Improvising at the Borders and without Borders: Therapeutic Valency and the Discovery of Self in Eastern Siberian Alternative Medicine

The article addresses the problem of how the emic classifications of healers and alternative medicine specialists in Eastern Siberia relate to their institutional affiliations, hierarchies, and the possibilities for improvisation. While to an outside observer the field of alternative medicine appears differentiated by categories of specialists (lamas, shamans, whisperers, etc.), in practice it is more complexly organised, so therapeutic profiles and jurisdictions cannot be described unambiguously. The authors suggest considering the emic classifications with which healers and their clients operate as labels or advertisements which do not fully define the jurisdiction of a particular practitioner and do not limit the scope of potential services. To denote the ability to expand jurisdictions and collect the skills of healing in a portfolio, the article introduces the concept of therapeutic valency. It can be informed either by an institutional track or by self-education or self-discovery. This analytical category allows us to see the basic principles of the structure of healing practice, regardless of the labels applied, and to describe professional dynamics through following more or less rigid scenarios and going beyond them. Each of the variants of professionalisation provides practitioners with different spaces for improvisation with principles and techniques of treatment.