A Brief Sketch of Therapy with Witchcraft and Paranoia
In therapy with D, after establishing that there were no concerns of safety and risk issues, the first aim was to reduce his intense painful emotional dysregu- lation. So with D, we explored the whakapapa or genealogy of his trauma.
We explored the early years or his whakapapa to understand his intergenerational traumatic and abusive past, and how this may be related some of his unusual paranoid or psychotic experiences. The personal and the political intertwined at this point in that D was able to appreciate that the severe alcohol abuse of his parents was the result of not coping with the traumatic land loss imposed by the government on his grandparents. This created an important shift for D, as he felt that he was not just an unwell individual, but that his distress was related to the politics of the land. He stated that he felt he had more mana (personal power) because of this insight. His internal battle had a deep connection to political injustice of colonization; it was not based on some inherent weakness. This work was based on an integration of the whare tapa wha model, and on psychodynamic and developmental formulations of his whanau (extended family) and intergenerational trauma, involving the tinana (body) effects defined by a trauma neurodevelopmental model (Read et al. 2001). The intergenerational political-personal trauma affected the complex personal and cultural web of family systems, neurodevelopmental factors, and his inner world.
In therapy and in his life, D presented with signs of hypervigilance, avoidance, had some startle responses, and struggled with intense emotional dys- regulation (Schore 2003). When unpacking his whanau or familial past emotional whakapapa (genealogy), it was helpful to address his attachment and mentalization (hinengaro) issues. His positive relation with his grandmother, a significant attachment figure in Maori whanau (Glavish 2014), was central as a protective factor in the face of very early pre-verbal neglect. In regard to his relationships, we explored and mentalized other options carefully, such as that at certain times people around D were possibly responding with fear to his increased agitation, hence withdrawing from him out of fear, and not only because of makutu.
Also, large sections of therapy explored his paranormal experiences, which are beyond the scope of this chapter and are explored elsewhere (Lambrecht 2017). However, it was central for him to be culturally safe and feel understood by his therapist. Because of a sense of respect and engagement with his culture in the sessions, working with witchcraft or makutu became possible by gently allowing for a discerning approach that does not deny experiences of fear, but carefully checks whether this is related to past patterns within him, or whether he experienced some synchronistic or anomalous experiences. Mentalizing others more carefully (Bateman and Fonagy 2004), and checking carefully whether he was being cursed or not, was helpful. At certain points, he could acknowledge his hypermentalization when it came to certain specific incidences of makutu. No attempt was made to deny or agree with makutu, but rather to become discerning, reminding him that even traditional Maori healers or tohungas would not always assume makutu. Tohungas were equally discerning, and sought proof. With time, he began to settle, his thinking and feeling became clearer and regulated. He began after many months to build up his own business again. He first became fearful of remission, so gently exploring risk factors and supporting him with stabilizing dialectical behaviour therapy skills (Linehan 1993) were central. Self-soothing skills and being reflective and effective in mentalizing also led to positive outcomes in regard to relapse and remission. He found this integrative style of therapy helpful, using cultural concepts that fit or are close to the therapeutic concept, thereby creating congruence. Another important factor was our therapeutic relationship, for trust is more effective than rhetoric. He appreciated that personal trauma is political trauma. Through either therapy, rituals, and shamanic interventions, such attacks of either real or perceived witchcraft can be healed through achieving a sense of spiritual balance, protection, and the calming effects of down- regulation, that positively attunes the nervous system together with the whole inner psychological space, as well as harmonize cultural and social relations.