2. Marco referencial
2.1 Antecedentes investigativos
When I asked a Tibetan friend, Gyaltsen (28), what he knew about any local mental health facilities, he mentioned that he knew someone – ‘Lobsang’ – with ‘mental depression’, and suggested introducing us. My attempts to meet Lobsang proved to be rather protracted however; the result not of Lobsang’s reticence, but that of my friend. Gyaltsen initially mentioned Lobsang and his illness in September 2011, and in early October, confirmed that he had spoken to Lobsang, who had been told about my research, and was happy to meet me. However, as he did not own a mobile telephone, we would have to wait until Gyaltsen bumped into him in town – which he assured me he often did. As time went on, and I asked Gyaltsen about meeting Lobsang again, I started to wonder if he was procrastinating. Each time he confirmed that Lobsang was happy to talk to me, but had some reason why we could not meet him. Finally, Gyaltsen explained that although Lobsang had agreed to meet me, he felt that talking to me about his condition would make Lobsang feel worse.Contrary to the western conception of the ‘cathartic’ function of talking about one’s problems, Gyaltsen was echoing a view that I heard from several other informants; that talking about one’s difficulties makes one feel worse, and that talking about other things as a ‘distraction’ is generally preferable.
When Gyaltsen finally agreed to introduce me to Lobsang, the encounter proved interesting. Gyaltsen brought another friend along too, who tagged along until the interview, when he tactfully stood a slight distance away for the duration. Gyaltsen knew roughly where Lobsang lived, so we walked down the street as he tried to
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determine exactly which building it was, asking neighbours along the way. He referred to Lobsang as ‘the man with sems ma bde ba [uneasy mind]’, and people often clarified using an English term, ‘the man with mental problems?’ Before we found his home, several neighbours told us he was most likely sitting on one of the benches nearby some of the local shops, where they said he often spent time during the day.
Indeed, we found Lobsang there, and he led us over to another, quieter bench, where we sat down and I explained my research again to him, reconfirming that he was happy to talk about his experience. The interview was a slightly strange encounter for me too – perched on a bench in the light rain, with my translator’s friend standing nearby, and a number of locals watching this foreigner talk to a local man, well- known in the area for his ‘mental problems’, I was concerned that Lobsang might feel uncomfortable with this situation. He, however, did not seem perturbed. He answered all my questions willingly, and appeared comfortable discussing his experience of illness and the different healing methods which he had tried.
Lobsang (50) had been born in the area, his parents having fled Tibet for India before he was born. He lived with his elderly mother, and his two sisters lived locally. Lobsang was quiet and polite, answering questions and explaining when he could, and describing his illness:
My health condition is not bad – compared to [the] early time... Before I felt pressure on my chest – like someone holding me from behind... I was thinking continuously – strange things, no control over it. Now I’m really better than before – because of medicine... I take Indian medicine [biomedicine]... ‘Paxidep’ [i.e. paroxetine, one of the class of medicines known as selective serotonin reuptake inhibitors (SSRI), generally used to treat anxiety and depression], and two others [he was not sure of their names].
Lobsang explained that he visited a ‘neuro doctor’ in Siliguri, who had prescribed this medication and whom he visited for check-ups. He had been taking medicine for six years, after the problem began seven years previously.
Lobsang described how, when he first began to experience symptoms, he had visited a monk he knew of in Nepal. The monk had blessed him, and held a rdo rje (“dorje”,
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Skt.: vajra)1 to the top of his head. However, as he did so, Lobsang had had the strong desire to run away. Next, the monk tried to give him a srung nga (“soonga”, protective amulet), but as Lobsang held out his hand to receive it, he felt as if someone was pulling his hand away. He described how the monk had grabbed the collar of his T-shirt so that he could not move, and placed the srung nga into his hand. Lobsang related how as he took the srung nga, ‘I felt as if someone was leaving my body’. I asked if this treatment had helped, and he explained that it helped a ‘little bit’, describing how he had felt ‘relaxed for a few days... a little bit cured from this’. He went a few times to this monk for blessings, but unfortunately some of his symptoms persisted.
Lobsang’s description of the events on visiting the monastery perhaps suggests the presence of a spirit or possession of some kind. And yet, even with the presence removed, some symptoms continued, leading him to consult other practitioners in addition to this. Lobsang had tried ‘Tibetan Medicine’, but found that it did not help and, believing that other herbal medicines such as Ayurvedic medicine would not help either, he tried biomedicine instead, initially consulting a local Indian
biomedical doctor who was popular with the Tibetan community in Darjeeling. The doctor suggested he visit a psychiatrist, and the initial psychiatrist, on being unable to help, recommended a second psychiatrist, who Lobsang continued to consult. It was this doctor who prescribed his medicine.
Gyaltsen translated as Lobsang described the symptoms he experienced:
Sometimes I feel the earth is coming towards my face. When feeling pressure [he indicated his chest], I have no problem breathing, but feeling fear and pressure on the back of my neck... I have many thoughts... [which I] can’t control... I feel threatened.
He explained that before he had started taking the medicine, he had also had trouble sleeping. Lobsang explained that he was now much better, but the symptoms had not totally gone. For example, although he no longer had trouble sleeping, he explained that, when sleeping, ‘I do not fully relax’. He felt that ‘medicines are best, but also
1 Translated as ‘thunderbolt’ or ‘diamond’, this ritual object was originally associated with the Vedic god Indra and symbolises strength and power (Samuel 2012, p. 50), and is commonly used for Tibetan Buddhist ritualistic purposes.
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support and encouragement from others helps... The doctor says it will take time, but it will be cured’.
Discussing the possible cause(s) of the illness, Lobsang explained that he had experienced a lot of ‘pressure’ in a previous job. Gyaltsen translated: ‘He had been designing carpets... He was deeply thinking about designing all the time... [his] brain got a lot of pressure’, explaining that the concentration and ‘pressure’ of the job had been involved here. I enquired about his diagnosis. Lobsang and Gyaltsen discussed this briefly in Tibetan – both seemingly unable to recall the English word – Gyaltsen finally saying, ‘Yes – depression, that’s it’. I asked if the doctor had also mentioned ‘anxiety’, but Lobsang said no – only ‘depression’. Asked how he referred to his illness in Tibetan, he used the terms sems nad and srog rlung. More recently, in 2011, Lobsang had been to work in a tea factory in Bhutan for eight months. He explained that he had been appointed as a low-level leader, but unfortunately he had experienced some difficulties, and he had found it very ‘stressful’. This had
exacerbated his illness, and consequently he had resigned and returned to Darjeeling where, unable to work, he usually spent his days in town, talking to others and looking after his elderly mother at home.
In many ways this is an unremarkable story: a man with a fairly common case of depression, exacerbated by stress, which was responding to some degree to
biomedicine. However, it is also a good example of some of the ways in which the Tibetan notion of rlung has been linked to contemporary discourses on ‘stress’ and ‘pressure’ in relation to ‘modern life’. Named srog rlung, rlung and ‘mental depression’ by others, and diagnosed as ‘depression’ by his psychiatrist, Lobsang viewed his illness as caused by ‘stress’, ‘mental pressure’ and ‘concentration’. In this chapter I will examine the concepts of rlung and srog rlung and their relation to mental health and illness from the perspectives of amchi and lay Tibetans; and contemporary Tibetan notions of ‘stress’, ‘pressure’ and ‘depression’, as well as the politicisation of the rlung diagnosis.
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