The health system of the West is very unhealthy. This slide show interrogates the ways in which Health has been colonised, commodified and turned into a consumer industry in the capitalist world. It contrasts this model with pre-capitalist, indigenous models of health and suggests ways in which we might learn from these and work to improve out own system. This slide show and others of a similar nature can be viewed and downloaded from my website at www.tonywardedu.com

1. ANTI-CAPITALIST MODELS OF HEALTH
AND WELL-BEING
“The most odious form of colonisation, and that which has brought with
it the greatest pain for the colonised – (is) the colonisation of the mind”
Franz Fanon
“Only now, in the Twenty-first Century, are Europeran peoples just
starting to appreciate the value of indigenous knowledges about health,
medicine, agriculture, philosophy, spirituality, ecology and education”
Joe Kincheloe
Western models of health have been penetrated by a pharmaceutical industry
that makes huge profits on a model of health that in many ways has been
counter-therapeutic. The 20 largest pharmaceutical and biotech companies in
the world amassed profits in excess of $110,000M in 2007, with an average
net income of $504,000M each. In 2008, the top 15 had a combined sales
income of $358,302M.1
Not surprisingly, given these staggering amounts of
money it is not surprising that these companies spend millions promoting a
model of health that demonstrates a need for their product. In the US alone,
they promote this model, through advertising, marketing and lobbying (to
influence political decision-makers) to the tune of $19 billion a year. Annually,
the 1274 registered drug lobbyists in Washington DC spend approximately
$150 million seeking to steer healthcare legislation their way.2
Since the US Health Insurance Industry also exercises enormous power and
influence in which drugs are prescribed, and since they too rake in
extraordinary profits from the health care system, little wonder that in
Obama’s attempt to reform the system, the Health Insurance lobby spent
more than $1.4million a day to ensure that public health care remained off the
agenda and that their profits remained safe.3
The success of their campaign is
demonstrated by the fact that not only did Obama’s public system fail to pass
a bipartisan vote, but that the result of legislation was that every citizen is now
legally required to have health insurance. The insurance companies must
have laughed all the way to the bank. In 2009, the year when the Health Care
legislation debate was at its height, the five largest US health insurance
companies set new profit records, while the greatest economic downturn
since the Great Depression sent millions of Americans onto the
unemployment line and into poverty.
1
“Top 50 Pharmaceutical Companies Charts & Lists”, Med Ad News, September 2007.
Has the Pharmaceutical Blockbuster Model Gone Bust?, Bain & Company press
release, December 8, 2003
2
R. Jeffrey Smith and Jeffrey H. Birnbaum, “Drug Bill Demonstrates Lobby’s Pull”,
Washington Post, Friday, January 12, 2007
3
Dan Eggen and Kimberly Kindy, “Familiar Players in Health Bill Lobbying: Firms Are
Enlisting Ex-Lawmakers, Aides”, Washington Post, Monday, July 6, 2009

2. “The five firms reported $12.2 billion in profits last year, an increase of
$4.4 billion, or 56 percent, over 2008. At the same time, 2.7 million
Americans who had been enrolled in private health plans the year
before lost their coverage.” 4
Given all of this, it is difficult not to conclude that America is not a good place
to be sick. Nor would it be unreasonable to suspect that given the
unimaginably immense financial gains to be had, the very model of what it
means to be a healthy human being might itself have been shaped by the
Health economy. The biomedical model of human health that lies behind this
industry and these huge profits is specific to and grew alongside western
capitalist culture, through the Enlightenment philosophies of René Decartes
(1596-1650) and Carolus Linnaeus' the 18th
Century taxonomist whose
Systema Naturæ (1st ed. 1735) divided nature into three kingdoms: mineral,
vegetable and animal. Linnaeus used five ranks: class, order, genus, species,
and variety to classify all the objects in his world. His method is still used to
formulate the scientific name of every species. This reductionist and
mechanical view of the world saw biology through the same mechanistic lens
as the parallel development of physical science. Biological systems –
including that of human biology - were seen as simple machines.
4 Health Care for America Now, “Health Insurers Break Profit Records as 2.7 Million
Americans Lose Coverage”, Report, Feb. 2010.
http://healthcareforamericanow.org/site/content/reports/

3. Within the framework of this model, the human body has been regarded as a
machine that can be analysed in terms of the functioning of its parts; disease
is seen as the malfunctioning of biological mechanisms which are studied
from the point of view of cellular and molecular biology; the physician's role is
to intervene, either physically or chemically, to correct the malfunctioning of a
specific mechanism. The process is seen as essentially curative, where the
doctor is the active participant upon a passive recipient who patient-ly (how
passive is that!) awaits a cure. This model is built around the accumulation of
capital through the sale of medical services. It is a direct result of the
economic system within which it operates.
The Linnean penchant for taxonomising everything extended, in medicine, to
all of the previously unified aspects of health – the physical and the mental,
which were now treated as separate spheres of knowledge, each further
broken down into smaller and smaller specialised components (paediatrics,
geriatrics, Gynaecology, Oncology, etc. on the one hand, and psychiatry,
psychology, psychotherapy etc. on the other). In the realm of the psyche the
proliferation of sub-disciplines or practices has been staggering and with each
new sphere of practice, the scale and extent of diagnosis has increased
exponentially. The fourth edition of the Diagnostic and Statistical Manual of
Mental Disorders (better known as the DSM-IV) covers all mental health
disorders for both children and adults. It also lists known causes of these
disorders, statistics in terms of gender, age at onset, and prognosis as well as
some research concerning the optimal treatment approaches.5
Each form of practice – Freudian Psychiatry, Jungian Analytical Psychology,
Adlerian Analysis, Rogerian non-interventionism, Psychotherapy of numerous
sorts - Transactional Analysis (Berne), Gestalt Therapy (Fritz Perls),
Neurolinguistics (Bandler and Grinder), Hypnotherapy (Milton Erikson), and
(more recently) Poststructuralist Psychoanalysis (read “subjects” rather than
“patients”) supports its own small industry, each with its own practitioners all
swearing that their form of intervention is the most effective. Yet despite all of
this hoopla, it appears that there is very little measurable difference in effect
between any of them. Referring to what they call the Dodo effect (The Dodo’s
verdict that ‘Everybody has won, and all must have prizes’),6
Stiles, et. al.
debunk the mythology of what has been called “Psychotherapy’s equivalence
paradox” – that there is any measurable difference in effectiveness between
different kinds of psychotherapy.7
5
The DSM was first published in 1952. At that time, it contained only 66 disorders with
short lists of symptoms for each and some discussion of the believed cause of the
various disorders (Holmes). In 1968, the number of disorders was expanded to just
over 100 with the publication of Edition II. Edition III of the Manual (1979) introduced
a multiaxial diagnostic system of five scales. The DSM-IV is the current edition of the
manual and was first published in 1994. This edition presents nearly 400 disorders.
DSM-5 is currently being compiled and can be expected to identify substantially more
disorders.
6
Lewis Carroll, Alice in Wonderland, 1865/1946, p. 28;( italics in original)
7
William B. Stiles, Michael Barkham, Elspeth Twigg, John Mellor-Clark and Mick
Cooper, “Effectiveness of cognitive-behavioural, person-centred and psychodynamic
therapies as practiced in UK National Health Service settings” in: Psychological

4. The proliferation of these many different forms seems therefore to operate
perhaps not as a response to therapeutic need but to marketplace conditions
– from the need to have a distinguishable therapeutic brand. And following on
from this, it would not be surprising to discover that the parallel proliferation in
diagnostics and mental disorders as defined by DSM-IV is similarly market-
driven.8
Capitalism as shaped all of the disciplines in this way, and the fields of
biology, medicine and psychotherapy are no exception. Throughout the
history of Western science the development of biology has gone hand in hand
with that of medicine, and psychotherapy has tagged along for the ride.
Naturally then, the mechanistic view of life, once firmly established in biology,
has also dominated the attitudes of physicians and psychiatrists and
psychotherapists toward health and illness.
The influence of the Cartesian paradigm on medical thought resulting in the
so-called biomedical model has constituted the conceptual foundation of
modern scientific medical practice. The human body (and mind) is regarded
as a machine that can be analysed in terms of its parts; disease is seen as
the malfunctioning of biological mechanisms which are studied from the point
of view of cellular and molecular biology; the doctor's role is to intervene,
either physically or chemically, to correct the malfunctioning of a specific
mechanism. The mentally disturbed “patient” must be suffering from enzyme,
hormonal or other chemical deficiency or oversupply, and this condition can
now be “treated” withy the latest drugs.
The result is that there has been a phenomenal increase in the prescribing of
psychotropic drugs such as Ritalin (for the treatment of Attention Deficit-
Hyperactivity Disorder (ADHD) over the last 20 years.9
Our (mostly male)
children are now diagnosed and medicated for “medical” conditions” that
might more properly be attributable to the boredom or repetitive classroom
drudgery, lack of healthy activity-outlets, enforced inactivity, suppression of
creative curiosity, an isolation from risk that characterises much of American
Medicine, Cambridge University Press 2006, 36, 555–566. See also: William B.
Stiles, David, A. Shapiro and Robert Elliot, “Are All Psychotherapies Equivalent?”,
American Psychologist, February 1986, pp. 165-180.
8
For a brief overview see: Psychiatry is a Mental Disorder at:
http://www.youtube.com/watch?v=bPOrD6xfDNo
9
“While ADHD drug treatment was generally on the rise throughout the 1970s and
1980s, use of psychiatric drugs to treat behavior problems increased dramatically
after the U.S. Department of Education determined in 1991 that children with ADHD
could qualify for special education services under the Individuals with Disabilities
Education Act (IDEA). In the 1990s alone, there was over 700 percent increase in the
use of Ritalin, with the U.S. consuming nearly 90 percent of the world’s supply of the
drug. 2 By the year 2000, nurses delivered more medications in American schools for
mental health conditions than for any other chronic condition, and more than half of
all such medications were prescribed specifically for ADHD.” See: Gretchen B.
LeFever, Increased Use of Psychiatric Drugs in American Schools,
www.lexingtoninstitute.org/library/.../increased-use-psychiatric-drugs.pdf

5. school life.10
We blame and medicate the child but forgive and reproduce the
system and the society tto which the child may be responding while at the
same time falling prey to and supporting a drug and medical industry that is
making billions from our childrens’ suffering. For the education system as a
whole, Ritalin and its chemical alternatives has become the classroom
management tool of choice.
The view of the human organism upon which this system is built contrasts
starkly with that of the pre-Enlightenment era. Even the words we use betray
the differences between our current Western model of health and the
perception of well-being in traditional, indigenous or pre-enlightenment
cultures.
• The word health itself comes from the Old English word ha, meaning
whole, or the Old Norse word helge meaning holy or sacred.
• The Māori word for health – hauora – derives from two roots, hau,
meaning breath, vital essence, and ora, meaning life, vitality (n) or to
survive (v). The emphasis here is on well-being, that is, an active state in
which the person plays a central role. It is a state of being-in-the-world.
• The Lakota word got health – zanî means to be unmolested, whole.
• The Cherokee word for health - tohi - is the same as the word for peace.
You’re in good health when your body is at peace. The “medicine circle”
which is common to most Native American cultures, has no beginning and
no end and therefore represents a concept of “harmonious unity.”
• In Myaamia, the concept of ‘health’ is constructed quite differently than it is
in English. There is not a word in Myaamia that functions like the English
word ‘health’. In other words, there isnt really a way to say ‘he is healthy’.
What one would say is: nahi meehtohseeniwita , meaning ‘he lives well, in
a proper way’. This concept is much more holistic and goes way beyond
‘body function’ notions of health that we express in English11
10
Between 1993 and 1997, neurologist Fred Baughman corresponded repeatedly with
the Food and Drug Administration (FDA), the Drug Enforcement Agency (DEA), Ciba-
Geigy (now Novartis, manufacturers of Ritalin), and top ADHD researchers around
the country - including the National Institute of Mental Health - asking them to show
him any article(s) in the peer-reviewed scientific literature constituting proof of a
physical or chemical abnormality in ADHD and thereby qualifying it as a disease or a
medical syndrome. Through sheer determination and persistence, Dr. Baughman
eventually got these entities to admit that no objective validation of the diagnosis of
ADHD exists. See: John Brteeding PhD., Does ADHD Really Exist, The Natural Child
Project : http://www.naturalchild.org/guest/john_breeding.html and:
Fred Braugman, MD., Attention Deficit Hyperactivity Disorder: Exposing the Fraud of
ADD and ADHD., http://www.adhdfraud.com/
11
Personal Communication with Daryl Baldwin, Director of the Myaamia Project. 10
th
Nov. 2010.

6. • In the Diné (Navajo) language,the prefix hózhó (sometimes translated as
“health”) denotes the holistic aspect of the environment, the world, or the
universe. It connotes beauty, harmony, good, happiness, and everything
that is positive. The Diné ritual healing practices or ‘sings’ seek to restore
the individual’s state of balance in the universe, through multiple
pathways, connected to the
• The Sanskrit word for “health” is sáhitya, and connotes association,
connection , society , combination , union with, agreement or harmony.
Indigenous conceptions of health are essentially wholistic – they embrace and
include all aspects of life and existence. They are also preventative, rather
than curative. They suggest a state of being in balance with the universe, that
is both social, spiritual and material. They infer an active participation by the
individual in his or her well-being, and they also include aspects of life that the
scientific/reductionist model is unable to grasp – specifically the notion of spirit
or life force, that is seen as permeating the universe and at the core of each
individual’s inner state. In a word, they include the spirit-ual.
The following are a few models of Health in the modern indigenous world.
They are not actually traditional models, rather than attempts to describe the
traditional indigenous perspectives on well-being from a modern perspective.
Māori Models:12
Maui Pomare
TE PAE MAHUTONGA
A MODEL FOR MĀORI HEALTH PROMOTION
Sir Maui Wiremu Pita Naera Pomare, (1875 or 1876–1930) was a Māori
New Zealand doctor and politician, being counted among the more prominent
Māori political figures. He was well educated, receiving his professional
training in the United States, and was one of the most Anglicised of Māori
leaders at the turn of the century. He was unconcerned about the
disappearance of Māori culture, going so far as to sponsor the Tohunga
Suppression Act (an Act of Parliament that prohibited traditional Māori
healers fro practicing their skills). He is particularly known for his efforts to
improve Māori health and living conditions. Pomare promoted a five-point
strategic health plan rather than a model of health.
• The first point was about health leadership, understanding the need for
strong leadership (including his own) in improving Māori health, .
• Secondly Pomare linked health with socio-economic adversity, recognizing
that ill-health and poverty were closely related.
12
These examples are taken directly from Maori Health:
http://www.maorihealth.govt.nz/moh.nsf/fefd9e667cc713e9cc257011000678d8/1c22c
439ddc5f5cacc2571bd00682750?OpenDocument

7. • The third strategy was linked to the cultural realities of Māori aligning
health practice with Māori cultural precepts and principles,
• His fourth point was to engage politically in improving the health of Māori
• His fifth strategy was to develop a sufficient team of skilled health workers;
While these were not, per se, models of Māori Health, but rather strategies for
its improvement, they nevertheless point to the important relationships that
prescribe what Māori health is and might be.
MASON DURIE
TE PAE MAHUTONGA. (THE SOUTHERN CROSS)13
Sir Mason Durie, (1938) is a New Zealand professor of psychiatry well known
for his contributions to Māori health. He is known for his model of Māori
health - Te Pae Mahutonga. Te Pae Mahutonga is the name for the
constellation of stars popularly referred to as the Southern Cross. It is a key
navigational aid which has been used over the centuries to help guide our
direction, distinguished by the four central stars arranged in the form of a
cross, and two stars as pointers. In Mason’s model the four central stars
reflect particular goals of health promotion: Mauriora, Waiora, Toiora, Te
Oranga while the two pointers are Nga Manukura and Te Mana Whakahaere.
Mauriora
Access to te ao Māori
Mauriora rests on a secure cultural identity. Good health depends on many factors,
but among indigenous peoples the world over, cultural identity is considered to be a
critical prerequisite.
Waiora
Environmental Protection
The distinctions between waiora and mauriora are subtle but whereas mauriora
encompasses inner strength, vitality and a secure identity, waiora is linked more
specifically to the external world and to a spiritual element that connects human
wellness with cosmic, terrestrial and water environments. Good health is difficult to
achieve if there is environmental pollution;
13
Durie, Mason (1999), ‘Te Pae Mahutonga: a model for Māori health promotion’,
Health Promotion Forum of New Zealand Newsletter 49, 2-5 December 1999.

8. Toiora
Healthy Ljfestyles
Major threats to health come from the risks that threaten health and safety and have
the capacity to distort human experience.
Te Oranga
Participation in Society
It is now well recognised that health promotion cannot be separated from the
socioeconomic circumstances. Wellbeing is not only about a secure cultural identity,
or an intact environment, or even about the avoidance of risks. It is also about the
goods and services which people can count on, and the voice they have in deciding
the way in which those goods and services are made available. In short, wellbeing, te
oranga, is dependent on the terms under which people participate in society and on
the confidence with which they can access good health services, or the school of
their choice, or sport and recreation. Durie also borrows from and extends Pomare’s
strategic five-point programme, adding the issue of Cultural and personal autonomy
– tino rangatiratanga:
Ngi Manukura
Leadership
Leadership in health promotion should reflect a combination of skills and a range of
influences. Regardless of technical or professional qualifications, unless there is local
leadership it is unlikely that a health promotional effort will take shape or bear fruit.
Health professionals have important roles to play but cannot replace the leadership
which exists in communities; nor should they.
Te Mana Whakahaere
Autonomy
No matter how dedicated and expertly delivered, health promotional programmes will
make little headway if they operate in a legislative and policy environment which is
the antithesis of health, or if programmes are imposed with little sense of community
ownership or control. Capacity for self governance, not only for a specific health
promotional programme but more importantly for the affairs and destinies of a group
are central to notions of good health and positive wellbeing.
TE WHARE TAPA WHA
The model that Mason Durie is probably best known for is his description of te
whare tapa wha - the seamless connections of spiritual, mental and
emotional, physical and social well-being. .All four dimensions are necessary
for strength and symmetry. The model is based upon the typology of the
traditional Māori Wharenui or Meeting House, with each of the four
dimensions being represented symbolically as one of the walls.

9. Taha Tinana (Physical Health)
• The capacity for physical growth and development.
• Good physical health is required for optimal development.
• Our physical ‘being’ supports our essence and shelters us from the
external environment.
• For Māori the physical dimension is just one aspect of health and well-
being and cannot be separated from the aspect of mind, spirit and family
Taha Wairua (spiritual health)
.
• The capacity for faith and wider communication
• Health is related to unseen and unspoken energies
• The spiritual essence of a person is their life force. This determines us as
individuals and as a collective, who and what we are, where we have
come from and where we are going

10. • A traditional Māori analysis of manifestations of illness will focus on the
wairua or spirit, to determine whether damage here could be a
contributing factor.
Taha Whānau: (Family Health)
• The capacity to belong, to care and to share where individuals are
part of wider social systems.
• Whānau provides us with the strength to be who we are.
• This is the link to our ancestors, our ties with the past, the present
and the future.
• Understanding the importance of whānau and how whānau (family)
can contribute to illness and assist in curing illness is fundamental
to understanding Māori health issues
Taha Hinengaro (mental health)
• The capacity to communicate, to think and to feel mind and body
are inseparable.
• Thoughts, feelings and emotions are integral components of the
body and soul.
• This is about how we see ourselves in this universe, our interaction
with that which is uniquely Māori and the perception that others
have of us.
RANGIMARIE TURUKI ROSE PERE
Te Wheke (The Octopus)
Dr Rose Pere is an International Educationalist with experience from
Preschool through to the Tertiary Level. She embraces both traditional Māori
and Western perspectives. Her monograph on the traditional modes of
learning of the Māori, "Te Wheke - The Celebration Of Infinite Wisdom", is
used in the USA, Canada, the United Kingdom, Australia, Europe, Japan, and

11. has been translated into Japanese and Germany, and is used between times.
Her monograph is used as a training model of education by all Government
agencies in New Zealand. She has been strongly influenced by teachings that
go back over 12,000 years. Traditional Māori Health acknowledges the link
between the mind, the spirit, the human connection with Whānau (family) and
the physical world in a way that is seamless and uncontrived – until the
introduction of Western medicine there was no division between them. The
concept of Te Wheke – the octopus – is to define family health. The head of
the octopus represents te Whānau, the eyes of the octopus as waiora (total
wellbeing for the individual and family) and each of the eight tentacles
representing a specific dimension of health. The dimensions are interwoven
and this represents the close relationship of the tentacles.
Te Wheke
THE MEDICINE WHEEL
Native American Model of Health
The tradition of the Medicine Wheel is ancient. The example at Bighorn,
Wyoming (below) is between 300-800 years old and is part of a larger

12. complex going back 7,000 years. It is thought to have been used for
astronomical purposes and for ritual performances.14
Medicine Wheel, Bighorn County, Wyoming
There are many versions of the Medicine Wheel, and not all tribal groups
attribute the same characteristics to it. For simplicity, Iwill refer to the Lakota
Medicine Wheel.
In traditional Lakota society, the Medicine Wheel is represented as a circle or
hoop divided into four quadrants – one for each of the Four Directions – East,
South, West and North. Each quadrant is represented by a different colour ( in
counter-clockwise order – (yellow, white, black and red), four gifted elements,
(fire /sun, air/animals, earth/minerals and water/plants), different aspects of
being (Spirit, Mind, Physical and Emotion) and four different periods of life
(infancy, adolescence, adulthood, Elderhood).
While the quadrants are apparently in opposition to each other, they are all
connected by the hoop, which represents the circle of life. The centre of the
Medicine Wheel is the locus of the Self, where all of the different elements of
personality are resolved and where, in microcosm, the macrocosmic (worldly)
14
http://solar-center.stanford.edu/AO/bighorn.html

13. aspects of life find their expression. In our modern world we tend to allocate
different aspects of our lives to different specialists. The spiritual aspect is
assigned to the priest, the mental aspect to the teacher or psychiatrist, the
physical to the physician and the emotional aspect of our lifes is shared with
our friends and relatives. This places the locus of control external to the
individual. By comparison, in the Medicine Wheel, the individual is placed at
the centre of the wheel, at the locus of control, and is therefore seen as
responsible for their own spiritual, mental, physical and emotional health.
Within this conceptual framework, illness is seen as a state of imbalance
between the four areas of life. The role of the traditional healer in this
situation, is to help the individual regain balance through prayer (spirit),
meditation (mind), herbal medicine (plants) and getting in touch with their
emotions.
There are attempts current to integrate the Medicine Wheel cosmology with
elements of western psychotherapy. A leading proponent of this movement is
Dr. Joseph Gone, a member of the Gros Ventre Nation of Montana. He is an
associate professor of Clinical Psychology and American Culture (Native
American Studies) at the University of Michigan at Ann Arbor, specialising in
finding more appropriate ways of treating his Native American clients.15
THE NAVAJO (DINE´E) MODEL
Similar to the Four Directions/Sacred Hoop model suggested by Joe Gone,
the Dineé or Navajo model of health usually are in the form of a circle, usually
including the Four Directions, often in the form of sand paintings like the one
below. Unlike Gone’s model, they involve multiple symbolic representations,
each expressed differently and used in differing ritual practices to achieve
‘balance’ in the universe, The many complex Navajo healing ceremonies or
"ways" use songs, chants, sand paintings, sacred objects, and dance to
recreate or enact stories and events that link ceremonial participants to their
sacred origins, thus connecting them to the spirit world where balance can be
restored. Each different design or model is used for a different ceremony,
officiated and facilitated by a hataali (singer). Ceremonies or ‘sings’ can take
days and may involve the entire extended family of the seeker in the process.
Preparations can take months, and the process of bringing everyone together
plays an important part in the reestablishment of balance in the social realm.
Such ceremonies are time-consuming and expensive and are rarely
performed in modern times, save in times of dire need.16
15
Joseph Gone, The red road to wellness: Cultural reclamation in a Native First Nation
treatment center. Invited colloquium presentation, Department of Psychology, Miami
University, Oxford, OH. Octiober 2009.
16
Locke, R. F., The Book of the Navajo, Mankind Publishing Co., Los Angeles, 1979

14. Navajo sand painting: The Slayer of Alien Gods
17
Singer building a Whirling Log sandpainting
18
MANDALA
There is an interesting relationship between the Sacred Hoop/Four Directions
model, the sand-paintings of the Dineé ritual practices and the Mandala (a
Sanskrit word meaning “circle”) commonly associated with Tibetan Buddhism,
which are also used in ritual practices to “restore balance” – in this case through
an identification with and ultimately the achievement of a transcendent statein
which Maya - the “veil of illusion” is removed and the ultimate reality of the
universe is apprehended. The mandala thus operates as a gateway or connection
between the macrocosm or outer world and the microcosm or inner world of the
individual.
The basic form of most Hindu and Buddhist mandalas is a square with four gates
containing a circle with a centre point. Each gate is in the shape of a T. In some
forms of Tibetan Buddhism, mandalas have been developed into sand-painting
similar to the Dineé practice. Mandala are key instruments in creating a sacred
space for the practice of meditation, or trance-induction the goal being the
attainment of a state of Enlightenment through offering access to progressively
deeper levels of the unconscious, ultimately assisting the experience of a mystical
sense of oneness with the ultimate unity from which the cosmos in all its manifold
forms arises.19
17
Madelyn Iris, “Life in Balance”, The Park Ridge Center for Health, Faith and Ethics.
See: http://www.parkridgecenter.org/Page126.html
18
From: José and Maria Arguelles, Mandala, Shambhala, 1995.
19
David Fontana Meditating with Mandalas, Duncan Baird Publishers, London, 2005, p.
10.

15. Vajradhatu Mandala Sri Yantra Mandala
The use of the mandala has also played an important role in nthe
development of some Western forms of psychotherapy. Taking his lead from
the ancient Taoist text, The Secret of the Golden Flower, the Swiss
psychoanalyst Carl Jung saw the mandala as "a representation of the
unconscious self."[
Working with schizophrenics, he believed his paintings of
mandalas enabled him to identify emotional disorders and work towards
wholeness in personality.20
He also believed that the construction of
mandalas enabled individuals towards a state of individuation through a
process of action and reflection.21
WESTERN ADAPTATION OF TRADITIONAL MODELS
All of these pre-Enlightenment models – Te Pae Mahutonga (the Southern
Cross constellation), the Whare Nui (Meeting House), Te Wheke (the
20
Carl J. Jung, The Secret of the Golden Flower, Routledge & Kegan Paul, London.
1979.
21
In Jung’s analytical psychology - individuation is the process through which a person
becomes his/her 'true self'. Hence it is the process whereby the innate elements of
personality; the different experiences of a person's life and the different aspects and
components of the immature psyche become integrated over time into a well-
functioning whole. Individuation might thus be summarised as the stabilizing of the
personality. Individuation has a holistic healing effect on the person, both mentally
and physically. Besides achieving physical and mental health,
[5]
people who have
advanced towards individuation tend to be harmonious, mature and responsible.
They embody humane values such as freedom and justice and have a good
understanding about the workings of human nature and the universe. See:
http://en.wikipedia.org/wiki/Individuation. A comprehensive (and illustrated) version of
this process can be found in: Kristine Sodersten and Williams, C., Both Sides of the
Door, University of Queensland Press, Brisbane, 1981.

16. Octopus), the Ayurvedic system, Sacred Hoop and Four Directions and the
Mandalas - all share common features.
• They are all concerned with prevention rather than cure – with “living right”
at every level of existence.
• They are all integrative, encompassing all aspects of material, emotional
and spiritual existence.
• They see all of these aspects as seamlessly connected, so that (in terms
of treatment) it is possible to move between these aspects, perhaps
influencing one (the physical) through the medium of another (the
spiritual).
• They all speak to the issue of relationships - to individuals, to family, to
society, to the environment and to the world of spirit.
• They also each draw on symbols and metaphors that are of direct cultural
relevance to their respective peoples,(for Māori , the Southern Cross, the
Octopus, the Meeting House etc.) and these symbols too, speak about
relationships – the relationship of the economy, of the environment, of a
strong and autonomous cultural identity, of harmonious human relations,
of the ability to openly express feelings, and of the ability to pursue
creative thought and action – to the issue of personal health.
• They all imply the active participation of the individual through “right living”
• They all either implicitly or explicitly refer to the concept of balance.
• They all suggest implicitly that the “cure” for an “illness” may require the
readjustment or rebalancing of these relations and that the “individual” has
an active part to play in the process.
• They all contrast strongly with the Western biomedical model of health
which sees the physician as the dispenser of commodified cures to a
passive and “patient” recipient.
• They all characterize the individual not as an isolated entity but rather as a
social identity – enmeshed (constructed one might say) in a web of
relations (social, cultural, family etc.
A MOMENTARY REFLECTION: R. D. LAING
The anecdotal evidence seems to be that the application of Western
biomedical models to indigenous communities has limited and possibly
detrimental effect in that they cuts across cultural belief systems that are
closely linked to identity. And indeed, if the statistics are to be believed, then
minority indigenous peoples in all of the colonized countries (America,
Canada, Australia and New Zealand etc.) place them at the very bottom of the
well-being tables. They suffer the highest rates of drug and alcohol addiction,
suicide, imprisonment and physical ill health.
Psychologists and psychiatrists like Joseph Gone – who are members of
indigenous communities who have learned their professional disciplines in
Western academies face a dilemma. Recognising the close link between
culture and identity, they struggle to apply Western biomedical models in
situations where these can be counterproductive, and where they may even

17. directly conflict with the cultural beliefs and heritage of the clients they work
with. Two examples will suffice to make the point.
1. Western models of the Self are largely influenced by the models
created by the Developmental Psychologist Jean Piaget. Piaget
developed his theories through work with white middle class Swiss
children (including his own). The models conceive of the self as an
autonomous being whose development follows predictable and uniform
patterns that bear no relationship to the context in which they are
shaped. Deviations from the developmental pattern are automatically
labeled “abnormal” even though, in a different cultural context (let’s say
a tribal setting with extended families and very different cultural and
ritual practices) they may be very normal indeed. An acceptance of the
Piageian model automatically predisposes a colonising Eurocentric
interpretation (and imposition) of normality across cultural boundaries.
2. Using a Western analytic, the “normal” diagnosis for a person who
hears voices of people who are not present would be that he or she is
possibly schizophrenic. To an indigenous person engaged in ritual
practices, the hearing of voices may signify the beginning of dialogue
with ancestors or spirit guides which might be extremely beneficial to
that person’s life and future actions.
In the 1960s and 1970s the Scottish psychiatrist R. D. Laing gained a degree
of fame and notoriety because of his radical views about schizophrenia –
views that resonate with these two examples. The theories that he developed
revolved around issues of identity and family relations in ways that support
somewhat the pre-Enlightenment and indigenous perspectives that I have
described.
Laing had graduated in Medicine from Glasgow University, before joining the
army as a psychiatrist. From there he moved eventually to the Tavistock
Institute for Human Relations, where he worked until 1964 and where he
developed his theories of family relations and psychosis. Much like the
Marxist psychiatrist Erich Fromm, Laing developed a theory of psychosis that
was linked directly to and critical of the social processes and structures of
capitalism. He began at the Tavistock by engaging in research (with
colleagues Aaron Esterson and Phillip Lee) that charted the interactions and
communications within families. They discovered that these (mis)-
communications could lead to schizogenic experiences of family members
that were connected to family politics and exclusions. Extrapolating from this
research he drew parallels with the processes and structures in the wider
society. At the core of his theory was the process by which someone is
labelled psychotic. From this Laing formulated theories that linked definitions
and categorisations of madness with structures and processes of power,
implicating in the process the entire discipline of psychiatry as a repressive
system of social control.
With colleague David Cooper he formed the Philadelphia Association,
devoted to the non-abusive and non-repressive care of the emotionally

18. disturbed. In the tradition of Franz Fanon and along with Cooper, Foucault,
and Thomas Szasz, Laing became renowned as one of the proponents of
Anti-Psychiatry and their work remains up to the present a benchmark of
critical analysis and an indictment of the psychiatric profession and the state
institutions and pharmaceutical companies that it supports. His critical
analysis tied the person’s state of well-beingness to the social, political,
economic, material and emotional environmental. Rather than focus on the
separated individual, Laing looked to the society and environment in which
that person lived, and, like Fromm, he came to the conclusion that we live in a
largely insane world, and that the labelling and diagnosis of mental illness
constituted a form of social control with racist implications. He linked all of
these (psychotic) systems back to the exigencies of capitalism, without
directreference to the Marxist Base-Superstructure metaphor. Along with
colleague and fellow existential psychoanalyst David Cooper, he attempted to
explicate this relationship by reconciling the Existenjtialism of Sartre with
Marxism.22
A WESTERN INTERPRETATION AND INTEGRATION.
In 2000 I was invited by Ngati Porou Hauora - a small Māori Tribal Health
provider (situated on the remote East Coast of the North Island of Aotearoa-
NewZealand) – to develop a refurbishment and development plan for their
small hospital at Te Puia Springs. Working closely with the Māori community
and with the staff of the hospital, we (my undergraduate Architecture students
and I) developed a model of Health that seemed to encapsulate all of the
characteristics that are so common to indigenous systems and at the same
time so different from the western biomedical model, while at the same time
not being tied or linked to any geophysical or cultural symbology or metaphor.
22
R. D., Laing, The Divided Self, Tavistock Publications, London, 1959;
R. D., Laing,, The Self and Others, Tavistock, London, 1961;
Laing, R.D. and Cooper, D.G. (1964) Reason and Violence: A Decade of Sartre's
Philosophy. (2nd ed.) London: Tavistock Publications Ltd.
R. D., Laing., H. Phillipson, and A. R., Lee, Interpersonal Perception, Harper and
Row, New York, 1966;
R. D., Laing., The Politics of Experience and the Bird of Paradise, Penguin Books,
Harmondsworth, 1967.
Erich Fromm, The Sane Society, Fawcett, Greenwich, Conn, orig. Holt Reinhart,
Winston, New York, 1955

19. The model was useful in that it allowed us, as a group of architects, planners
and designers, to engage with the issue of Māori Health in a multi-disciplinary
way, ensuring that we did not corral ourselves into a mindset suggesting that
a building solution might be the only option. We were able in this way to look
at the building design as a means to creating employment in the community,
at the potential for institutional self-sufficiency and the sustainability of natural
resources. The building itself was able to be designed to incorporate
important features of spirituality (like the constant views of Hikurangi the
sacred tribal mountain) as well as social and cultural factors (a separate room
for Whānau to live-in, a community library, staff and elderly housing, etc.) Yet
beyond these practical matters, we also took the design process itself into the
community so that the discussions around issues of community health and
well-being could become empowering to the community, could reinforce its
sense of cultural autonomy and identity.

20. WHĀNAU ORA
Responding to the relatively poor health statistics for Māori, the Māori
community has been successful in initiating a new policy of Healthcare that
largely addresses the previous disparities between the Western biomedical
model and the indigenous models I have described. In June 2010, the New
Zealand Government – at the insistence of the minority Māori Party initiated a
new programme of wellness intervention – Whānau Ora, designed specifically

21. to aid Māori families, but available to all New Zealanders. Whānau Ora is an
inclusive approach to providing services and opportunities to whānau
(families) across New Zealand. It empowers whānau as a whole, rather than
focusing separately on individual whānau members and their problems.
• Whānau Ora is an inclusive, culturally-anchored approach to provide
services and opportunities to Whānau and families across New Zealand.
• The Taskforce on Whānau-Centred Initiatives identified six goals that
suggest that Whānau outcomes will be met when Whānau are: self-
managing; living healthy lifestyles; participating fully in society; confidently
participating in Te Ao Māori; economically secure and successfully
involved in wealth creation; and cohesive, resilient and nurturing.
• It empowers Whānau and families as a whole, rather than separately
focusing on individual family members and their problems.
• It also requires multiple Government agencies to work together with
Whānau and families rather than separately with individual family
members
The intention is to deliver healthcare for Māori, by Māori in a Māori way,
consistent with Māori beliefs and cultural practices. The new legislation brings
about a fundamental structural change in the Health delivery system,
consistent with the needs of New Zealand’s indigenous population. The
programme cannot fail to be successful in many of its aims, yet it remains to
be seen whether improvements will carry through into the areas of labeling,
diagnostic stigmatizing, over-proscription of mind-altering medications, and
the (political and) social control functions of the pharmaceutical industry. We
are fortunate, in New Zealand, that the Ritalin plague has not yet fully
inundated our shores, and this despite the fact that in 1984, New Zealand was
the first of the developed countries to engage in the now-failed global free-
market experiment..
CAPITALISM AND HEALTH
The displacement and attempted destruction of traditional indigenous health
perspectives and practices was not the first cultural assault in the colonization
process. It only happened after the first genocidal strategy – the destruction of
self-sufficient indigenous economies and the forced dependence upon the
State. In the US this was accomplished by displacing agrarian communities
and by the strategic eradication of the great bison herds upon which the
nomadic communities depended. Elsewhere, as in New Zealand, the
confiscation of native lands was the primary genocidal strategy.23
The
attempted destruction of indigenous culture followed the destruction of
indigenous economies. Fortunately the process was never completely
successful, and indigenous communities have retained their cultural identities
and many of their cultural beliefs and practices down to the present time. Yet
they still face an increasing threat from the effects of globalization and free-
market economic ideologies that continue to promulgate modes of chemical
23
Tony Ward, Colonialism, 2997. http://www.tonywardedu.com/content/view/227/123/

22. social control and (when that fails) criminalization.
The question must therefore be asked, whether these indigenous
perspectives on different aspects of cultural existence – health, education,
justice etc. have anything to offer beyond the identity needs of their own
communities? Do they provide a vehicle whereby we might reinvigorate the
life of the wider community, reinstating a more holistic approach to our
conception of what it might mean to be a healthy human being? Is the
promise of the Whānau Ora programme to serve the needs of all New
Zealanders – Maori and non-Maori realistic, and if so, can it go some way to
reconstructing the quality of life that has been so diminished over the last
twenty years of economic assault?
When phrased like this, the answer must be a resounding No! Whatever
benefits the programme may have (and they may be many) they will still not
address the root cause of our health problems – the impoverishment of the
wider community by an elite capitalist class who have bled the poor in their
lust fior increased profit. The impact of the shift in the global economy has
been most strongly felt by the poor and the disenfranchised. The myth of the
“trickle down” economy has been well and truly blown as the poverty gap has
widened and as increasing numbers of the middle class fallen below the
poverty line. In the face of high domestic unemployment and the creation of a
global labour market, labour itself has become dramatically polarized as
increasing numbers of women, minority indigenes and people of colour
become trapped in low-paid insecure work or welfare dependency. As
Mclaren rightly notes, in the face of an apparent victory for global capitalism,
the predisposition of critical theorists to focus on issues of difference, voice
and cultural identity at the expense of class is to collude with the power status
quo.24
While issues of cultural identity may be crucial at the local level, they
tend to insignificance at the global level, where the shifts in capital have
occurred. And while it is possible to discuss and even address issues of
environmental and economic sustainability locally, it must never be forgotten
that the greatest unsustainability of all – capitalism and the private ownership
of global resources – is the ultimate cause.
Yet there is a danger here too, that all too often, Marxist theorists have
neglected to embrace at their cost. The predisposition to consider class as an
overriding social category at the expense of culture has contributed to some
notable socialist failures. Following the Nicaraguan Revolution in 1979, the
Sandinista Government failed to address the concerns of the Atlantic Coast
Miskito, Sumo and Rama Amerindian peoples, who in December 1981 found
themselves in conflict with the authorities following the government's efforts to
nationalize Indian land. Their concerns included:
24
Peter McLaren, “The Future of the Past: Reflections on the Present State of Empire
and Pedagogy” in: McLaren, P. and Kincheloe, J., Critical Pedagogy: Where Are We
Now? Peter Lang 2007, p.292,

23. • Unilateral natural resource exploitation policies which denied Indians
access to much of their traditional land base and severely restricted
their subsistence activities.
• Forced removal of at least 10,000 Indians from their traditional lands to
relocation centers in the interior of the country, and subsequent burning
of some villages.
• Economic embargoes and blockades against native villages not
sympathetic to the government.
Under the banner of national unity and in an attempt to forge a national
socialist economy, the Sandinistas failed to address issues of cultural and
geographical autonomy to their cost. The Indians instead aligned themselves
with the counter-revolutionary forces (the Contras) who were funded and
trained by the Reagan administration and the CIA, and the continuing counter-
insurgency war (as well as the US initiated economic blockade and the mining
of Nicaraguan harbours) drained the Nicaraguan economy and ultimately led
to the demise of the Sandinista Revolution.25
The balance, then, between the global socialist imperative, and the need to
address local issues of cultural autonomy and self-sufficiency is key to any
attempt to forge an anti-capitalist movement. This balance cannot be
universally prescribed, but has to emerge from a dialogue in which global
causes can be compared to local effects, and where local grievances can be
addressed without resorting to the imposition of totalizing strategies.
Academics have a role to play in this dialogue, but to do so, they must engage
with the community directly in a shared attempt to demystify causes and
effects and to develop consensus solutions. For academics, the development
of anti-Capitalist programmes, strategies and coalitions must therefore be an
essential component of their theorizing in this globalised capital Empire. The
amelioration of the pain and hardship experienced by the poor through
programmes such as Whānau Ora can only be a stepping-stone in this long
journey back to health and sanity
Tony Ward
November 2010
25