Transcultural Psychiatry

An understanding of the nature and meaning of ‘dissociative,’ ‘altered’ or unusual states ultimately turns on the meaning and definition of consciousness. The view of consciousness from the discipline of psychiatry is largely based on a biomedically endorsed, culturally specific perspective of ‘normal’ consciousness as an integrated pattern of quotidian relationships with the ‘observable’ physical world. This perspective underlies the nosology for mental disorders, particularly psychoses, suggesting irreconcilable difference in cognition and affect of persons with these diagnostic labels. This article reviews some theories of Carl Gustav Jung regarding the structure and content of human consciousness and their relationship to aspects of ‘dementia praecox’ or ‘schizophrenia.’ It traces the origin and development of these ideas in part to Jung’s early contact with, and intense interest in spiritualists and spirits, to later influences comprised of his own altered states (dreams and fantasies) and his involvement with patients diagnosed as schizophrenic. Data on current Spiritist beliefs and healing practices focused on ‘madness’ (i.e. most often diagnosed as schizophrenia in mental health settings), are described to explore parallels with Jung’s ideas on the structure and dynamics of the psyche. These parallels are of special interest because the experience of spirits is ubiquitous, not well explained and often rejected as meaningful by psychiatrists and clinical psychologists. Jung, however, offers a cogent explanation of spirit phenomena as manifestations of the unconscious. A concluding section suggests contributions to cultural psychiatry by Jung.

This article begins with Jung’s description of two predicaments which confront the contemporary psychiatrist: ‘the mystery of the patient’s difference’ and the danger of ‘committing psychic murder in the name of therapy.’ The article then presents the example of one suffering individual from within a non-Western culture who used Jung, as well as her Native culture’s traditional knowledge, to find healing. This Cree woman, Yvonne Johnson, created what Jung would call temenos in order to facilitate change and called upon images of theriomorphic guides to manoeuvre within the confines of her suffering. The article concludes by considering how the equivocal language of Jung’s analytical psychology may function as an effective bridge between transculturally oriented psychiatrists and their patients, and particularly between Western medical practice and the healing practices of other cultures for whom the word ‘medicine’ carries a religious connotation.

The great majority of South Africa’s people consult traditional healers. The deeper meaning of much traditional healing centres on ancestor reverence. This belief system and its accompanying rituals may positively influence the mental health of the individual and the community. Among traditional Xhosa-speaking peoples, the relationship with the ancestors is given expression in life cycle rituals that have much in common with Western psychotherapeutic principles and practices. The common thread that underpins many rituals is that of making links via concrete, literal means. Examples include the participation of the community in the healing of the individual; the linking of body and mind through dancing and drumming. Dreams form an essential connection between conscious life and the unconscious. Understanding the psychological depth of these practices is important so that a respectful relationship between Western-trained professionals and traditional healers can develop. Analytical psychology, with its notion of the collective unconscious has a particular contribution to make to cross-cultural understanding. The ancestors may be understood as archetypal representations of the collective unconscious.

This article reviews some contributions of the Jungian analytic tradition to indigenous ethnopsychiatric thought in Australia. The authors review Jung’s writings on Aboriginal culture, then describe some of their own fieldwork findings. Acknowledging that the contemporary post-Jungian tradition is pluralist, they propose a notion of ‘Jungian sensibility.’ They discuss some of the ways in which the Jungian sensibility might contribute positively to Aboriginal mental health, with especial reference to theories of subjectivity, and note that some Aboriginal people find the Jungian world-view very compatible with the Aboriginal one.

Scholars of transcultural psychiatry have long wondered why psychoanalysis has remained marginal in Japan, despite its early introduction there. Psychotherapy, however, has been steadily growing in popularity, and Jungians have played no small part in this development. This article provides a brief historical sketch of psychotherapy in Japan by focusing on how Jungians have cultivated a following through imaginative cultural critiques and therapeutic practices such as sandplay therapy. The article also touches upon the particularly Jungian themes that have appealed to popular audiences, as well as the dilemmas psychotherapists have encountered in their attempts to institutionalize psychotherapy as a form of clinical practice in Japan.

The clinical encounter is structured hierarchically: explicit technical action is embedded in levels of organization that reflect the personality and biography of the clinician, which in turn, are embedded in a larger matrix of cultural values or ethos. Systems of medicine can be compared at each of these levels. Shamanism and other elementary systems of medicine are built on an ethos that identifies healers’ calling, authority and effectiveness with their own initiatory illness experiences. The Asklepian religious cults of ancient Greece also drew from the image of the wounded-healer. This essay argues that ethos of the wounded-healer remains relevant to contemporary medicine, psychiatry and psychotherapy. Developmental changes in the relationship of the healer to his wounds during psychiatric training are illustrated by a series of dreams. The ethos of the wounded-healer has implications for the training of clinicians, as well as for the ethics and pragmatics of clinical work.