The Naming of Illness: How Medical Language Shapes What Communities Believe About Their Bodies

ANCESTRAL WISDOM · PUBLIC HEALTH

“Diagnosis names an experience. But whose experience? And in whose language? The word that opens a door for one person can close a room for another.”

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The Power of the Name

There is a reason people cry when they finally get a diagnosis. After years of being told they are fine, dramatic, seeking attention, or simply hard to manage — a name arrives. It says: this is real. It has a category. Other people have had it. There is knowledge about it. That knowledge could help you.

This is not a small thing. Diagnosis, at its best, is an act of recognition. It translates suffering into a form that systems can respond to — clinicians, insurance structures, families who might otherwise dismiss what they cannot see or categorize. For many communities, particularly those historically told their pain is psychological or their complaints are exaggeration, a diagnosis can be the first time the medical system says: yes, this is happening.

The fight for diagnostic recognition has been real and consequential. The formal acknowledgment of complex trauma, of the racial stress that accumulates in Black bodies over time, of intergenerational trauma as a health determinant — these naming victories matter. They have shifted funding, research attention, and clinical protocols. They have given communities a language for speaking to systems that otherwise would not listen.

But the power to name is always also the power to frame. And framing is never neutral.

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When the Name Doesn’t Fit

Biomedical naming of illness is built on a particular architecture: illness is located in the individual body or mind, it has identifiable pathological mechanisms, it can be distinguished from “normal” function by measurable deviation, and it can be treated by intervening in those mechanisms. This architecture has produced extraordinary medicine. It has also produced extraordinary blind spots.

Communities whose healing frameworks organize experience differently do not slot easily into this architecture. The question is not whether biomedicine works — it does, in many cases — but whether the diagnostic frame captures the whole of what is happening, and whether what it leaves out matters for healing.

Consider what is lost when a spiritual emergency is named depression. The person experiencing what their tradition would recognize as a calling, an initiation that has not yet found its container, enters a mental health system that categorizes the experience as pathology and treats the symptoms without engaging the meaning. They may receive real relief from that treatment. They may also lose the thread of what was being communicated. Both can be true.

Consider what is lost when collective trauma is named as individual disorder. Post-traumatic stress disorder describes something genuine about what happens to a nervous system that has been overwhelmed. But when a community has experienced generational harm — enslavement, colonization, ongoing structural violence — locating the pathology in the individual body while leaving the conditions that produced it unnamed and unaddressed is itself a form of mis-naming. The disorder is not only in the person. It is in the system that created the conditions.

Consider what is lost when hypervigilance is named anxiety. In a body that has learned, across generations, that the world is not reliably safe — the elevated cortisol, the hair-trigger stress response, the difficulty trusting unfamiliar environments — these are not maladaptive features. They are adaptations that made sense. Naming them as disorders to be corrected, without naming the conditions that made them necessary, describes the wound without acknowledging the knife.

Harriet Washington documented in Medical Apartheid the long history of medical systems misclassifying and pathologizing Black bodies — from Samuel Cartwright’s invented “drapetomania” (the supposed mental illness that caused enslaved people to seek freedom) to modern patterns of undertreating pain in Black patients. Sickle cell carries the same story: long named a Black disease, it is better understood as a map of ancestral latitude our DNA carries, written by our ancestors’ survival of malaria. The naming of illness has never been a purely clinical exercise. It has always been embedded in the power relations of the society that produces it.

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How Communities Name Illness: Ancestral and Relational Frameworks

Before the diagnostic manual, there were elders. Before the clinic, there was the compound. And the compound had its own naming systems — not less rigorous than biomedicine’s, but differently organized. Among the Dogon and the Yoruba, this generative power of naming and speech has a name of its own: Nommo, the ancestral understanding that the word does not merely describe an illness but helps shape what happens to the person carrying it.

In Yoruba tradition, illness is understood within a web of relationships: between the person, their ori, their ancestors, the orisha, and the community. A chronic illness that does not respond to treatment might prompt questions not only about what is happening in the body, but about what relational disruption may be feeding it — a vow unfulfilled, an ancestor unacknowledged, a spiritual calling not yet answered. This is not anti-empirical. It is differently empirical: it draws on a longer observational record about what actually heals people, one that includes relational and spiritual dimensions that Western biomedicine systematically excluded when it constituted itself as a science.

Across Central and West Africa, what Western psychiatry might name psychosis may be recognized by traditional practitioners as a form of spiritual emergence — the opening of a channel that requires initiation, containment, and guidance rather than suppression. This is not a simple inversion of the clinical picture. Some people in this experience are in genuine crisis and benefit from biomedical support. The question is not whether to use biomedical resources, but whether the name given to the experience — and the treatment protocol that follows from it — accounts for the full range of what is happening and what healing requires.

The Akan concept of sunsum — the personal spiritual essence whose disturbance underlies much illness — is not visible in a blood panel. Neither is the state of a person’s ancestral relationships. Neither is the presence or absence of the community’s capacity to hold the person through what they are experiencing. These are real variables in the outcome of illness. When the name given to an illness cannot accommodate them, the name is partial. And a partial name can produce a partial treatment.

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The Politics of Naming: Who Decides What Counts as Sick

Diagnostic categories are not discovered in nature. They are constructed through a social process: expert committees deliberating, evidence being weighed, power dynamics shaping which experiences get named and which remain invisible. The history of the DSM — the Diagnostic and Statistical Manual of Mental Disorders — is also a history of who was in the room.

Homosexuality was a DSM diagnosis until 1973, removed through a combination of research evidence and sustained community advocacy. The pattern is not an artifact of the past: the process by which distress is named as pathology, by which the naming is contested, and by which communities with less power in the room are more likely to have their experiences pathologized — this is ongoing.

Naming also controls access. In systems where care is rationed by diagnostic category, the name a person receives determines what treatment they can access, what accommodations they can claim, what insurance will cover. Communities that have historically been over-diagnosed in some categories (Black children and ADHD, Black adults and schizophrenia) and under-diagnosed in others (Black patients and pain, Black women and autoimmune conditions) are navigating a system in which the naming of their experience has consequences far beyond the clinic — for employment, child custody, immigration status, and more.

The naming of illness is not separate from the conditions of justice. It is one of its sites.

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Holding Both: When Two Names Are True

The hook for this post begins with a community that had two names for the same thing. Both were true.

This is the hardest position to hold. It is easier to say biomedicine is wrong, or to say traditional frameworks are insufficient, than to say both can simultaneously be right and both can simultaneously be incomplete. But this is where the communities Ubuntu Village works alongside actually live.

A person in Nairobi seeking care for what their clinic names as major depressive disorder, and what their grandmother names as the grief of an ancestor not yet received, does not need to choose between frameworks. They need a healthcare system and a community structure that can hold both names, pursue both threads, and not require them to deny one in order to access the other.

Arthur Kleinman’s work on illness narratives established this decades ago: healing improves when clinicians take the patient’s own explanatory model seriously as information — not to override clinical judgment, but to let it inform treatment, build trust, and surface what the clinical intake form never asked. The implementation has been slow. The communities with the most at stake in this slowness are the same ones that have always paid most dearly for what the system could not see.

Ubuntu Village does not offer a resolution to the tension between naming systems. We offer the conviction that sitting with that tension honestly — holding the both/and rather than forcing a resolution — is more honest and ultimately more healing than collapsing it in either direction. The both/and is difficult. But it is where the people are. And the people are who healing is for.

If you carry a name for your experience that no one in the clinic ever recognized — and another name your grandmother gave it that no doctor ever asked about — you are not confused. You are holding more of the truth than either system can. We trace how African spiritual frameworks have long named trauma in The Crossroads in the Body. Share this with someone who is living in that same gap.

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What does a community lose when the only language available for its suffering is the one given by a system that did not design that language with the community in mind? It loses the capacity to locate the healing it already built — the practices, the relationships, the frameworks that have long been used to make sense of illness, to hold people through it, and to bring them back. These are not replacements for biomedical care. They are the context in which biomedical care either helps or falls short. Ubuntu Village’s work in Kenya, Uganda, and Nigeria proceeds from the conviction that both naming systems are present, both are partial, and honoring health in communities means honoring the complexity — not requiring a choice. Reach out.

If you have ever felt the gap between what the system called it and what you knew it to be — this is for you. Share it with someone who is living in that gap.

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Sources & Research

1. Kleinman, A. (1988). The Illness Narratives: Suffering, Healing, and the Human Condition. Basic Books.
2. Washington, H. A. (2006). Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. Doubleday.
3. Fanon, F. (1963). The Wretched of the Earth. Grove Press.
4. Lewis-Fernández, R., & Díaz, N. (2002). The cultural formulation: A method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly, 73(4), 271–295.
5. Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47.
6. Mbiti, J. S. (1990). African Religions and Philosophy (2nd ed.). Heinemann.

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