Traditional Healing and Mental Health in Rural Nepal

Abstract

To explore the relationship between traditional healers and psychotherapy, we conducted a combined qualitative study and structured observational rating of healers in the middle hills region of central Nepal. We interviewed and observed 84 participants, of 29 were traditional healers. We conducted qualitative observations of healing, as well as rated healing behavior using an observational multiple measure of empathy, emotional validation, and therapeutic alliance. Using the rated measures of healing behaviors in a case study, we found that healers who were perceived by their clients as successful scored well on alliance, empathy, promoting expectations of recovery, and use of cultural models of distress. From our thematic analysis, participants described a range of interventions that improved health through belief, satisfaction in the soul, social support, and symbolic transference. The results of our structured observation suggest healers use the same processes also observed in psychotherapy. Our qualitative results suggest that healers offer an explanatory paradigm to accept a disease state, cope with it, and to experience palliation of distress. Further research is needed to explore if these practices can be generalized to healers in other parts of Nepal and other settings.