Māori Approach to Mental Health Offers Empowering Alternative to Western Psychiatry

A new article explores Mahi a Atua, an affirming, indigenous Māori healing practice which stands in contrast to the Western psychiatric methods typically promoted by the Movement for Global Mental Health.

Rebecca Troeger
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An article published in Transcultural Psychiatry introduces readers to Mahi a Atua, a Māori approach to addressing emotional distress and mental health difficulties. Mahi a Atua uses traditional Māori customs to facilitate clients’ healing in the context of the family (whānau) and community (iwi). The practice was developed by Māori psychiatrist Diana Maree Kopua and Māori art and culture expert (Tohunga) Mark A Kopua, who are co-authors of the article with critical psychiatrist Pat Bracken. The authors suggest that Mahi a Atua provides a much-needed alternative to the Western pharmaco- and psycho-therapeutic interventions championed by the Movement for Global Mental Health (MGMH), which has been criticized for extending neo-colonial practices.

“Indigenous approaches to mental health offer not just an adjunct to, but a real alternative to, the interventions of Western psychiatry,” the authors write.

Sculpture by Rewete Arapere

The Movement for Global Mental Health (MGMH) is a decade-old initiative aimed at addressing mental health problems around the world, primarily through the dissemination of Western, “evidence-based” psychiatric and psychological treatments such as pharmacotherapy and cognitive behavioral therapy (CBT). As Kopua, Kopua, and Bracken explain, a burgeoning “counter-discourse” to this movement warns of the potential harms of such wholesale expansion of Western psychiatry.

Critics have expressed concern that Western psychiatric approaches are often culturally incongruent and inattentive to sociopolitical causes of illness and distress such as historical trauma in the countries to which they are exported and that they do damage to local “healing systems.” This threat of lost traditional healing knowledge is reminiscent of the destruction of indigenous healing infrastructure that occurred in the wake of colonial legislation outlawing traditional Māori medicine in New Zealand in the early 1900s.

“The highly individualized idiom of psychiatry fails to capture the ways in which whole communities are struggling and can serve to obscure the social, cultural, and economic dynamics that lead to such suffering,” the authors write.

The consequences of colonially rooted historical trauma and communal suffering are visible in Māori health measures and markedly different experiences in New Zealand’s mental health system. For example, approximately 51% of Māori “develop a mental health disorder” in their lifetime; Māori have higher rates of suicide attempts than the general New Zealand population, and Māori receive compulsory mental health treatment 3.5 times more often than non-Māori in New Zealand.

Given these factors and broader concerns about the impact of MGMH on indigenous communities, the authors argue that there is a crucial need for the development and implementation of Māori indigenous approaches to mental health. The authors add:

“There is a need to develop ways of discussing states of madness, dislocation, and distress in indigenous societies without automatically invoking the idiom, language, and assumptions of Western psychiatry.”

Māori practitioners have responded to this call by exploring and creating indigenous models for understanding and repairing mental health. These include Māori psychiatrist Mason Durie’s Māori mental health plan, which prioritizes economic empowerment and the “promotion of a strong and positive identity for Māori people,” and Melissa Taitimu’s study of Māori conceptualizations of “schizophrenia” and “psychosis.” Mahi a Atua continues this lineage. The authors explain that Mahi a Atua is “not a therapy or a new set of techniques,” but instead is a:

“Process whereby Māori creation stories, or pūrākau, are explored and used to provide a set of words, ideas, images, and narratives that can help provide a matrix through which communal family, and individual challenges can be met without recourse to a ‘psychologized’ and ‘psychiatrized’ vocabulary.”

Key to this process is the Māori concept of wānanga, which although not easily translated into English, may be described as “a process involving meeting, discussing learning, and the passing on of wisdom.”

The authors detail a case history in which Mahi a Atua was used to support a young woman who was engaging in challenging behaviors, such as bullying, at school. The Mahi a Atua practitioner shared Māori creation stories (pūrākau) with the client and her family (whānau), inviting them to reflect on which character they most connected with and explore the meaning of these identifications. Through this process, the client was able to make sense of her experience in a non-pathologizing way, by seeing the links between her frustration about communication with her mother and a Māori god known for his anger in the face of injustice. She was also able to begin to find ways to change her behavior, develop a positive sense of Māori identity, and share what she had learned with friends and other school community members.

The authors explain that Mahi a Atua is representative of a broader Māori “renaissance” in research, psychology, and community advancement, which is itself a part of a global indigenous movement to “reassert positive identity in the wake of colonial oppression and genocide.”

“The technological assumptions of Western psychiatry make it singularly ill-suited to help with the psychological and social problems that emerge in indigenous societies in the post-colonial period.” The authors conclude. “In the wider debate about ‘global mental health,’ we argue for a ‘scaling down’ of Western psychiatry and a ‘scaling up’ of indigenous approaches like [Mahi a Atua].”

 

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Kopua, D.M., Kopua, M.A., & Bracken, P.J. (2019). Mahi a Atua: A Māori approach to mental health. Transcultural Psychiatry. Advance online publication. doi:10.1177/1363461519851606 (Link)

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Rebecca Troeger
MIA Research News Team: Rebecca Troeger is a doctoral student in the Counseling Psychology program at the University of Massachusetts Boston and has a Master’s degree in Psychology. Her work explores how Western psychology can move towards valuing other cultures' knowledge more deeply. She is also interested in the impact of social support and community life on mental health and anti-racism interventions.

25 COMMENTS

  1. Navajo (a First Nations tribe, what White people want to call Native Americans) veterans coming back from the numerous wars that this country has involved itself in found that what little help that they got from the Veterans’ Affairs Dept. was actually not helping at all but was detrimental to their recovery of health and well-being. Their PTSD was not helped at all and this was and still is leading to many suicides of Veterans who’ve returned to the United States.

    So, being the intelligent people that they are many of them have returned to their indigenous medicine practiced for them by their traditional medicine men. They’ve found this to be much more beneficial than anything that they received through the colonial “mental health” system at the hands of Western psychiatrists and the Western drug companies.

    The thing about indigenous medicine is that it’s a communal approach rather than just dealing with the afflicted individual. It shows the individual that the community actually cares about them. The Western colonial “mental health” system clearly doesn’t give a damn about anyone as it works to keep people in thrall to the drugs and psychiatry itself.

  2. I think there is an issue which has to be looked at here. Maori and their practices are of a primitive society.

    Totally different from our middle-class society. The distinguishing feature of the middle-class is that it lives in Bad Faith, that is, to be middle-class means that you do not live up to your own values.

    So the middle-class has children, not by nature, but by deliberate intent. Middle-class identity is something to hide behind, and children are an essential part of this. The middle-class family exists for one reason, to psychically scar and maim children.

    Primitive societies scar and maim children too, but it is a collective process, and the people really believe in it. They have never been in position to question it.

    With the middle-class though, they know that having children is a choice, and they are pledged to support an enlightenment ethic. They read pedagogy manuals, and they hire their own doctors. They do not really believe in what they are doing, its just easier to have children and then to break them, then it is to face their own pain.

    So anytime you start directing talk about healing at the survivors of the middle-class family, you are just converting their experience of injustice into a medical problem and a self-improvement project.

    Makes no difference if these healing practices originated with primitive societies, with nature spirits, with licensed psychiatrists and psychotherapists, with extraterrestrials, or with Creator God Almighty, talk about healing directed at the survivors of the middle-class family is just turning their problems back on them. Its just more denial and abuse.

    The way people can grow and start to reclaim a public identity is by facing their pains and by working shoulder to shoulder with comrades, and if they are doing this, then they will want to punish perpetrators, seize reparations, and protect the would be next generation of victims. People grow when they fight shoulder to shoulder with comrades, in the trenches, not in the therapist’s offce.

      • Most of all I mean that it is not like the Middle-Class Family. That is, what they do is what they believe. Right or wrong, good or bad, children just come and they do what they do.

        The Middle-Class Family is different, everything is done for appearances and people do not actually live true to their own beliefs. The Middle-Class uses pedagogy manuals, which are just ways to justify exploiting children.

  3. Given what the “mental health” world has done with ‘mindfulness’ by abstracting it from the Buddhist philosophy that underpins it and in some cases making it a requirement in someone’s “treatment plan,” I am very skeptical that Western Psychiatry will do anything but distort and ruin any helpful practice the Maori may have developed. Maybe we should skip reforming psychiatry and instead pay the Maori what we used to pay the psychiatrists rather than expropriating their spiritual practices and turning them into yet another bastardized western product for sale?

    • I agree, well, except I doubt they’d need the multibillions that psychiatry is always demanding our government give them, for their never ending and fruitless research, to try to prove the scientific validity of their DSM theology. The Maori healers would probably even acknowledge that taking that much money – to help people – is unethical.

      But I agree, “we should skip reforming psychiatry.” If for no other reason than, “We can’t solve problems by using the same kind of thinking we used when we created them.” And the psychiatric “bible” was debunked six years ago, but the psychiatrists still haven’t stopped using it. So obviously the psychiatrists, and their “mental health” minion, are unable to change their way of thinking.

      I absolutely agree with the authors’ conclusion, “In the wider debate about ‘global mental health,’ we argue for a ‘scaling down’ of Western psychiatry and a ‘scaling up’ of indigenous approaches like [Mahi a Atua].” Anything is better than Western psychiatry’s defamation and iatrogenic illness creation system.

      • All of those elements are involved in creating or alleviating distress, for sure. For instance, loss of sleep definitely increases my feelings of hopelessness or anxiety and reduces my ability to communicate effectively. So sleeping could be said to be a “treatment” for my negative feelings, but really, all they are “symptoms” of is a lack of sleep.

        So by all means, we should be addressing deficiencies in our social environment, eating better food, working on our own attitudes, working to improve the economic situation, etc. The problem is that my reacting badly to, say, a very oppressive school environment as a child (I was deeply depressed, did act out one time, had a psychological evaluation, etc.) meant that I had a “disorder” or “disease” or “condition” – it meant that the school’s rules, expectations, and processes and the complete lack of recourse that I or any of the other students had to address any kind of injustice or arbitrariness provided a horrible environment for me to grow in. The real answer wasn’t to ‘treat’ me, but to get me the heck out of there or to change the environment so I didn’t feel so hopeless about having to go there and be bored and lonely and angry and frustrated 5 days a week, 6 hours a day.

        Do I have a tendency more than other people to be anxious or depressed? Yes, I do. Could some of this tendency be built into my personality? Sure, it could. But so is empathy, compassion, willingness to fight for justice, humor, and lots of other things that go along with being “sensitive.” I don’t think I needed to be “assessed” or “evaluated” or “treated,” I needed to be loved and listened to and provided more opportunities to take more control of my own life.

        So I’m all for looking at all the factors that contribute to someone’s distress. I’m just opposed to the idea that being distressed in a particular way that is inconvenient for those in charge means that I have a “disorder.” I think it means I’m human, and we humans are all different and unique in our needs and goals and values and deserve to be treated that way. We don’t deserve to be slotted into categories of “wrongness” for the convenience of those who want to pretend that life is a garden of delights and that anyone who is not loving every minute of it needs to be “fixed.”

          • They say a lot, but it’s mostly speculation and nonsense. The one thing we do know is that brain chemistry is constantly changing as we encounter different stresses and needs. So to suggest someone’s brain is “chemically imbalanced” means practically nothing. We also now know that the actual physical structure of the brain is changed by experience. So it seems to me we waste a lot of time studying genetics, which can’t be changed, instead of studying which EXPERIENCES help people feel more strong and capable.

        • “We don’t deserve to be slotted into categories of ‘wrongness’ for the convenience of those who want to pretend that life is a garden of delights and that anyone who is not loving every minute of it needs to be ‘fixed.’”

          Please don’t forget that psychologists and psychiatrists also attack those who are happy, for being happy, optimistic people. The “mental health” workers call general happiness, and optimism, “mania.”

          Although, the “mental health” workers do do this for the unhappy, child sacrificing, jealous, child raping, “cocaine dealing,” Bohemian Grove attending wealthy, who are also apparently the globalist scum of the universe.

  4. Lewis Mehl Madronna is a Native American doctor who has thought a lot about how to bring indigenous wisdom into healing practices. One interview with him is at https://www.stillharbor.org/anchormagazine/2016/11/11/the-healing-of-narrative-an-interview-with-lewis-mehl-madrona . Or you could check out this talk, which includes a lot about using traditional stories to assist mental health recovery https://www.youtube.com/watch?v=qS-km545WbM

  5. I just read the news: A man stabbed his own head with a knife in order to get rid of the blocked nose due to flu. According to the doctors, he has schizophrenia. That’s what mental health is in Western Psychiatry. Did they say something about psychosis? No, they say – schizophrenia. And everyone reads such news and smiles. Maybe he wanted to commit suicide? Nobody cares. As for the article – why Maori? They didn’t have diversity of psychedelic plants to know what psychosis is. What is this, a joke?

    • dmshanin83,

      I heard something similar at first hand. A young man expressed his wish to put his head in a vice and to tighten the vice. But the people listening to him, did care.

      This young man was on medication for depression and I would have liked to express my opinion on what might be causing his grief but I held back for a suitable opportunity. I have experienced lots of distressing emotions but never felt as he did “When Off My Medication”.

      As regards “Schizophrenia”, I believe there are plenty of people that have made full recovery from “schizophrenia” through one means or another. I believe Dr Pat Bracken himself has helped people through the “maze”.

  6. I think the culture is geared to fail one basic need, especially with children, to have their lives, which is their feelings, known to those around them. The internal equation is, my feelings being known and accommodated, equals life. I think this is being ignored in our supposedly advanced culture.

  7. Great article. When I visited NZ with the Power Threat Meaning Framework, I was privileged to have the chance to present it alongside Maori speakers and attenders. It was one of our hopes that the PTMF, in contrast to diagnostic models, conveys a sense of respect for indigenous understandings and healing, and it was very gratifying to find that the attenders saw compatibilities and commonalities between the PTMF and traditional Maori perspectives. I was left with many reflections about what we (as in Westerners) have to learn from older traditions. The blog is here:

    https://www.madintheuk.com/2019/02/crossing-cultures-with-the-power-threat-meaning-framework/

  8. Yep. Great article. Thank you.
    I had a Native American friend, and a Veteran, who shared his own experiences and then introduced me to some of the practices and ways of the Native Americans. So helpful. So healing to have had the honor and then instruction. Not to mention the stories he told. Of his own journey, so to speak, and experiences. As well as some of the more sacred ones…..the stories.

    It came at such a perfect time in my own journey too. I was still tapering off my last medication and had just left psychiatry behind.

    New practices, new paradigms. Yes, we do, have much to learn from older traditions. I agree.

    I think it’s important to add, that we should also respect the older traditions and peoples……before we begin to share their practices and traditions. Let them guide us, if you will, ask permission, etc. Otherwise we risk offending. At least with our Native American friends.

    I don’t know much about the Maori culture. Yet, as I am hoping to learn more.

    Thanks again!

    • I think that your caution about respecting and asking permission of the older traditions is very important. We don’t want to be “colonizers” once again. First we took their land and almost destroyed their cultures so we have no right to just up and appropriate their healing traditions and sacred stories. These traditions work within their own cultural context and shouldn’t just be lifted out of their culture and plopped down onto ours; it just won’t work. This was done with mindfulness from Buddhism and Hinduism which was wrong. Some things will transfer and many things won’t because of the cultural context.

      I also don’t know how well this has worked with the Maori peoples. They have shared their haka tradition with everyone so that most New Zealanders seem to know how to participate in it whether they are White or Maori. But I don’t know how much of a spiritual context haka has for them. It seems to be used for all kinds of things. It seems to me that participating in a haka places things in the context of a group and it seemed to give New Zealanders a chance to grieve the loss of the people murdered in the mosques in their country as a group, society, nation. It was a vehicle for community grieving and shock. Americans don’t seem to have anything that compares to it. I guess our candlelight vigils perform the same thing for us.

  9. Turning difficulties in life into healing projects is just another form of abuse. The “healing project” is a con, because the real issue is always social and civil standing. Healing efforts have nothing to do with this. The real issue is always the need to engage in public conflict in order to restore honor.

  10. I am a psychologist who, together with my partner a LICSW, offer a process called Seeing with Your Heart, which integrates family systems therapy, indigenous ancestor/spirit communication and existential phenomenology. We lead intensives in New Zealand every two years and have greatly benefited from learning Maori healing practices. Many Kiwis are of mixed Euro-Maori ancestry and the blending of these cultures is the norm in post-colonial New Zealand. The emergence of Maori healing practices will continue to evolve and serve as a valuable alternative to conventional psychiatric treatments.