34 BUREAU OF AMERICAN ETHNOLOGY [Bull. 175 



is based on criteria that are sometimes obscure and not wholly 

 satisfactory ones.^* 



The diagnosis of particular disorders is determined by a combina- 

 tion of all tlie factors mentioned in this chapter and is subject to 

 modification or expansion in the manner described in the subsection 

 "Stages in the formulation of a diagnosis." On the whole, there is 

 usually complete diagnostic unanimity whenever the clinical pic- 

 ture is a relatively simple one and the precipitating event is gen- 

 erally known. Thus, there was complete unanimity about the diag- 

 nosis of all cases of hi : wa itck, which is a straight and relatively 

 benign mental disorder. Where the clinical picture is more com- 

 plex, diagnostic differences usually pertain to whether the basic dis- 

 order is or is not complicated by ghostly influences or by witch- 

 craft, i. e., whether it is a straight or not straight disorder. 



As the preceding pages indicate, the problem of a final diagnosis is, 

 among the Mohave, closely related to the effectiveness or failure of 

 therapy. 



Treatment. — The Mohave treatment of mental diseases is, roughly, 

 of two kinds. 



Genuine supportive psychotherapy is administered not only by 

 shamans, but also by laymen, though usually only in such minor 

 ailments as hi : wa itck. This treatment consists in reasoning with 

 the patient and in giving him such moral support as he may need. 

 Tcatc's attempt to comfort me and to reason with me at a time when 

 I was thought to have hi : wa itck (pt. 3, pp. 91-106) is a good example 

 of genuine Mohave psychotherapy. Supportive psychotherapy and 

 reasoning with the patient is also resorted to in combination with 

 more magical methods in persuading certain individuals, who wish 

 to die, to give up their spiteful and vindictive intentions. Thus, 

 sucklings who make themselves ill because they are jealous of un- 

 born siblings (Devereux, 1947 a), future shamans who do not wish 

 to be born (Devereux, 1937 c and 1948 e), and twins who refuse to re- 

 main on earth (Devereux, 1941) are urged by shamans to behave 

 rationally and to stay alive. 



Serious mental disorders are, on the other hand, treated in the usual 

 shamanistic way: by singing songs or, if the traditional songs are 

 no longer remembered, by reciting the appropriate portion of the 

 Creation myth (Devereaux, 1957 b) ; by massage; by blowing upon 

 the patient ; by the use of saliva ; by food taboos and baths ; and by 

 other magical means. This type of treatment is described, e. g., in 



'♦ Psychiatrists who, In the course of their work, had to wrestle with official nomen- 

 clatures of disease, will, perhaps, sympathise with the difficulties the Mohave experience 

 In this respect. 



