A Tibetan Approach To Mental Health
Princeton-educated medical anthropologist Carroll Dunham has been living in Tibet, along with her husband and two sons, for over a quarter century. She not only offers yoga on her Mongolian horseback treks for National Geographic, but avidly collects both medicinal herbs and cultural information, due to her special interest in Tibetan mental health.
After a talk at the Rubin Museum, she sat down with YogaCityNYC’s Sharon Watts to share observations regarding not only what treatments for mental health are, but whether they can be complementary to the western approach to health.
Sharon Watts: Every week, it seems, a New York City tabloid will announce that an “evil monster” has performed a heinous act after hearing voices. But where you live, those who hear voices are not abhorred, but revered.
Carroll Dunham: Voices are exploding. Mongolia in particular is going through tumultuous change--since the end of Communism there’s been an unleashing of voices that have been repressed for a long time. These shamans communicate with ancestral spirits who share their experiences and give advice. They’re urging people to follow the old ways, at a time when Prozac usage in Asia is on the rise. It seems we westerners are exporting our consumer society along with our whims of discontent.
SW: Some of us look eastward for understanding health issues. How does a Tibetan approach to mental illness fit within our cultural context?
CD: I agree, there is a growing cultural overlap. Yet there’s a real danger if we take these beliefs literally by importing Tibetan cosmogony and ideas. It’s a language that doesn’t speak to the modern predicament, and should be taken more as a metaphoric example. For example, demons and spirits have always played a large part in Tibetan culture, controlling the health of the villagers, the land, and the animals. As Buddhism evolved, a more philosophical rather than literal approach took hold, and “demons in the mind” became “demons of the mind.” Still, the western approach to mental health is based on brain chemistry, a tough template to complement.
SW: What are some more of the Tibetan traditional beliefs regarding mental health issues?
CD: There are 84,000 listed emotions in the Buddhist sutras! Both defined and subtle, they embrace the relationships between us and the Universe. The term srog rlung refers to life-sustaining wind, and imbalance of that results in “wind illness,” or mental conditions ranging from mild depression and anxiety to extreme disturbances such as schizophrenia.
The Tibetans have over 63 kinds of wind illnesses, all believed to be curable. Phobias, for example, are perceived as bad dreams that stay within the body, are caused by trauma, or result from a problem with Lha, which is a body-life element similar to a shadow that follows you until you die (but can be lost or stolen while you are alive). A point that might be easier to grasp for westerners: wind disorders can be caused by over-thinking and/or too much TV!
SW: Should we mix and match eastern and western approaches, and if so, how?
CD: We live in a very interesting time with this complimentary medicine. A fusion attempt is occurring as we speak--trying to make bridges between these very different languages and profoundly different cosmogonies.
Medical language can be very comforting, but it doesn’t respond to the whole person. At the same time, traditional Tibetan metaphors are up against an unprecedented level of anxiety, depression, and PTSD, rising with the number of torture victims from conflict with the Chinese government. Many young people are coming to the Dalai Lama Institute, trying to understand western medicine. Or a New Yorker might ask, “Why should I believe in Tibetan medicine just because the Dalai Lama uses it?” People tend to not want ambiguity--they want answers, particularly in their healing modalities.
SW: How strong is belief, as a healing factor?
CD: Belief and personal choice are strong components in anyone’s own healing. I see westerners come to Nepal with a belief so pure, based on the fact that because it is exotic, it is good.When there are no other options, Tibetan medicine practice gives something to believe in. It does not pathologize the illness, which is a very powerful healing tool.
SW: Back to more basics--what about that old standby, the breath?
CD: The simplest things can make the most profound shifts in our health. Breath is at our disposal, all the time, and it is free! Its potential impact on our wellbeing is huge in this era of mind-medicine. I’m not trying to simplify complex illnesses by saying “look at our breath,” but it is a good preventative.
SW: How do you view the way the East and West have culturally defined mental illness?
CD: There seems to be less tolerance in the West. We embrace labels, and for economic and political reasons, the narrower the definition, the better. Our desire for certainty is partly based on fear of litigation. Our own paradigm of healing is in a very transitional phase; the Diagnostic and Statistical Manual of Mental Disorders is in its 5th edition because we’re not even clear ourselves on these definitions of mental illness.
A shaman would be, from a western perspective, labeled a psychotic. You can’t become a shaman without going through profound mental suffering, and then you try to heal everyone else. The difference seems to be in perceiving our interconnectedness. We are reclaiming aspects of the non-rational while science continues to move forward. We are blessed and cursed to live in interesting times, so why not try to use as much as we can to try and understand things?