Mental Health in India: Religion and mental health distress
Image: Tim Mossholder on Unsplash
Historically, religion has had a complicated role in serving as an alternative to therapy. Sadaf Vidah explores the opportunities and challenges from both Indian and Western religious traditions in regards to mental health.
The ‘Mental Health in India’ series on The Chakkar will look at various gaps in conversation regarding mental health issues in the country, from the effects of history, to current cultural speed-bumps, solutions for coherent policies for the future, and much more.
Under the surface of many mental health concerns there lies a common sense of disillusionment, common triggers of stress like the fear of uncertainty, avoidance of discomfort, the inability to identify with “the point of it all”, and the struggles of interpersonal distance. These issues form the basis of a number of mental health cases, according to much of existential psychology and therapy.
Irvin Yalom, one of the proponents of existential therapy, said that these are the four issues that are below the surface for all people coming to therapy.
death
meaninglessness
isolation
freedom or a responsibility to make the best choices
These spaces were and continue to be unique in the way that they allow marginalised sections in the society to speak more freely and to feel safe in the movement of their bodies—permissions not always allowed in the ‘outside world’. In that sense, ideas of ritual healing generate the same environment that the therapy room tries to create.
While therapy could be part of the answer to many of these concerns, another social practice that has historically been useful for a number of individuals is religion. Religious beliefs can help in tackling the biggest, most gruelling questions. What is the point of life? How am I supposed to live my life? What happens if I do something bad? Is the world just random or is there a creator who has infused meaning into our existence? As this explainer article from Dummies shows, different religions provide different answers to these questions. But having a readymade answer for these questions is a relief for some—and this is why religious faith is still so prevalent for the majority of the world’s population.
Religion can be an uncomfortable explanation for those who adhere by science and logic, because of the principle of “falsifiability”. Falsifiability, or refutability, is the capacity for a statement, theory or hypothesis to be contradicted by evidence. However, religious explanations are never falsifiable because you may get answers like “it didn’t happen because you did not believe in it enough” or “some answers can only be had in the afterlife”. Nonetheless, the extent of established religions in the world shows that most of us do need this belief system—despite its pitfalls.
The discord in the external environment can often be a major cause for mental distress and disharmony. Religion has the potential to provide a sense of community and accountability and some rules, by which society can organise it’s daily purpose. Or at least, this was the conceit of much of religion before subgroups arose with time, leading to clashes over different contexts.
Morality and order, however, play a big role in helping us feel that “things are under control”, helping us to achieve a sense of mental peace, to shed anxiety and aggression. The shift in the personal and social fabric can be seen around war and other times of unrest when this basic belief of “okayness” is shaken; usually, religion—or some explanation about a “bigger/divine purpose”—is used to get people back to their usual selves.
Closer home in India, apart from serving the above functions, religion also provides much relief in terms of expression. In India, relationships are hierarchical and patriarchy plays a huge influence on how people communicate with each other. Expressing disappointment, anger, hurt, betrayal or talking about oppression becomes very difficult. Sudhir Kakkar, in his book Shamans, Mystics and Doctors, talks about the role of dargahs and shrines and religious possession as a necessary way in which people, usually the oppressed (women and children) can express frustration, albeit by splitting from their main frame of consciousness. As this post from Colgate faculty’s Reflections From India eloquently describes the collectivistic nature of ritual healing,
Dargahs (along with Hanuman temples, goddess temples and other places for ‘chasing out demons’) are where people suffering from all kinds of conditions we might call depression, anxiety, post-traumatic stress syndrome, etc. come for what amounts to family therapy. Rarely does a female (or male) patient come alone. Whatever afflicts the patient is connected to a whole network of beings—family members, djinns, the patient herself, the saint, God—and so her treatment and cure also entail changes made within this network.
Work done by The Swaddle on their Instagram videos around ritual healing, and the insights by a paper titled “Ritual Healing and Mental Health in India” suggest that, while ritual healing clashes with western ideas of psychiatry, it is a place where (at least pre-colonially) we did not look at the concept of ‘possession’ and ‘madness’ as shameful, but rather, something that strikes awe, or gets us to have sympathy for the subject. These spaces were and continue to be unique in the way that they allow marginalised sections in the society—especially women—to speak more freely and to feel safe in the movement of their bodies—permissions not always allowed in the ‘outside world’. In that sense, ideas of ritual healing generate the same environment that the therapy room tries to create. The cultural sanction allows deeply suppressed thoughts and feelings to get expressed; and the assigning of a supernatural meaning helps facilitate healing and moves the family to change in relation to the person’s distress too.
This space and this healing are very important in a world that is largely unfair for these people who are on the margins. It gives them a sense of agency and purpose, and helps their concerns to be taken seriously. While religious healing has often been rubbished as “mumbo jumbo”, it is important for us to look at what we mean by “treatment”, and at the ideas of treatment that are often “white-washed” (sometimes, literally so).
The concern with ritual healing is the immense power invested in the ‘healer’, and the potential for misuse. The Erwadi incident of 2001, where people chained for mental illness in a faith based asylum we’re caught in a fire, led to a huge outrage and also brought about the ratification of CRPD (convention of rights of people with disabilities) in 2007. These are definitely pitfalls we need to avoid even as we look at the benefits of ritual healing.
However, power like this has gone unchallenged in Western mental health professions as well. The bigger question then, is not whether religion/ritual healing is better than western healing or vice versa, but how the two can be integrated and provide help to a larger diversity of people. Treatment compliance, or the sincerity with which the treatment regimen is followed is affected by various factors such as the degree of discomfort of the therapy and the level of belief in the treatment modality and in the therapist. In such cases, treatments or therapies that weave in higher powers/spirituality may be helpful. Studies show that beliefs around health and ill health do affect treatment strongly, and that belief in god helps people to continue treatments well to the end—and to also prevent relapse.
It’s about time that mainstream medicine in India stops thinking of the psychiatrist as the ship captain and therapists and psychologists trailing behind him. Rather, we need to work with various levels and types of help—including social workers, midwives and ritual healers—to provide those under duress the personalised help they need.
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Sadaf Vidha (she/her) is a therapist and researcher with five years of experience. She is interested in cross-disciplinary understanding of human behavior at the intersections of mental health, sociology, social justice and economics. In her free time, she likes to read, paint, bake and play with her cats. You can find her on Instagram: @shrinkfemale and Twitter: @randomwhiz.
