The Role of Faith Healing in Mental Health Seminar
Hosted by
The Banyan Academy of Leadership in Mental Health (BALM)
12th November 2009
Su sh ru t,
BALM ha s
sse d th e n e xt
Contents
Page number
3.
Background to the seminar
4. – 5.
Mental health in India – Historical and Cultural Perspectives
Dr. Anup Dar
6.
Dava and Dua project
ALTRUIST Project Founder
Milesh Hanlai
7. - 8.
Mental illness or Evil Spirits?
Dr. Brigitte Sebastia
9. – 11.
The Banyan – Community Mental Health Project (CMHP)
Ms. Porkodi – Project Director
12.
Faith Healing: Anthropological perspectives
Professor Littlewood
13. – 14.
Panel discussion: The role of faith healing in mental health care
BALM would like to thank Anna Campbell for the compilation of this report.
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Background
India has a rich history of treatment of mental illnesses in traditional spiritual practices. Durgahs,
temples and churches are just a few examples of places where people seek cure for various ailments.
In addition to these remedies rooted in religion, there are several ancient medicine systems such as
Ayurveda, Siddha and Homeopathy that provide treatment.
Faith healing has been used extensively in India as a method of treatment of mental illness,
especially in rural areas. Even though there might be no direct scientific proof for the effectiveness
of faith healing, anecdotal evidence suggests that certain people benefit from faith healing, either in
conjunction with allopathic medication or without.
Several factors contribute to people resorting to faith healing as a means of psychiatric treatment.
To begin with there is complete lack of awareness of mental illness being a treatable illness esp. in
rural India and even where there is, there is a severe shortage of professional psychiatrists in the
rural areas1, compelling people to access treatment by ‘faith-healing’ methods.
Despite this however, faith healing is not always the last resort after seeking psychiatric treatment.
It very often precedes other forms of treatment, since faith healing as a means of treatment is
rooted in India’s cultural tradition and offers both reason and treatment for psychiatric ailments.
This explains why faith healing is not just accessed by those in rural areas, but by the average urban
Indian as well.
Against this background, BALM organises a one day deliberation on ‘The Role of Faith Healing in
Psychiatry.’ The seminar will provide a platform to a wide range of opinions and experiences on faith
healing.
Objective
The objective of the seminar is to discuss the following topics:
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What is faith healing?
What are the operational aspects of faith healing?
What are the factors that contribute to the popularity of faith healing as a treatment for
mental illness?
Topics
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Mental health in India – Cultural and historical perspectives
Faith healing as a form of psychiatric treatment
Case studies of people who have only accessed faith healing practices.
Case studies of people who have accessed faith healing practices, as well as psychiatric
treatment.
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A recent article published in The Times of India on February 12, 09 ‘Just 3,300 shrinks for
13 crore with mental illness’ draws attention to the fact that India only has 3,300 trained
practicing psychiatrist, out of which 3,000 practice in the four metros.
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Mental health in India – Historical & Cultural Perspectives
Dr. Anup Dhar
Centre for Study of Culture and Society
http://www.cscsarchive.org/irps/irp.2008-10-14.6748323572
Poses the question: is there space for faith-healing in the context of mental health in India? Dr. Anup
proposed that historical and cultural perspectives of mental health in India must be contextualized
within a geographical perspective. He uses the paradigm of maps to trace a journey through time
and space and suggests that a ‘remapping’ is required to create a framework for mental health in
India in which faith-healing works alongside a bio-medical model to form a true multi-disciplinary
approach.
Map 1: One dimensional Eurocentric map of bio-medicine
In Map 1 he argues that time sets a particular frame distinguishing the ‘modern’ from the past. Biomedicine is considered modern and anything before this western medical revolution is considered
pre-modern and is thus relegated conceptually and schematically to old. Faith healing falls into this
category and is aligned with superstition, suggestive of lack in this model.
He defines culture as the ‘difference that matters’ and suggests that within the first map there is no
space for ‘cultural perspectives’ as all that is different is conceived as ‘pre’ or ‘prior’ and is
therefore relegated to below and irrelevant. This perspective is ‘indifferent’ to culture and different
perspectives and therefore allows no space for traditional healing methods.
He suggests that the two main problems with this map are:
- Space, in that none is made for faith healing and other cultural perspectives
- Time, in that it is focused only on the period since the birth of the medical clinic and
discounts all prior knowledge and practice
Map 2: Stigma, pathology and the birth of the clinic
The map addresses the beginnings of a multidisciplinary approach that begins to place psychiatry in a
position in history and medical development rather holding it as the final ring on the ladder of
development.
The critical ideas here are interdisciplinarity and intradisciplinarity that emphasise the importance of
placing studies and paradigms in their context in a scheme of development rather than at the
pinnacle. Throughout history there has been suffering and methods of healing; psychiatry is one
healing response to one kind of suffering.
Dr. Anup then traced the birth of the clinic to illustrate this medical positioning and discussed
medical paradigm changes in terms of what is ‘normal’ in the context of societal shifts in thinking.
The birth of the clinic came 200 years ago as doctors’ anatomical understanding of the body
increased. The clinical experience changed from a hearing experience (what is the matter with you?)
to a seeing experience (where does it hurt?). Psychiatry however, remains in the hearing stage of this
development and thus has something in common with older forms of healing.
He talked about the notion of abnormal and how it has developed beginning as a large, ill-defined
confusion of a definition that incorporates anything physically or sexually unlike ‘us’ for example
Siamese twins or hermaphrodites. The definition was honed over time and now rests as more of a
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‘moral’ monster – a movement from the flesh to the mind that was developed in the context of
Christianity.
All these definitions place parameters by which a person is diagnosed and laid the foundations for
diagnositic criteria for mental health disorders.
Map 3:
Places psychiatry in perspective as part of the CUSP map of mental health care. This map places all
aspects of treatment on one plane demonstrating that the medical experience is just one option
within a range that includes:
• Medical experience
• Non (A-) Medical Experiences
o Formalised as in Ayurveda
o Faith healing and cultural questions
• Community mental health which sits in the middle and incorporates both, bridging the gap
Here Dr. Anup also pointed out that the medical experience is an individual experience and also and
institutionalized one – faith healing and other alternative treatments are more of a community based
approach that needs to be accommodated in the model of care.
Questions
Lucie Potter, a volunteer at The Banyan asked: How can we practically achieve the integrated
approach?
The response was that the sector needs to assess how many different options there are available in
the sector and how many different languages they are speaking. This would establish an
understanding of compatibility. He also pointed out, continuing with the language metaphor, that if
one language alone is adopted to speak for all options, it remains specific and uniform for such a
diverse audience.
A point was made by Dr. Lalit from Bangalore who suggested that it was perhaps not a common
language, but a common space that is required for progression. He talked of the politics of
engagement and raised the point that the way people engage with a power system is based on their
context; creating a more neutral setting for engagement may have positive effects.
A question was asked: Where does the map go from here? Where is CUSP going?
Dr. Anup emphasized that the work of CUSP is respectful of all systems of care and is working
towards an integrated, yet interrupted system of care that does not reduce differences in practices
to lack (as per the first map).
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ALTRUIST Founder – Dava-Dua Project
Milesh Hamlai
Milesh described his experiences in providing psychiatric services to a durgha in Gujarat. He
described the Indian context where religion and health go hand in hand and traditionally medication
and treatment has been sought from religious establishments. It is from this stand point that his
team began their interactions with an 800 year old durgha that has a reputation of badly managing
patients and of human rights issues.
The project is a public-private partnership between the government, Altruist and the durgha
designed to integrate psychiatric, bio-medicine into the religious practice at the site without
questioning the religion itself in any way.
To integrate the two practices they have trained the Priests to identify mental illness that would
benefit from bio-medical treatment and then to direct those patients to the psychiatric services
provided by Altruist. In the Indian context there is a missing link between health care services and
the client. This could be due to a lack of understanding of mental illness, a lack of psychiatric
services in Primary Health Centres or to the preventative costs associated with private practice; this
gap is bridged in this instance by the faith healer who can identify and direct clients to the care they
require.
The project incorporates training of identification of mental illness with some therapeutic and
counseling training so that Priests at the durgha can speak to devotees about their illness and their
medication on using their language and in a setting in which the clients are comfortable. The project
has achieved many of its aims and shown that the durgha was willing to work with psychiatric
services in an integrated model of mental health.
Questions:
How long is such a collaboration possible before bio-medicine takes over in these circumstances?
Milesh stated that this is a pilot-project with the objective of bringing the two together not for one
to dominate. The project was started in response to human rights violations and its aim was to bring
together and not to take over.
A point was made about the acceptance of help – with the anecdote described of the common
people that protested at the request for psychiatric services at a particular PHC because they did
not want the integration of the two types of client.
Jane Derges of the UCL team asked if any of the priests had left the durgha to become mental health
professionals? Is it part of the aim of the project to get people from the durga to work as mental
health professionals? Milesh answered that nobody had left the durgha as a result of this project,
nor was that one of the aims of the project. These families have been healers for generations.
However, through the partnership it was envisaged that the Priest’s children would have the
opportunity to go to school.
One participant noted that this is the introduction of psychiatry into religion and asked if religion
would ever enter into psychiatry?
The importance of the training of Priests was expressed in the light that people may discuss their
issues more freely with the Priest rather than a counselor.
Have the faith healing techniques changed? Milesh said he was not in the best position to answer
this question but the durgha is 800 years old and in his opinion the techniques have been diluted
over
time and are
perhaps not as intense or involved
as in the past.
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Mental illness or Evil Spirits? Dr. Brigitte Sebastia
Dance of St. Anthony: Devotion, Affliction and Possession
Puliyampatti
The clients in this video fell into three categories:
- Those suffering from severe mental illness (such as bipolar and schizophrenia)
- Those affected by domestic violence (mainly women)
- Those suffering from incurable diseases and rejected from the hospital
The video drew particular attention to the rituals at St. Anthony’s – other activities also take place
at the shrine aside from this. The community comes together here and moves fluidly between the
shrine and the town outside.
She explained that it was a system controlled by patients and posited that many of the behaviours
exhibited were a mechanism for escaping tension; those that have deep family or personal problems
become ‘possessed’ and those with other mental illnesses tend to behave very differently.
She explained that many clients had visited Psychiatrists before coming to the shrine but
discontinued because of:
- Lack of money
- Bad psychiatric practice
She elaborated on the problems clients had with Psychiatrists:
- They only addressed the care giver and not the client with their limited repertoire of
questions
- The prescription is given to the family member
- No information is provided on illness or medication
Questions
Why do people visit the shrine of St. Anthony?
64% of 67 devotees had already accessed psychiatric treatment before visiting the shrine. In her
opinion biomedical treatment had failed due to a combination of lack of money to fund treatment
and individual cases of bad psychiatric practice. Examples included the psychiatrist talking only to
the care giver and not the client and therefore not exploring the symptoms completely; sourcing of
medication from only a small selection controlled by the psychiatrist; limited/ no information
supplied to the client on their illness, medication or possible side effects. Together this lead clients
to have little faith in government hospitals and bio-medical treatments.
The high level of mental health issues in India is not a result of the lack of psychiatrists but of the
failure of psychiatry as a discipline to engage with the community and address the needs of the
people.
Experience from a Delhi clinic of one participant working with psychiatrists demonstrated that a
presenting patient’s current prescription was treated as evidence of a diagnosis and therefore a
proper assessment was not undertaken.
Dr. Anup posed the idea of spectacle - comparing the participants to those in wrestling for the
nature of the reaction they spark in the audience.
Is St. Anthony’s representative of faith healing?
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Brigitte supplied the context for the shrine in terms of location and denomination and suggested
that the video did not seek to be representative of all faith healing – just to show the practice at
St. Anthony’s.
How long did the performance last?
The performance started slowly as devotees gathered in the space, slowly building up to a frenzy in
time with the music and stimuli. The actual ritual lasted only 15 minutes in total; as the music died
down, the devotees slowly recovered themselves, tied up their hair
and walked
away.
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The Banyan – Community Mental Health Project (CMHP)
Ms Porkodi – Project Director
Other guests presented by The Banyan
Gajalakshmi, Kavitha and Murthy – Community Workers at The Banyan
- Mother of a client of The Banyan:
- Daughter has Schizophrenia and lived in the durgha for 3 years
- Resisted treatment at the health centre and eventually decided to take medication but not
leave the durgha
Sudha - Client of The Banyan
- Predicted the Tsunami
- Diagnosed with schizophrenia
- Will not take medication
Allahudin - Faith healer/ private
- Informal referral relationship with The Banyan
CMHP is a new experience for The Banyan which started as an institution-style home for mentally ill
women in Chennai. CMHP was designed to provide accessible mental health care in a rural setting.
Based on the same design as the District Mental Health Programme, CMHP integrates physical and
mental healthcare in the same outlet. Mental health services include allopathic medicine,
psychotherapy, family therapy, day care centre activities, awareness campaigns and other
engagement practices. Referrals to CMHP come from various sources including Panchayat members
and youth clubs alongside local faith healing sites: a temple, a durgh and independent faith healers.
The philosophy behind all of The Banyan’s projects is the provision of healthcare for all in the format
that is most accessible. The cultural context of India requires sensitivity when offering health care
services that are not always respected and integrated by government bodies. The focus here is on
the engagement of clients that need treatment in the manner most suited to themselves so as they
achieve a level of health.
The example was given of a man that receives a combination of treatment. He doesn’t know which
helps him so he continues to receive treatment from all.
One main issue is a lack of awareness. Clients either don’t know about psychiatric treatment or
experience bad practice and then shift back to faith healing.
The Banyan client experiences of faith healing at sites local to CMHP
Durgha: Porkodi explained that although the practices at Durgha (chaining etc…) appear disturbing
to an outsider, after speaking to the client you can understand that there is nothing else to be done
with the limited resources of a poor family and the challenging behaviours exhibited by the client.
The durgha provides a safe environment, stopping the client from running away and being a danger
to themselves. The durgha provides a space for clients to express themselves and for all to make
contact with those in a similar position.
Temple: Porkodi described the performance in the temple that is orchestrated by those that stay in
the temple. The atmosphere and behaviours build up as the gathering waits for the Deity. The
‘performance’ only occurs at certain times of the day – not during all of the pujas that are
performed.
Porkodi commented that the openness of faith healing centres is admirable. In this environment,
people are free to express themselves however they want – unlike in an institution. There is no
judgment.
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The system in the local Gunasheelam Temple is such that all devotees are those that have recovered
as a result of their treatment at the temple. They continue to follow the systems of the temple that
helped them recover.
In The Banyan’s experience, it is possible to rehabilitate patients only once they are in tune with
reality – the connection to everyday life required. The temple offers a setting for this as it provides
routine, functions and people that are based in reality. The culture provides a support system for a
the mental health issue.
Guest experiences
Faith healer
He explained that he addresses the whole problem, from the root cause, to its symptoms. He said
that he felt that seeking out biomedical treatment is a case of money; if a client has paid for some
treatment then it feels strange to then accept that free treatment can work.
In order to become a healer it requires austerities, everyone has the ability but takes great
dedication to use it.
He questioned why we give medication for the body when it is the spirit that is the problem?
Medicines reach out to the spirit. In his experience the fight is between the spirit and the deity –
injury is to the spirit and not the individual.
How do you decide who to refer to The Banyan?
Can decide when he sees the client individually. 11 days intense therapy then 3 months of
connection via photo and durgha. Doesn’t distinguish mental health problems and can cure most
problems.
The clients 1 = Mother client, 2 = Sudha
How did the change come about within you/ your daughter? Can you pinpoint how the change
happened?
1. Both the centre and the durgha – both helped a bit
2. Medication helped her sleep.
Have you faced stigma?
1. Her daughter behaved very badly but no one said anything derrogatory in front of her. The
question was asked, ‘did they look at you differently?’ and she replied that she was never
ostracized.
2. Her symptoms were withdrawal and not aggressive, therefore the community felt sad for
her. She felt that nature was speaking to her heart.
Does the healer have special power or is it knowledge that can be learnt from a book?
2. God is there in every individual and it’s about how you realize the God. The healer will
have read something and learnt things that can be used to heal in combination with the power.
God provides the way
Does the doctor work in the same way as a faith healer?
2. Same in a way; doctor gets rid of illness and the faith healer treats the spirit. God is love
and out of love both the doctor and the faith healer practice. Neither are God.
Why did you feel that you were well/ not well?
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2. She always felt connected to God (a particular Goddess) and had a dream that instructed
her not to get married or lose her virginity – the dream explained that if she followed this it would
be good for others. At that time she felt some witchcraft that was done against her – someone fell
in love with her. The thoughts of this person were caused by witchcraft. She has experience the
fusing of the evil spirit with her body. This was her illness.
What does she think of the diagnosis of Schizophrenia?
2. Her symptoms included lack of sleep and a delusion of pregnancy along with obsessive
thoughts of God. These symptoms were reduced by medication. She said that she was never
mentally ill, just lack of sleep that was the problem – witchcraft caused this symptom.
Mother client: How does she feel about the temple and about The Banyan?
1. Both just as good as each other.
Sudha: Does she have other things to give to people?
2. She stayed longer at CMHP because she liked helping the people around her. The doctor
told her to stay and help and she stayed because she wanted to help.
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Anthropological perspectives on faith healing
Professor Roland Littlewood, University College London
Professor Littlewood posed that the description ‘faith healer’ is misleading; he used the term
traditional/ alternative healer.
Is faith healing universal?
Societies have desired and undesired states of being. Methods to turn client back to desired state.
This is universal definition. The term can include all sorts of activities including hypnotherapy and
counseling.
Symbolic healing has properties that are in common around the world.
1. Experience of the healer and the to be healed explained by the term myth – both sides come from
the same culture and share these myths. Experience is explained by this. The two share a mythical
culture.
2. The sufferer defines the problem in terms of the myth (cultural explanation) and the therapist
fully explains the problem in terms of the myth to be understood by both sides. Representation of
the myth – stethoscope, couch puts the myth in context (non verbal). The healer provides a verbal or
non verbal explanation by making assumptions on the interactions shared by the two sides.
3. Dowl: Healer transfers the patient’s story into symbols. Symbols suggest they are experiencing
something and form a link between the myth and the personal experience in their mind.
4. The healer manipulates the myth further.
Problems with the model:
- Does technological transformation also take place in the medical model
- Is this only anthropological or is it in the patient’s experience? Do individuals have to be
aware of the symbols?
- Single healer
- How can we measure efficacy?
Example:
Levi-Strauss studied a woman in obstructed labour in an Indian community in Panama. Resolution
involves the myth provided by the Shaman. The explanation: the power is located in the womb, the
Mu (mythical goddess) is jealous of the mother and will not allow the baby out. Together both the
mother and the healer engage in the myth linking the physical with the cognitive. The shaman
creates figures and tells the story. The figurines are used to indicate a visual journey up the vagina
of the woman to confront Mu and to release the baby.
- Different levels of the myth – the shaman links the levels together in a language that she his
experience of to relax the woman in order that she can deliver
Collective healing
Where healing slides into ritual – for example at Carnival time when everyone comes together and
releases their problems. Turning things upside down.
Cultural schemas that have developed around ailments:
Chief Ship of the Scrotal Hernia – Congo: in this culture the hernia would be very debilitating and
those that suffered from it would not be able to go out and hunt. As a result of this they became
political figures, earning the title the Chief Ship of the Scrotal Hernia.
In Rwanda in 1950s there was a drum society for people that experienced bad dreams about
Europeans. Alcoholics anonymous - displacement of agency for illness onto God. This is an example of
symbolic healing forming a part of biomedicine.
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Panel discussion
Dr. O. Somasundaram, psychiatrist
Dr. Sushrut Jadhav , University College London
Dr. Roland Littlewood, University College London
Dr. Harish Naraindas, Jawaharlal Nehru University, Delhi
Dr. Brigitte Sebastia, French Institute of Pondicherry
Mr. Allahudin, Traditional healer, Kovalam
Moderator: Dr. K.S. Jacob, CMC, Vellore
Dr. O. Somasundaram pointed out that mental diseases are brain diseases, but that medicines do not
work in all people. So additional help from other traditional ways of healing is very necessary. For
example, very old form of healing such as Jainism etc. treated people with mental illness with
compassion.
Temple treatment is very popular
Gunasilum temple reduces aggression
Routine in temple habits are trained at these places
What contributes to the popularity of faith healing?
- Dr. Sushrut: Attributed it to the failure of established psychiatry to provide the services it should
do.
- Prof. Harish: Referred to the client of The Banyan whose daughter was chained at the durgha. He
highlighted that the durga provides a sanctuary with activity not available elsewhere.
- Prof Littlewood: Is money an issue? Are middle class people going to a traditional healer because
they want something a bit different and non-medical?
Insights from hospital ethnographies suggest that the outside culture is represented inside the
hospital (with temples and other structures finding their place). Perhaps hospitals should be made
more permeable and more open to the outside world. Part of this includes the dismantling of
structures and colonial concepts of the mind.
The significance of Jerome Frank’s work on ‘non specific issues in psychotherapy’ was raised
highlighting that it is a series of activities that cannot be directly controlled or predicted that
contribute to recovery. Faith healing is one such factor.
One issue is that there is no dialogue at the moment between different methods of healing.
We are all trapped in our own frameworks and difficult to see other’s point of view. The points of
view are diverse and one framework may be more useful than others; and yet no one perspective
provides complete solution or even an understanding.
This point was developed and it was posited that experts are trapped in the framework but people
hold a variety of beliefs and models. Professionals cannot integrate everything or often even fully
appreciate because they are stuck in their background.
How can we provide a package that includes all perspectives? Can we talk across disciplinary
frameworks?
There are no exclusive solutions for mental illness and therefore people are open to seeking various
treatments.
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The biomedicine perspective is happy to incorporate things that are understood (e.g. yoga) but
religion is not studied and understood well enough yet in a scientific way in order that it can be
accepted.
The faith healer crossed the divide by incorporating various myths from various religions. If he can
bridge the gap, why can’t others?
Why do people go to the faith healer?
Because the hospital has failed!
Are there levels of faith healing care as in biomedical care?
Charges are based on the individual and therefore it has the benefit of affordability. These arethe
only levels to consider.
It was posed that faith healing has a role in neurotic disorders but not in psychotic. This was
dismissed as too simplistic an explanation to account for all the factors involved.
The fact is that there is no generic solution, only individual solutions for problems based on cultural
perspectives.
Faith healing brings in the larger meaning making layer that therapists often try and encourage
clients to access.
Both sides are perhaps treating symptomatically and in this case have more in common that we
think.
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