Shamans, Mystics and Doctors: A Psychoanalytic Enquiry into India and Its Healing Traditions.
New York, 1982. [KaS]
[KaS 7] [India is] ... a culture whose soil is not particularly conducive to psychoanalysis, either as a method of therapy or as a theory of human nature. For instance, ... it is rarely recognized how much a certain kind of introspection a sine qua non for psychoanalysis is a peculiarly Western trait, deeply rooted in Western culture. Indeed, ... the introspective element of Western civilization is ancient and can be traced back to later Greek thought... The activity of introspection became closely connected with the idea of the true self, as typified by the Socratic use of the phrase Know Thyself. This kind of introspection is simply not a feature of Indian culture and its literary traditions.
[KaS 7] The meditative procedures of Indian psychophilosophical schools of self-realization to which introspective activity may conceivably be compared are of a different nature and follow radically different goals. The Indian injunction Know Thyself (atmanamvidhi) is related to a Self other than the one referred to by Socrates. It is a self uncontaminated by time and space and thus without the life-historical dimension which is the focus of psychoanalysis and of Western romantic literature.
[KaS 39] The belief that it is the person of the healer and not his conceptual system or his particular techniques that are of decisive importance for the healing process is also an unquestioned article of faith for most Indian patients.
[KaS 146] The difference between the two healing traditions lies in the fact that whereas idealization and identification are strategic and temporary in psychoanalysis. they are strategic and intended to be permanent in the ... mystical cults. The cults group activities ... all propel idealization to its culminating point, where the guru can be experienced as God, and take the identification to its logical conclusion, where the disciple has the feeling of complete unity with the guru.
[KaS 146-147] As a counterpoint to the disciples dependence [the guru] emphasizes his dependability and his assumption of total responsibility for the disciples welfare throughout eternity. To the disciples feeling of insignificance, the guru offers his omnipotence, his ability to perform miracles... To the disciples feeling of crippling inertness, [the guru] offers his energy... To the disciples feeling of limitation and circumscription, he offers his all-pervasive presence.
[KaS 149-150] We have, however, still to explore the other side of the relationship: namely, what happens to the guru who is the recipient of such flattering projections?  To be consistently thought greater, more wonderful and more intelligent than we are is a burden only in the sense that we may feel impelled to be greater, more wonderful and more intelligent. And indeed there is many a guru ... who has become a guru because of the followers ascription of guru-like qualities to him. Most often, however, the guru simply accepts these projections as belonging to his self and enters into an unconscious collusion with the followers Im uncannily sensitive, infinitely wise, miraculously powerful; you are not thus making the followers more stupid, more infantile and more powerless than they actually are.
[KaS 150] [But] what psychoanalysts see as the infantilization of the seeker and his search for the ideal parent, the [disciple] will consider as ... a surrender to the divine in the [guru] ... and the way of the infant is the only way to approach the divine...
[KaS 153] Of the many Indian mystical-spiritual cults, tantra is perhaps the most congenial to a psychoanalyst. [Because of] its antispeculative thrust and to its emphasis on increasing the individuals awareness of his mental life with all its fantastic gods, ghosts, demons and the clamor of a hundred voices of human desire. This is not to say that tantriks do not believe in liberation (mukti) as the overall goal of their path or that they do not subscribe to the mystical axioms of transcendence of duality and the unity of I and the phenomenal world. The tantric goal of liberation. however, is like the psychoanalytic ideal [sic. perhaps he means idea] of genitality, a speculative construct that does not unduly interfere with its vastly more important practice. Both in tantra and in psychoanalysis, this practice remains the discovery of psychic contents and structures and the possibilities of their transformation.
[KaS 154] ...like psychoanalysis, tantra is based upon a recognition, even a celebration, of mans sensuous nature.
[KaS 154] [Difference] Psychoanalysis, whatever its later developments and the status accorded it in Western culture as a philosophy of human nature, did begin as an empirical psychotherapy promising freedom from particular pathological conditions; and tantra, whatever its therapeutic content, does aim at a mystical freedom from all human conditions and predicaments.
[KaS 156] Tantra claims that a person can become whole (and, in the extended, mystical sense, liberated) only when he annuls se+ual differentiation and dissolves his gender identity into a kind of bisexuality. ...the recreation of a primordial androgyny looms large as the goal of a bulk of tantric practices.
[KaS 156] ...the notion of divine bisexuality is not a tantric peculiarity but is also met with in other cultural traditions.  Yet the tantriks ... did not speak of biunity in the symbolic, religious sense characteristic of other traditions, but as a concrete phenomenon and a personally attainable goal.
[KaS 156] The tantric language of se+uality which also pervades its mythology and cosmology is both concrete and symbolic at the same time; God and p-.-., coitus and enlightenment, are interchangeable...
[KaS 156] Whenever the term ananda came up in a text and ananda comes up often, since it is the name of the state in which every tantrik must aspire to live perpetually and I translated it as supreme bliss, I was told to forget all the mystical balderdash since ananda was the pure and simple pleasure of intercourse.
[KaS 158] Although a sadhana may incorporate meditation procedures and bodily exercises from other yogas, the chief tantric techniques involved in a sadhana ... are: (a) a sequence of sound units (mantra); (b) patterned gestures (mudra); and (c) visual imagery, which includes the full range of tantric iconography (pratima) as well as the use of mystical diagrams (yantra, mandala and prastara).
[KaS 158] ...knowledge through devotional worship [bhakti], rational understanding and a direct knowledge through identification are the chief modes of understanding which are aspired for in a tantric sadhana, with identification [with Woman] holding the pride of place.
[KaS 159] Tantric practice, not unlike psychoanalysis, seeks to resurrect the elemental fantasies around incest, together with their associated anxiety, in order to find a new resolution for an old yet nagging dilemma of human development. Of course, the tantric solution, unlike that of psychoanalysis, where one strives for a final renunciation of incestuous fantasy, aims at its anxiety-free reenactment and symbolic fulfilment. The power acquired by the tantrik is then another name for the feeling of expansiveness which follows the reduction of anxiety and which has its source in the release of psychic energy that was bound in maintaining inappropriate defensive structures.
[KaS 165] Cultures, it seems, differ with regard to which of the major universal concerns they pick and choose to highlight. Androgyny, and thus the sons encounter with the mothers femaleness and his own femininity, is highlighted in India, just as, perhaps, Oedipality, where sons and fathers encounter each other in conflict, has been the chosen theme of modern Western cultures. The classical Oedipal complex ... is not the major nuclear complex in the Indian setting. The father-son encounter in India tends to be overshadowed by the earlier confluence of mother and son and the pressing needs it has generated in the latter.
[KaS 169] ...tantric texts prescribe different ways or rather sets of practices (acharas) for different classes of aspirants. The assignment of an individual into one or another class is based on his disposition or character (bhava). The three major dispositions described in the texts are the godlike (divya), the heroic (vira) and the animallike (pashu). Roughly speaking, this threefold classification corresponds to the gnostic distinction between the spiritual, psychic and material man or the sattvik, rajasik and tamasik temperaments of traditional Hindu psychology...
[KaS 170] Consequently, of the seven types of tantric practice identified in the texts vedachara, vaishnavachara, shaivachara, dakshinachara, vamachara, siddhanthachara and kulachara the first four are meant four the animallike, and are inferior to the next two, which are the paths for the heroic man, while the highest form of tantric practice kulachara can only be undertaken by the godlike man.
[KaS 171] Mantra is so central to tantrism that tantriks are often called mantriks and tantra itself is seen as synonymous with mantra-shastra the science of mantra.
[KaS 172] Mantra japa (silent or otherwise) holds a preeminent position in realization of the tantric goals of establishing the adepts identity with a goddess and in helping the tantrik to concentrate and enter a desired psychic state.
[KaS 176] ...mantras are used not in isolation but as part of a complex routine which blends together many other techniques. Mantras also have visual counterparts, the tantric iconography being as complex as the mantric aurologie to which it exactly corresponds. In the visual sphere, besides the images (pratima) of the goddesses that the adept creates there are: (1) diagrammatic forms (yantra) symbolizing divine manifestations, or, in secular language, human potentials to which the practitioner aspires; (2) symbols of protection and invulnerability (mandala) which the tantric uses to contain the anxiety that may be released during the sadhana; and (3) there are symbolic elaborations of central themes (prastara) which are contemplated in order to create certain emotional states.
In connection with visual techniques, I should also mention nyasa. This is a technique in which the tantrik visualizes the goddess and then introjects her into the various parts of his body by touching them.
[KaS 177] The precise nature of the psychic experience produced by a tantric sadhana remains elusive since its hallucinationlike intensity is beyond the ken of our everyday psychic life and commonsense reality. One may speculate that the kind of imaginative reality tantric exercises seek to create is akin to artistic creativity and may well have its source in that particular human capacity and propensity [yes, of course, who else but a human has fantasies that we know of?] which creates metaphors in the waking state and dream images in sleep. The tantric imaginative reality is not the personal, imaginary reality of the psychotic, though it may sometimes slip in that direction. The imaginative reality created by tantric exercises is both shared and public [remember my impressions of the Kumbha Mela in Hardwar as a shared fantasy] in the sense that it is based upon, guided and formed by the symbolic, iconic network of the tantric culture which the adept inhabits. In other words, if tantric visualizations are conscious dream creations, then they are dreams which have been dreamed by others. A tantric vision does not seem to be imposed by unconscious forces, nor is it idiosyncratic (as in the case of the psychotic), but it is consciously chosen and controlled, its form and content preselected to the last detail.
[KaS 177-178] In helping a person ... to concentrate, pay attention, be attuned, the tantric sadhanas intend to usher in a permanent psychic transformation whose outcome is a state of focused receptivity. By focused receptivity I mean the circumscribing of a particular psychological state (state of consciousness in the currently fashionable jargon) which differs from our normal, intellectually active and problem-solving mode of thought that is the legacy of our development from infancy to adulthood. Similar in some respects to what Keats called the negative capability of the artist, [KaS 178] a condition where there is no irritable reaching after fact and reason, the attention of a person in a state of focused receptivity is concentrated yet not seeking.  Focused receptivity pulsates with an intense concentration which, however, is not used for a categorizing mode of thought or for an active grasping of percepts, but for an alert, nondiscursive contemplation.
[KaS 179] The tantric ideal of an androgynous identity as contrasted with the goal of true masculinity or femininity in most Western systems, and the tantric preparation for an ego receiving the world in concentration as against the Western, Faustian notion of the ego advancing against the world on a broad front in order to change it, are not simple, right-or-wrong alternatives.
[KaS 180] The phenomenon of occult tantric powers and miracles can de viewed in different ways. The dominant [Western commonsense] view will be that of people whose consciousness has been formed in the crucible of that psychological revolution which has narrowed the older metaphysical scope of the mind to mind as an isolated island of individual consciousness, profoundly aware of its almost limitless subjectivity and its infantile tendency to heedless projection and illusion.
In this view, the widespread Indian belief in tantric powers and miracles is an expression of an ancient (in history) and infantile (in life history) magical world view. Tantric claims and assertions are then mental phenomena based on the unconscious dispositions of both those who make and believe them; and it would be better for the society and people who affirm the reality of these phenomena to bid farewell to that miraculous world in which mind-created things live and move.
This view would also see the tantric preoccupation with the control of the environment through powers as the darker side of its receptivity ideal. The concern with powers is the an expression of defenses against relinquishing conscious control and against the unexpected and unknown defenses which are activated by the unnatural tantric striving for ... focused receptivity.
[KaS 181] Another view, which for the sake of convenience may be prefixed as traditionally Indian, South Asian or perhaps simply Eastern, will look at the phenomenon of the occult somewhat differently. In this view, which takes the existence of the psyche and psychic reality for granted, there is greater acceptance of psychic products, including the mind-created gods and goddesses.
[KaS 186] ...since the [tantric] healer is believed to be endowed with suprahuman powers, there is a general belief that all he needs to know is the right mantra for a particular psychic affliction and success is inevitable. Such a belief in the healers powers, as we know, is of immeasurable value since it harnesses the patients state of expectant trust which is vital for the healing of emotional disorders.
[KaS 188] In the tantric system the severe forms of mental disorder, where one completely loses touch with reality, are attributed to an unplanned and unprepared rising of energy through the central channel. [sushumna] Under severe bodily or mental strain, it is claimed, this energy may accidentally make contact with the sahasrara in the brain with disastrous results. Similar to an ancient tradition, found in many other cultures [really? which?], which links madness with holiness and equates the lunatic with the saint (as also with the lover and the poet), tantra posits a common underlying physiological mechanism for both madness and mystical states.
[KaS 188] How does a chakra get disturbed? The major underlying cause is undigested karma. When the disturbance of a chakra passes a certain level, a bhuta (lit. and interestingly a has-been) is generated. The term bhuta is a generic name for a host of spirits male and female which can take hold of a person and against which the ... treatment rituals ... are directed.
[KaS 189] ...a tantric healer then attempts to diagnose the particular malfunctioning chakra and the nature of the bhuta controlling the patient. This diagnosis is based on the patients overt behaviour (achara), his expressed thoughts and ideas (vichara) and his specific behavioral disorder (vikriya).
The malfunctioning of the chakras can also be determined by the more direct method of feeling them, a method which requires the healer to know his own chakras thoroughly.
[KaS 243-244] Manas, often translated as mind, has in fact a more concrete and limited meaning than the corresponding Western concept. As part of the subtle body, manas, together with intelligence (buddhi) and I-ness (ahamkara), is a part of the internal organ set the antahamkarna in contrast to the set of external organs (bahamkarna), i.e., the five sensory organs and the five motor organs.
Manas is different from the mind in other ways too. As an atomic entity made of subtle matter that becomes conscious and  capable of performing its assigned task only through the power of the underlying atman, the imagery of manas seems more concrete than that of the mind. Psychologically a mediator between the inside and the outside, metaphysically, manas is also the barrier between the two, the sheet covering the true nature of reality. [Maya]
The functions of manas have been described as: (1) activation, direction and coordination of the sensory and motor organs (indriya bhigraha); (2) self-regulation (svasya nigraha); (3) reasoning (uha); and (4) deliberation, judgment and discrimination (vicara). Mental illness [in the Ayurvedic sense] primarily refers to the impairment of these functions. Considering the nature of the mental function, the closest counterpart of manas in Western psychology would seem to be the ego of psychoanalytic theory with its very similar list of functions and processes, rather than the psychic apparatus which we call the mind.
Given the Ayurvedic thesis of psyche-soma identity, manas is naturally influenced by the humoral imbalance that also disturbs the gross body. There are different types of insanity ... linked with the disturbances of wind, bile and phlegm.
[KaS 244] Besides [these] disturbances..., manas is permeated by the three qualities (gunas) of purity, light (sattva), activity, passion (rajas) and inertia, darkness (tamas). These qualities wage a constant struggle for supremacy and therefore keep manas in an ever-changing state of restlessness. Of the three qualities, rajas and tamas are called the humors of manas. They are, so to say, the mental humors whose excitation and disturbance lead to mental illness or, more exactly (remembering the principle of psyche-soma identity), to illnesses whose origins are chiefly mental. Of course, the vitiation of the mental humors will also be reflected and expressed in the bodily sphere.
[KaS 244-245] ...the reasons for the disturbing increases in the mental humors of rajas and tamas...[are] desire (ichha) and repulsion (dvesha)...
[KaS 245] As a category, desire is defined as the wish to obtain an object which has pleased the body or the mind and includes the emotions of lust, elation and covetousness. Of course, to be desirous of certain objects is natural. It is only when desire steps over the bounds of propriety (maryada) inherent in the object and becomes a slave that the humors get excited. The second category, repulsion, is defined as the avoidance of an object that has caused pain to the body or mind and associated with the emotions of anger, fear and envy.
[KaS 245] Where Hindu psychology differs from psychoanalysis is in attributing to desire and repulsion a power and a kind of eternal fixity in human affairs which even the most dour of psychoanalysts contemplating the human condition is hard pressed to match. For in Hindu psychological theory, desire and repulsion are not only the products of individual life experience from birth onward but have two other roots. One of these roots goes down to the prenatal stage... In this period, the unfulfilled longings of the mother as also her unrelieved fears are said to be transmitted to the [newly activated] psyche of the fetus, to be stored there and thus build the fount for its eventual suffering.
[KaS 245] The other root of desire and repulsion goes back even further in time to a previous existence. It is postulated that the unfulfilled longings and unsolved traumas at the end of a previous life enters the conceptus as a memory-trace (samskara) of the subtle body which, in time, will rise to the surface, demanding completion and closure, and will increase both rajas and tamas.
[KaS 255] ...it was one of Freuds distinctive departures from the psychiatric tradition of his time to consider himself solely the individual patients agent and thus to repudiate any obligations (when they were conflicting) to the patients family and society. This radical strain in psychoanalysis ... is still uncommon within the psychiatric profession.
Most therapists, though paying lip service to the adage in the best interest of the patient, do not really consider themselves the agent of the patient but rather that of his family and society since it is economically and professionally imprudent for them to do otherwise.
[KaS 257-258] Many psychotherapists would perhaps agree with Szaszs contention that the conduct of the human encounter is the only skill that a therapists needs. [Szasz, Thomas. The Ethics of Psychoanalysis. London, 1974. p.25] If we psychoanalysts also add the therapists self-awareness and self-discipline, his critical and inquiring attitude, the ability to understand the patients communications and the meaning of his illness, [rather idealistically put] then these additions describe the tools of the psychotherapeutic trade; they are, in a sense, the superstructure built upon the foundation of the primacy of the human encounter. Of course much of the rest of psychotherapeutic paraphernalia diagnostic tests of various kinds, administration of drugs to facilitate psychotherapy belongs to the realm of gadgetry. They are pale imitations of the medical enterprise, designed to share in its prestige and lend scientific credibility to a basically human encounter which otherwise may not be considered scientific enough. In this sense they are little different from the chicken entrails, divining sticks and mystical squares and circles which lend metaphysical respectability to the encounter between a traditional healer and his patient.
[KaS 274-275] [Quoting the unpublished manuscript of the anthropologist McKim Marriott] ...the dominant Indian and Western concepts of the person are quire different, if not antithetical. Whereas the modern Western sciences of man conceive of the person as an individual (indivisible) nature that is enduring, closed and has an internally homogeneous structure, Indian theories (as evidenced in astrological, biological, moral and ritual texts) hold the person to be dividual, i.e., divisible. According to Marriott, the Hindu dividual is open, more or less fluid and only temporarily in integration; he is not a monad but (at least) dyadic, deriving his personal nature interpersonally. Hindu persons, then, are constituted of relationships; all affects, need and motives are relational and their distresses are disorders of relationships.
[KaS 277] ...a major psychotherapeutic factor in the healing by the gurus is the patients (insofar as seeker or disciple is also a patient) emotional relationship with the guru.  In identifying with the guru, the patient incorporates idealized images of the guru which he feels as genuine and valuable additions to his own personality. Looking at himself, at others and at his problems with new eyes (the eyes of the guru), the problems no longer seem as intractable as they did earlier. Better adjustments to the real-life situation can and do take place, the changes often being sustained over long periods of time. Psychoanalysis, with its characteristic notions of individuality and personal autonomy, will see the limitations of these approaches in the fact that these identifications and incorporations (and hence the personal changes) are ultimately defending against an underlying fear, the fear of the loss of the guru, and the most a patient can hope to become is a poor imitation, a smudged copy of the gurus idealized image. In the Indian culture, however, where the fear of separation and loss is considered the most legitimate of human anxieties, and where the ideal model of learning and personal transformation stresses identification the student being proud to be even a poor copy of the preceptor it is precisely the limitations of the guru-disciple model that are seen as its virtues. It is therefore not surprising that some Indian psychiatrists consider the guru-disciple relationship as the most acceptable model of psychotherapy in the Indian setting.
[KaS 277] [But] even the purest of uncovering therapies classical psychoanalysis with its insistence that only the acceptance of truth in all its effective and cognitive aspects can lead to any true healing, has nonetheless some components of support and reassurance. It has also, in spite of the analysts sustained and self-conscious effort to guard against the danger, occasions when covert suggestions may indeed be conveyed to the patient.