International Review of Psychiatry (1999) 11, 92 - 96

Mental health and spiritual values. A view from the East

NARENDRA N. WIG

Panchkula, Hanyana 134109, India

Sum m ary

Psychiatry and psychiatrists often forget the value and role of spiritua lity in the life of their patients. This paper deals with the inter-

relationship of mental health and spiritua lity in India and using illustrations from Hinduism suggests that Indian system does not follow

theWestern concepts of mind ± body dichotomy. Furthermore the Hindu view of life includes r ighteousness, biological needs, social needs

and release from worldly bondage and union with ultimate reality. The dangers of ethno-centricity in reaching clinica l diagnosis and

managing patients with mental illness across cultures are highlighted. The clinician must be aware of scienti ® c progress but without

giving up the role of relig ion.

Introduction

India is a country which is associated with spir itual

traditions for thousands of years; which has been the

home of some of the greatest religions of the world

like Hinduism, Buddhism, Jainism and Sikhism. All

other great relig ions of the world like Islam ,

Christianity, Zoroastrianism, Judaism have also deep

roots in India for many centuries. It is a land where

spirituality is almost a way of life; where even an

illiterate farmer, or a labourer or a housewife may

surprise you with their knowledge and familiarity with

philosophical issues of life.

Brought up in such a tradition and also in a Western

education system where the medical training often

includes science, art and humanities as seen in Europe

or North America. As a result any physician starts to

see the world through Western eyes but their

innermost feelings remain Indian at heart. To give an

analogy, in a lighter vein, the Western alcohol products

like whisky, gin and rum are now manufactured in

India. In the Government Excise records they have a

funny common name, `IM FL’ or `Indian Made

Foreign Liquor’ . Thus some clinicians may well feel

that they have similarly become an `Indian Made

Foreign Doctor’ once they get out of medical school

boundaries and work in the community.

Along with one’s training and contact with trainees

also comes the realization that: (1) the spiritual values

are not the monopoly of any single culture: each and

every culture, East or West, had deeply experienced

and examined such issues and (2) in the matters of

health, science alone can not provide all the answers.

The spir itual dimension is an essential and important

aspect of health particularly mental health. I propose

to discuss these two issues in this paper.

The Indian view of mind and mental health

It must be clari ® ed at the outset that there is wide

diversity of cultures and philosophical systems in India

and a historical mix with Western modes of thinking

in recent years has made it difficult to identify a

uniform Indian paradigm of mind and mental health.

The following account is more in the nature of a

personal perception.

There are certain obvious diffe rences between

Jewish± Christian ± Islamic religions and the religious

traditions as evolved in the Indian subcontinent. The

® rst difficulty comes with the very word `Religion’ . In

Indian languages there is no equivalent term to convey

the meaning of the word `Religion’ . The nearest term

`Dharma’ is not an equivalent of religion. It is a

mixture of cosmic order, sacred law and religious

duty, etc. In Jewish± Christian ± Islamic tradition there

is one God, one book, one ® nal prophet. As a result,

religious history and written code of laws play a very

important role in the Jew ish ± Chr istian ± Islam ic

religions. In India, however, philosophy and mythology

occupy a much more prominent position in the

religious teachings. Working in Islamic and Christian

societies, one is often struck by how different the

concept of `religion’ is compared to what may be

understood as `Religion’ in India. It is interesting to

note that, how our upbr ing ing controls our

understanding of even such common and universal

concepts as `religion’ .

Another striking difference between Indian and

Western religions is the concept of `God’ or `Divine

Reality’ . In Jewish± Christian ± Islamic tradition, `God’

is the Creator of the universe and everything in it.

Thus the Creator, in a way is `outside’ this world

which He has created. In Indian tradition `God’ is

not `out there somewhere’ but within you and within

Correspondence to: Narendra N. Wig, MBBS, MD, DPM, FAMS, FRCPsych (Hons), Emeritus Professor of Psychiatry,279, Sector 6, Panchkula, Hanyana 134109, India.

0954± 0261/99/02/30092± 05 ½ 1999, Institute of Psychiatry

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everything. The creation is continuity of the Creator

like a spider’s web which is part of the spider. This

thought is beautifully expressed in Sanskrit in the

opening invocation to the famous Isa-Upanisad:

`PURNAM ADAH, PURNAM IDAM, PURNAT

PURNAM-UDACYATE. PURNASYA, PURNAM

ADAYA PURNAM EVASISYATE’ . `That is whole.

This is whole. From the whole emerges the whole.

The whole is taken from the whole but the whole

remains’ .

In other words, the Ultimate Reality or BRAHMAN

as we say it in India is both transcendent and

immanent. The creation of the universe does not in

any manner affect the integrity of BRAHMAN.

Some signi® cant features of Indian philosophy

At this stage it may be useful to list some of the

important tenets of Indian philosophy as they relate

to our understanding of mind and mental health.

The following account which has largely been taken

from the book on Indian philosophy by Dr

Radhakrishnan and Charles Moore (1967), illustrates

the m ajor diffe rences of Indian and Western

philosophical traditions:

1. The chief mark of Indian philosophy in general

is its concentration upon the spir itual. Both in

life and in philosophy the spiritual motive is

predominant in India. Neither man nor the

universe is looked upon as physical in essence

and material welfare is never recognized as the

only goal of human life.

2. In India, philosophy and religion are intimately

related. Philosophy is never considered as merely

an intellectual exercise. Every Indian system seeks

the truth not as `academic knowledge for its own

sake’ but to learn the truth which shall make the

man free.

3. Indian philosophy is characterized by introspec-

tive approach to reality. In pursuit of truth, Indian

philosophy has been strongly dominated by

concern with inner life and self of man rather

than the external world of physical nature.

4. Indian philosophy is essentially idealistic. The

tendency of Ind ian philosophy, especially

Hinduism, has been in the direction of monoistic

idealism. Almost all schools of Indian philosophy

believe that reality is ultimately one and spir itual.

5. Indian philosophy makes unquestioned and

extensive use of reason, but intuition is accepted

as the major method through which the ultimate

truth can be known. Reason and intellectual

knowledge are not enough. Reason is not useless

or fallacious, but it is insufficient.To know reality

one must have actual experience of it. One does

not merely know the truth in Indian philosophy,

one has to realize it and live it.

6. The Indian philosophy is dominated by synthetic

tradition which is essential to the spirit and

method of Indian philosophy. According to Indian

tradition, true religion comprehends all religions;

hence the famous Sanskrit saying `God is one

but men call him by many names’ .

Mind± Body Dichotomy

One common and recurrent theme in European

literature is the body± mind dichotomy. It may be

in teresting to note here that in m ost of the

non-European cultures this is not such an important

issue. It appears that European thought, for some

reason; is very much preoccupied with thinking in

terms of dichotomies, be it body or mind, or good or

evil or nature and nurture. It is a kind of mind set.

Science and medicine are full of controversies like

what is more important, nature or nurture?, genetics

or environments?, physical or mental?, biological or

psychological?, cognitive or emotional? and so on.

Most of the time we end up by accepting that both

sides are important.

In the Indian philosophical tradition, the world is

seen more as a cyclic phenomenon or a continuum

like the Chinese concept of YIN and YAN G. As a

result there is more tolerance and acceptance of

opposing points of views than in European cultures.

Mental health in Indian tradition

One-line de® nitions do not do justice to complex

cultural concepts.There are many references in Indian

philosophical texts as to what constitutes as ideal

person. M ost often quoted text is from Srimad

Bhagwad Gita describing the balanced person as one

who has controlled his mind, emotions and senses.

For understanding the concept of mental health,

perhaps more important than any one quote is the

broad H indu view of life as summed up in the well

known four ends or broad aims of life (PURUSH -

ARTHA). These are DHARMA, KAMA, ART HA

and MOKSHA. DHARM A is righteousness, virtue

or religious duty. KAMA refers to fu l® lment of our

biological needs or sensual pleasures. ARTHA refers

to the ful® lment of our social needs and includes

material ga in, acqu isit ion of wealth and social

recognition. M OK SHA which is a ver y typical

Indian concept means liberation or release from

worldly bondage and union w ith the ult imate

Reality.

These four aims highlight harmony of different

dimensions of life: KAMA as the biological dimen-

sion, ARTHA as the social dimension and MIKSHA

as the spiritual dimension. DHARMA appears to be

more as central axis around which life rotates. It one

pursues KAMA or ARTHA without DHARMA, the

long-term result is suffering for the individual and

others around them.

Mental health and spiritual values 93

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The cultural context of mental health

In many documents on mental health programmes in

the M iddle East countr ies, the `Aims’ of such

programmes have listed that the promotion of mental

health should be `in keeping with the cultural tradi-

tion of the country’ . References to cultural factors

including religion are repeatedly found in the publica-

tions on psychiatry and mental health in these

countries. Almost all major psychiatrists of India,

Pakistan, Iran, Egypt, Sudan or other countries of

this region have written something or other about the

importance of the cultural and religious factors in

psychiatr y. M any psychiatr ists regularly use the

religious teachings as a basis for the treatment of

their patients and also for promoting community

mental health programmes.

One needs to be conscious of two lurking dangers:

one is that of ethno-centricity or the belief that `my

culture is the best’ and the second is the likelihood of

mental health becoming a movement away from

science which is at present the basis of medicine and

health.

The danger of ethno-centricity

The historians repeatedly remind us how people in

ever y major civ ilization in the past have been

convinced that they are very special people and they

are the very best of the best; may it be the Greeks or

the Romans, or the ancient Egyptians or Persians or

Vedic Aryans in India or people of Maya± Inca± Aztec

civilizations in South America. All of them shared

this common belief. To illustrate this I cite here two

interesting historical records.

The ® rst is a letter from Emperor Chien Lung

(1735± 1795) in reply to King George III’ s letter

suggesting that the two countries, i.e. China and

England should enter into diplomatic and commercial

relations with each other:

As to your entreaty to send one of your national to

be accredited to my Celestial Court and to be in

control of your company’s trade with China, this

request is contrary to all usage of my dynasty and

can not possibly be entertained. Our ceremonies

and code of laws differ so completely from your

own that even if your envoy were able to acquire

the rudiments of our civilisation you could not

possibly transplant our manners and customs on

your alien soil. [regarding the import of industrial

goods from England] I set no value on objects

strange or ingenious and have no use of your

country’s manufactures. (Toynbee, 1946)

This letter was written by the Chinese Emperor

around the year 1780. The views about racial

superiority are of course not the monopoly of any

one culture. Listen to what Abu-Rayhan al Birauni,

one of the greatest Muslim intellectuals, astronomer,

mathematician, historian (973 ± 1048) who visited

India a number of times with the armies of Mahmud

of Ghanzi, had to say about the people of India in his

famous `Book of India’ :

The Indians believe that there is no country but

theirs, no nation like theirs, no king like theirs, no

religion like theirs, no science like theirs . . . They

are niggardly in communicating what they know

and they take the greatest possible care to withhold

it from any foreigner . . . When sometimes they

® nd out about my knowledge of mathematics and

astronomy, they assume that I must have learnt it

from an Indian and they immediately ask me who

was my `Guru’ .

Toynbee (1946) stated `What will be singled out as

the salient event of our time by future historians

looking back at the twentieth century say in the year

2046? Not, I fancy, any of those sensational or

catastrophic political and economic events which

occupy the headlines of our newspapers today . . .

The future historians will say, I think, that the great

event of twentieth century was the impact of Western

civilisation upon all other living societies of the world.

They will say that of this impact that it was so powerful

and pervasive that it turned the lives of all its victims

upside down and inside out, affecting the behaviour,

outlook, feeling and belief of individual men, women

and children’ .

What will happen still later in the centuries to

follow? Here the views of Arnold Toynbee are even

more interesting. He foresees that `By that time, the

victims will have produced tremendous counter effects

in the life of the aggressor . . . The impact of the

Western civilisation on its contemporaries in the

second half of the second millennium of the Christian

era, will be regarded as the epoch making event of

that age because it was the ® rst step towards the

uni® cation of mankind into one single society’ .

This analysis of Arnold Toynbee is very relevant for

understanding the cultural con¯ icts of our times. The

process of `counter effect’ of other cultures on Western

culture about which Toynbee thought would take a

long time to come, has probably already started much

earlier. Towards the end of this century science no

longer seems to occupy that exalted position as a

panacea for all the life’s problems. The irony is that

Western culture, the originator of modern science, is

itself having serious doubts about the dominant place

of science in life.

Two recent examples are worth discussing. The

® rst one is the phenomenal success of the book `The

Celestine Prophecy’ by James Red® eld published in

1994. Since its publication it has remained almost

continuously on the best-seller list. One is puzzled by

the popularity of the book. It is the story about an

ancient manuscript discovered in Peru with nine

`insights’ . The thin story revolves around how the

hero goes to Peru in search of the ancient manuscript,

how various coincidences occur and how one by one

94 Narendra N.Wig

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he discovers nine `insights’ . The author seems to

convey that by studying these insights we can become

more spiritual, transporting ourselves to a higher plane

of being. Rarely a book on philosophy or `Do-it-

yourself-spir itualism ’ as some people have called it,

has been so successful in the US. It is being translated

into over 20 languages. A follow-up book `Celestine

Prophecy Ð An Exper iential G u ide’ has a lready

appeared. Audio and video tapes are available. A

journal has been started.Training courses in different

cities are being organized by the author and his wife.

Critics who in the beginning ridiculed the book as

literary trash are now seriously examining how the

book has attained so much success and popularity.

One critic said that this book has `tapped into the

spir itual hunger of a beleaguered world. A huge

number of people today are dissatis® ed with old ways

of looking at the world. They want more out of the

world’ . Randall Balmer, a professor of religion at

Columbia University said, `After an era in which we

were ® xated with science and technology we are now

realising that although they made our lives easier,

they did not teach us how to live’ .

A round the same time, when `The Celestine

Prophecy’ was making a big splash in the US and was

being considered as a symbol of new spir itual

awakening , there was a meeting of leading US

scientists at the New York Academy of Sciences in

June 1995. The title of the meeting was `The Flight

from Science and Reason’ . Defenders of scienti® c

methodology were urged to counter-attack against

faith-healing, astrology, and various other kinds of

non-scienti® c creeds and practices. Scientists seems

to be in an aggressive mood. Dr Gerald Weissman of

New York University Medical Centre said, `Medicine

and Science today are being confronted by lunatics,

fascists and the practitioners of magic’ . Dr Saul Green

formerly of Sloan Kettering Cancer Institute, New

York, declared that `It is time to get nastyÐ to launch

a crusade against quackery’ (New York Times, 6 June

1995).

It seems that the intellectual climate is changing

fast. Science which was earlier considered supreme is

now suddenly on the defensive. The people all over

the world are now talking about `alternatives’ to

science, alternatives to modern medicine and so on.

Three factors may have played an important role in

this development. The ® rst is that though achieve-

ments of science continue to dazzle, people are now

seriously worried about the heavy price which science

demands in terms of destruction of natural resources

and pollution. Its more malign creations like the

nuclear weapons have made people doubt its value

and question its virtue. The second factor is that

though science continues to proclaim its `neutrality’

and `objectivity’ the people from the non-Western

societies see science predominantly as a symbol of

Western civilization and not free from cultural bias. It

is useful to view Lock’s perceptions; `Much recent

research shows that the Western Scienti® c endeavour

is a product of speci® c historical and cultural contexts

. . . Analysis of knowledge and practice in health care

sciences reveals the extent to which psychiatry and

psychology as it is understood today are culturally

dependent. One must accept the European Enlighten-

ment concept of ``mind’ ’ and its relationship to

`̀ body’ ’ , usually now embellished by a Freudian style

unconscious or some variant of this concept’ (Lock,

1993).

The third and perhaps the most prominent factor

is that science has produced a vacuum in our spiritual

life. Science has inspired a vision of the universe, of

the world and of man, that was utterly opposed to all

preceding versions. It has denied man the possibility

of ® nding an ultimate meaning and purpose of this

life.

Bryan Appleyard recently writing under `Post

Scienti ® c Society’ in New Perspective Quar terly

(1993) observed that `By insisting on an open ended

view of the world, liberal science based societies, deny

the possibility of any stable conviction or positive

virtueÐ only bland tolerance. But the soul of man

requires explanations and guides for living . . . It is

any wonder that pious Muslims on the upsurge ® nd

our liberal societies so incomprehensible in their moral

laxity and tolerance of anything that came along? Are

they right in their suspicion that though the scientific

West has triumphed economically and politically we

may now be sinking beneath the weight of our own

impiety?’ .

The Japanese philosopher Takeshi Umehara has

gone even further and has written that the collapse of

Marxism, which was only a side current of modernity,

was the precursor to the collapse of secular liberalism,

the main current of modernity. Both excommunicated

`the other world, the world of spir it’ .

Where do we go from here? My own conviction is

that we are moving towards some kind of merger of

scienti® c and spiritual cultures, though at present it is

very difficult to say how it will come about. May be

the initiative will come from science itself. Science by

its ver y nature is constantly chang ing . O ne

generation’s certainty is quite likely to be overthrown

by the next. New developments in scienceÐ chaos

theory and quantum physicsÐ actually open the way

for the reinvigoration of the religious imagination, of

piety, of virtue, because they reintroduce complexity

and eliminate reductionsim in science. Above all, they

promise to restore man to his precopernican identity,

rescuing him from the role to which he was assigned

by nineteenth century science as a mere speck among

others in the vast stretches of time and space.

Mental health and spiritual valuesÐ moving

towards a synthesis

There is no perfect de® nition of mental health accept-

able across all cultures. De® nitions differ, according

Mental health and spiritual values 95

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to the point of view of the one who is de® ning it. Still,

there is a broad argument in most of the de® nitions

to include under the term mental health, a state of

harmony within the individual and harmony between

the individual and others around him. There are

common pitfalls in trying to de® ne mental health.

First of these, is to believe that mental health or

somatic health can exist on its own. Health is indivis-

ible. Next is the belief that mental health and mental

illness are mutually exclusive. Health is always present

regardless of the presence of disease: as the skies are

present in spite of the clouds on the horizon (Sarto-

rius, 1988).

Is it necessary to include spiritual dimension in our

attempts to de® ne mental health? Perhaps it may not

be necessary if we are satis® ed to work with a limited

medical model and de® ne health as merely absence

of disease but to most of us especially those who are

involved in the long-term care of the mentally ill, or

promotion of mental health, such limited de® nitions

are not sufficient.When we consider mental health as

a harmony within the individual and with the environ-

ments outside I think we are talking in spiritual terms.

Furthermore, whatever be the debate among profes-

sionals, for a common man, the ideal state of mental

health has always a spiritual connotation. Roland

(1988) has proposed a four part structural theory of

the self that includes: (1) familial self; (2) individual-

ized self; (3) sp ir itual self; (4) expanding self .

According to Roland the spir itual self , which Freud

ignored , remains `deeply engraved in the

pre-conscious of all Indians’ . He further states that

`to interpret spir itual strivings, merely as a manifesta-

tion of psychological con¯ ict, would be grossly

misleading’ .

Science and spirituality

Mental health professional must accept both science

and spiritual values as essential ingredients for

understanding another human being and to help

him/her.Traditionally mental health has been a bridge

between medical sciences and humanities.This special

position should not be given up. A secular medical

science without a spir itual basis slowly tends to

become mechanized and dehumanized. For example,

in all cultures, uncontrolled emotions like fear, anger,

lust, greed are considered bad for the happiness of

the individual and the society. In European psychiatry

we have arbitrarily taken two emotional states, i.e.

anxiety and depression and in keeping with the tradi-

tion of modern secular techno-medicine, raised these

to the status of mental disorders. If excess of anxiety

or excess of depression is a mental disorder, why

excess of anger, or excess of lust or excess of greed

shou ld not be regarded as m ental disorders?

Incidentally, who bene® ts from such classi® cations?

The maxim um bene ® t of course goes to the

pharmaceutical industry. No sooner do psychiatrists

label anxiety or depression as diseases, the industry is

out with the `anti-anxiety’ and `anti-depressant’ drugs

or designer drugs.

The standard dictionary phrases for spiritual like

`a system which affirms the existence of immaterial

reality imperceptible to senses’ or `any philosophy

accepting the notion of an in ® nite personal God or

immortality of the soul’ do not seem to cover all the

various ways in which the term is understood. What

is therefore, the essence of spir ituality? In some ways

it is nothing, and in some ways it is everything. As

Tao Te ChingÐ the great Chinese book of wisdom

states (trans. by Stephen Mitchell):

We join spokes together in a wheel,

but it is the centre hole

that makes the wagon move.

We shape clay into a pot,

but it is the emptiness inside

that holds whatever we want.

We hammer wood for house,

but it is the inner space

that makes it liveable.

We work with being,

but non being is what we use.

Conclusions

The central theme in spir itual approach to life is that

there is an essential mystery at the heart of all things.

This mystery cannot be understood but has to be

experienced. From the experience of this mystery we

get this urge for `transcendence’ , which is the essential

feature of all spiritual approaches. In the past, mythic

images in all cultures, partly ful® lled this human need.

One sad thing in our times is the slow erosions of our

mythologies and their place in our lives.

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APPLEYARD, B. (1993). Post scienti® c society, New Perspec-

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body and Utopias of health. Margaret Mead MemorialLecture. Proceedings of WFMH 93 Congress, Japan.

M ITCHEL, S. (1988). Tao Te ChingÐ A New English Version.London: Harper and Row.

RADHAKR ISHN AN , S. (1964). The B ook of Indian Philosophy.Bombay: Bharatiya Vidya Bhewan.

RADHAKR ISHN AN , S. & MOO RE, C. (Eds) (1967). A source

book in Indian Philosophy. Princeton, New Jersey, Prince-ton, New Jersey, Princeton University Press.

RE DFIELD, J. (1994). The Celestine Prophecy. New York:Warner Books.

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