‘‘They have a story inside.’’ Madness and healing on Elcho Island, north-east Arnhem Land Cecilia De Donatis Submitted in total fulfilment of the requirements of the degree of Doctor of Philosophy September, 2010 School for Social and Policy Research Charles Darwin University 1 ABSTRACT This thesis is based on an ethnographic investigation of concepts related to mental health and madness among the Yolŋu peoples of north-east Arnhem Land, with a particular focus on Elcho Island and its main settlement, Galiwin‘ku. Over the past decade, there has been a proliferation of medically oriented research and mental health intervention programs in Indigenous health. Most of these refer to the principle that ‗culture‘ must play a fundamental role in Indigenous health care. However, lack of in-depth investigations about Indigenous knowledge related to health indicates that this principle plays only a nominal role in the implementation of these programs and has not resulted in a rethinking of basic assumptions guiding mental health services. The ethnographic research which informs this thesis started from the assumption that all societies around the world have developed ideas of ‗madness‘ or ‗abnormality‘, but that these are not necessarily understood in terms of ‗health‘ or ‗illness‘. Accordingly, the fieldwork focused on Yolŋu concepts related to ‗madness‘: what are the signs indicating mental or emotional problems? What causes madness? What are the responses of the ‗normal‘ members of society? What kinds of issues are elicited by the encounter with Western psychiatry? What are the self-representations of the ‗mad‘ person? The ethnography demonstrated the existence of an articulated body of knowledge related to ‗mental illness‘, although not one fashioned in medical terms. Understanding Yolŋu reflections about madness clearly involved embracing wider categories of life, person and relationships which their stories convey. The aim of this thesis is not to provide material for cross-cultural comparison between a Western and an Indigenous medical system but to clarify the relationship between Yolŋu conceptualizations of the world, person and relationships and Yolŋu 2 representations of illness and healing. The work adds to understanding of some issues in the anthropological literature about healing and illness in Yolŋu society. 3 DECLARATION This is to certify that (i) the thesis comprises only my original work towards the PhD, (ii) due acknowledgement has been made in the text to all other material used, (iii) the thesis is less than 100,000 words in length, exclusive of tables, maps, bibliographies and appendices. 4 ACKNOWLEDGEMENTS I wish to thank my thesis supervisors Dr Gary Robinson, Dr Franca Tamisari and John Greatorex for supporting me through all the stages of the study. I am also indebt to my Yolŋu adoptive family and to all those friends in Darwin, Italy and Arnhem Land who have welcome me with generosity and warmth and have offered me their intellectual and material support. The research reported in this thesis was supported by an International Postgraduate Research Scholarship and an Australian Postgraduate Award provided by Charles Darwin University. It was also conducted within a co-supervision program between the Charles Darwin University and the Ca` Foscari University of Venice. I am thankful to these institutions for providing me with the opportunity of developing my project. Finally, I thank the examiners who have reviewed this thesis for their corrections, comments and suggestions. This thesis is dedicated to my Yolŋu relatives and friends, who always and bravely persist in their efforts to create a common ground of mutual understanding. 5 ETHICAL CLEARANCE Ethical clearance for the research conducted for this thesis was granted by the Charles Darwin University Human Research Ethics Committee (Reference H06047). WARNING This thesis contains names of deceased persons. 6 ORTHOGRAPHY AND OTHER CONVENTIONS All through the thesis, words in language other than English are in italics, exception made for ‗Yolŋu‘ and names indicating groups of people and places and for transcriptions inserted into tables. Often, Yolŋu mix English and Yolŋu languages in their talk. I used single inverted commas (e.g. ‗mad‘) and double inverted commas (e.g. ‗‗foundation‘‘) to mark respectively my own translation of Yolŋu expressions and the one provided by Yolŋu themselves. English and Aboriginal English expressions used by Yolŋu are indicated with double inverted commas. Square brackets always indicate my own insertions. Also, some transcriptions of recordings appear into double column tables, with the vernacular on one side and the English translation on the other side, while others are reported indented and without a table. At times, in fact, the use of Yolŋu words in a discourse was so sporadic that I chose to report only one version of the text, with the Yolŋu expressions inserted in between parenthesis. The orthography used throughout the thesis is consistent with Christie (2004a). Yolŋu language is composed by six vowels and twenty-four consonants and phonemes. The following notes about pronunciation are adapted from Christie (2004b): The vowels a, i and u are short, the vowels ä, e an o are long. The consonants d, n, l, r are retroflexed (the tongue is curled back, the underneath part of the tongue facing the hard palate). The consonant dh, th, nh are interdental (the tip of the tongue is between the teeth). The consonant dj is pronounced as the ‗g‘ in ‗George‘. The consonant tj is pronounced as the ‗ch‘ sound in ‗chair‘. The consonant ’ indicates a glottal stop. The consonant ny is pronounced as the ‗ni‘ sound in ‗onion‘. The consonant ŋ is pronounced as the ‗ng‘ sound in ‗sing‘. 7 TABLE OF CONTENTS ABSTRACT .................................................................................................................... 2 DECLARATION .............................................................................................................. 4 ACKNOWLEDGEMENTS .............................................................................................. 5 ETHICAL CLEARANCE ................................................................................................ 6 ORTHOGRAPHY AND OTHER CONVENTIONS ........................................................ 7 TABLE OF CONTENTS ................................................................................................. 8 LIST OF FIGURES ....................................................................................................... 10 CHAPTER 1: INTRODUCTION ................................................................................... 11 1.1 Notes on some key terms .................................................................................... 13 1.2 Location of the research...................................................................................... 15 1.3 The study rationale: the Aboriginal Mental Health Worker Program ............ 19 1.4 Adoption and ‘being family’ ................................................................................ 22 1.4.1 Use of personal names and pseudonyms in this thesis .............................. 28 1.5 Data collection and issues of translation and interpretation ......................... 28 1.6 Overview of thesis structure ............................................................................... 31 CHAPTER 2: HISTORICAL AND INSTITUTIONAL BACKGROUND ...................... 33 2.1 Protectionism (1880-1950) and establishment of Northeast Arnhem Land missions ............................................................................................................. 33 2.2 Assimilation (1950-1970) ..................................................................................... 37 2.3 Self-determination (1970-) ................................................................................... 40 2.4 Health policies from the 1970s: community-based health programs and ideological continuities ...................................................................................... 44 2.5 Conclusions .......................................................................................................... 47 CHAPTER 3: LITERATURE REVIEW ........................................................................ 49 3.1 Explaining mental illness in the colonial context: cross-cultural psychiatry and socio-cultural studies ..................................................................... 50 3.2 Health initiatives in the contemporary panorama ............................................ 56 3.2.1 Types of mental health initiatives ................................................................... 58 8 3.2.2 Aboriginal health workers and the debate about ‘two ways medicine’ ........................................................................................................... 62 3.3 Anthropological approaches to Australian Indigenous societies ................. 66 3.4 The anthropology of health: from disease to person ...................................... 73 3.5 Ethnographic approaches to illness and healing ............................................ 81 3.5.1 Sorcery as a logic system and as a creative force ....................................... 81 3.5.2 Healing and the figure of the marrŋgitj .......................................................... 88 3.5.3 The ‘magic’ of healing: ancestral powers or feelings? ................................ 93 CHAPTER 4: ORDER AND DISORDER IN CONTEXT OF CHANGE