Recovery from psychosis may depend on how people relate to their distressing experiences in ways that expand rather than diminish agency. In the Dakhla oasis of Egypt, interpretations of psychosis as spirit possession offer a broader range of intentionality than biomedical interpretations, allowing more ways to relate to psychotic states. Modes of relating to spirits can be active or passive, with active forms aligning with the recovery goal of symptom control. Factors that shape an active, agency-expanding mode include the nature of the spirits, the subject's values and beliefs, and broader cultural or religious discourses that influence the likelihood of achieving control over symptoms.
Ayahuasca, a psychoactive substance traditionally associated with Amazonian shamanism, has spread globally over the past two decades. This paper examines its adoption by the Guarani Indians on Brazil's southern coast, arguing that this process is tied to the growing identity politics of Brazilian indigenous peoples and public policies promoting cultural diversity. In the case analyzed, the adoption of ayahuasca is linked to ongoing cultural revitalization in shamanism, health, and education, as well as the specific desires and actions of a leading family in one Guarani village.