Paging Dr. Shaman…

The Wisdom of Mental Illness: Shamanism, Mental Health, and the Renewal of the World by Jez Hughes (Book Review)

“I live in New York City, a culturally diverse place where everyone is in therapy and most people talk rather casually and uninhibitedly about their diagnoses and medication regimens, but when it comes to the subject of race and gender in mental health, I find the conversations a bit limited.”

— Samantha Echo

In his 2021 book The Wisdom of Mental Illness, UK-based Shamanic healer Jez Hughes proposes a balanced and well-researched new framework for how we discuss, view, and treat mental illness, drawing on the traditions of shamanism and psychedelic research, and incorporating them with the more popular Western biochemical model. I was deeply excited to discover this book. Ever since reading about the early 1990s studies of DMT and its inherent presence in the human brain, I have been fascinated by the possibility of psychedelic healing methods. For an even longer time I have been frustrated by the “one size fits all” discourse surrounding psychiatry and its treatment of the human mind as a machine or a soulless puddle of chemicals. Hughes not only addresses this problematic paradigm but actually provides some practical solutions towards revising it.

Chapter 1 opens by posing the question, “Do humans become sick individually, or does society contribute to the decline in mental health of its citizens?” (1) This should not be a particularly controversial question, but it is. The book surprised me by inspiring me to ask "What is the official definition of mental illness?” The American Psychological Association defines it as “any condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these” and goes on to say that "such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors.” (dictionary.apa.org/mental-disorder) Paradoxically, it seems that the elusive nature of mental disorder is built into its very definition. Hughes hones in on this elusiveness (especially as it relates to the biochemical model of mental health) and dissects the word “disorder” in terms of its societal and ethical implications.

As he walks us through the history of mental health treatment and the flaws in the biochemical model—from the Ancient Greek “four humours” theory to the lunatic asylums of the 16th and 17th centuries to the now-infamous lobotomies of the 20th century to the psychotropic drugs provided by pharmaceutical companies—Hughes argues that what ties together these seemingly disparate approaches to human psychology is the pervasive fear of the “other” and Western Culture’s urge to tame what they view as disorderly and irrational. 

I would say that the Western view of mental illness is a theoretical descendant of the colonial mindset, one that we, as a mental health conscious culture, have not addressed at all, because we are in denial about it. As Hughes points out, there is a “predominance of white, male doctors who are proposing the theories and carrying out the treatments. Class, cultural, and gender bias has always informed our treatment of the mentally ill. In the United Kingdom, women are treated with antidepressants at nearly double the rate as men.” (75) 

I am so glad that someone is finally discussing this. I live in New York City, a culturally diverse place where everyone is in therapy and most people talk rather casually and uninhibitedly about their diagnoses and medication regimens, but when it comes to the subject of race and gender in mental health, I find the conversations a bit limited. The conventional wisdom I usually hear goes something like “men are less likely to seek mental health treatment because they don’t like talking about their feelings” or “people of color in disadvantaged economic positions are less likely to be able to afford mental health treatment.” 

Although these statements acknowledge the sexism, racism, and classism within society at large, they fail to acknowledge the possibility that these prejudices are embedded within the structure of the treatments themselves and the mental health system at large, and that the practice of Western psychology may actually have sexism, racism, and classism at its very foundations. Jez Hughes not only recalls these foundations in a historical context, but proposes a new model which, rather than doing away with the Western rational biochemical paradigm that we know and love, seeks to integrate it with shamanistic frameworks and psychedelic substances.  It makes sense that during a time when there seems to be more diagnosis of mental illness than ever, we need to look into more treatment options, and there is no reason not to include shamanic and psychedelic treatments for those who benefit from them in addition to the currently more popular biochemical and rationality-based treatments for people who benefit from those.

After describing the history of Shamanism and the history of Western mental health in separate chapters, Hughes proposes a way of combining the two and administering psychedelic drugs in hospital settings, under the close supervision of doctors. Many of us find it hard to reconcile images we associate with shamanism and psychedelics—indigenous leaders administering Ayahuasca in a forest and hippies sitting in a circle amongst colorful tapestries—with images of doctors in white coats and scrubs walking around in austere buildings surrounded by machinery. However, Hughes points out the fact that the hospital, too, is a place of ceremony, ritual, and even mystery. Science does not contradict spirituality. In fact, the Western doctor can be a kind of shaman, too. As Hughes points out, “Largely, as a culture, we revere doctors; they are seen as having a moral authority as, at times, they hold such power over life or death. Thus, they are our modern day magicians, able to transform reality for the better. The hospital itself is a liminal place, where time stops and reality becomes heightened…It is a place where fear and dread mix with hope and potential relief. It is a potent combination.” (143) Science does not contradict spirituality. What if we were to bring some LSD into our hospitals and allow deeper experiences to unravel?

Hughes suggests that the hospitals can act as an appropriate backdrop for a psychedelic journey that the patient could take during a visit. “Ritual adapts…to the circumstances and civilization it finds itself in.” (143) Hughes argues that by embracing the hopeful aspect of hospitals and diminishing the fear associated with such settings, the hospital could serve as a backdrop for a psychedelic journey. 

I believe that it is time to address the paradoxical nature of the times, and that Hughes’ detailed new approach towards mental illness, which involves not only a philosophical reframing but actual guidelines for practical implementation, is a crucial step we need to take to integrate the rational biochemical treatment model with the shamanistic-based model.