Treatment for mental disorders
R. THARA
RESTORING MENTAL HEALTH IN INDIA: Edited by Brigitte Sebastia; Oxford University Press, YMCA Library Building, Jai Singh Road, New Delhi-110001. Rs. 795.
This book is an attempt to present the wide range of therapies in India for the management of mental disorders. Its three parts discuss the restoration of mental health with codified Indian medicines, folk therapy, and psychiatry.
Cultural impact
Considering that subjects like yoga and meditation, and the impact of culture are included in the first part, the use of the word ‘medicine’ in its title could have been avoided and the word, ‘intervention,’ used instead. In the first chapter, Somasundaram, a retired Superintendent of the Institute of Mental Health, Chennai, and one very proficient in Tamil literature, elucidates the role of Siddha medicine in treating mental disorders. Suicide is by no means a modern malady.
The Sangam classics narrate in detail the various kinds of suicide including what was termed “honour suicide” committed by kings and some others in position and power. The practice of the widow committing immolation by entering her husband’s funeral pyre met with social sanction and was even glorified.
Even in the 9th century, the mentally ill were admitted for cure or healing in some chosen temples in south India such as Gunaseelam, Thiruvidaimaruthur, and Sholingur. I would hasten to add that this practice continues, albeit with a low profile
The Ayurvedic perspective of mental disorders and their treatment is provided by Nadia Giguere, who spent some time at the Government Ayurvedic Mental Hospital at Kottakkal in Kerala. Based on his experience as a yoga teacher and practitioner, Kumara Babu, a Chennai-based psychiatrist, cites case-vignettes and hopes that in the years to come, yoga and meditation “may gain an undisputed place in the management of common mental disorders.” He also recommends that yoga practices be taught in schools as a prophylactic measure and in the community by trained health workers.
The rather long chapter on Darsan being a healing force, by Pilar Abal, makes interesting reading, but does not have much relevance to the subject of the book. The very strong psychoanalytical interpretations of the author may not appeal to all readers. At the end of the chapter, the reader is left confused about the precise role of such practices in the healing of mental disorders.
‘Possession’ method
Marine Carrin describes ‘possession’ as witnessed in two societies — a patrilineal tribal society and a matrilineal Tulu society of south Kanara. ‘Possession’ is still very common, especially in rural areas. Even in Tamil Nadu, there are some temples such as Hanumanthapuram where I have observed a group of young women who used to remain in a so-called trance state for about 30 minutes around noon almost everyday. Even if considered a cry for help or attention, this practice gets social sanction and not perceived as a deviant behaviour.
The chapter on mythologising distress also deals with ‘possession’ and its healing as practised in Rajasthan. This describes a series of procedures and behaviour patterns of people with some kind of physical or emotional distress seeking help in the Balaji temple at Mehendipur. The author’s account of the interpretation of mental illness by sociology, ethnopsychiatry, psychiatry, and ethnopsychology make very good reading.
In the concluding chapter of that section, the editor discusses why persons with mental illness and their families opt for religious ‘remedies’, besides highlighting the inadequacy of formal mental health services in many parts of the country and the factors that led to the devastating Erwadi tragedy in Tamil Nadu.
Psychiatry
The third part deals with the role of psychiatry in restoring mental health.
Murthy and Jain trace the growth of NIMHANS, Bangalore, right from its inception centuries ago. This captures the development of allopathic medical care for mental disorders.
Bose’s psychoanalytical methods are well described by Jean Nimylowycz but I do wonder about the therapeutic role they might have in the management of mental disorders. Renu Addlakha, based on her work in two psychiatric centres in Delhi, concludes that psychiatric practitioners, both men and women, in India tend to make patriarchal judgments of their female patients. She wants psychiatric theory and practice to be ‘engendered’ in India by including gender issues in the curriculum of medical education.
Bibeau and Corin, in their afterword, raise some interesting questions on the role, significance, and importance of religious and traditional treatment methods for mental disorders and how they can be linked to scientifically grounded therapies.
To sum up, this volume is a conglomeration of some interesting facets of mental health care in the communities in India, the plurality and divergence of which are striking as much as they are intriguing.
It will be a welcome addition to all medical libraries as well as the personal collection of those interested in culture, anthropology, psychoanalysis and mental health care.
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