Sinethemba Makanya //
South African morbidity data show that mental disorders are the third highest contributor to the local burden of disease, after HIV and other infectious diseases (1). The rise in the number of people in South Africa with mental disorders highlights the growing burdens of mental illness that the country faces. Yet despite the increasing need to turn the focus to mental health issues and establish the appropriate services to maintain mental health, services in South Africa are “grossly under-resourced and there are many barriers to health care for the mentally ill” (2). Several studies have shown that “traditional practitioners may play an important role in offering this care and that they provide care that is associated with the indigenous explanatory models of illness held by many South Africans” (3).
This article is the first of a series of two articles for Synapsis based on my thesis. My work attempts to understand how (if at all) traditional healers understand the concept of mental health. I had conversations with traditional healers to understand how they were initiated into the system of traditional healing and how they understand health and illness. It was necessary for my own spiritual and academic journey to undergo initiation and assume my own practice as a traditional healer. This ensured that I would be careful to collect and analyse the responses from my perspectives as both traditional healer and psychology student (as insider/outsider).
Critical psychologist and UKZN lecturer Nhlanhla Mkhize states that “it does not make sense to explain the psychological needs and experiences of people in developing societies only with reference to conceptual categories and philosophical systems imported from the west” (4). To do so would be to incorrectly assume that before colonisation, the indigenous of the world have not been grappling with forms of knowledge; considering the changes in the social, historical and cultural contexts and the implication of these on their wellbeing.
Thus, this project is one of self determination, of identifying indigenous practices and placing them within a universal claim for conceptual categories and frameworks coming from the global south. This is a project concerned with the decolonisation of psychology — a psychology that was used to justify “the exploitation of black labour and to deny black people access to education and economic resources” (5). This project seeks to add to the conversations concerned with the work of expanding what it means to be human” (6) beyond the frameworks inherited from a legacy of othering and further pathologising the other.
Although there are different types of traditional healers, most of them are consulted in times of physical, spiritual and psychological distress. Their interventions include prescription of treatments which include plant and animal medicines as well as rituals which affect their patients physically, socially and spiritually. It is important then to understand that within this worldview the human is simultaneously physical, social and spiritual and is part of a network of various beings. These beings live parallel to each other in a weave of interdependence. In this way we see the human in an interdependent relationship with the creator beings (Mvelinqangi and Nomkhubulwane) and various spiritual beings (nature spirits and ancestors) which can express themselves through plants and animals in various sites in nature. In this worldview the concept of ancestor is simultaneously biological (in the blood), social, historical, environmental and spiritual. This is what we understand to be the individual’s cosmology. This cosmology is simultaneously collective (like Jung’s notion of the collective unconscious) and individualised. In this way diagnosis and treatment are individualised based on the needs of the various beings within the individual’s cosmology. I also suggest that understanding of the various layers of personhood, as expressed through the cosmology can offer the potential of producing the layers and players implicated in mental illness.
The precursor of health is understood as a balance of the various beings within the collective and individual cosmology as well as a balance of the social (including socio-economic, educational and interpersonal relationships), environmental and biological aspects of life. The human is inherently a multiplicity of voices. Each voice needing to be heard and attended to in the developmental journey of human life. This also has implications on human development in integrating the various layers of the human. Health is expanded across dimensions and times, and mental health cannot be separate from a concept of biological, spiritual, social and environmental health. This concept of health throws into question the concepts of Cartesian Dualism of mind and body as separate. In this way within traditional healing, the causes of illness consider the multiplicity of the human and interventions seek to balance the various aspects of the human’s cosmology.
(1) Bradshaw, 2003; Myer, Seedat, Williams, Herman, Moomal, Williams, Jackson, Stein, 2009.
(2) Seedat, Williams, Herman, Moomal, Williams, Jackson, Stein, 2009.
(3) Benjamin-Bullock, A., & Seabi, J., 2013.
(4) Mkhize, 2004.
(5) Laher and Cockcroft, 2013.
(6) Wynter, 2007.
Benjamin-Bullock, A., & Seabi, J. (2013). Mastery and Discovery in Black/African Psychology. Journal of Black Psychology, 39(3), 342–344.
Bradshaw D, Norman R, & Schneider M. (2007). A clarion call for action based on refined DALY estimates for South Africa. South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, 97(6).
Hook, D; Kiguwa, P; Mkhize, N (Eds.). (2004). Critical psychology. Lansdowne [South Africa]: UCT Press.
Laher, S & Cockcroft, K (2013). Psychological Assessment in South Africa: Research and Applications. Johannesburg: Wits University Press
Seedat S, Williams DR, Herman AA, Moomal H, Williams SL, Jackson PB, Stein DJ. (2009). Mental health service use among South Africans for mood, anxiety and substance use disorders. South African Medical Journal, 99(5), 346–52.
Wynter, S. (2007) Human Being as Noun? Or Being Human as Praxis? Towards the Autopoetic Turn/Overturn: A Manifesto