Below is an interview with Dr. Thanabalsingam Gadambanathan, senior consultant and specialist in Psychiatry attached to the Teaching Hospital in Batticaloa. He has working experience of collaborating with the practitioners of indigenous and traditional medical systems and followers of varying spiritual and religious beliefs.
The below interview is conducted in the backdrop of the entire world being under the fear psychosis of the Covid-19 pandemic. Hence, the interview looks at the middle ground needed in mental attitude when dealing with the current situation to help citizens and policy makers to shape their decisions so as to ensure mental equilibrium that will enable a better connection between mind and body to facilitate a stronger immunity and healing.
The lack of time and space did not allow for a detailed discussion on the energy frequency aspect of thought processes as detected in disciplines such as metaphysics which although not directly connected with psychiatry examines dimensions connected with the mind through other lenses.
In future interviews with Lankan psychiatrists, psychologists, and self-help promotion speakers we hope to look at aspects of the cosmic mind connection as explained by American psychologists such as Carl Jung and Dr. Joseph Murphy where thought is considered a powerful energy force and is believed to influence our actual reality and change how the cells in our body react.
An interview
The following is an interview with Dr. Gadambanathan he highlights the need to understand the concept of health as being a multi-dimensional construct, encompassing the physical, mental (emotional), intellectual, social, spiritual, environmental,and occupational components.
He said that there is a need to have both the indigenous system and Western systems to complement each other when attending to the healing of the mind and body of a human being.
Q: We can see sometimes that those who have strong minds, who meditate and are confident of their mental power and wellbeing of their bodies rarely succumb to illnesses. Could you specifically comment on the impact ‘meditation’ or ‘will power’ (confidence in their individual immunity) has on the human body in preventing illness. I ask this in a background where few in modern times, especially those in Western medical practise giving importance to this sphere.
A: It is better to understand human health as multi-dimensional that encompass physical, mental (emotional), intellectual, social, spiritual, environmental and occupational components. There is a need to consider the levels of health across all these dimensions when one embarks on improving one’s well-being or in supporting a person to recover from an illness or infirmity.
The indigenous and western medical systems have their inherent strengths and weaknesses. It is essential to update and enrich the systems to make it more effective and holistic. The incorporation of intermittent fasting, mindfulness training to the Western medical practice is a way forward. It is also equally important that whatever measures taken that we need to abide the “do no harm” principle and to have some evidence of them being effective.
Spiritual practices (meditation, yoga) are components that soothes the mind, relaxes the body,empower the individual, and enhance social cohesion.
These positive effects are more obvious in most of us, Sri Lankan’s, who have grown up in a culture that perceives these spiritual practises as protective, supportive and life prolonging from childhood.
The positive energy thus built upon positive thoughts, belief, trust and contentment has the potential to act as buffers against the diverse challenges that create the potential of developing as illness.
Q: In indigenous medical practices such as Sinhala Wedakama/Sri Lankan Ayurveda or Siddha and Unani, there is a very major significance given traditionally to placating the mind of the patient and strengthening their confidence of wellbeing. In Sinhala wedakama this is called ‘Hitha Hadeema’) where the physician will console the patient and assure that all will be well. This seems to be the opposite of the Western medical system where an inordinate measure of fear is often emphasised and in the very first step of taking a medical test the patient is made to feel much fear about the ailment. Your comments?
A: Both western and indigenous medical practices have different foundations that are based upon empathetic and supportive communication. These eases the stress, offer reassurance, and instill hope.
The difference in the perception by the society about the role of practitioners has some influence about the nature of communication. The strength of traditional medical system lies in the fact that it is blended well with traditional foods, cultural practices and at times religious rituals.
Naturally during a poor outcome involving the patient, society tends to view it more as decided by some superpower, or fate.
Western medicine in Sri Lanka, is practised in a setting that relatively lacks social support systems (financial and social) in par with the West. For asignificant amount of people, the treatment processes are something difficult to comprehend and is “alien”.
The general tendency is to seek a western practitioner with the hope of immediate alleviation of symptoms or instant diagnosis of their illness which contributes to the “popularity” of the practitioner. The sole responsibility enjoyed by these practitioners also put them into trouble with the transformation of efficiency and trust into incapacity and negligence when there is a poor treatment outcome. At the extremes, the sole responsibility imparted on these practitioners lead to communications delivered inadvertently with a frightening tone that may have the potential to create panic in vulnerable persons.
Q: In the Eastern philosophy (mentioned also in the Vedanta) it is said that the body/mind changes from minute to minute. The Naadi system of discovering ailments is vastly different to the Western science method of ‘tests.’ There have been cases in the Western system where a perfect full body checkup report with emphasis on heart health of a patient being received and the patient dying the next day. So, in this case the reverse also could happen is it not, where the patient could recover with the bad cells (for example cancerous cells) healing on account of good food such as the indigenous food of Sri Lanka which has near miraculous medicinal immunity boosting properties?
A: A full body checkup only checks measurable parameters of physical health, and there are many parameters that evades this. Physiological and biochemical processes are dynamic and is never fully measurable and does not reflect in the current ‘checkup’ systems available both in western and indigenous health traditions.
These systems helpto detect ominous signs mainly. Environmental and genetic vulnerability cannot be predictable, and they can shift the state from wellness to illness or vice versa.
Many indigenous food items, spices and herbs have inherent medical properties that are antioxidant, analgesic (pain killer), anti-anxiety agent and anti-depressant.
They are also sources of energy and nutrition.
Being grown up in a culture with enriched traditional systems – where certain food or ingredients have been used even as home remedies, the positive belief in addition to its inherent property can delay the progression of certain illnesses and boost immunity.Thus, in cancers with good prognosis these can expedite the recovery, though these cannot be generalised to all type of cancers.
Q: Would it be too harsh a judgement of the Western medical system to say that the Western medical ‘industry’ earns a lot of money by keeping fear as a constant phenomenon in the minds of patients especially in diseases such as cancer that it cannot cure, but only earn major amounts through treatments such as chemotherapy which is known to be immensely harmful to the body and destroys immunity but without being able to fully ‘heal’ the cancer?
A: With increasing globalisation and the emergence of newer illnesses, there is an increasing demand on health services and there are few people in both indigenous and western systems who manipulate this as an “industry” and thrive on it.
In the Sri Lankan setting, relatively more western health entities exist under private and corporate ownership. The fact remains as there is increasing awareness on many illnesses, specially of the non-communicable variety that even with the best of medications which can control and reduce further progression, the illness remains.
It can be only controlled but not cured. This also paves the way to combine other healing approaches that include traditional/indigenous medicines, to provide the patient with a better quality of life.
Regarding cancer there are certain types of cancers that can be cured but there are few cancers that can only be kept in control. It is important to consider the comfort and quality of life, a principle of adding life to years than adding more years of life.
It is good to see the effects of chemotherapy in this light. Considering the nature and ferocity of cancerous cells, the Western medical treatment given whether it is medication, chemotherapy, or radiotherapy the effects on other normal cells cannot be prevented though newer techniques are being designed to target cancerous cells and thus reducing the collateral damage on normal cells.
In this light what is important is that the human being lives a holistic life as possible to prevent the body and mind succumbing to such diseases and here wise living through a sensible diet is important.
Q: In this time of the Corona fear psychosis there are segments of the population who are staunchly confident of the power of indigenous medicine based immunity boosting and their individual knowledge of traditional medicine, foods and herbs is akin to what we had prior to colonisation. What is your advice to people to strengthen their minds in general, aimed at safeguarding themselves from disease in these challenging times?
A: Considering the current Covid-19 situation in our country the ‘fear’ that has been created over the last one year has led to chronic fear that amounts at times to panic. This will invariably lead to irrational thoughts and the script created in the minds will prevent rational or logical thinking that is very essential to cope with the crisis.
Our behaviours in this context, will make others to worry unnecessarily thus causing a chain of changes leading to a fear psychosis.
It is of paramount importance that there is a certain degree of fear to be maintained to abide safety measures. The mere spiritual belief or healing rituals will not be the sole panacea, but these may contribute to the expedition of healing.
Recently we have witnessed how some religious rituals held in India led to the spread of the virus. The “fear”needs to be generated from the self (being wisely cautious) than from any external sources.
Contrary to general belief, fear and intimidation never cause positive attitude changes.The apparent changes are only temporary and once the source of fear is removed the unhealthier attitudes and practices reappear again, leading to disaster.
Positive thinking, consumption of balanced nutritious food, regular exercise, being part of nature, emotional regulation (especially of the fear), self-control, feeling of connectedness, maintaining harmony with others providing volunteering the support to another person certainly helps to improve the well-being of the person and thus boost the immunity.
Q: The methods of psychiatry are completely different when compared between Western methods and other traditions such as our ancient indigenous systems and African systems etc., where people did not get locked up in buildings. Instead, there were many cultural traditions associated with different methods of dealing with minds going through a tough time. Could you explain modern day psychiatry?
A: Western psychiatry that is being practised in Sri Lanka had shifted from the asylum based (locked-down) care to community care within the past two decades. Currently only a few are in need of admission to a psychiatry ward and a larger proportion of patients get treatment from hospital clinics and further steps of expansion of community care is in the pipeline.
Currently the psychiatric practice in Sri Lanka has utilised principles of the Western medical system in a modified manner to suit the local setting. The cultural and religious values, the available human resources, feasibility of treatment methods have been considered and the therapies with longer duration have been replaced by therapies of shorter duration.
Family support is considered as the prime mechanism of social support for people suffering from mental illness and mental health problems and the current psychiatric services are developed to address the needs of a collectivistic society.
This has been considered in the revising of mental health policy and this will help in providing effective mental health services throughout the island.
There is a need to have both the indigenous and western system to complement each other and not as competitiveelements. This is the only cost-effective way to reduce distress and promote healing in a person whether it is due to long-term or terminal illnesses affecting primarily the body or mind. The latest initiative of the government to have hospitals with both indigenous and western (allopathic) practitioners in place for Covid-19 patients is a move in this direction to share the experience and to widen horizons by thinking beyond just any single medical system.
Dr.T.Gadambanathan MBBS,MD(Psychiatry) FSLCPsych
Senior Consultant & Board Certified Specialist in Psychiatry
Office: Consultant Psychiatrist, Teaching Hospital, Batticaloa
(District Consultant Psychiatrist, Batticaloa)
Supervising Consultant Psychiatrist - Mental Health Rehabilitation Centre, Mavadivempu
Visiting Lecturer in Psychiatry - Eastern University of Sri Lanka & University of Jaffna
Member, Examiner - Board of studies in Psychiatry, Post Graduate Institute of Medicine, University of Colombo