ways made very conscious and deliberate attempts to define their doctrines in reference--and in opposition--to them [ 39]. They require that reformed spirit mediums, for example, bring their spirits' paraphernalia to the church so that they may be destroyed. In so doing the exorcists illustrate that their power (or, more appropriately, that of God) is greater than the power of the tromba spirits. This action is also designed to erase all memory of tromba's existence in the medium's life.
This notion of power is pivotal to the process of restructuring or redefining the patient's identity, and it is accomplished through a remaking of the symbolic order. This is especially evident in the style of interaction that occurs during exorcism sessions, where the exorcist and the patient assume dominant and submissive positions. The patient kneels or sits on the ground before the exorcist, who stands. Throughout the session, the exorcist periodically places his or her hand or the Bible on the patient's head. In this way the exorcist's actions are a direct violation of Malagasy rules of status etiquette. The head is sacred and should not be touched, and only elders and royalty may raise their heads above others. Thus, the patient, in accepting the exorcist's treatment, submits to Protestant authority. Only after the patient joins the christian community is the relationship between the patient and the exorcist redefined as egalitarian. As is true of tromba possession [29, Chap. 7], this association is defined by fictive kinship--in this case, through christian principles. At the healing retreats, all individuals who embrace Christianity are defined as "brothers" and "sisters" of each other, and all are children before God, the Father. In this way, through exorcism rituals patients break from Sakalava structural relationships to new, christian ones. As Pappas argues, "Power cuts two ways: it both constrains and enables" [20, p. 200]. Here, unlike the clinical setting, both exorcist and patient are empowered.
While conversion may relieve the suffering of some Sakalava, it nevertheless raises other questions. Clearly, Protestantism poses a potential threat to the local social and cultural order, since it seeks deliberately to undermine tromba and other elements of Sakalava culture. Karp, for example, reports that within a year's absence from Tesoland in Kenya, all mediums had converted to Christianity and no longer practiced possession [ 58]. In Ambanja, however, I do not foresee Protestantism making major inroads into the Sakalava community, because among Sakalava this faith is too strongly associated with French colonial and Merina enemies. At this time, conversion among Sakalava is rare and it is a last resort, for the price that one pays is heavy. In joining this new christian community the afflicted may in turn be alienated from Sakalava kin and friends, as happened in the case of Vivienne. As the three examples from the Lutheran church illustrate, candidates for such a shift may already occupy socially marginal positions. This church offered each a new community to join, albeit a non-Sakalava one. These are extreme examples, involving individuals who desperately seek relief.