Healing Psychiatric troubles continues to challenge old and new medical approaches and practitioners. This article discusses how Igbo people view insanity in a changing global centre and try to follow tradition to address it.
Igbo Culture of Exposure and Science of Therapy:
A Clue to Managing Challenges of Insanity in Our Today’s Cultural World
Holding a secret or covering up by a culture is considered a value. In all aspects of life, covering up provides a hope for honour and dignity to those involved. But not in all cases that keeping secret or covering up has helped practitioners of that culture. Nigerian Igbo folklore beliefs that even in illness, protection is important for the family and community honour. Examining this belief in the purview of inanity and mental illness is what this article seeks to highlight as it also suggests that in the modern world, the opposite is equally culturally affirmed by the same Igbo and related societies. In a situation of health challenge contradictory complexes point to issues of disorder and remedy and what individuals and families need to do in coping with the expectations and changes of the times. A strategy of exposure is an elaboration upon the other side of honour – the moral axiom which is implicit in its kinship rites of redressing forms of affliction.
After listening to the episodic story of Oluchi and Ikedi – a husband and wife who have been married for 22 years, and who have lived in South Africa, Europe and North America, I developed the urge, as a social mental health anthropology counsellor, that a write up to share what mentally distressed people can do to cope is necessary in order to alleviate some consequences. Their story is typically tied into this piece such that I am thinking through their experiences and applying them in general to provide information.
In 1985, Ikedi and Oluchi left Nigeria for South Africa and have since moved from there to Europe and North America. Way back home, the belief in spirit propitiation was observed by both whose life-worlds were linked to some powerful deities or gods. Emigration has posed problems continuing this propitiation to the supernatural forces. In the narrative, Oluchi, the wife served their household chi or god and patronized a healer before immigrating to South Africa and eventually to the United States. They failed to settle the god in terms of letting it know that it will be cut off due to their relocation to a distant place. Upon migration, nothing has been going well. The couple and their children are erratically sickly and each has difficulty finding and holding a good job despite their important fields of specializations. Investigation to know why they have been facing all sorts of misfortune point out that the ancestor spirit or ignored family chi and other related deities at home had followed them in anger and envy to have their propitiation rites restored to them. Not until this was carried out through kin members at home, they never knew peace, order and progress in the family and with their neighbours. Since then, Oluchi and Ikedi have been sharing their experiences with people around them. In so doing, they have been helping disturbed individuals and families of their like to speak out and expose the cultural issues as they pertain to the restless spirits and challenges such ancestral forces impose on life in the diaspora. The concept of voodoo beliefs and practices in light of Haitian and related cultural backgrounds exemplify how powerful supernatural forces influence the success or failure of immigrants who shy away from paying their due to their life-world forces. A point to be clarified is the tendency to associate non-progress or misfortunes to cultural issues and how the situation merges with current economic, political and social and educational elements in a changing society. Root causes of misfortune can be traced to cultural issues but it is critical also to explain them in what is happening with the affected person/s’ life in another culture including their responses to the challenges of adaptation and survival as the case of Oluchi and Ikedi illustrate.
The common view of ‘insanity’ (ara, in Igbo parlance of Nigeria) is broad and, in fact, takes a wider scope than ‘mental illness’ (isi mgbaka). As being defined by biomedical science as disorder of the brain – mental illness is therefore seen as a dysfunction of the head as an organ of the body. Mental illness suggests that the mental functioning or ratio of the head is not going well. And that is, particularly, to say that the brain is sick, neurotically misbalanced or damaged. Someone misbalanced in his or her brain life would show inappropriate ways of doing things in a given society. This includes showing a tendency by such a person with mental disturbance to harm him- or herself, destroy or attempt to handle a property in erratic form. The person in question finds it difficult to manage proper and acceptable behaviour with his or her close kin-population and neighbours. He or she is often at war with “self” and the “other”. A serious split of mental gaze is cast to public speculation – of what is going on? Mental lifestyle as shaped by the society calls into question the social meaning of mental orderliness.
As insanity may mean different things from a cultural point of view of societies such as the Igbo of Nigeria where I have conducted fieldwork and continue to interact with healers and people from the area in the diaspora; providing insight onto insanity is apparently a legitimate urge a medical anthropologist would like to engage in, and I do so in light of people’s cultural mode of explanation rather than the one that is too much fixated in biomedicality - a depiction which is just only a part of the total whole. I therefore highlight that insanity is an all-inclusive breakdown of condition of mental and physical wellness for the individual and society taken as a whole. Furthermore, I indicate that understanding insanity from a cultural side of the illness encompasses and offers a better insight for helping the afflicted to seek help and return to spaces of normality in the society.
In his Why Good People Do Bad Things: Understanding Our Darker Selves (2007), Hollis raises the question, “why is our personal story and our societal history so insane, so bloody, so repetitive, so injurious to self and others, so self-defeating? (Hollis 2007: xi). In the same way, why is insanity such a complex of ill health that shapes an autonomous world of distress within? – what Jungian psychologists would call a shadow? The activities of the shadowy force fields not only show up in more than our personal lives, they challenge us – in our spaces of sane lives. Understanding how to report insanity will make it easier to grasp our own shortcomings when blaming someone else and ultimately helps what remains in the unconscious to manifest in our lives. Its importance will also show in how helpful it is in repairing our inner fractures or contradictions such that we can explore what inner forces are working against us and pourquois (why) the psychopathology of everyday life is vital.
As Hollis (2007:65) further shows in his work that “we learn to blunt our feelings, lest we feel too much. We learn to deny, repress, suppress, project onto others, distract, dissociate – all in service to avoiding what we perceive to be overwhelmingly threatening.” It has been argued that the only truly pathological state is denial, which after all is a rejection of reality. This is as true as saying that human kind cannot bear very much reality in a denying state and still hope to have a sustained life and society. All of us at different stages of psychosocial development relate to burdensome or threatening reality of insanity. Disorders, in particular, of self, constitute part of insane life in a social context.
One with personality disorder (there are a number of them: paranoid, narcissistic, compulsive, and borderline) – hence a level of insanity, is one who in one way or another can be associated with a traumatized life. The one may not merely suffer the wound of trauma; but will turn out to be the wound itself. According to Hollis (2007:76) “the one is owned by it, and lives within its limited imaginal purview at all times. Because, when the one acts and speaks, it is through the window of the wound, with little or awareness of parallel possibilities.” There is a need to get organized, observe, listen and speak to the wounds, windows and shadows of insanity. Where the power of insanity prevails, love and peace-order, will not. Hidden agendas of insanity are shadows of hate and honour thing we are afraid of – to speak to meaningfully and decisively for a change through critical psychosocial therapy.
Given the above situation, insanity provides a condition of life that looks at both the brain and other related unhealthy functioning of the body and society. For that reason, insanity is much more than a mere dysfunction of the mental organ, the head or brain. It involves cues and gestures of disorder manifested by the insane person as well in domestic and public social situation. Insanity is therefore a problematic of the society and persons merged together in cultural disarray.
To understand what sense the behaviour of the insane amounts to, people closely involved try to analyze what is going on and if possible seek help for the disturbed person. As serious as insanity can be, this is just the beginning of the journey of disturbance, plunging the insane person and all those involved in a curious condition in search for safety, healing and recovery. According to mental health journals I have read, in particular, the report recently carried by the Awake Magazine (Awake, Sept. 8, 2004:20-22), it is estimated that 1 in 4 people worldwide will be afflicted with a mental illness at some point in their life. Chances are that people will likely have a parent, child, sibling, mate, colleague or friends develop some form of mental or brain disorder and therefore inevitably show some display of behaviours of concern. It suggests the question: what can those of us, as family members or allies, do if someone we love, work together with, live or associate with becomes insane or mentally disturbed all of a sudden? What rational can we bring to bear on the situation? Can we fly or fight it? What manner of professional attitude can we display and stay culturally competent with the disorder of common life or the disability? Would pharmaceutical drugs or something else be considered appropriate in the wings of endogenous forms of attention? It is obvious to lay bare the fact that the disorder of mental life can be a serious challenge we are less prepared to cope with. Sometimes, we delay so much covering up mental behaviours of concern until it is too late to do something about it. What should today’s home or migrant person do when mental opprobrium rears its challenging head?
With mental disorder or insanity, a home becomes a theatre of verbal warring, intimidating, swearing, conspiring, abusing, blaming and accusing; and of course, a progressive aggression and insults of non-relating pattern - and the implications of which will range from loss of friends to police calling. A major characteristic of the untamed mental illness development is what can be referred to as insidious provocation, destruction, suspicion, conspiracy and hate. High blood pressure and structured depression (Iroegbu 2008) will set in motion to codify the flight of family peace. The signs that represent symptoms of mental depression and its challenge in a household or workplace will always be evident in the perceptions and actions those who experience the disturbance are willing to take to represent and deal with it. For sure, episodes of mental trouble cannot be helped by yelling and complaining alone. Protectionism or covering up will be counter productive. A concrete launch for solution must be considered and real therapeutic action pursued with zest for meaningful recovery (cf. Cawte 1974).
Insanity is a critical health problem – it can be a medical issue or cultural factor. It brings a burden of behaviour and anticipates a social concern that challenges the afflicted and all those who share life with the victim. It is acknowledged that sustaining mental health is the most challenging of all health care services. And up to today, psychiatrists have no adequate cure for it. Persons overwhelmed by insanity have less ability to search for answers to their disturbance. More often than not, they resort to covering up their behaviours by blaming others and by imagining negative and possible reasons why they did this or that; or will pursue a situation to do what they think and feel will be a pattern to their condition. Usually such persons may resort to dodging responsibilities and participating in events to avoid being blamed. They may also engage in a pattern of argument and verbal attack to cover up being noticed and being complained against by observers. They try to act smart through apparent and strategic quarrels, constant claim of being put down and avoidance of tasks. Increasingly they attempt to do things to provoke others to pick on them and in turn they use such scenarios to cover up why they stay out of taking up their responsibilities. When these developments are at issue or the case, something is really happening and it s important to get concerned people together to understand the tactics of which the insane will often design to play games of insanity.
Persons with insanity show limited capacity to challenge themselves to do things right or to excel others. Experience shows that some resort to turn things upside down – therefore take home advantage in destroying the image of anyone around asking them to change and do things better. Constant accusations and allegations are noticeable. There is also the issue of turning any social contact with other people – friends and mates and access to information as challenges that must be fought against. Positive remarks from other persons will regularly trigger the afflicted person to rage and engage into crossfire of misrepresentation and non-inclusion in many events around. Insane persons are, as it may be, disproportionate to search their own conditions and do something positively for the better. Friends, mates and closely related members of the community of the insane need be assisted with written and oral information to grasp the experiences developing and minimize bad and violent life being played out in non-supportive, derogatory relationship or family conflicts. Such information will open knowledge doors for information and concrete involvement to manage the behavioural disorder. Being able to recognize the very symptoms insanity can manifest in different forms begins the process of understanding that something is wrong. Symptom recognition is a crucial fact all people faced with cases of insanity should master (Iroegbu 2005). Signs of trouble, the pattern these troubles are experienced and confronted are to be taken seriously for analysis and use in dealing with the question – what is all this and what can now be done? An invitation of a third party, family therapist, psychologists or engaging a lawyer may lead to consulting a healer or psychiatrist or mental health professional.
Once issues of abnormality have become patterned and unceasing, it is necessary to take a hard look on them rather than covering the disturbed at this moment. Various warning signs and symptoms of insanity include but not limited to the following. Prolonged sadness or irritability, social withdrawal, extreme emotional highs and lows, excessive anger, violent behaviour, substance abuse, excessive fears, worries, and anxieties, persecutory dreams and imaginations, abnormal fear of weight gain and infancy, irregular time and change in eating or sleeping and waking up habits, consumption of disorganized food in storage places – freezers, fridges, subterranean vault or cellar, keeping dirty home and disordered wardrobe and cosmetic applications, uncontrolled use of water, electricity and other appliances. Others are un-timed telephone calls to others, borrowing items from others and inability to return them in good order in addition to causing loss or damage to those items without effort to avoid repeated tendency of damage occurrences.
There are also the issue of yelling, getting into outbursts and loud phone answering during conversations with others. Others are timeless shopping spree or going to market places, confused thinking, staying idle, resorting to schooling, unusual staying long at workplace, excessively long-time-staying phone calls or malignant self-talking to avoid work and home responsibilities, child intimidation and gross abuse of various forms. Delusions and hallucinations, thought and or acts of self harm – deliberate or gradual suicide and death, inability to cope with problems and daily chores, denial of obvious problems, faking and manipulating situations to cover misbalances of behaviour up, drinking, financial misappropriations, criminal mindsets and related acts, and numerous unexplained physical and emotional ailments, as well as manifestation of constant negative attitude to issues requiring co-operation and commitment. Threats and pronouncement of what will happen or will do, including frequent swearing (e.g., using over-my-dead-body, join-dead-parent), and intimidation, lying and staying aloof are other serious issues that must not be ignored. Unusual snoring while asleep, asking bed partner to leave the bed, leave the home, or he or she will see things odd enough, as well as goofing and turning in bed uncharacteristically, muttering, dreaming and waking up in sad moods, sometimes intermingling with spirits while asleep equally counts a lot. When housekeeping proves to be a torment, generates a puppy face showing rather than a routine for delight - keeping unwashed clothes and plates for longer times also matter.
If at any moment the acting out person engages in discussing issues and it is noticed that examples he or she will be invoking or referring to reflect linking how other persons ate their husband’s, wife’s or friends’ money, smashed their cars, forged their cheque signatures or so and they were still tolerated; without in turn coming up with suggestions and supportive efforts to handle issues co-operatively – then something is fishing. Moreover, alluding to sending more money home to in-laws, train junior ones at home, refusing to listen to help buy groceries, put gas in the car, pay or manage bills or mortgage or may even resort to stashing family resources in other people’s accounts and homes, to frustrate peace and co-operation, this typically will suggest that there is an underlying manipulative covering up. When these are emotionally and physically experienced and constantly evident, they indicate something more serious. There is then a need to seek ways to expose the afflicted person’s behaviour to light, obtain intervention to discuss the problems, establish counselling, and most importantly secure required treatment. A shared life – the so-called love is defined by the language of how and what each contributes to make the relationship work. Love is a shared contribution. Its attributes range from tolerance to support and protection. Love means invested emotional and material contribution with hope to live a good life. Love pursues happiness through giving. It is emotional and resources based thing. Theology describes love as sacrifice – a meaningful laying down of one’s life for another. Love is peace – which refers to contribution that makes peace to supremely reign. It is not about how much one gets through stage-managed distress, hurting, avoidance from involvement, allegation, denying, cheating and mentally disruptive life. Unfortunately, insanity brings dirtiness to love and therefore calls for its cleansing to restore the dimensions and virtues of love in pursuit of contribution and happiness.
Is there an Approach for Coping?
Yes. There are several things people who are affected by the life of an insane person can do. First, do not be eaten up in stubborn silence. Get heard! Seek help. Do something by starting to observe critically the behaviour pattern of the troubled person. Take note of any unusual behaviour that is of a deep and visible concern. Make an inventory of such behaviours. Let others take notice of your observations too – for validation and calling the illness observed its name in the local culture. Have the observed person know about the behaviour of concerns and how people around are expressing their concerns. Suggest some best practices for changing or coping with such mental disability realities, behaviours and interventions. Situate what those considered normal do and how they expect him or her (the afflicted person) to do to comport with the cultural and social values of the society. Behaviours of concern must be exposed in the first place – not covering them up. Any form of insanity must not be ignored, in particular, by family members, experts working in the field, as well as support workers of diverse calling. There is obviously something, for example, community development workers and medical anthropologists can do starting with observation and exposure of the forms of disorder and behaviours of concern followed by developing best strategies or ways of coping and lastly by prompting for an early and honest medical and social therapeutic intervention. Taking steps with psychiatrists, psychotherapists, social mental counsellors and indigenous healers in this field will surely provide a useful opportunity to treat successfully what is possible to remedy the situation of mental disorder or insanity of individuals and groups in community for a healthy society.
It is culturally and medically claimed that once insane, the individual and his or her network of relations will put up with the stigma and identity of the mental palaver. And perhaps a life lasting treatment with rituals and medications for the rest of the victim’s life in this world and the other beyond our therapeutic gaze – which adds to the implications of being constructed as disturbed. This may equally last with the notion of suffering from bad head, scattered brain and disordered mentality (isi mgbaka, isi adighi nma) until a metaphysical re-birth into cultural and social spaces of normality is secured. But the good news is that a life challenged in traditionalism can possibly be recreated in modernism and vice versa through uncovering and softening all there is in the dimensions of mental trouble and its healing approaches – through exposure and care as against cover–up to hold family reputation and cultural dignity and honour free from illnesses of isolation. There is fear of insanity and avoiding mental affliction and inheritance is essentially viewed as a way to keep the future generation safe and healthy. Unlike any other form of illness, insanity is highly discriminated against. My cultural gaze is that unveiling incidents of mental trouble rather than covering them up will go a long way to helping a family and community forge peace and order, in particular, for people in diaspora who suffer orchestrated distresses of incapacity to expose what is occurring around them and thereafter seek required therapeutics - medical and social remedy as it is expected in the modern world. Sanity or order will hardly settle unless when it is promptly exposed and critically pursued for remedy.
Life condition, like the Igbo would say, goes with the caveat that agbaa oria oshi ya turu ute ya (literally, when sickness is exposed, it will gather its mat and depart). The Igbo are aware that enduring silence is sometimes not the best practice in a matter of life, health, and family social order. It is because when illness is exposed, its hiding place gains a public gaze such that the forces behind the misfortune will look for another space to operate. In like manner, exposing forms of mental health challenges is a clue to critically manage them in the context of care. As such, one can carefully say that a hidden insanity has no opportunity to be questioned and challenged in a cultural framework of therapeutic help.
Issues are bound to go complex in insanity when keeping silent is given a chance in a culture of covering. Recovery from being ill to health must be given its due of attention and powerfully implored for exposure. When the state of health is socially critical and tolerably questionable it must be distanced and implored for assistance. Not imploring exposure to mental problematic is a systematic way of keeping silence when we should not – and this can be viewed as a gross tautology of affliction and release. But speaking out when we should ensures a candid approach to understanding the contradictions of people and their life matters.
Awake Magazine. 2004. ‘Mental Illness”, Sept. 8, pp. 20-22.
Cawte, J. 1974. Medicine is the Law: Studies in Psychiatric Anthropology of Australian Tribal Societies. Honolulu: University of Hawaii Press.
Hollis, J. 2007. Why Good People Do Bad Things: Understanding Our Darker Selves. Penguin Group (USA) Inc: Gotham Books.
Iroegbu, P. 2005. Healing Insanity: Skills and Expert Knowledge of Igbo Healers. In Africa Development. Vol. XXX, No. 3, pp. 78-92. CODESRIA: Council for Social Science Development Research in Africa.
Iroegbu, P. 2008. Mental Migration and Diaspora Cultural Associations: Insight on Traditional Solution Approach for Nigerian Immigrants. In: ThisGlobeWorldThisGlobe Africa (ThisGlobe.com). Ref: 184.108.40.206/smf/index.php?board=2.80 - 114k.
See also www.gamji.com/article8000/NEWS8141.htm - 82k.