Traditional Healing and Its Discontents: Efficacy and Traditional Therapies of Neuropsychiatric Disorders in Bali

Abstract

In a discussion of patients suffering from obsessive-compulsive disorder (OCD) and/or Tourettes's Syndrome (TS), in Bali, Indonesia, traditional healing and psychiatric perspectives are used to highlight the power and weakness of each to treat these conditions. Given they are drawn from the same culture, should not indigenous explanatory models provide meaning and be more efficacious at relieving the suffering of people with OCD and TS-like symptoms? What if they provide an understandable meaning for patients but these meanings have no efficacy? Ethnographic data on Balinese models for illness are presented. Multiple data sources were used to frame the complex Balinese traditional healing systems. Forty patients were interviewed regarding their utilization of traditional healers, and healers were observed treating patients and interviewed regarding their treatment regimens and explanatory models. Traditional explanatory models for illness provide an understandable and integrated system of meaning for these disorders but are not successful in relieving symptomatology. Neurobiological approaches, traditional healing, and ethnographic methods are compared and contrasted to highlight the strengths and weaknesses of each in relation to issues of exegesis and efficacy.

Explanatory models in psychiatry

“…These include ideas about mental distress (Eisenbruch, 1990), schizophrenia in four cultural groups (McCabe and Priebe, 2004), and ideas about substance misuse among German and Turkish youth in Germany (Penka et al, 2003). Focused studies on determinants of undesirable outcomes have considered the role of explanatory models in a study of use of traditional healers for obsessive-compulsive disorder and Tourette's syndrome in Bali (Lemelson, 2004). Ethnographic data from interviews with participants of an internet community with a 'proanorexia' anti-treatment agenda consider their underlying explanatory models, showing how they diverge from the views of health professionals and others who regard anorexia nervosa as a dangerous disorder (Fox, Ward and O'Rourke, 2005).…”

Steps Toward an Integration of Psychological and Visual Anthropology: Issues Raised in the Production of the Film SeriesAfflictions: Culture and Mental Illness in Indonesia

“…While the films explore many issues beyond these general psychiatric categories, including the Balinese and Javanese local and alternative explanatory models and categorical systems which frame the subjects’ experience, this division is useful for translational purposes and follows the delineations of the first author's two research projects, which preceded the visual ethnography and through which the film subjects were recruited. The first of these projects researched the existence and cultural shaping and variation of Obsessive Compulsive Disorder and Tourette's Syndrome in Indonesia (Lemelson , , , ), and the second investigated the role of culture in the course and outcome of psychosis (Lemelson, forthcoming; Lemelson and Suryani 2003; Lemelson and Tucker, forthcoming) . A brief summary of each of the films is provided below, followed by a greater explication of overarching and specific themes addressed in their production.…”

“…Estu was recruited during extension of this research onto Java. For a more complete discussion of project methodology, aims, and further elaboration on results, see Lemelson (, , ).…”

Cultural competency in clinical consultation at the Alberta Children's Hospital: how to deliver equitable, effective, and adequate health care to minority people

“…That is, "when an illness is not curable by physicians, it must surely have been caused by witchcraft ... because biomedicine fails to cure or alleviate an array of dysfunctions, numerous illnesses fall under the category" of illness caused by supernatural forces (Finkler, 1985, p. 50). Lemelson (2004) The second is the prevailing cultural models used to understand and find meaning in the symptoms. The third perspective is that of local experts, often belonging to but not restricted to such categories as traditional healers, religious, or ritual specialists who provide explanatory models for the disorder.…”

“…Lemelson (2004) argues that "traditional healing is at least effective and frequently more so than modern medical and psychiatric approaches for a variety of disorders, including various mood disorders, psychosomatic and somatoform syndromes, acute or reactive psychotic states, and alcohol and drug dependence" (p. 52-53).…”