WACP


Wolfgang JILEK, M.D.

Advisor

I was born as the son of an internist and a Red Cross nurse, in Central Europe, just before the advent of Nazism. I decided to follow the family tradition of medicine, studying at the universities of Munich, Innsbruck and Vienna, from 1950 to 1956. I always had to work to finance my studies, but I found time to be active in the socialist student movement of Austria. In medicine, I first was attracted to neurology, but soon became interested in psychiatry and was introduced to Freudian psychoanalysis. However, the lasting influence of my medical student years was that of Viktor Frankl, who I first encountered in 1954, in Vienna. Frankl guided me toward his logotherapy, a psychotherapeutic approach which I later found to be applicable in diverse ethnic-cultural groups. Soon after obtaining my medical degree, I did a one-year rotating internship in Chicago, where I had relatives. This was followed by a year of residency at a psychiatric hospital in New York State. I attended M. H. Hollender’s seminars in Syracuse, NY, and later found the old concept of hysterical psychosis‚ which he had revived, relevant to the transient psychotic reactions I described in African populations. Before returning to Europe, I tramped through North and Central America, from Canada to Guatemala. Back home in Austria, I decided to go to Switzerland for further psychiatric education, under the supervision of the renowned psychiatrist Manfred Bleuler, in Zurich. I spent three years in Zurich, training in psychiatry and epileptology, while also getting acquainted with the psychology of C.G. Jung. This was the beginning of my personal ties to Manfred Bleuler, who visited my wife and I in the 1970s, at our home near Vancouver, and after traveling with us along the Northwest coast to visit indigenous elders and healers, wrote the foreword to my book “Indian Healing”. Among the residents at the Burghoelzli Klinik in Zurich, I met a young Norwegian colleague named Louise Aall, who had just returned from adventurous years of medical experience in tropical Africa. My acquaintance with Louise would become a lifelong marital and professional association. As our first joint venture, we traveled to Tanganyika (now Tanzania) to look after the bush clinic that Louise had founded for untreated epileptics, who had been forced to lead an outcast existence. Today, the Mahenge Clinic for Epilepsy is a regional center for treatment and research, still supported and supervised by Louise, now assisted by our daughter Martica, a clinical nurse. Even before our engagement, Louise and I had separately been in contact with Eric Wittkower, at McGill University in Montreal, upon learning of the new discipline of transcultural psychiatry. Immediately after getting married, in 1963, we sailed for Canada, to study under Wittkower’s supervision. We had intended to stay in Canada only for postgraduate studies, but were soon intrigued by the prospect of living and working in an emerging multi-cultural society. So we stayed on as “new Canadians”, even though we had to re-take all our general medical examinations. I lost my Austrian citizenship when I became a Canadian citizen. However, in 1997 the Government of Austria re-awarded my Austrian citizenship, on the basis of scientific achievement. The time at McGill was the most interesting of my eight years of postgraduate training, mainly because of our association with the newly founded Section of Transcultural Psychiatric Studies under Eric Wittkower and Henry B.M. Murphy, who became our mentors and eventually our personal friends, as later did Raymond Prince. I completed a M.Sc. degree in social psychiatry under H.B.M. Murphy. After passing our specialist exams, Louise and I spent one year doing neuropsychiatric research, in a team that first described the positive psychotropic effects of carbamazepine. Through Edward Margetts in Vancouver, whom we knew from Africa, the Director of Mental Health in British Columbia suggested that we develop psychiatric community and hospital services in the upper Fraser Valley, where hitherto no psychiatrist had practiced. This vast area of immigrant settlers and several “reserves” of Amerindian tribes, appeared to us an ideal place to practice cross-cultural psychiatry. It was during those years, from 1966 to 1974, that we witnessed the cultural renaissance taking place among the Coast Salish Indians of British Columbia and Washington State, under the leadership of the surviving traditional elders and shamanic healers who, noticing our empathic interest, invited us to be participant observers of the revived Salish guardian spirit ceremonial. We first reported on “Transcultural Psychotherapy with Salish Indians” at the 5th World Congress of Psychiatry, in Mexico City, in 1971. On the basis of clinical experience with young indigenous people suffering from depressed mood and substance abuse with behavior disorder, I formulated the concept of anomic depression, resulting from anomie; the loss of traditional societal norms, cultural identity confusion, and relative deprivation. I also documented the psycho-hygienic and therapeutic effects of the Salish spirit dance ceremonial. My study of altered states of consciousness in the context of indigenous rituals paralleled the scientific interests of Joan Obiols, Barcelona, and Caesar Korolenko, Novosibirsk, who later became our collaborators and friends. To obtain a theoretical framework for our work, Louise and I took graduate courses in anthropology and sociology at the University of British Columbia (UBC) and obtained MA degrees there. Our observations were of interest to Claude Levi-Strauss, Paris, who we introduced to Salish ritualists and to the spirit dance ceremonial. Eventually we extended our work with indigenous peoples to the northern Northwest Coast and to Alaska. In an effort to attract attention to the mental health situation of Canadian indigenous populations, I organized with like-minded colleagues, the Canadian Psychiatric Association's “Section of Native Peoples’ Mental Health”, which I chaired from 1970 to 1981. Our group won the cooperation of “First Nations” leaders and healers and convened “Transcultural Mental Health Workshops” in several Canadian provinces. American Indian representatives, and colleagues from the APA Task Force on American Indians, also participated in these ventures In 1974, Louise and I were invited to join the Department of Psychiatry at UBC, where I was active in teaching and supervision of residents, until becoming emeritus professor in 1996. At the 6th World Congress of Psychiatry in Honolulu, in 1977, where we presented a paper on cross-cultural collaboration with traditional healers, H.B.M. Murphy invited us to join the World Psychiatric Association’s Transcultural Psychiatry Section, that he was organizing. When Wen-Shing Tseng became its chairman, in 1983, I took over as Section Secretary. I came to recognize Wen-Shing as one of the outstanding representatives of our discipline and worked closely with him to raise the profile of transcultural psychiatry. Early in the 1980s, I became a member of the Society for the Study of Psychiatry and Culture, founded by Ron Wintrob, Edward Foulks and John Spiegel a few years earlier. The 1980s and 1990s were years of my most intensive involvement in the field of comparative cultural psychiatry. In these two decades I published three books and over 100 articles and book chapters. I also gave numerous invited lectures at universities and institutes in North America, Europe, Asia, the Pacific, and in South America, where I collaborated with Alberto Perales in Peru and Mario G. Hollweg in Bolivia. In the early 1980s, we were introduced to societies of cultural psychiatry and ethnomedicine in German-speaking countries, through Wolfgang Pfeiffer, who had published one of the first textbooks of transcultural psychiatry. That began our collaboration with Ekkehard Schroeder, the editor of Curare, and with Wolfgang Krahl, in the ‘Work Association Ethnomedicine’ (A.G.E.M.). I also renewed my contacts with Vienna University. Our friend Armin Prinz had founded the first European Department of Ethnomedicine at the medical faculty of the University of Vienna, where I later became guest professor of transcultural and ethnopsychiatry. In 1986 I was appointed affiliate professor at the Department of Psychiatry, University of Washington, in Seattle. I served as WHO Mental Health Consultant in Papua New Guinea in 1984 and 1985, as consultant to the Ministry of Health of the Kingdom of Tonga in 1987, and as Refugee Mental Health Coordinator of UNHCR in Thailand 1987-1989. In 1991, I presented a report to WHO on the role of traditional healing in the management and prevention of substance abuse. I was elected chairman of the WPA TP Section in 1993, serving until 1999. As editor of the Transcultural Psychiatry Newsletter, I endeavored to expand its content and extend its distribution. Colleagues in several countries helped me organize International Symposia on Cultural Psychiatry: in 1993 in Rio de Janeiro; 1995 in Lahore and Chandigarh; 1996 in Madrid; 1997 in Rome; 1998 in Florianopolis, Brazil; and 1999 in Hamburg, Germany. I was happy to see GoffredoBartocci, who has made a significant contribution to our field, succeeded me as chair of WPA-TPS in 1999. Looking back over the many years of my career in cultural psychiatry, as clinician, teacher, researcher and administrator, I cherish the memory of the many colleagues all over the world who encouraged me and worked with me. I am confident they will also contribute to the continuing vigor of WPA Transcultural Psychiatry Section and to the growth of the newly founded World Association of Cultural Psychiatry.




  •  I. Herrera y Cairo No. 611. Col. centro
         Guadalajara, Jal., Mex. C.P.44100
  •  (+5233) 36139877
  • paceves@gladet.org.mx

WACP

Culture impacts mental illness so that culturally relevant care is needed for patients of diverse ethnic and cultural backgrounds. From a social point of view, there has been rapid social and cultural change, as well as migration within and between nations. Societies are becoming multi-ethnic and poly-cultural in nature worldwide. From a clinical perspective, there is a need to improve cultural competence to provide proper psychiatric care of each patient, considering the ethnic/race/cultural background, irregardless of minority or majority status.


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