To many of his patients and colleagues, Ignacio Aguilar, 63, is known as a licensed clinical social worker with 18 years of experience. He has a framed master's degree from USC to prove it. But to others who seek him out, Aguilar is known as "the witch doctor."
"Some of my own colleagues call me the witch doctor. It doesn't really bother me," he says, referring to his status in the Latino and mental-health communities as a curandero, or folk healer.
Aguilar is the clinical coordinator of Amanecer, an in-patient psychiatric program for Latinos at the Bellwood Health Center in Bellflower, where he incorporates mainstream psychotherapy with religious and folkloric practices. Frequently Aguilar is asked to present his unique technique at universities and conferences.
Aguilar honed his skills by observing other curanderos while they performed limpias (spiritual cleansings), which involve incense and candle burning, praying, chanting and touching heads--elements that help him make "a cultural connection with patients."
He began incorporating "mystical, Old World" methods into his treatment regimen 19 years ago when he realized patients didn't always respond to traditional therapy, he recalls. At the time, Aguilar, a Mexico City native, was working at Metropolitan State Hospital, a psychiatric hospital in Norwalk.
"There were very few Spanish-speaking psychotherapists. It was then I realized that patients were seeing curanderos and going to botanicas," he says. At first, Aguilar would sneak curanderos into the hospital to assist in a patient's treatment. Later, he began a treatment program exclusively for Latinos, and eventually the hospital allowed him to blend his Latino customs with modern medicine.
He left Metropolitan last year after a new administration "didn't support my techniques," he says.
Bill Silva, executive director of Metropolitan, acknowledges that Aguilar "was instrumental in the hospital's Latino program, in developing it and in nurturing it, but we wanted to change the direction of the program."
"For many years we focused on patients particularly from rural Mexico and rural Central America, and now we want to get patients in the local Hispanic community," Silva says. "I'm not criticizing one type of treatment over another, but matters such as a limpia haven't come up as an issue."
At his new post, Aguilar is once again mixing the old with the new.
And he has the support of Bellwood's administration, including Elvia Correa, Amanecer's program director. Correa, also a licensed clinical social worker with a masters in social work from USC, leads therapy groups in Spanish with Aguilar. "I am not a curandera," she says. "I am Mexican. I understand the culture, the language, but I am not skilled as a curandera. I observe."
Correa says Bellwood recently began advertising limpias in Spanish-language newspapers as a way of reaching out to those in the Latino community who observe such customs and rituals. Limpias are charged on a sliding-fee scale and usually average $30.
Explains Aguilar: "My concept of medicine is this: There is a road to health that a patient has to travel in order to get well. And when it comes to the Hispanic patient, they already have their own perception of illness.
"In the Mexican culture, there is no such thing as mental health. Your are crazy or you are not. Any time there is an unusual behavior, that behavior is attached to an external force--bewitchment, something that is out of their control--which is why the limpias , the herbs and the amulets are so important in the healing process."
Often, Aguilar performs limpias --individual and group--at Bellwood Health Center when he and the patient agree it can be a benefit.
Recently, such a limpia involved sweeping a patient's body with branches from a pepper tree (believed to be the tree from which Christ's cross was fashioned) while incense and candles burned in the dark room. The patient's family stood nearby praying, asking God to help their loved one, who believed he was possessed by evil spirits. Then Aguilar waved a ceramic pot with incense over the man's body "to draw all the bad things clinging to the patient."
"The patient then usually goes into a trance," he explains. It is at this stage of the limpia that Aguilar says he "manipulates the patient by praying and touching the head and sweeping the branches. The patient actually feels that something is happening, and of course, that is the effect you want. At the end you cleanse the patient with holy water and a blessing, and the patient feels protected and rid of whatever evil he felt was clinging onto his body."
The treatment for this patient also involved traditional therapy sessions and medication.
"The ideal thing to happen," says Aguilar, "is for health care professionals and psychotherapists to make a cultural connection because then that patient is going to trust us and hopefully will be willing to accept orthodox treatment, medication and psychotherapy along with their Old World practices."