Synopsis
The rural Xhosa people of South Africa have retained social cohesion through traditional custom, purity of language and the dominant role of ancestor worship, traditional medicine and witchcraft in lifestyle, beliefs and ceremonies. Abstract concepts are limited and ego defence mechanisms include projection, displacement and rationalization but cognitive disturbances per se are not regarded as important. Major attention is paid to severe conative and affective disturbances, ascribed to object or spirit intrusion, witchcraft or sorcery, which necessitate treatment by a traditional “witchdoctor”. Therapy is community orientated as far as possible unless uncontrollable violent behaviour necessitates referral to a mental hospital.
