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Obeyesekere, G, (1985) "Depression and Buddhism and the work of culture in Sri lanka" from Kleinman,
A; Good, B, Culture and depression : studies in the anthropology and cross-cultural psychiatry of affect
and disorder pp.134-152, Berkeley: University of California Press ©
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Depression, Buddhism, and
4
the Work of Culture
in Sri Lanka
Gananath Obeyesekere
found among Yoruba or Sinhala, while the illness is the cultural con-
ception surrounding the disease. In physical medicine the disease can be
extracted from the illness, and this makes a great difference for control
and treatment. In the realms of the so-called mental diseases, however, a
different situation prevails. I doubt that the illness-disease distinction is
applicable since the cultural conception of the disease is intrinsic to its
character: it is both illness and disease at the same time. A determinate
biological/genetic mechanism is absent in mental illness or, if present, is
accompanied and superlaid by social-psychological conditions that are
products of human experience in different sociocultural settings. In this
situation the manner in which the so-called symptoms are put together
and given cultural meaning or symbolization is intrinsic to their nature as
illness/disease. The conception of the disease (i.e., illness) is the dis-
ease. Or to put it differently, there are only illnesses and no diseases.1
On one level it is possible to prove that depression in its various forms
is universal. Depression in this sense is defined from the modern psy-
chiatric perspective in the Diagnostic and Statistical Manuals I, II, and
III. These handbooks have operationalized depression into clear-cut,
specific, and unambiguous symptoms and types. The intention is laud-
able since it is assumed that this will facilitate the identification of the
disease—depression—wherever it is found, and also provide for cross-
culturally valid statistical and epidemiological information. The results
also seem incontrovertible: the depressive affects or symptoms seem to
exist everywhere even if culture bound. Therefore it is concluded that
depression in its Western sense is a disease universally present.
It is easy to show that this conclusion is not as logical as it may seem
and may indeed be tautological. To illustrate my argument, let me
practice a piece of reverse ethnocentrism. Take the case of a South Asian
male (or female)2 who has the following symptoms: drastic weight loss,
sexual fantasies, and night emissions and urine discoloration. In South
Asia the patient may be diagnosed as suffering from a disease, "semen
loss." But on the operational level I can find this constellation of
symptoms in every society, from China to Peru. If I were to say,
however, that I know plenty of Americans suffering from the disease
"semen loss," I would be laughed out of court even though I could
' 'prove" that this disease is universal. The trouble with my formulation
is that while the symptoms exist at random everywhere, they have not
been "fused into a conception" (as semen loss) in American society.3
Yet if I were to employ the methodological norms implicit in the several
Diagnostic and Statistical manuals and apply them from a South Asian
Depression, Buddhism, and Work of Culture 137
This is, I believe, a serious error. If people who have symptoms can
function in society as well as those without, surely the solution is not to
drop this issue (which is of enormous significance) but to make it a
central question for research.
The pilot survey itself was carried out among men and women in the
nonsample area to avoid contamination of the final results. But note that
the nonsample area is in the same general area of the three villages
studied. Anyone who knows of gossip and communication networks in
Indian villages would expect contamination of the sample area. The
authors reflect with unconscious irony:' 'The villagers (even those in the
sample area) came to know about our investigation and were prepared
for us when we went to them" (ibid., p. 90). They go on to state: "Often
we had to see men while they were working in their vegetable gardens, or
mending their fishing nets, and women while they were engaged in
cooking or cleaning the house" (ibid., p. 91).
Depression, Buddhism, and Work of Culture 139
enjoys life and dresses well while living in the world it is of no use
for the other world. . . . My body is revulsive like a corpse, like
feces. [Again the generalization:] The bodies of others are also
foul. So's the female body. I care not for women. I feel nauseous
toward them."
Only two of the respondents stated that their sil and meditation
activities were precipitated by specific antecedent events. Case 6 stated
that she was regularly beaten and abused by her husband, who subse-
quently abandoned her and her children. He used to haveflagrantliaisons
with other women. Then her father died: "The sorrow [sokaya] of my
father's death was such that I took the white cloth that he wore during sil
and his rosary and his books and I started taking sil myself.'' She did not
remarry for she thought, "If this man was bad, so must they all be. The
married life is troublesome. Several proposed marriage to me but I
refused. There is no freedom here." The other was a seventy-two-year-
old man who used to observe occasional sil from childhood. However,
sixteen years earlier, when the head monk of his village died, he began to
regularly observe sil four times a month. He loved this monk, he said,
and suffered great shock (kampanaya) at his death. In both cases, the
pain of mind and sorrow was articulated in Buddhist terms and expressed
in the activity of sil and meditation. The signs of sorrow (unlike the
symptoms of depression) are not free-floating: they are expressed in
Buddhist terms. In all the other cases there were no specific antecedents:
rather sil was a response to old age. It is likely (though no direct evidence
is available from the interviews) that old age did produce in some of these
respondents a sense of hopelessness and loss ("depressive affects") but
these feelings were generalized and given Buddhist meaning. The prob-
144 Meanings, Relationships, Social Affects
lems of personal sorrow resulting from the conditions of old age with its
attendant ills became a problem of existence in its ontological sense.
One of the problems of contemporary psychiatric methodology is the
assumption that the language that expresses "depressive affects" can
also be operationalized. Yet the attempt to give operational specificity to
the vocabulary of emotion is to destroy what is integral to that form of
speech (parole), namely, its intrinsic diffusiveness, multiplicity of
meanings, and capacity to assimilate and express emotional states that
are not easily differentiated and indeed run counter to the very canons of
operationalism (Ricoeur 1974:347-375). Furthermore, and I specifi-
cally refer here to the vocabulary of suffering and despair, that speech is
linked to specific traditions, such as those of Buddhism or Christianity. It
is almost impossible for a Sinhala person to use words expressing sorrow
without articulating them to the Buddhist tradition. Even if all the words
he uses do not come from that tradition directly, the larger context of
usage will eventually embody it in the doctrinal tradition. Let me give
some examples of Sinhala words employed to express sorrow with a
rough approximation in English.
I have already mentioned sokaya, sadness or sorrow, and kampanaya
or kampdva, the shock of loss; another word is sanvegaya, pain of mind.
The Buddhist term dukkha also has a variety of meanings ranging from
ordinary sorrow to suffering in its doctrinal sense. One of the most
common terms in the lexicon of sorrow is kalakirima, a sense of hope-
lessness, or despair with life. Etymologically kalakirirma is derived from
the words kala and kriyd, "the termination of time," that is, death.
When the word is used in its formal etymological sense as kalakriya, it
refers euphemistically to "death." However, in its popular form as
kalakirirma, it refers to a sense of hopelessness, but not a free-floating
one: it is a reaction against life itself. Specific emotional words for
sorrow and loss—such as sokaya, kampava, sanvegaya—are easily
assimilated into more general terms that express an attitude to life in
general, such as dukkha and kalakirima. This is reflective of the Bud-
dhist orientation of this culture. The situation is such that any kind of
affect or sorrow or despair can and must be expressed in ordinary
language that is itself for the most part derived from Buddhism or can be
articulated to Buddhism. Moreover, one is socialized into myths, para-
bles, and legends that deal with the phenomenon of personal loss and
sorrow as part of the nature of existence in general. One of the most
famous is the parable of the mustard seed, familiar to most Buddhists.
This text deals with the story of Kisa GotamI whose first and only child
died in infancy. Distraught with pain and grief, she went from place to
Depression, Buddhism, and Work of Culture 145
place seeking some medicine to resurrect her child. She eventually came
to the Buddha and asked the sage whether he could revive the dead child.
The Buddha said that he could if only she would bring a mustard seed
from a house in which death had not occurred. Elated, Kisa Gotami went
from one house to another seeking the impossible mustard seed. She
soon came to the realization that her own personal grief is simply a part of
a larger universal problem of suffering. In this recognition of the nature
of life lay her redemption. The parable of the mustard seed could as
easily serve us as a parable on the nature of depression (see Kaufmann
1961:396—405 for a good discussion of a related text).
The lay virtuosi or upasakas discussed earlier have read texts such as
that of Kisa Gotami and they have resorted to sil, a temporary movement
away from domestic living, and to meditation. The text of pilikul
bhavana deliberately denigrates the body in order to deny the self as real.
The metaphor used in the denigration of the body and the self is feces. In
major depression also the self is denigrated: lowering of self-esteem and
self-worth is conspicuous in this state. But in Buddhist virtuosos this is
deliberately undertaken. I do not know whether a person who suffers a
sense of worthlessness can overcome it by techniques such as that of
"meditation on revulsiveness." Perhaps some do and others do not. In
some situations it is likely that a person who has not been afflicted by
negative sorrowful affects may be encouraged to deliberately cultivate or
resurrect them through meditation—that is, meditation itself may create
the "depressive affects" as a step in the larger quest for understanding
the world.
One thing is clear enough: that which may be labeled as depression in
the West is given a radically different form of cultural canalization and
expression. Furthermore, this idiom of feces is specially effective in
conveying the emotional feel of the horror of putrescence. The medita-
tion is designed to make the meditator feel that his body is something that
belongs to him yet is outside of him, so that he can view it (and its parts)
in detachment; it also exists in others and in the world. It is likely that the
ideal virtuoso, once he effects full detachment, can transcend both feces
and body, so that they become neutral objects existing outside himself.
True detachment must free a person from both disgust and attachment.
However, I believe that for most persons meditation sends taproots into
infancy and childhood: to the infant, feces are part of himself yet also
something that is differentiated from him. In other words, the detach-
ment of the self from the self—in order to deny its ontological real-
ity—is facilitated by the metaphor of feces.
The metaphor of feces as putrescence is also implicated in the values
146 Meanings, Relationships, Social Affects
of Sri Lankan society and the socialization of its children. In Sri Lankan
society, as elsewhere, what is important is not the technology of child
care—its time and place—but the maternal attitude that in turn ex-
presses the values of the culture. Freud noted this in Civilization and Its
Discontents (1930), in which the socialization of the anal system is
linked with the values of Western civilization: order, cleanliness, rou-
tine, and through a long detour, to aestheticism. In Sri Lanka the formal
techniques of toilet training are similar to those in many parts of the
non-Western world. There is extreme permissiveness: time and place are
not defined; the child gradually moves from the home to the backyard
and, when he is old enough to look after himself, to the outhouse or bush.
But this idyllic picture is soon dispelled when we focus on the maternal
attitude toward feces: the mother's reaction is one of horror if the child
attempts to play with it. Chi is the typical Sinhala expression of
revulsion, which prototypically refers to feces. In socialization, the child
is soon made to feel that all dirt is feces: thus when a child plays with
mud, the exclamation "chi, feces" is used. In training, the mother may
even rebuke a child by saying "Chi, feces baby," which is the earliest
usage of the metaphor of feces to lower someone's self-esteem. The
idiom of feces and foul smells are extended to other contexts also, for
example, to "shame": a person who has lost face is someone who
' ' stank''; dirt, mud, and bad smells all appear in the idiom of shame. All
these feelings are activated or reactivated in "the meditation on revul-
sion' ' to convey the horror of putrescence, which is a preliminary step in
the very transcendence of the body leading to a recognition of the
impermanence or transitory nature of life itself.
The preceding discussion demonstrates that certain affects and the
antecedent sociocultural-psychological conditions that produce these
affects are crystallized into a "conception" in Buddhist Sri Lanka. This
conception is not a conception of disease/illness. The term "depres-
sion" itself is, I believe, such a cultural conception, but a Western one,
in which a constellation of symptoms is defined as illness. Once defined
in ontic or existential terms, as in Sri Lanka, it ceases to be an illness and
the unpleasant affects associated with this existential condition are
expressed and perhaps even resolved in a variety of meanings and
activities provided by the Buddhist orientation of the culture. In such a
situation, it would be meaningless to consider the conception here as
disease/illness. The question I now raise is this: Are there situations in
which the constellation of symptoms associated with depression is in fact
defined as illness in Sri Lanka? The answer is "yes," but even in this
Depression, Buddhism, and Work of Culture 147
attack and no doubt into other symbolic forms also. To study work, one
needs a case history approach contextualized in a specific culture. This
would enable us to identify the mechanisms involved in symbolic trans-
formation, as Freud did in the dream work. Work also implies failure; if
mourning is successful work, melancholia is failure. Success and failure
in turn entail a critique of culture—a critique through which one might
be able to connect anthropology with critical theory.
The idea of work could introduce a whole host of fruitful problems in
the study of symbolic systems, and I can only hint at them here. What are
the social, economic, and personal conditions and processes that result in
the transformation of similar affects into differing symbolic systems?
Why does the same symbolic system (be it meditation on revulsion or
spirit possession) work for some and not for others? Then there is the
problem that is central to this volume. Is it indeed possible that sorrowful
affects may not be capable of transformation into public meanings under
certain circumstances? What these circumstances are cannot be pre-
determined, though we can make some guesses. For example, it is likely
that in Western culture the affects of depression are not given cultural
meaning and significance because of what Weber (1958) called the
process of rationalization in Western society and the demystification of
the world. In this situation, affects exist more or less in a free-floating
manner, awaiting a different symbolic formulation: their conceptualiza-
tion as a disease, "depression." A similar process may occur in Sri
Lanka. It may be possible that under certain conditions the affects may
not receive cultural crystallization and may exist in a free-floating
manner. What these conditions are must become the subject of investi-
gation—an inquiry into the conditions wherein the work of culture does
not succeed in the symbolic transformation of affects. It may be that if
affects are specially strong, they may elude the work of culture, but this
is a problem for research and further investigation.
CONCLUSION: DISQUIET
ACKNOWLEDGMENTS
NOTES
nate physical "disease" like malaria and "illnesses" like depression is that the
latter are often fused into larger cultural or ideological meanings and con-
sequently become invested with existential significance. In this situation, the
disease/illness distinction is hard to maintain.
2. South Asians generally believe that both men and women have "semen"
and both can ejaculate and experience night emissions.
3. In any system one might have bodily signs that have no meaning. For
example, a villager in Sri Lanka might experience ' 'palpitations,'' but to him it
need be no more significant than a mosquito bite or occasional sneezing. But
when / have palpitations I feel anxious, since, for me, this is a symptom of my
conception of "heart disease," and not a fortuitous bodily sign.
4. I have deliberately limited the notion of "work of culture" to the
symbolic transformation of affects, but one might want to extend it to larger
areas of species existence.
5. I specifically refer to the experimental studies that involve the infliction
of trauma on animals. It is doubtful whether the results of these studies could be
meaningfully compared with human problems. Even human problems show
considerable variations. When I slice onions I shed tears, but is this the same as
when I shed tears owing to the loss of a loved one? If you tickle the sole of my
foot I will laugh, but is this the same as when I laugh at your joke?
REFERENCES
Obeyesekere, G.
1981 Medusa's Hair: An Essay on Personal Symbols and Religious
Experience. Chicago: University of Chicago Press.
Ricoeur, P.
1974 Freud and Philosophy: An Essay on Interpretation. D. Savage,
trans. New York: Yale University Press.
Schwartz, T.
1973 Cult and Context: The Paranoid Ethos in Melanesia. Ethos 1
(2): 153-174.
Vajiranana, P.
1975 Buddhist Meditation in Theory and Practice. Colombo: Guna-
sena and Co.
Weber, M.
1958 Science as a Vocation. In From Max Weber. H. H. Gerth and
C. Wright Mills, trans, and ed. New York: Oxford University
Press.