Were and the Ontological Politics of Global Mental Health: Distributed Cognition in Yoruba Traditional Medicine

Cult Med Psychiatry. 2026 May 27;50(2):35. doi: 10.1007/s11013-026-09992-1.

ABSTRACT

Global mental health initiatives increasingly replace indigenous diagnostic categories with neuropsychiatric frameworks, framing this as anti-stigma progress. Drawing on twenty years of ethnographic research with traditional healers in southwestern Nigeria and my position as both researcher and practitioner, this paper examines wèrè-the Yorùbá term for mental illness-to reveal fundamental ontological incommensurability between Western personalistic medicine and Yorùbá ecological-cosmological healing. Through linguistic analysis, micro-phenomenological interviews, and participant observation, I demonstrate that wèrè (wé = weave; ìrè = misery) diagnoses not individual brain dysfunction but unraveling of interconnections across bodily, environmental, ancestral, and spiritual domains. Yorùbá language grammatically locates cognitive processes beyond the brain-fear in chest (ayá), happiness in stomach (inú), focus in liver (ẹ̀dọ̀)-while recognizing environmental agents (rivers, trees, earth) as cognitive beings with agency requiring ritual attention. Therapeutic protocols operationalize “totalness” (gbogbo àyè), addressing not only persons but ecological-cosmological fields where disequilibrium occurs. Replacing wèrè with àrún ọpọ̀lọ (brain illness) constitutes epistemic violence, imposing personalistic ontology where ecological-cosmological ontology operates. Global mental health must recognize ontological pluralism: multiple valid healing sciences operating in incommensurable realities.

PMID:42201517 | DOI:10.1007/s11013-026-09992-1