Is Schizophrenia a valid diagnosis for a potential Shaman.

Angela Bardon
RELN7110 Shamanism, Trance and Altered States of Consciousness
Lecturer: Dr Sylvia Shaw

What western psychology and psychiatry explain as psychosis and psychopathology, has been experienced by inhabitants of Indigenous Cultures as far back as history dates. In Indigenous cultures the appearance of bizarre behaviour and visions can, but not always, be seen as a sign that spirit or ultimate being has chosen the individual to work for the spirit world. The following essay seeks to discuss using theoretical and experiential knowledge, attitudes towards what the scientific biomedical model, refers to as psychopathological symptoms that emerge in western society and traditional Indigenous cultures. The epistemologies of the Shamanism, Psychiatry and Transpersonal psychology have been outlined. Following this, the essay seeks to explore the attitudes and outcomes of the shamanic crisis in a traditional indigenous culture and given that the symptoms of schizophrenia are similar, the outcomes and attitudes in western societal culture in regards to an individual receiving a diagnosis of schizophrenia or psychosis. The final segment of the paper presents an analysis questioning Walsh’s comparisons of a fully trained shaman and an individual experiencing schizophrenia and the control displayed in altered states of consciousness. The diagnosis of schizophrenia made by psychiatrists after a six month period of psychotic symptoms is also questioned and explored in comparison to the procedures undertaken in Indigenous cultures with the emergence of psychotic symptoms. Stigma and its effects on the chemical balance in the brain and recovery of those diagnosed with a mental illness in Western Society, is an issue that is briefly explored.
Shamanic Crisis
The Shaman is the tribal diviner and healer, who enters altered states of consciousness to “communicate with the spirits on behalf of the community” (Eliade in Winkelman, 2002: 387). With the assistance of the spirit helpers the shaman can retrieve a lost or stolen soul. Through the practice of shamanic rituals, shamans can also helps individuals to find meaning and understanding for personal psychodynamic processes, which can lead to unconscious integration of aspects of the self that have been disassociated from conscious awareness and social identity (Winkelman: 2002: 390). Also painful memories can be restructured and integrated in a positive way leading to forgiveness and hence resolution of intra-psychic conflict (Winkelman: 2002: 395). The shaman-to-be is generally called to serve as a shaman in their teenage years. The individual that is called, is often ambivalent and resistant to the shamanic call (Walsh, 2007: 54; Booi, 2004: 3). The call to become a shaman can manifest in a variety of ways, such as through dreams, dramatic recovery from an illness, involuntary visions, voluntary search through a vision quest and any other way that the spirits may display preference for working with a particular person (Winkelman,2002 (Journal Article); Walsh, 2007: 53).
Following the call the shaman-to-be undergoes a crisis. Symptoms vary between different people, however common symptoms include, anxiety, delusions, auditory and visual hallucinations, mental confusion, social isolation, loss of appetite, violence, aimless wandering, neglect of appearance and hygiene, sleeping a lot and the shaman-to-be may experience seizures (Walsh,2007: 54-56; Booi, 2004: 4). The symptoms continue until the shaman-to-be, surrenders and chooses to accept the call to serve his/her community as a diviner who communicates with the ancestors and as a spiritual healer. Mentors are located to help the shaman-to-be move through the shamanic crisis and rebirth. Mentors help the shaman-to-be to develop the gifts and abilities to work as a shaman for their community (Witzel, 2011: 43). A failure to accept the shamanic call can lead to insanity, continuing sickness and death (Walsh, 2007: 54: Booi, 2004: 3). The shamanic crisis is viewed as a process of spiritual cleansing and purification that washes the psych clean from all that no longer serves the individuals higher spiritual purpose, so that the shaman to be, births into a new identity complete with spirit helpers and power (Kalweit, in Booi, 2004; Walsh, 2007: 54; Winkelman, 2002: 392). The shaman-to-be may suffer the symptoms of the initiation crisis for weeks, months or even years (Walsh, 2007: 54). Sams (1990: 302), Native American Indian Shaman, states that in many Native American tribes, those who failed their initiation trials and continued to experience psychotic symptoms were cared for by the people of the community as one who had been “touched by the gods”.
Transpersonal Psychology
Transpersonal psychology researches and treats spiritual emergencies that emerge as transcendent, beyond the “personal and biological” self (Lukoff, D. & F. Lu & R. Turner, 1998: 44). These transpersonal crises may spontaneously emerge or may emerge as one participates in spiritual practices such as Zen Buddhism or Patanjala Yoga. Due to activation of Kundalini energy, in these practices, this can lead to intense spiritual experiences (Lukoff, Lu & Turner, 1998: 44). There are three ways that individuals respond to spiritual phenomena,(a) they can integrate the spiritual experience into their life (b) they can have a spiritual emergency, that may involve symptoms such as anxiety, delusions and hallucinations, which with transpersonal counselling the person may transform, grow and mature, enabling the individual to resume life at optimal levels of functioning, (c) the person does not emerge from the spiritual crisis and personal disintegration occurs (Johnson & Friedman, 2008: 514). There are a greater number of people experiencing mystical phenomena, due to the fact that there has been an emergence of spiritual practices in the west such as yoga, tai chi, meditation and martial arts and an explosion of interest in esoteric knowledge, shamanic practices, neo-paganism and new age spirituality (Lukoff, Lu & Turner, 1998: 43). Diagnostic criteria has been created and added to the DSM IV-V, in order to define and categorize spiritual and religious emergencies as opposed to simply defining all psychological crises as pathological requiring the treatment of a biomedical model (Lukoff, Lu & Turner, 1998: 23-25).
Psychiatry
Lindemann Nelson (2001: 111) states that dominant groups who universalize their norms and values and seek to apply their norms and values to other cultural groups, is a form of oppression called Cultural Imperialism. Cultural Imperialism occurs when the dominant culture renders the understandings and knowledge of another culture as invisible and then stereotype the other culture as abnormal (Lindemann Nelson, 2001: 111). Psychiatrists throughout time have labelled Shamans as many things including tricksters, healed madmen, neurotic, charlatans, epileptics, mentally deranged and schizophrenic (Walsh, 1997: 101-102; 2007: 8). De Mause (2002: 965) found shamans to be “schizoids, who spent much of their lives in fantasy worlds where they were starved, burned, beaten, raped, lacerated, and dismembered, yet were able to recover their bones and flesh and experience ecstatic rebirth”. Hence shamans are similar to wounded healers who work through many emotional trials in order to find their calling in life (Saunder in Krippener, 2002: 965).
The reduction of mystical phenomena to psychopathology, commenced with Freud who diagnosed those who expressed religious content in their therapy sessions as having regressive neurotic pathology. Depending on the intensity of the religious content, the patient could be diagnosed as psychotic (Walsh, 2007: 8). Freud did not believe in God and reduced all religious phenomena to the relationship that occurred between the patient and their father. God was simply a projection of the patient’s father figure (Rempel 1997). In the 1990’s, shamans began being beautified in popular literature and their altered states of consciousness were compared to that of the Buddhist and Christian saints who experienced mystical states of consciousness (Walsh, 1997: 102). Due to the fact that science and medicine are the legitimate form of health care in western society, and medicine has in the past pathologized religious and spiritual phenomena, anyone who may have been experiencing a transformational shamanic crisis, has been diagnosed and treated as a schizophrenic or diagnosed as having some form of psychotic illness by psychiatrists (Lukoff, Lu& Turner, 1992: 692).
Common symptoms of schizophrenia according to the DSM IV, include delusions (fixed false beliefs), auditory and visual hallucinations, formal thought disorder, thought insertion and withdrawal, thought broadcasting, thought blocking, tangential thinking, catatonic behaviour including mutism, stupor, negativism, posturing; loss of interest in everyday activities, loss of motivation, social withdrawal, blunting and incongruence of affect and emotions (Khouzam, Tiu Tan & Singh Gill, 2007: 206-207). Zigler and Glick (1988: 285) and Walsh (1997: 112) state that a diagnosis of schizophrenia can be made after the continuous experience of psychotic symptoms over a six month period.
Outcomes in Traditional Indigenous Culture.
Whilst psychiatry interprets spiritual emergencies which may include symptoms of acute psychosis and “expressions of psychic ability” as psychopathology, the shamanic paradigm reinterprets these symptoms as natural manifestations of consciousness, with the opportunity for growth and development of the individual experiencing them (Winkelman, 2002: 395). Recent developments in neurotheology have indicated that certain forms of altered states of consciousness are universal throughout many cultures and indicate that the brain is operating normally (Winkelman, 1997: 403).
Individuals undergoing the shamanic transformational crisis in traditional Indigenous cultures had strong support from the community at large and were helped to work through the initial transformational crisis. A suitable mentor was found who could help the effected person move through the crisis and release their gifts, by developing the spiritual skills that would enable the individual to serve their community (Walsh, 1997: 117; Some’, 1999: 97). Some’ (1999: 98) Shaman from the Dagara Tribe in Africa, states that it is the responsibility of the entire community to watch over the person in crisis. If the individual becomes lost whilst wandering aimlessly in crisis, then it is the responsibility of the whole community to put aside what they are doing to search for the missing person. Some’(1999: 97-100) states that regardless of whether the individual is suspected of undergoing a shamanic crisis or some other form of psychological disturbance, the whole community is involved in watching over the individual until the shaman can divine and affect a cure. Community provides the safety net for the individual in crisis, until the individual can reintegrate themselves back into normal community functioning. In modern society disturbed behaviour is considered to be an individual problem and an individual’s responsibility (Some’, 1999: 97).
Some’ (1999: 113-114) relates the story of one female adolescent who appeared to be psychotic as she was experiencing visual and auditory hallucinations. The illness continued for months. The female involved was receiving communications from kontombli (fairy folk). The process was extremely distressing for the female adolescent, as the fairy folk were relentless in communicating with her at all times of the day and night. The young girl eventually stopped sleeping and became physically dishevelled and lost weight. It took a long time for a female shaman to be located that could help the female adolescent. The female shaman lived in another village one hundred miles away. The young adolescent moved to the other village to commence her training. It becomes clear in hearing this story that without the help of a mentor, this girl could not have developed into a healthy functioning member of the community group. Walsh (2007: 57) states that shamanic training involves a lengthy process in which one must learn to control the mind, conquer cravings, face one’s fears, develop patience, endurance and concentration. One cannot be an effective instrument of spirits, if one has not first undergone a rigorous training program which can take years. Individuals simply do not recover from the shamanic crisis or any other form of illness or disturbed behaviour and return to normal functioning, without help from a loving supportive community.
Outcomes in Western Society
Patients diagnosed with Schizophrenia or related psychotic disorders generally enter hospital as an acute admission to the psychiatric wards. Affected individuals are treated with antipsychotic medication which can have devastating side effects such as tardive dyskinesia which involves involuntary facial and motor movements. Another side effect of antipsychotic medication is acute dystonia, which involves an acute stiffening of the neck and jaw muscles and requires anticholinergic medication to counteract the side effects (Public Health Agency of Canada, 2002). These side effects are highly distressing for the patient. Electroconvulsive therapy (ECT) continues to be used as a form of therapy for depression, bipolar disorder and patients diagnosed with schizophrenia that are unresponsive to medication. ECT involves inducing a seizure whilst the patient is under anaesthetic. (Tharyan & Adams, 2005).
If the patient stops their antipsychotic medication, psychotic symptoms generally re-emerge within several weeks. Due to low levels of social functioning, gradual intellectual impairment that occurs with each remission of the illness, loss of concentration, poor memory and impaired problem solving skills, people treated and diagnosed with schizophrenia generally cannot find employment and spend their lives supported by their families living on government pensions (Long, 1995-2011). According to FRANK (Fostering Resources and New Knowledge, 2004: 3) seventy-five percent of all mental illnesses occur before the age of twenty-five years. Due to deinstitutionalization and the change to community based care in western societies across the world, 80% of those suffering from schizophrenia find themselves unable to access appropriate community care and rehabilitation (SANE, 2002). Many of the young people who cannot access community care attempt to self-medicate in order to relieve their symptoms. This leads to drug abuse and addiction problems. Approximately 70% of schizophrenics can be diagnosed with both a mental illness and drug abuse (FRANK: 2004: 1-11). Those people suffering with schizophrenia are twelve times more likely to commit suicide then the general population (SANE, 2002). SANE ( 2005) reports that prisons are becoming de facto psychiatric institutions, as more and more mentally ill people become homeless due to shortages of suitable accommodation. Reports from the Mental Health Council of Australia (2007) indicate that 85% of homeless people have a mental illness.
Young people who suffer a mental illness state that one of the reasons they do not seek professional help is due to the stigma attached to a mental illness diagnosis. This is a reason why many young people seek to self-medicate and form problems of drug abuse and addiction (SANE, 2011). Stigma formed by community reactions and displayed in the media is extremely damaging for any person experiencing any form of mental illness. It is damaging for an individual’s self-identity if they accept the stigma attached to mental illness and start to view themselves from the perspective of the person or social group who is stigmatizing and labelling them. The stigmatized individual internalizes feelings of shame and guilt and will generally start to isolate themselves from others. This then contributes to the individuals changed sense of self-identity (SANE, 2011;). Becker (in Roach Anleu,1999: 28) states that the label of deviance has been successfully applied by the oppressive other or oppressive segment of society, if the stigmatized person accepts the label placed on them.
Analysis:
According to Hume (2007:1) a shift in perception away from everyday ordinary reality, into Altered States of Conscious (ASC) or the trance state, is achieved by shamans, monks, nuns and religious specialists the world over. Entering an ASC and the spirit world involves blocking rational thought processes and cognized models of reality (Hume, 2007: 11-12). Shamans generally use triggers such as sensory overdrive in the form of repetitive sounds, chanting, clapping and dancing. Sensory deprivation and ethnogenic drugs are other methods used to enter an ASC. There are some sensitive individuals who enter ASC without any triggers (Hume, 2007: 13-14).
Walsh’s (2007: 234-244) scholarly work on comparing the shamanic crisis, to the state of schizophrenia in the west, seems to suggests that the shaman-to-be simply accepts the call and rebirths without the aid of a mentor to help them work through the birthing process and develop the necessary skills to work as a shaman. Walsh compares the symptoms of schizophrenics and there degree of control over their altered states of consciousness with that of a fully trained shaman. Whilst some people do resolve their spiritual crisis with therapy and guidance and get even better (Lukoff in Walsh, 1997: 114-115), that does not indicate that the person was a shaman-to-be, nor does it indicate that the improved person developed the skills of a shaman. The example from Some’, Shaman from the Dagara Tribe in Africa, is one perspective that I hope will illuminate that shamanic rebirth is not always as simple as Walsh’s research tends to indicate. Some’s (1999) stories about the shamanic crisis in the Dagara tribe, clearly indicate that the shaman-to-be do not rebirth from the shamanic crisis without the aid of a mentor. Mentors are required as they understand what shamanic skills need to be developed, what herbs or flower essences could help to calm the neophyte and help them integrate communication between this world and the spirit world. A key tool the mentor uses with the neophyte, involves the sharing of his/her own stories and experiences, which helps to calm the neophyte during the challenges they face. Story telling helps the neophyte to understand what is happening, as their own gifts and abilities seek to emerge. Many of the females in Some’s stories experienced terror and extreme confusion as part of their transformational crisis. In reading Some’s books, finding a mentor for a person in a shamanic crisis does not appear as straight forward as what some anthropologists have reported. Precognitive visions were defined by Jung (in deLaszlo Violet , 1985) as the ability of a person to have synchronistic inner perception in the form of premonitions, dreams or visions of an event happening, prior to the event occurring in external reality. A young person experiencing precognitive psychic vision who experiences a crisis as the pre-cognitive visions emerge cannot be mentored by a shaman with no precognitive abilities. Not all shamans have this ability. The right mentors with the right spiritual gifts and abilities must be found for the person in spiritual crisis. Some’ relates in more than one story, often this involves finding suitable mentors and healers in other villages. Often more than one mentor is required.
The apprentice must learn to deal with the challenges they are experiencing and also learn to steer their own consciousness during altered states of consciousness. Merkur (in Haule, 2011: 27) gives an example of this process using the process of hypnosis. Initially the shaman helps the neophyte by making hetero-hypnotic suggestions during the training session whilst the neophyte is in an altered state of consciousness. Gradually the neophyte learns to use auto-hypnosis to guide their own trance state (This is an example only). Also the neophyte must learn to attend to whatever emerges in consciousness without attaching to the images and sensation that emerge. Much like the Buddhist monks, the neophyte must learn that they have the power to exercise control over the feelings and sensations that arise within their consciousness during the trance state (Haule, 2011: 28). This process of being in control of one’s feelings and sensations and learning to steer one’s consciousness through trance states does not happen spontaneously, but through training. There are many skills that the neophyte must learn, including how to discern where the voices of the spirits are coming from or which spirits are communicating with him/her and what the spirit’s intention is (Sams, 1990: 303). The neophyte must learn how to create and hold sacred space, how to run a ceremony, how to do healing work and how to maintain balance between this world and the other world. Jamie Sams (1990: 302) states that if the shaman-to-be recovers from the depths of insanity, then their minds are strong and cannot be altered by sorcery and mind invasion that are dark arts used by black witches and sorcerers. Hence the shaman-to-be experiences insanity, to strengthen consciousness. The list of skills that need to be mastered takes years of work with competent mentors. Without a competent mentor, the potential shaman simply remains in the crisis illness or continues in a state of insanity and remains that way indefinitely until they die. To practice shamanism without full training can be lethal (Sams, 1990: 302-303).
Booi (2004: 4) states that most modern psychiatrists have failed to recognize the significance of the symptoms associated with the shamanic crisis and would-be-shamans have simply been diagnosed by psychiatrists as psychotic and often end up institutionalized. Symptoms are always different for each individual who experiences a shamanic crisis or schizophrenia. However if the symptoms of an individual experiencing their first presentation of schizophrenia and the symptoms of a shamanic crisis are compared, many of the symptoms are similar if not identical. Prior to the emergence of the spiritual crisis being recognized and added to the DSM IV in 1994 , all patients presenting to hospital emergency centres in a spiritual crisis would have simply received the diagnosis of psychosis as spiritual and psychic phenomena were viewed as psychotic symptoms (Lukoff, Lu & Turner, 1998: 25; Johnson and Friedman,2008: 506). According to Khouzam, Tiu Tan & Singh Gill, (2007: 567) in many cases, patients presenting to hospital in a spiritual crisis continue to be misdiagnosed by medical, paramedical and religious professionals. Not all psychologists and psychiatrists have a transpersonal focus and professionals with training in behavioural, cognitive and psychodynamic frameworks would be more likely to diagnosis a mystical experience as psychotic (Johnson and Friedman, 2008: 506).
Walsh (1997: 112) states that a diagnosis of schizophrenia can be made if psychotic symptoms persist for six months. Walsh (2007: 54-55) also states that a shamanic crisis can last anywhere from a few days, to months, to years. In the scientifically driven western world where shamanism has been labelled as delusional and psychotic, there has not been the ability for one experiencing a shamanic crisis to orient themselves to the shamanic framework, answer the call, find a mentor, or have their relatives find them a mentor, simply because of Cultural Imperialism and the legitimacy of science. This may have started to change in the last twenty years with the re-emergence of neo paganism, and Indigenous people across the world campaigning for the right to their land and the right to practice their culture. If a shaman-to-be had been birthed into a scientific or Christian family, they would have been diagnosed with schizophrenia in the face of a shamanic crisis. The Christian church have in the past demonized shamans and in some cases such as in Korea, continue to demonize Shamans today (Jilek, 2005: 8-9; Lee, 2009: 192).
Some’ (1999: 97) makes the comment that every time he encounters a person who has been labelled as crazy in the western world, he wonders what spiritual gifts have been lost to the community. Kalweit (in Booi, 2004: 2) states that illness is the inherent wisdom of the body, which when the individual surrenders to the crisis process, this can open the doorway to higher spiritual learning and can help one to find one’s purpose in life. Winkelman (2002: 395) also states that the shaman reinterprets what psychiatrists refer to as psychosis and acute emotional states, as natural states of being that can function as opportunities for personal growth. The bio-medical and scientific framework pathologizes, and medicalizes all states of illness or behaviour that it views as abnormal. According to social constructionist theorists, illness in itself is not abnormal, it depends on the system that defines illness as deviant (Roach Anleu, 1999: 198). Friedson (in Roach Anleu, 1999: 198) states that the Bio-medical model views illness as something bad which must be eradicated. The bio- medical and scientific framework works from a deterministic framework which seeks a cause for all it perceives as deviant or abnormal. Using Lindemann Nelson’s (2001: 111) theories of oppression, the bio-medical/ scientific view has been the oppressive view dominating western society since the enlightenment and has sought to destroy spiritual frameworks and also cultures that lived by a spiritual framework. Whilst this situation is beginning to change, the biomedical framework is in essence a reductionist and negative framework. Western society is orientated by the scientific, economic, consumerist, dualistic and materialist versions of reality, rather than the gentle, spiritual, loving; unifying reality that indigenous people lived in prior to colonization.
Perts (1997) work on neuropeptides and receptors demonstrates that emotions and feelings are thought forms that manifest into the physical as neuropeptides and chemicals in the body, hence establishing the mind body connection. If a diagnosed mentally ill patient internalizes the shame, guilt and abnormality that they are told they embody by society and science, would that not simply further imbalance their neuro-chemical processes, and contributing to an individual schizophrenics relapses and deterioration in their bio-psychosocial functioning? How can one experiencing psychotic symptoms associated with the spirit world ever hope to orientate themselves into a position of service, without the support of a loving community and a mentor to guide the way.
Conclusion:
What I have attempted to demonstrate in this paper is that people experiencing spiritual or shamanic crisis in Indigenous Cultures, would be viewed as experiencing a normal process towards spiritual growth and the ability to serve their community as a healer and diviner. However those experiencing the same or similar symptoms in Western Society, are psycho-pathologized, medicalized, and diagnosed with a mental illness if symptoms continue for a six month period. The expected outcomes for a person not recovering from a Schizophrenic illness may include repeated relapses and a deterioration in bio-psychosocial functioning. Homelessness, suicide and jail are possibilities for the individual diagnosed with chronic schizophrenia, as community care seems only to be able to provide rehabilitation for twenty percent of those diagnosed with a chronic mental illness. Transpersonal psychologists are the exception to the rule, and are the driving force behind the spiritual emergency being included as a diagnosis category in the DSM IV. However without the appropriate skills to work in the spirit world, a transpersonal psychologist cannot train a shaman.
There is need for research exploring cross cultural and spiritual forms of treatment for adolescents presenting with psychotic symptoms to a hospital for treatment, regardless of their skin colour. Having access to shamanic mentors could mean the difference between becoming a functioning member of society or a statistic in the jail, suicide and homelessness figures. Also research needs to be conducted on how stigma and the internalization of guilt, shame and abnormality affects the chemical balance of the body and neurological systems of an individual experiencing mental illness and their long term functioning. Whilst the cost of medical treatment is forever skyrocketing, an ethical and loving academic community would be looking at integrating other forms of healing that could reduce the costs of health care and prevent the increasing numbers of people questioning and experiencing unsatisfactory results from biomedical treatment regimes.










References:
Adams, C.E. and P. Tharyan, 2005, ‘Electroconvulsive therapy for schizophrenia’, in PUB MED.gov, viewed 2/5/2011, at http://www.ncbi.nlm.nih.gov/pubmed/15846598?dopt=AbstractPlus .
Booi, B. N. 2004, ‘Three perspectives on ukuthwasa: The view from Traditional beliefs, Western Psychiatry and Transpersonal Psychology’, Masters Thesis, Rhodes University Website, viewed 15/4/2011, at http://eprints.ru.ac.za/175/ .
deLaszlo Violet. S. 1985, Psyche & symbol: a selection from the writings of G. Jung, Garden City, New Jersey: Doubleday Anchor Books.
FRANK (Fostering Resources and New Knowledge) 2004, The monthly newsletter for the youth coalition’s alcohol and other drug projects, October, Issue 7, 1-16, viewed on 2/5/2011, at http://www.youthcoalition.net/dmdocuments/Frank_Oct.pdf .
Haule, J.R. 2011, Jung in the 21st Century: Volume Two, Synchronicity and Science, London: Routledge.
Hume, L. 2007, Portals: Opening Doorways to Other Realities through the Senses, New York: Berg.
Jilek, W.G. 2005, ‘Transforming the Shaman: Changing Western Views of Shamanism and Altered States of Consciousness’, in Articulo en Salud, Vol. 7, No. 1, 8-15, accessed 14/3/2011, at http://www.medigraphic.com/pdfs/invsal/isg-2005/isg052c.pdf .
Johnson C.V. and H. L. Friedman, 2008, ‘Enlightened or Delusional? : Differentiating Religious, Spiritual, and Transpersonal Experiences from Psychopathology, Journal of Humanistic Psychology, Vol. 48, No. 4, 505-527, viewed 27/4/2011, at http://jhp.sagepub.com .
Khouzam, H.R., D. Tiu, Tan and T. Singh Gill, 2007, Handbook of Emergency Psychiatry, Philadelphia: Mosby Elsevier.
Krippener, S.C. 2002, ‘Conflicting Perspectives on Shamans and Shamanism: Points and Counterpoints, in American Psychologist, November Issue, 962-977, viewed 27/4/2011, at Proquest.
Lee, J. 2009, ‘Shamanism and Its Emancipatory Power for Korean Women’, in Affilia, Vol. 24, No. 2, 186-198, accessed 20/3/2011, at http://aff.sagepub.com/content/24/2/186 .
Lindemann Nelson, H. 2001, Damaged Identities: Narrative Repair, Ithaca, New York: Cornell University Press.
Lukoff, D and F. LU and R. Turner, 1992, ‘Toward a more Culturally Sensitive DSM IV: Psycho-religious and Psycho-spiritual Problems’, in The Journal of Nervous and Mental Disease, Vol. 180, No. 11, 672-682, accessed 28/04/2011, at LWW Journals at Ovid.
Lukoff, D and F. LU and R. Turner, 1998, ‘From Spiritual Emergency to Spiritual Problem: the Transpersonal Roots of the New DSM-IV Category’, in Journal of Humanistic Psychology Vol. 38, No. 21, 21-50, accessed 27/04/2011, http://jhp.sagepub.com .
Mental Health Council of Australia. 2007, Facts on Mental Health, viewed 2/5/2011, at http://www.mhca.org.au/documents/AboutMentalHealth/FactsonMentalHealth.pdf .
Pert, C. B. 1997, Molecules of Emotion: Why You Feel The Way You Feel, London: Pocket Books.
Public Health Agency for Canada. 2002, Schizophrenia: A Handbook for Families, viewed 2/5/2011 at http://www.phac-aspc.gc.ca/mh-sm/pubs/schizophrenia-schizophrenie/chpt08-eng.php .
Rempel, M.H. 1997, ‘Understanding Freud’s Philosophy of Religion’, Canadian Journal of Psychoanalysis, vol. 5, no. 2, viewed 15 March 2011, at Proquest.
Roach Anleu, S. 1999, Deviance, Conformity and Control, 3rd Ed, Australia: Addison Wesley Longman Australia PTY Limited.
Sams, J. 1990, Sacred Path Cards, New York: Harper Collins Publishers.
SANE. 2002, Schizophrenia Costs, viewed 2/5/2011, at http://www.sane.org/information/research/382-schizophrenia-costs .
SANE. 2005, Submission by SANE Australia to the Secretary: Inquiry by the Senate Select Committee on Mental Health, viewed 2/5/2011, at http://www.aph.gov.au/senate/committee/mentalhealth_ctte/submissions/sub133.pdf
SANE. 2011, What is Stigma, viewed 2/5/2011 at http://www.sane.org/stigmawatch/what-is-stigma
Some’, M.P. 1999, The Healing Wisdom of Africa: Finding Life Purpose Through Nature, Ritual and Community, New York: Penguin Putnam Inc.
Walsh, R. 1997, ‘The Psychological Health of Shamans: A Re-evaluation’, in Journal of the American Academy of Religion, Vol. 65, No. 1, 101-124, accessed 28/4/2011, at JSTOR.
Walsh, R. 2007, The World of Shamnaism: New Views of an Ancient Tradition, Woodbury, Minnesota: Llewwllyn Publications.
Winkelman,M. 1997, ‘Altered States of Consciousness,’ in Glazier, S.,ED, Anthropology of Religion: A Handbook of Method and Theory. Westport, Conn: Greenwood Press, 393-428.
Winkelman, M. 2002, ‘Shamanism as neurotheology and evolutionary psychology’, in The American Behavioral Scientist, Vol. 45, No.12, 1875-1887, acessed 28/4/2011 at Proquest.
Winkelman, M. 2002, ‘Shamanism and Innate Brain Structures: The Original Neurotheology’, in R. Joseph, (ed.), Neurotheology: Brain, Science, Spirituality, Religious Experience, San Jose, Californa: University Press, 387-396.
Witzel, M. 2011, ‘Shamanism in Northern and Southern Eurasia: Their distinctive methods of change of consciousness’, in Social Science Information, Vol. 50, No. 1, 39-61, accessed 3/5/2011, at http://www.sagepublications.com .
Zigler, E. and M.Glick, 1988, ‘Is Paranoid Schizophrenia Really Camouflaged Depression?’, in American Psychologist, Vol. 43, No. 4, 284-290, accessed 28/4/2011, at Proquest.