The Ghizer district in Gilgit-Baltistan is in the local media’s limelight, and one of the most favourite topics for researchers nowadays is the increasing trend of suicides in the district during the last one-and-a-half decade.
However, it is not only Ghizer where suicides are occurring. Suicides have been reported from other parts of the region too. However, most cases go unreported. The suicides are a manifestation of different kinds of mental illnesses. Nevertheless, research and discussion related to suicides in Gilgit-Baltistan tend to ignore the broader question of mental health. Hence, the explanations rolled out about the suicides are at best misleading, and at worst incoherent.
More problematic are the institutional and social practices used in Gilgit-Baltistan to diagnose mental illness and treat it. One of the pitfalls of having a one-dimensional approach to understanding a multifaceted phenomenon like mental illness and its manifestations – in the form of suicides or schizophrenia, depression, hysteria, psychosis, neuroses etc – is the failure to identify the causes and rectify errors within the regimes of cure. The term ‘regimes of cure’ refer to the entities, vocations and institutions that claim to cure mental illness to keep both self and society sane. Their reason of existence derives legitimacy from the very social, institutional and knowledge structures that at the same time produce mental illness within society. Seen in this way, the process of curing mental illness needs to be treated more than the ‘patient’ itself.
This article attempts to explore the problematic relationship between a patient and their treatment in the particular setting of Gilgit-Baltistan, and its impact upon an individual and society. Before delving deep into the problematic nature of mental illness and its treatment in the region, it is imperative to locate the individual within the overall social, cultural, political and psychological processes in society. The current mindset of Gilgit-Baltistan is functioning in a time where the level of change is extremely drastic. The phenomenal speed of change has defied all the traditional and existing frameworks of explanation. As a result, it has given birth to a situation where traditions are crumbling, and modernity remains unstable. It is this disjunction that is shaping the structure and contours of the contemporary mindset of an individual. This is why the illness should be seen as a manifestation of the mind or mindset formed in the dizzying vortex of transition.
Like in other parts of the world, the framework and treatment of mental illness in Gilgit-Baltistan has undergone various changes under the influence of modernity. But instead of incorporating modern disciplinary approaches in the treatment of mental illness, this modernity provided a fertile ground for hybrid practices, institutions and actors to take root. This has broader social and psychological ramifications.
Traditionally shamans and soothsayers helped an individual identified as being mentally disharmonious to restore balance in personality. Unlike in the modern age, traditionally not all mentally deranged people and sociopaths were considered detrimental to the social fabric and cultural ethos of Gilgit-Baltistan. Since the traditional healing system functioned under the shamanic cosmology, some forms of mental disturbance were attributed to fairies or pure spirits, and others were categorised as being under the influence of evil spirits. Thus, madness in shamanism had metaphysical dimensions. Shamanism in its essential form provided an autochthonous idiom for cultural psychiatry. This is testified by the terms people used in everyday life to explain a particular state of mind. The role of shaman as healer is problematic because he himself suffers from hysteria, if not complete psychosis. Nevertheless, he cannot encompass the sense and sensibilities that emerge from experiences of the non-metaphysical context of modernity. For example, there is no local word for depression and tension, but people use these words to describe their mental condition and sectarian violence in the modern age.
Though the shamanic techniques of treating mental states have withered to a great extent, they are still used by people living on the margins of modernity. Today, in Gilgit-Baltistan, pirs, millennial cults, sorcerers, clerics, doctors, religious scholars and psychologists have entered the discourse regarding mental illness and sanity. These actors and institutions are vying against each other to establish their legitimacy. This is the reason shamanism is declared a pagan practice by the clergy. On the other hand, local modern medicine practitioners deem themselves as the sole owners of mind. They take mental states to be the result of physiology.
Amidst the fight for monopoly over treatment and discourse of sanity, the patient suffers even more. The case of a teenager from a village in Hunza who began harbouring strange thoughts was initially taken to a shaman. After sometime his family was compelled to take him to a cleric who declared shamanism to be against Islam. When the teenager’s condition worsened, he was taken to a psychiatrist in Karachi but the family could not afford to bear the expenses. He was brought back to the village and given in the care of a cult figure. The boy ended up committing suicide.
The purpose of quoting this case is to show that the diverse actors and institutions involved in a single person’s treatment have instead become the cause of mental disharmony. Instead of curing, they aggravate the person’s condition. In Gilgit-Baltistan, these entities have become guardians of the discourse on sanity.
With the disappearance of shamanic vocabulary, people have lost the capacity to self-analyse. Hence, they have become existentially mute, which is a state where an individual faces serious experiences that drastically change their outside world and deeply influence their subjectivity and sensibilities; but they don’t have the words to explain it. This makes an individual vulnerable to mental collapse. In order to save an individual and society from psychological collapse, it is indispensable to give voice through new social arrangements and ontological securities.
Because of rapid changes, all institutions and characters, including religious figures, politicians, intellectuals, schoolteachers and parents in the region have lost connection with self, society and the world. The tragedy is that it is these lost people who are ‘mapping out’ the destiny of the future generation: the youth. This youth is unable to find the vocabulary that would explain their reality, because state and society force their own ideas on them. They are not given a chance to be who they are and instead take on a personality that is in dissonance with the self and the state of ego.
An alienated person in a closed society is more vulnerable to ontological insecurities. Other members capitulate to primordial sanity accepted at a collective level, but this kind of sanity fails to accommodate the experiences and feelings of a new age. Hence, a transitional society faces schizophrenia, aggravated more by exposure of the self to exogenous forces and ideas, whereas society becomes more insulated in the fear of losing its essence because of assault by outsiders. This explains the sect-based physical division of Gilgit, and increasing xenophobia on the basis of valleys, regions and languages.
R D Laing in his famous book ‘The Divided Self’ provides an existential solution for recovery. He believes a psychologist should facilitate this recovery of the mind. To change the mind we need to create a condition that enables the suppressed mind to celebrate freedom and beauty. A closed society ultimately turns into a prison. So it can be said that Gilgit-Baltistan is a prison house where different insanities fight to establish their own version of sanity. The region is in perpetual abeyance because of a lack of vision for the future.
New vocabulary needs to stem from the existential experiences of being here, which will be conceptualised to create new codes of self and society. For that purpose there is a dire need of a mind that can retain the past, experience the present, envision the future, and forge a new path that will open fresh horizons for society and self.
The writer is a freelance columnist based in Gilgit.