Temple-healing in South India

Sir,

Temple-healing is an important part of traditional care in south India. Persons with psychotic disorders were found to improve in the “supportive, nonthreatening” environment provided at a temple.[1] While the earlier finding of a better outcome of psychosis in “developing countries” has been attributed to psychiatric pluralism;[2] the high rates of psychiatric morbidity and suicide in India, highlights the presence of significant barriers to access of medical care, lack of acceptance of a biological model of psychosis, and a strong belief in faith and religion as a means to overcome psychological distress.[3] It is hence conceivable that models of care that combine medical treatment with traditional practices (such as the Dava-Dua project in Mehsana, Gujarat, and the combined medical care and temple-healing at Gunasheelam, Tamil Nadu[4]) may be better positioned to deliver culturally-sensitive, and less-stigmatized care. The purpose of this letter is to highlight specific temple-healing practices at Chottanikara temple in south India and to draw attention to an under-studied tradition that has been impacted by a Western model of care.[5]

Chottanikara Bhagavathy temple, located in Ernakulam district of Kerala, is famous for the treatment of persons with psychiatric disorders. The temple is particularly sought after for the cure of possession states. The process of temple-healing is overseen by the “Melshanthi” or high-priest.

The following facts about temple-healing at Chottanikara are notable:

1. The temple priests are well attuned to local “idioms of distress” and categorize illnesses as those of “Paedi” (caused by fear/anxiety), “Cheeta” (caused by bad thoughts/guilt/bodily deficit) or “Prethum/Thullal” (possession states)

2. The prescribed temple-healing varies according to the category of illness and is also individualized to the patient. Persons with “paedi” are given amulets, persons with “cheeta” are prescribed chants and rituals at other temples; those with “pretham/thullal” are asked to participate in “Guruthy,” an evening prayer session with an accompaniment of drum-beats and chanting during which the Goddess is said to possess the bodies of the disciples and rid them of evil spirits

3. In the case of “possession states” the Melshanthi asks the person what it would take for the “spirit” to leave the body. Unresolved issues and areas of distress are revealed by this process. The absence of the use of punitive techniques or branding in the healing process is noteworthy

4. The priests encourage patients to seek medical advice and to continue medication prescribed to them to improve sleep and enable patients to comply with the rituals of temple-healing. Patients who don't improve within 3 days are also referred for psychiatric care.

An understanding of the specific components of temple-healing that afford benefit is equally important and may go beyond just the fact that the temple provides a “supportive” environment. For example, the continuous repetition of a chant, the task of walking barefoot over the hard rock and gravel of the temple and the inescapable sensory stimulation from sounds at the temple premises, in addition to the placebo response that comes with strong religious faith may all contribute to the healing process. It is likely that a certain subpopulation of patients gains greater benefit with temple-healing than others. An understanding of the factors that differentiate these individuals from others and the identification of those individuals would allow us to devise a more culturally-sensitive treatment plan. In addition, traditional healers can play an important role in the referral of patients with major psychiatric disorders to psychiatric services.[4] The case of Chottanikara temple may, of course, be an exception rather than the rule, but merits further inquiry.

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Conflicts of interest

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