Home
Pr Jilek Reflections
By Wolfgang G. Jilek
The World Congress of Cultural Psychiatry 2009 was for me a journey into the past. Not only because it was held in the ancient Roman city of Nursia, but also because I presented a paper on the early history of cultural psychiatry, and because it afforded a reunion with old friends with whom I have shared the growth of our discipline in the past decades. After the Congress, the journey went further into the past when Louise and I visited Castello Miramar near Trieste, where one of my ancestors, Dr. August Jilek, had stayed in the 1860s as personal physician to Archduke Maximilian, the ill-fated Emperor of Mexico. Dr. A. Jilek, Marine-Stabs-Arzt [staff physician] in the Imperial Austrian Navy, sailed around the world on the frigate Novara. His memoirs in my grandfather's library had stimulated my early interest in exotic lands and peoples, together with the old tomes of Lander und Volker-Kunde. Fascinated with heraldic emblems, as a young boy I collected cards with pictures of arms and flags. In later years this led to my research publications on symbols and their psychological effect.
Before World War II, I met visitors and patients from all over Europe at the private sanatorium where my father, Dr. Oscar Jilek, physician-in-chief, had introduced natural and psychological therapies to treat psychosomatic conditions. My father was an Austrian officer in World War I, when he met a young nurse, who later became my mother. During World War II, he was drafted into the German army as a medical officer. In the last war year we lost our home, and in the post-war chaos my mother, with us two teenage boys, drifted around central Europe. I had to change high schools several times but finally managed to complete secondary education in 1948 with the final exams at a Gymnasium in Munich. I was lucky to receive a passing mark in math thanks to the generous old teacher who knew of my excellence in other subjects and had read my literature essay on Dr. Faustus and the Modern Man. I therefore could not immediately enter medical school and enrolled for one year in courses of German and English literature, history, geography, and psychology at Munich University, while working as a part-time Werk-Student, which I had to do throughout my university years. Later, I felt this one year prepared me well for my career. I started medical school in 1950 and, like students in the past, went from one university to another: Munich, Innsburck, and Vienna.
As a student, I travelled through Europe and the Near East on a shoestring budget. I was active in the Austrian Socialist Student Association and participated in summer courses and international camps in England and Yugoslavia. In Vienna I was exposed to many experiences of the city's academic and artistic life. Besides the obligatory medical courses, I heard lectures on the history of medicine, psychoanalysis, Adlerian individual psychology and Volker-Psychologie. But it was the clinical teaching of Viktor Frankl that made the deepest impression on me. Frankl remained my lifelong mentor and friend. I have found his logotherapy, conceived while he went through the ordeal of Auschwitz, to be the one psychotherapeutic approach useful with patients of all ethnic-cultural backgrounds. During my service with UNHCR in Thailand, I composed a field guide for mental health workers that contained a sketch of Frankl's logotherapy for counselors in refugee camps. I was proud when Frankl wrote me in his letter of November 19, 1989. I must say that I have rarely had the opportunity to find logotherapy presented so precisely, so concisely, on such a small space, and yet very accurately conveying its essential concerns; I find his formulations brilliant!
After graduating as M.D. in 1956 and [completing] one year of internal medicine and neurology in Austria, I left for a rotating internship in Chicago. Upon completion I toured the western States, Mexico and Central America, learning Spanish on the way. Then I decided to venture into psychiatry and entered a residency at a New York state hospital. At the Upstate Medical Center in Syracuse, N.Y., I attended seminars by M. Hollender. His concept of hysterical psychosis-a term coined by Morel in Paris 1860-later alerted me to the transient psychotic reactions observed in persons fearing magical persecution, [found] among Mediterranean migrant workers in Switzerland and African and South Pacific populations. In a letter commenting on our article on transient psychoses (Jilek & Jilek-Aall 1970), M. Bleuler considered them [psychotic reactions] to be intermediary forms between schizophrenias and reactive emotional shocks; in a similar letter, H.B.M. Murphy thought they represent a rejection or abandonment of ego control under difficult conditions. The years of 1960 to 1963 turned out to be of considerable consequence for my future.
In Zurich, I trained under M. Bleuler at the Burgholzli Klinik, under K. Ernst at its affiliated Nerven-Sanatorium, and under H. Landolt at the Swiss Institute of Epilepsy. At the Burgholzli, Bleuler and E. Bohm taught the Rorschach Test, which I later found quite useful in interviewing patients of diverse cultural backgrounds. I heard lectures at the C.G. Jung Institute and studied Jung's works; I consider his constructs of archetypes and the collective unconscious as relevant to cultural psychiatry.
My most important experience in Zurich was that I met at the Burgholzli a young Norwegian colleague, Louise Aall, who would become my irreplaceable life companion and partner in profession and research. She had just returned from years of work in Africa as a doctor in the bush of Tanganyika (now Tanzania), an assistant to Dr. A. Schweitzer in Gabon, and a UN medical officer in the Congo. On a weekend excursion on Lake Zurich, Louise told me of the epilepsy clinic she had organized in the remote Mahenge area of Tanganyika, where the patients waited for her to return. My offer to accompany and assist her, which was not primarily motivated by professional and scientific interest, surprised Louise. She had not been able to secure support for her clinic and for research into the causes of the high prevalence of epilepsy in that area. In fact, such research had to wait until the 1990s when Louise's publications on neurologic and psychiatric symptoms of epilepsy in this area, including the hitherto unknown head nodding syndrome, were finally acknowledged and she was able to organize research projects in Tanzania, still ongoing.
In 1962 we obtained a small grant from a pharmaceutical lab to gather plants of anticonvulsive potential in Tanganyika. In the few months available to us, we examined new patients at Louise's clinic and identified, collected, and dried bush plants with the help of a medicine man. As doctors assisting the local people, the traditional healers and diviners readily informed us of their concepts of mental illness and its treatment. Meanwhile, comparative and ethno-psychiatry-somewhat dormant since Kraepelin's time-had aroused renewed interest in Europe, and our reports were soon published. We already knew of the new Section of Transcultural Psychiatric Studies at McGill University, Montreal, and its Review and Newsletter, which in 1962 carried a report by Louise on epilepsy in Tanganyika.
The McGill Transcultural Psychiatric Research Review has been the leading organ of our discipline under the editorship of E. Wittkower and Murphy, continued by R. Prince and L. Kirmayer, and we were frequent contributors. I was asked to review two pivotal works for the TPRR: Murphy's Comparative Psychiatry and W. Pfeiffer's Transkulturelle Psychiatrie; I wrote the preface for this German handbook of cultural psychiatry.
In 1962, Louise and I had independently contracted Wittkower who invited us to enter the McGill Diploma Course in Psychiatry. We quickly arranged for our weddings-one in Oslo, the other in Vienna-and sailed for Canada to start the Diploma Course in 1963. This course was a unique learning experience with teachers like Wittkower, Murphy, H. Lehmann, and fellow students, like R. Wintrob. In 1964 we traveled to Haiti to study Voodoo healing rituals. We had little money, but Wittkower recommended us to L. Douyon in Haiti, who arranged contracts with Voodoo priest-healers. In the healing shrines of this syncretistic religion, we encountered pictures of Catholic saints representing West African deities, and spirit-laden holy trees to be touched the patients. As H. Ellenberger in Montreal later advised us, these Voodoo trees had been charged with animal magnetism by the former French plantation owners, students of Mesmer, for the benefit of their slaves. We documented Voodoo rituals on photo and film.
In my last year of the Diploma Course, as a research fellow at the Queen Mary Veterans' Hospital, I investigated the residual syndrome of veterans receiving Canadian Government benefits for psychiatric illness. My research was conducted under the strict supervision of Murphy, who then also acted as thesis adviser of my M.Sc. degree in social psychiatry. After completion of our exams in psychiatry at McGill University and the Royal College, and lastly also for the Medical Council of Canada, we spent one year doing neuropsychiatric research and upgrading our French at the Institut de Recherches Psychiatriques in Joliette, Quebec. We then decided to settle in British Columbia, mainly because of its beautiful scenery, although we would have had better academic chances at McGill, as letters by Murphy and Wittkower assured us.
However, both these former teachers became our friends; they visited us in our new home and were most supportive with advice and recommendations. From 1966 to 1975 we were the only psychiatrists in the Upper Fraser Valley for a population of varied ethnic-cultural backgrounds: Anglo-Canadians, immigrants from continental Europe, and indigenous people. This cultural mosaic offered a unique opportunity for research in transcultural psychiatry. We examined and analyzed the prevailing symptom formation in well-defined cultural groups: Dutch Reformed, Germanic Mennonite, Russian Doukhobor, and the Coast Salish Indians, who became the main focus of our ethno-psychiatric investigations. We were well accepted by the indigenous people, especially by their elders and Indian doctors whose knowledge of traditional rituals and healing had survived the era of suppression by government and church authorities. As their physician friends, we witnessed the revival of the Salish winter spirit ceremonial in the native renaissance of the 1960s and 70s in North America (Jilek 1978). We reported on its therapeutic benefits, in particular for young indigenous people, victims of what I described as anomic depression characterized by loss of traditional norms, cultural identity confusion, and relative deprivation (Jilek 1974). Through personal acquaintance with the ritualists, we were able to observe ceremonial dances, potlatches, and healing procedures amongst the Coast Salish and other Amerindian nations along the Pacific Coast from Washington State to Alaska.
In 1974 I was finally appointed to the faculty of the University of British Columbia through M. Miller, its first head of psychiatry showing interest in socio-cultural matters. Our close contacts with indigenous elders along the B.C. coast were made possible through our active role in the U.B.C Psychiatric Outreach consultations. We also volunteered for the State of Alaska alcohol prevention project among North Alaskan Eskimos, based at Nome and St. Laurence Island. Later we learnt about arctic populations in general through participation in Circum Polar Health Congresses, where we first met our tour friend, C. Korolenko, a cultural psychiatrist in Siberia.
To theoretically underpin our fieldwork, we had taken courses at the U.B.C. Department of Anthropology-Sociology, while also working at the hospital, mental health center and private office. We achieved the M.A. degree in social anthropology, with research theses that formed the basis of later publications. We also studied the theory and methods of the structural anthropology of Claude Levi-Strauss, member of the Academie Francaise. When he visited B.C. in the 1970s to continue his analysis of Amerindian mythology, we arranged for him to meet a Salish chief and key informant at our home, and elder ritualists at a Salish spirit dance ceremonial. Levi-Strauss cited and credited us with being "grands connaisseurs de la culture salish" in his work la Voie des Masques (1979; p. 52).
In A. Favazza's innovative Journal of Operational Psychiatry, we published a paper on our collaboration with traditional Amerindian therapists (Jilek & Jilek-Aall 1978). We both have been privileged to have in M. Bleuler a friend and adviser all through our careers. When he came to visit us, we made excursions along the Northwest Coast to meet indigenous elders, among them the old Salish shaman Isidor Tom. In his foreword to my book (Jilek 1982), Bleuler wrote: "I have known Wolfgang Jilek and Louise Jilek-Aall since they trained with us in Zurich as young physicians . . . Some years ago I traveled the North Pacific Coast together with the Jileks, visiting the beautiful homeland of the Indian nations. I was intrigued by the rich symbolism of their oral traditions, the noble greatness of their art, the psychological wisdom of their elders, and I shall always treasure the memory of my encounters with them." Encouraged by Wittkower and Murphy, I organized and chaired throughout the 1970s the Section on Native Peoples Mental Health of the Canadian Psychiatric Association, which held Transcultural Workshops in several provinces of Canada, as platforms for discussions of indigenous leaders with mental health professionals.
Our involvement with WPA began in 1971 when Murphy invited us to present papers at the 5th World Congress of psychiatry in Mexico City, together with R. Wintrob and W.S. Tseng. Murphy then organized the Transcultural Psychiatry Section of the WPA in which we have been active ever since. In the October 2006 issue of the WPA/TPS Newsletter (pp.1-5), I gave a full account of the history of this WPA Section in which I served as Secretary from 1983 to 1993, and as Chairman from 1993 to 1999, editing the T.P. Newsletter and organizing Symposia in many countries, together with Tseng, F. El-Islam, and local colleagues. In my memory stands out the two-tier symposium held 1994 in Pakistan and India when we brought colleagues from these hostile countries together in a friendly encounter.
The 1970s, 80s, and 90s were times of wide travel for international assignments, ethno-psychiatric explorations, meetings, and guest lectures at many universities in the Americas, Europe and Asia. I treasure the memory of the hospitality of friends like G. Bartocci, Tseng, J. Obiols-Llandrich, and other colleagues. We twice toured South America for information on traditional therapies. I remember well these experiences of the 1970s: in Ecuador the alcohol-deconditioning by curanderos of the Colorados Indians; in Peru the reunion with our McGill colleague A. Perales; our encounters with F. Sal y Rosas, C. Seguin, and F. Cabieses; our participation at the 1st World Congress of Folk Medicine 1979, and the ayahuasca healing center in the Amazon; and in Paraguay the shamanic rituals of the Ayoreos in the Chaco bush, close by the Mennonite colonists whom we assisted with plans for a mental health facility. In later years, we took part in informative get-togethers organized by our Latin American friends in Bolivia by M. Hollweg, in Brazil by M. de Noronha, and in Mexico by S.J. Villasenor-Bayardo.
To B. Kimura I owe the introduction to Japanese culture and tradition, to Zen priests, and Morita therapists, in 1973. On a guest lecture tour in Japan 1992, I addressed the Japanese T.P. Section organized by F. Noda. Our daughter, Martica, who as a young child already came with us to congresses, often accompanied Louise and me on our travels; Martica was the youngest participant at the WPA Regional Symposium in China in 1985. We had been to Mao's China before, with a Canadian doctors group invited to marvel at herbal medicine, acupuncture anesthesia, and barefoot doctors. After the symposium in 1985 we examined victims of an epidemic of koro in Sough China with the help of Chinese colleagues (Jilek 1986).
In 1976 we had already observed a koro epidemic on tour of Thailand. In that year I had also encountered pseudo-amok on our first trip to Papua New Guinea with B. Burton-Bradley. In Indonesia, the introduction of our friend W. Pfeiffer, well known for his research in that country, opened many doors for us in Java, Sumatra, and Bali in the 1980s. We obtained ethno-psychiatric information from colleagues and traditional healers (duckun), became acquainted with latah and other trance states, and filmed the therapeutic horse-spirit possession dances. Later in Malaysia, our friend W. Krahl facilitated my recording of the Hindu trance rituals taipusam and mariaman of devotees undergoing sacrificial ordeals. N. Sartorius, Director WHO Mental Division, recommended me for international service.
From 1984 to 1985, I served in Papua New Guinea as a Consultant in Mental Health, visiting all provinces of this country of ca. 500 ethno-cultural groups, providing teaching and assistance to health staff and primary care workers, also at remote outposts. In contacts with indigenous healers and diviners I gathered information on traditional medicine and psychotropic plants, and interviewed cargo cult prophets and adherents. Once I climbed a mountain peak to a dream house where diviners received diagnostic advice from spirits while dreaming. I also initiated mental health workshops, with input from traditional practitioners. Finally, I edited for WHO a volume on traditional medicine in Papua New Guinea (Jilek 1985).
As metal health consultant to the Minister of Health of the Kingdom of Tonga in 1987, I consulted in hospitals, devised teaching programs, conducted epidemiological surveys, and collaborated with traditional Tongan healers who used medicinal plants and massage to successfully treat patients with psychosomatic and mental disorders, including chronic schizophrenia. Of ethno-psychiatric interest were attacks of avanga, a culture-typical psychotic reaction affecting socially restricted Tongan women believed to be possessed by spirits of the dead (Jilek 1988).
In the years of 1988 to 1989 I was UNHCR Refugee Mental Health Coordinator in Thailand. Together with Louise as volunteer, I assisted NGO staff and refugee health workers in the operation of mental health services in the refugee camps for people traumatized through civil war terror in the former Indochina. In our work with the hill-tribes refugees from Laos, still adhering to a shamanic belief system, we cooperated with Hmong shamans in patient care. I encouraged the shamans to conduct a traditional ritual of appeasing the opium goddess, thereby facilitating detoxification and rehabilitation of opium addicts (Jilek & Jilek-Aall 1990). Knowing of my field experiences, N. Sartorius and J.J. Lopez-Ibor later asked me to write chapters on the role of traditional medicine and culture-related disorders in psychiatry, for handbooks co-edited by them (Jilek 1993; 1995; 2000; Jilek & Jilek-Aall 2001).
I never forgot my European roots. Since the 1970s I have belonged to the Arbeits-Gemeinschaft Ethnomedicine in Germany, together with W. Krahl, A. Boroffka, and E. Schroder, founder and editor of Curare, the outstanding journal of ethnomedicine and transcultural psychiatry in central Europe.
Fond memories bind me with Vienna and its university, where Th. Stompe is known for his research in comparative psychopathology. I am affiliated with the Unit Ethnomedicine of the Medical University of Vienna, headed by our old friend A. Prinz, assisted by R. Kutalek, editors of the Viennese Ethnomedicine Newsletter. In 1999/2000 I taught at this center as a guest professor in transcultural and ethno-psychiatry. I was pleased that my Austrian citizenship, lost when I became a Canadian, was again conferred on me by the Government of Austria in recognition of my scientific merits. Now I am officially standing with one foot in Canada and the other in the European Union.
-Edited by Laurie Neale
The World Congress of Cultural Psychiatry 2009 was for me a journey into the past. Not only because it was held in the ancient Roman city of Nursia, but also because I presented a paper on the early history of cultural psychiatry, and because it afforded a reunion with old friends with whom I have shared the growth of our discipline in the past decades. After the Congress, the journey went further into the past when Louise and I visited Castello Miramar near Trieste, where one of my ancestors, Dr. August Jilek, had stayed in the 1860s as personal physician to Archduke Maximilian, the ill-fated Emperor of Mexico. Dr. A. Jilek, Marine-Stabs-Arzt [staff physician] in the Imperial Austrian Navy, sailed around the world on the frigate Novara. His memoirs in my grandfather's library had stimulated my early interest in exotic lands and peoples, together with the old tomes of Lander und Volker-Kunde. Fascinated with heraldic emblems, as a young boy I collected cards with pictures of arms and flags. In later years this led to my research publications on symbols and their psychological effect.
Before World War II, I met visitors and patients from all over Europe at the private sanatorium where my father, Dr. Oscar Jilek, physician-in-chief, had introduced natural and psychological therapies to treat psychosomatic conditions. My father was an Austrian officer in World War I, when he met a young nurse, who later became my mother. During World War II, he was drafted into the German army as a medical officer. In the last war year we lost our home, and in the post-war chaos my mother, with us two teenage boys, drifted around central Europe. I had to change high schools several times but finally managed to complete secondary education in 1948 with the final exams at a Gymnasium in Munich. I was lucky to receive a passing mark in math thanks to the generous old teacher who knew of my excellence in other subjects and had read my literature essay on Dr. Faustus and the Modern Man. I therefore could not immediately enter medical school and enrolled for one year in courses of German and English literature, history, geography, and psychology at Munich University, while working as a part-time Werk-Student, which I had to do throughout my university years. Later, I felt this one year prepared me well for my career. I started medical school in 1950 and, like students in the past, went from one university to another: Munich, Innsburck, and Vienna.
As a student, I travelled through Europe and the Near East on a shoestring budget. I was active in the Austrian Socialist Student Association and participated in summer courses and international camps in England and Yugoslavia. In Vienna I was exposed to many experiences of the city's academic and artistic life. Besides the obligatory medical courses, I heard lectures on the history of medicine, psychoanalysis, Adlerian individual psychology and Volker-Psychologie. But it was the clinical teaching of Viktor Frankl that made the deepest impression on me. Frankl remained my lifelong mentor and friend. I have found his logotherapy, conceived while he went through the ordeal of Auschwitz, to be the one psychotherapeutic approach useful with patients of all ethnic-cultural backgrounds. During my service with UNHCR in Thailand, I composed a field guide for mental health workers that contained a sketch of Frankl's logotherapy for counselors in refugee camps. I was proud when Frankl wrote me in his letter of November 19, 1989. I must say that I have rarely had the opportunity to find logotherapy presented so precisely, so concisely, on such a small space, and yet very accurately conveying its essential concerns; I find his formulations brilliant!
After graduating as M.D. in 1956 and [completing] one year of internal medicine and neurology in Austria, I left for a rotating internship in Chicago. Upon completion I toured the western States, Mexico and Central America, learning Spanish on the way. Then I decided to venture into psychiatry and entered a residency at a New York state hospital. At the Upstate Medical Center in Syracuse, N.Y., I attended seminars by M. Hollender. His concept of hysterical psychosis-a term coined by Morel in Paris 1860-later alerted me to the transient psychotic reactions observed in persons fearing magical persecution, [found] among Mediterranean migrant workers in Switzerland and African and South Pacific populations. In a letter commenting on our article on transient psychoses (Jilek & Jilek-Aall 1970), M. Bleuler considered them [psychotic reactions] to be intermediary forms between schizophrenias and reactive emotional shocks; in a similar letter, H.B.M. Murphy thought they represent a rejection or abandonment of ego control under difficult conditions. The years of 1960 to 1963 turned out to be of considerable consequence for my future.
In Zurich, I trained under M. Bleuler at the Burgholzli Klinik, under K. Ernst at its affiliated Nerven-Sanatorium, and under H. Landolt at the Swiss Institute of Epilepsy. At the Burgholzli, Bleuler and E. Bohm taught the Rorschach Test, which I later found quite useful in interviewing patients of diverse cultural backgrounds. I heard lectures at the C.G. Jung Institute and studied Jung's works; I consider his constructs of archetypes and the collective unconscious as relevant to cultural psychiatry.
My most important experience in Zurich was that I met at the Burgholzli a young Norwegian colleague, Louise Aall, who would become my irreplaceable life companion and partner in profession and research. She had just returned from years of work in Africa as a doctor in the bush of Tanganyika (now Tanzania), an assistant to Dr. A. Schweitzer in Gabon, and a UN medical officer in the Congo. On a weekend excursion on Lake Zurich, Louise told me of the epilepsy clinic she had organized in the remote Mahenge area of Tanganyika, where the patients waited for her to return. My offer to accompany and assist her, which was not primarily motivated by professional and scientific interest, surprised Louise. She had not been able to secure support for her clinic and for research into the causes of the high prevalence of epilepsy in that area. In fact, such research had to wait until the 1990s when Louise's publications on neurologic and psychiatric symptoms of epilepsy in this area, including the hitherto unknown head nodding syndrome, were finally acknowledged and she was able to organize research projects in Tanzania, still ongoing.
In 1962 we obtained a small grant from a pharmaceutical lab to gather plants of anticonvulsive potential in Tanganyika. In the few months available to us, we examined new patients at Louise's clinic and identified, collected, and dried bush plants with the help of a medicine man. As doctors assisting the local people, the traditional healers and diviners readily informed us of their concepts of mental illness and its treatment. Meanwhile, comparative and ethno-psychiatry-somewhat dormant since Kraepelin's time-had aroused renewed interest in Europe, and our reports were soon published. We already knew of the new Section of Transcultural Psychiatric Studies at McGill University, Montreal, and its Review and Newsletter, which in 1962 carried a report by Louise on epilepsy in Tanganyika.
The McGill Transcultural Psychiatric Research Review has been the leading organ of our discipline under the editorship of E. Wittkower and Murphy, continued by R. Prince and L. Kirmayer, and we were frequent contributors. I was asked to review two pivotal works for the TPRR: Murphy's Comparative Psychiatry and W. Pfeiffer's Transkulturelle Psychiatrie; I wrote the preface for this German handbook of cultural psychiatry.
In 1962, Louise and I had independently contracted Wittkower who invited us to enter the McGill Diploma Course in Psychiatry. We quickly arranged for our weddings-one in Oslo, the other in Vienna-and sailed for Canada to start the Diploma Course in 1963. This course was a unique learning experience with teachers like Wittkower, Murphy, H. Lehmann, and fellow students, like R. Wintrob. In 1964 we traveled to Haiti to study Voodoo healing rituals. We had little money, but Wittkower recommended us to L. Douyon in Haiti, who arranged contracts with Voodoo priest-healers. In the healing shrines of this syncretistic religion, we encountered pictures of Catholic saints representing West African deities, and spirit-laden holy trees to be touched the patients. As H. Ellenberger in Montreal later advised us, these Voodoo trees had been charged with animal magnetism by the former French plantation owners, students of Mesmer, for the benefit of their slaves. We documented Voodoo rituals on photo and film.
In my last year of the Diploma Course, as a research fellow at the Queen Mary Veterans' Hospital, I investigated the residual syndrome of veterans receiving Canadian Government benefits for psychiatric illness. My research was conducted under the strict supervision of Murphy, who then also acted as thesis adviser of my M.Sc. degree in social psychiatry. After completion of our exams in psychiatry at McGill University and the Royal College, and lastly also for the Medical Council of Canada, we spent one year doing neuropsychiatric research and upgrading our French at the Institut de Recherches Psychiatriques in Joliette, Quebec. We then decided to settle in British Columbia, mainly because of its beautiful scenery, although we would have had better academic chances at McGill, as letters by Murphy and Wittkower assured us.
However, both these former teachers became our friends; they visited us in our new home and were most supportive with advice and recommendations. From 1966 to 1975 we were the only psychiatrists in the Upper Fraser Valley for a population of varied ethnic-cultural backgrounds: Anglo-Canadians, immigrants from continental Europe, and indigenous people. This cultural mosaic offered a unique opportunity for research in transcultural psychiatry. We examined and analyzed the prevailing symptom formation in well-defined cultural groups: Dutch Reformed, Germanic Mennonite, Russian Doukhobor, and the Coast Salish Indians, who became the main focus of our ethno-psychiatric investigations. We were well accepted by the indigenous people, especially by their elders and Indian doctors whose knowledge of traditional rituals and healing had survived the era of suppression by government and church authorities. As their physician friends, we witnessed the revival of the Salish winter spirit ceremonial in the native renaissance of the 1960s and 70s in North America (Jilek 1978). We reported on its therapeutic benefits, in particular for young indigenous people, victims of what I described as anomic depression characterized by loss of traditional norms, cultural identity confusion, and relative deprivation (Jilek 1974). Through personal acquaintance with the ritualists, we were able to observe ceremonial dances, potlatches, and healing procedures amongst the Coast Salish and other Amerindian nations along the Pacific Coast from Washington State to Alaska.
In 1974 I was finally appointed to the faculty of the University of British Columbia through M. Miller, its first head of psychiatry showing interest in socio-cultural matters. Our close contacts with indigenous elders along the B.C. coast were made possible through our active role in the U.B.C Psychiatric Outreach consultations. We also volunteered for the State of Alaska alcohol prevention project among North Alaskan Eskimos, based at Nome and St. Laurence Island. Later we learnt about arctic populations in general through participation in Circum Polar Health Congresses, where we first met our tour friend, C. Korolenko, a cultural psychiatrist in Siberia.
To theoretically underpin our fieldwork, we had taken courses at the U.B.C. Department of Anthropology-Sociology, while also working at the hospital, mental health center and private office. We achieved the M.A. degree in social anthropology, with research theses that formed the basis of later publications. We also studied the theory and methods of the structural anthropology of Claude Levi-Strauss, member of the Academie Francaise. When he visited B.C. in the 1970s to continue his analysis of Amerindian mythology, we arranged for him to meet a Salish chief and key informant at our home, and elder ritualists at a Salish spirit dance ceremonial. Levi-Strauss cited and credited us with being "grands connaisseurs de la culture salish" in his work la Voie des Masques (1979; p. 52).
In A. Favazza's innovative Journal of Operational Psychiatry, we published a paper on our collaboration with traditional Amerindian therapists (Jilek & Jilek-Aall 1978). We both have been privileged to have in M. Bleuler a friend and adviser all through our careers. When he came to visit us, we made excursions along the Northwest Coast to meet indigenous elders, among them the old Salish shaman Isidor Tom. In his foreword to my book (Jilek 1982), Bleuler wrote: "I have known Wolfgang Jilek and Louise Jilek-Aall since they trained with us in Zurich as young physicians . . . Some years ago I traveled the North Pacific Coast together with the Jileks, visiting the beautiful homeland of the Indian nations. I was intrigued by the rich symbolism of their oral traditions, the noble greatness of their art, the psychological wisdom of their elders, and I shall always treasure the memory of my encounters with them." Encouraged by Wittkower and Murphy, I organized and chaired throughout the 1970s the Section on Native Peoples Mental Health of the Canadian Psychiatric Association, which held Transcultural Workshops in several provinces of Canada, as platforms for discussions of indigenous leaders with mental health professionals.
Our involvement with WPA began in 1971 when Murphy invited us to present papers at the 5th World Congress of psychiatry in Mexico City, together with R. Wintrob and W.S. Tseng. Murphy then organized the Transcultural Psychiatry Section of the WPA in which we have been active ever since. In the October 2006 issue of the WPA/TPS Newsletter (pp.1-5), I gave a full account of the history of this WPA Section in which I served as Secretary from 1983 to 1993, and as Chairman from 1993 to 1999, editing the T.P. Newsletter and organizing Symposia in many countries, together with Tseng, F. El-Islam, and local colleagues. In my memory stands out the two-tier symposium held 1994 in Pakistan and India when we brought colleagues from these hostile countries together in a friendly encounter.
The 1970s, 80s, and 90s were times of wide travel for international assignments, ethno-psychiatric explorations, meetings, and guest lectures at many universities in the Americas, Europe and Asia. I treasure the memory of the hospitality of friends like G. Bartocci, Tseng, J. Obiols-Llandrich, and other colleagues. We twice toured South America for information on traditional therapies. I remember well these experiences of the 1970s: in Ecuador the alcohol-deconditioning by curanderos of the Colorados Indians; in Peru the reunion with our McGill colleague A. Perales; our encounters with F. Sal y Rosas, C. Seguin, and F. Cabieses; our participation at the 1st World Congress of Folk Medicine 1979, and the ayahuasca healing center in the Amazon; and in Paraguay the shamanic rituals of the Ayoreos in the Chaco bush, close by the Mennonite colonists whom we assisted with plans for a mental health facility. In later years, we took part in informative get-togethers organized by our Latin American friends in Bolivia by M. Hollweg, in Brazil by M. de Noronha, and in Mexico by S.J. Villasenor-Bayardo.
To B. Kimura I owe the introduction to Japanese culture and tradition, to Zen priests, and Morita therapists, in 1973. On a guest lecture tour in Japan 1992, I addressed the Japanese T.P. Section organized by F. Noda. Our daughter, Martica, who as a young child already came with us to congresses, often accompanied Louise and me on our travels; Martica was the youngest participant at the WPA Regional Symposium in China in 1985. We had been to Mao's China before, with a Canadian doctors group invited to marvel at herbal medicine, acupuncture anesthesia, and barefoot doctors. After the symposium in 1985 we examined victims of an epidemic of koro in Sough China with the help of Chinese colleagues (Jilek 1986).
In 1976 we had already observed a koro epidemic on tour of Thailand. In that year I had also encountered pseudo-amok on our first trip to Papua New Guinea with B. Burton-Bradley. In Indonesia, the introduction of our friend W. Pfeiffer, well known for his research in that country, opened many doors for us in Java, Sumatra, and Bali in the 1980s. We obtained ethno-psychiatric information from colleagues and traditional healers (duckun), became acquainted with latah and other trance states, and filmed the therapeutic horse-spirit possession dances. Later in Malaysia, our friend W. Krahl facilitated my recording of the Hindu trance rituals taipusam and mariaman of devotees undergoing sacrificial ordeals. N. Sartorius, Director WHO Mental Division, recommended me for international service.
From 1984 to 1985, I served in Papua New Guinea as a Consultant in Mental Health, visiting all provinces of this country of ca. 500 ethno-cultural groups, providing teaching and assistance to health staff and primary care workers, also at remote outposts. In contacts with indigenous healers and diviners I gathered information on traditional medicine and psychotropic plants, and interviewed cargo cult prophets and adherents. Once I climbed a mountain peak to a dream house where diviners received diagnostic advice from spirits while dreaming. I also initiated mental health workshops, with input from traditional practitioners. Finally, I edited for WHO a volume on traditional medicine in Papua New Guinea (Jilek 1985).
As metal health consultant to the Minister of Health of the Kingdom of Tonga in 1987, I consulted in hospitals, devised teaching programs, conducted epidemiological surveys, and collaborated with traditional Tongan healers who used medicinal plants and massage to successfully treat patients with psychosomatic and mental disorders, including chronic schizophrenia. Of ethno-psychiatric interest were attacks of avanga, a culture-typical psychotic reaction affecting socially restricted Tongan women believed to be possessed by spirits of the dead (Jilek 1988).
In the years of 1988 to 1989 I was UNHCR Refugee Mental Health Coordinator in Thailand. Together with Louise as volunteer, I assisted NGO staff and refugee health workers in the operation of mental health services in the refugee camps for people traumatized through civil war terror in the former Indochina. In our work with the hill-tribes refugees from Laos, still adhering to a shamanic belief system, we cooperated with Hmong shamans in patient care. I encouraged the shamans to conduct a traditional ritual of appeasing the opium goddess, thereby facilitating detoxification and rehabilitation of opium addicts (Jilek & Jilek-Aall 1990). Knowing of my field experiences, N. Sartorius and J.J. Lopez-Ibor later asked me to write chapters on the role of traditional medicine and culture-related disorders in psychiatry, for handbooks co-edited by them (Jilek 1993; 1995; 2000; Jilek & Jilek-Aall 2001).
I never forgot my European roots. Since the 1970s I have belonged to the Arbeits-Gemeinschaft Ethnomedicine in Germany, together with W. Krahl, A. Boroffka, and E. Schroder, founder and editor of Curare, the outstanding journal of ethnomedicine and transcultural psychiatry in central Europe.
Fond memories bind me with Vienna and its university, where Th. Stompe is known for his research in comparative psychopathology. I am affiliated with the Unit Ethnomedicine of the Medical University of Vienna, headed by our old friend A. Prinz, assisted by R. Kutalek, editors of the Viennese Ethnomedicine Newsletter. In 1999/2000 I taught at this center as a guest professor in transcultural and ethno-psychiatry. I was pleased that my Austrian citizenship, lost when I became a Canadian, was again conferred on me by the Government of Austria in recognition of my scientific merits. Now I am officially standing with one foot in Canada and the other in the European Union.
-Edited by Laurie Neale
Submitted on August 15, 2011 in By David.
