cosmological order has beenasserted for different societies across the globe. In the Lao P.D.R., Platenkamp(2009) and Sprenger (2006) basically confirmed this pattern for the ethnic groups ofthe Lao and the Rmeet. A variety of societies in Indonesia (Barraud 1979;Platenkamp 1988), in the Pacific (de Coppet and Zemp 1978; Iteanu 1983) and innorthern Africa (Jamous 1981; for a valuable comparison see Barraud et al. 1994)were likewise found to follow a similar pattern of ritual constitution of self.

Construction of Selves

Cultural conceptions of the person may vary radically across cultures (Alvi 2001;Gaines 1982; Hallowell 1955; Ikels 2002; Kirmayer 2007; Ohnuki-Tierney 1993;

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Sokefeld 1999). In an oversimplified dichotomy, Western conceptions of the self asan autonomous, bounded, and individuated locus of personal will and agency aresometimes contrasted with non-Western sociocentric views of the person in whichpersons are inextricably woven into a fabric of social roles and corporate identities(Comaroff and Comaroff 2001). It is important to keep in mind that models of theself are part of value systems and should not be conflated with the experiential self(Hollan 1992). They do not exist as an unmediated sociological reality, or as theautonomous person in Western countries or as the relational person in a non-Western context. As ethnographically inspired research reveals, social reality isalways infinitely more complex than any theoretical antinomies allow (Sokefeld1999). Therefore, individualism as a systematized ideology certainly was absent inprecolonial African contexts, but notions of individuality were not (Comaroff andComaroff 2001). Western academic psychiatry promotes values of individualism,but Christian psychiatrists may pursue a sociocentric conception of the person(Gaines 1985). Broad contrasts of Western and non-Western selves are thereforeideal types that may be useful to start cross-cultural thinking with which to acquire acomparative critical perspective. However, they turn out to be too simplified andidealized to be applicable in cross-cultural research devoted to analysis of concretesubjective experience. Cultural and experiential selves are dynamically related,coconstructing or contradicting each other in a complex biographic process that hasto be assessed in empirical research (Hollan 1992).

One of the most important aspects of models of self is the normative orientationthey afford (Hallowell 1955). The Canadian social philosopher Charles Taylorprovides us with some basic concepts useful in the analysis of moral identityformation. According to him, every self invariably exists in webs of interlocutionwith significant others (Taylor 1989). Significant others are dialogical counterpartswho are essential for the individuals full self-realization in a collectivity of peopleaccording to shared basic values. Thus, the significance of others is profoundlyshaped by cultural values. Significant others may include relatives, friends andcolleaguesbut, similarly, ancestors, spirits or deities (Gaines 1985; Taylor 1989).Taylor describes the establishment of relationships to these significant others as abasic dialogical structure of identity which he understands to be a transcendentalcondition of human subjectivity. Thus, contrary to ontological individualism, Taylorassumes that one cannot be a self on ones own. I am a self only in relation tocertain interlocutors. A self only exists within what I call webs of interlocution(36). At the very core of the self is the ongoing imagined or real dialogical exchangewith others (Taylor 1995). These exchanges are not only a constitutive dynamic ofmaturation from infancy to adulthood but also an inherent factor of any identityemergence. While humans are physically individuated, ongoing identity formationties their selves into complex webs of exchanges. Who I am invariably refersbeyond me as an individual to my relationships with meaningful others in a medleyof significant dialogues (Taylor 1989).

Of course, every individual might choose to change his or her social and culturalsetting, to put an end to a web of interlocution in which he or she was settleddown imaginatively, or in reality. One of the most dramatic examples is leavingones cultural framework to live in a completely alien setting. However, one never


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escapes the anthropological necessities of the self. For Taylor (1989, 1991), relatingto significant others in processes of normative identity formation is an inevitable andontological property of human constitution.

Entering the Fieldwork Site

What does the dialogical nature of identity mean for an anthropologist arriving in aHmong village in the Laotian highland as a newcomer, without consanguinal oraffinal kinship ties? A stranger who is incapable of identifying with any Hmongsignificant other in the social or cosmological realm? A newcomer who, even morebasically, has no sense of the distinction of what the Hmong perceive as worthwhileversus worthless?

During my first few days in the village the dominant topic of most dialoguesbetween myself and my Hmong hosts revolved around the need to determine whoand what I was, precisely. How should I be addressed? What code of conduct shouldapply? What was to be expected from me in exchange relations? and so forth. Whydo you want to stay in our village? was consequently one of the questions mostoften put. At a lost to fathom my presence, they were quick to avail of establishedcategorieshe must be a development worker, supralocal government repre-sentative or, as I was to learn later, a notorious spy, either governmental orforeignto explain my being with them. However, I was presuming that there aredialogical ways of incorporating strangers into the Hmong village that tend to beclosed to representatives of the above-mentioned provenances. Therefore, I tried asbest I could to distance myself from these established categories for outsiders inorder to let other, indigenous classifications I did not yet know kick into play. Thus,by emphasizing my being an anthropologist, not a development worker, andGerman, not the notorious U.S.-American, I was an other who resisted an easydialogical tagging, someone who was not an easy fit because he did not correspondto any established outside category: thus, a stranger who, in terms of categorization,was clearly a nuisance.

In Hmong village communities in Laos, the category of the individual is oflesser importance. In its place, the sense of sharing an ancestral lineage with othersplays a crucial self-defining role. Ones position in a specific lineage defines termsof reference, conduct codes, exchange obligations and significant relations to thecosmological realm. An individual residing in the village for a longer period of timewho had not been categorized either as a Hmong or as a well-known other, like theKhmou migratory worker, the Lao village teacher, the missionary or even thenotorious U.S.-American or Laotian government spy, presented a challenge.Without exchange relationships to even the most basic Hmong significant others inthe social or cosmological realm, without consanguinal or affinal affiliation with anyof the local descent groups, my self lacked culturally significant relations. I had nodiscernible contours and, in the long run, ran the risk of being tantamount to apathological hazard to my hosts. To use a term coined by Erik H. Erikson (1975), Ipersonified a latent Hmong identity crisis.


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Somewhat perplexed by my presence, and with the implicit intention of keepingan eye on this strange stranger, one of the Hmong households accepted me in as aguest. What for me, in the beginning, appeared to be nothing more than a matter offood and lodgings was retrospectively the beginning of a process initiating myparticipation in the gift exchange of the descent group. In her historicalanthropology of Japan, Ohnuki-Tierney (1993) describes the symbolic power ofrice to act as a symbol of self identity. In Japan rice was perceived as an animatedentity establishing relationships to the gods. Its communal consumption led to theembodiment of a strong metaphor of the collective identity and operatedmetonymically to represent the presence of the descent group including ancestorsin each of its consumers. Accordingly, it turned out that my food and lodgings werenot as innocent as expected. In the household, I was eating the rice that had beenharvested and ritually appropriated by the hosting descent group. I was inhabiting aritual space assigned to a specific constellation of exchanges between particularliving persons and their dead. Sleeping in this house as a ritual space, eating theirrice as an important exchange object, I was already unsuspectingly taking part in thehouseholds relationships with the cosmos, without yet having formally establishedrelations with it. Thus, without realizing it, I was already inhabiting some Hmongtwilight zone. Unfortunately, this very state of in-betweeness made me especiallyvulnerable to other others who proved to be less benevolent than my Hmonghosts: hungered wild spirits (dab qus) waiting for prey.

Constructing the Person in Hmong Village Cosmology

To describe the dramatic circumstances of my transformation from anthropologist toHmong, I wish to give a brief account of the relations that are deemed essential forexisting as a person according to my hosts. Especially important in this respect is aconstituent called vapor or breath (pa), which pervades the whole cosmos andis essential to sustain a persons vitality, fertility and ability to grow and move. Itoriginates in the earth; it can be seen evaporating from the land as the breath/vaporof the earth (pa av) when the sun is shining very intensely. Growing crops isessentially an effort to secure the presence of this vital constituent in food. This isusually done by the combined agricultural efforts of an extended family. To be ableto do so, they have to enter into a reciprocal relationship with a local spirit (dabthwv tim) specific to the village area they are living in. By making the appropriatesacrifices in the fields he will be prevailed onto safely oversee the transformation ofnonsocial, nonconsumable pa of the land into social, consumable pa of the food.

Harvested rice usually serves two different purposes: the more obvious being thatof nourishing the living members of a household. The breath/vapor of the cookedrice (pa mov) is freed in the cooking process and visible as steam. This vapor isconsidered to be such a nourishing constituent of rice that some Hmong considerrice that has cooled down to be nutritionally almost worthless. If someone eatswarm rice, the rices pa will pass into the individuals blood as breath/vapor of theblood (pa ntshav) and render the person vital, healthy and fertile. When persons


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accidentally cut themselves on a cold day, pa will be seen visibly evaporating fromthe blood dripping onto the ground.

The second purpose of rice is that of sacrifice: each household will regularly offercooked, steaming rice to the spirits of the house and the ancestors of the lineage(laig dab). They are supposed to come and take the gift by inhaling the breath/vapor (hnia pa) of the rice. Reciprocally, the ancestors offer their names asprotection for the household members. The ancestors names are presumed to havegood hmoov, a concept that covers a complex semantic field from luck and successto competitive spirit. It is common for a Hmong father to giveparticularly maledescendants in a birth ritual the name of an especially fortunate ancestor. Thiscreates a relationship between the two, in which the ancestors hmoov protects thedescendant, who in turn regularly reciprocates with steaming rice and the sacrificeof specific animals (for a detailed analysis, see Postert 2003).

A person residing in a well-functioning descent group will usually be able tokeep his or her pa intact owing to careful attendance to exchange relationshipsbetween the living and the dead. Health is therefore not self-evident to humanexistence, but a social property that has to be actively nourished again and again in anetwork of social relationships connecting the living and the dead.

According to Hmong discourse, the existence of pa in a human body manifestsitself in the presumed presence of diverse souls (plig) each person has to have, forinstance, the chicken, pig or cattle soul. For want of a better term, I translate pligas soul throughout, although it must be kept in mind that the term is liberallytinged with Christian connotations not applicable to the Hmong context. Soulsand life force pa seem to be interrelated: if the pa of a person is affected, thesouls of a person tend to desert, and vice versa, if the souls of a person desert,this tends to adversely affect the pa and thus the vitality of the respective person.

Another important Hmong category of the cosmological other is that of the wildspirits (dab qus) who do not take part in ordered sociocosmological exchangerelationships as human beings or ancestors do. To be vital, they depend onambushing other beings and robbing them of their vital pa. One specific kind of wildspirits is the spirits of the accidents (dab vij sub vij sw), who close their victimseyes and ears and thus expose them to life-threatening risks. Once an accidentoccurs and the victim is bleeding, the spirits of the accidents approach him or her tosnatch by inhalation the vitality of his pa. Usually, if one is in favorable exchangerelationships with ones ancestors, one bears a good name whose hmoov shouldmanage to stave off the wild spirits. Apparently, the names protective propertieswane the farther one moves away from the social domain of the village. Beyond thevillage, ones protection very much depends on the relations that one0s descentgroup established with the local spirit.

If ritual exchanges with important significant others, either living or dead, havebeen neglected, the weakening of protective bonds between a descent group and itsancestors will, in all likelihood, result in affliction for members of the descentgroup. Thus, Taylors dialogical self, responsible for maintaining exchanges,should in this context not be considered to be an individual but, rather, a group. Thecosmological, social, psychological and physical realms alike may be affected bythe consequences of ritual neglect and are not categorically differentiated in this


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respect. The affliction might be cosmological, as in withdrawal of a protectiveancestor spirit; social, like constant failure in economic transactions; psychological,such as enduring bad mood and fatigue; or physical, like a sudden accident. In mostcases, misfortune will affect all realms at the same time. In many cases, the integrityof the person will be considered to be jeopardized, usually expressed in the idiom ofsoul loss, necessitating a therapeutic ritual to re-establish relationships withsignificant others and to secure the integrity of the dialogical self. Therefore, ritualhealing, from a Hmong perspective, serves much more than just psychotherapeuticpurposes. It must be conceived of as an integral unity of concurring somatic therapy,psychotherapy, sociotherapy and cosmological therapy.

The Anthropologists Accident from a Hmong Perspective

The subsequent account is a reconstruction of circumstances of the accident thathappened to me in 2000, after having been in the village for just a few weeks. In theframework of this article, I confine myself to summing up the interpretations of theincidents given by the Hmong retrospectively. This focus on the Hmong perspectivenot only turned out to be a fascinating gateway to underlying concepts of health,ritual and the person, but also a personal opportunity to work through what hadhappened in those turbulent days.

My German name, which was probably capable of protecting me in the vicinityof my German ancestors, was deemed a strange and worthless appendage in Laos:Your name did not fit to the village, did not taste good. The spirits of the accidentsdid not know, did not like your name. Without this protection, the innocentanthropologist was an easy prey for wild spirits loitering around the village. Afterbeing in the village for a few weeks, I thought that it would be a good idea to draw amap of the whole area from the peaks of the surrounding mountains. However, as amatter of fact, spirits of accidents influenced your liver/will (siab) that youwanted to climb up a hill. Transferring their victim to the nonsocial sphere beyondthe village, the spirits would be undisturbed while taking hold of it. Apparentlysome children in the village tried to dissuade me from doing so: The children toldyou not to go, but there were spirits of accidents closing your eyes, covering yourears. Thus, I did not understand what they wanted to tell me. In an attempt to wardoff even greater calamity, the children joined the unswerving anthropologist on hisdemanding expedition up into the mountains. After climbing up for a while, I feltquite exhausted. My vision became a bit blurred, but I kept moving on. MostHmong would have read this as a warning sign indicating the presence of wildspirits who were closing ones eyes to induce one to lose one0s footing. Theappropriate countermeasure would have been to sacrifice a small amount of rice ormeat on the spot and to say: You [spirits of accidents] want to eatI give you toeat; you stay here, do not go with me. Unfortunately, I didn0t do any of this.Climbing onward, I slipped on a rock, lost my footing and slid down a steep slopefor about 10 meters. The local spirit with whom I was at least informally in anexchange relationship prevented the worst. He protected that your body did not fallwith full force, your head did not hit off the ground. However, I suffered several


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serious fractures and could hardly see or breathe, further proof that there were spiritsof accidents present inhaling the pa of my blood. Most of my souls, especially thechicken, pig and cattle souls, thought the body is dead. They saw the spirits ofaccidents eat your blood. They were afraid and ran away. The children whoaccompanied me informed the villagers, and measures were taken to bring me to theprovincial hospital. The German Red Cross finally flew me back to Germany,terminating a 10-day odyssey through various Laotian and Thai hospitals.

Return to the Fieldwork Site

After hospitalization and subsequent reconvalescence in Germany, I was stilldetermined to continue my fieldwork. Four months after the accident, I returned tothe fieldwork site, this time accompanied by my wife, who joined me for the firstweeks of my stay there. However, smooth integration into the Hmong communitywas still out of range. On the contrary, as I got to know later, I posed an even largerproblem to my Hmong hosts upon my return. Not only had I still not establishedformal relationships with the descent groups ancestors and still not have a namecapable of protecting me, but even worse now: I had lost several souls, who werewandering around in the jungle. In the short run, this would not have harmedanybody. Without a body, the souls have no place to sleep, have no rice to eat.They miss the body and come back to the place of the accident to look for thebody. Their interest in the body is being fed: When the man eats hot rice, paevaporates. The souls inhale this pa. In my case, I was absent from the village forfour months. If ones souls cannot find the body over longer periods of time, theymight leave and reincarnate in another body, for instance, that of a fetus in thewomb of a pregnant woman. Being deprived of these important constituents of theperson, I would constantly feel very weak, lack drive and want to sleep all dayastate that is not that different from the symptoms of a depression. However, I wouldfinally die when the respective woman gave birth to her child. Hosting such avulnerable person in ones house is akin to taking the risk of attracting wild spiritsagain. These would perhaps attack not only the exposed person, but also othervulnerable members of the household such as children or sick persons. However,initiating me was an attractive option for my hosts, as I was, for Laotiancircumstances, a wealthy exchange partner who was not yet bound up in thenetworks of reciprocal village exchange relations. After consulting each other, myHmong hosts decided to take the appropriate ritual measures to banish the lurkingdanger. They decided that my ritual initiation into the descent group offered asolution to my plight as well as their dilemma, creating new opportunities ofinteraction.

Initiation into a Hmong Self

The ritual solution to the crisis was a healing ritual initiating exchange relationshipswith significant cosmological others endowing me with a Hmong self. My hosts told


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me what I had to buy as sacrificial gifts: one pig, two chickens, two eggs and piecesof paper, which are considered to be money for the spirits and transferred to them byburning. The first thing to do was to call my souls back into my body, a ritualcalled hu plig. Second, a relationship between me and the local spirit had to beestablished, to be formally acknowledged in the village. Third, and most important,I ritually had to be put in touch with my descent groups ancestors in exchangerelationships to be endowed with a patrilineal ancestors name renowned for itsprotective hmoov. But what was to be done with my wife? She obviously could nothave been born into the same clan as me due to the obligations of clan exogamy.Thus, her origin had to be set elsewhere. My wifes Hmong name was chosen by awoman of another clan who was in affinal relations with my hosts.

Therefore, early on a misty morning, my Hmong hosts, my wife and I went upinto the mountains until we had reached the scene of the accident. One of therenowned shamans of the village who acted as a ritual elder of the descent groupstarted summoning my souls while sacrificing the meat of two cooked chickensand burning spirit money for the local spirit.

With this part of the ritual completed, we returned to the village, where thesecond part of the ritual followed. With us wearing traditional Hmong clothing, thesacrifice of a pig, the binding of the souls to our bodies by using white threads ofcotton (khi tes) and, most importantly, the initiation of formal exchange betweenourselves and the descent groups ancestors took place. Our duty was to makecooked rice and pig meat available for sacrifice to the ancestors. The countergiftswere the new names the shaman called from the realm of the ancestors, which weretransferred to us and thus made us members of the descent group. It was especiallyimportant to choose an ancestor name with a lot of hmoov to prevent a repetition ofthe previous incident. The name is considered to be the owner (tswv) of thesouls. Without it, the souls could not be convoked and would remain in theextrasocial realm of impermanence. With it, the souls could be temporarilysocialized again and incorporated into a new person as a member of the descentgroup.

A ritual elder presented a bowl with the gifts at the door of the house, a pair ofcooked chickens, rice and an egg. He summoned our souls again while attractingthem by knocking a divinatory device, a split buffalo horn, against the right and leftdoorpost. The souls were not considered to come and inhale (hnia) the vitalconstituent pa of the gifts as in the case of sacrificing rice or meat for the ancestors.Rather, they were assumed to take up temporary residence in the gifts, which werethen carried into the midst of the descent group to be later handed over to us.

In the next ritual step, the ritual relations established were consolidated by aritual sweeping and binding of the hands (cheb khi tes) (see also Tapp 1989;Symonds 2004). The ritual elder took white threads, made a sweeping movementfrom our body to the wrists with them, took them to the doorway of the house andburned them. This ritual cleansing kept wild spirits at bay, who may threaten thehealth of family members. With other threads he again directed the lost soulsfrom the doorway to the new members of the lineage, performed a reverse sweepingmovement from our wrists to the body and tied the threads around our wrists. As the


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different members of the descent group are not sharply distinguished in terms oftheir vital constituents of the person, the most vulnerable of them also got pieces ofthread bound around their wrists. This was considered to be most relevant for thechildren who had been eye witnesses to my accident. As unexpected and shockingevents like the sight of a sudden accident might lead to a soul loss, especially inchildren, their participation in the ritual renewal of the constitution as a person wasconsidered to be of utmost importance.

The male representatives of the descent group then approached us, blessed us,bound our wrists with white threads and pressed banknotes in our hands. The wealthsymbolically presented testified to the descent groups good fortune and competitivespirit hmoov, further securing the presence of the fleet-footed souls. Now, thesacrificed animals were consumed in a communal meal. The threads were supposedto remain tied around our wrists for the most vulnerable phase of our newpersonhood, at least three days.

Moral Selves and Health

A person living for any length of time in the midst of a Hmong village communitywho resists any easy assignment to established categories of the other poses aserious challenge to his hosts. Not organizing ones life by some sense of moralorientation or strong value as personified by ancestors or local spirits cannot remainwithout consequences for the conception of ones personhood (Hallowell 1955).Taylors (1989) claim is that living within such strongly qualified horizonsis constitutive of human agency, that stepping outside these limits would betantamount to stepping outside what we would recognize as integral, that is,undamaged personhood (27). For Taylor, moral orientation in life is therefore notjust a virtue for a person, but an anthropological necessity of its sociality. If it ismissing, basic personhood is at risk, predisposing the individual to calamity from aHmong perspective. When calamity strikes, it underscores the necessity of restoringbasic relations that are required to constitute whole persons in a Hmong villagecommunity. The cultural model for this restoration is the ritual construction of theHmong self. As Gaines (1982) put it: Other persons are conceivable only in termsof the self, for the self is the key and central point of reference which makes itpossible for other selves, called persons, to be characterized, described, andperceptually apprehended (169). On account of the fact that Hmong identity isinvariably in a state of flux, affliction necessitates ongoing resynthesis of the pastand future from the perspective of present incidents. According to Taylor (1989),narratives provide the means of identity formation vis-a`-vis omnipresent contin-gency. Healing rituals construct narratives connecting the afflicted to essentialmoral sources of their self in exchange relations with significant others. Myaffliction was much more than a few fractures; it was a threatening lastingdisintegration of the basic constituents of my person, probably leading to death, ifnot ritually treated in time. The healing of this affliction was not just a restoration ofbalance between the social and the cosmological realm that could have been


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assumed to have existed before the accident. Rather, ritual healing was a chance tobring my latent identity crisis to an end, to fill my empty self with significant socialand cosmological relations. The instrument of healing in Hmong rituals is anexchange object that contains some quality of the giver (cf. Mauss 1954). Theinalienable gift of a Hmong name not only continued to embody the hmoov of theancestral giver, but also imposed this identity on me as a receiver, and bound me tosocial and moral obligations of reciprocation in the expanded kin network. Byexchanging my indeterminate identity for a more wholesome Hmong self, I wasplaced in a relationship terminology and positioned in an ancestral lineage, whichprescribed obligations in reciprocal exchanges with affines, consanguines, ancestorsand other significant others.

The quest for a moral compass is an inevitable undertaking of human agency.Without it, how is one to orient oneself in complex and meaningful webs ofdialogical exchanges in an alien social and cosmological order? Taylor (1989)exposes the close connection between self and agency as the essential link betweenidentity and a kind of orientation. To know who you are is to be oriented in a moralspace, a space in which questions arise about what is good or bad, what is worthdoing and what is not, what has meaning and importance for you and what is trivialand secondary (28). Thus, the dialogical narrative of the healing ritual provided aninitiation into basic Hmong relationships connecting social and cosmological orderin a creative piece of identity work that restored not only health, but also moralagency, in a very basic sense. From the perspective of the Hmong, it is evenquestionable whether one could ever be achieved without the other.

Thus, the healing ritual created a shared space of interlocution in the social andcosmological realm. Restoring health meant reconstituting a Hmong persona(Mauss 1985) in terms of significant exchange relationships connecting the socialand the cosmological order in a ritual narrative. An orientation to a culturallydefined good is an essential feature of human health and agency from a Hmongperspective. Healing and providing identity by establishing a moral orientationthrough exchange were part and parcel of the same process. Ritual action helped torender a fragile life meaningful, manageable and comprehensible, restoring a senseof coherence as described by the founder of the theory on salutogenesis, AaronAntonovsky (1987).

However useful Taylors account of identity constitution in a moral space is forthe present analysis of ritual healing and incorporation of the other, one of its mainshortcomings for an analysis of identity formation ought not to go unnoticed.Taylors concept of identity formation focuses almost only on the ideal sources ofthe self, on moral goods and narratives. However, his approach tends to neglect thesomatic dimension to identity. One would expect a full-blown theory of the self tobe informative about aspects of embodiment as exemplified in emotionaldispositions and their cultural transformation in a bidirectional coconstructiveprocess. Taylor has little to say about the interrelations of somatic and idealdimensions of the self, and this casts doubt on whether his approach suffices as ageneral account of the self.


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Implications for Further Fieldwork

Of course every Hmong prima facie saw that my wife and I were not native Hmong.Later during my fieldwork it often happened that I met Hmong whom I had notpreviously been introduced to. If it came up in conversation, I did not make a secretof the fact that I was Hmong and was curious to see how my vis-a`-vis would react tothe information. My vis-a`-vis never seemed to be puzzled but, rather, was concernedto find out whether a consanguinal or affinal relationship could be establishedbetween their and my descent group. I suppose that the above-described procedureof incorporating the other is not that alien to most Hmong people. Whereas Westernrepresentations of descent are based on the cultural idiom of blood relationshipsthat tend to be equated with biological relationships, a descent system inanthropology is a patterned set of symbolic categories structuring relations thatare not necessarily biologically grounded (Barnard and Good 1984). In this respect,my Hmong hosts helped me to free myself from the conceptual straightjacket of myown cultural models of kinship. With the healing ritual, I became one of theconnecting elements in the dialogical web of relations shaping and connectingdescent group, affines and their respective cosmological counterparts. Why wouldone be so surprised about that? As Sahlins (1993:1516) coined it: Westernpeoples have no monopoly on practices of cultural encompassment, nor are theyplaying with amateurs in the game of constructing the other.

My newly acquired agency in the web of relations did not remain unnoticed. As arather wealthy operator in the web of relations, I got to know the expectations andobligations associated with my emerging moral agency on various occasions ofaffliction, transition or need. However, backed by my consanguinal, affinal andcosmological affiliation, I was now able to refer to a multiplicity of relations tonegotiate and initiate contact with a variety of significant others in a long andintensive process of dialogue. From this perspective, appropriating the anthropol-ogist conceptually should be seen not as a failure to appreciate the others identity,but as unavoidable and, as in my case, potentially integrative and healing, if ithappens with attentive empathy.

Conclusion

Contrary to assumptions of an ontological individualism, ones identity, from aHmong perspective, is not fixed in itself or self-evident. It is the dialogical exchangerelationships between social and cosmological order that make up ones identity.Thus, an anthropologist in a latent and severe identity crisis who turned out to beprone to physical and mental illness could be treated by engaging him in ritualrelations with diverse social and cosmological beings. The respective healing ritualwas curative, appropriating and incorporating into the descent group at the sametime. The ritual construction of an identity in Hmong terms was a precondition tobeing credited with the robust physical and mental health that only a whole personcan be blessed with, according to the Hmong perspective.


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As I see it, my accident was nothing more than an opportunity to realize thisoption. If it had not happened, I am convinced that a later incident would haveoffered the opportunity to ritually appropriate what represented a categoricalnuisance. The drama of my own incorporation into a Hmong community is thereforea microstudy highlighting the flexibility one discovers in ritual systems, capable ofhealing and appropriating strangers in a state of deep identity crisis. The initiationinto significant exchange relationships between the social and the cosmologicalorder transformed my being from indeterminate other in a life-threatening state ofidentity crisis to a wholesome Hmong self in a state of physical and mental healthand moral agency. This exemplary rite of passage highlights the unique affinity ofritual healing and appropriation of the other in a relational conception of theperson. Such a concept makes it easy to incorporate into a kinship unit persons who,from a Western perspective, cannot be incorporated oron the flip side of thecointo excorporate the same person or others who are born into that descent groupin cases of dissent.

Ritual exchange was the driving force for obtaining Hmongness and health in ahealing process that saw me shifting from other to self. From then onward, itserved to perpetuate Hmongness and health in periodic communal ritual exchangesbetween my descent group and its social and cosmological significant others. In aworld of constant transience, the exchange of identities was not the end in itself, butthe beginning of a dynamic process of physical and mental salutogenesis inrecurrent cycles of ritual exchange.

However, the perpetuation of these ritual exchange cycles is critically vulnerableto sudden disruptions in the constellation of the social networks. Most rituals requirethe presence of certain ritual specialists and relatives, who are usually not difficult tolocate in the extended kinship groups, if these are intact (Postert 2004b). However,death and scattering during the civil war and elopement fragmented most Hmongpatrilineages. In a typically individualist bias, U.S.-American agencies resettledHmong refugees as individuals or nuclear families across the United States ofAmerica, with a view to more rapid assimilation into American culture (Miyares1998). Therefore, in the first years of migration, most Hmong kinship groups weresettled across states and continents unable to perpetuate their ritual cycles ofexchange. If the expression of basic sociomoral agency is severely and suddenlyinterrupted in a completely alien sociocultural setting, the consequences for mentalhealth may be devastating, especially in the presence of additional severe stressors.The Hmong migration experience bears evidence of this process. Culturaluprooting, role discontinuity, identity crisis, unemployment, social marginalization,racism, dysfunctional coping strategies and prior traumatic experiences severelycurtailed previous salutogenetic agency and led to an exacerbation of self-rateddepressive symptoms of the Hmong refugees in the first years after migration to theUnited States (Westermeyer et al. 1984). Initially, symptoms tended to be morepronounced among men and employed women. Several years later, this finding wasreversed, so that women who had remained at home reported the highest level ofsymptoms, apparently due to delayed onset of acculturation pressure (Westermeyer2000). In comparison to ethnic Laotian, Khmer and Vietnamese refugees, of whoma greater percentage originally came from urban backgrounds, the Hmong were


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significantly more likely to report depression (Chung and Bemak 1996). However,even nondepressed Hmong controls reported significantly higher symptom levels onitems like hopelessness, loneliness and uselessness (Westermeyer 1986). It may besurmised that the massive cultural-ecological changes especially prominent in thefirst years of migration account for this stress (Westermeyer et al. 1984).

The diasporic Hmong communities of the United States have undergone and stillundergo rapid sociocultural change since the 1970s. Any generalizing statementabout their present situation is difficult and prone to oversimplification, as they arevery heterogeneous groupings. Regional differentiation, different waves of migra-tion and varying coping strategies have to be taken into account (Yang 2003). Therehas been no research on diasporic Hmong concepts of the person to date, but it is tobe expected that these have been severely challenged and transformed due to basicchanges in the patterns of social and cosmological life in the West. However,enduring differences in conceptions of moral agency, mental health and identitybetween Americans of Hmong and Americans of European descent can be assumed(Gensheimer 2006; Mouanoutoua 2003). More and more diasporic Hmong aregetting in touch with psychiatric services, voluntarily or involuntarily (Tatman2004; Westermeyer et al. 1989). Many of them challenge and are challenged byvalues of individualism as inherent in psychiatric concepts of the person (Gaines1992; Kirmayer 2007; Sadler 2004). Psychiatric services must be prepared toaccommodate substantial differences in the concepts of the person when treatingHmong migrants from Laos.

Acknowledgments The authors data collection and analysis were supported by a grant from theGerman Research Council (DFG) in the framework of the interdisciplinary Research Group CulturalDiversity and the Construction of Polity in Southeast Asia: Continuity, Discontinuity, and Transforma-tion (FOR 362) at Munster University.

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Postert 2010 Moral Agency Identity Crisis Mental Health Hmong Laos

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