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The Management of Mental Illness Among Maharashtrian Families: A Case Study of a Mahanubhav Healing Temple Author(s): Vieda Skultans

Source: Man, New Series, Vol. 22, No. 4 (Dec., 1987), pp. 661-679 Published by: Royal Anthropological Institute of Great Britain and Ireland Stable URL: http://www.jstor.org/stable/2803357 Accessed: 16/11/2010 09:26
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OF MENTAL ILLNESS AMONG THE MANAGEMENT OF A FAMILIES: A CASE STUDY MAHARASHTRIAN TEMPLE HEALING MAHANUBHAV SKULTANS VIEDA
Universityof Bristol
Fieldwork was carried out in a Mahanubhav healing temple in Maharashtra. Women's responsibility for the health and well-being of the family is given a novel and literal interpretation in this setting. Women come as care givers accompanying a mentally ill family member. But although they arrive as care givers and, indeed, continue to fulfil that function, they become afflicted by trance soon after their arrival. Women see this transformation into patienthood as resulting from their devotion to their families. Indeed, they pray that the illness be transferred from their sons, husband or daughters to themselves. It is thought that regular trance will channel the force of the earlier affliction away from the original patient. Thus women cultivate trance as a sacrificialdevice to ensure the health and well-being of the rest of the family. This view of trance is vigorously contested by the temple experts, however, who see trance as symptomatic of feminine pollution and characterweakness. This lack of consensus regarding the nature of trance and the distribution of affliction has cautionary implications for a monistic approach to religious and medical institutions.

Women, illness and treatmentopportunities

Fieldwork was carried out in a Mahanubhav temple in Maharashtrarenowned for its trance inducing properties and its therapeuticpowers in relation to mental illness. This setting was chosen because it was anticipated that large numbers of people who considered themselves, or were considered by others, to be mentally ill would gather there. The research had two kinds of distinct but interrelated aims: one being of a psychiatric epidemiological nature and the other socio-anthropological. The psychiatric questions were prompted by the apparent contrast between the sex distribution of psychiatric disorder in the west and in traditional societies. Western mental health surveys, admission and consultation figures all point to the greater psychiatric morbidity of women. Psychiatric surveys in developing countries do not follow this trend. Epidemiological studies in non-industrialised societies do not appear to confirm the excess psychiatric morbidity found among women in the western world. Although the field of cross-cultural psychiatry is large and flourishing, however, and although women's mental health is a topic of concern, the interesting apparent difference between women's mental health in western industrialised societies and non-industrialised societies has not been investigated. A review of population surveys in India suggests the direction of research. Incidentally, 'more population surveys for psychiatric illness have been conducted in India than in any other developing country' (Leff I98 I: 90). A
Man (N.S.) 22, 66I-79

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study of the prevalence and type of mental disorder in a village of West Bengal found a lower rate of psychiatric morbidity for women than for men (Elnagar et

al. I97I:

50I).

A studylookingattheprevalence of mentalillnessamongfamilies

registered with an urban health centre at Lucknow again found women to have slightly lower rates of mental illness than men (Thacore et al. I975: 365). The work of Carstairs and Kapur in Karnataka State in south India provides an exception in that their survey found a slight excess of female psychiatric morbidity: only 6o per cent. of women in their sample were symptom free, as opposed to 68 per cent. of men (Kapur I975: 37). However, this slight bias towards women in no way approaches the situation obtaining in the west (see

Carstairs& Kapur I976:

I04).

findings must, of course, be Epidemiological

approached with caution, since each survey employs different criteria for assessing mental illness, but it remains true that whatever the threshold level used, a more equal male/female ratio is found than western findings would lead one to expect. Hospital in-patient and out-patient figures show that men outnumber women by 3 to I (Kynch& Sen I983: 372) andpsychiatric admission figuresappear to be in line with general hospital figures. It therefore seemed to be important to establish the psychiatric morbidity of supplicants seeking indigenous forms of cure at a healing temple, particularly since there appears to be an implicit and widely held assumption that 'neurotic' women form the bulk of the clientele of traditional healers and healing temples. Although unforeseen practicalproblems meant that psychiatric assessments using the Present State Examination (a standardised psychiatric interview schedule, see Wing et al. I974) could not be made, the anthropological interviews throw some light on the direction in which answers to the epidemiological puzzles might be sought. It is generally recognised that Indian women are held responsible for the

& ZeidensteinI982: family'shealth(see, for example,Abdullah

52).

Moreover,

health and, in particular, mental health, may be viewed as a property of families rather than individuals: 'South Asian rural family members may not have any clear perception of individual welfare, having instead some unsplittable compound notion of family well-being' (Kynch & Sen I983: 364). However, data from the Mahanubhav temple suggest that this compound notion of family well-being remains intact when mental illness of a male family member is involved whereas when women encounter mental health problems the notion of family wellbeing is not as 'unsplittable' as Kynch and Sen imply. It may be that the threat of separation from the family as well as the active role assigned to women in the promotion of family health all contribute towards a lower rate of mental disorder among Indian women. Mysticalaccounts of illness Common to Maharashtrianpopular culture is a set of beliefs regarding illness and misfortune: namely, that they are frequently the result of possession by a spirit or bhutbhada.In general, little interest is shown in discovering the identity of the bhutor its characteristics. Possession by bhutmay sometimes give rise to trancing, but more often it results in ill-health or bad luck. Often possessed

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persons are not aware of suffering from bhut bhadauntil they come into the vicinity of a healing temple. Here the power of the God or saint associated with the temple or shrine is thought to draw out the possessing spirit, thus encouraging trance. In most cases of bhutbhada,karaniis involved. Literally translatedthe word means 'things done' and there is an implicit understanding that the things done are bad. Stanley, in a paper on possession in Maharashtra, has translated karanias black magic (Stanley n.d.: 3). Perhaps the more general word witchis craft best covers the several uses of the term karani.It is thought that bhutbhada usually brought about by means of karani. In such instances an angered or envious person will either ask God to send a bhutupon their enemy, or else will request a mantrik(magician) or devrishi(shaman) to do so. Again, there appears to be little interest in the technical details of karani,although the reasons for the bad feelings will be spelt out in some detail. Thus there exists a set of common beliefs about the spiritual provenance of illness which underpin the widespread resort to healing centres. Throughout Maharashtra many healing temples specialise in the management and cure of spiritual afflictions. The Muslim shrines or dargahsin Bombay and Pune cater for many thousands a week who present with a wide variety of afflictions. The temples of the Hindu Mahanubhav panth (sect) also cater for spiritual afflictions, in particular, those which give rise to mental illness. The Mahanubhav sect arose in the thirteenth century forming part of a wider movement of the time which emphasised bhaktior devotion. The characteristics of this sect which set it apart from orthodox Hinduism have been described by other scholars (Raeside I976; Feldhaus I983). Feldhaus cites the rejection of caste and the worship of idols, the refusal to acknowledge the scriptural authority of the Brahmins, the creation of a female order of sannyasis and the belief in a single God Parmeshwar as evidence of the heterodoxy of the Mahanubhavs (Feldhaus n. d.: i) Despite doctrinal differences, however, the Mahanubhav temples are frequented by all Hindus in times of trouble and at the major Mahanubhav festivals. Temple users have in common poverty and illiteracy rather than sect affiliation. Feldhaus describes the Mahanubhav God as one who 'can be addressed in the language of the people, not just in the Sanskrit of the erudite and the religious professionals, and can be approached by members of all castes and both sexes' (I984: 4). Thus the Mahanubhav temples provide the setting for a direct experience of and dialogue with God. Given the nature of the problems besetting many of the supplicants the immediacy of this relationship is important. Individuals and their families are drawn to the temples because they can get detailed and personal information and advice about their particular health or family problems. Here unconventional and uncontrolled behaviour is tolerated and even encouraged. For example, dialogues with God take place during trance. Indeed, there is a divine precedent for outrageous behaviour. According to Mahanubhav belief, Parmeshvarhas taken five avatars or huma-nincarnations: Krishna, Dattatreya, Cakradhara, Govindaprabhu, also known as Gundam Raul, and Cangdev Raul. The biography of Gundam Raul portrays him as breaking all the social and religious rules regarding proper behaviout. Feldhaus writes: 'The text shows that God transcends not only the rules of ritual and

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morality and the hierarchies of caste, sex and learning, but the conventions of politeness and sanity as well. For the text shows that Gundam Raul was God, and it shows that he was mad' (I984: 4). Indeed, that madness is itself evidence of his divinity. Thus the Mahanubhav writings suggest that their temples are particularly well suited to the management of madness. The Mahanubhav temple One such centre which attracts large numbers of people considered mad is Phaltan. Phaltan is a small town with a population of about 40,000 in district Satara. In terms of the religious geography of the Mahanubhavs, Phaltan occupies an important position. It is the birthplaceof Cakradhara,the founder of the sect. There are three Mahanubhav temples in the town. One of these, the Abbasai temple caters for the mentally ill. Here accommodation is provided for patients and their families. Thirty-five small open dormitories surround the temple (see fig. i). Each family is assigned a space measuring about 4' X IO' where they can store their cooking pots, bed rolls and other belongings. Families come from the whole of Maharashtraalthough most are from district Satara.The average stay lasts three to four months, although families are usually prepared to stay until the sick person is cured. Whatever the turnover of temple residents, the temple remains full at all times. During the period of the study (November I984 to April I985) there were forty-one 'cases' for which a spiritual resolution or cure was being sought. All the cases were investigated by lengthy interviews with the patients and their families. The following picture emerged: there were fifty-six women and twenty-eight men supplicants. These figures appear to confirm both the anthropologists' account of healing temples and trancing and the views of priests and local townspeople. However, when each case was looked at more closely a different picture emerged (see fig. 2). Twenty-two families came on behalf of a man, twelve came on behalf of a woman and nine women came alone. There were more women than men accompanying the sick person. The greater number of female caretakers and the fact that middle-aged and older women were often unaccompanied accounts for the greater overall number of women in the temple. This might prompt a casual observer to conclude that the temple caters largely for women's needs. In fact, the temple answers the needs of two quite different categories of persons. In one category are women who come to the temple because of some major upheaval or conflict in family relationships. Nearly all the women in this category are divorced, widowed or childless and they come to the temple alone. Frequently, their husbands have remarried. They come to the temple feeling depressed and tired. Without exception all these women learn to trance at the temple. In a few cases women who appearto be expressing family problems through their trancing are accompanied by other family members. Although psychiatric interviews were not carriedout,1 it was my impression that many of these women would not score high on neuroticism. These women come to the temple, not so much because their symptoms are intolerable, as because their social situation is intolerable: they have failed to attain or have lost a respectable position in the family. In these cases the temple

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bounds of social acceptability delineated, is not made altogether explicit. Although there is no dispute over who is designated as mad, the criteria determining madness do not appear to be given much thought. Given that the temple is considered the appropriate refuge for the mad, there is a curious absence of reflection or theorising about madness. Answers to questions about how madness was recognised were hesitant and it became clear that there were no explicit and detailed theories of the kind that anthropologists often expect.

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Answers were given after considerable thought and prompting. Among the behaviours given as evidence of madness the following were cited most frequently: dirtiness, incoherent and inappropriate talk, fighting without reason, inability to work or execute orders, aloofness and having no structure to one s daily activities. Although informants were reluctant to spell out the parameters of such general deterioration in behaviour most were confident of their ability to identify it in others. Indeed, the criteriafor recognising madness would not be out of place in western psychiatric text books. There is consensus over who is considered mad and this is given outward expression by chaining the patients. In some cases the chaining serves to restrain violent patients or to prevent them from running away, in other cases, the chains simply tell the community at large of the person's condition. In particular,it was thought that chains were useful in alerting unsuspecting townspeople and shopkeepers to the possibility of bizarre behaviour by the chained person. This emphatic policy of restraint with regard to the patients is in complete contrast to the licence afforded to trancers, discussed later. The mad patients usually arrive at the temple with one other family member (see fig. 2). In the case of men, the family care-giver is usually the mother, less frequently a wife. Younger women are most commonly accompanied by their mothers, older women by their daughters. No one who fell into this mad category came alone. The mad patients play little part in temple life. Although a few attract attention by their wild appearance and noisy behaviour, most sit around in a listless and withdrawn fashion throughout the day. They are cajoled and bullied into performing various ritual acts of worship, such as circumambulation of the temple, but their participation remains minimal. Although everyone is encouraged to go into trance, the mad patients with one or two exceptions do not go into trance. Thus although the families are there on behalf of the mad members, they take very much a back seat in the round of temple activities. The intense communal life of the temple interspersed with mandatory trancing seems to be designed with the needs of the care-givers in mind. However, whilst the care-givers throw themselves into a round of frenzied, ritual activity, the patients remain detached and seemingly disinterested spectators. They do not receive any form of treatment or special ritual attention, over and above the benefit of the alleged healing powers of the sacred site. Patients receive special attention only when they are particularly violent or disobedient. Paradoxically, such episodes of misbehaviour result in requests for extraneous help: a visit either to the police station or to the local psychiatrist. On returning to the temple, chains are reinstated and the patient is more tightly bound. Thus, although the temple has a reputation for curing the mentally ill, crises are most often dealt with by recourse to outside agencies, rather than member arriveat the temple internal ritual remedies. Families with a mad famnily very much at a loss to know the causes of the condition or, indeed, how to cope with it. Although explanations in terms of karaniresolve perplexities about causation, perplexities about management remain. For the temple dwellers the financialburden of madness is considerable, since neither the mad person nor the chief care giver is able to work. Psychiatric consultations and drugs are expensive and are beyond the reach of all the temple dwellers as a regular form of

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treatment. Many families would have welcomed hospitalisation as a solution to the burden of family care. However, demand for hospital beds exceeds availability and access to hospital care is restricted. Thus the burden of care in the community falls upon women. In becoming sole guardians for their mad charges women are conforming to traditional expectations. The sacrificial roleof trance In Maharashtra, as in the rest of India, the health of the family is a woman's responsibility. Women go on pilgrimages, and undergo ritual penance and weekly fasts in order to safeguard and promote the health of their husbands and children. In the event of illness women are the principal care-givers. Their care-giving role is very much in evidence at the Abbasai temple. Kakar has described 'the formidable consensus on the ideal of womanhood which . . . still governs the inner imagery of individual men and women as well as the social relations between them' (I 98 I: 68). Of particularimportance is the legend of Sita who chooses the rigours of banishment in the forest ratherthan separation from her husband. Above all else, the Sita legend is synonymous with feminine devotion and faithfulness, which is unaffected by the husband's rejecting and inconsiderate behaviour. The legend embodies a potent ideal of Indian womanhood. A further elaboration on the theme of self-sacrifice and devotion is found in the Mahabharatawhich tells of the marriage of Princess Gandhari to King Dhritarashtra. On learning that her husband-to-be is blind, Gandhariblindfolds herself, thus ensuring that she should not enjoy an advantage lacked by her husband and sharing fully her husband's fate. These ancient cultural stereotypes continue to influence the attitudes and behaviour of women in the temple. The considerable female presence in the temple is largely to be accounted for in terms of their nurturing, self-sacrificing role; but, although women arrive as care givers and, indeed, continue to fulfil that function, they frequently become afflicted by trance after their arrival at the temple. Although some women and men come to the temple because they are already afflicted with trance and want to remove their affliction, many more find themselves going into trance because of their stay in the temple. The temple has a reputation both for its healing powers and its trance-inducing properties and the two are connected in that trance is thought to confer therapeutic benefits. Temple trancing has a long history. The founder of the sect, Cakradhara, behaved as though he were mad and contact with him would induce trance in others. Since Phaltan is the birthplace of Cakradhara, the trance-inducing properties of the God have been transferredto the site. Thus the association of the Mahanubhav sect with madness and trancing dates from the sect's origins in the thirteenth century. But although the madness of the founder is taken as evidence of his divinity, present day trancers have an ambiguous position. At the time of the study there were forty-seven people who suffered regularly from trance and of these thirty-nine were women. Although the beneficial and therapeutic effects of trancing are acknowledged by the entire temple community, many people would take offence at the suggestion that they might be susceptible to trance. Whilst trancing is encouraged, its benefits are confined to

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those whose social and spiritual adjustment is in question. Priests and monks, for example, scoff at the idea that they might be afflictedby trance. The one nun who did trance acknowledged this fact about herself with some shame. In other words, trancing is not an absolute good but benefits those whose health and wellbeing are already threatened by malevolent spiritual attack. To acknowledge such attack is to admit failure in the ability to conduct one's life and affairs satisfactorily. Thus trancing might be considered as a successful response to a family's spoiled identity. The concept of trance is itself somewhat elastic: the term encompasses a wide spectrum of behaviour. Whether or not a person is defined as going into trance depends not so much upon what he or she does as upon a common consensus that a particularbehaviour constitutes trance. Even if there is no exact definition of trance, however, trancing behaviours do form a 'family resemblance'. Jerking movements of the waist, hiccoughing, somersaults and headstands all serve to signal the occurrence of trance. There are instances where two people are behaving in an identical fashion, but whereas one is agreed to be in trance, the other is not. Thus verbal descriptions have shortcomings and ostensive definition provides the surest guide to identification of trancers. The officialdoctrine concerning trance Priests share a common view of the nature of trance which is somewhat at variance with that of the trancersthemselves. They view trance as unequivocally a female affliction and account for this epidemiological distribution in terms of women's weaker nature in relation to men, their greater vulnerability due to menstruation and their general carelessness about where they urinate. Priests attribute the temple's success in dealing with spirit possession to their control and punishment of the possessing spirits. They claim that whereas in other healing temples spirits are appeasedand placated through luxury gifts and fancy food, the outstanding record of the Mahanubhavs for curing lies in the harsh treatment meted out to spirits. Placatory offerings, it is argued, would merely postpone the final resolution of the problem. During trance, the trancers throw themselves violently about and this is seen as a kind of mortification for the spirits. Trancers also drink polluted water and again this is seen as punishment for the spirits. The official line is that the trancers themselves do not suffer as a result of such behaviour, but that through continual subjection to such mortification, the spirits are persuaded to leave the site of unrelieved pain. Thus the trancers are eventually released from the burden of the spirits afflicting them. It is significant that the spirits afflicting the trancersare all minor, malevolent and unnamed spirits, such as diminish rather than enhance the spiritual status of the trancers. Given the monotheistic emphasis of the Mahanubhav sect, the priests deny that angatyene or divine possession is possible. The afflicting bhutdo not have divine status. Women themselves, whilst not directly disputing the truth of these priestly observations, do not attach much causal or explanatory significance to the priests' remarks. Whilst accepting that they are the weaker sex, women go on to make claims which run counter to such an assumption. Women themselves

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assert that their trancing is self-inflicted. Women pray that the direction of malevolent attack be shifted away from the suffering family members onto themselves. The onset of trancing is seen as the answer to such prayers. The most frequent movement of illness is away from husbands and sons towards wives and mothers. The indigenous theory underlying such beliefs is that families rather than individuals are the target for malevolent spiritual attack. Physical and mental illness, misfortunes and general bad luck are seen as the outward manifestation of spiritual affliction. The disappearanceof symptoms in one individual does not signal the end of the history of illness. The family anticipate further manifestations of the original affliction in some other guise in other family members. The implicit understanding is that a given amount of malevolent spiritual power is directed at a particularfamily and that until its full force is spent, the family cannot enjoy peace and well-being. In most cases, affliction results from karanior witchcraft, with subsequent involvement of possession by bhut or spirit. Usually the affliction follows in the wake of a dispute over land or property involving members of the extended family. In some cases there is simply envy of the prosperity, success or happiness of the family by more distant relatives. The family sees itself as the victim of a malevolent misuse of spiritual power, and in all cases the first target of attack, namely the 'index' patient, is absolved from all blame and is seen as wholly innocent-the sacrificial victim of regrettable but unavoidable family feuding. Thus whilst temple dwellers deplore the occurrence of family disputes with their inevitable consequence of mystical attack and illness, they feel powerless to avert them. There is a fatalistic acceptance of family feuding. One informant neatly summed up the attitude by saying that one could plead with God but not with an angry relative. Thus, whereas quarrellingand illness are seen as an inevitable part of life, their resolution depends in some measure upon the spiritual discipline, endeavours and self-sacrifice of individual family members. The malevolent spiritual force can be dispelled more quickly if individual family members experience large amounts of illness, thus substantially decreasing the central fund of illness. The amount and intensity of illness experienced by other family members are thereby decreased. Women inviting trance see themselves as actively contributing towards this redistribution of illness within their families. Temple-dwelling families see themselves as being marked out for misfortune by some mystical means. As a result individual illness is seen as part of the family destiny and not necessarily of an individual's destiny. Janzen has described the importance of the 'therapy-managing group' to the successful outcome of individual illness. 'The legitimacy bestowed by a closely knit social group upon a therapeutic course is just as strong as the patient's individual belief in the rightness of the physician who treats him' (I978: 226). In Maharashtra,however, the therapy-managing group acts not only as the decision-making body regarding the treatment of the initial illness, but also recognises its responsibility for the development of the illness. Although all the women trancers endorsed this view and their families gratefully acknowledged the self-denial of their women-folk, the priests were unanimous and emphatic in their denial that such shifting and sharing of

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affliction was possible. Nor did they appear to be aware of the wide extent to which such beliefs were in fact held, treating them as simple errors of fact on the part of ignorant women. Religiouspluralismwithin the temple Thus two quite distinct doctrines coexist on the nature of trance. The first is the official priestly line which is given token acknowledgement, though not much weight, by the trancers themselves. The second is the more elaborate account developed by the trancers and their families and reflecting in greater measure the family's perception of the illness experience. When confronted with the patients' version of events, the priests reject it completely. However, they appear to have remarkably little knowledge of what is going on. For example, belief in karanior witchcraft is universal among temple dwellers and belief in karanias a cause of the illness is well-nigh universal. Priests have little awareness of such beliefs within the temple. Indeed, they described another Mahanubhav temple a day's travelling distance from Phaltan, where such allegedly strange beliefs were held: it was claimed that women in Sukhena were possessed by the spirits of living men. On reaching the temple, it emerged that what the priests had described as a strange and rareform of affliction, was, in fact, the commonly experienced affliction referredto by temple dwellers as karani.Knowledge of the reputation of other temples was greater than information about happenings within their own temple precincts. The existence of such discrepant beliefs within a single community concerning the 'natural history' of trance raises certain questions about the status of so-called culture-bound syndromes or folk illnesses. From the earliest studies onwards there is an assumption that culture-bound syndromes are characterised by typically recurring clusters of behaviour about which there exist shared theories of causation and beliefs about appropriate treatment: 'in the present state of the study of folk illness, when several symptoms regularly cohere in any specific population, and members to suchmanifestation of thatpopulationrespond in similarlypatterned ways the cluster of symptoms be defined as a disease entity ' (Rubel I964: 269, my emphasis). Research among afflicted families at the Mahanubhav temple indicates that there is no such consensus regarding explanations of the trance syndrome. Even the accounts regarding the nature and severity of symptoms conflict with each other. Whilst priest and bystanders emphasise that the woman herself experiences no harm during trancing, the violence of the trance being experienced solely by the spirit possessing her, this account is challenged by the women themselves who lay claim to considerable physical suffering and exhaustion during and after trance. Women's accounts of the ill-effects of trancing seemed to visualise the invasion of the body by a spirit as occasioning a leakage of vital health and strength. Thus closer examination of the views of all interested parties reveals that there is no common agreement about trance and that accounts vary according to the social position of the informant. This variety of definitions and explanations of illness is one which a western family therapist might expect. However, whilst social anthropologists are alert

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to inter-cultural variations in illness definitions and behaviour, they tend to ignore differences between individuals. The social anthropologist tends to look for examples, and informants are often willing to satisfy this expectation. Zempleni describes the ethnographer and informant as 'accomplices in the abuse of generalizations' (I977: 88). In this way the anthropologist shields himself from the problems of diversity and the informant can escape from subjectivity. In the Mahanubhav temple discussion with all the temple residents clearly revealed a diversity of views. The priests and outsiders unaffected by trance view trance as a negative occurrence and envisage punishment and expulsion of the possessing spirit as the ideal outcome to the temple stay. Trancing women, however, see permanent expulsion as unrealistic and damaging to the health of other family members. Their aim is to establish a working relationship with the possessing spirit. Whilst a few trancers feel they have achieved this, others feel that their own health is suffering. Anthropologists have also suggested that trance falls into two categories depending on whether it is viewed in a positive or negative way. Mary Douglas has written somewhat cryptically that trance is 'feared as dangerous where the social dimension is highly structured but welcomed and deliberately induced where this is not the case' (I970: 74) Once again two seemingly contradictory attitudes to trance co-exist within a single community. Priests view trance as a bad occurrence which reveals a weakness in the characterof the victim. Those with a more intimate experience of trancing recognise it to be self-induced and to have beneficial consequences for other family members. Thus within the same community trance is viewed as either positive or negative depending upon one's position within that community. Although the precise identity of spirits is not established or of concern to trancers or priests two general pictures of the characterof possessing spirits emerge. The picture of spirits favoured by priests is one of childish petulance which requires firm handling. No particularbenefits are thought to accrue to the women through possession. Women trancers by contrast see the spirits as punitive and controlling and see themselves as having to learn to submit to their task masters. Thus, whilst women have the difficult task of controlling their mad relatives, they themselves come under the control of possessing spirits. Case studies Some examples will clarify family attitudes to illness and trance. The family are from Baramati some thirty miles away. Sixteen-year-old Balu lives in the temple with his father. He is the only child to survive among six. The father is a tailor by trade and unlike most inhabitants in the temple he is literate. The family, consisting of mother, father and son, arrived at the temple four years ago. Balu's trouble had started after he was caught in heavy rain and floods on his way home from the fields. After he was pulled from the water he started to talk incoherently and behave in an unpredictable fashion. He would not eat or drink. He hit his mother and ran away from home. He also spoke Telugu, a language the family claimed he did not know. Although the parents spent a vast sum of money consulting three doctors and a devrishi,there was no improve-

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ment in Balu's condition. At the suggestion of friends they came to Phaltan. After a year of living in the temple, the wife started going into trance and in this way learnt that the son's condition was due to possession by bhut.At one stage the mother diagnosed the son as being possessed by a formidable I45 bhut. Although the reasons for the affliction were not discovered, it was clearly perceived as affecting the family as a whole. Four sons and a daughter had died in infancy and Balu's sudden turbulent behaviour was interpreted as part of this continuing onslaught. As the mother continued to trance daily, so her physical health declined and Balu's turbulent behaviour subsided. However, this simultaneous process of recovery and decline in health culminated tragically in the mother's death a year ago. To Balu's father her death is indicative of the gravity of Balu's earliercondition and her unconditional love for her child. As a result of the mother's death Balu has recovered totally from bhutbhadaand the earlier behavioural disturbances. He does, however, suffer from a memory impairment, but despite this residual symptom he is able to hold down a job in a government canteen. Thus the mother's death is seen as redeeming the son's affliction. However, despite the mother's sacrifice of her life, the affliction is not seen as resolved and the fund of illness has not been exhausted. Balu's father has begun to suffer from sleeplessness and a tumour has appeared on his chin, and these symptoms are taken as outward manifestations of the relentless pursuit of the family by malevolent bhut. With the mother's death, father and son feel particularly vulnerable, since the source of diagnostic information has been taken away. A similar sense of shared affliction is to be found in the following example. Sindhu is twenty-five years old and has been living in the temple with her mother and mother's sister for three years. The family home is some forty miles distant in Solapur district. Sindhu has suffered from tras or trouble for eight years, when she suddenly started behaving unpredictably. For three months she refused to wear clothes. She would attack everyone around her and beat her mother. She spent two months in hospital in Bombay and a fortnight in Pune mental hospital. Mother and aunt still find her difficult to manage and try regularly, though unsuccessfully, to obtain institutional care for her. Episodes of violent behaviour are followed by trips to the police station, where their request for institutional treatment is met with the reply that they should approach the police in their own taluka.In the temple Sindhu spends a lot of time sleeping, but when not asleep she is troublesome. For much of the time she is chained. However, despite the difficulties which it poses for her mother and aunt, Sindhu's condition is perceived as a matter of shared family concern. The history of their stay in the temple illustrates this. Sindhu initially came to the temple with her mother. Shortly after their arrival they were visited by Ratan, the mother's sister. Ratan immediately came under trance and in this way learnt that the source of Sindhu's trouble was karani. More specifically, karanihas occurred because land was purchased in Sindhu's name and this aroused the envy of her mother's brother-in-law. This envy is thought to have resulted in the death of Sindhu's father and karaniis now directed at all three women, mother, aunt and daughter. Although the malevolent force attacking the family comes from a single source its manifestations vary according to the individual

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under attack. Sindhu has suffered from madness, the aunt has suffered trance, fever and swelling of the limbs and the mother also has suffered trance. Thus despite the friction caused by Sindhu's behaviour, her condition is treated as a joint misfortune arising from family animosities beyond her control. The case of twelve-year-old Sachala and her family illustrates the complex movement of illness between family members. The family, consisting of mother, father, daughter and two sons, come from a village some thirty miles away. At the time of the first interview the family had been living in the temple for two months. On a return visit fourteen months later they were still there. The father works as a stonemason building walls. However, he has behaved strangely for many years, talkiftg senselessly, not taking food and wandering about the countryside. In short, he behaves like a madman. After first visiting the temple five years ago the mother started going into trance and learnt that the family troubles were due to karani brought about by her maternaluncle or mama, who had got into a dispute over sheep with the husband's family. As a result the entire family were affected by karani. At the time of the first interview the mother's trancing had subsided and it was thought that Sachala had taken over the brunt of the affliction. Indeed, the daughter was trancing in what appearedto be a life-endangering and spectacularfashion. Fourteen months later, however, Sachala has stopped trancing completely and the mother was again trancing twice a day. The family saw the trance in mother and daughter as stemming from the same source and the mother described the situation as the trouble coming from the daughter to her. Both the mother and the rest of the family acknowledged her suffering to be self-willed: because of her love for her child she had asked God to remove the trouble from her child and give it to her. As a result not only was trancing transferredto the mother but she was also suffering from pains in the head and waist and described all her strength as ebbing away. However, despite her self-sacrificial stance, the husband has been unable to throw off the effects of karaniand has not yet improved. Also, the younger son has begun to suffer from swollen limbs. Thus the entire family has been drawn into the web of affliction. Six of the parents' children have already died and the family clearly sees itself as the target of unremitting mystical onslaught. Ramu and his mother have lived in the temple for five years. Last year they left but have now returned. Ramu is about thirty-five and the younger of two brothers. His problems started five years ago when he was married against his wishes. At the time he was in the army and on his return to the army after his marriage trouble started. He beat people up, laughed without reason, talked without stopping and on returning to his home hit his mother. He also stopped eating and sleeping. He spent a month in the military hospital but showed little improvement. After coming to the temple Ramu began to improve and he is now '75 per cent.' improved and is able to earn his own livelihood. The improvement in his health is seen as linked to his mother's trancing. The mother has suffered intermittently from trance: during the two years that she tranced regularly Ramu's health was seen as improved, but during the year that she ceased trancing his health was perceived as deteriorating. Now that she has resumed trancing, his health is thought to be on the mend again. Although in

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this case little is known about the nature or reasons for the affliction, save that bhut is involved and probably karani, the history of Ramu's illness and his mother's trancing provides a vivid illustration of their interdependence. The above cases illustrate the way in which trance is perceived, its chronological development in relation to other family illnesses and its perceived therapeutic function. Trancing in Maharashtrais thus of a different nature from zar possession, described by Lewis (I97I) and others. Possession by zar spirits is common throughout north-east Africa and the Arabian peninsula. Zar spirits are peripheral to the central religious beliefs of the society and possession by zar causes illness which can be propitiated by dancing and trance within a cult group

(Messing I958; Kennedy I967; SaundersI977; Morton I977). Lewis has put
forward the so-called 'deprivation hypothesis' to account for the distribution and form taken by zar possession. He argues that women in deprived circumstances become possessed and through possession exact some advantage which they would otherwise lack. He writes: 'The prime targets for the unwelcome attentions of these malign spirits are women and particularly married women. The stock epidemiological situation is that of the hard-pressed wife struggling to survive and feed her children in the hard nomadic environment and liable to some degree of neglect, real or imagined, on the part of her husband' (I97I: 75). He goes on to describe how zar possession is used as a weapon in the unequal contest between marriage partners: 'and in every example I encountered some grudge against her partner was borne by the women involved' (I97I: 76) Through possession women may gain a variety of benefits: attention and solicitude from otherwise neglectful husbands, the upper hand in disputes and gifts of material goods and special foods which the zar spirits might crave. accounts of trance Anthropological This specific epidemiology and interpretation of spirit possession have been formulated with the societies of north-east Africa in mind. However, the deprivation hypothesis does not illuminate the role of trancing in the Mahanubhav temple. Whilst it has been acknowledged that 'the spirits are not reducible to any single psychiatric diagnosis even within a single culture' thatthereis a unifiedpattern to their (Crapanzano I977: I3) it hasbeenassumed use and to the way in which they are perceived. Through trance women are thought to become what they are not and to achieve ends which they otherwise could not. In this connexion Crapanzano writes of 'a dialectic of identity transformation' (I977: I 5). Thus from a psychoanalytic point of view women might be seen as using trance to project repressed or otherwise unattainable desires. Although Crapanzano acknowledges that there can only be projection where there has been introjection, the full implications of this are not much in evidence in the writing on spirit possession. However, the role of spirit possession and trance in the temple community can only be properly understood in terms of the introjection of stereotypes of desired feminine behaviour. Through trance women become exaggerated versions of their everyday selves rather than their opposites. My understanding of women's interpretation of trance at the Mahanubhav

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temple is close to that of Constantinides (I985). She describes many women as joining the zar cult when they 'fail in some way to live up to their expected womanly role . . . In these circumstances most Sudanese women adopt the sick role' (I985: 688). The zar cult is led by an older woman and has a largely female membership. Through elaborate and prolonged rituals centring on trance, membership of the zar cult enables women to come to terms with the spirits possessing them and thus to improve their health. An important feature of the Sudanese zar cults is that the healers are women as, indeed, the title of Constantinides's article makes plain. In this respect the activities of Sudanese zar cults resemble those of the Mahanubhav healing temples. However, whereas among the adherents of the zar cult the beneficiaries are the women themselves, in the Mahanubhav temple women's trancing is thought to benefit their relatives. Indian culture emphasises the importance of devotion and self-sacrifice to a woman's character. Princess Gandhari's marriage is an example. This ancient scriptural precedent is re-enacted by Indian women confronted with family illness. Neither general deterioration in health, however, nor susceptibility to trance appears to interfere with women's ability to look after the erstwhile original patients. Between periods of frenetic trancing women still chaperone, nurse and cook for their demented charges. How can women's claims to suffering and general debilitation be reconciled with their manifest zest and enjoyment of temple life and their continued effectiveness in performing housewifely duties? Part of the answer is to be found in the continuing influence of cultural stereotypes. Princess Gandhari's response to her discovery that she has been married to a blind man is to mimic his blindness, thus sharing his disability. The general expectation that women who arriveat the temple with no particular complaints will start to trance, fits in with the cultural requirement that women sacrifice their wellbeing if close male relatives suffer from mental disturbance. Women appear to be reproducing the symptoms of their male relatives. The horsefestival The values put upon male strength and health and female vulnerability and self-sacrifice are given most dramatic and intense expression at the time of a major festival, the horse fair. Although this may not be the most important festival in strictly doctrinal terms, it attractsby farthe largest number of visitors. According to legend the festival is several hundred years old, although no one knows its exact age. The legend recounts that a brass horse was carriedby some devotees of Lord Vishnu to the nearby temple of Khandoba. The devotees stopped to rest for the night in Phaltan and found in the morning that they could no longer lift the horse. This was taken as a sign that the horse properly belonged to Lord Krishna and should live in the Mahanubhav temple. Since that time the arrivalof the brass horse is celebratedannually. The original brasshorse has been joined by other horses given in gratitude for health restored. At the time of the festival the horses, bedecked with flowers, are carriedout ceremoniously on the heads of young male devotees who have been cured of their afflictions. The

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horses represent the reality of cure and thus hold out hope for the multitudes of afflicted who flock to Phaltan. After the procession has reached the river the horses are bathed in clean water specially carriedfor that purpose. The other important component of the festival is the extent and violence of the trancing. Many women arrive simply as devotees for worship and find themselves unwittingly drawn into trance. Others come specifically with the idea of promoting family health and well-being. It is generally believed that through the experience of intense suffering concentrated within the few days of the festival, women can safeguard the health of their families for the rest of the year. Whatever the long-term effects of participating in the festival may be, many hundreds of women do go into trance at this time. Trancing takes place as womenjoin the procession led by the brass horses which wends its way through the town. It is thus very much a public event and indeed the streets arelined with townspeople who come to watch the trancing women. On the fifth and final day of the festival the procession aims for the river Banganga, at a point where the town sewage is disgorged into the river. The river banks are lined with hundreds of spectators, mostly men, eagerly awaiting the arrival of the trancing women. The women fling themselves into the filthy water, scooping up the mud from the river bed and drinking the water. The spectacle lasts a full afternoon. Through this public abasement it is thought the afflicting spirit can finally be persuaded to leave the woman and her family in peace. In contrast to the punishing routine exacted of women during the festival, the brass horses carried by young men seem to represent serene health and strength. Whilst the women drink sewage-contaminated water, the horses are washed in pure water carriedin a separate container. Whilst the women roll in the mud of the river bed the horses are carriedhigh on the shoulders of young men who have themselves been cured of their afflictions. It does not seem too far-fetched to suggest that some sort of public statement is being made about the relative health expectations of women and men and the dependence of male wellbeing upon female self-sacrifice and abasement. Maharashtra peasant women appearto be particularlyready to take on responsibility for family health in this spectacular fashion. Daily life in the temple embodies the belief that male health improves at the expense of female trancing. At the festival this belief is affirmed on a massive and public scale. Whilst trance is thought to divert spiritual malevolence away from the index patient, it also has the practical consequences of giving him or her very much a back seat in the daily life of the temple. The pattern of temple activities seems to be geared to the requirements of the care-givers ratherthan their charges. To an outside observer the trancers are more visible, particularly on ritual occasions, than the patients. However, whereas there is no agreement between women and priestly experts over the aetiology and function of trance, such discrepancies do not appear to trouble the definitions of so-called mad patients: in their case indigenous, priestly and western models of madness meet. Most of the patients have had many years experience of western style psychiatrists. Some have been and are in contact with a private psychiatrist practising in the town. Most of the families would prefer their sick relative to be cared for in hospital, thus supporting Minocha's argument that treatment choice depends upon: 'availabil-

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ity, accessibility and quality of careprovided by the diverse systems' (I980: 2I9) More often lack of resources means that there is no real choice. As a result community care remains the only option and the family is burdened not only with problems of management but also with additional financial problems. There appear, however, to be no problems over the identification of acutely psychotic patients. Patients are designated as mad by pointing the index finger at the right temple. The concept of madness is seen as simple and basic. Questioning on the subject was taken as further evidence of the field-worker's pitiable lack of basic knowledge and sense. And, indeed, although the detailed psychiatric interviews which had been part of the research plan could not be implemented the psychotic patients could be readily identified. However, little was done for these patients apartfrom providing them with basic physical care. Instead, the healing activities of the temple were concentrated on the promotion and control of trancing among women. This served both to deflect attention away from the temple's ineffective management of patients and to confer upon women the sense of actively contributing to the health and well-being of their families.

Conclusion In summary, therefore, trancein the Mahanubhavtemple is not the response of a marginal individual who thereby manoeuvres -herself into a more favourable position and projects her unsatisfied desires and conflicts onto the characterand behaviour of the spirit possessing her. Rather it seems to underline the woman's central responsibility for the health of her family, whilst at the same time encapsulating an unresolved ambivalence in ideas about feminine character. This ambivalence is reflected in the contradictory explanations held about the nature and function of trance. Women see themselves as steadfast, devoted to for their family's their family and willing to sacrifice their health and wvellbeing women as unstable and easily led the weak, sake. However, priests represent with These two are never encounters malevolent spirits. positions astray by openly confronted one with the other let alone reconciled. Only the priests' position is given public acknowledgement.
NOTES

I am grateful to the ESRC for their generous support of the research. (Personal Research Grant Goo and I should like to thank Dr Pam Constantinides for reading the article. 1 The research was originally planned as a two-pronged investigation using psychiatric as well as anthropological techniques. However, due to visa difficulties the research was cut short and the psychiatric interviews could not be implemented.
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REFERENCES

prospectsfor Abdullah, Tahrunessa A. & Sandra A. Zeidenstein I982. Villagewomenof Bangladesh: change.Oxford: Pergamon. in andmentaldisorder of Kota:stress,change Carstairs, G. Morris & R. L. Kapur I976. Thegreatuniverse an Indianvillage. London: Hogarth.

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Constantinides, Pamela I985. Women heal women: spirit possession and sexual segregation in a Muslim society. Social Sci. Med. 2I, 685-92. Crapanzo, Vincent I977. Introduction. In Case studiesin spiritpossession(eds) V. Crapanzano & V. Garrison. New York: John Wiley. in cosmology. London: Barrie & Rockliffe. Douglas, Mary I970. Naturalsymbols:explorations Elnagar, M. N., Promila Maitra & M. N. Rao I97I. Mental health in an Indian rural community. Brit.J. Psychiatr.ii8, 499-503. sect. New Delhi: Manohar. Feldhaus, Anne I983. The religious systemof the Mahanubhava I984. The deedsof God in Rddhipur. New York, Oxford: Oxford Univ. Press. -n. d. The orthodoxy of the Mahanubhavas. ms Janzen, John M. I978. The questfortherapyin lowerZaire. Los Angeles: Univ. of California Press. and society in India. Delhi: Kakar, Sudhir I98I. The inner world: a psychoanalytic study of childhood Oxford Univ. Press. Kapur, R. L. I975. An illustrative presentation of a population survey of mental illness in south countries. India. In Mentalhealthservicesin developing Geneva: WHO. Kennedy, John I967. Nubian zar ceremonies as psychotherapy. Hum. Org. 26, I85-94. Kynch, Jocelyn & Amartya Sen I983. Indian women: well being and survival. Cambr. J. Econ. 7,
363-80.

around theglobe:a transcultural view. New York, Basel: Marcel Dekker. Leff, Julian I98I. Psychiatry Lewis, loan I97I. Ecstatic religion: an anthropological study of spirit possession and shamanism. Harmondsworth: Penguin. Messing, Simon D. I958. Group therapy and social status in the zar cult of Ethiopia. In Cultureand mentalhealth(ed.) M. K. Opler. New York: Macmillan. Minocha, Aneeta A. I980. Medical pluralism and health services in India. Social Sci. Med. I4B,
2I7-23.

Morton, Alice I977. Dawit: competition and integration in an Ethiopian Wugabi cult group. In Case studiesin spiritpossession(eds) V. Crapanzano& V. Garrison. New York:John Wiley. Raeside, Ian M. P. I976. The Mahunubhavas. Bull. Sch. orient.Afr. Stud. Lond. 39, 585-600. Rubel, Arthur J. I964. The epidemiology of a folk illness: susto in Hispanic America. Ethnology3,
268-83.

Saunders, Luce Wood I977. Variants in zar experience in an Egyptian village. In Case studiesin spirit possession(eds) V. Crapanzano & V. Garrison. New York: John Wiley. Stanley, John. n.d. Gods, ghosts and possession. ms. Thacore, V. R., S. C. Gupta & M. Suraya I975. Psychiatric morbidity in a north Indian community. Brit.J. Psychiatr.i26, 364-9. and classification Wing, J. K., J. E. Cooper & N. Sartorius I974. The measurement of schizophrenic an instruction symptoms: manualforthepresentstateexamination andCategoprogramme. Cambridge: Univ. Press. Zempleni, Andras I977. From symptom to sacrifice: the story of Khadi Fall. In Case studiesin spirit possession(eds) V. Crapanzano & V. Garrison. New York: John Wiley.