Maori healers' views on wellbeing: The importance of mind, body, spirit, family and land

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Abstract

From an indigenous and holistic perspective, the current dominant biomedical model of health and illness has a limited view of people and their wellbeing. The present study aimed to explore Māori spiritual healers' views on healing and healing practices, and the implications of these for conceptualisations of holism, health and wellbeing. Six indigenous Māori in Aotearoa/New Zealand took part in in-depth, semi-structured interviews with a Māori researcher from March to September 2007. Transcribed interviews were analysed using interpretative phenomenological analysis techniques. We found that Māori cultural perspectives influenced views of the mind, body, spirit and healers also identified two additional aspects as significant and fundamental to a person's health, namely whānau/whakapapa [family and genealogy] and whenua [land]. We propose a model called Te Whetu [The Star], with 5 interconnected aspects; namely, mind, body spirit, family, and land. Results are discussed in terms of the contribution of Māori knowledge to our understandings of health and wellbeing, and their implications for conceptualising holism, as well as health policy and care for Māori and other indigenous populations.

Introduction

Many ancient non-Western cultures embrace a holistic approach to health and illness which includes a focus on interconnections between the mind, body, and spirit (MBS). Cultures around the world offer perspectives on the relationships between spirituality, healing and illness (Young & Koopsen, 2005) that differ from perspectives in mainstream Western culture (Struthers, 2003). However, although some literature has shown how different understandings of health might be important for Western medicine (Miller and Thoresen, 2003, Zimpfer, 1992), these ideas have had relatively little impact. Below we review ideas about the MBS and the nature and importance of holism in indigenous worldviews on health and wellbeing. The present research aims to explore Māori spiritual healers' views on healing and healing practices in Aotearoa/New Zealand (NZ), and the implications for understandings of MBS, health, illness and wellbeing.

Mind, body, and spirit are terms used in everyday lay language and often associated with ‘new age’ views on health and healing. According to academic definitions, ‘mind’ refers to ‘mental processes’, while the body is said to include the physical, biological, and chemical aspects of an individual (Fosarelli, 2002). Spirituality is defined variously as existential reality, connectedness, and energy (Chiu, Emblen, Van Hofwegen, Sawatzky, & Meyerhoff, 2004), or as a dimension of a person that is concerned with the transcendent and life's meaning (Hiatt, 1986, Young and Koopsen, 2005). The interrelationship of the mind and body has gained widespread acceptance in recent years (e.g. the rise in health psychology, particularly the field of psychoneuroimmunology (Lyons & Chamberlain, 2006)), with a large body of research investigating how mind (thoughts, beliefs, cognitive processes etc.) relate to physical health outcomes. Less attention has been paid to spirituality, although some work has explored the relationships between physiology, physical health and spirituality. Religiosity/spirituality has been linked to health-related physiological processes including cardiovascular, neuroendocrine, and immune function (Seeman, Dubin, & Seeman, 2003), as well as mental and physical health (Aukst-Margetić & Margetić, 2005). Religious and spiritual beliefs and practices may provide physiological, affective, behavioural, and cognitive mechanisms for coping with distress and illness, mechanisms which may also act as protective resources preventing the development of disease in healthy people (Fetzer Institute and National Institute on Aging Working Group, 1999, Mytko and Knight, 1999, Powell et al., 2003). Indeed, meditation and spirituality in the elderly has been related to reduced anxiety, despair, and improved physical, emotional, and spiritual health (Lindberg, 2005). Further research is required to determine factors linking spirituality with both physical and mental health outcomes (Seeman et al., 2003).

The word ‘holism’ has been defined in various ways. For some scholars, holism views a person's MBS as inseparable (Narayanasamy, 1999) making it artificial to try to separate these three dimensions (Young & Koopsen, 2005). The MBS are said to be interconnected, interacting in dynamic ways with one another (Young & Koopsen, 2005) and the environment (Burkhardt & Nagai-Jacobson, 2002). ‘Holistic health’ broadens the traditional medical focus on symptoms and disease to include other health-related domains such as nutrition, psychological and spiritual wellbeing, interpersonal relations, and environmental influences (Lowenberg & Davis, 1994). It adds the concepts of balance, harmony, and mind-body integration to traditional ideas of physical, mental, spiritual, and social wellbeing, complementing a multidimensional view of health (Saylor, 2004). Such views of holistic health are essential foundations for complementary and alternative health therapies (Saylor, 2004). A holistic practitioner focuses on the interrelationships of physical, mental, emotional, and spiritual dimensions of the individual and how they jointly affect health and wellbeing (Lowenberg & Davis, 1994).

It is difficult for ‘holistic’ perspectives to be assessed. Western medicine tends to require that alternative forms of healing adhere to the predominantly empiricist, bio-reductionist framework of medicine (McKee, 1988). However, holistic health is usually defined in subjective, experiential terms including feelings of wellbeing, attitudes, a sense of purpose and spirituality. Such aspects are often not able to be objectively and scientifically observed, measured or tested (McKee, 1988). Nevertheless, views on holism deserve further attention and scrutiny.

Indigenous perspectives on holism and wellbeing are based on cultural values, beliefs and traditions passed down the generations, including beliefs in the unity of MBS. Indigenous cultures frequently believe that all life is interrelated with one another, the environment, and the cosmos (Lee & Armstrong, 1995), and that holism is the most appropriate way to understand health and wellbeing. For example, Matsigenka people of South America see health and wellbeing as a holistic reflection of the biological, cognitive, emotional, social, environmental, and psychological aspects of their lives (Izquierdo, 2005) while Native Americans recognise the four elements of the person as spiritual, emotional, physical, and mental (Canales, 2004, Matthews, 2002). For African Americans, good health is seen as derived from a holistic balance among MBS (Russell, Swenson, & Skelton, 2003), while Chinese traditionally see the physical, emotional, social, and spiritual wellbeing of individuals as indivisible (Chan, Chan, & Lou, 2002). In Canadian First Nation and Inuit communities health and wellbeing are viewed as stemming from balance across the mental, physical, emotional, and spiritual elements of a person (Richmond & Ross, 2009), while for the ‘Anishinabek’ First Nations peoples, land and their relationship to it are also central (Wilson, 2003).

From a Māori perspective, health is invariably holistic (Cram, Smith, & Johnstone, 2003), including wellbeing across spiritual, mental, and physical dimensions. Although there are several Māori models of health, two have been particularly influential in Aotearoa/NZ in the previous two decades, namely Whare Tapa Wha [the four-sided house] (Durie, 2001) and Te Wheke [the octopus] (Pere, 1995). The Whare Tapa Wha model has four walls, which represent the four dimensions of whānau [family], hinengaro [mental], tinana [physical], and wairua [spirit], which are viewed as interrelated and working in harmony to influence health. Te Wheke employs an octopus metaphor to illustrate the interdependence of all things: the head represents the child/family and each tentacle represents an intertwined dimension that helps give sustenance to the whole. The eight tentacles represent wairuatanga [spirituality], hinengaro [mental], taha tinana [physical], whanaungatanga [extended family], whatumanawa [emotional], mauri [life principle in people and objects], mana ake [unique identity], hā a koro mā a kui mā [inherited strengths], and finally other Māori concepts. These aspects of health are apparent in traditional Māori healing, which involves the five cornerstones of: wairua [spirit], hinengaro [mental], tinana [physical], whānau [family], and matauranga [education] (Jones, 2000).

Traditional Māori healing techniques include deep tissue massage in Te Oomai Reia and mirimiri [massage], which is used for healing injuries and releasing tension (O'Connor, 2007). Rongoā [Māori herbal medicine] uses the medicinal properties of plants (Jones, 2007), and other Māori healing techniques include karakia [prayer] (Durie, 2001, Jones, 2007, O'Connor, 2007); kōrerorero [discussion] (O'Connor, 2007); and water therapy, suffusions, and heat applications (Durie, 2001). Traditional Māori healers were called tohunga, or experts in a specific discipline (Durie, 2001), and often had spiritual abilities, knowledge of the healing properties of plants, and an inherent belief in the interrelated nature of wairua [spirit], hinengaro [mind], and tinana [body].

Holistic healers are non-biomedical health practitioners who use botanical, animal or mineral products to treat physical, mental, and social diseases (McMillen, 2004). Spiritual healers also draw on aspects of spirituality such as psychic abilities (Mark, 2008; Mcleod, 1999), spiritual communication (Mark, 2008; Mcleod, 1999), being a channel or vessel for healing energy (Mark, 2008; Mcleod, 1999), or using the gift of touch, energy work or rituals to heal people spiritually, emotionally or physically (Hill, 2003). They have a worldview on health, illness and healing that is grounded in holism (Patterson, 1998); research with these healers has focused on investigating phenomena such as the nature of energy (Warber, Cornelio, Straughn, & Kile, 2004), spiritual diagnosis (Mzimkulu & Simbayi, 2006), integration between traditional and Western methods of health treatment (McMillen, 2004), and the use of medicinal plants in healing (Vandebroek, Van Damme, Van Puyvelde, Arrazola, & De Kimpe, 2004).

Only a few studies have examined spiritual healers' perceptions of the holistic nature of the actual healing process. For indigenous women spiritual healers of the Ojibwa and Cree tribes in the USA, healing involved cultural traditions, and mastery of the indigenous culture was integrally involved in their work (Struthers, 2000). Māori spiritual healers view ill health as resulting from factors such as emotional blockages, unsettled ancestral grievances, curses originating in the whakapapa [genealogy], and imbalances between physical and spiritual dimensions (Mcleod, 1999). These healers strongly believed that clients needed to learn about their cultural connections and bloodlines, to re-establish their whakapapa, restore their identity and sense of belonging, as well as learning about taha Māori [Māori culture and values] to enable healing of the spirit (Mcleod, 1999). Thus cultural values and beliefs are a strong part of the healing process among indigenous spiritual healers.

In summary, holism is strongly related to indigenous and Māori concepts of health and wellbeing. Māori worldviews, the cultural perspectives of Māori healers, and healing techniques were seen as an ideal way to explore Māori perspectives on the MBS, health, and healing. While other studies have described Māori views about health and healing, this study extends current knowledge by exploring the views of Māori spiritual healers who actively and regularly undertake healing practices that include aspects such as spiritual communication with ancestors.

Section snippets

Process

To establish a collaborative partnership between the researcher and Māori participants, two kuia [elderly females] were consulted, and both supported the nature of the research endorsing Māori cultural sensitivity utilised with Māori participants and the use of koha [gift], where a small gift and food was given to each participant to thank them for their time. The study was approved by the Massey University Ethics Committee and conducted within the ethical guidelines of the New Zealand

Results

Five superordinate themes emerged from the analysis of Māori spiritual healers' talk about spiritual healing, understandings of the MBS, health and wellbeing, namely: impact of colonisation; wairuatanga: spirituality for Māori; whānau and whakapapa [genealogy]; whenua [land]; and Māori healing techniques. Within three of these superordinate themes, a number of subordinate themes were identified. All themes are displayed in Table 1 and described in greater detail below. A Māori word glossary is

Discussion

This study provided insights into Māori spiritual healers' views on health, illness, and wellbeing, adding to the research in this area. It demonstrated the importance of whanau/whakapapa [family and genealogy] for Māori health, that included spiritual communication with ancestors and considerations of family transgressions from past generations, and importance of connections to ancestral land. Healers' viewed the term ‘MBS’, and particularly understandings of ‘mind’, as brought into Māori

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