Anthropology & Medicine

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Listening to disembodied voices: anthropological

and psychiatricchallenges

Helene Basu

To cite this article: Helene Basu (2014) Listening to disembodied voices: anthropological
and psychiatricchallenges, Anthropology & Medicine, 21:3, 325-342, DOI:
10.1080/13648470.2014.928095

To link to this article: http://dx.doi.org/10.1080/13648470.2014.928095

Published online: 25 Jun 2014.

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 Anthropology & Medicine, 2014
Vol. 21, No. 3, 325 342, http://dx.doi.org/10.1080/13648470.2014.928095

Listening to disembodied voices: anthropological and

psychiatric challenges
Helene Basu*

Institute of Ethnology, University of Munster, Muenster, 48149, Germany

Downloaded by [University Of South Australia Library] at 14:00 06 March 2016

(Received 7 February 2014; final version received 22 May 2014)

What is the role of the voice in Indian explanatory models of madness and psychiatric
nosology? Anthropological and psychiatric challenges, it is argued, are crystallised in
the voice, a medium that signifies the intersection of models of occult madness and
schizophrenia. The psychiatry and religious healing practised at a Sufi shrine in
Gujarat differed in terms of the status accorded to the voice: psychiatry interpreted the
voice as a symptom of mental disorder, whereas religious healing used the medium in
ambiguous practices of possession trance, combining performances of madness and
healing. Although doing trance is considered an essential part in the process of
healing, patients diagnosed with schizophrenia do not experience trance. Their
patiency is displaced onto a caretaker. Psychiatric theories resting on the somatised
mind partly converge with theories of madness based on sorcery and possession in so
far as both posit a direct link between the brain and behaviour. Against the
background of the contested religious healing sites that are currently debated in Indian
public mental health, attention to multiple dimensions of the voice reveals its
significance as an alternative to the psychiatric institutionalisation of people coping
with mental disorder. The voice reconciles the dichotomy between scientific
psychiatry and traditional ritual healing, partly by making sense of madness by
engaging with the sense of hearing.
Keywords: explanatory models; help seeking; mental health in low income countries;
psychiatry

Introduction
The pluralistic religious landscape in India comprises temples and shrines of Hindu gods as
well as of Christian and Muslim saints. These places of religious worship are visited by
supplicants afflicted with spirit possession and sorcery, an affliction that is often associated
with madness. Pilgrimage places specialising in the ritual healing of possession and mad-
ness such as the temple of Balaji (a form of Hanuman) in Rajasthan, the shrine of the
Muslim saint Mira Datar in Gujarat or the shrine of the Catholic Saint Anthony in Tamil
Nadu and others are of interest to anthropologists and psychiatrists alike (Pakaslahti
2009; Dwyer 2003; Sax and Weinhold 2010; Basu 2009; Skultans 1991; Pfleiderer 2006;
S
ebastia 2004; Halliburton 2009). Yet, under the influence of the global mental health
movement propelled by the WHO and the implementation of policy reforms in India, such
places are becoming increasingly delegitimised, as many argue that they violate the human
rights of the mentally ill (Vyas 2006).1
The status of centres of exorcism is contested within the psychiatric community in
India. In their explanatory models of madness, spirit possession and sorcery are based on

*Email: hbasu_01@uni-muenster.de

2014 Taylor & Francis

 326 Helene Basu

false beliefs. Biologically oriented psychiatrists therefore tend to dismiss exorcism and
trance enacted in practices of ritual healing as remnants of a superstitious past. Cultural
psychiatrists, on the other hand, recognise ritual healing as being on par with Comple-
mentary and Alternative Medicine (CAM), which is currently flourishing in Europe and
North America (e.g. Raguram et al. 2002; Kapur 1979; Kakar 1982). A third approach
advocates collaboration between psychiatry and religious healing places in order to
spread knowledge about psychiatric disease and treatment and thus improve the provision
of community mental health care (Padmavati 2005).
The politically contested status of religious healing places entails new challenges for
the dialogue between psychiatrists and anthropologists, who must try to understand the
relation between ideologies of affliction, the institutions (re-)producing them and corre-
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sponding practices of treatment and care. How do vernacular ideologies of madness relate
to psychiatric classifications of mental illness? This paper examines the role of the voice
in vernacular and psychiatric conceptions of pathology and ritual and psychiatric practi-
ces of care. As will be seen below, the medium of the voice simultaneously links and
divides possession and psychiatry.
The discussion here is based on ethnographic research conducted by the author with
the assistance of Chitra Khare between 2008 and 2012 at the Muslim shrine of Mira Datar
in Gujarat. The dargah is probably the most well-known Muslim centre in Gujarat, where
treating madness is synonymous with practices of counter-sorcery and exorcism. The
shrine is a cosmopolitan site situated in a rural area in North Gujarat; it draws a large cli-
entele of Muslim and non-Muslim pilgrims from Gujarat and other regions, especially
from Rajasthan, Maharashtra and Mumbai. The owners and guardians of the shrine,
mujavar or khadim, speak Urdu and Gujarati. Mujavars organise a ritual arena privileging
the voice as a medium of healing madness. Madness (pagalvanu) refers to behavioural
problems associated with possession and sorcery conceived of in terms of alien forces
controlling the brain (magaj) of an afflicted person. Ritual treatment depends on states of
trance, which are ambiguously construed as embodiments of affliction and of healing or
deliverance from suffering.
At the time of fieldwork, there was a psychiatric clinic (OPD) at the shrine, which was
organised jointly by the government, a mental hospital and an NGO (Basu 2014). The
psychiatrists were trained in biological psychiatry and consulted pilgrims for one or two
hours a day. Their practice was based on the assumption that mental and behavioural dis-
orders were caused by chemical imbalances in the brain, and they believed psychotropic
drugs to be the best treatment. The psychiatrists had large stocks of sleeping pills, anti-
depressants and anti-psychotics that they gave to pilgrims free of charge after a diagnosis
based on an encounter that usually only lasted a few minutes. They also offered patients
displaying symptoms of an acute psychotic crisis free transportation to the mental hospital
a suggestion that usually made the caretakers of such a patient prohibit him or her from
going to the clinic again.
Suffering pilgrims often share similar social backgrounds with other patients confined
in mental hospitals. Both come largely come from lower castes, rural and urban poor and
the lower middle and business classes. Psychiatrists tend to read the refusal of people to
accept psychiatric care in a mental hospital as signs of ignorance and backwardness,2
whereas anthropologists may stress diverse experiences of illness and health (mind-body-
unity against mind-body-dualism) as well as values of care associated with cultural con-
structions of relational personhood and the self. Moreover, psychiatrists in India feel par-
ticularly challenged due to the low professional esteem accorded to psychiatry in
comparison with other medical specialisations and the relatively low level of public
 Anthropology & Medicine 327

awareness of mental health problems (but this is changing with recent reforms, media
campaigns, mental health day, etc.), which is due to the history of psychiatry in India.
The bifurcation of biological psychiatry and psychoanalysis, characteristic of the emerg-
ing field of the psy-sciences in the West since the beginning of the twentieth century, has
not shaped the history of psychiatry in India in the same way. In the West, the psy-disci-
plines have exercised great influence upon the emergence of psychological understand-
ings of the self and theories of the mind and thus, as a corollary, on institutionalised
treatment of mental disorder and suffering (Rose 1998; Ehrenberg 2008). Furedi claims
that Euro-Americans have produced a therapy-culture (Furedi 2004). In India, the image
of psychiatry is that of lunatic asylums introduced by colonialism at the end of the nine-
teenth century institutions that are only now being reformed. Psychoanalysis has hardly
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taken root in India, except amongst some pockets of the Indian elite.3 With biotechnologi-
cal inventions, especially the psychotropic drugs developed in the 1950s and 1960s, the
relationship between biological psychiatry and psychoanalysis in the West has shifted to
privilege the brain rather than unconscious conflicts (Rose 2007). Rose argues that a shift
from a psychologised to a somatised mind has emerged, thus stripping the language of
psychiatry of its Cartesian dualism (Rose 2007: 192). The psychiatric understanding of
the brain as the principal organ steering behaviour was circulated globally, causing psy-
chiatry in India to leap from the lunatic asylum to treatment with psychotropic drugs (for
the use of psychotropic drugs, see Ecks and Basu 2009). Whereas the dominance of the
somatised mind of biological psychiatry in Western countries is challenged by religious
and spiritual movements of healing (Complementary Alternative Medicine) (Basu, Little-
wood, and Steinforth forthcoming), Indians see some of these alternatives as epitomes of
the old. Despite the fact that suffering pilgrims are familiar with psychiatry, they still
turn to shrines and temples because they associate psychiatry with the asylum and with
the accompanying social ostracism and abandonment (S
ebastia 2009). Although those
with symptoms of mental distress may be sceptical of institutionalised care, they do not
necessarily reject psychotropic medication and initiatives of community mental health
care (Jain and Jadhav 2009). They seek help for their madness from both psychiatric treat-
ment and practices of ritual healing, which treat madness as the result of sorcery and pos-
session by spirits (Quack 2014; Halliburton 2009).
On the level of illness ideologies, one may ask: are notions of sorcery as a vernacular
theory of madness indeed as irreconcilable with psychiatric classifications of mental dis-
order as is sometimes assumed? In the authors fieldwork, she observed how pilgrims
who were diagnosed with schizophrenia did not experience trance. This seems to coincide
with the arid definition of schizophrenia given in the International Statistical Classifica-
tion of Diseases and Related Health Problems Manual (ICD-10), which states that trance
does not occur at the same time as schizophrenia (F-20-F29), or mood disorders with hal-
lucinations or delusions (ICD-10, F44.3). Despite the continuing psychiatric debate of
the definition of that enigmatic and complex mental disorder called schizophrenia (Yuhas
2013; Littlewood and Dein 2013), it remains a disease at the core of psychiatry accorded
cross-cultural validity.4 Medical and anthropological research on schizophrenia in India
is concerned with genetic (biological), socio-cultural and subjective dimensions of
schizophrenia (Cohen, Patel, and Gureje 2008; Corin, Thara, and Padmavati 2004).5
Hearing disembodied voices figures importantly in the clinical picture of the syndrome of
schizophrenia. In states of trance, however, hearing disembodied voices is considered a
normal experience. Boddy points out that trance refers to a general human capacity to
abnegate wakeful awareness. Yet how trance is experienced depends not only on univer-
sal aptitudes but on the culturally specific contexts in which they are invoked (Boddy
 328 Helene Basu

2010, 114). Trance is not a spontaneous experience but a practice acquired with the
socialisation of a habitus. In the ritual healing performed at the shrine of Mira Datar,
trance was used to foster the disposition to speak with the voices of Others and to hear
disembodied voices.
Psychiatric models comprehend the voice as a factor guiding the diagnosis of severe
mental disorder, whereas models of trance employ the voice as a medium of healing.
After Gayatri Spivak famously asked, Can the Subaltern speak?, the voice became a key
term in conceptualising the nexus of agency and patiency (the possibilities of acting and
being acted upon) distributed over positions of speakers and thus indicative of power rela-
tions (Spivak 1988). And it is more than a medium of speech (Dolar 2006); it is a liminal
and ambivalent phenomenon marking a precarious border between the inside and the out-
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side of the body and the normal and the pathological. What is the status of the voice in rit-
ual healing/exorcism and psychiatry? By focusing on the medium of the voice, this paper
argues that sorcery/possession emerges as a discourse of impaired subjectivity, which sit-
uates itself as an alternative to psychiatric understandings of mental disorder despite its
apparent overlapping. This was manifested in the experiences of schizophrenic patients
and other pilgrims suffering from madness (induced by sorcery and spirit possession)
who sought help at the shrine. Unlike the latter, psychotic patients do not participate in
the process of healing mediated by the voice in states of trance.

The medium of the voice

Scholarship conducted on the aesthetics of religion suggests that different religions tend
to privilege specific sense modes such as visualisation in Hinduism and Christianity and
hearing in Islam. Accordingly, religious healing places are sensuous geographies that
privilege and mobilise different sense modes to make sense of madness (Rodaway
1994).6 At the Muslim shrine of Mira Datar in Gujarat, the voice has become the pre-
eminent medium employed in ritual healing through trance, making hearing the privileged
sense mode.
Hearing is a basic sense mode that allows us to relate to the world through sound. As
Don Ihde points out, [A]ll sounds may be conceived as voices, the voices of things, of
others, of the gods, and of myself (Ihde 2007 [1976], 147). What makes the human voice
special? Scholars such as Mladen Dolar, Sybille Kramer and Doris Kolesch have begun
to focus on the peculiar topology of the voice and develop a theoretical understanding of
it (Kolesch and Kramer 2006; Kolesch 2006). The voice transcends dichotomies such as
body and mind and soma and semantics as well as borders between Self and Other
(Kolesch and Kramer 2006). Dolar depicts the topology of the voice as a precarious bor-
der between the inside and the outside: while the voice emanates from within the body, it
is also a part of the world, an uncontrollable outside, a missile with its own trajectory
(Schuster 2009; Dolar 2006). The voice links language and the body, and it is more than a
medium of speech. Meaningful speech depends on the corporality of the voice, but this in
itself does not contribute to the production of meaning in a linguistic sense. The voice
paradoxically defies its elimination from meaning making by the ways in which sounds
are pronounced through intonation, high or low pitch, melody or cadence. This makes the
voice into an ambiguous phenomenon; it does not belong to linguistics, which treats its
material corporality as a vanishing mediator, or to the body, since the voice floats,
[and] has detached itself from its source (Schuster 2009: 5). At the intersection of lan-
guage and the body, the voice is pure enunciation. While the materiality of the voice iden-
tifies us as individuals, marking us like our fingerprint, it is a fugitive incidence appearing
 Anthropology & Medicine 329

in the act of hearing. The voice is performative, at once appealing, compelling and evok-
ing emotions. The topology of the voice transcends dualisms, failing to correspond to
Western dualist thought. In Gujarat, notions of madness related to possession and sor-
cery draw on dual conceptions of embodied and disembodied minds, or mind-powers
(man shakti) which are transcended in trance by the medium of the voice.

Sorcery: an alternative theory of madness

For Westerners raised in cultural environments deeply impregnated by the values of
individualism and bolstered by a pervasive psychologisation of social experience (e.g.
(Elias and Schr oter 2001), to perceive sorcery and possession as something other than
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psychological phenomena seems to present a major challenge. In the course of the twenti-
eth century, scholars routinely interpreted sorcery as a pathology in terms of aggressive,
paranoid tendencies and possession as hysteria (Benedict 1934, 238; Fortune 1932).
Since Evans-Pritchards seminal study of Azande witchcraft, social anthropologists have
countered the pathologising of sorcery by considering the constructive and destructive
powers and conditions of modernity (e.g. Kapferer 1997, 2003; Par
es and Sansi 2011).
Possession came to be understood in terms of embodied practices of knowledge, memory
and healing (Sax and Weinhold 2010; Lambek 1993; Boddy 1994; Csordas 1999). Still,
in Gujarat, sorcery and possession are concerned with impaired selves, ritual aggression,
and emotions such as hate, envy, and madness.7 But it cannot necessarily be inferred that
these ideas are psychological theories in disguise. The ideas that have been institutional-
ised at the shrine of Mira Datar represent an alternative theory of madness, one that
stresses the transgressions in relationships of exchange between human and non-human
agents and emotions as moral appraisals of social relationships.
The pilgrims and patients with whom the author of this paper worked did not see
themselves as unique minds locked in enclosed bodies. The discourse prevailing at the
shrine emphasised, instead, relational personhood, or the dividual rather than the indi-
vidual. Marriots concept of the dividual emphasises the persons porous boundaries,
which is constituted by the exchange of coded substances and merges biological and
moral dimensions (Marriott 1976). Marriott writes, To exist, dividual persons absorb het-
erogeneous material influences. They must also give out from themselves particles of
their own coded substances essences, residues, or other active influences that may
then reproduce in others something of the nature of the persons in whom they have origi-
nated (Marriott 1976, 111). This is important for understanding the logic of sorcery as
one possible origin of madness.
Non-dualist notions of personhood, however, coexist with dualisms on another level.
In Hinduism dualism is reflected in the distinction between the immortal Self (atman)
and its repeated, temporary incarnation in perishable human and non-human (demons,
gods) bodies. The tripartite Islamic model of human personhood (ruh/ soul, aql / reason,
nafs / instincts and emotions), on the other hand, emphasises embodied life on earth and
spiritual existence in paradise after death (Kurin 1984). Mira Datar and other Friends of
God (vali) or Sufi saints whose souls remain on earth after death are ambiguously
placed between human bodies and spirits without bodies. Jinn, spirit beings created by
God from fire and air who live and die like human beings but have no material bodies,
further stress a distinction between embodied and disembodied minds. Life and death
thus give rise to manifold disembodied minds or spirits.
In the language used at the Sufi shrine, the composite parts of the person are mapped
onto the human body: the brain is the seat of reason (aql) and the heart (dil) is the place
 330 Helene Basu

of emotions and desires (nafs). According to the guardians of the shrine (mujavar), mad-
ness sets in when the relationship between heart and brain is severed. Gujarati contains a
rich vocabulary of madness (pagalpanu) which links impairments of the head refer-
ring to the brain (magaj) and the mind (man) with unreasonable behaviour and painful
sensations. These include wild, violent conduct (divanu), negligence of personal cleanli-
ness (gandu), inability to work or perform ones social duties, deranged speech and
actions (pagal) as well as feeling hollow, stomach or chest pain, fear and general confu-
sion (gabhrat). Sorcery is said to be one of many causes of madness.
The logic of sorcery invokes a triad. First, someone (who is usually close to the family)
must cultivate hatred and envy against another person. This person then approaches a
second person, a tantric or a fakir knowledgeable about the techniques of black magic
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(kala jadu), which can be deployed to secretly harm and exercise control over the third per-
son, the victim. The first person is taught how to use black magic on the victim; for exam-
ple, by contaminating a food offering with a poisonous spell. The same means which under
normal circumstances establish or reconfirm a human bond, such as gifts of food, are
employed in sorcery for destructive ends. Gifts are imbued with negative emotions and
harmful intentions, which are then transferred onto the receiver. As the gift of food enters
the stomach and travels inside the body, the heart (emotion) and brain (reason) become dis-
sociated. The person who eats the food begins to experience a fragmentation of body and
mind, or brain and heart, as well as terrible pain, which causes him to become mad and
to act out aggressive and destructive behaviour.
The practices of healing at the shrine of Mira Datar are based on how the bava sur-
vived his own death in a war against a sorcerer-king. This narrative provides the template
for rituals whereby the divine hero, along with an assembly of related co-saints (his
mother, paternal grandmother and a mothers brother, who have shrines distributed over
the wider landscape), heal madness and other afflictions by mobilising defences against
sorcery. Although the agents of affliction are invisible when inside a human body, they
can still be heard. In the language of the shrine, the spirits (or disembodied mind-powers)
of the dead, of Islamic jinn, of human sorcerers and their affronted clients are collectively
referred to as bala. Balas wield the power to seize human bodies, control the brain
(magaj) and mind (man), and consequently a persons behaviour. The notion of bala is
marked by polysemy, which is described in Indian textual traditions as a type of physical
strength that is needed, for instance, by the king to rule over people, by the warrior in bat-
tle or by the yogi in wrestling. Bala transcends the distinction between embodied human
beings and disembodied non-human spirits by making mind-powers accessible to humans
when skilfully applying techniques of black magic or sorcery.8

The voice of sorcery agency and patiency

The non-psychological underpinnings of sorcery-induced madness become more apparent
when the status attributed to the voice in countering afflictions of madness and sorcery is
examined. In practices of trance, multiple dimensions of the voice articulate shifting con-
stellations of agency and patiency. Since the 1980s, much ink has been spilled on agency
as the capacity of individuals to actively and consciously exercise control over, or at least
influence, the circumstances of their lives. It has been argued, however, that this notion of
agency is too constricted to the human individual and does not take account of the fact
that non-human objects also exercise agency in actor networks (Latour and Woolgar
1979; Latour 2007). And Sax has demonstrated that ritual healing of possession mobilises
agencies distributed over networks of human and spirit actors, things and substances (Sax
 Anthropology & Medicine 331

2009). Analogously, practices of sorcery and counter-sorcery also distribute patiency over
human and non-human actors along with multiple enunciations of the voice.
The first dimension of the voice pertains to the position of the speaker, such as the
afflicted pilgrims, the shrines ritual guardians, disembodied spirits and saints. Each
speaker mobilises a different register of the voice. One register makes sense of the afflic-
tions by talking about the events, thoughts, feelings or the conditions of the patiency.
Another experiences the afflictions by embodying the agents who displaced the selfs
agency; it speaks with the voice of the Other and hears the voices of the agents in states
of trance when ones tormenters are turned into patients. For pilgrims at the shrine of
Mira Datar, trance is a routine experience of both hearing and speaking the voices of
affliction and healing.
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Voices of the afflicted

Pilgrims coming to the shrine of Mira Datar can be broadly separated into three groups.
The first group consists of those seeking help for acute adversities. Their stay ranges
between a few days and a year. The second group includes those who have resolved afflic-
tions in the past but continue to show their loyalty and gratitude to the saints by visiting
regularly. The third group represents those who have settled more or less permanently in
or near the shrine (i.e., have been at the shrine for at least five years). Most of the mem-
bers of the third group care for a member diagnosed with schizophrenia. All groups are
composed of people who have been afflicted either directly or indirectly.
The shrine opens up a space for pilgrims to talk about personal failures, feelings of
alienation and experiences of abjection, which would normally be met with embarrass-
ment and shame in other social contexts. The narratives of misfortune centre on madness
and black magic as key tropes of ruined lives, which is evident in the story of a sister,
Quresha, and her brother, Sameer,9 who spent seven months in the common hall of the
shrine.
Quresha was busy cooking vegetables when she told us the story of her familys ruin.
Her brother Sameer, a young man in his twenties, sat next to her and listened. They left
their hometown of Uttar Pradesh over a year ago and travelled from one dargah to
another, passing through Uttar Pradesh, Haryana and Rajasthan, until they reached Mira
Datar in Gujarat. Her fathers extended family owned forestland and engaged in growing
and selling wood. They were doing well, Quresha said, and she, her elder sister and
Sameer studied up to High School. Then things went wrong. Our whole house was
cursed by our relatives, and we were completely ruined. Coinciding with a decline in the
joint business, her father and his brothers could not pay the instalments of a loan they had
taken from a local moneylender. In those days, there would be huge quarrels in the fam-
ily. Whatever good my father tried to do would go wrong. There was no success. Then,
everyone fell ill, one after the other. At first, her elder sister went mad. Black magic hit
her brain. Black magic does not allow your mind to function. The person under its powers
can see and hear people around her but does not understand what she is doing and how.
That is why one is called mad. One hears the voices of spirits talking. Along with her
mother, they brought the sister to a nearby dargah, but her condition continued to worsen.
After staying for three weeks, news reached them that the father had fallen seriously ill,
and he died shortly after they returned home. Although there was hardly any money left,
the sister was taken to a hospital in Delhi where her brain was X-rayed. The doctors
said that if one gets a fever, one hears voices in the head. Sometimes they could see the
disease in her brain, sometimes they could not. So, under the influence of spirit powers
 332 Helene Basu

the sickness is visible at times, at others it is not. Medicine does or does not take effect.
While the doctors could not resolve the uncertainty about the sisters condition, Sameer
became affected by black magic.
In a peculiarly flat voice, contrasting with Quershas rapid and breathless speech,
Sameer interrupted his sister and said, I used to feel the power inside me . . . the dirty
magic made me so angry . . . would make me pick fights with the family . . . I would hit
her [Quresha], my elder sister, my father. . . Quresha resumed her narrative about the sis-
ter, in which things went from bad to worse. They took the sister to a dargah once again,
this time to a shrine near Delhi. Here, all of us were called to the order [of the saint].
Each one went through the suffering. We did not have the order [hukm] to hire a room in
a lodge. We had booked a room in the lodge but the command was to stay inside the dar-
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gah all twenty four hours. It felt like being someone who was jailed for a murder or a
crime who needs to be kept under surveillance day and night. My sister was kept that way
in front of the tomb. Still, the sister died, and the spirit powers came back with a ven-
geance to us. After the death of the sister, they lost their house and possessions. Quresha
and Sameer continued to seek help at the dargahs, which they finally found at Mira Datar,
where they have stayed the past seven months. Here, Sameer said, I feel my life is safe.
I did not think I could be saved. But Mira Datar has taken pity on me. I trust in the friends
of God, they have saved me from everything, from all pain and hurt. My brain has finally
come round to work again.
Events that may appear contingent from an outsiders perspective, such as economic
pressures, conflicts over jointly held property, severance of social ties, sickness, madness,
death and destitution, are linked in this story. In sociological terms, such experiences of
marginalisation circumscribe the everyday life of large numbers of people from lower
social classes in India; institutions such as the shrine of Mira Datar give them a position
to speak from as victims of sinister forces of disempowerment.
Another pilgrim of suffering, Abdul, talked about how alienated he felt from himself.
Abdul had worked hard to open his own medical store in his hometown of Gujarat. But
about a year ago, he had become unable to manage his shop properly. He opened late or
not at all and forgot to keep track of his stock, causing customers to dwindle away.
Although Abdul was 35 years old, he was still unmarried. He shared a house with his
parents and an elder brother who was married with three young children. When his
brother urged him to be more careful about his work and his mother worried about his
marriage prospects, Abdul got angry and withdrew from his surroundings. His brother
eventually took him to Mira Datar, where he had been staying alone for the last seven
months.

Previously I did not believe in black magic [. . .] and all this. But then I had this trouble
myself. . . that is. . . wherever I go I feel such a weight, such uneasiness. . . [. . .] It is a spiritual
power that you cannot see, only feel through the pain you undergo. [. . .] It destroys all rela-
tionships, like sibling relationships, parental relations, and everyone rejects you. . . because
your mind is not your own. . . It does not allow you to talk when you want to . . . and when
you should say nothing it makes you talk too much. . . You cannot control it, it controls you.
[. . .] you start thinking of suicide. . . you keep thinking that you have lost everything. . . wher-
ever you go you lose respect. . . it forces you to do things you should not do.

While Abdul talked about how it feels to be directly afflicted, the caretakers, who are
indirectly afflicted, related how their own situation was impacted by the madness of a rel-
ative. Most of the caretakers were women from the third group of pilgrims who cared for
a son or daughter with schizophrenia and whose stay at the shrine extended over many
 Anthropology & Medicine 333

years. Their stories were quite similar, as most of them stressed how the onset of the dis-
ease shattered joint domestic living with their husbands and relatives as well as their own
hopes for the future. Arvind, for example, was the first in his family who moved from
Rajasthan to study at a college in Delhi. His mother was proud of her sons educational
achievements, and she already saw him as a prestigious IAS (Indian Administration Serv-
ices) officer. But after a year in college, his behaviour changed. Arvind began to skip clas-
ses, slept during the day, roamed the hostel at night and troubled other students by
shouting loudly until he was eventually expelled. The situation did not improve at home.
The family briefly sought treatment for Arvind from a psychiatrist. Arvinds mother
insisted that the medicine only made him sleep and withdraw into himself even more, and
it also failed to stop his bouts of shouting, making it impossible for him to resume his
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studies. His mother then dreamed that Mira Datars voice was calling her and Arvind to
his dargah. After the dream, she accompanied her son to the shrine to care for him. This
occurred five years ago. Her husband and her second son occasionally come to visit.
Arvind himself denied being ill and blamed his mother for forcing him to stay at a Muslim
place although they were Hindus.

The voice of mujavars

The voice of the mujavar is the medium that transmits the pilgrims experiences of suffer-
ing to the saints through acts of supplication. Embodying the role of deputy of the saints,
the mujavars voice is one of authority. Several hundred mujavars perform ritual services
at the shrine, and each mujavar serves his own network of clients. Clients maintain inti-
mate relationships of trust with their mujavar in which they tell him about their personal
relationships, family quarrels, emotional turmoil, worries about spouses and children,
financial problems, etc. Conversations with ones mujavar usually take place around the
time for prayer in the evening. Three types of prayer are practised at the shrine: namaz,
the five daily prayers proscribed by Islam; dua, the congregational prayer of supplication
routinely performed during daily shrine rituals at dusk and dawn; and a particular prayer
of supplication addressed to the saints in the name of the client. While the former two
forms of prayer use words from the Quran, the latter invokes the saints as executors of
justice in a transcendental court (darbar).
Each form of prayer is articulated in distinctly patterned modulations of the voice.
Namaz can be recited quietly, and the emphasis lies on the correct performance of bodily
gestures and postures. Performed in the mosque by men only, namaz prayers are led by a
moulvi (Quranic teacher) whose strident voice broadcast over loudspeakers beyond the
walled compound of the shrine momentarily silences other sounds. At dawn, namaz is fol-
lowed by collective prayers of supplication (dua) in which mujavars take turns perform-
ing the role of the prayer leader. This performance is centred on the tomb of the saint
around which pilgrims gather in concentric circles, maintaining a separation between
male and female spaces only in the area closest to the tomb. Otherwise, groups of men,
women and children closely sit or stand together while praying. In a melodic voice, the
prayer leader intones the dua greeting the saints and leads the congregation to join in the
choir chanting harmoniously.
Collective prayers of supplication are followed by the prayers of supplication, also
called dua, that each mujavar performs specifically for his clients. These follow a call-
response pattern, as the client repeats each line spoken by the mujavar and holds a red
thread between his hands. Mira Datar [. . .] we have come to your court [. . .], A mujavar
may begin the prayer in a grave, slow voice but then gathers speed and hurries his clients
 334 Helene Basu

in a rattling voice through a long list of spirit categories, witches, sorcerers and potential
enemies addressed as shadows (shaya), asking for deliverance and protection. At the
time of this prayer, the shrine fills with the murmuring sounds of people repeating the
words of their mujavar in halting or hushed voices.
Through different sensory modulations of the voice, each prayer marks a different
level of belonging: the austere voice of namaz indicates a normative recognition of the
laws of Islam; the gentle voice of the congregational dua invokes a feeling of shared
belonging to the saints community of followers; the alteration between the flattened
voice of the routine of the mujavar and the shaky voice of the client mobilised in the last
dua performance marks the relationship between client, mujavar and the saints, analogous
to the plaintiff, defendant, advocate (vakil) and judge in a court of law. By speaking this
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prayer, a client simultaneously expresses complaints (arzi) against defendants (enemies,

sorcerers, spirits) and a pledge of allegiance to the saints and the morality they stand for.
While complaints are also submitted in a written form to an auxiliary shrine, they become
performatively activated by the voice when spoken into the red thread while repeating
the words of the mujavar. This prayer is spoken at least once every day throughout the
duration of the clients stay. It aims to transform the patiency of the suffering pilgrims
from being haunted by destructive, maddening forces to becoming controlled by the
powers of the saints restoring health, wholeness and reason and ultimately human agency.

The voice of spirits

The congregational prayer heralds the summoning of spirits to the transcendental law
court. Harmonious chanting is punctuated by the voices of spirits erupting in pure enunci-
ations as paroxysmal recitations of meaningless syllables, as shrill screams, hoarse groan-
ing, wailing lamentations, as missiles of the voice that, if heard in places other than the
shrine, would make listeners shudder. In this case, listening to the voices of spirits both as
pure enunciation and as a medium for spitting out filthy words, words of abuse and hate is
a routine practice exorcism. In this context, exorcism is associated with the saints admin-
istering justice, which is described as the separation of spiritual agents from the bodies
and minds of those of whom they have taken possession.
In a state of trance, a spiritual court case is negotiated when the mind-powers of the
person that turned the victim into her patient is then itself turned into a patient of the saint.
One cannot see spirits, but one can hear their voices. One mujavar explained: Mira Datar
challenges balas by asking why they have entered a human body and create problems.
When sufferers come to this court, the spirit that haunts their body must give witness in
front of Datar Bava. It must disclose its identity, where it has come from, and if it has
been sent by someone. [. . .] Datar Bava, with his secret technique that is revealed to no-
one, makes it confess everything.
The state of trance in which spirits are made to reveal their identities and confess their
crimes is alluded to as presence (hajri). There might be many presences in one body as
multiple voices make themselves heard: During hajri, the mujavar continued, the per-
son who is possessed cannot be heard. It is the spirits voices possessing her which are
present. The voice of the one who has sent the black magic spell is also there, as is the
voice of the one who has taught her how to do this. All of them are made to suffer, they
are punished by Datar Bava. Balas often scream, shout, moan, but the victims voice is
not recognizable.
The acts of a person in a state of trance are expressed in Gujarati by the verb dunvu
and its causative form dhunavu. Dunvu means to inflict pain by harsh words, to
 Anthropology & Medicine 335

torment, to abuse, and dhunavu means to be pained by harsh words, to be

tormented, to be abused. The shift between active and passive phrasing indicates the
interplay of agency and patiency (i.e., between the spirits, sorcerers and their masters and
opponents) as a routine practice of deliverance from afflictions.
In the state of possession trance, the voice of the afflicted self is displaced by the mul-
tiple voices of disembodied Others; these voices oscillate, tormenting and causing pain to
the afflicted, and by causing the person to articulate them through abusive speech, threats
or mocking of the divine. One evening, we met with Abdul again. While telling us about
his feelings of alienation his voice had been soft and gentle, now he was rhythmically
dashing his body against a wall, while a defiant and spiteful voice of one of his presences
declared:
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The spirit of Allah exists by black magic. . .

I was forced. . ..

To do black magic. . .

I became an enemy of Allah

My world became hell. . .

Abduls balas speech oscillated between reversing the most sacred words uttered by
a Muslim, mocking God and denying responsibility. Another spirit of an elderly woman
was desperately trying to escape the grip of the saint, confessing and pleading with a tear-
ful voice for forgiveness, before turning to furious screams of resistance:

Datar Bava,. . .my strength is over.. bava

[. . .]

leave me.. bava

stop stalking me, bava

I did all of this for money

I did this to take her life

but nothing happened!

My daughter-in-law hit me, bava

where should I go?

And then the voice rose to a shrill crescendo while the womans hands slapped her face,
yelling

Leave. . .leave. . ...leave!

 336 Helene Basu

Later in the evening she told the fieldworkers: I feel good after hajri, as if a weight
has been lifted from my body. Other pilgrims have also reported feeling well after trance.
It is not they who cry of pain, but their tormenters. The more the latter are punished by
the saints, the more an afflicted person may regain control over her own sensations and
behaviour. The voices of aggression and desperation making themselves heard in hajri
indicate a shift of patiency, whereby the afflicted gradually regains his or her own agency,
and that means his or her own voice.

The voice of saints

The dualisms between visible and invisible, and corporeal and disembodied spirits are tran-
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scended by the medium of the voice, making their presences tangible. By becoming
embodied and seizing the organ of the voice of a human being, disembodied voices are
publicly heard. The disembodied voice of the saint, by contrast, is only heard by those to
whom the saint speaks. Those who have become the patients of spirits claim that while
they do not remember the spirit speaking with their voice in trance, they do remember hear-
ing the voice of the saint in hajri or in dreams. The voice of the saint gives orders (hukm):
it determines how long the stay at the shrine will be, what rituals to perform, what to eat,
etc. By lodging ones case with a saint, the agencies of those who are directly and indi-
rectly afflicted are transferred to the saint. Saints routinely order patients to stay 40 days
(period in rites of passage, e.g. states of impurity after a birth or a death). Oftentimes, how-
ever, the process separating spirits from a persons body takes much longer. In due course,
the saints voice reveals the identity of the enemy who cast the spell. It should be noted,
however, that the disclosure of the identity of a sender of madness, sorcery spells and spi-
rits does not mark a great milestone in the process of ritual healing, as has been argued
with regard to counter-sorcery in Tamil Nadu (Nabokov 2000). The aim of counter-sorcery
at the shrine is not revenge but to shift patiency and re-transform powerlessness into
agency. Knowledge of the culprit enables the afflicted pilgrims to reflect on strained inti-
mate relationships and family quarrels and learn new ways of coping with hostility.

Pathological voice hearing

Some of the afflicted pilgrims, such as Arvind and others suffering from schizophrenia,
heard the voices of spirits in their head but did not speak them in trance. Chaganlal was a
schizophrenic who heard the voices differently from other afflicted pilgrims. He heard
the voices of ghosts, which he identified in the following way: One is a girl who sings
like a nightingale. Then there are the ghosts of a man and his wife. Another one is [. . .]
an old jinn. He fell in love with me. Chaganlals voices did not colonise his body like
those of other suffering pilgrims, but remained separate and spoke from an external site
to him rather than through him. For some time, Chaganlal had taken medicine from the
psychiatrist at the shrine which, he said, helped him. The voices had not completely gone
away, but they came less often. He told the psychiatrist that he heard the voices coming
from the ceiling fan when he stayed in a room or from a distant corner in the shrine when
he sat in the yard. Although the ghosts voices did not criticise or torment him but rather
uttered his praise, Chaganlal said he hated that the voices were constantly speaking to
him and about him, commenting on his clothes or putting all kinds of demands on him.
Chaganlals condition oscillated between periods of suffering from hearing voices, in
which he experienced them as unwelcome and oppressive, and times when the voices sub-
sided and he thought about leading a different life, looking for a job, etc. He had studied
 Anthropology & Medicine 337

political science in a city in Rajasthan but could not finish his degree. By the time the
author and her assistant met him, he had been cared for by his mother for the past eight
years. After his illness set in, he became known as the mad body of the neighbourhood
and became an embarrassment to his family. His mother explained that the family had ini-
tially considered three options to cope with the burden that Chaganlals madness placed
on all of them. One option was to have him admitted to a mental hospital. This was ruled
out as his father found out more about the conditions prevailing in the mental hospital
close to their hometown: He said our son would be locked up. We could not have been
able to care properly for him. They secretly put medicine into patients food so that they
become like vegetables. And they give them shocks [etc.]. We did not want that for our
son. He might never have come back alive. The second option was suggested by the
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fathers brother, who resented having to share in the responsibility for his mad nephew.
According to the mother, Chaganlals uncle said take him to another big city and leave
him there. He likes to travel and he will get along by himself. Here, he is useless. He
doesnt study, he doesnt work. We are spending our money but nothing comes out of it.
Just get rid of him. This suggestion outraged the parents who stopped talking to the
brother and his family ever since. The third option was to take Chaganlal to a dargah and
ask the saints for help. They took him to a small shrine in Rajasthan not far from their
home, where Chaganlals mother experienced hajri for the first time, receiving the bavas
order to take her son to Mira Datar.
As Chaganlals voices did not surface in his own trance, his patiency was transferred
to his mother in what may be called proxy hajri. By embodying the spirits discerned as
the origins of Chaganlals madness on behalf of him, his mother participated in her sons
affliction by sharing his patiency. This practice has also been recorded in other religious
healing places (Skultans 1987; Skultans 1991). Skultans suggests that mothers go into a
trance on behalf of their sons because of their inferior position in the gender hierarchy.
She argues that because mothers bear greater responsibility for the health of the family
than men, they are more likely to practise trance as a way of [self-]sacrificing their own
health and well-being [thus] cementing the bonds that tie them to their male kin (Skul-
tans 1987, 4). As far as the cases encountered at Mira Datar are concerned, women bore
the brunt of the burden placed by severe mental disorder on the family as a whole. At this
shrine, caring for a schizophrenic son or daughter implies a womens separation from the
family, rather than cementing her relational bonds. Sharing in the state of patiency,
women protect the family unit from social stigmatisation and loss of status.
Like other families trying to cope with the demands involved in caring for a schizo-
phrenic patient, the solution Chaganlals family adopted entailed the spatial separation of
husband and wife, and of the mother from her other children as well as from her partici-
pating in common everyday activities. A caretakers life revolves around the ritual rou-
tines of the shrine. In many cases, family members are convinced that sending a son or
daughter to a mental hospital will lead to a complete social death and the fulfilled desire
of the ill-wisher. To place oneself under the protection of Mira Datar, by contrast, offers
the possibility of hope. However long it may take, at least one will be saved as
Sameer insisted and most pilgrims agree that staying at the shrine has a calming effect
on any person afflicted with madness. This also applies to patients suffering from schizo-
phrenia who cannot participate in trance, the main healing practice at the shrine. Even for
them, the dargah provides at least a protective space against social ostracism. It offers
inclusion into an alternative social world to all those who are excluded from the world of
normal people: madmen, but also destitute families, widows or abandoned and divorced
women. They find shelter in a universe where the abnormal is the norm.
 338 Helene Basu

Challenging voices
Sorcery, this paper argued, is a discourse of impaired subjectivity paralleling and partly
intersecting with psychiatric understandings of mental disorder. The psychiatric discourse
of schizophrenia stresses impaired subjectivity, whereas the discourse of madness and
sorcery accentuates impaired sociality. Thus, patients of sorcery embody, as do patients
of schizophrenia, fragmenting, agonising and alienating forces. Rather than testifying to
the modern and traditional dichotomy, patients of counter-sorcery and patients of psy-
chiatry become trapped in competing discourses in a shared contemporary world. The
focus on the voice and its different registers reveals that religious healing places such as
the shrine of Mira Datar do more than address symptoms of madness. They give a posi-
tion to the disempowered subject to speak from, people uprooted from their homes, sev-
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ered from social relationships and alienated from themselves. They thus receive a social
voice in a metaphorical sense, a voice that is heard by others.
Analogous to the challenges biomedicine faces with regard to the New Age move-
ments of spiritual healing in the West, psychiatry is challenged by the language of sorcery
and possession in India. Routine ritual performances of possession healing and counter-
sorcery invoke ambiguous shifts between hearing embodied and disembodied voices. Sor-
cery, as Pares et al. notes, is more than to believe in the sorcerers secret, its power has to
be tested; it has to be partially revealed in order to achieve its goal (Par
es and Sansi 2011,
16). The shrine of Mira Datar is an institution where the power of sorcery over human
bodies, brains and behaviour is revealed in the madness of the afflicted. The medium of
revelation is the voice. Anthropological and psychiatric challenges crystallise in the voice
as the point of convergence between models of occult madness and schizophrenia. The
definition of schizophrenia quoted at the beginning of this paper claims that this type of
severe mental disorder excludes experiences of trance. Whilst taking into account that the
meaning of trance is subject to cross-cultural variation, in this case the role of the voice in
trance and in psychiatric diagnosis brings about a comparable distinction between the
normal and crazy hearing of voices. Chaganlals madness is different because he hears
but does not articulate disembodied voices. Other pilgrims hear and articulate disembod-
ied voices at the same time.
While trance is an ambiguous practice evoking simultaneously the patiency and agen-
cies of healing in embodying disembodied voices in speech and hearing disembodied voi-
ces, the psychiatrists who practised at the shrine tended to interpret trance both
speaking and hearing of the voices of alien agents as pathological signs, either of disso-
ciative disorders or paranoid psychosis. In accordance with biological psychiatric episte-
mology, Gujarat psychiatrists understood voice hearing unambiguously as a symptom of
pathology.10 According to them, spirit possession and sorcery are delusional beliefs
which, although culturally widespread, indicate that a person has a mental disorder. Psy-
chiatrists generally ignored the distinction between being directly and indirectly afflicted
with madness, which is articulated in the distinction between ones own state of trance
and that of another (proxy hajri). Anthropologists have argued, on the other hand, that
auditory hallucinations emerge from the interplay of biological conditions and cultural
interpretations (Luhrmann 2011). They need not always be pathological. A study con-
ducted by Dein & Littlewood on members of a white Pentecostal Church in England
reported that hearing the voice of God demonstrated that such experiences were part of
peoples normal religious experiences (Dein and Littlewood 2007; Luhrmann 2012).
Anthropologists, however, are challenged by the convergence of psychiatric theories
resting on the somatised mind with theories of madness based on sorcery and possession.
 Anthropology & Medicine 339

Both posit a direct link between the brain and behaviour, albeit differing in regard to the
forces intervening in balanced working chemical actors in the first case and human/spirit
actors in the second. While anthropologists studying sorcery and possession tend to refute
psychiatric categories, cultural psychiatrists have integrated sorcery as a valid language
expressing mental distress (e.g. (Callan 2012; Littlewood 2009). Regarding possession, a
study conducted by a Dutch team of transcultural psychiatrists explored the connection
between dissociative disorders and possession in Uganda. Researchers found that some
categories from the cluster of dissociative disorders could be usefully applied in Uganda,
while others did not correspond to local concepts (Van Duijl, Cardena, and De Jong
2005).
Considering that the legitimacy of religious healing places has come under fire in
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India in spite of the ethnographic research that demonstrates their importance as an

alternative of care the opposition between scientific psychiatry and traditional ritual
healing must be redressed. At this moment, further collaborative research to produce a
more nuanced understanding of vernacular and psychiatric nosologies in interaction with
institutions and practices of care is needed.

Acknowledgements
The author wishes to express her gratitude to pilgrims, patients, ritual specialists and psychiatrists
willing to participate in the research and share their views and experiences with the researcher. Chi-
tra Khares assistance has been of invaluable help in the research process. The authors is also grate-
ful to Martina Wagner-Egelhaaf and the participants of a joint research group on mediality in the
Cluster of Excellence Religion and Politics in Pre-Modern and Modern Cultures for fruitful theo-
retical and interdisciplinary discussions on the voice.
This work was supported by Deutsche Forschungsgemeinschaft, Cluster of Excellence
Religion and Politics in Pre-Modern and Modern Cultures [B-1, 2007-2012]. The enclosed work
upholds ethical standards of publication: no data fabrication, proper citation, and all relevant con-
tributors have been listed. No financial interests are involved in this research and there are no con-
flicts of interest.

Notes
1. The unfortunate death of 26 pilgrims at a South Indian Muslim shrine in the village Erwadi in
2001 is taken as a watershed separating psychiatry before and after.
2. Asylum-type mental hospitals with several hundred, sometimes more than a thousand, beds
represent the most extreme pole of a continuum of institutionalised mental health care extend-
ing to psychiatric wards in general hospitals as well as to private psychiatric clinics catering
to the needs of the middle classes and the elite.
3. In the early twentieth century, psychoanalysis did travel to India, mainly to Bengal (Hartnack
2001), and a few psychoanalysts do practise in India (the most famous of whom is probably
Sudhir Kakar). But its concepts of the unconscious and therapeutic practice in which a patient
is alone with the analyst talking about his or her secret emotions, fantasies and childhood trau-
mas does not have many followers.
4. A growing body of medical anthropological literature, however, challenges the reduction of
schizophrenia to biology and neurological processes and argues for an integrated approach
accounting for the interpenetration of physical and cultural configurations and handlings of
psychotic illnesses (Jenkins and Barrett 2004; Kirmayer 1989, 2006)
5. See also the website of Schizophrenia Research Foundation, http://www.scarfindia.org/.
6. See (Halliburton 2009) for the relevance of aesthetic experiences of healing practices in
Kerala.
7. Indian religions spawn ambivalent conceptions of both madness (e.g. divine madness of
saints) and possession by distinguishing oracular possession by gods and goddesses from ill-
ness-inducing possession by demons or evil spirits (McDaniel 1989; Smith 2006).
 340 Helene Basu

8. In Gujarat (as elsewhere in South Asia), concepts of black magic merge tantric and Islamic
variants. Powers of sorcery are acquired and enacted by reversing mediums ordinarily
employed to invoke divine protection. For example, instead of using ink made from pure sub-
stances when writing lines from the Quran for a tawidh (a protective charm), as done by a
mujavar, a sorcerer is said to write the same lines with menstrual blood, whereby he turns the
shield into a weapon. Or, instead of asking God for blessing, a person is cursed with a spell of
destruction.
9. All names of interlocutors are changed.
10. For the history of medicalising hearing voices in psychiatry, see McCarthy-Jones (2012).

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