Itako in Aomori prefecture belong to an overarching association.
They are renown for their capacity to speak for the dead, through a ritual process known as "kuchiyose." Many itako deploy the ritual figurines known as oshirasama in this process, and at times recite the mythic chant, the oshirasaimon.
In the Tsugaru region, itako are often contrasted with "kamisama" spirit mediums, who do not belong to an overarching association.
Since she's an itako, she's been trained not to let her emotions seep in when making decisions, since that is a disservice to those she is divining for.
Since she was training to be an itako, she had to learn discipline, so whatever her grandmother wanted, whether it be to stand on her head and recite the sutras backwards or something as simple as picking up groceries, Mae had to do it, no questions asked.
Her mother was an itako, her grandmother, great-grandmother, and for as far as she can go, all the women in her family were itako.