Thursday, March 26, 2009

Transcultural Education for Clinical Psychologists, Part #2

Curriculum: The Linguistic Turn

The position from which my proposed multicultural curriculum emerges is located in the ideas generated since the “linguistic turn” in the humanities and certain branches within the social sciences, including psychology. For the sake of brevity, I will quote Stuart Hall’s definition. The linguistic turn is,

"[a conviction of ] the crucial importance of language and of the linguistic metaphor to any study of culture; the expansion of the notion of text and textuality, both as a source of meaning, and as that which escapes and postpones meaning; the recognition of the heterogeneity, of the multiplicity, of meanings, of the struggle to close arbitrarily the infinite semiosis beyond meaning; the acknowledgement of textuality and cultural power, of representation itself, as a site of power and regulation; of the symbolic as a source of identity" (Stuart Hall, as cited in Chrisman, 2003, pp. 148-149).

In the following section, I will introduce two interrelated, interdisciplinary, humanities disciplines, Culture Studies and Postcolonial Theories, both of which are legacies of the linguistic turn and could provide conceptual frameworks for multicultural education.

Culture Studies

Culture can be conceptualized as a way of life made up of the relationships between all its elements (Golby & Purdue, 1999), or more discursively as “the constant process of producing meanings of and from our social experience, and such meanings necessarily produce a social identity for the people involved” (Fiske, 2000, p. 1). Culture studies seem most interested in understanding how culture is made; how it shapes and is shaped by people various locations and historical settings, its contradictions and its systems of power relations.

Three foci may characterize a critique based on contemporary culture studies. First, it would address the junctures of language, meaning, and power in the construction of cultural meanings and in material practices (Barker & Galasinski, 2001; di Leonardo & Lancaster, 1997). That is, culture studies are in the tradition of poststructuralist thought, which conceives of discourse as the structure through which we perceive reality and views social realities as “organized by signs and meanings patterns in relations of identity and difference” (Seidman, 1997, p. 67). Institutions and social practices are produced by and founded within discursive formations, and are the basis upon which knowledge, values, and norms are justified (Edgar & Sedgwick, 2002). Discourses can and do have hegemonic (repressive) functions. Hegemony, as conceived by Gramsci (2000), is the regulation of social relations by the dominant class through forms of culture. Morag Shiach clarifies:

Gramsci offers us another explanation of the nature of dominant culture. It can be understood as the site of hegemonic representations: those which ‘foster forms of consciousness which accept a position of subordination’. It is also, therefore, a sphere that must be won over by any social group aspiring to social leadership: struggles over definition of culture can thus be seen as struggles for intellectual, moral and philosophical hegemony.” (Schiach 17)

Similarly, sociologist Pierre Bourdieu’s (1984) analysis of the unequal distribution of “cultural capital” (the collection of accepted and esteemed cultural resources) reveals how social hierarchies are reinforced and reproduced in cultural forms. He argues, far from being a neutral expression, cultural consumption is the “means by which [distinctions and differences in social classes] are produced, maintained and reproduced” (Storey, 1999, p. 44). Michel Foucault understands discourse as both “an instrument and effect of power” (Foucault, 1978, pp. 100-101), no matter what one’s social standing is, individuals are both subjects of and subject to discourses. Foucault’s understanding of power as relational rather than material extends the reach of a critique of dominant discourses to resistant “reverse” discourses, the structural necessities of dominant discourses.

Second, a culture theorist is likely to focus in on specific events, intimate relationships, and experiences in relation to their historical contexts, including “changes in production, consumption, technology, and law that set the stage for everyday life” (di Leonardo & Lancaster, 1997) as influenced by Foucault’s geneology of subjectification, which

"focuses directly on the practices that locate human beings in particular ‘regimes of the person’. It does not write a continuous history of the self, but rather accounts for the diversity of languages of ‘personhood’ that have taken shape . . . and the norms, techniques, and relations of authority within which these have circulated in legal, domestic, industrial, and other practices for acting upon the conduct of such persons."

Third, a culture studies critique would incorporate a focus on the co-production of popular culture by consumers, because ideological implications in cultural discourse do not translate automatically into ideological effects. The Italian Marxist, Gramsci (Forgacs, 2000) wrote that, in order for hegemonic forms to be taken in by the subordinated, they had to be chosen, not passively interpolated. Michel Foucault’s theory of power has particular relevance for exploring the boundary phenomenon of popular culture consumption (Foucault, 1978). He conceptualizes power as relations that are immanent in all interrelationships, non-binary and rooted in “local oppositions” and differences (p. 94), “intentional and nonsubjective” (p. 94), and as always co-generative with resistance.

The approach explores the webs of power in both the producers of official and mass discourses and the consumers. Resistance to the oppressive psychological and material effects of the dominant culture for the unprivileged begins with education as critique, as with Friere (2000), including that the persistence of hegemonic power in discourse relies upon everyone’s complicity, and discourse’s multisemic characteristics provides openings for resistance through deconstruction. The culture studies view of the audience has direct relevance for how those of us in the West objectify and erase the Other; we underestimate their powers of resistance because we assume the superiority of our epistemology. The assumed radical potency of Culture Studies lies in the power attributed to making meaning or, to use Foucault’s words, discovering and applying the power of reverse discourses.

Sunday, March 22, 2009

Transcultural Education for Clinical Psychologists, Part #1

I will now propose a transcultural expansion to diversity training in which I hope to integrate the critical dialogism of Paulo Friere (2000) and Ignacio Martín-Baró (1994), with the more recent ideas appearing under the label of "postcolonial".


This section on pedagogy is curriculum-wide proposal. It is crucial that liberation pedagogy not be marginally located only in certain courses, typically those concerned with minorities, such as a required diversity course, but rather should be both the norm in the majority of courses and linked to the establishment of public community dialogue events. Boyle-Baise and Gillette (1998) urge us to prioritize pedagogy in multicultural education, which would include providing “an intellectually safe, respectful place for learning, a place to share personal knowledge, agree to disagree, experiment with new ideas, and wrestle with contested issues…(p. 23). They suggest that educators involve themselves in “encouraging student-generation of knowledge, creating democratic teaching and learning communities, pursuing cultural critique, and fostering activism that makes a difference” (Boye-Baise & Gillette, 1998, p. 23).

In order to address issues of social justice, training in multicultural diversity must be grounded in processes of conscientization. Ignacio Martín-Baró said, “the task of the psychologist must be to achieve the de-alienation of groups and persons by helping them attain a critical understanding of themselves and their reality” (p. 39), and “can only be realized through dialogue” (p. 42). His proposal for a liberation psychology included three elements: (a) focus on serving the needs of the poor rather than on preserving the status of the discipline, (b) view knowledge as something that is created by thinking with the oppressed rather than for them, and (c) recognize that knowledge is informed by taking action in real life for social change, through “a new praxis” (Martín-Baró, 1994, pp.27-28). He warned:

"Thus, to acquire new psychological knowledge it is not enough to place ourselves in the perspective of the people; it is necessary to involve ourselves in a new praxis, an activity of transforming reality that will let us know about what is but also what is not, and by which we may try to orient ourselves toward what ought to be" (Martín-Baró, 1994, pp.28-29).

Conscientization refers to a process of developing critical awareness of contradictions in one’s economic, political and social world, which is followed by action to undue oppressive social structures. Conscientization’s most distinctive feature is its critical attention “to how power and meaning are employed in the construction and organization of knowledge, desires, values, and identities” (Giroux, 1992, p. 52). To my mind, a commitment to conscientization in the training of clinical psychologists for social justice would mean that each learning context (classroom, supervision, advising, collaboration) would involve the co-examinination of power and meaning, as suggested by Giroux, in combination with creative engagement in envisioning and enacting alternatives, however local.

In order to facilitate Paulo Freire’s process of conscientization, there would be instructor-supported dialogic opportunities for engaging students in uncovering and reducing those power differences in their own learning situation (Freire, 2000). Faculty would bear the responsibility of creating an atmosphere that would foster students’ capacities to criticize and affect both the nature and processes of their education, which means a greater commitment from faculty to view education holistically. As bell hooks (1994) explains, in “progressive, holistic education, ‘engaged pedagogy’ is more demanding than conventional critical or feminist pedagogy. For, unlike those two teaching practices, it emphasizes well-being” (p. 15). I would say that engaged pedagogy emphasizes and models “being,” and that an educator embodies specific characteristics of dialogue: an immediacy of presence, openness to unanticipated consequences, willingness to be surprised, vulnerability (openness to being changed, persuaded), belief in human interdependence, and genuineness (Cissna & Anderson, 1994).

I am proposing that an engaged pedagogy founded on dialogue, as described above, that is facilitated and modeled by the teacher, parallels our educational objective: that students feel morally committed to engaging in the dialogic process of multicultural awareness as a practice for social justice. The structural demands for dialogue to occur do not reflect our current social or academic order. Necessary conditions for dialogue are fair and equal access to speech, listening, and decision-making without retaliation (safety). Only when these conditions are met can optimal conditions for dialogue, such as openness, curiosity, reflexivity, occur. Therefore, a teacher will implement basic formal structures and ground rules to build in safety for students. In addition, she will perform a practice of “dialogic reflexivity” (Hawes, 1997) as part of the course’s commitment to conscientization. Dialogic reflexivity is an explicit engagement in “reflexive critique” of oneself, the particular context of hierarchical power relations, the institutionalization of these power relations, and “the multiple, shifting ways in which power is exercised and contested in and across each of these domains.

The next section will argue for the inclusion of postcolonial theories as an important expansion of multicultural training for clinical psychologists, beginning with a brief introduction to some of the ideas most relevant for professional psychology.

Tuesday, March 17, 2009

Training Clinical Psychologists for a Mulitcultural World

If there could be professional psychology training programs in which the explicit commitments to social justice, where the unpacking and critiques of the values, assumptions, and practices (Prilleltensky & Nelson, 2001) in psychology were incorporated into in their curriculum, what would they look like? What would such programs contain, both in their coverage of theories and research and in their transformative practices (praxis)? I could begin at any number of points, but for now I will consider the competency of Diversity.

Multicultural Education for Social Justice

. . . multiculturalism is about social justice, cultural democracy, and equity. (Sue, Carter, Casas, Fouad, Ivey, Jenson, et al., 1998, p. 5)

In this section, I will begin by introducing some criticism of the current state of multicultural education, the thrust of which is that what began as a transformative endeavor has become controlled and diluted affirmation. I will then emphasize the importance of liberation pedagogy as praxis for social justice. The last two sections recognize the necessity of acknowledging the linguistic turn in theories of oppression and the transformative potential of postcolonial criticism for our contributions in a globalized world.

Critique of contemporary multicultural education

Multicultural education, envisioned at its inception during the 1960s civil rights movement as “an effective counter-hegemonic strategy to reverse centuries of racialized domination in the United States” (Baltodano, 2006, p. 123) has failed to achieve its goal. Baltodano mourns that,

"what began as a politically inspired counterhegemonic movement was gradually appropriated and soon became merely another mainstream policy, more and more defined by the interests of the dominant class. . .Consequently, the institutional and social policies of the multicultural project stagnated, leaving untouched the complex economic conditions that transformed the welfare state of the 1960s to the transnational, global economy of the 21st century. (2006, p. 124)"

Stephen May (1999) concurs that multicultural education has not resulted in significant improvements for minority students, has not effectively altered majority students’ racism, nor replaced “the inherent monoculturalism of school practice;” further, multicultural education has seemed to have little or no impact on our society’s racial inequities (p. 1). The failure of multiculturalism, according to some, was its oversimplification of social power relations, its “deracialized” conceptualization of education, “an educational approach which reifies culture and cultural difference, and which fails to address the central issues of racism within society” (May, 1999, p. 2). In addition, there has been little “substantive change in the structure of teacher education and in the attitudes of teachers toward cultural diversity” (Baltodano, 2006, p. 124).

On the other hand, there are problems related to a program based on race-oppression alone. For one thing, the focus on color reinforces the binary dimension of black and white, and is thus requires a perpetual bond with its uniformly constructed oppressor. There is also the likelihood that the privileging of race obscures other potentially involved marginal subjectivities, such as gender, class, and religion (May, 1999, p. 2).

The Critical Pedagogies, as articulated by Paolo Friere, Henry Giroux and Peter Mclaren, have introduced a non-racist, theoretically sophisticated, transformative model they have linked to

"wider issues of socio-economic and political inequality. The ongoing ravages of late capitalism-particularly on the poor and the marginalized-are increasingly being addressed and contested by critical multicultural educators, again most notably in the US. . .In the process, the inexorable globalization of capital, its effects on the economies of nation-states, its links with historical and contemporary forms of racism and colonialism, and its impact on the changing nature of work and patterns of employment are also being critically examined."

The critical multiculturalists influenced by Freire and others have been criticized for their failures to effective link their theories to actual educational programming or policies.

Finally, all of the above have stayed within the boundaries of specific western nationalities, addressed themselves to “national markets with their own particular historical and ideological emphases. Little, if any, reference is made to developments elsewhere and attempts to build a cross-national perspective have been extremely rare” (May, 1999, p. 5). In my next post, I propose a shift to a transcultural education for clinical psychologist of the 21st century.

Thursday, March 05, 2009

Threats to Child Development in Developing Countries, continued

The HIV/AIDS Pandemic

According to the UNAIDS data (2006), Southern Africa is the world region most affected by HIV/AIDS, and that is where most of the children living with HIV live. Other high infection regions are in the Caribbean, Latin America, and South/Southeast Asia. South Africa, where I have direct experience, has the 6th highest prevalence in the world; almost 20% of its citizens are estimated to be infected, and new infections are increasing with no sign of reaching a natural limit. However, the disease is not equally distributed among South African society: Black Africans have the highest prevalence (18.4%) compared to other racial groups (whites-6%; coloured-7%; indians-2%).

Indeed, while anyone can get the virus under the right conditions, HIV/AIDS is not an egalitarian disease; even in affluent countries the groups most at risk for contracting the virus have shifted to the poor, and particularly the female poor. Like the history of Tuberculosis, which today can only be found in impoverished and abandoned communities in the poorest regions of the world (or the poorest sections of western cities), HIV/AIDS is globally selective of its victims; it is most virulent among the poor in the poorest nations and there is evidence that the highest rates of infection now occur in women (Farmer, 2001; Walker, 2007).

The HIV/AIDS pandemic has perpetuated its most devastating effects upon the poor in developing countries across the world, particularly in sub-Saharan Africa, including South Africa. In 2003, one fifth of South Africa’s adults were HIV positive and 16,000 were dying every day (Hunter, 2003). The highest death rates occur among employable adults, decimating the income-generating members of communities, leading to lower tax income to support community infrastructures, such as education and the now over utilized health services. This cycle of AIDS and poverty has meant that South Africa has dropped dramatically over the course of the last five year on the scale of economic development, creating greater numbers of poor and people vulnerable to the virus and without adequate services.

While the afflicted in the early years were predominantly heterosexual men who, due to Apartheid’s system of separate homelands for Black South African employable men, who were forced to become migrants in order to earn a living for white mines and factories in large cities. Far from their wives, these men caught and spread the virus through their exchanges with sex-workers, who also had migrated to cities for money to survive. By 2003, the HIV/AIDS epidemiology statistics made a gender switch: women came to make up two-thirds of Africans infected with HIV (Hunter, 2003). South African women also came to have a higher prevalence than men; 18% compared to 13%, and that gender infection gap is thought to be widening. Women, like children, are more vulnerable than adult men because they have no power or rights in their communities. However, global statistics remind us that, even in our own country, it is poverty that makes misogyny so toxic. [UN on Women}

The high occurrence of HIV in southern African women has meant that, due to vertical infection, rates of HIV in children have also risen. About 90% of infected children get virus from their mothers during pregnancy, birth, and/or breast milk. Without antiretroviral treatment (HAART): (a) 1 in 3 infected newborns will die before age one, (b) over ½ die before reaching their 2nd birthday, and (c) most are dead before 5 years. In Zimbabwe and Botswana child mortality rates have doubled since 1990. Tragically, only 15% of the 780,000 children living with HIV in these regions were receiving treatment at the end of 2006; every hour, 40 children die due to AIDS.

As the greatest number of infections and deaths are adults ages 20-35, the physical, emotional and cognitive impacts of HIV/AIDS on infants and children has reached a tragic scale; more and more poor households are headed by grandmothers and children who have, respectively, lost their children and parents to AIDS-related diseases. In addition to suffering the stresses of multiple losses, upheaval of their family systems, inadequate care from ill-prepared or frail caregivers, and removal from their homes, infants have been infected with the virus by their HIV+ mothers. Before ART, infection was an early death sentence for a child; with treatment, these children still face the stresses above, and many will grow up in institutional settings.

Linda Richter and colleagues of South Africa’s Human Sciences Research Center (HSCR) report that “it has been argued, particularly where children are concerned, HIV/AIDS needs to be treated as a broad developmental concern rather than as a narrow health or even public health issue” (Richter, Manegold & Pather, 2004, p. 4).

As a result of the AIDS Pandemic, a new international crisis category has emerged: “Orphans and Vulnerable Children” (OVC). These are (Richter, Manegold & Pather, 2004, p. 3):

  1. Children infected with the virus
  2. Children living in regions with high infection rates affected by the stress, the decrease in services and the damage to social institutions
  3. Children
  • Who lose a parent or parent substitute
  • Who live in a household in which one or more people are ill, dying or deceased
  • Who live in households which receive orphans
  • Whose caregivers are too ill to continue to look after them
  • Living with very old and frail caregivers
  • Older than 15 years of age

HIV/AIDS has torn apart South African family structures more effectively than Apartheid’s homeland and migrant worker systems. Here is a partial list of the impact of the virus on South African families (Richter, Manegold & Pather, 2004, p. 5):

  1. "The emergence of child- or adolescent-headed households
  2. An increase in elderly caregivers, and children caring for old people;
  3. Increases in household dependency ratios;
  4. Separation of siblings
  5. Family breakdown
  6. Child abandonment
  7. Remarriage”

AIDS has also impacted communities by producing declines in skilled and professional services, strains on health care and educational service delivery, and extreme stress on small communities who must absorb the children of the dead and dying into their care (Richter, Manegold & Pather, 2004, p. 6). HIV/AIDS is ravaging sub-Saharan societies, especially by diminishing health, welfare & education systems due to the extreme volume of needs due to the epidemic, loss of people to staff these institutions due to AIDS-related illness & death, and reduced tax-base because of the illness & death of employable persons (Richter, Manegold & Pather, 2004, p. 5).

The next set of influences on the impact of AIDS in South Africa will leave us in no doubt of its complex web of psychological, social, physical forces and needs. This set consists of the influences of gender, age, and household location (Richter, Manegold and Pather, 2004, p. 7-8):


  • Education for boys valued more highly (they are considered to be potentially more economically productive), so girls are often the ones to leave school or work to care for the sick or younger children;
  • Female-headed households are poorer than those headed by men;
  • Female-headed households tend to allocate more of the family’s resources to children’s healthcare and education than male heads;


  • Infants and toddlers are most vulnerable to effects of AIDS and health risks;
  • Preschoolers are vulnerable to malnourishment, abuse and neglect, poor stimulation, and lack of opportunities for schooling;
  • Adolescents are vulnerable to school drop-out, sexual exploitation, and overwork;
  • All children are vulnerable to the emotional consequences of multiple losses, including parents, and to being separated from their homes and communities.

Location of household

  • Rural households are typically poorer and have fewer employed adults than urban households;
  • Children are expected to contribute substantially to subsistence activities
  • Social networks in informal urban areas are less developed and less supportive;
  • Caregivers often leave their children alone because of their “livelihood activities.”

Like on the global stage, South African HIV positive children’s mental health and cognitive developmental needs have historically been neglected in the child development research and in most intervention programs. South Africa is not the only developing country lacking national psychoeducational data. Most child development research and programming has been done with U.S. and European samples, and psychologists in western nations have not concerned themselves with internationalizing their theories and studies, particularly in those parts of the globe with the greatest needs for help and understanding. In the international and national responses to the HIV/AIDS pandemic in southern Africa, “psychological” has, until recently, been considered a less important or less acute problem than HIV/AIDS affected children’s nutrition and shelter, as if, Linda Richter (2003) suggests, their “need for food and shelter is greater than their need to feel loved by others and to respect themselves” (p. 245). The 2007 HIV and AIDS and STI Strategic Plan for South Africa, 2007-2011, makes no mention of insuring that children’s conditions actively contribute to rather than undermine their emotional and social development, and by extension their academic achievement and potential to contribute to South African society. This oversight confirms the relative neglect of orphans’ and vulnerable children’s mental health and achievement by funders and policy makers, at least in South Africa. National policies that support multifaceted treatments in the services of children’s development are crucial components of meeting the first and second UN Millennium Development Goals: (a) eradication of extreme poverty and hunger, and (b) insuring that all children complete primary schooling.

As the preceding suggests, we know a fair amount about the risks and stressful conditions that occur under conditions of chronic poverty and HIV/AIDS; however, there are as yet only a few studies on the psychological effects of HIV/AIDS and poverty on South Africa’s (and other severely affected nations’) children, including their cognitive functions, academic achievement, and mental health (Cluver, 2007; Richter, 2003; Walker, 2007). For example, studies on the mental health of AIDS orphans are not only few in number but incapable being interpreted across studies; the variabilities of procedures, measures and samples used makes it impossible to come to firm conclusions. There are suggestive trends, however, such as the higher levels of psychological problems in AIDS African orphaned children, such as internalizing problems (hence depression and anxiety), symptoms of post-traumatic stress, behavioral problems, and delinquency (Cluver & Gardner, 2007; Cluver, Gardner & Operario, 2007). However, more research on the mechanics of increased mental health problems in these children is needed in order to better understand the factors in their lives “which are acting as stressors or buffers in mental health outcomes” in order to inform options for therapeutic intervention” (Cluver & Gardner, 2007, p.9).

A 2003 round-table on mental health consequences of the pandemic, compiled by the Human Sciences Research Council includes a list of people projected to be likely to experience mental health problems due to AIDS by 2015: those who are uncertain about their HIV status, people living with the infection, families and caregivers of people with HIV/AIDS, children and adolescents orphaned by AIDS, people caring for AIDS orphans, and those who fit into more than one of the previous categories (Social Aspects of HIV/AIDS and Health Research Programme, 2003, p. 40).

International and national studies are unanimous on calling for internationally accepted measures and indicators for child development for planning, monitoring, and assessment (Cluver & Gardner, 2007; Engle, et al., 2007; Irwin, Siddiqi, & Hertzman, 2007; Social Aspects of HIV/AID and Health Research Programme, 2003). “Very few of the programs that try to intervene for children, families and communities have been monitors systematically and none have been rigorously evaluated (experimentally). This has meant an over-reliance on local knowledge to the detriment of building a knowledge base on “the real impacts of AIDS” and “what the responses should be in any given context” (Richter, Manegold & Pather, 2004, p. 7).

Need for Interventions

We must also ask ourselves, where are the western psychologists when there is so much global poverty? A South African psychologist asks why it is that in psychology, have we such a “lack of knowledge in terms of interventions to prevent and ameliorate the effects of poverty on infants and small children. In our professional child development journals and conferences, why is there no strong and growing theme that expresses concern for the compromised conditions which the majority of infants and small children in the world live” (Richter, 2003, 245)?

There are urgent needs for the design and implementation of culturally sensitive and evidence based intervention programs to improve the conditions of infants’ and young children’s psychological development in impoverished communities across the globe. More than ever, psychologists need to prioritize humility and collaboration as practices by cooperating with local networks of community health services (professional and paraprofessional), community members and leaders, nongovernment organizations, and politicians in order to be effective in the developing world. Psychologists living in developing countries are hard at work trying to meet these needs, but there are not enough of them to tackle these problems on their own. Where should we Western psychologists turn, if we want to make a difference?

Thankfully, there are a number of opportunities for western psychologists to explore of sufficient diversity that we can choose the type and degree of investment we want to make from international and global psychological associations and publications. Another way we can help is to expand the engagement of psychologists and trainees in the field of international/global psychology by developing undergraduate and graduate curricula and practice opportunities.

Sunday, March 01, 2009

Removing Stones and Demons: Medieval "Psychotherapies"

The image to the right (a "permanent" feature) is a painting by Hieronymous Bosch and is entitled, The Cure of Folly: Extracting the Stone of Madness. This early form of psycho-surgery was emblematic in Renaissance art.

For the time being, I will upload some images I have found. Later on, I will edit for more description and explanation.

In my previous post, I included images of demons being exorcised as examples of the association between insanity and the demonic. I have more images, which I will include below as examples of healing the 'mad'.

Removing the Stone

Let us begin with the stone removal operations. (Much gratitude to Jessica Palmer's bioephemera; I had found these images on my own, but she has well surpassed my efforts with her impressive art history annotations.) The more recent works are actually characatures of 'quacks', so I'm including them under somewhat false pretenses.

Jan Sanders van Hemessen's The Surgeon

Pieter Breughel's Witch of Malleghen
Here is a close-up of the witch at work

Frans Hals, Das Narrenschneiden

HW Weydmans, Removing the Stone

I cannot find the artist for this caricature, L'Operation Inutile
This could be mistaken for a cure of folly: it is a medieval image representing the proper cure for epilepsy


Christ Cures a Madman

Christ exorcises a man's demons
The Possession of St. Catherine

Exorcising frog-demons

Christ exorcising demons

Rubens' The Miracle of St. Ignacius