Paper short abstract:

This paper will use a Tibetan case study of 'madness' from fieldwork conducted in North India to examine the relationship between local and biomedical categories of mental illness, and investigate how these divergent approaches play out in terms of treatment, prognosis and community understanding.

Paper long abstract:

To what extent are Tibetan medicine and biomedical systems analogous in terms of the classification, diagnosis and treatment of mental illnesses, and where do they diverge? Research has suggested a certain amount of 'overlap' between these two systems in terms of symptoms; but with widely divergent perceptions of causation, contemporary Tibetans' explanatory models of mental illness and health-seeking behaviour frequently encompass a patchwork of Tibetan Buddhist, 'folk-religious' and Tibetan cultural concepts, as well as biomedical ones. Furthermore, as each system reflects a particular view of personhood and the individual's place in, and relationship with, the world, divergent aetiologies highlight the significantly different - and sometimes contradictory - perspectives on mental illness which inform illness management and health-seeking behaviour. This paper will illustrate the frequently complex interplay between multiple nosological and aetiological systems in the Tibetan context through the description of a case of 'madness' (Tib.: smyo nad) from ethnographic fieldwork conducted within a Tibetan exile community in North India. It will examine the multiple explanations for his condition commonly held by the community, including 'karma' resulting from the theft of religious artefacts, spirit possession and 'psychosis'; and what these perspectives mean in terms of treatment (or lack of), prognosis and understanding within the community. It will explore how patients and their families navigate a pluralistic medical system in the Tibetan context in their search for meaning and treatment in the event of severe mental illness.