Conclusion

The foregoing cases and resumes of problems typify those brought to ngoma diviners and therapists. Most cases of this kind are dealt with on an individual or family basis and are referred to a range of other therapists as well. Only a few of the cases are diagnosed as appropriate for full therapeutic initiation by ngoma dance and song. In both Nguni and Sotho-Tswana societies the diagnosis ukutwasa characterizes these latter, meaning they have been singled out by the spirits or ancestors, and afflicted. As in the Central African examples cited above, so the Southern African "twasa" cases demonstrate very little symptom-sign specificity. The question of who is singled out or called in this manner needs to be answered in connection with a more general study of contextual issues. It is not appropriate to assume that the twasa diagnosis, or call, corresponds to Western psychoanalytic or therapeutic labels. In fact, there may be better reason to suspect that this diagnosis singles out individuals for recruitment to ritual leadership roles on the basis of characteristics of greater sensitivity, ego strength, and cultural receptivity in a time or situation of stress.

Affliction cults in Central and Southern Africa have thus expressed the classic theme of identifying and utilizing marginality, adversity, risk, or suffering for the ever-necessary task of renewing society in the face of profound economic and social change.