Editors' Postscript

This paper is the beginning of what we hope will be regular submissions to our journal concerning the practice of “psychoanalytic psychiatry” in different cultures and the meaning of illness to individuals from these cultures. Dr. Brockman's sensitive discussion of possession, particularly the role of the doctor/guru in possession states and the role of the sick individual in the community raises many issues for analysts who make assumptions that self understanding is the royal road to health. As Dr. Brockman points out, intrapsychic conflict has no real place in medicine as practiced in Southern India, nor does introspection. It was interesting to us as analysts to see how the holy man/physician “channels” the healing, which is seen as external, as is the illness, yet the ill individual has a very different role in the community as a whole than in the West. Being possessed is not seen as a stigma, as it is in our culture. Perhaps more difficult than the illness itself, often mentally ill individuals in the West suffer from stigmatized isolation from the community as a whole reflected in questions about suitability for jobs and other responsibilities.

As we explore the contribution of psychoanalysis to social issues in our journal, papers like this one challenge us to think of the various ways in which the excluded, stigmatized mentally ill individual can be re-included in our social group. As one of the early analysts, Alfred Adler, so clearly demonstrated, membership in the community group is a right, not a reward. Mental illness excludes one from the community in cultures that do not recognize that right. What is it that Indian communities have that we lack? We believe Dr. Brockman raises such questions that we all, as analysts who are trying to contribute to what really matters in society, need to consider very seriously.

Nadia Ramzy, Ph.D., and Stuart Twemlow, M.D.