1047 82 Articles the Psychological Health of Shamans a Reevaluation

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R '.I.- ,-, d -of Religion. &. 101 124, 1997

Journol of lhc Amcricm Academy of Rcligion W / 1

The PsychologicalHealth of Shamans:

A Reevaluation*Roger Walsh

INTRODUCTION

T H E P s Y C H O L O G ~ ~ LEALTH of spiritual practitioners has longbeen a point of contention, both in the culture at large and amongresearchers such as anthropologists, religious scholars, and especiallymental health profcssionals. William James wrestled with this issuein The Varictics 01Rcligiou Expcricncc, and almost a century later thedebate co ntinue s (Lukoff. Lu, and Turner; Walsh. 198 0; Wilber 1993).Witness, for example, the title o l a report on mysticism by the Groupfor the Ad vance me nt of Psychiatry: Mysticism: Spiritual QucsL or PsychicDisonlcr?

Perh aps th e m ost controversial figures ol all have been shamans. Therange ofdewriptions and diagnoses that have been given these individu-als is nothing less than extraordinary, and two extreme views are nowprevalent.

Among mainstream academics probably the most common assess-ment of shamans is that they are psychologically disturbed individualswho have managed to adapt their psychopathology to social needs.Sham ans have been diagnosed. labelled, an d dismissed in m any ways. Tostart with som e of the k inder diagnoses, sha ma ns have been described 3s

tricksters and healed madmen (Eliade; Warner). The terms neurotic,epileptic, an d ch arlatan have been ap plied liberally, and t he shaman has

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also been called a 'veritable idiot." 'menta lly deranged ,' and 'an outr ight

psychotic" (Devereaux; Wissler). But perhaps rhe most common diag-noses have been h ysteria and schizophrenia (Kakar; Noll).

On the other hand, an equally extreme but opposite view is nowappea ring in the po pular literature. Here shamanic practitioners an d the irstates of consciousness are being beatified a nd com pared with the s aintsof Buddhism, yoga, or Christian mysticism. Consider, lor example, theclaims that 'shamans, yogis and B uddhists alike are accessing the sam estate of consciousness" (Doore:223) and that the shaman 'experiencesexistential unity--the samodhi of the Hindus or what Western spiritu-alists and mystics call enlightenment, illumination, unio myslica"(Kalweit:236). As if this were not enough, shamans have also beendescribed as 'psi masters . . . veritable early warning systems for their

peoples" (Wescott:340) and, apparently quite seriously,as

'a master ofdea th; he actually dies an d is actually reborn' (Kalweit:15).Clearly, then, there is e norm ous confusion about the psychological

statu s of shamans. Un fonuna tely both the diagnoses and beatifications ofshamans seem to be based on imprecise assessments. W ~ t hhe exieptionof Noll. there have been almost no carefu l comparisons of the signs andsymptoms of alleged shamanic psychopathology using the criteria out-lined in diagnostic m anuals such as those o f the Am erican PsychiatricAssociation. Likewise, claims that sham anic states of consciousness areidentical to those of practitioners from other traditions have been notablydevoid of the careful phenomenological mapping and comparisons nec-essary lor the precise determination ofequivalm ce. When such p hen om -enological analyses are perform ed, then significant differences between

sham anic. Buddhist. an d yogic states, rather than equivalence, leap intoview (Walsh 1990 . 19 93; Walsh and V aughan). This is not to deny thatthere may be some overlap in th e psychological processes and goals.'e.g.,attentional training and compassionate se ni ce (Peters 198 9), of these dif-ferent practices and states, but i t is to say that the states appear ro beexperientially d istinct.

In this oawr I want to examine the evidence for claims that shamans. . . . .~ ~

are nec esv nly psychologic3lly disturbed . To d o this I will outline the def-inillon of shamanism being used here , describe the shamanic behaviorsthat researchers have viewed as pathological, summarize some of thebiasing factors that historically may have skewed assessments of sha-manic health, and hen examine the evidence lor more common diag-noses, namely, epilepsy, hysteria, and schizophrenia. Finally I will suggest

a possible reinterpretation of shamanic symptoms that may encompassand explain both shaman ic symptoms a nd strengths.



Walrh: Thc Prychologirol Hcolth oJShamonr , 103

DEFINITION

There is no universal agreement on the definition of shahanism(Hultkrantz), and so i t is important to make clear the one being usedhere. There seems to be a spectrum of tribal practitioners, healers, andreligious figures wh o bear a family resemblance to on e another (w ink le-man 198 4. 19 89) so that there is probably a certain arbitrariness to anysingle definition. However, this paper will focus on those individualsw ho f it the definition o f shamanism as a family of traditions wh oie prac-tilioncrs focus on voluntarily entering altered states ol co ns cio u~ ne ssnwhich they experience themselves, or their spitit(s), traveling to otherrealms at will and interacting with other entities in order to srrve theircom mun ity (Walsh 1989a. 1990).

While no single definition can probably satisfy all researchers, thison e has th e advantage of being relatively narrow a nd p ointing to a gr ou pof practitioners who almost all researchers would agree are indeedshamans. This definition specifically excludes mediums who 90 notengage in sh arna nic journ eys (soul flighr), since although s om e re-searchers do include such medium s (Blacker; Peters 1989; Peters andPrice-Williams 198 3), and although there is clearly a n o verlap,(someme diu ms may journey and some shamans may act as mediums), medi-um s an d sha man s have becn reported to show differences in states ofconsciousness as well a s in geographic an d social distribution ( b u r -guignon; Winkelman 1989). In addition, the shamanic journey has becnone of the behaviors that has aroused suspicions of psychopathology so

that we will want to focus on i t in this paper.This definition seem s to clearly distinguish this tradition fro; oth er

traditions and practices as well from various psychopathologies withwhich it has been c onfused. For example, priests may cond uct ceremoniesand medicine men may heal, but they usually do not enter altered statesof consciousness (Winkelman 1989). Mediums usually enter alteredstates (Bourguignon) but may not journey; some Taoists, Muslims, andTibetan Buddhists may journey occasionally, but this is not a majok focuso l their practice (Baldrian; Evans-Wentz; Siegel an d H irschrnan), whilethose w ho suffer mental illness may enter altered states and meet 'spir-its." but they d o so involuntarily as helpless victims rather than as volun-tarily creators of their experience.

Of course, we must acknowledge a t the beginning that even with a

relatively narrow definition such as this. there is no reason to assume th atshamans are an homogenous group with identical personalities andpathologies. In fact, psychological lesting suggests they are not (Fabrega



10 4 Journal of th e Amm'can Acadmy 01Rcligjon I

an d Silver). For all we know, they may no more display a single person-,ality or neatly fi t a single diagnosis than d o all Western doctors. This maylseem an obvious point, but i t is amazing how often it is forgouen. .

IBEHAVIORS THAT MAY INDICATE PSYCHOPATHOLOGY '

1

Th rees ham anic behaviors need to be assessed, since they have most.often been interpreted as pathological. These are the initiation crisis,,med ium ship , and sham anic journey. The initiation crisis is the dram aticIonset of painful symptoms and unusual experiences that marks thebeg innin g of the shamanic life for some practitioners and co rrespond s t o 'what Jose ph Campbell de xr ib ed as "the call to adventure." While medi-lumsh ip is not universal among shamans, i t is common enough and its,psychological nature cu rious enough to have aroused claims by s omeresearch ers that it is evidence o f psychopathology.

IDuring a journey the s hama n enters an altered state of con sciousn ess,.

the n experiences himself or herself as leaving the body and journeying totot he r worl ds (Eliade; Walsh 1989 b). The journey contains several expe-riences that have a r o w d the suspicion of Western researchers. The first Iis t he a lte red a t e of co ns do & nw that the shaman induces, and the sec- .on d is the rich imagery an d visions that accompany it, especially visio nsmof "spirits.' Finally, there is the fact that shamans believe that theseimages , visions, spirits, and worlds are a s real a s or, in some cases such asthe Jivaro Indians, even more real than our ordinary waking reality.(Ham er 1984). I

I

B W I N G FACTORS IN ASSESSMENTS OFSHAMANIC PSYCHOPATHOLOGY

ISe ve nl factors app ear to have biased interpretations of shamans' psy- ,

cholog ical sta tus. Since these have been reviewed elsewhere (Noll; Walsh1990). hey need only be summ arized here.

The first is the general Western "Zeitgeist. the spirii of the times. 1wherein the Western rationalistic-positive ideology was considered theno rm against which othe r cultures and institutions were judged' (Kakar:90) . A lack of psychiatric expertise and of personal experience of sha- i

man ic practices may also have reduced researcher's sensitivily. Likewise, 'th e failure 'to distinguish clinic an d culture' (Opler: 109 2) and reliance ,

o n psych oanalytic interpretations can be pathologizing of cross-cultural ,

religious behaviors (N oll). Psychoanalysis has proved particularly pro b- 'lematic in this regard as compared to many other psychological schoolsbecause of its marked tendency to interpret unusual experiences- I



..Walsh: Thr Psychological Hcalrh of Shama nr 1 I05

rspecially trans pers ona l and mystical experiences-as pathologiial. Thisis an'ex amp le of 'the pr dt ra ns fallacy- in which transperso nal brogres-sions arc misidentified as prepermnal regressions (Wtlber 1993. 19 95).

The fact that altered states of consciousne ss are involved raises addi-tional concerns. First, there can exist a negative bias towards a!ternatestates of consciousness, a bias that Michael Harner (1990) callsl"cogni-centrism.' Seco nd, a growing body of research suggests the exis:ence ofstate-specific limits for understanding alternate states of which one hasno personal experience (Noll; Tart 198 3. 1992; Walsh 1 9 8 9 ~ ; alsh andVaughan). All of the above factors may have biased in~er~retajionsfshamanic psychological status. I

Ol co ur se , bias-free observation is probably a myth , as Francis Baconlong ago pointed ou t in his discussion of the various 'idols' to wbich weare all susccptiblc. The re are probably n o value-free observations, only(relatively) value-aware observers, and we can but try to be aware ofthese idols as we examine the more common diagnoses attributed toshamans. These diagno ses have been. t o use the old and imprcc;sc lan-guage found in most ofthe literature, epilepsy, hysteria, and schizophre-nia. Let us therefore exa mine theev iden ce for and against each of thestvenerable diagnoses and then consider more recent intcrpretatioris.I

IEPILEPSY I

IThe conclusion that sh amans are epileptics is du e to descriptions of

their 'fits' du ri ng initial crises. These fits have rarely been observed

directly by anthropologists. Rather information usually comes fromshamans' recollections many years afterwards. This alone woul? makeprecise diagn osis dilficu lt, since recollections of past illness can noto-riously inaccurate. T he situation is exacerbated becau se many anthro-pologisu have not known the correct questions to ask in order to allowaccurate diagno sis. The net result is a collection of descriptions sy vagueand so unhelpful that it is quite impossible to determine p~ecisclywhether the condition was, in fact, epilepsy, let alone what type ofepilepsy might be inv olved. I

Shirokogoroff (347) did observe a series of fiu in a woman whodesired to become a sha ma n but was rejected by her tribe. He codcludcdthat:

the most typical picture of hysterical character. with strong s uua l exbte-ment. was beyond any doubt: she was lying on a stove-bed in a con-dition varying betw een great rigidity ('arch') and relaxation: she was

hiding hersell from the light . . there waz temporary loss o l sensitivenessto a needle . . . a t times continuous movements with the legs and basinI

I



106 Jottrnol oj th r Arnm'cm Acadmy oj Rrligioni

were indicative of a strong sexual excitement . . Her cognition of reality Iwas rather doubtful, for during her fi t she did not cognize persons !being around her. However, from time to time, or a t least a t the end ofher fits, she was quite conscious of her surroundings and before a fi t she Ilooked for isolation and for certain comfort for herself during the fit.

This description is one of the most detailed in the literature and o?eof the very few firsthand observations, yet is still not detailed enough lo

allow certain diagnosis. The description is consistent with 'hysteric~lepilepsy," bu t definitive diagnosis wo uld require a more precise descrip-tion of the atta ck, an account of the patientk experience, and ultimatelylaboratory d ata (Sutherland. Tait. and Eadie). I

What then are the possible causes of shamanic 'fits? Possible diag-

nose s w ou ld inclu de va rious ty pes of epilepsy , "hysterical seizures." an!emotional agitation. The possible types or epilepsy to be consideredwo uld inclu de especially generalized and temporal lobe epilepsies.

,

Generalized, or grand ma1 epilepsy, is the classic form of convulsio fland in ancient times was know n a s "the falling illness' and 'the sacreddisease." After a possible prodromal period of irritability and tension.with out w arnin g the patient sud denly loses consciousness, becomes rigidin e xtension. falls to the g roun d, ceases breathing, and may urinate. 6few second s of intense whole body tonic spasm is followed by i n t e yjerking movements. T he movements gradu ally become less frequent andfinally cease, leaving the patient comatose and flaccid. Consciousneisthen gradually returns, though the patient often remains confused an 3drowsy and has n o memory of the attack. I

Such a clinical picture is, of course, inconsistent with both the 'fit"described above and the self repons by shamans who would not 6eexpected t o remember such an episode. Consider, for example, the ca&Iof a Nepalese shaman w ho recalled that, at age thirteen, I began to shakeviolently an d was unable to sit still even for a minute. even when 1 waknot trembling- (Peters 1987: 164).

Of greater possible significance to shamanic pathology is temporallobe epilepsy. This form of epilepsy is particularly intriguing because i t

elicits not only changes in behavior but dramatic and unusual experi-ences. These may include hallucinations, intense emotions ranging fromterror to ecstasy, and feelings of unreality (depersonalization or dereali;zation). D uring this time the patient may display automatisms, which areunc onsc ious stereoty pic mo vem ents tha t are quite out of place (Suther;

land, T ait, and Eadie) IThe unusual experiences that accompany temporal lobe epilepsy

might perhaps be consistent with some experiencs of initiation crises;.However, both the generalized and temporal lobe syndromes are forms of



Walsh: Thc Psychological Hcalih ojSharnons 10 7

organic epilepsy and usually reflect chronic neuropathology. Given thisfact, i t is not surprising that these forms of epilepsy tend to recur overlong p eriods of lim e. However, the ac coun ts of sham anic 'fils" usuallyimply that the attacks occurred only during the initial shamanic crisesand then disappeared spontaneously. This, plus the fact that they.oc-curred only during a time of psychological agilation, suggest that the filswere not organic in origin and hence were neither generalized epilepsyno r temporal lobe epilepsy.

Th is leaves two othe r major possibilities: 'hysterical epilepsy" orem otio na l agitation . 'Hysterical epilepsy" is a form of what now is

described technically as a 'conversion disorder" (American PsychiatricAssociation). Here psychological conflict is expressed a s, or conve rted to.behavior that mimics an epileptic attack. I t seems quite possible that

some shamanic fits are of this nature. Th e fact that th e fits occur durin g atime o f psychological stress, apparently disappear im mediately after-ward s, an d are exp ected of would-be-shaman s, all suggest the possibilityof a psycholog ical cause. Anothe r possibility is that so me of the 'fits' aresimply episodes of intense agilalion rather than any true or even hysteri-cal epilepsy.

In summary, available descriptions of shamanic fits are usually sovague, so clinically imprecise, an d based on recollections of events so farin [he past that it is impossible to make any definitive statement aboutthe incidence of epilepsy in shamans. However, there seems to be littleevid ence for organic epilepsy, and most fits that d o occ ur may well beexamples of either conversion type epilepsy or episodes of agitation.Moreover, only some sha man s experience fits, an d epilepsy could h ardly

a c c o u n ~ or oth er sham anic experiences such as the shaman ic journey.Consequently i t is clearly incorrect to label all sham ans as epileptics o r loimagine that shamanism can be either explained or dismissed on thebasis of epilep sy

HYSTERIA

The second condition that has of~ en een used to diagnose (andsometimes dismiss) shamanism is hysteria. Hysteria is actually an oldterm for a variety of disorders that are now called conversion disordersand dissociative disorden (American Psychiatric Association). Conver-sion disor ders are thought lo occur when a person unconsciously con-verts psychological conflicts into physical symptoms. as for example withthe previously discussed epileptiforrn episodes.

In dissociative disorders, symptoms are psychological rather thanphysical. Th e key element is loss of conscious aware ness and control o f



108 Journal oj lhc Arnm'can Acadmy 01Rcllglon

certain n ~ cn ta l rocesses such as memory, perception, or identity (Hil-gard). Dissociative disorders include multiple personality disorder, de-personalization, an d trance states.

We have already discussed conversion disorders and their possiblerelationship to shamanic fits. We can now consider dissociative disordersan d see to what extent they may account for other shamanic experiences.Th ree types of shama nic experience have been labeled 'hysterical,' an dwe can examine each in turn. These three arc the initial crisis, medi-um ship , and the shamanic journey.

With its wide range of bizarre experiences and behav iors it is not sur -prising that the sham anic initiation crisis has been labeled hysterical. Theconstellation of dramatic changes in consciousness, identity, and behav-ior that can accompany it might perhaps be classifiable as an unu sual or

culturally specific form of dissociation. However, again the m ajor prob-lem is that the descriptions we have of initiation crises are too imprecise,too far in the past, and too lacking in adequate background psychologicalassessm ent of th e vicdms to allow accurate diagnosis. Consequently, allwe ca n say at this time is that dissociation might p erha ps play a role ininitiation crises. but it should be noted tha t in itiation c r i ccur in onlya minority of shaman s.

The second aspect of shamanism that might reflcct dissociation is thcp r o c w of m cdium ship or spirit possession. This process is relativelycommon. and o ne survey found it in eleven of twenty-one cultures wherepractitioners met the criteria for shamanism being used in this paper(Peters an d Price-Williams 1980). During this process one or more spir-its seem to speak through the shaman whose state of consc iousness may

vary from lull aleitness to a complete absence o l personal awareness.During this absence the spirit(s) may seem to displace the shaman'spersonality whose body posture, behavior. mannerisms, and voice maychange dramatically.

This type of phenomenon has been surprisingly common' acrossdiverse cultur es an d times and has recently surged again un der th e nam eof channeling (Hasrings; Klimo; Schultz). Western psychiatry tends toregard this general phenom enon. whatever its name, as a form oldisso ci-ation. W i t n w the CornprchcnsivcTcxlbwh oJPsychiatry which notes that'a cu rio us an d not fully explored or und ersto od fo rm of dissociation isthat of the trance states of spirit mediums who preside over spiritualseances" (Nemiah: 150).

There is an interesting clash of worldviews here. For Western psy-chology a nd psychiatry, mediu mship is a form o l dissociation in whichthe 'spirits" are assumed to be splintered fragm ents of the p syche. For thesham an, on the other hand (and the Western medium o r channeler), the



W a k h Thc Prychologlcal Hcalrh oj S h a m r IW

'spiriu" are experienced as, and usually believed t o be, distinct entitiespossessing know ledge and wisdom sepaiate from, an d often greater than.that of the medium. To decide between these two views may at firstglance seem a simple matter. However, analysis soon reveals significantepistemologicil difi cul ties in providing definitive proof for either view,

leaving u s in a situation of ontological indeterm inism (Walsh 1990).However, from a Western perspective, spirit possession would usu-

ally be inte rpreted as an example of dissociation. Th is does not mean thatall shaman s can be diagnosed or denigrated as hysterics, since possession

occu rs in only som e of them, is only one o fth eir many role activities, andserves a socially valued function.

A third phenomenon that might be considered dissociative is theshamanic journey. During the journey the sh aman enters a trance,

becomes less aware of the environment, and experiences journeying tooth er world s to contact a rich range of spirit beings an d visionary experi-ences (Eliadc; Noll; Peters and Price-Williams ,1 98 0; Walsh 198 9b,199 0). For a definition a nd phenomenological m app ing of the shamanic

trance see Walsh (1990 , 1 993).Western psychiatrists might argue that the journ ey is indeed a form

of dissociation, since it involves enterin g a trance an d trances are oftendescribed as one form of dissociation. A common implication is thatthese tran ces arc therefore necessarily pathological. S ham ans and theirtribesp eople wou ld disagree with this. Ind eed for the trib e the shamanicjourn ey is regarded a s a ray of hope by whic h h ealing and h elp can reachthe wo rld from the sacred realms.

The re seem to be several argumen ts against con clud ing that the

shamanic trance and journey are necessarily pathological. The Krst ofthese is that the journey is not only culturally sanction ed b ut culturallyvalued and that to label it as a disord er may be to 'fail to distinguishclinic an d culture " (Opler: 1092). Moreover, sha ma ns have control overtheir trances. They enter trance at will and leave it at will (Peters and

Price-Williams.1983; Walsh 198 9b). This is quite dillerent from the clas-sic dissociative disorders which ap pear to overtake an d control their vic-

tims. Thu s i t has been pointed o ut that:

the S iberian sham an may fall into a ware of partial hysterical dissociationlike h e hysteric in, say Britain. but hisstate he volunrarily x c k s and indo ing - he obrains auh ori ty and respect from the tribe. (Yap)

Another consideration is that the sham anic journ ey does not seem

necessarily to function as a psychological defen se mecha nism . In clinicaldissociative disorders the dissociation fun ctions, like oth er defense mech-anism s, by unconsciou sly reducing and distortin g awareness in order to



110 Journal 01he Amm.can A c d m y 01Rcligion

avoid the recognition o f psychological pain a nd conflict. The shama nicjourney seems to do almost the oppo site. Here shamans deliberately openthemselves to either thcir own pain a nd suffering, that of thcir people ,or even to that of the 'spirits' in other worlds, and thereby attem pt tofind a resolution to that p ain. This is consistent with recent suggestion sthat dissociation may sometimes be a psychologically beneficial ratherthan a necessarily only pathological condition (Richards). I t may beimportant to draw a distinction here between dissociation as a psycho-dynamic mechanism a nd as a pathology.

OI course, this is not to deny that the journey, or almost any othershamanic behavior for that matter, can sometimes be used as a psycho-logical defense. However, this is very different from saying that the jour-ney serv es primarily o r exclusively a s a defense. Therefore, the shama nic

trance an d journey may well be culture-specific txamples of dissociativemechanisms. However, wheth er they sh ould be regarded as pathologicaland ex amp les of dissociative disordcn is another qu estion. An a ppro pri-ate analogy might be a self-hypnotic trance voluntarily induced for thera-peutic purposes.

In sum mary, then, the existence. extent, and nature in sh aman s ofwhat the literature traditionally labelled as 'hysteria" is unclear. Conver-sion an d dissociation may conceivably account for some 'fits" an d oth erabnorm al behaviors during the sham anic initiation period. However, it isdifficult to be sure. since our information about what shamans reallyexperience d uri ng this period is imprecise at best.

Dissociation might also be involved in two othe r shamanic behaviors,namely, spirit possession and the sham anic journey However, this does

not mean that thesc phenomena should be regarded as nothing but dis-sociative disorders. To do so risks imposing Western cultural and di-agnostic perspectives, thereby reducing and pathologizing these rich,comp lex, culturally valued, and as yet little understood pheno men a tomere diagn ostic categories.

SCHIZOPHRENIA

Althou gh shamans' experiences may make perfect sense to them andtheir tribespeople, they may seem bizarre and incomprehensible to some-one from another culture. Consequently i t is not surprising that someWesterners have therefore decided that shamans are psychotic an d x hiz o-

phrenic. Thus, for example, one researcher dexribed the Mohavesha man as 'an outright psych otic" (Devereaux), and a psychiatrist con-cluded tha t schizophrenia and shamanism have in common 'grossly non-reality-oriented ideation, abnormal perceptual experience, profound



Walsh:Thc Psychologica l Hcnlrh oJShmnnnr 1 1 1

emotional upheavals, and bizarre mannerisms" (Silverman: 22-23) . Theonly difference that this psychiatrist could see between shamanic andWestern schizo phrenic episodes was the degree to which the two culturesaccepted them.

Th e bizarre (to the Western mind) sh amanic experiences that havemost concerned observers and led to diagnoses of schizophrenia havebeen the initial crisis and the visionary experiences du ring the sham anicjourn ey Consequently we need to examine both of these phenomena.

Unlike the initial crisis, the s ham anic journey experiences and statesof consciou sness can be assessed with some degree of accuracy sincelwepossess many detailed accounts of them. These accounts include ger-sonal descriptions by shamans, observers' reports, and more recentlyaccounts by Westerners wh o hav eund ertake n sham anic training. Wh en

these de scriptions of sham anic journey experiences are subjected to care-ful phenom enological ma pp ing they are found to display significant dif-ferences on several dim ension s from schizophrenic experiences (Noll;Walsh 1990. 1993). Consequently i t is n o longer appropriate to suggestthat sham anic journey experiences are evidence of schizophrenia.

For the initial crises, the situation is less clear. As previously dis-cussed, we have very little firsthand data on these crises, and what wehave is sketchy It will therefore be impossible to reach any definitivediagnosis. However, two questions need to be addressed. These arewhe ther the behavior du ring the crises is consistent with psychosis and .if it is, wheth er it is consistent with schizophrenia. Let us then first exam-ine the evidence for a possible initiation crisis psychosis.

Th e diagnosis of psycho sis during the initial crisis has been based on

both shamans'experience and behavior. At this time shamans-to-be mayexperience themselves as torme nted and controlled by spirits. They mayexhibit considerable confusion . em otional turm oil, withdrawal from soci-ety, and a range of unusual and even bizarre behavior such as goingna ked , refusing foo d, and b iting themselves (Boas; Eliade; Peters 19 87.ShirokogoroTD. These beliefs and behav iors are certainly bizarre by M'est-e m s tandards .

Of course , the belief in spirit possession and persecution is not con -sidered delusional in the shamanic culture. What is unique aboutsha ma ns is not that they complain of persecution by spirits; it is that [heyeventually learn how to master an d use the m (Eliade; ShirokogoroTD.

Given the cultural se tting and th e limited da ta, we canno t say defini-tively whether shamanic initiation crises sometimes include psychoticepisodes. All that we ca n conc lude is that the bizarre behavior, emotionalturmo il, confusion, an d inco herence could b e consistent with a psychoticepisode. Therefore it is possible that some would-be-shamans who are



112 Journal 01 hc Amdc a n Acadmy 01kligion

compelled to their profession by an initial crisis may unde rgo a tempo-rary psychosis.I f a psychotic episode does occur during the initiation crisis, then

there seem to be four possible diagnoses that might be given to it . Thefirst is a brief reactive psychosis. As the name suggests, this is a briefstress-induced episode lasting from a day to a month, often marked byconsiderable em otional turmo il, yet with eventual full recovery (Ameri-can Psychiatric Association).

Other possible diagnoses would be schizophrenia or its short-livedvariant, schizophreniform disord er. Curren t diagnostic practices requirecontinuous signs of psychopathology for at least six months before adiagnosis of schizophrenia can be made. Where disturban ces are shorterbut the clinical picture is still consistent with schizophrenia, then the

diagnosis of schizophreniform disorder is made (American PsychiatricAssociation).

The fourth possibility would be 'psychotic disorder not otherwisespecified." This diagnosis is given when a psychotic episode does notmeet the diagnostic criteria for specific psychotic disord en su ch as schizo-phrenia or when there is inadequate information to make a specificdiagnosis.

I f a psychotic episode does ind eed occur du ring initiation crises, thenits differential diagnosis includ es these four categories. W ha t is the evi-dence for and againn each of them? Given how limited and unreliablethe clinical data is, i t will obviously be impossible'to make a definitivediagnosis, although we can consider the possibilities as follows. TheAmerican Psychiatric Associationk Diagnostic and Statistical Manual sug-

gests that the diagnosis of psychotic disorder not orherwise specifiedshould be used for psychosis about which there is inadequate i n f o m -tion to make a specific diagnosis. This certainly fits the shamanic situ-ation, and so we could simply say that i fa psychotic episode does occurdu rin g the initiation crisis, then i t can be considered of this type.

However. it is schizoo hrenia that has been the mow com mo n duenos is.L,

Thls may partly reflect a lack of ps ych~ atn dp syc ho log ~c aloph~st~cationamo ng early anthrop olog~ cal esearchers Nonrnental health profestonalsare of& u ~ y a m - o ihe m an y varieties of psychosis and there fore assumethat all are schizophrenic. Indeed. although schizophrenia hasbeen the most common diagnosis, i t seems the least likely because o fth ebrief duration of the initial i l l n w and i t s succ wfu l outcome.

There are also other da ta that argue against either a schizophre nic orschizop hmniform diagn osis. The first of these is that many s ham ans haveseemed not at all schizop hrenic to anthropologisrs. Likewise, native peo-ples often make sh arp distinctions between shamanic crises and mental



Wnlsh- Thc Psychologicnl Hmlth oJShamnns 113

illness. Moreover, sha man s often seem to en d u p n ot on ly psychologicallyhealthy bu t eve n exceptionally so. This is in m arked contrast to x h i z o -phrenics of whom about a third deterlorate progressively over the years(Kaplan and %dock). Indeed this exceptional psycholo~lcalwell-beinn ofsham ans also argues against most of the othe; diagnoses that have bi enmade, e.g.. epilepsy an d hysteria. While so me patients may recover spo n-taneously from any of these, one would not usually expect them to endu p as the mo st able me mbe rs of society

Moreover, shaman s end up serving the community. Indeed, this isone of their defining characteristics, while schizophrenics rarely makemajor contributions. Several researchers have pointed to a correlationbetween psychological health and service, for example Alfred Adler's'social in terest." Eric Eriksonk 'generativity.' f i r a h a m Maslow's self-

actualizerk generosity, Pitirim Sorokink 'creative altruism." and , ofc ourse .the 'xl ll& s service" described in several Asian psychologies (Walsh1988: Walsh and Shapiro; Waterman). Since healthy people tend todevote themse lves more to aiding others, this m ay be a further argumentagainst seeing the sh ama n as psycholopjcally d isturbe d.

It wou ld b e helpful in assessing the health of shaman s to have goodpsychological test da ta. Unfortunately the re is very little available at th epr ex nt time. A Rorschach study of Apache Ind ians that has been widelycited foun d n o evidence that shaman s are severely neurotic or psychotic(Boyer. Klopfer. Brawer and Kawai)..Unfortunately this stu dy was flawedin several ways, and so the evidence it provides is very weak (Fabregaand Silver). Anoth er stud y revealed a striking similarity between the u n-usual Rorschach test patterns generated by an Apache shaman (Klop-

fcr and Boyer) and a Buddhist meditation master (Brown and Engler).bu t it is impossible to generalize from a single case. At the present timepsychological tests are therefore of little h elp in evaluating the sham an'spersonality o r psychological health.

What then can we conclude about the oft repeated claims echoingthrough d ecad es of literature that shaman s are healed madm en at best oractively psychotic and schizophrenic at worst? The experiences mostoften diagnosed as psychotic have been sha ma nic journeys and initialcrises. Of the sharnanic journey we can clearly say that i t is a uniqueexperience that should in no way be confused with psychosis.

The initial crisis is less clear, and some of those shamans whound ergo su ch a crisis might suffer a tempo rary psychotic episode. How-ever, i t is important to note that only a small percentage of shamansund ergo initial crises, an d, of these, probably only som e experience psy-chosis. This means that only a very small percentage of all shamanswou ld suffer a psychosis. Moreover this psychosis is usually short-lived



114 Journnl oJ lhc Ammican Aradrmy oj Rcligion

and for a variety of reasons seems most unlikely to bea

form of schizo-phrenia. In addition, the shaman may end up as one of the healthiestmem bers of the tribe.

This is not to say that all shamans are models of health and helplul-ness. Indeed, some engage in all manner of trickery and deceit, theirintentions can be malevolent (Harner 1984; Rogers; Warner). and theirministrations sometimes merely delay adequate treatment (Li and Phil-lips). However, it is now clear that contrary to decades of specula tion, themajority of shama ns cannot be diagnosed as mentally ill or labeled as e p il e ptic, hysterical, schizophrenic, or psychotic.

REEVALUATING THE INITIATION CRISIS

Perhaps w hat is just as impo rtant as the initiation crisis itself is whatcomes ou t of it . According to Eliade the shaman is a person 'who hasbeen cur ed, who has succeeded in curing himself" (27). From this per-spec tive 'shamanism is not a disease but being healed from disease"(Ackerknechc 46).

In fact, shamans may end u p as the most highly functional mem bers'of the com mun ity an d, according to Eliade (29), 'show proof of a moretha n normal nervous constitution." They have been described as display-in g remarkable energy and stamina, unusual levels of conce ntration, con -trol of alt ered states of consciousness, high intelligence, leadership skills.an d a grasp of complex data, myths, and rituals. So the symp toms an dbehavior of shamanic initiation crises are unusual and even bizarre byboth Western and tribal standards. Yet shamans not only recover but may

fun ctio n exceptionally well as leaders and healers of their peo ple (Eliade;Reichel-Dolmataot Rogers).

What then can we make of this curious combination of initial dis-

turba nce and su bsequen t exceptional health? With the excep tion of exis-tential crises (Bugental; Yalom), the possibility of exceptional healthfollowing psychological disturbances, especially psychosis, is rarely rec-ogn ized by main stream psychiatry an d psychology. We are left, therefore.to a sk whether there are any data and diagnoses that could en compassbofh the initial pathology a nd the subsequent recovery? Is there an alter-native framew ork for unders tand ing shamanic crises?

Th e answer is clearly yes. Shamans are certainly not the on ly peop le

observed to be better off after a psychological disturbance t han before it.Ov er 20 00 years ago Socrates declared that 'our greatest blessings com eto u s by way o f m a d n w , provided the madness is given us by divine gift'( L u k o E 155). More recently the eminent psychiatrist Menningerobserved that 'some patients have a mental illness and then they get



Walrh: Thc Psychological Hcallh oJShamns 115

weller! I mean they get better than they ever were. . . . This is an extra -ordinary a nd little realized truth" (Lukofl: 157).

In ou r own time a surprisingly large numbe r of mental health pro-fessionals have made similar observations. I say surprising because thepossibility is barely mentioned in traditional psychiatric texts. Yet asignificant number of researchers, some quite eminent, have recognizedthat som e psychological disturbances, even includ ing psychoses, may[unction as growth e xp erim ce s that result in greater psychological well-being. Examining these disturbances may therefore shed light on sha-manic initiation c rises.

The general process is one of temp orar y psychological d isturb ancefollowed by resolution and repair to a higher level of functioning thanbefore the initial crisis began. From this perspective what seemed at thetime to be purely a crisis of distur ban ce an d disease can now be re inter-preted as a stage o l development an d g rowth. These crises have beengiven many names, and each of them illustrates a dilfercnt perspectiveand piece of inlormation about the process. For example, disturbanceswith positive grow th outcomes have been described as positive disinte-gratio n," 'regenerative processes." 'renewal." 'resilience,' and 'creativeillness" (Dabrowski; Ellenberger; Flach; Pelleteir and Garfield; Perry).

Some crises are either induced by contemplative practices or arespecifically associated w ith mystical or transper sonal experiences. T he whave been desc ribed as 'visionary states." 'divine illnesses." 'spiritualemergencies," 'spiritual ernergences." 'mystical expe rienc es wit h psy-chotic features," and "transpersonal crises" (Gro fan d Grof 1986. 1 989.

1990; Laing; Lukoff 1985 ; Vaughan 199 5a. 1995b).What these names and descriptions suggest is that a period of psy-chological disturbance may sometimes be par t of , or at least be followedby, significant growth and development. Thus there is the possibility ofviewing these disturb ances a s developmental rather than merely patho-logical processes. Consequently s om e, but only som e, psychological dis-turbances can n ow be seen as developmenral crises.

These crises can be precipitated by stress or spur red by psychologicalor contemplative practices. They can also occur spontaneously an d ex-press inner developmen tal forces that have been described by such term sas pulls towards individ uation , self-actualization. =If- tranx ende nce, an deros (Maslow; Singer; Wilber 1980. 1995). These developmental forcescan become quite compelling, and, then, as the Jungian psychiatrist

John Perry observed, 'if development is not undertaken voluntar-ily with knowled ge of the goal and with con siderable ellon , then th e psy-che is apt to take over an d over whelm th e conscious personality. . . . Theindividuating psyche a bho rs stasis as nature abhors a vacuum- (Perry: 35)



11 6 journal 01 lhc Amcrican Acadnny oJ Rrllglon

In other wo rd s,t he psyche may actually create cr ix s that force devel-opm ent . Such can cer ta inly be the case with shamans. Many are not the

least bit pleased by the pros pect of their new profession and resist the ini-tial signs and sy mpto ms with all their might, what J o x p h Campbell calls'refusal of the call." How ever, resistance is n o easy matter, and man ytribal myths hold that th e person w ho resists the call will sicken , go m ad.

o r d ie (Boas; Eliade).W hen the forces of gr o w h overwhelm the forces of inenia , then a

developmental crisis occurs. The symptoms of this crisis may vary

dep end ing upon the individual 's personality and maturity. They may

range from primitive pathology to existential, transpersonal, o r spiritualconcerns (Wilber. Engler. and Brown). In the latter case the crisis has

com e to be known as a trans pe no na l crisis. spiritual emergency, or spiri-tual emergence (Assagioli; Grof an d Grof 1986. 1989. 199 0), an d it isthese that seem closest to and most helpful in understanding thesham anic initiation crisis.

The study of transpersonal crises or emergencies is in i t s infancy as

yet. Although they have been described for centuries as complicationsof spiritual practices, careful exam ination , classification, and systematictreatment have only jus t begun. Contemporary m a r c h e r s have de-scribed several varieties of trans person al crises. Of these one type bea rs

such a resemblance to the shamanic crisis that i t has specifically been

nam ed a crisis 'of the shamanic type' (Grof and Grof 19 86 ,19 89 ,1 99 0) .It is claimed that:

Transpersonal crises of this type bear a deep resemblance to what (he

anthropologisrs have deKnbed as the shamanic o r initiatory illncss. . . .In the uperienc es of individ uals whose transpersonal crises have nm ngshamanic features, there is great emphasis on physical sullering andencountcr with death followed by rebirth and dcm cnrs of aw eni or magi-cal Mght. Thcy also typically sense a special connection wilh the ele-ments of nature and experience com munication with animals or animalspirirs. It is also not unusual to feel an upsurge of unraordinary powersand impulses lo hcal. . . . Like the initiatory crisis, he transpersonalepisodes of a shamanic typ e, if p roperly suppo rted, can lead to goodadjustment and superio r lunctioning.(Grof and Grof 1986: 1 0-11)

The similarity of these experiences-death-rebirrh. magical flight.animal spirits, impulses t o hea l--to classic shamanic experiences is strik-

ing. Thus, it seems that shamanic initiatory crises may reflect psycho-

logical processes not limited to a few cultures or times. Clearly somedee p, perhaps archetypal, pattern is being played out h ere. Such was cer-tainly the view of Ju n g w h o argued for 'the psychological inference thatmay be draw n from shamanis tic symbo lism, namely that it is a projection



Mkh. Thc PsychologicalHcalth ofSharnanr 117

of the individuation prwess' (Jun g: 341). The Grofs therefore conc ludethat.in divid uals whos e crises follow this pattern are 'involved in anancient process that touches the dccpest foundations of the psyche" (Grof

and Grof 1986: 11) Of course, i t is quite possible that future researchwill reveal that there is more than one specific syndrome or type ofsham anic crisis.

Clinical observations suggest that .several factors may be helpful intreating transperson al crises. The first is a trusting rela tionship in whichthe patient leels cared for and safe. The second is a specific cognitive set,namely, a positive attitu de in which the patient exp ects that the processwill prove valuable and may ultimately be transforming and healing.Such attitudes in patients also favor good the rapeutic ou tcome s in othe rpsychopathologies (Flach). Ope nly expressing the emerg ing experiencescan be helpful and ca n be facilitated by a variety of psychotherapy tech-niques (Grof and Grof 1990).

It can now b e seen h ow the shama nic initiation crisis may fit into thisscheme. The crisis contains sym ptoms and behaviors that app ear bizarreand even pathological. Even i f the descriptions available to u s are notprecise enough to be able to d iagnose the criw s precisely, it is clear thatthey are often painful--even trauma tic--episodes. However, their out-come may be positive when the shaman-to-be is recognized as such bythe tribe and receives culturally appropriate support, guidance; and'therapy." This su pp od th er ap y includes a relationship with an experi-enced shaman. a positive reinterpretation (what cognitive therapistswould call reattribution) of the disturbance as part of a shamanic call.

and sh ama nic practices that enable the novice to work w ith the em ergingexperiences. With th is assistance the sham an may n ot o nly recover fromthe initiation crisis but may emerge strengthened and enabled to helpothers. In short. for centuries shamanic cultures se em to have providedthe types of sup port that co ntemporary thera pis~ s re now finding help-ful for spiritual emergencies.

I t thereforc appears that transpcrsonal crises, spiritual emergencies.or spiritual emergences, may be newly recognized forms of perennialdevelopmental crises. This developmenlal perspective allows us to viewboth sham anic crises and con temporary transpersonal crises as related.difficult, but potentially valuable maturation crises. This perspective alsohelps us to recognize both thc psychological disturbancc as well as thepotcntial for growth. As such i t denies neither the pain and pathology

nor the potential for development.Since developmental crises tend to bring unresolved conflicts to the

surface, i t follows that sham anic initiation crises may be a mix of progres-sive and regressive forces, signs of growth a nd sy mp tom s of pathology.



118 Journal oJ rhc Amm-can Academy oJ Religion

an d a co m p reh en s i v e acco u n t w i ll r eco g ni ze b o t h . Ho wev er , a t t h e vl east , i t n o. !o n ger s eem s ap p ro p r i a t e t o d i s m i s s s h am an s a n d t h e i r i n i

t ion cr i ses a s invar iab ly an d purely pathological . Som eth in g mu ch r ich

m o r e c o m p l e x , a n d m o r e b e ne fic ia l s e e m s t o b e g o i n g o n a n d d e s e r

o p e n - m i n d e d r e se a rc h .

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Documents

1047 82 Articles the Psychological Health of Shamans a Reevaluation