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Abstract
Ritual healing is very widespread in the Indian state of Uttarakhand, and is by far the most common option for those with serious behavioral disturbances. Although ritual healing thus accounts for a very large part of the actual health care system, the state and its regulatory agencies have, for the most part, been structurally blind to its existence. A decade of research on in this region, along with a number of shorter research trips to healing shrines and specialists elsewhere in the subcontinent, and a thorough study of the literature, suggest that such techniques are often therapeutically effective. However, several considerations suggest that ritual healing may not be usefully combined with mainstream “Western” psychiatry: (a) psychiatry is deeply influenced by the ideology of individualism, which is incompatible with South Asian understandings of the person; (b) social asymmetries between religious healers and health professionals are too great to allow a truly respectful relationship between them; and (c) neither the science of psychiatry nor the regulatory apparatus of the state can or will acknowledge the validity of “ritual therapy”—and even if they did so, regulation would most likely destroy what is most valuable about ritual healing. This suggests that it is best if the state maintain its structural blindness to ritual healing.
References
| Adams, V. (1998) Doctors for democracy: Health professionals in the Nepal Revolution, Cambridge, UK: Cambridge Studies in Medical Anthropology. Google Scholar | |
| Balzer, M. M. (1983) Doctors or deceivers? The Siberian Khanty shaman and Soviet medicine. In: Romanucci-Ross, L., Moerman, D., Tancredi, L. (eds) The anthropology of medicine, New York, NY: Bergin/Praeger, pp. 54–76. Google Scholar | |
| Basu, H. (2009) Contested practices of control: Psychiatric and religious mental health care in India. Curare 32(1–2): 28–39. Google Scholar | |
| Bell, C. (1992) Ritual theory, ritual practice, New York, NY: Oxford University Press. Google Scholar | |
| Bellamy, C. (2011) The powerful ephemeral: Everyday healing in an ambiguously Islamic place, Berkeley: University of California Press. Google Scholar | Crossref | |
| Bhat, R., Maheshwari, S. K., Rao, K., Bakshi, R. (2007) Mental health care pilots in Gujarat: Processes, outcomes and learning, Ahmedabad, India: Indian Institute of Management. Google Scholar | |
| Blos, P. (1967) The second individuation process of adolescence. The Psychoanalytic Study of the Child 22: 162–186. Google Scholar | Crossref | Medline | |
| Csordas, T. J. (1994) The sacred self: A cultural phenomenology of charismatic healing, Berkeley: University of California Press. Google Scholar | |
| Csordas, T. J., Kleinman, A. (1990) The therapeutic process. In: Johnson, T. M., Sargent, C. F. (eds) Medical anthropology: A handbook of theory and method, New York, NY: Greenwood Press, pp. 11–25. Google Scholar | |
| Daniel, V. E. (1984) Fluid signs. Being a person the Tamil way, Berkeley: University of California Press. Google Scholar | |
| De Jong, J. T. V. M. (1987) A descent into African psychiatry, Amsterdam, the Netherlands: Royal Tropical Institute. Google Scholar | |
| De Jong, J. T. V. M. (1997). Therapists or healers, by whom would you prefer to be cured if you go mad? In Place de la dimension culturelle en sante mentale. Brusseles, Belgium: Fondation Julie Renson. Google Scholar | |
| Desai, P. N. (1989) Health and mdicine in the Hindu tradition: Continuity and cohesion, New York, NY: Crossroads. Google Scholar | |
| Desjarlais, R. (1992) Body and emotion: The aesthetics of illness and healing in the Nepal Himalayas, Philadelphia: University of Pennsylvania Press. Google Scholar | |
| Doctors, S. B. (2000) Attachment-individuation: I. Clinical notes toward a reconsideration of “adolescent turmoil”. In: Esman, A. H. (ed) Adolescent psychiatry: The Annals of the American Society for Adolescent Psychiatry Vol. 25, Hillsdale, NJ: The Analytic Press, pp. 3–16. Google Scholar | |
| Donaldson, L. (2005) Collaboration strategies for reforming systems of care: A toolkit for community-based action. International Journal of Mental Health 34(1): 90–102. Google Scholar | |
| Dow, J. (1986) Universal aspects of symbolic healing: A theoretical synthesis. American Anthropologist 88(1): 56–69. Google Scholar | Crossref | ISI | |
| Druss, B., Bornemann, T., Fry-Johnson, Y., McCombs, H., Politzer, R., Rust, G. (2006) Trends in mental health and substance abuse services at the nation’s community health centers: 1998–2003. American Journal of Public Health 96: 1779–1784. Google Scholar | Crossref | Medline | ISI | |
| Dumont, L. (1970) Homo Hierarchicus. The caste system and its implications, Chicago, IL: University of Chicago Press.(Original work published 1966). Google Scholar | |
| Dwyer, G. (2003) The divine and the demonic. Supernatural affliction and its treatment in North India, London, UK: Routledge Curzon. Google Scholar | Crossref | |
| Ecks, S. (2005) Pharmaceutical citizenship: Antidepressant marketing and the promise of demarginalization in India. Anthropology & Medicine 12(3): 239–254. Google Scholar | Crossref | Medline | |
| Eisenberg, D. M., Kessler, R. C., Foster, C., Norlock, F. E., Calkins, D. R., Dlbanco, T. L. (1993) Unconventional medicine in the United States: Prevalence, costs, and patterns of use. New England Journal of Medicine 328(4): 246–252. Google Scholar | Crossref | Medline | ISI | |
| Engel, G. (1977) The need for a new medical model: A challenge for biomedicine. Science 196(4286): 129–136. Google Scholar | Crossref | Medline | ISI | |
| Fallot, R. D. (1998) The place of spirituality and religion in mental health services. New Directions for Mental Health Services 80: 3–12. Google Scholar | Crossref | |
| Fava, G. A., Sonino, N. (2000) Psychosomatic medicine: Emerging trends and perspectives. Psychotherapy Psychosomatics 69(4): 184–197. Google Scholar | Crossref | Medline | ISI | |
| Fava, G. A., Sonino, N. (2005) The clinical domains of psychosomatic medicine. Journal of Clinical Psychiatry 66(7): 849–858. Google Scholar | Crossref | Medline | ISI | |
| Firth, R. (1940) The work of the gods in Tikopia, (2nd ed. Oxford, UK: Berg. Google Scholar | |
| Flueckiger, J. B. (2006) In Amma’s healing room: Gender and vernacular Islam in South India, Bloomington: Indiana University Press. Google Scholar | |
| Frank, J. D., Frank, J. B. (1991) Persuasion and healing, (3rd ed. Baltimore, MD: John Hopkins University Press.(Original work published 1973). Google Scholar | |
| Franz, C., White, K. (1985) Individuation and attachment in personality development: Extending Erikson’s theory. Journal of Personality 53(2): 224–256. Google Scholar | Crossref | ISI | |
| Geertz, C. (1983) Local knowledge: Further essays in interpretive anthropology, New York, NY: Basis Books. Google Scholar | |
| Greene, S. (1998) The shaman’s needle: Development, shamanic agency, and intermedicality in Aguaruna Lands, Peru. American Ethnologist 25(4): 634–658. Google Scholar | Crossref | ISI | |
| Halliburton, M. (2003) The importance of a pleasant process of treatment: Lessons in healing from South India. Culture, Medicine, and Psychiatry 27(2): 161–186. Google Scholar | Crossref | Medline | ISI | |
| Haram, L. (1991) Tswana medicine in interaction with biomedicine. Social Science and Medicine 33(2): 167–175. Google Scholar | Crossref | Medline | ISI | |
| Hobart, M. (Ed.). (1993) An anthropological critique of development: The growth of ignorance, London, UK: Routledge. Google Scholar | |
| Hoff, W. (1995) Traditional practitioners as primary health care workers, Geneva, Switzerland: World Health Organization, Division of Strengthening of Health Services and the Traditional Medicine Programme. Google Scholar | |
| Hollis, M., Lukes, S. (1982) Rationality and relativism, Cambridge, MA: MIT Press. Google Scholar | |
| Humphrey, C., Laidlaw, J. (1994) The archetypal actions of ritual: A theory of ritual illustrated by the Jain rite of worship, New York, NY: Oxford University Press. Google Scholar | |
| Incayawar, M. (2009) Future partnerships in global mental health: Foreseeing the encounter of psychiatrists and traditional healers. In: Incayawar, M., Wintrob, R., Bouchard, L. (eds) Psychiatrists and traditional healers: Unwitting partners in global mental health, Oxford, UK: Wiley-Blackwell, pp. 251–260. Google Scholar | Crossref | |
| Incayawar, M., Wintrob, R., Bouchard, L. (2009) Psychiatrists and traditional healers: Unwitting partners in global mental health, Oxford, UK: Wiley-Blackwell. Google Scholar | Crossref | |
| Jain, S., Jadhav, S. (2009) Pills that swallow policy: Clinical ethnography of a community mental health program in Northern India. Transcultural Psychiatry 46(1): 60–85. Google Scholar | SAGE Journals | ISI | |
| Janzen, J. (1978) The quest for therapy: Medical pluralism in lower Zaire, Berkeley: University of California Press. Google Scholar | |
| Kaiser, P. (2007) Religion in der Psychiatrie: Eine (un)bewusste Verdrängung? [Religion in psychiatry: An (un)conscious repression?], Göttingen, Germany: V&R Unipress. Google Scholar | |
| Kakar, S. (1983) Shamans, mystics and healers. A psychological enquiry into India and its healing traditions, Oxford, UK: Oxford University Press. Google Scholar | |
| Kapferer, B. (1983) A celebration of demons: Exorcism and the aesthetics of healing in Sri Lanka, Bloomington: Indiana University Press. Google Scholar | |
| Kaptchuk, T. (2002) The placebo effect in alternative medicine: Can the performance of a healing ritual have clinical significance? Annals of Internal Medicine 136(11): 817–825. Google Scholar | Crossref | Medline | ISI | |
| Kendall, L. (2001) The cultural politics of “superstition” in the Korean shaman world: Modernity constructs its other. In: Connor, L. H., Samuel, G. (eds) Healing powers and modernity: Traditional medicine, shamanism, and science in Asian societies, Westport, CT: Bergin & Garvey, pp. 25–41. Google Scholar | |
| Kirov, G., Kemp, R., Kirov, K., David, A. S. (1998) Religious faith after psychotic illness. Psychopathology 31(5): 234–245. Google Scholar | Crossref | Medline | ISI | |
| Kleinman, A. (1979) Why do indigenous practitioners successfully heal? Social Science and Medicine 13(1): 17–26. Google Scholar | |
| Koenig, H. G. (2008) Religion and mental health: What should psychiatrists do? Psychiatric Bulletin 32: 201–203. Google Scholar | Crossref | |
| Koenig, H. G., Cohen, H. G., Blazer, D. G., Pieper, C., Meador, K. D., Shelp, F., …DiPasquale, B. (1992) Religious coping and depression among elderly, hospitalized medically ill men. American Journal of Psychiatry 149(12): 1693–1700. Google Scholar | Crossref | Medline | ISI | |
| Krauskopff, G. (1999) Places and memories: Exorcism and curing among the Tharus of Western Nepal. In: Carrin, M. (ed) Managing distress: Possession and therapeutic cults in South Asia, New Delhi, India: Manohar, pp. 155–167. Google Scholar | |
| Langenbach, M. (1995) Phenomenology, intentionality, and mental experiences: Edmund Husserl’s Logische Untersuchungen and the first edition of Karl Jaspers’s Allgemeine Psychopathologie. History of Psychiatry 6(22): 209–224. Google Scholar | SAGE Journals | ISI | |
| Latour, B. (1993) We have never been modern, Cambridge, MA: Harvard University Press. Google Scholar | |
| Lévi-Strauss, C. (1963) The sorcerer and his magic. In Structural anthropology, New York, NY: Basic Books, pp. 175–185. Google Scholar | |
| Lipowski, Z. J. (1986) Psychosomatic medicine: Past and present. Canadian Journal of Psychiatry 31(1): 2–21. Google Scholar | SAGE Journals | ISI | |
| Luhrmann, T. (2012). Beyond the brain. Wilson Quarterly Summer, 28–34. Google Scholar | |
| Lukes, S. (1975) Political ritual and social integration. Sociology 9(2): 289–308. Google Scholar | SAGE Journals | ISI | |
| Mahler, M. (1968) On human symbiosis and the vicissitudes of individuation, New York, NY: International Universities Press. Google Scholar | |
| Majumdar, M., Grossman, P., Dietz-Waschkowski, B., Kersig, S., Walach, H. (2002) Does mindfulness meditation contribute to health? Outcome evaluation of a German sample. The Journal of Alternative and Complementary Medicine 8(6): 719–730. Google Scholar | Crossref | Medline | ISI | |
| Marriott, M. (1990) India through Hindu categories, New Delhi, India: Sage. Google Scholar | |
| May, J. (2011) College of medicine: What is integrative health? British Medical Journal 343: d4372. doi:10.1136/bmj.d4372. Google Scholar | Crossref | Medline | |
| McDaniel, S. H., Hepworth, J., Doherty, W. J. (1992) Medical family therapy: A biopsychosocial approach to families with health problems, New York, NY: Basic Books. Google Scholar | |
| McNally, R. J. (2011) What is mental illness?, Cambridge, MA: The Belknap Press of Harvard University Press. Google Scholar | |
| McNichol, T. (1996, April 7) The new faith in medicine. USA Today. p 4. Google Scholar | |
| Mines, D. P. (2005) Fierce gods. Inequality, ritual, and the politics of dignity in a South Indian village, Bloomington: Indiana University Press. Google Scholar | |
| Moerman, D. (2002) Meaning, medicine and the “placebo effect.”, Cambridge, UK: Cambridge University Press. Google Scholar | Crossref | |
| Moore, M. A. (1985) A new look at the Nayar Taravad. Man New Series 20(3): 523–541. Google Scholar | |
| Mosher, L., Burti, L. (1989) Community mental health: Principles and practice, New York, NY: W. W. Norton & Company. Google Scholar | |
| Mueller, P. S., Plevak, D. J., Rummans, T. A. (2001) Religious involvement, spirituality, and medicine: Implications for clinical practice. Mayo Clinic Proceedings 76(12): 1225–1235. Google Scholar | Crossref | Medline | ISI | |
| Mullings, L. (1984) Therapy, ideology, and social change: Mental healing in urban Ghana, Berkeley: University of California Press. Google Scholar | |
| Nabokov, I. (2000) Religion against the self: An ethnography of Tamil rituals, New York, NY: Oxford University Press. Google Scholar | |
| Nandy, A., Visvanathan, S. (1990) Modern medicine and its non-modern critics: A study in discourse. In: Apffel, F., Marglin, S. (eds) Dominating knowledge: Development, culture, and resistance, Oxford, UK: Clarendon Press, pp. 145–184. Google Scholar | Crossref | |
| Nunley, M. (1996) Why psychiatrists in India prescribe so many drugs. Culture, Medicine and Psychiatry 20(2): 165–197. Google Scholar | Crossref | Medline | ISI | |
| Okwaro, F. (2010) Modernity and efficacy in Kenyan ritual healing. The Journal of Ritual Studies 24(2): 57–79. Google Scholar | |
| Ospina, M. B., Bond, K., Karkhaneh, M., Tjosvold, L., Vandermeer, B., Liang, Y.,… Klassen, T. P. (2007). Meditation practices for health: State of the research (Evidence Report/Technology Assessment No. 155). Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. Google Scholar | |
| Pakaslahti, A. (1998). Family centered treatment of mental health problems at the Balaji Temple in Rajasthan. In A. S. Parpola & S. Tenhumen (Eds.) Changing patterns of family and kinship in South Asia: Proceedings of an international symposium on the occasion of the 50th anniversary of India’s independence held at the University of Helsinki, 6 May 1998 (pp. 129–168). Helsinki, Finland: Finnish Oriental Society. Google Scholar | |
| Pakaslahti, A. (2009) Health-seeking behaviour for psychiatric disorders in North-India. In: Incayawar, M., Wintrob, R., Bouchard, L. (eds) Psychiatrists and traditional healers: Unwitting partners in global mental health, Oxford, UK: Wiley-Blackwell, pp. 149–166. Google Scholar | Crossref | |
| Pfeifer, S. (1994) Belief in demons and exorcism in psychiatric patients in Switzerland. British Journal of Medical Psychology 67(3): 247–258. Google Scholar | Crossref | Medline | ISI | |
| Pfleiderer, B. (2006) The red thread. Healing possession at a Muslim shrine in North India, New Delhi, India: Aakar Books. Google Scholar | |
| Pigg, S. L. (1995) The social symbolism of healing in Nepal. Ethnology 34(1): 17–36. Google Scholar | Crossref | |
| Polit, K. M. (2011) Women of honour: Gender and agency among Dalit women in the central Himalayas, Hyderabad, India: Orient Blackswan. Google Scholar | |
| Press, I. (1971) The urban curandero. American Anthropologist 73(3): 741–756. Google Scholar | Crossref | ISI | |
| Puckree, T., Mkhize, M., Mgbobhozi, Z., Johnson, L. (2002) African traditional healers: What health care professionals need to know. International Journal of Rehabilitation Research 25(4): 247–251. Google Scholar | Crossref | Medline | ISI | |
| Quack, J. F. (2010) Postulated and real efficacy in late antique divination rituals. Journal of Ritual Studies 24(1): 45–60. Google Scholar | |
| Quack, J. (2012) Ignorance and utilization: Mental health care outside the purview of the Indian state. Anthropology & Medicine 19(3): 277–290. Google Scholar | Crossref | Medline | ISI | |
| Raguram, A., Venkateswaran, A., Ramakrishna, J., Weiss, M. G. (2002) Traditional community resources for mental health: A report of temple healing from India. British Medical Journal 325(38): 38–40. Google Scholar | Crossref | Medline | |
| Sax, W. S. (2002) Heilungsrituale: Ein kritischer performativer Ansatz [Healing rituals: A critical performative approach]. Paragrana 12(1–2): 385–404. Google Scholar | |
| Sax, W. S. (2004a) Healing rituals: A critical performative approach. Anthropology and Medicine 11(3): 293–306. Google Scholar | Crossref | Medline | |
| Sax, W. S. (2004b) Heilrituale der Dalits im indischen Zentral-Himalaya. In: Harth, D., Jasper Schenk, G. (eds) Ritualdynamik: Kulturübergreifende Studien zur Theorie und Geschichte rituellen Handelns, Heidelberg, Germany: Synchron, pp. 363–380. Google Scholar | |
| Sax, W. S. (2007) Heilen Rituale? [Do rituals heal?]. In: Michaels, A. (ed) Die neue Kraft der Rituale, Heidelberg, Germany: Universitätsverlag Winter, pp. 213–236. Google Scholar | |
| Sax, W. S. (2009a) God of justice: Ritual healing in the central Himalaya, New York, NY: Oxford University Press. Google Scholar | |
| Sax, W. S. (2009b) “I have no one!” Ritual healing and family relationships in Garhwal. In: Guenzi, C., Zupanov, I. (eds) Divins remèdes. Médecine et religion en Asie du Sud, Paris, France: Éd. de l'École des Hautes Études en Sciences Sociales, pp. 239–262. Google Scholar | |
| Sax, W. S. (2009c) Performing God’s body. Paragrana 18(1): 165–187. Google Scholar | Crossref | |
| Sax, W. S. (2010a) Introduction. In: Quack, J., Sax, W., Weinhold, J. (eds) The problem of ritual efficacy, New York, NY: Oxford University Press, pp. 3–16. Google Scholar | Crossref | |
| Sax, W. S. (with Quack, J.). (2010b). Introduction: The efficacy of rituals. The Journal of Ritual Studies, 24(1), 5–12. Google Scholar | |
| Sax, W. S. (with Weinhold, J., & Schweitzer, J.). (2010c). Ritual healing East and West: A comparison of ritual healing in the Garhwal Himalayas and family constellation in Germany. The Journal of Ritual Studies, 24(1), 61–77. Google Scholar | |
| Sax, W. S. (unpublished manuscript) Oracular possession, authenticity, and the ideology of absence. In: Basu, H., Sax, W. (eds) The law of possession. Google Scholar | |
| Scheper-Hughes, N. (1990) Three propositions for a critically applied medical anthropology. Social Science and Medicine 30(2): 189–197. Google Scholar | Crossref | Medline | ISI | |
| Schweitzer, J., von Schlippe, A. (1998) Lehrbuch der Systemischen Therapie und Beratung [Textbook of systematic therapy and counselling], Göttingen, Germany: Vandenhoeck & Ruprecht. Google Scholar | |
| Skultans, V. (1987) The management of mental illness among Maharashtrian families: A case study of a Mahanubhav healing temples. Man New Series 22(4): 661–679. Google Scholar | |
| Sloan, R. P., Bagiella, E., Powell, T. (1999) Religion, spirituality, and medicine. Lancet 353(9153): 664–667. Google Scholar | Crossref | Medline | ISI | |
| Sloan, R. P., Bagiella, E., VandeCreek, L., Hover, M., Casalone, C., Hirsch, T. J., Poulos, P. (2000) Should physicians prescribe religious activities? New England Journal of Medicine 342(25): 1913–1916. Google Scholar | Crossref | Medline | ISI | |
| Speca, M., Carlson, L. E., Goodey, E., Angen, M. (2000) A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine 62(5): 613–622. Google Scholar | Crossref | Medline | ISI | |
| Strathern, M. (1993) Making incomplete. In: Broch-Due, V., Rudie, I., Bleie, T. (eds) Carved flesh/cast selves: Gendered symbols and social practices, Oxford, UK: Berg, pp. 41–52. Google Scholar | |
| Taylor, C. (2007) A secular age, Cambridge, MA: Harvard University Press. Google Scholar | Crossref | |
| Tepper, L., Rogers, S. A., Coleman, E. M., Malony, H. N. (2001) The prevalence of religious coping among persons with persistent mental illness. Psychiatric Service 52(5): 660–665. Google Scholar | Crossref | Medline | ISI | |
| Turner, V. W. (1968) The drums of affliction: A study of religious processes among the Ndembu of Zambia, Ithaca, NY: Cornell University Press. Google Scholar | |
| Waldram, J. B. (2000) The efficacy of traditional medicine: Current theoretical and methodological issues. Medical Anthropological Quarterly 14(4): 603–625. Google Scholar | Crossref | Medline | ISI | |
| Wall, L. L. (1996) Ritual meaning in surgery. Obstetrics and Gynecology 4(1): 633–637. Google Scholar | Crossref | ISI | |
| Weiser, J. (1999) Adapting traditional healing practices. AIDS Action 46: 7. Google Scholar | |
| Weiss, M. G., Sharma, J. S., Sharma, S. D., Gaur, R. K., Desai, A., Doongaji, D. R. (1986) Traditional concepts of mental disorder among Indian psychiatric patients: Preliminary report of work in progress. Social Science and Medicine 23(4): 379–386. Google Scholar | Crossref | Medline | ISI | |
| Wells, R., Morrissey, J., Lee, I., Radford, A. (2010) Trends in behavioral health care service provision by community health centers, 1998–2007. Psychiatric Services 61(8): 759–764. Google Scholar | Crossref | Medline | ISI | |
| Whyte, S. R. (1989) Anthropological approaches to African misfortune: From religion to medicine. In: Jacobson-Widding, A., Westerlund, D. (eds) Culture, experience and pluralism: Essays on African ideas of illness and healing, Stockholm, Sweden: Almqvist & Wiksell International, pp. 289–301. Google Scholar | |
| World Health Organization. (1978). The promotion and development of traditional medicine (Technical Report No. 622). Geneva, Switzerland: Author. Google Scholar | |
| World Health Organization (2002) WHO traditional medicine strategy 2002–2005, Geneva, Switzerland: Author. Google Scholar | |
| Worsley, P. (1982) Non-Western medical systems. Annual Review of Anthropology 11(1982): 315–348. Google Scholar | Crossref | ISI |
