27 May, 2019

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Diagnostic And Statistical Manual Of Mental Disorders And The Buddhist Jathaka Stories

By Ruwan M Jayatunge

Dr. Ruwan M Jayatunge MD

Several years ago, I exchanged views on DSM (Diagnostic and Statistical Manual of Mental Disorders) and the Buddhist Jathaka stories with some Psychologists / Psychiatrists of the USA, UK, Australia and Canada. Only a very few knew the existence of the Buddhist Jathaka stories and how deeply it touches the DSM based mental illnesses.

What are Jathaka Stories ?

The Jathaka stories or Jathaka tales are a voluminous body of folklore concerned with previous births of the Buddha which is based as a collection of five hundred and fifty stories. Originally it comprise of 547 poems, arranged roughly by increasing number of verses. According to archaeological and literary evidence, the Jathaka stories were compiled in the period, the 3rd Century B.C. to the 5th Century A.D. The Khuddaka Nikāya contains 550 stories the Buddha told of his previous lifetimes as an aspiring Bodhisatta.

According to Professor Rhys DavidsJātaka stories are one of the oldest fables. Rev Buddhaghosa, translated most of the Jathaka stories into Pāli about 430 A.D. Jathaka stories can be considered as cases studies of the Buddhist philosophy. Most of the DSM (Diagnostic and Statistical Manual of Mental Disorders ) based mental ailments could be seen in the Jathaka stories. It discusses profound psychological themes and analyses the human mind. The Consultant Psychiatrist Dr D.V.J Harischandra in his famous book Psychiatric aspects of Jathaka stories points out that the Western Psychologists should study the essences of mind analysis in Jathaka stories.

Jathaka Stories and the Western World

Among the Westerners Professor Rhys Davids Ph.D., LL. D., of London, Secretary of the Asiatic Society studied the historical and cultural context of the Jathaka stories and he translated a large number of stories in 1880. Professor E. B. Cowell, professor of Sanskrit in the University of Cambridge, brought out the complete edition of the Jataka stories between 1895 and 1907.

The Diagnostic and Statistical Manual of Mental Disorders (DSM)

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the APA or the American Psychiatric Association and it provides broad symptomatology and standard criteria for the classification of mental disorders. The first version of DSM was published in 1952. The current version of the Diagnostic and Statistical Manual of Mental Disorders is known as DSM-IV-TR (Text Revision ) and it was published in 2000. DSM-IV-TR recognizes the impact of culture on psychological health within a bio-psychosocial framework. The diagnostic criteria now reflect a focus on behavioral symptomatology and suggest the importance of drug-management in therapy over psychotherapy (Shorter, 1997). The next (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), DSM-5, is currently in consultation, planning and preparation. It is due for publication in May 2013.

Mental Disorders and the influence of Buddhist Jathaka stories

In general terms a mental disorder is a psychological or behavioral pattern that is associated with subjective distress or disability that occurs in an individual and which are not a part of normal development or culture. The mental disorder is characterized by impairment of an individual’s normal cognitive, emotional, or behavioral functioning, and caused by social, psychological, biochemical, genetic, or other factors, such as infection or head trauma.

Buddhism is a religion that deeply discusses human mental process. Human mind has a special place on Buddhist philosophy. There is no other religion that has gone in depth to analyze the human mind than Buddhism. Buddhist philosophy talks about the human mind and its pathological and non-pathological portions.

The Buddhist Jathaka stories describe various types of mental disorders and how it affects the individual as well as the society. For centuries these stories helped the people to view individuals with mental illnesses with a compassionate eye. In the Medieval Europe, psychiatric patients were often targeted as the agents of Satan and subjected to torture and execution. As Prof Adam Jones of the international studies at the Center for Research and Teaching in Economics (CIDE) in Mexico City indicates in his famous book Gendercide and Genocide, writes.

…….. for three centuries of early modern European history, diverse societies were consumed by a panic over alleged witches in their midst. Witch-hunts, especially in Central Europe, resulted in the trial, torture, and execution of tens of thousands of victims; about three-quarters of victims were women. Arguably, neither before nor since have adult European women been selectively targeted for such large scale atrocities. Modern estimates suggest perhaps 100,000 trials between 1450 and 1750, with something between 40,000 and 50,000 executions, of which 20 to 25 per cent were men. (Gendercide and Genocide – Adam Jones)

The humane way of treating mental patients started in Europe mainly with the reformations introduced by Dr. Philippe Pinel (1745- 1826) and he initiated moral treatment for the psychiatric patients. Many centuries before Philippe Pinel the Buddhist societies in Asia treated psychiatric patients with compassion. The Jathaka stories may have had a profound effect on de-stigmatizing metal disorders.

Psychoanalysis and Jathaka stories

Psychoanalysis was introduced by Sigmund Freud in which free association, dream interpretation, and analysis of resistance and transference are used to explore repressed or unconscious impulses, anxieties, and internal conflicts. The renowned Sri Lankan Literary genius Martin Wicramasinghe D.Lit. argues that the Psychoanalysis was initiated not by Freud but by the Jātaka Storyteller. Martin Wicramasinghe gives solid examples to qualify his opinion. Wicramasinghe intensely wrote on Buddhist Jathaka stories. In his books The Buddhist Jataka Stories and the Russian Novel(published in 1952) and Jataka Katha Vimasuma (The Literary Aspects of Buddhist Jathaka  Stories) published in 1968 Martin Wicramasinghe shows the mind analysis that is evident in the Jathaka stories. The Jathaka storyteller revealed and analyzed the noble to ignoble characteristics of the human psyche. The Jathaka storyteller knew the complexity of the human mind. He described the human behavior in vivid situations. He knew the internal mental conflicts, repressions and hysteria type of behavior that people exhibited. A vast amount of abnormal behaviors were recorded in form of stories by the Jathaka storyteller. The Jathaka  stories represent a broad structure of mental phenomena.

Hysteria Types of Reactions Described in the Jathaka Stories

The Webster’s dictionary defines Hysteria as a psychiatric condition variously characterized by emotional excitability, excessive anxiety, sensory and motor disturbances, or the unconscious simulation of organic disorders.

Jean Martin Charcot, Pierre Janet, Freud, and Joseph Breuer comprehensively wrote on hysteria. Sigmund Freud saw a traumatic experience in childhood that is uniformly of a sexual nature as general aetiology of hysteria. Freud’s famous case study of Anna O (real name Bertha Pappenheim ) suffered from a rigid paralysis, accompanied by loss of sensation, of both extremities on the right side of her body over a two years. Anna O was the classic study of Hysteria. The DSM- IV -TR distinguishes hysteria under Somatoform Disorders and the Dissociative Disorders.

The Vibhanga Atuwawa – a Buddhist scripture part of the Pali Canon of Theravada Buddhism describes vibrant neurotic features that are perceptible in laymen. The Jathaka stories give numerous case examples of neurotic behaviour.

The Prince Asanaga – a character that was described in Chula Phalobhana Jathaka Story suffers from Gyenachophobia or an abnormal, irrational and persistent fear of women. He fears women and is anxiety rises up in the presence of women. From birth to the adulthood, he was in the company of males and never had a chance to associate women. Accidentally he got acquainted with a woman and experiences an erotic relationship with her. His suppressed sexual desires emerge like a volcano and the Prince Asanaga goes in to an acute stress reaction. He becomes violent and attacks the men on the street with his sword. The Jathaka storyteller colorfully describes the inner mental conflict of the Prince Asanaga and his fears, anxiety , sudden desire and the acute emotional reaction.

Sexuality Discussed by the Jathaka storyteller

Many centuries before Sigmund Freud, Richard Freiherr von Krafft-Ebing or D.H. Laurence Tantric Buddhist monks discussed the wider aspects of human sexuality.

Tantric is often viewed as the third major school of Buddhism, Tantric philosophy has a complex, and multifaceted system of Buddhist thought and practice which evolved over several centuries and encompasses much inconsistency and a variety of opinions. (Macmillan Encyclopedia of Buddhism, 2004).

Based on the general definition human sexuality is how people experience the erotic and express themselves as sexual beings; the awareness of themselves as males or females; the capacity they have for erotic experiences and responses. Sexuality varies greatly by culture, region, and historical period, but in most societies and individuals has a large influence on human behaviour.

Nalini Jathakaya describes broad aspects of human sexuality. It is a story of a young hermit who lived in a jungle since his birth and never had seen or heard of women. He had not heard of sexual relationships between men and women and when the young Princess Nalini comes to his hermitage, he could not recognize her as a member from the opposite sex. With an erroneous assumption he thought that Princess Nalini was a hermit like him. The princess deceived the hermit and made him commit a sexual act. So the young hermit eventually experienced a physical relationship with a woman for the first time in his life. In this story the narrator deeply explore the primal sexual reaction of a human male who was deprived of prior sexual education and sex initiation by a female.

Sexual jealousy is another element that is deeply discussed in the Jathaka stories. In Chulla Darmapala Jathakaya the King Prathapa kills his infant son following sexual jealousy. Jealousy is a universal feeling. The feeling is normal until it is acted upon and the behaviour or actions become irrational. Many psychologists believe that in human males, sexual jealousy is often marked by violence and consistent attempts to restrict the sexual behaviour of women.

The Jathaka storyteller describes complex behavioral components of a young man named Pinguthara who exhibits firm features of Hypoactive sexual desire disorder. The Hypoactive sexual desire disorder (HSDD), is considered as a Sexual Dysfunction and is listed under the Sexual and Gender Identity Disorders of the DSM-IV DSM-IV. It is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time. According to the story Pinguthara was a young man (described in the Ummaga Jatakaya ) who suffered from Hypoactive Sexual Desire Disorder. He had no interest in his newly wedded beautiful wife Udumbara Devi. He finds no erotic satisfaction in her and the wife becomes a burden to him. He abandoned her and fled due to lack of interest in women.

The Sexual arousal is stunningly described in the Haritha Jathakaya. By seeing a naked female body the hermit could not resist his feelings and he eventually commits adultery. His suppressed sexual desires come in to action like a serpent coming out of a cage. In this story the hermit’s sexual arousal is extensively described. Sexual arousal, or sexual excitement, is the arousal of sexual desire during or in anticipation of sexual activity. For the hermit it was an unexpected event. Many years he had practiced voluntary celibacy. His erotic desires were suppressed but when he saw the naked woman’s body his sexual response became overpowering.

Incest and Jathaka Stories

Incest refers to any sexual activity between close relatives often within the immediate family irrespective of the ages of the participants and irrespective of their consent that is illegally or socially taboo. Incest is considered as the oldest crime. The Seggu Jātakaya of the Jathka storybook tells about incest. A father takes his young daughter to the jungle and tries to molest her in order to check her purity. When the girl cries in fear and shame, he releases her.

Personality Disorders Described in the Jathaka Stories

Many Personality Disorders are described in the Jathaka Stories and the Kshanthivadi Jathaka depicts a character who bears psychological criteria that is similar to the Antisocial Personality Disorder.

APD is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. Lack of remorse, poor behavior control, Tendency to violate the boundaries and rights of others, aggressive violent behavior, are more common in Antisocial Personality Disorder.

The Kshanthivadi Jathaka story narrates negative characteristics of an aggressive King name Kalabu. The King Kalabu became angry when he saw Kshanthivadi Hermit was giving a sermon to his harem women. The King Kalabu orders his men to torture the hermit. With the King’s orders, the executioner cuts the hands, and legs of the Hermit. But the Hermit shows no anger. It ignites the King’s anger further he orders to kill the hermit.

The King demonstrates swallowed emotions, a distorted sense of self, manipulation of others without remorse or empathy for the victim, egocentrism, lack of responsibility, extroversion, excessive hedonism, high impulsivity, and the desire to experience sensations of control and power. He truly fits in to APD criteria.

The King Kalabu ’s lack of empathy was much similar to the NAZI s who exterminated millions of men women and children. The Psychologist Gustave Gilbert interviewed a number of NAZI leaders (including Hermann Göring) at the Nuremberg trial after the WW2. According to Gustave Gilbert NAZI s lacked empathy.

The Western Psychology has limited answers to explain the reaction of the Kshanthivadi Hermit. Although he was subjected to unspeakable torture, he generates no anger. The hermit has a loving-kindness feeling towards his tormentors. Until his last breath, the hermit does not hate the King. According to the modern psychology it was an unusual human response.

The modern Western society was influenced by the non-violence movement by led Mahatma Gandhi

and the Civil Right movement launched by Martin Luther King Jr. But the emotional reaction of the Kshanthivadi Hermit remains an extraordinary human reaction. Perhaps such emotional reactions could have explained by Victor Frankl who practically showed that under the extreme physical and psychological pain man can preserve his spiritual freedom of independence of mind.

Oedipal Conflict and Jathaka Stories

As Freud described in the Oedipus complex, largely unconscious ideas and feelings, which concentrate, on the desire to possess the parent of the opposite sex and eliminate the parent of the same sex. Freud analyzed the story of Oedipus Rex, and describes the unconscious motives of patricide He postulated that patricide was the great crime at the base of all social evolution.

Thayo Darma Jathkaya is a story about the conflict between a father and a son. The father (king of the monkeys) destroys the genitals of male baby monkeys in order to liquidate any impending future threat by a male monkey. One of the male baby monkeys was able to escape physically unharmed and grows up in a separate area of the jungle and later comes and challenges his father. In this conflict, the son kills the father.

Conduct Disorder

Children with conduct disorder repeatedly violate the personal or property rights of others and age-appropriate social standards and rules. Associated features of conduct disorder include an inability to appreciate the importance of others’ welfare and little guilt or remorse about harming others. Children with Conduct Disorder often view the world as a hostile and threatening place and they have difficulty maintaining friendships. They often have low self-esteem and low frustration tolerance. Peers and family members become negative and irritated with their misbehavior, which leads to a vicious cycle.

The Virochana Jatahkaya of the Jathaka storybook gives details of a prince who had positive features of Conduct Disorder. The prince has aggressive impulsive behavior, property destruction, lying, rule violation etc. The King sends the young Prince to a hermit who has knowledge and wisdom. The hermit uses a form of behavior modification to treat the child. The hermit gives an insight to the child by using a Kohomba plant (Azadirachtaindica) which bears leaves with a bitter taste. The hermit says that the children with aggressive behavior often harms others are like these leaves and no one likes them. The child gains insight and refrains from aggressive behavior.

Pathological Grief

Grief is an intense sorrow caused by loss of a loved one (especially by death) something that causes great unhappiness and it has multi-faceted responses. Grief is an overwhelming emotion. Individual experiences of grief vary and are influenced by the nature of the loss. Sometimes grief reactions are prolonged and the affected person is unable to come to terms with the loss. Pathological grief deserves a place in the diagnostic nomenclature (Horowitz 1993).

The Sujatha Jathakaya explains a pathological grief reaction experienced by a person following the death of his father. His emotional pain does not heal with time and lasted for a long period. Most of the days his mind was preoccupied with the memories of the lost father and used to cry for him. He was emotionally overwhelmed. The sufferer’s pathological grief reaction was healed by using an existential mode of intervention by his young son.

Existential psychotherapy is a method of therapy that operates on the belief that inner conflict within a person is due to that individual’s confrontation with the givens of existence. The young son gives his father the insight and hence reducing his prolonged grief reaction.

Posttraumatic Stress Disorder

PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. People with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb. They may experience sleep problems, feel detached or numb, or be easily startled.

According to the DSM –IV-TR PTSD or Posttraumatic Stress Disorder is defined as thus.

The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criterion A1). The person’s response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent re-experiencing of the traumatic event (Criterion B), persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (Criterion C), and persistent symptoms of increased arousal (Criterion D). The full symptom picture must be present for more than 1 month (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

The Jathka storyteller elegantly portrays the clinical picture of a monk (in DummbalaKatta Jathakaya) who had fear feelings, flashbacks, hyperaousal, avoidance and startling reactions. The monk named Marana Bhiruka Bikku fits in to DSM criteria of PTSD.

Conclusion

Although the Western scholars like Anatole France, Albert Einstein, Bertrand Russell, Professor Roderick Ninian Smart etc. had profoundly written about the Buddhist philosophy ironically no one had revealed the Western world about the psychological significance of the Buddhist Jathaka stories. The Jathaka stories analyze the human mind revealing its noble and ignoble parts and how the mind works in different circumstances. The Jathaka story teller knew the complexity of the human mind. He described the human behavior in vivid situations. The Jathaka  stories represent a broad structure of mental phenomena. Therefore the Western world should carefully study this priceless piece of work.

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    It is good that others should study buddhism. The same applies to all religons. We should all study the teachings of other religons to create a better understanding amongst all of us.

    Followers should not only talk about but also follow the teachings in their day to day lives and specially when dealing with others and especially those belonging to other faiths. When we are exemplary human beings, free of malice and hatred, that would be the day we could be proudly to say I am a follower of xxx.

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