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Wolfgang
G. Jilek, M.D., M.Sc.
Canada
I
was born as the son of an internist and a Red Cross nurse, in
Central Europe
, just before the advent of Nazism. During my youth, the experiences of
World War II and its aftermath created a lasting aversion to nationalistic
hatreds that had destroyed the multi-national Austro-Hungarian state that
some of my ancestors had served with distinction.
An
important childhood influence had been my grandfather, whose library was
filled with old geographic and ethnographic works, inspiring an early
interest in "exotic" lands and peoples. I was also fascinated by
heraldry, which later led me to the study of the semiotic and psychological
aspects of national and political symbols, which I am still pursuing.
My
family experienced the material hardships of WW2 while my father was
away during military service and then interned in Russian POW camps.
Accordingly, from my early teenage years, I was forced to earn money
doing odd jobs. Nevertheless, I was determined to finish secondary
school and go on to university.
After
taking courses in history, geography, and literature, 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
. I acquired some proficiency in languages, which was useful in making
contacts with student organizations abroad. On shoestring budgets, I
made hitch-hiking trips throughout
Europe
, where I met people of many nationalities.
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 post-graduate 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, HBM 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
ethno-psychiatry. 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 Goffredo Bartocci, 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‚s Transcultural Psychiatry Section and to the growth of
the newly founded World Association of Cultural Psychiatry.
October 5, 2006
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