Collaborative and Indigenous Mental Health Therapy

Collaborative and Indigenous Mental Health Therapy
Tataihono – Stories of Maori Healing and Psychiatry
By Wiremu NiaNia, Allister Bush and David Epston
Routledge Publishing, New York
2017
ISBN: 978-1-138-23028-6.
Reviewed by Susan Tomlinson
It’s an unlikely relationship. A child psychiatrist, and a traditional indigenous healer and yet somehow, they’ve made it work with astonishing results.
This book examines the collaborative working relationship between two mental health practitioners with entirely opposed worldviews. Child psychiatrist, Allister Bush and traditional New Zealand Maori healer, Wiremu NiaNia write about their work together in this extraordinary and unusual book, Tataihono, Stories of Maori Healing and Psychiatry.

We exist in our echo chambers on social media, and increasingly spend so much time talking and listening to other people who agree with us, we have forgotten how to have an honest and open dialogue with those who oppose our views

Increasingly, we live in a world of polarities. A world where the clash of opposing ideas, with no scope for understanding the other person’s position has become the new norm. We exist in our echo chambers on social media, and increasingly spend so much time talking and listening to other people who agree with us, we have forgotten how to have an honest and open dialogue with those who oppose our views. We have forgotten how to debate and work with people who have completely different world-views from our own and the world is a poorer place for it.

That’s why this book and the working relationship between NiaNia and Bush feels so hopeful.

The interface between the opposing world-views of science and indigenous knowledge have often been a hotbed of complete and utter disagreement, lack of respect and even mutual ridicule. But as these two entirely different world philosophies are brought together in this work, the differences are replaced by something bigger than each of them.

divergence can be replaced by a synergy

As New Zealand Emeritus Professor of Maori studies, Sir Mason Durie puts it: “Too often mental health treatment and care have focussed exclusively on the mind without due consideration for wairua (spirit), tinana (body) or whanau (family). Similarly traditional indigenous healing has often been largely associated with spiritual renewal, though not necessarily with health gains in other dimensions. The divergence can be replaced by a synergy that dwarfs the scope of either acting alone.”

The book is written through a number of case studies from the Te Whare Marie, the Maori and Pacific Island mental health service based near Wellington, New Zealand, where Bush and NiaNia work together. And what’s brilliant, is that each case study is written from several points of view: Bushs’s, NiaNia’s, the individual who has the mental health issue and their family members. There are often direct transcripts, particularly of NiaNia’s healing sessions, which show his spiritual knowledge and skills in action. Sometimes he is tapping into unresolved intergenerational or ancestral issues, often from many, many generations back that he senses is playing out in the individual today. Sometimes he will feel a “presence” within the person, and very often as he puts it, there needs to be a “process of forgiving and releasing past unresolved hurts or offences.” Sometimes the individual may be hearing voices or having hallucinations that simply don’t fit neatly into a psychiatric framework and diagnosis of psychosis, it is at this point where NiaNia’s spiritual outlook, and Bush’s open mindedness work together.

As NiaNia puts it: “I am descended from a long line of seers…Since I was young I have often seen things, heard things: or even felt, tasted and smelt things that others were unable to see, hear, feel, taste or smell. Consequently, I would be in danger of being misdiagnosed. I could have been labelled as having hallucinations or being psychotic. When I say this, I’m not suggesting that mental illness doesn’t exist. But far too often the wairua side, the spiritual side, has gone unrecognised, which has had very negative outcomes for us as Maori.”

Tataihono (as in the title of the book), means reparation, reconciliation, collaboration and connection

This book shows that through reaching out to each other in mutual trust and respect, much healing can take place. And not just for the individuals with mental health issues and their families but also culturally too.

There is a Maori saying “Apiti hono, tatai hono,” which translated means: “Let that which has been joined remain intact.” Tataihono (as in the title of the book), means reparation, reconciliation, collaboration and connection. As NiaNia puts it: “It is about a binding together, a kind of spiritual binding that gives unity and strength.” He goes onto add that in this case, Tataihono is an active process whereby Maori and Pakeha (those descended from the English) have not only opposing points of view in culture but that the past colonial history has meant “we had to find a way to reconcile and forgive those things that have taken place between our cultures.” So there was not just the potential barrier of opposing views but also the need to acknowledge the acrimonious recent New Zealand history between NiaNia’s Maori culture and Bush’s Pakeha culture.

collaboration requires a willingness to acknowledge that neither approach has all the answers.

So how did the two approaches manage to merge so successfully?

This analysis of Bush’s and NiaNia’s collaboration from Durie: “Three principles for collaboration stand out. First the temptation to understand the other by using, for example the tools of science to “explain” indigenous approaches, or using indigenous worldviews to comprehend scientific approaches, lead nowhere. Mutual respect is necessary.

Secondly, collaboration requires a willingness to acknowledge that neither approach has all the answers. Thirdly, in the end the purpose of any healing process is to benefit the patient, using methods that most align with each case.

Therein lies the challenge – to determine which approach is likely to be the most appropriate and whether there is an indication for the application of both in parallel.”

The deep collaborative nature of their work together, has left me intrigued about the potential for healing for those with mental health issues in other cultures. I am left wondering what this collaboration could look like if it was extended beyond the Maori and Pacific Island communities. Could it work in Pakeha and other cultures? What would a spiritual framework for mental health look like if it was based on this kind of collaboration and extended across the world? The book has left me with the distinct impression that by embracing unity between the polarised frameworks of science and traditional medicines, a new collaborative framework for mental health could be realised. One that brings hope and that could foster new ways of working and healing.

 

 

 

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