What Is The Relationship Between Psychiatry and Traditional Medicine?

by Ian Brown

Pills, pills, pills! Are they helpful?
Do they work? How do they work?
What are their side effects?

The relationship between traditional healing practices and psychiatry is an uneasy one. There is a fear in some communities that if a person is referred to a psychologist or psychiatrist, they will be prescribed pills. Specifically, the fear is that a chemical dependency is being created through this response to mental illness while the larger social ills are being overlooked.

On the other hand, there are other communities who see pill medication as a miraculous invention. For example, the new family of anti-depressants (Prozac, Zoloft, Paxil, etc.) are seen by many as non-addictive, effective against depression, and a better choice than ‘drowning one’s sorrows’ in large amounts of alcohol. The other kind of pill that has had considerable impact is the new family of drugs designed to treat schizophrenia. As in the non-Native community, the greater concern is with ‘sleeping pills’ and ‘muscle relaxants’ such as Valium and Ativan, which are known to be addictive.

In recent years, pan-Indian healing movements have enjoyed increasing popularity in Aboriginal-run treatment centres. There has been an emergence of a form of pan-Indian spirituality in prison settings and halfway houses. In some cases, traditional healing approaches have been combined with standard methods of western psychotherapy. These new
combinations have proved to be effective and meaningful to a large proportion of Aboriginal clients with different cultural, linguistic and personal backgrounds.

In the ongoing debate about traditional medicine and psychiatry, the important questions are (a) which healing methods are effective? and (b) which healing methods are appropriate?

There is always cause for caution where the interests of the pharmaceutical industry are concerned. On the other hand, some people (e.g. medical anthropologists) have been criticized as being too quick to accept traditional healing methods without ‘proof’ of their effectiveness with people in mental / emotional / spiritual distress.

Government programs that provide funding for health services require explanations and justifications for how money is spent. That is reasonable enough. However, the problem is that the focus of traditional healing is broader and more holistic than that of the biomedical approach.

Take an individual who has been referred to health authorities for depression. While biomedicine may say that the solution lies in the prescription of anti-depressants, the traditional healer may determine the problem as being loss of ‘soul’ or ‘spiritual essence’. Who is correct?

What complicates matters is that traditional healers are often reluctant to allow scientists to document their work or test it for its effectiveness. Much traditional healing involves spiritual assistance or intervention, which has strict rules as to how it is carried out. A healer may not be able to disclose the mix of herbs he or she uses, or allow recording devices inside sweat lodges, because it would offend the spirits who allow the healer to heal.

There is little scientific evidence for or against the effectiveness of current treatment programs based on traditional Aboriginal healing practices, but from a mental health perspective, whether or not traditional medicine will get rid of specific symptoms, it is likely to be effective in increasing morale, providing meaning and hope, and promoting community solidarity. Csordas (1992) gives examples of therapeutic results such as these in referring to traditional Navaho healing practices such as chants, sand painting, crystal- or coal-gazing, peyote rituals, the sweat lodge and Christian faith-healing.

Healing ceremonies are not just for individuals. Individual-centered therapies encourage people to think of themselves as autonomous, separate, powerful agents whose goal is to identify and achieve their own goals. Success or failure in life is seen in terms of these individual goals. In other cultures, family values and belongingness are central so that, far from viewing parents and others as causes of suffering, the emphasis is on what has been gained from them. In Japan, for example, Naikan therapy was developed as a method of treatment for young people with delinquency problems; the client was encouraged to meditate on all he owed to his
parents. The technique was reported to be successful.
There is much literature about how mental illness is directly related to a sense of disconnectedness from family, community, culture, and God. The French sociologist, Emile Durkheim, in his classic study entitled Suicide, said one of the main causes of suicide was what he called ‘anomie’, which means lack of structure in your life (e.g. the vacuum experienced following job loss or divorce). Other writers have talked about how the capitalist system, with its big bureaucracies, creates alienation, i.e. lack of connection to the means of production, to the sources of power, and ultimately to community and family. Loss of structure, loss of connection, loss of meaning – forces that can, and do undermine emotional, spiritual and mental health.
Traditional practices such as the sweat lodge are not just for individual healing experiences. They must be viewed in the light of how they can help regenerate a sense of Aboriginal identity, and hence connection to something larger than one’s self.
None of this is to say that traditional healing practices should be ‘off-limits’ to critical examination. Nor does it mean that psychiatry (whether pills, one-to-one consultations or group therapy) is ‘bad’, or ‘inferior’. Not many people question the use of aspirin or heart medication. Anyone who doubts the potential value of pill medication for depression or schizophrenia should listen to the grateful testimonies of people who suffered for many years before being relieved of their distress once and for all by the ingestion of a chemical whose positive effects, they say, vastly outweigh real or imagined negative effects.

The approach of taking what is best from different areas of the healing movement seems to make sense. Those who are distressed need practical help now. They do not need to become pawns in yet another political power struggle between conflicting interests.