The Healer and the Psychiatrist 2019, 74 min

Synopsis

On the South Pacific Island group of Vava’u, the traditional healer Emeline Lolohea treats people affected by spirits. One day away by ferry, the only Tongan Psychiatrist Dr Mapa Puloka has established a public psychiatry well known across the region. Though they have never met in person, this film creates a dialogue between them on the nature of mental illness and spiritual affliction. Their commitment and transformative communication offers challenges and opportunities to help address the growing global mental health crisis.

Short Synopsis

In the South Pacific Island group of Tonga, a traditional healer and a Psychiatrist treat spiritual affliction and mental illness in challenging and inspirational ways.

Credits

Director of Photography,  Director and Producer    Dr Mike Poltorak

Film Editor       Heidi Hiltebrand

Translation & Cultural Advice       Sefita Hao’uli

Sound Design     Reto Stamm

Digital Colour Design        Andi Chu

Graphic Design         Sergio Constantini

Voiceover Advice     Silvana Ceschi

Subtitles (French)    Timothée Mc Dwyer & Virginie Dourlet

Distributor

Documentary Educational Resources- order for your university or school here.Watch at home on Vimeo VOD here.

Available on Kanopy.

For events in Tonga and for NGOs working on Pasifika health we offer dedicated free screenings. Please contact Dr Mike Poltorak the Director on msp@kent.ac.uk

Interactive Resource and Teaching Site

Project Pouono

Reviews and Press

Religion and Society-September 2022-Gemma Aellah

‘A scene from The Healer and the Psychiatrist stayed with me long after watching the film. Not the more viscerally potent moment when traditional healer Emeline Lolohea squeezes a liquid herbal medicine into the eyes of the daughter of a Christian minister suffering from spirit possession. But rather the calm, peaceful scene of men sitting around a large bowl of kava singing in Tongan, their voices ringing out in harmony, reminiscent of a men’s church choir. These men are participating in a unique ritual—a traditional collective kava drinking ceremony, but one led by Dr. Mapa Puloka, the only psychiatrist in the Kingdom of Tonga, an archipelago of islands in the South Pacific Ocean. Frequent gathering and talking around the kava bowl is a key part of his psychiatric practice, both as a form of therapy and as a space where he makes diagnoses and assesses whether his patients’ medication requires adjustment. Kava has analgesic and sedative properties and is traditionally drunk by men in clubs. Excessive use within the community has lately come under public scrutiny and criticism. Yet Dr. Puloka compares his use to the ‘amytal interview’ technique, barbiturate-assisted interviews once used in Western psychiatry to reveal concealed emotions. “No need for injections here,” he says. “Just drink kava and talk.”

For me, this scene perhaps best captures the essence of the film. First, that mental distress in terms of both its cause and treatment is not an individualistic phenomenon. Traditional healer Emeline connects it to the spirits of the dead and their relationships with the living, and Dr. Puloka advocates treatment through the communitas invoked through his version of kava ceremonies. Second, compared to common assumptions that ‘traditional’ practices and biomedical psychiatry exist in tension, Dr. Puloka at least seems to see no such opposition.

Avanga, or spirit possession, is the main Tongan source of mental distress. Some avanga can be treated by traditional healing, while other forms require psychiatrist intervention. Even then, what is needed is not just medication, but also somatic practices, like the kava sessions or the growing of food, which Dr. Puloka encourages his patients to do at his own farm. “What happens if you don’t have traditional healers?” he asks at an international conference of psychiatrists. “Does our government have the money to treat everyone? No way!” Or, in the words of Emeline, sometimes you do not need to “plaque yourself with pills” to find healing. It seems clear to both practitioners, and to others in the film, that some things are the business of spirits, and some are not.

Directed by anthropologist Mike Poltorak, The Healer and the Psychiatrist, through a mix of observation and interviews, introduces us to the therapeutic life-worlds of Emeline Lolohea, a spirit healer in the island group of Vava’u, and Dr. Mapa Puloka, the only local psychiatrist living on the main island of Tongatapu. The two have never met, but through Poltorak’s intervention, a dialogue of sorts is created between them; it should be noted, however, that it is somewhat one-sided. Dr. Puloka is invited to comment on some of Emeline’s patients when Poltorak shares video footage, leading to interesting questions such as how to distinguish psychotic speech from spirit possession. But this activity does not go the other way. Perhaps due to the particular relationship the anthropologist has with each of them, Emeline is most often seen at home, and Dr. Puloka in his office.

During the film we are taken into several of Emeline’s therapeutic encounters. What is most striking is not the treatments themselves, but their gentle insertion into the everyday life scenes of families. Relatives and children sit casually around the patient, birds sing quietly in the background, and these occasions seem quite ordinary. The moments of healing do not feel like liminal events. This is further emphasized by the depiction of Emeline’s multiple roles in the community, including lay preaching in a Christian church. Dr. Puloka reinforces this when he notes that although patients face stigma if they attend his hospital, there is no stigma at all associated with spirit possession and visiting traditional healers.

The film also follows a parallel story, that of a physical illness suffered by Emeline’s husband. He had suffered from a chronic knee infection for several years, and the family struggled to get effective treatment at the hospital. But they do not return for follow-up appointments, with eventually devasting consequences. Including this story serves to reveal the deep relationship that developed between the family and the anthropologist. It also shows the struggles some Tongans face with gaining accessing to and placing trust in health services. But it also leaves questions unanswered. Emeline does use some traditional healing with her husband alongside biomedical medications, but it seems that this is because of the difficulties engaging with the hospital. There is no suggestion that the persistence of the illness has a spiritual source, and in fact it feels quite different from the dilemmas facing Emeline’s other clients. I was left wondering if the family considered this affliction part of the cosmological world in which Emeline practices, partly because others suffering spirit possession had identified physical as well as psychic symptoms, including leg pain. This film and the life stories it reveals make me realize that there is still much to be learned about avanga, suffering, and distress in Tonga.

Gemma Aellah

Brighton and Sussex Centre for Global Health’

(Aellah, G. 2002. Review of the Healer and the Psychiatrist. Religion and Society 13: 1 pgs 265-66). Online here.

 

Journal of the Royal Anthropological Institute-Film Review-December 2021 -Professor David Lipset

Education Media Review-Recommended-August 3, 2021

‘The Healer and the Psychiatrist is a languid film; the pacing showcases the deep caring inherent in the two practitioners’ different health care styles.’

New Zealand Sociology (Film Review), June 2021-Dr Bruce Cohen

Tongan News Bulletin– (Tongan and English). January, 20, 2021.

Volksfreund Online Newspaper. January 19, 2021. Featured photo  of Emeline Lolohea and Paula Lolohea. Triel Ethnographic Film Festival.

Tongan Broadcasting Corporation-Post Premiere talanoa (discussion). December 19, 2020

American Anthropologist  (2020)  Samuele Collu (McGill University)

Matangi Tonga December 2020

School of Anthropology and Conservation News December, 8, 2020

ERIC blog– November, 14  2019

BBC Radio Kent -Dominic King Show- November, 12, 2019

Screenings

For full list of screenings click here.

Testimonials

THE HEALER AND THE PSYCHIATRIST successfully presents two sides of the same coin, in traditional medicine and modern medicine. Both approach the same outcome of healing. Pacific researchers practice “talanoa,” an established format for generating discussion about complex topics used throughout the Pacific. Director Mike Poltorak, a lecturer at the University of Kent in Social Anthropology, has crafted a beautiful and empathic film, full of thought, humanity and discovery.

 Anderson Le- Hawaii International Film Festival 2020

This is going to be a valuable resource for mental health here in New Zealand and in Tonga. The reason being the Government has finally agreed that  healing ought to happen, or the system, closer to the community. What really touched someone from the front line perspective, is how you had culture, community and clinical knowledge come together and connected up but also the story itself reminded me when the system fails it costs lives. This is something for us to be mindful of.

Pauline Taufa -Clinical Psychologist

The questions and issues that you raise in this film are so needed to be talked about and so interesting. I have so many more questions I want to ask you from watching this film. That is an indication of how successful it is because people want to know more and they want to have more discussion. And that is the key, creating more discussion.

Vea Mafile’o -Film Director (For My Father’s Kingdom)-Artist

The strength of this project is that there are a huge number of relationships that have contributed to this film. That is key for a documentary of this nature, especially when you are coming from the outside.

Paul Janman- Film Director (Tongan Ark)

There is a dire need for the two ways of healing the so called scientific medicine and the Tongan medicine to converse a lot more than what has already been happening . What came across to us viewers of this most beautiful film is there is less talanoa and there needs to be a lot more conversation. We are dealing with different way of dealing with one and the same reality, not two different realities and we need to have more talanoa.

 Hufanga He Ako moe Lotu Dr ‘Okusitino Mahina-Professor of Tongan Philosophy, Anthropology and Art- Vava’u Academy for Critical Inquiry and Applied Research, Vava’u, Kingdom of Tonga.

It was mafana [inwardly moving or exhilarating] and a little disturbing at the same time for me. That Tongan paradox. There is this line from Margaret Southwick’s study, ‘when you have disconnected discourses it is disconnected outcomes for that person’. The more that the two knowledge systems that understand the same symptoms so differently can integrate, then those of us who have those symptoms and go through both systems, will be much more likely to have healing. [the film] It’s beautiful, really beautiful.

Dr Karlo Mila -New Zealand Poet & Sociologist

One of the things that really moved me personally is how you are able to tell the story of Emeline the traditional healer so that everyone knows the effectiveness of these people. But what is more touching is the challenges we have in the Western paradigm. Dr Mapa Puloka, Dr Alani, the frustrations that we have. They have the knowledge of both worlds, yet, they are being restricted within the biomedical model. When you see Emeline and her freedom to go around and meet people in that setting and Mapa and Alani know that but are restricted.

Dr Sione Vaka-Senior Lecturer-AUT

So full of thought, humanity and discovery. And what beautiful and compelling people. So evident that they trust and love you.

Professor Hugh Brody

You have made a very important film Mike, a labor of love, a gift for the Tongan people you know and care about deeply. I found the journey you take the viewer on to be fascinating, if not riveting, and the content authentic and imbued with tender loving care. The people you feature in your film are generous and giving, of their time and their knowledge, and they obviously care very much about your efforts to tell their story your way. They trust you, and you have not let them down. I like very much your personal voice in the film, explaining your reasons for making the film, and your hopes for collaboration between healers and psychiatrists not just in Tonga, but also in many other parts of the Pacific and beyond. Your film took me back to Rotuma when I was growing up in the 1950s and 60s, and similar beliefs my own people had then, and probably today still, that need better understanding and illumination. You shine a spotlight on matters of life and death, a concern all humans share in common. Most importantly, you were able to reciprocate the Tongan people’s love and care for you in such a meaningful and generous manner. Congratulations!

Professor Vilsoni Hereniko  Academy of Creative Media, University of Hawai’i. You can read Professor Hereniko’s  Authenticity in Cinema: Notes from the Pacific Islands here. 

The Healer and the Psychiatrist is a very moving and intense documentary  that speaks to the value of ethnographic research over a long period of time.  It  explores the value and limitations of Tongan indigenous and Western medicine. The traditional healer,  Emeline Lolohea, may have access to nature’s  abundance and the richness of spiritual knowledge but her husband Tevita’s tragic illness speaks to the need for better access to biomedicine. Dr Mapa Puloka combines psychiatry and what is valued in Tongan culture, but how much does the continuity of his novel practice and healing  depend on his individual efforts? This insightful and sensitive ethnographic documentary asks us to consider how  the treatment of illness and wellness can be ‘decolonised’ even in a country that was never colonised.

Associate Professor Jacquie Leckie -Victoria University of Wellington, NZ  & University of Newcastle, Australia. Author of Colonizing Madness.

The Healer and the Psychiatrist offers a glimpse into the intimate daily work of healing. It shows the ways that caring for others can be onerous and enlivening for healers from across traditions. Whether those healers are using ethnomedicine, engaging psychodynamic theory or delivering people from spirits, healers are unrelenting in the face of widespread chronic sicknesses that must be managed through insufficient healthcare systems. The film also offers the best of ethnography by showing the audience the intimacy of healing through the lens of a fieldworker with obviously loving and longterm ties to the community. Ultimately, the film shows what anthropology does best – the seamless intervening of bodies of knowledge and practice thought to be distinct but are in fact interstitial, which of course should inform clinical practices and health interventions.

Dr Jessica Hardin-Rochester Institute of Technology. Author of Faith and the Pursuit of Health: Cardiometabolic Disorders in Samoa. New Brunswick, NJ: Rutgers University Press, 2019.

Research background

This documentary and visual intervention is based on long term medical anthropology research and collaboration since 1998 with the Vava’uan spirit healer Emeline Lolohea and the Tongan Psychiatrist, Dr Mapa Puloka. Inspired by Tongan use of funeral videos for creating connections with relatives and friends located in New Zealand, Australia and the USA, this documentary creates a video conversation between positions on the influence of spirits in the sickness of the living that are popularly regarded as contradictory.  It is based on extensive research on mental health and Tongan traditional healing (Poltorak 2007, 2010, 2013, 2016) and video recorded as part of research.

We explore Tonga’s health challenges from the perspective of a healer and her family, doctors, patients and caregivers, and the value they give to Tongan medicine and the challenges of public health provision. The extraordinary dedication and commitment to the value of giving and being available to heal, and involvement in the lives of their patients is common to both the healer and psychiatrist. The documentary embraces visual anthropological insights on the inquisitive camera and presence of filmmaker, video elicitation, use of archival footage, the use of video messaging for diagnosis, the reception of mainstream movies and the vital process of feedback.

Jean Rouch aspired and argued for a  ‘shared anthropology’.  The process of production of this documentary is attentive to multiple and diverse audiences:  first to the participants in the film, secondly to the extended Tongan community and those engaged in understanding and representing it, thirdly to those working within a global health paradigm and finally to an audience interested in mental health but with little knowledge of Tonga. The ethnographic, interventionist and documentary credibility of this documentary rests on the ability to move these multiple audiences to greater appreciation and action.

The future of Emeline Lolohea’s and Dr Mapa Puloka’s healing practices and initiatives is fragile. This documentary will encourage conversations and policy actions on the opportunities of greater collaboration between traditional and biomedical medicine.  Imagining new healing futures for Tonga requires collaboration in New Zealand where there is a large, active and engaged Tongan diaspora. In New Zealand the development of a public psychiatry sensitive to traditional healing will also bring positive health outcomes.

In New Zealand two recent films, Belief: The Possession of Janet Moses  ( a documentary, 2015) and One Thousand Ropes (drama, 2017) frame very dramatic  relationship with spirits.  In the Healer and the Psychiatrist spirits are familial  and the relationship between their actions, sickness and access to health care very clear. The message of the film is of great importance to encourage a growing expansion of mental health services around the world to engage sensitively and productively with traditional ideas and healers.

Process and Feedback

The film is the result of more than two decades of research and collaboration in Tonga.  I brought a camera to document healing encounters because of the challenge of noting everything on pen and paper. In Vava’u people asked me to record important events such as funerals, rugby matches, birthdays and church feasts to share the videos with families overseas as a form of gift for help given. The documentary aims to integrate these two different uses of video, as documentation and as a form of socially transformative communication, an audio/visual gift.

A feedback version was created from footage filmed in 2011, 2005 and 1998. It was screened in New Zealand (AUT & Onehunga), Tongatapu (‘Atenisi University, Lo’au University and the Psychiatric Unit) and Vava’u (Tefisi) in October 2018. Further filming and research in October and November 2018 was informed by feedback to ensure engagement with contemporary issues and update the current situation of the key protagonists. Sections were screened at the Ecologies of Mind Workshop in May 2019 in Freie Universität (FU) Berlin.

Resources

The doctoral thesis on which this documentary draws can be read here.

Dr Karlo Mila speaks about her mental health challenges and relationship with Tongan spirits on an Out of My Mind podcast.

A resource booklet on cultural competence for treating Pacific Islander patients produced by Mauri Ora for the Medical Council of New Zealand.

A key publication in Pacific Health dialogue on finding the interface between cultural understandings.

Stills from Documentary