Grappling with affliction: autism in the Jewish ultraorthodox community in Israel.

In this essay we seek to examine the cultural tool kit employed in the Jewish ultraorthodox community to cope with autism, a predicament deemed resistant to massive cultural molding. Through 30 open-ended interviews with ultraorthodox mothers of children with autism we portray the mothers' emerging recognition of the disorder, their care seeking activities, and their construction of explanatory models. The health care system on which the ultraorthodox mothers rely is extremely diverse, including mainstream medical and educational services, various alternative therapies, therapies specific to autism, and spiritual and mystical interventions. The outcome of these endeavors is a dual system of illness perception in which bio-medical and spiritual-religious frames of references coexist. This duality cuts across all the facets of the explanatory system: etiology, pathophysiology, treatment, and prognosis. Metaphysical accounts, and especially the notion of the transmigration of souls, serve as meta-accounts, bridging the epistemological gap between God's mysterious intention and the specific bodily mechanisms underlying the disorder. The religious and moral theme of suffering is highlighted in the narratives as a salient constituent of the ultraorthodox mothers' attempts to understand and come to terms with their plight.