Eating Drugs

Psychopharmaceutical Pluralism in India

Stefan Ecks

• Publisher: NYU Press
• Year: 2013
• ISBN:
  9780814789179
• Topic: Social Sciences
• Subtopic: Anthropology
• Index: Social Sciences

· “A significant, difficult-to-achieve advancement.” – Kalman Applbaum, University of Wisconsin-Milwaukee

“An enthralling account…This book is essential reading for anyone interested in culture, science, and technology.” – Janis H. Jenkins, editor of Pharmaceutical Self

1

Popular Practice

The Belly and the “Bad Mind”

“If the Belly Stays Cool, the Head Stays Cool”

The first principle of Bengali body concepts is that the belly is the somatic center of good health. The basic Bengali term for belly is pet, which signifies “stomach,” “belly,” and, in women, also “womb.” Bengali has terms for the various organs that are contained in the belly, such as yakrit (“liver”), pliha (“pancreas/spleen”), or antra (“intestines”), but pet is most encompassing and most widely used. The belly is so vital for health because it is like a kitchen where food is cooked and refined. Pakasthali, the “place of cooking,” is a Sanskrit word for “the belly.” Thali here stands for “place,” and paka means both “digesting” and “ripening.” Another Sanskrit word for the belly-as-kitchen is jatharagni, the “digestive fire.” Mandagni, the “slow fire,” is indigestion. According to Jonathan Parry, “the digestive process is itself represented as a matter of cooking—or re-cooking—food in the digestive fire of the stomach (jatharagni)” (1985: 614; Barrett 2008: 134). The expression surya grantha (“sunbelt”) underlines that the belly is defined by heat. Heat, cooking, sun, fireplace: all these concepts are united by heat. The belly cooks food, but it also “cooks” babies: the gestation of embryos in the female womb is a form of slow cooking. A formal word for “belly” is udar, which can be traced to the Indo-European root udero, which also informs Greek uderos and Latin uterus, both meaning “abdomen” or “(lower) belly” (Mallory and Adams 1997: 2). To cook food to perfection, the fire must neither be too high nor too low. Heat is good, but it must not be excessive. Bengalis focus on humoral moderation and balance. A “burning” stomach is a clear symptom of disease. Likewise, too much cold imperils the fetus, while too much heat can lead to a premature birth.

For Bengalis, health depends on the proper alignment between the belly and the mind. In this alignment, the belly is a “hot” source of energy that needs to be controlled by the “cool” sovereignty of the mind. A peaceful and controlled mon is seen as a precondition for a healthy life. When you are not worried about anything, when you keep your mind concentrated, you will always be healthy. The symptoms of a cool mind are a shiny, radiant face; success in any sphere of life where one chooses to excel; and the ability to transcend petty worldliness altogether. Conversely, there are dire consequences for the whole body if mon is disturbed, distilled in the saying “if the mind is bad, the body is ill” (mon kharap lagle, sharir kharap lage). A jumbled mon can be the source of any disease: fever, headaches, high blood pressure, diabetes, obesity, deranged hormones, heart stroke, or drug addiction. In popular etiology, mon does not cause these problems directly, but it is the hot belly let loose that imperils health.

In turn, mental power (moner jor) can overcome all ills. When the heat of the stomach is under control, the mind can stay under control as well. At its simplest, this is expressed in the Bengali saying bhudi thanda thakle, mudi thanda thake (“if the belly stays cool, the head stays cool”). Bhudi means “a fat tummy.” It appears commonly together with mudi (a colloquial form of mudo, “head”) in the expression mudibhudi. To keep the whole body healthy and whole, mind and belly must be aligned and properly balanced. Keeping the mind healthy will keep the belly healthy, and vice versa. A Calcutta woman explained this as follows: “Bhudi thanda thakle, mudi thanda thake. If food properly is digested, all health will be good. Also: If someone is hungry, he gets irritated. He gets annoyed quickly. His mood changes. When appetite is satisfied, the mood cools down.”

For good health and lucid thinking, the belly must not be allowed to overpower the mind. An aphorism attributed to the Hindu saint Ramakrishna (1836-1886) lists udar with the anus and sexual organs as the third constituent part of a tribhumi (“three-partite land”). For Ramakrishna, most people’s thoughts never rise up to the divine, never get beyond the borders of these “three lands” governed by the gross desires of eating, sex, and excretion. Sarbani Ma, a female guru in the Kriya Yoga tradition, whom I once interviewed in her ashram on what she thinks about psychopharmaceuticals, said that drugs could only ever act temporarily. Conversely, true peace came from changing one’s inner attitude to the outside world: “Depressed people are misguided, they don’t know the other side of life, they go with the material life.” The mind must rise upward: “All ego problems come from the lower self. The lower self rules the mind when the mind becomes attached to it. But when the mind is attached to the higher self, then it washes the lower self, and all good qualities come when a person practices yoga, all diseases will go, insomnia and mental disorders.”

Calcuttans are not specific about how a disturbance of mon produces illness. That too strong outside disturbances and too many worries make you sick is taken as an obvious fact that needs no further justification. One explanation I heard about the “inside machine” used a peculiar combination of religious ideas and chemical production: eating was like doing worship. If there is no concentration on the act, there cannot be good results. If the mind is not peaceful, no saliva will be produced. No gastric secretions will flow; the liver will not give its juices. Only if you concentrate your mind on the meal will digestive rasa be produced in the intestines. Urine and stool will be separated from the subtle matter, which goes into the blood. If the mind is deeply disturbed, one cannot digest anything. Only with the concentrated mind can the machine inside do its work.

Many South Asianists, above all the ethnosociologists, emphasize that popular Hindu notions of the body are monist, and not dualist as in the Cartesian West (e.g., Marriott 1976, 1989). Since “all is one,” there is no fixed boundary between the inner and the outer, and personhood is “fluid” (Daniel 1984). Ironically exaggerating the difference between Western “bounded bodies” and ethnosociological descriptions of Indian “fluid bodies,” Lawrence Cohen notes that stereotypical Westerners suffer from constipation, whereas Indians suffer from diarrhea: “they let everything out. They survive the heat, but at the cost of any attention to boundaries” (1998: 23). The main reference for the ethnosociological interpretation of Indian personhood is the philosopher Adi Shankara (eighth–ninth century CE), who consolidated the doctrine of Advaita Vedanta. In his version of nondualism, atman (soul) and Brahman (eternal reality) are one; differences are illusions.

Bengali Hinduism is strongly influenced by Tantrism, and the worship of the black goddess Kali is more popular here than in most other regions of India. The mythical imagination of a nondualist cosmos is also colored by the cult of Kali. When I once asked Mr. Mukherjee, a Brahmin pundit, about the meaning of the Sanskrit term vishvatomukhah, the “mouth of the universe,” he explained that it expresses the divine destruction of the world at the end of time. Visva means “universal,” and mukha means both “face” and “mouth.” As the “universal face,” the Supreme Being (Brahma) is looking into all directions, into the past, the present, and the future. Mukh is also “mouth,” and Kali takes on the twin roles of creator and devourer of time. From Her mouth, everything is created, and at the end of time, Her mouth eats up everything again: “Out of Her mouth, She creates. And then . . . [moves his hand to his open mouth as if he were eating food].” This was a mythological image to illustrate the philosophical insight that all physical matter is the product of mind: “Mind precedes and creates matter. So if mind is the creator of matter, and matter is nothing but a particular transfiguration of mind, then this entire universe is nothing but mental.” Anyone who engaged in deep meditation realized that everything is maya, an illusion, and that the entire universe is a creation of the mind. Mother Kali eating up the entire universe was a vivid image for a timeless philosophical truth of the unity of atman and Brahma: “Ma Kali is not gulping any matter. She’s gulping the transfiguration of mind,” explained Mr. Mukherjee.

Not all Bengali Hindus are able to give the same scholarly explanation of why Ma Kali swallows up the world, but nondualism is undoubtedly the most widely shared philosophical position among them. Such nondualism does not mean, however, that they do not see a separation between mind and body, as is often suggested. Nondualism is popular in Bengali Hinduism, but there is no firm belief that the mind and the body are made from the same “substance codes.” The model that I extracted from dozens of interviews looks as follows: (1) Mind and body are separate entities. (2) Mind and body interact with each other. (3) This interaction should be hierarchically structured: it is a good interaction when the mind is in control over the body; it is a bad interaction if the body is in control over the mind. (4) To control the body, the mind must be disciplined, steady, and calm. If it is disciplined, it can control the body. If it is undisciplined, it loses control over the body. (5) Ideally, the body is controlled by the mind, whereas the mind is not influenced by the body. (6) If the mind is in control, anything can be eaten. It will not have an impact on the mind. (7) Only if the mind is weak will the qualities of food have an influence.

Popular Bengali ideas of mind/body relations are shifting amalgamations of different philosophical ideas that are logically coherent only if they are kept apart. For example, in the Sanskrit canon, mon is only one among many levels of mind and consciousness. In the Upanishads, and also in later philosophical streams such as Samkhya, Yoga, and Advaita Vedanta, mon is distinguished from cit (consciousness). The mind is influenced by sensory perceptions, whereas consciousness transcends them as illusions. The states of the mind are linked to food, drink, and outer experiences, whereas consciousness remains a witness, pure and unaffected (Gupta 2003: 34). In the Katha-Upanishad—written after the fifth century BC and the most famous in the canon—the mind (manas) appears in the metaphor of a chariot (Katha Upanishad 3, 3-4). The atman (individual soul) is compared to a passenger. The chariot is the physical body. The intellect (buddhi) is the charioteer. The horses are the organs of sense perception. The outside objects passing through perception are likened to the path on which the chariot travels. The mind is the rein that controls the horses (the senses). When the charioteer keeps the rein tight, he can steer the passenger to perfection; when the charioteer slackens the rein, the horses veer off course. In this depiction of the mind, the definition of perfection is neither coolness nor stillness, but firm control. Cool stillness is the perfect state of buddhi and atman, but not of manas.

At the least, this passage from the Upanishads shows that Indian concepts of the mind should not be reduced to an opposition between either dualism or monism—if one looks closely, many subtle shades of unity and difference in between the mind and the body can be discovered (Halliburton 2009). One of the senior psychiatrists I interviewed in Calcutta, Dr. Gangopadhyay, also said that there was a spectrum of opinions about mind/body relations. Based on his experience, he felt that nondualism was more common in the cities, whereas rural people tended toward a clear dualism between body and the mind. In his consultations with patients, he shunned any discussion of this question. If challenged, he replied that the body is material and perishable, whereas the soul is immaterial and imperishable. The mind (mon) was part of the body and separate from the soul (atman): “Mon is in the brain. It is a qualitative manifestation of biochemicals. Serotonin and brain chemicals are not mind. But the manifestations that they effect, that is mind.” The soul always remained untouched by the materiality of the mind, as well as by any medications that might be taken. To locate the mon in the body and not in the soul helped avoid alienating patients who strongly believe in the transmigration of souls: “Your mind definitely dies. Mon dies, but atma goes on. Everyone will say that body and mind are separate, that is a deep philosophical belief in our culture.”

Bengalis might tend to be monists philosophically, but in everyday conversations, mon and belly are antagonists. Where the belly exerts an animal-like agency, mon brings the person closer to the gods. The belly desires to be filled and to be fed, but the mind aims to take in as little as possible. Where the belly is moving and heating, the ideal mon is still (mon thaka) and cool (mon thanda). Where the belly constantly threatens a person’s self-control, the mon is the part of the body that can bring self-control. The belly as a hot, undisciplined, and greedy part of the body can only be brought under control by a cool and restrained mon.

The “Bad Mind” (Mon Kharap)

Mon is so often mentioned in everyday conversations because, among other reasons, it expresses personal opinion: amar mone hay simply means “I feel” or “I think.” When one “makes mind” (mon kara), one clarifies one’s goals. When one convinces others of one’s own point of view, one succeeds in “winning” their minds (mon paoya). A lasting impression on others is achieved when one “draws a line in the mind” of others (mone dag kata). Or one can “melt” (mon gola) the mind of others with sweet words. To say “that depends on your mon” (eta tomar moner bepar) is a catch-all phrase for individual preference. For Bengalis, it depends on your mon whether you believe that the gods accept your sacrifices, or whether you feel drawn to one deity more than to others. It depends on your mon whether you find one political party more convincing than another. It depends on your mon whether some drugs work better for you than for others. To cite the orientations of mon when discussing the eating habits of different castes and religions is regarded as a marker of enlightened tolerance. For example, even if most Hindu Bengalis reject eating beef (because cows must not be killed for food), many pointed out that impurity only results when the mind believes in impurity. And it depends on your mon whether the evil eye exists and exerts a harmful effect or not.

The cool mind (thanda mon) and the hot belly are opposed to each other. When the mind begins behaving like the belly, trouble starts. For example, the mind can be “on fire” and heat up, but that reflects a serious disturbance. When the “mind’s fire” (moner agun) burns, the person feels grief, worry, and all kinds of negative emotions. The mind’s fire that burns slowly like the dried shell of the coconut (moner agun dhiki-dhiki jvale) is a mind that smolders after an emotional insult. Moner agun can also express passionate feelings for another person. In contrast to the “belly’s fire,” which can easily be sated with a good meal, the “mind’s fire” is hard to extinguish. A Bengali saying identifies the body with the belly and holds that the body’s fire can be put out, but the mind’s fire cannot (sharirer agun nibhana yay, kintu moner agun yayna).

The belly is a physical container, whereas the mind is without a fixed place in the body and without strict boundaries between an outside and an inside. Hence it is problematic when the mind also acts like a deep and dark container. Moner kali, the “mind’s blackness,” stands for destructive urges within. A person who appears to harbor evil thoughts can be asked to “open” this obscure container and let his words and feelings come forward (mon kholo!). Someone with a dark mind can be urged to speak directly “from the mind” (mon theke bala!). Once the mind (as container) opens up, it can become “clean” again (mon parishkar). Like the “belly’s word” (peter katha), the “mind’s word” (moner katha) also denotes secrets hidden away from others in the dark chamber of the mind. In contrast to peter katha, however, the moner katha is not nasty gossip, but one’s true feelings. Similarly, to feel affection may mean to give a place in one’s mind (mone sthan daoya). When these emotions are harbored in secret, the truth needs to come out sooner or later.

When the mind loses its cool and start to heat up, confusion results. Concentration is lost when the mind starts to wander. At once, the person becomes “unmindful” (anmona hay yaoya). Even if the mind “stays,” it remains vulnerable to disturbances. It may start to “shake” under pressure. It may “become small” (mon choto haoya) when it feels inferior toward others. Tensions and depressing feelings may cause “mind’s pain” (moner byatha) and, eventually, make it “break” (mon bhanga). A broken mind can lose all interest in the world (udashi mon). At its worst, the broken mind becomes a “dead mind” (mon mora), when the person feels no joy or hope. The broken mind is “cold”: not in the sense of “cool” sovereign control but in the sense of inertia and death.

The “mind becoming bad” (mon kharap haoya) is the closest equivalent in Bengali for the psychiatric concept of developing unipolar depression—without ever being synonymous with it. Mon kharap features in questions that doctors can ask about depressive symptoms. If a psychiatrist wants to ask a Bengali patient about feelings of depression, she might ask if the mind is not feeling well (mon bhalo lagchena?) or if the mind is feeling bad (mon kharap lagche?). Mon kharap is related to other negative affects, such as anxiety (dush cinta), sadness (dukkho), and hopelessness (nirasha).

To get a sense of how mon kharap is related to other bodily and mental states, I conducted a neighborhood survey (Ecks 2005). Using a semistructured questionnaire, I randomly contacted twenty women and twenty men and asked them about a range of problems that psychiatrists commonly associate with depression. All of the forty respondents were Bengali Hindus, most of them from lower- or lower-middle-class backgrounds. The questionnaire did not mention the term “depression,” and instead of starting with “mental” problems, I began by asking about physical illness (sharir kharap), appetite, and sleep, before gradually moving on to moods. Each open-ended answer was probed with a scale to captur...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Acknowledgments
• Introduction: “Mind Food”
• 1. Popular Practice: The Belly and the “Bad Mind”
• 2. Ayurveda: “You Are the Medicine”
• 3. Homeopathy: Immaterial Medicines
• 4. Psychiatry: Medicating Modern Moods
• Conclusion
• Glossary with Transliterations
• Bibliography
• Index
• About the Author