改框或改信？民俗宗教醫療的療效機制

"Reframing" or "Back-to Folk Belief"? Mechanism of the Religious Healing

張珣(Hsun Chang)

《臺灣宗教研究》 8卷2期 (2009/12) Pp. 1-25

摘要

本文宗旨在說明宗教醫療療效發生的機制。首先，說明台灣漢人宗教醫療長期存在的事實，繼而回顧幾項重要文獻與研究成果，接著闡述醫療人類學以病人為研究角度的方法學，並舉出筆者調查的乩童、卜卦、祭解等宗教醫療為例，說明以病人為中心的研究法。最後，討論宗教醫療療效發生的機制。
文化心理學的研究有兩個核心觀念，一為族群文化，一為個人心理，二者不可偏廢。近年學界說明台灣漢人宗教醫療療效發生的機制時，有以「改框」論，分析在個人心理層面療效發生的機制。然而，為了進一步解答病人為何願意接受改框，本文提出「改信」，亦即，回歸文化層面，說明西方生物醫療病因論無法解決病人的疑惑，病人回歸台灣漢人文化底層的民俗超自然宗教病因論。因此，理解民俗宗教象徵與醫療儀式仍有其重要性。

關鍵字

改框 ； 改信 ； 宗教醫療 ； 民俗醫療 ； 民間宗教 ； 病人中心論

並列摘要

This article tries to discern the mechanism of folk religious healing in Taiwan. First of all, this study reviews previous studies on folk therapy including folk religious healing in Taiwan, among them writings of medical anthropologists' are emphasized. Secondly, method and viewpoints of medical anthropology are introduced and elaborated. Thirdly, seven cases of three kinds of religious healing in Taiwan are provided to explain the mechanism of folk therapy.
Indigenous psychology has been progressive in recent year Taiwan. Most psychologists focus on individual cognition than on social cultural value system. Mechanism of ”reframing” is raised by some of the leading psychologists in Taiwan to explain why folk therapy is efficacious. Patients change their cognitive framework from western medical etiology to folk belief. Yet, question of ”why are patients willing to reframe their cognition?” is unanswered. We need an interdisciplinary dialogue here. The author suggests that back to an understanding of the basic folk culture and folk religious belief is necessary. Medical anthropologists' findings are complementary to indigenous psychologists' research.

並列關鍵字

reframing ； back-to folk belief ； religious healing ； folk therapy ； folk religion ； patient-centered