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| LUMINARIES IN SOCIAL PSYCHIATRY |
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| Year : 2022 | Volume
: 4
| Issue : 3 | Page : 182-186 |
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The Gurū-Chelā Relationship Revisited: The Contemporary Relevance of the Work of Indian Psychiatrist Jaswant Singh Neki
Vincenzo Di Nicola
Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal; Department of Psychiatry and Addiction Medicine, Université de Montréal, Montreal, QC, Canada; Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA; President, Canadian Association of Social Psychiatry; President-Elect, World Association of Social Psychiatry
| Date of Submission | 13-Nov-2022 |
| Date of Decision | 13-Nov-2022 |
| Date of Acceptance | 14-Nov-2022 |
| Date of Web Publication | 21-Dec-2022 |
Correspondence Address:
Prof. Vincenzo Di Nicola
Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, 7401, rue Hochelaga, Montreal, Quebec H1N 3M5, Canada
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/wsp.wsp_35_22
The aims of this appreciation of the life and work of Jaswant Singh Neki (1925–2015), a leading Indian psychiatrist and Sikh scholar, are: (1) to revisit Neki's contributions to social psychiatry through his employment of the Indian paradigm of the gurū-chelā relationship; (2) to contrast and compare Neki's gurū-chelā paradigm for psychotherapy with the Western “I-centred paradigm” of psychotherapy; and (3) to examine the impact of Neki's gurū-chelā paradigm in India and the Indian diaspora and to synthesize it with contemporary trends in psychotherapy in Western societies.
Keywords: Gurū-chelā paradigm, Indian psychiatry, Jaswant Singh Neki, psychotherapy
How to cite this article:
Di Nicola V. The Gurū-Chelā Relationship Revisited: The Contemporary Relevance of the Work of Indian Psychiatrist Jaswant Singh Neki. World Soc Psychiatry 2022;4:182-6 |
In a series of original and pathbreaking publications, Jaswant Singh Neki, a leading Indian Sikh scholar and psychiatrist,[1],[2] proposed the gurū-chelā (master-disciple) relationship to create a new paradigm for the therapeutic relationship, employing an accessible cultural idiom that Indian patients could identify with and understand.[3],[4],[5],[6],[7],[8],[9] Jaswant Singh Neki (1925–2015) was a pioneering Indian psychiatrist, Punjabi poet, and Sikh scholar (please see a translated excerpt of one of his metaphysical poems, below). He was born on the August 27, 1925 in the Punjab in then British India and present-day Pakistan. When he was a young child, his family moved to Baluchistan, now part of Pakistan.[2] Neki's scholarship across many disciplines was evident very early as he earned many merit scholarships from high school until his qualification as a psychiatrist, setting achievement records throughout his education and during his outstanding psychiatric career.[2]
Neki's key achievements in academic and administrative psychiatry include his becoming Professor and Head of Psychiatry at the All India Institute of Medical Sciences in New Delhi (1968–1978), Director of the Postgraduate Institute of Medical Education and Research (PGI) in Chandigarh (1978–1981), and a Consultant for Africa with the WHO in Geneva (1981–1985).[2] The “living legend” of Indian Psychiatry, Professor NN Wig (1930–2018) recalled Neki as one of the finest psychiatrists India has produced. Wig affirmed that Neki was one of those who laid the foundation of psychiatry in India.[10]
| India's Gurū-chelā Relationship | |  |
Let us turn our attention to Neki as a social psychiatrist and an original thinker in psychotherapy. In his series of original and pioneering publications, Neki proposed the gurū-chelā (master-disciple) relationship to create a new paradigm for the therapeutic relationship.[3],[4],[5],[6],[7],[8],[9] Neki's paradigm for the therapeutic relationship employed an accessible cultural idiom that Indian patients could identify with and understand. And this is how it came to my attention in the 1980s as a young psychiatrist-in-training with Prof. Raymond Prince, my mentor who was the Director of the Division of Social and Transcultural Psychiatry at McGill University.
For the uninitiated reader, an overview of the gurū-chelā (master-disciple) paradigm is in order, starting from the concept of gurū or master as a preceptor or spiritual teacher who not only “teaches” or “illuminates” the chelā or disciple but also “holds” them, takes care of them, and becomes responsible for them. Hence, the gurū-chelā relationship is transformational in that the chelā believes that the guru knows what is best for them. It is a “binding” relationship in which the chelā trusts in the gurū's benevolence.
Therefore, the chelā or disciple is more than what we usually understand as a student, but one who stays with the gurū, serves them, by getting wood from the forest for lighting the holy fire and collecting fruits for the household, for example. In short, the disciple learns by living with the master. Western approaches, notably Minuchin's structural family therapy which focuses on family roles and boundaries, might consider this to be a profoundly “enmeshed” and “overinvolved” relationship,[11] and Western psychotherapy may consider it “fusional” or even “symbiotic,” but in India, the gurū-chelā relationship is deliberately fostered and nurtured, though later, the chelā gradually “individuates” to follow their own path of growth. Moreover, the relationship is based on the foundation of shraddha, a concept loosely translated as “respect,” yet more than that – it's a way of fostering deep respect in the chelā by inculcating a deep respect for the gurū. Western philosopher Martin Buber's[12] celebrated formulation of the “I-thou” differentiation is voluntarily and temporarily suspended in the gurū-chelā context of learning and teaching. While some of these concepts were prevalent in the ancient Socratic philosophy, incarnated in Plato's Academy (founded 387 BCE) where Aristotle was taught 2400 years ago, the Western psychotherapy setting has become significantly more structured, with its rigid rules and boundaries.
| Similarities and Contrasts between the Indian Gurū-chelā and Western Patient-Therapist Relationships | | |
Contrasting his proposed Indian paradigm with the Western patient-therapist relationship, Neki explored both similarities and sharp contrasts between Western and Indian cultures. Neki argued that both the gurū-chelā and the therapist-patient relationships are: “voluntary associations wherein a master enables a change-seeker to dispel ignorance and the effects of undesirable social conditioning.”[4]
Working with Raymond Prince in the Division of Social and Transcultural Psychiatry, we identified three “I-centered assumptions” behind Western-based psychotherapy:
- The individual as the focus of therapy
- Introspection and insight as key therapeutic methods
- Personal independence as the goal of therapy.[13],[14],[15]
Neki's gurū-chelā relationship, by contrast, focuses on the dyadic relationship rather than on the patient as an individual, and “encourages permanent dependency, since the guru assumes total responsibility for leading the chela toward self-mastery through the disciplines of persistence and silence”[4] The gurū-chelā relationship, Neki explained, would be “most suited to cultures valuing self-discipline rather than self-expression, and creative harmony between individual and society.”[4], emphasis added Finally, in his exploration of other traditions, including the Yoruba of Nigeria, the Ras Tafarians of Jamaica, and China, Prince was fascinated by the examples of non-Western models of psychotherapy that eschewed introspection and insight and discussed Neki's gurū-chelā relationship as another example with me.[16],[17],[18]
Of all the constructions of Western psychiatry, psychotherapy is the most “culture-bound.” This is a now outmoded expression from the founding generation of transcultural psychiatry at McGill University implying that certain symptomatic expressions (such as anorexia nervosa) are “bound” or limited to their time and place (history and culture) or that certain cultural determinants are propitious for their emergence. The criticism of the notion of “culture-bound syndromes” (CBS) is that Westerners saw expressions of distress in other places as “exotic” exceptions. Two problematic assumptions of this approach are mirror images of each other – Western ethnocentrism and universalism. Hence, during my training, Prince and I started deploying CBS in the opposite way: examining the degree to which certain syndromes such as anorexia nervosa are more common in the West.[19],[20]
| Impact and Salience of Neki's gurū-chelā Paradigm | | |
In order to take stock of the impact and salience of Neki's gurū-chelā paradigm, I conducted a literature review across these domains:
- India
- The Indian diaspora
- Western-trained Indians returning to India
- Western psychiatric and psychotherapeutic cultures.
| Neki's Gurū-chelā Paradigm in India | | |
Numerous studies of the history of Indian psychiatry note Neki's work very positively, although I was not been able to identify any studies or summary reflections of the use and impact of Neki's paradigm in Indian Psychiatry and allied professions.[21],[22],[23] Nonetheless, Neki's paradigm is clearly based on the traditional aspects of Indian life, including history and tradition, sociology and religion; and an attempt to grasp and mobilize a key dynamic of traditional aspects of Indian society. It may be possible that it is more striking to the outside observer as a way to understand Indian traditions than as a formal research paradigm.
| Neki's Gurū-chelā Paradigm in the Indian Diaspora | | |
In his doctoral thesis in Ministry and Care at the University of Derby, UK, Paras Shridhar, discusses the possibility of the gurū-chelā (disciple) relation acting as a model for “therapeutic care for the Hindu patient in diaspora.”[24] Shridhar's study was conducted in “the heart of Hindu England” and reflects Neki's own synthetic approach of East and West:
- The study investigates the meeting ground for science-based western psychotherapy and intuition-based spirituality. Both subjects deal with pastoral care components for their respective respondents but are diametrically opposed in their approaches.[24]
The investigator emphasizes the cultural change of Indian immigrants to England and the adaptations that are necessary in their host country. Shridhar raises many interesting questions that parallel Ananth's concerns about Indian psychiatrists training abroad and then returning to India (see next section). There are no simple conclusions, although the researcher offers many rich and nuanced narrative observations and discussions. Shridhar addresses the issues of “authenticity” more than of “effectiveness.”[24] This could be translated in research terms as validity versus reliability.
| Western-Trained Indian Psychiatrists Returning to India | | |
Another of my professors of Indian origin at McGill University in Montreal, Jambur Ananth argued that medicine is a cultural institution so that “disease and treatment must be viewed within a cultural context.”[25] In his review of the cultural problems that Indian trainees face in Western training and its impact on their therapeutic and diagnostic skills, Ananth explores the implications of Neki's culturally responsive model of the therapeutic relationship.[23],[24] Ananth cites the work by Indian psychiatrists looking into indigenous Indian methods of conceptualizing and treating mental illness.[6],[26],[27]
”Self-fulfilment” – the goal of Western psychiatry – Ananth argues, is to help the patient achieve autonomy and to separate his or her needs from those of their family. In contrast, Ananth asserts that the goal is the opposite in Indian psychotherapy:
- An Indian is always the ambassador of his family … his achievements, ambitions and aspirations are merely the reflections of those of his family.[25]
| Neki's Paradigm in Western Psychiatric and Psychotherapeutic Cultures | | |
First, Neki's work was taken seriously in the West across a wide group of professionals in general psychiatry,[25],[28] social and transcultural psychiatry, pastoral counseling,[24] and family psychotherapy.[13],[14],[15] Second, it was employed by Shridhar in pastoral counseling with immigrant Indians in Britain. More specifically, in my synthesis of social and transcultural psychiatry with family therapy, I looked to Neki's paradigm to go beyond cultural sensitivity for a new way to conceptualize the nature of therapy.[13],[14] That paradigm became my model of Cultural Family Therapy.[15]
| Synthesis of Neki's Gurū-chelā Paradigm with Contemporary Trends | | |
Is a synthesis of Neki's gurū-chelā paradigm with contemporary trends in psychotherapy, psychiatry, and psychoanalysis possible?
First, a comment. The West in general and notably the USA has been a laboratory for generating new ideas. However, as Ananth observed, Western society is dynamic, where we generate the ideas and move on to the next bright idea.[25] Other cultures such as India are more traditional and stable, Ananth affirmed, encountering new ideas by working them through, and adapting locally before deploying them in practice.[25],[28] This idea could be revisited today through the World Values Survey whose Inglehart–Welzel Cultural Map shows that there are two major dimensions of cross cultural variation of values in the world: traditional values versus secular-rational values and survival values versus self-expression values.[29] What the Inglehard-Welzel Cultural Map reveals is a centrifugal movement where values are separating into historical-cultural tribes, lending credence to Ananth's and Neki's views of the contrasts between traditional Indian culture and at least some parts of Western culture.
My own work in family therapy offers an instructive example. Most of the pioneers in family therapy were in the USA, even if they were often immigrants, like Argentinian-born child psychiatrist Salvador Minuchin,[11] but it would be fair to say that in psychiatry, family therapy is now much less practiced than in say, Italy and Brazil, to mention two countries where I am active. As a social and cultural comment, it's very interesting that the countries where family therapy is most active – especially among psychiatrists – are “Latin” countries – Italy, Portugal, and Spain and in South America. This reflects the continuing centrality of “familism,” i.e., traditional family values, in those cultures. Another core differentiator in many social and cultural accounts is the traditional value of dependence versus independence or “self-expression” on the Inglehart–Welzel Cultural Map. Dependency was discussed by Manickam, another Indian psychiatrist who cited Neki's[9] recommendation that family therapy was more congenial to Indian society.[30] As I have demonstrated,[13],[14],[15] a family orientation in psychiatry and psychotherapy is much more congenial to traditional cultures that are family-oriented including southern Europe and Latin America but also including large swaths of Eastern cultures such as India and Pakistan.
Parallel changes have also occurred in Western psychotherapy and psychoanalysis that there have taken the celebrated relational or intersubjective turn, which highlights the relationships and shared subjectivity akin to the values of more traditional cultures.[31]
To conclude, a synthesis of Neki's gurū-chelā paradigm with contemporary trends psychiatric and psychotherapeutic practice is both very possible and still highly relevant. In order for that to come about, we need more people committed to intercultural dialog and syntheses across cultural and therapeutic traditions instead of the West and the Global North's relentless striving for novelty and change.
We must acknowledge the value of regional historical traditions both to understand and alleviate mental and relational suffering. The hallmarks of a maturing discipline are to find commonalities among the particularities and patterns among diverse phenomena. Both the West and the Global South are now embarked on a project of decolonizing psychiatry.[32],[33] And Jaswant Singh Neki represents precisely the kind of world-bridging psychiatric synthesis whereby the West and the North can learn from India and the Global South.
| Conclusions: Jaswant Singh Neki – Our Contemporary | | |
Jaswant Singh Neki represents the brilliant foundational generation of Indian psychiatry, along with NN Wig and others. This appraisal came from the founding generation of Indian psychiatry and Western observers.[10],[21],[22] The ultimate word on Neki's place in Indian psychiatry, however, must be given by contemporary Indians themselves with new critical tools, as Indian medical historian Amit Ranjan Basu asserts.[34] Basu argues for the use of “historical methods for serious enquiry of psychiatry” and heralds “a new genre of historicism that is critical of both colonialism and psychiatry as a universal science” raising “hopes to critically review the emergence of psychiatric knowledge.”[34]
Nevertheless, in my appraisal as an outsider looking in on Indian psychiatry and society, Jaswant Singh Neki was a brilliant synthesizer of Western and Indian traditions, reaching deeply into Indian social and religious traditions to open new paths in psychiatry, thus becoming one of the founding fathers of social psychiatry. With deep roots in the social and cultural traditions of his family, his Punjabi language and region, and his Sikh religion, Neki was able to integrate Western psychiatry into Indian society. At the same time, he had the courage not to become an epigone of Western masters, forging instead a proper Indian psychiatry and looking to Indian society as a model for the therapeutic relationship– gurū-chelā.
While I am proud of our Western contributions, my critical insight as a social and cultural psychiatrist working across cultures is that not all of our notions are universally valid or useful. More empathically, the richness and depth of other ways of being human demand to be acknowledged and integrated into a truly global vision of mental health. Jaswant Singh Neki offers us a model of psychotherapy in the clinic and is a pioneer in Social Psychiatry, Global Mental Health, and what some people now call “decolonizing psychiatry.”[33]
That is the lasting legacy and impact of Jaswant Singh Neki which makes him our contemporary as a social psychiatrist, poet, and Sikh scholar – a gift from India to the world.
”The boat will sway” – An extract from a poem by Jaswant Singh Neki
The impatience of people yearning for shore, one way,
The will of the restless waves pointing the other way
To which side the boat will glide?
Whichever shore, wave 'consents' to meet
Whichever shore the 'unchecked' winds greet
Is the way, the boat will sway
– Jaswant Singh Neki, extract from a Punjabi metaphysical poem
(Translated from the Punjabi by Dr. Raman Deep)
Acknowledgments
This paper is based on the author's Invited Plenary Address, “The Gurū-Chelā Relationship Revisited: A Review of the Work of Indian Psychiatrist Jaswant Singh Neki,” at the WASP Asia-Pacific Hybrid Congress – “Innovation in Social Psychiatry Across the World” – of the World Association of Social Psychiatry (WASP), held in New Delhi India, September 16, 2021. My first exposure to Jaswant Singh Neki and Indian psychiatry was facilitated by Prof. Raymond Prince, my mentor in the Division of Social and Transcultural Psychiatry at McGill University in the 1980s. I am most grateful to the congress organizers and to these Indian psychiatrists who trained with and knew Jaswant Singh Neki: Prof. Roy Kallivayalil, WASP Past President, Prof. Rakesh K. Chadda, WASP Secretary-General and Organizing Chair of the WASP Asia-Pacific Congress, and Prof. Debasish Basu, Editor-in-Chief of World Social Psychiatry, for stimulating discussions of Jaswant Singh Neki's work. Their memories and testimonials as well as their guidance in placing the gurū-chelā relationship in the Indian cultural context have been instructive and moving. Finally, thanks to Dr. Raman Deep, who translated an excerpt from one of Jaswant Singh Neki's Punjabi metaphysical poems.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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