Sunday, August 24, 2014

What Can Be Learned From Rwanda About Battling Depression (and bad music).



According to the National Institute of Mental Health, about 14.8 million adult Americans experience clinical depression in any given year -- or about 6.7 percent of the U.S. population over 18.[1] It’s possible the number is even higher, but even this is sufficient to show that there’s a mental health crisis in the US, despite the fact that the “mental health” industry is one of America’s few growth industries in recent years. As someone who has been diagnosed with a form of clinical depression, I have seen first hand how such "depression" is often treated by the mental health industry, and American society in general and have come to some understanding about why current “conventional wisdom” proffered by the mental health establishment is ineffective.

I was thus especially happy to read this quote by an unnamed Rwandan about “western mental health workers.” This quote not only offers a diagnosis of what is wrong with the mental health industry, but also suggests an alternative, which could be very helpful here, if we can apply some of this wisdom to America’s secular, individualistic, commercial society and an industry still by and in large based on Freudian models (to say nothing of pharmaceuticals):

“We had a lot of trouble with western mental health workers who came here immediately after the genocide and we had to ask some of them to leave. They came and their practice did not involve being outside in the sun where you begin to feel better. There was no music or drumming to get your blood flowing again. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgement of the depression as something invasive and external that could actually be cast out again. Instead they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to ask them to leave."
~A Rwandan talking to a western writer, Andrew Solomon, about his experience with western mental health and depression.  From The Moth podcast, 'Notes on an Exorcism'.


Many Americans got a taste of the hell of the genocide in Rwanda from the movie Hotel Rwanda. This genocide is a direct result of Colonization, or European attempt to control the population of Rwanda, and other countries in Africa. The most brutal, dramatic manifestations of the genocide may have subsided, but these “western mental health workers,” however well-intentioned, are not significantly different from the “Christian missionaries” who beheld “the white man’s burden” in Africa and attempted to “enlighten” them into Western ways. Less generously, it’s a form of cultural imperialism based on a spurious notion of Western cultural superiority that can be seen in every area of our culture.

The Rwandans have different cultural rituals and believe that they can heal their own collective wounds as they are manifested in individuals. They have enough of their own problems after the genocide, and obviously have no interest in trying to colonize America and impose their own cultural rituals here, but reading this statement makes me wish they would! At the very least, I wish to make the authority of this perspective more permissible and part of a serious discussion on the American mental health crisis. Mental health is understood not in isolation from physical health; being out in the sun makes you feel better. Music and drumming get your blood flowing again, and the spirit flows through the blood. Nor is mental health understood in isolation from the community: “There is no acknowledgement of the depression as something invasive and external that could actually be cast out again.”

The Western Psychiatric industry makes a little room for “environmental factors,”
It even sometimes acknowledges that a sick society produces sick individuals, but it rarely proposes healthy collective outdoor rituals with drumming as a way to address this societal crisis. Neither does American secular culture in general encourage this.  The “music industry” in America is usually viewed as entertainment (and it either involves alcohol or drugs, whether legal or not). Even more innovative programs such as “expressive arts therapy” that make an effort to combine the power of music with the paradigm of mental healing often lack that collective, holistic, outdoor, ritual that the Rwandans prefer, and that should at least be considered a legitimate health-care option here.

If the Western mental health professionals in Rwanda can be viewed as a “kinder, gentler” form of “brain police,” this policing is running rampant in America. We, too are being colonized by such professionals. When the mental health industry became dominant in America during the 20th century, for many the “mental health worker” replaced the traditional role of the “spiritual leader;” but the individual in the dingy room that is based on what Freud called “the talking cure” is somewhat similar to the Catholic Confessional.  Many believe the health care worker’s an improvement on that confessional, and on the metaphysics of the church with its “original sin” and sometimes strict, and unjust, moral codes. Freud’s “Copernican revolution” is still, in the official reality, viewed as a sign of progress.

But whatever the failings of the traditional church to combat what is now called “depression,” at least some churches make much more room for the kind of healing activities the Rwandans describe. The gospel music that has characterized the Black Church since Thomas Dorsey brought it in almost a century ago (contemporary to Freud) has been one way to bring this Rwandan wisdom in to the largely dominant secular society. But it need not be restricted to the church. What the Rwandan is speaking in favor of can not really be understood in terms of the specialization of disciplines and professions as we understand them: The Psychiatric Industry, The Church, and The Music (and Culture) industry, need to be combined, to see their common roots. We need a ritual that serves all three of these purposes in order to have any hope of getting out of our contemporary cultural malaise, and truly address health issues at the root.

Because we’re all born into, even baptized, into this individualistic, specialized, fragmented culture, we often have to choose one of these specialized disciplines to work in—if we need to move beyond it. These specialized disciplines, however, can all become “these dingy little rooms:” the office cubicle or heroic artist’s studio, the individual coffin buried in private property you must pay for, the private authentic, “real” self, with an “internal” problem that might be part of his salient character, or essence. All of this keeps us divided, fragmented, an alienated from each other, and thus ourselves. It’s grounded in a false consciousness. Can we operate “in” this world without being “of” it; I tried to.

I tried to start from music and drumming, music as drumming, music as drumming and dancing. Of course, I couldn’t do it alone. Of course, one doesn’t have to do it alone. That won’t help; that won’t really be music. In contemporary America, however, we call a “singer songwriter” a musician the same way we call a psychiatrist a mental health expert—both without drums, and both laboring alone. This might do some good for some people, and I’m not suggesting we ban it from this country. But I do think there are many of us who, like the Rwandans, would like to ask them to leave and stop being so damn paternalistic in speaking for a “norm.” We would like the option of “alternative” medicine, even if this “alternative” is ancient wisdom of the oldest culture on earth, a culture that has been threatened by hostile outside forces, been subject to cultural rape, and yet still preservers!

What the Rwandans propose is, in American culture, threatening to both the “mental health” industry and the music industry. This is one of the reasons there are so many depressed musicians; however well-known they are, they still are not permitted much of a context in which to present themselves as healers, or at least part of a healing process, and at their most "fun." The highest most profound purposes and functions that music can have can easily get lost because of an individualistic definition of what “music” is, and what the "self" is.

Sure, the vast majority of commercial popular songs today still make room for drums and dancing. Even this, however, is often created by electronic machines in dingy rooms, and recorded or broadcast. Real drums are harder to find. Musically, this was sold as “progress.” It’s cheaper to make music on your computer; it’s less likely to “disturb the neighbors” And it can even sound just as good. I don’t quarrel with any of these assessments. Except when it becomes an industry standard, just like you can only get Obamacare for western mental health care; they don’t cover “body workers” such as cranial sacral, chiropractors, and masseuses, who have at least done more good for me personally (and many others) than pharmaceutals have.  I am enough of a product of American society to find a Rwandan drum circle somewhat alien (I don’t really crave to be part of the social scene based on what some white Burning Man types call “ecstatic dance)” but I do hold up Soul Train in the 70s as superior to American Idol in more recent years, in part because Soul Train was less individualistic and more embodied.


In 20th century mass-culture, America never really had a ritual like the ones Rwandans describe, but the rituals of what Nelson George refers to as the “rhythm and blues world” (circa 1950—1975) came close. The music was closer to, and much more integrally, a part of the culture, and more connected to the “social body.” And, today, even with the synthetic, isolated, drum beats, such dance music can still touch the collective soul in a deeper way than other forms of music being pushed. I’ve seen the power a recent pop smash like Pharrell Williams’ “Happy” can have in bringing together, however momentarily, a wide group of people that transcends specialized “niches” the music industry usually pushes.

When I got into music, it was with the mission and purpose that we could at least bring more of this back, to use music as a force to bring people together. Yet, in Hollywood, I became a terrible heretic to music and to mental health and even a traitor to my body, when I became known as a “singer songwriter.” Of all the musical roles, “singer songwriter” is perhaps the stiffest, the most like what the Rwandan describes as the “western mental healthcare professional”-- at least it was for me. This doesn’t mean that I can’t find some pleasure, and health in the singer songwriter (the ability to make one, or many cry, with a heartfelt ballad is nothing to be sneezed at), but I saw firsthand how being cast in this role can be as destructive to mental health as the state-hired health care professionals were. This is not a coincidence. And if I wouldn't be surprised if they asked the singer songwriters to leave for the same reason. 

I am not saying that in order for music to truly have any power we must aspire to exactly the same kind of drum circles that one can still find in contemporary Rwanda. We are a different culture; at its best, America produced a music culture that combined elements of African music with elements of European music. “The singer songwriter” is much more a Euro invention of white America, but it can be brought much closer to the African paradigms, and if one feels a deep, authentic, need for drums and dancing to get the blood flowing, we should be able to include it—especially if we’re going to be called musicians (but even if we’re going to be called mental health workers, teachers, preachers, or other culture workers).

And this is only one aspect of what I learn, and admire, and long for, from this man in Rwanda. Seriously, I wouldn’t mind if this view “colonized” America; it wouldn’t be colonization however. The Rwandan isn’t telling the colonzing shrinks (or music professionals) that they’re wrong, they’re just asking them to leave. If they continue to speak for us, and tell us what’s supposed to better for us (despite the testimony of our senses), I wish they would leave here too…or can they change? Can they understand the damage they do? Can they give us an alternative that doesn’t rob of us our heart-beat, especially if they sincerely believe they are trying to help us (and I’m willing to grant they are sincere).



[1] http://www.nimh.nih.gov/statistics/1MDD_ADULT.shtml

2 comments:

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