Patient Education and Counseling 26 (1995) 159-167 ELSEVIER

Totemic medicine among the American Indians of the Northwest coast

S.W.A. Gunn’

Medical Society of the World Health Organization, Geneva, Switzerland

Abstract

A description is presented of the medical beliefs of the totemic people on the Northwest American coast. The principles of Shamanic therapy are analysed. The consequences for therapeutic views by medical schools are discussed.

Keywords: Totemic medicine; Amerindians; Cultural differences; Health beliefs; Ethnomedicine

1. Introduction

Cultural differences and beliefs are 2 elements that can be neither quantified nor laboratory- tested, the obligatory criteria for any scientific statement. Yet, we are all scientists here, seem- ingly gathered to reach objective, scientific conclu- sions. To be provocative, let us start by recruiting the support of 2 historical colleagues whose scien- tific authority cannot be in doubt: Wirchov, the cell pathologist and Billroth, the master surgeon. Unchallengeable scientists, yet both were rather of the opinion that medicine was a social science, which at once makes the inclusion of a socio-cul- tural approach both understandable and logical. Cultural differences and subjective health beliefs

’ Correspondence address, La Panetiere, 1279 Bogis-Bossey, Switzerland. Tel.: + 022 7762161; Fax: +4122 7766417.

do interface with objective health care, and in this context we should like to discuss with you the totemic medical beliefs and shamanic health care practices of the Red Indians of the Northwest coast of North America.

2. Northwest coast totemic Indians

When one thinks of the American Indians, one has, I dare say, the image either of Aztecs and Incas living in gold and silver palaces, or of Hollywood’s distortion of warriors in plumed head-dress, scalping people and fighting the cow- boys. The Amerindians whose primitive medicine is discussed here are entirely different. They wore no plumes, did not eat corn and did not even know what a horse was. These natives, now called First Nations of America, live on the Northwest

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Fig. 1. N orthwest coast elder, in Chiefs regalia, holding totemic talking stick and shamanic Raven rattle (University of British Columbia ).

Pacific coast of the North American continent, along a narrow littoral extending south from A laska down to the mouth of the Col- umbia River. They are entirely sea-going people and were the last to come under

European influence. Indeed, it was not until the end of the 18th century that they first met the white man, and medicine men of primitive thinking can still be encountered today.

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Fig. 2. Kwakiutl initiation ceremony, Hamatsa secret society dance. Canada West coast, early 1900s.

Pre-history here, then, is almost yesterday. In this society social life was very active, character- ized by riches, leisure and abundance. Under such easy circumstances life was pervaded by myth and legend, recounted from generation to generation at colourful and fantastic ceremonies in which spirituality flourished to an unprecedented degree. This society saw the supernatural in every object, animate or inanimate, governing every phase of human activity, in health and in disease. A vital and significant role in this culture was played by our professional predecessor on this coast, the shaman or medicine man.

The shaman has been described as a person endowed with supernatural, superhuman powers of curing, powers gained through practical as well as supernatural experiences. A man who in a trance was possessed of mysterious knowledge and ability, imparted to him by a spirit from the other world. This, as it can be imagined, brought

the aboriginal doctor into the realm of meta- physics and of religion. But it is significant that, although belief in the supernatural is of religious context, the shaman on the Northwest coast was not a priest. This distinction is important, for shamanism, in its original form, was a primitive religion of the tribes of Eastern Siberia, from where all American Indians are now known to have originated, some 12 000 years ago. In the process, the religious element became discarded on the Northwest coast.

The 2 principal avenues along which the Indi- an’s spiritual beliefs were exteriorized in daily life were a local and modified brand of shamanism and totemism. Before calling upon the help of the highly specialized shaman, the sick Indian first tried home remedies and lay recipes, and invoked the helpful spirits of his own ancestral totems. Totemism, derived from the Amerindian Ojibway word ‘ototomen’, meaning kin or relation, is the

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Fig. 3. Dramatic transformation of person into the Sun and Thunderbird totems (Bill Holm).

belief that all people have a kinship with animals, priests or royal intermediaries. This explains the and an anthropo-zoomiophic representation in absence of organized priesthood and of omnipo- the spiritual world. Totemism is an individualistic tent kings. Totems were respected but never wor- concept of personal or family ties with the super- shipped. In this sense they are the equivalent of natural. Under totemism, the primitive persona the European coat-of-arms. They are not idols, as came in direct contact with the world of spirits, the earliest missionaries classically and tragically without the necessity of shamans, mediums, misinterpreted.

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Fig. 4. An early photograph of the author examining a very rare Totem by Yaakuttas. The crests represent Thunderbird, Killer Whale, Shaman, Sea-Dog.

To become a medicine man was no easy matter. A person who acquired healing powers had to go through a very arduous novitiate and a training period counted in years. But even before such ‘internship’, when the novice was under the guid- ance and tutorship of an experienced shaman, there were long periods of initiation with taboos,

spiritualistic regulations, fasting, ablutions and complicated initiation rites, destined to prepare the healer for his honourable profession. And there is no doubt that this was indeed an hon- ourable profession, respected and feared too. Fol- lowing such preparatory training, the essential requisite for the specialty, the diploma, if you will, to become an acknowledged medicine man, was a spiritual encounter - an ecstasy, a trance, a supernatural experience, in which a vision would appear, a vision of the totem which indicated to him the fountain of his praeternatural ability of healing. In this vision he was also shown the dances, songs and masks of the spirits he would use and of the name he would carry in his curing seances as shaman.

Earlier observers and Eurocentric investigators were prone to discard any sincerity in the shamans and considered them as fraudulent char- latans. Not that the white physician of those days was any more effective in his treatment. More enlightened and modern students of society, reli- gion and medicine are now of the opinion that shamanistic ecstasy was genuine and that the shaman did play a therapeutic role among his people. 1 believe that the shaman was as credulous as his patient and that both indeed believed in his supernatural powers. He believed in the spiritual nature of the professional deceptions he used, and felt that he was acting under divine guidance.

3. Theories of disease among totemic people

It would be instructive to pass, now, to a brief consideration of the primitive theories of disease

Fig. 5. Ceremonial rattle, Raven totem (Douglas Cramer; Author’s collection).

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Fig. 6. Community big house of the Kwakiutl, for tribal ceremonies, initiation stances and kkimdtsa society gatherings.

among these totemic people on the Northwest American coast. The primitive Amerindian considered all disease to be due to super- natural causes. In this oceanic region there were 3 principal theories of pathogenesis: (1) disease by intrusion of foreign bodies, (2) dis- ease by soul loss, and (3) disease by spirit sick- ness.

Disease by intrusion

Disease by intrusion was believed to be caused by malevolent spirits that sent malicious foreign bodies such as splinters, pebbles or imaginary magical pellets, into the body of a person, caus- ing him to become ill. Such illness was outside the power of lay practitioners; only shamans had the supernatural ability to seek and remove the presumed pathogenic object. On the negative side, shamans were feared to possess also the power to introduce such contraptions into vic- tims, for gain or malice - a practice totally unbecoming to his profession, and punishable as black magic.

Soul loss

This was a mysterious disease in the form of severe apathy and lethargy. Besides his own totemic spirits, man was believed to possess a vaguely defined subsidiary soul, a kind of elan vital. The loss of this secondary soul did not cause outright death but led to gradual psychic and somatic depression, considered fatal if not ar- rested. Here again, only shamans of high compe- tence could intervene. The usual way to recover an absentee soul was for the medicine man to send his own soul or helping spirits to retrieve the strayed one and bring it back to the patient. Symbolically, this is represented by ‘spirit boats’.

Spirit sickness

This was a very serious condition, almost fatal, that befell the ritually impure or those suspected of having been contaminated by black magic. Breaking certain menstrual tabooos by a virgin, for example, would fall into this category of pathogenicity. Shamanic therapy was absolutely essential if the patient was to be saved.

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Fig. 7. Medicine man’s Soul-Catcher, representing Sisiutl, the double-headed serpent (Bill Reid; Author’s collection).

4. Shamanic Therapy

Although the shaman often used commonly known herbal, medicinal and physical aids, these were really a secondary form of treatment and as such left to the lay practitioner or old matriarch.

Fig. 8. Totem Pole. These typical monuments have given the name Totem Pole People to the Amerindian tribes of the Northwest Coast of North America (Alert Bay, B.C. Canada).

The specialist shaman’s main field and perogative was psychotherapy, disease by intrusion and soul loss constituting the bulk of his practice. This was no mere bedside visit. The shaman’s therapeutic seance was a spectacular performance, which usu- ally took place in the clan’s big house. It was put on with all the props of stagecraft, as a public performance of great showmanship, for the relief of the sick person, the comfort of his family, and the bemused admiration of the whole village. The scene can be imagined - a huge house, supersti- tious onlookers milling around, personal partici- pation, sweat, smoke and a huge central fire adding mystery to the whole operation. The ago- nizing patient, with his anxious family sitting around; the totemic statues of the tribe gazing down, and the central figure of them all, the magnetic medicine man, dressed in his impressive regalia and himself transformed into his power- spirit, dancing, drumming, incanting, fainting, healing. A scene, not without intention, of tense drama, excitement and mystery.

The gamut of cheap lay cure having been tried and failed, and the assistance of his totemic spirits having been sought to no avail, the native patient usually called the expensive specialist last. Enter the shaman, whose main therapeutic weapon was psychological. By means of suggestion, persua- sion, illusion, fear, legerdemain and hypnosis, backed by individual and mass hysteria, a most dramatic effect was given to these medical gather- ings. Repeatedly examining, manipulating, knead- ing, and sucking the presumed area of disease, the shaman would sing, dance, and recite over the agonizing patient for hours, or days if need be. Using all his professional paraphernalia - rattle,

166 S. W.A. Gum 1 Patient Educ. Counsel. 26 (1995) 159-167

drum, whistle, talking stick, puppet, masks, etc. - the doctor would perform in a magical state, gradually increasing the volume and tempo until, in a tremendous tension, he would suddenly ‘find’ or ‘see’ the cause of the disease, suck out the pathogen in his ‘soul-catcher’, and miraculously cure the patient.

The beneficial effect of such suggestive psy- chotherapy upon the poor patient - and on the specialist’s reputation - can be imagined. The shaman was indeed the psychotherapist par excel- lence. He was successful and highly regarded as a professional. No wonder that one can still see him top man on the totem pole.

5. Amerindian healing at present

Until now, we have been using the past tense, and may have given the impression that this is an account of prehistoric Indian ethnomedicine. What, may be asked, is the situation at present concerning totemic medical ceremonialism and of shamanic therapy, if these are practised at all. All culture constitutes a link between the past and the present, and in that sense there is always cultural continuity in time and space. As elsewhere, so in the Pacific Northwest, this culture has continued, but also as elsewhere, this has not been without stops and spurts, without its ‘golden eras’ and dark ages. In the historic period, that is during the 2.5 short centuries since these people were en- countered by Europeans, after a long period of dormancy and stagnation, indeed of governmental prohibition and socioeconomic decline, there is at present an upsurge, a very strong revival of Amerindian culture and cultural values, especially on this coast, This embraces all aspects of human endeavour, including tribal ceremonialism artistic expression, political consciousness, native power, and to come to our theme, traditional healing, spiritualistic gatherings and shamanic medicine.

This revival can be more or less dated from the post-World War II era, with its worldwide modifi- cations in society, the end of colonialism, the wane of Eurocentricity, the upsurge of liberal values and the assertion of national conscious- ness. On this coast, I also think that the 100th Anniversary of Canada, in 1967, heralded, albeit

unwittingly, the upswing of the Indian as full partner in the nation. His artefacts, that were until then sold as inexpensive curios, became ex- pensive art, exhibited in Western galleries; his aspirations, once oppressed and illegal, received attentive ears and formal recognition; and his previous submissiveness to imported values turned to a re-evaluation of his cultural heritage. Within these changes, he also began doubting the unassailability of the white man’s medicine and the cocksure prescriptions of the Indian Health Service. He turned, not without some eclecticism - for he still has recourse to proven Western methods - to the Indian medicine man and to traditional practices.

6. Conclusions

This brings us full circle back to the original specialty of the shaman - psychotherapy. The weaknesses and failures of orthodox psychological medicine and sociological attempts in dealing with psychopathological conditions, are known. Con- sequently, the Indian has been increasingly turn- ing toward his ancestral spirit dances, initiation stances, totemic search, and shamanic therapy. It is significant that while until quite recently such spiritualistic practices were derided and pushed aside as charlatanism, they are now being looked upon by medical schools and enlightened neu- ropsychiatrists as a valid form of therapy. Ther- apy that, within the specific context of Indian society, has been giving better results than those obtained by the white doctor. In such a tribal therapeutic seance, several factors take the upper hand over Western medicine. First and foremost, the patient submits voluntarily and fully expects that he will indeed be cured by spiritual interven- tion; the shaman himself believes in the aetiology of the disease and in his power of diagnosis and cure. Then there are the elements of group psy- chotherapy, cathartic abreaction, ego-support, sharing, psychodrama, physical exertion, occupa- tional therapy, and personal obligations, such as abstention, all of which, within the given sociocul- tural milieu, succeed better than our orthodox but equally unscientific attempts.

S. W.A. Gum I Patient Educ. Counsel. 26 (1995) 159-167 167

There is epidemiological logical - and not just anectodal - evidence to support this, at least in the case of Indian patients. For these results to be obtained, it is necessary to have the concurrent symbiosis of the tribal believing patient, the ambi- ent societal credulousness, and the initiated In- dian doctor. This explains why it works on the Indian psychiatric patient and not on the Western client. In 2 particular fields, that of psychoneu- rotic and psychophysiological states and of self- destructive and aggressive sociopathic behaviour (particularly with alcohol abuse and drug depen- dence), the ‘primitive’ Indian methods seem to be superior to Western prescriptions. As a teaching mechanism also, this personal and group partici- pation presents undeniable advantages and could be a model for several approaches in our Western culture. While improving the patient’s condition, the method also involves the participation of the society he lives in and, reciprocally, promotes re-insertion of the patient into the stream of life. An achievement for which it deserves at least our acknowledgement.

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