Allister Bush is a Pākehā New Zealander who works as a child and adolescent psychiatrist at the Māori mental health service based in Porirua, near Wellington, New Zealand.

Wiremu NiaNia is a Māori healer who lives near Gisborne, New Zealand. He is affiliated to Ngāti Tūwharetoa, Tūhoe iwi. From an early age Wiremu was identified by his kuia (Nanny) as having a fine spiritual attunement. During his life Wiremu has had many roles and worked as a shearer, a fencer, a scrubcutter, a musician, a songwriter, a Māori activist and a youth worker. Since the late 1990’s he is working as a cultural consultant for mental health services.

Allister and Wiremu both started working together in the Māori mental health service based in Porirua in 2005 and have recently published an award winning essay about their collaboration which they now will publish as a book called: Tātaihono- Stories of Maori Healing and Psychiatry.

Interview by Evelyn Einhaeuser

When and why did you start working together?

Allister: We both started working together in the Māori Mental Health Service (a New Zealand indigenous mental health service) near Wellington in early 2005. I was employed as a child psychiatrist and Wiremu was hired as a cultural therapist. So this is where we got to know each other, but it took me several years to actually understand what Wiremu was doing.

What is a cultural therapist?

Wiremu: When you think of the word ‘therapist’, this already can mean a whole range of things. But my context was cultural, which means it included Māori or indigenous paradigms or conceptual aspects. For example I would meet and greet people in the traditional way and build a rapport with them before I start working. I would also design models for their health and healing which included spiritual aspects.

Traditional healing cultures have had an understanding of family connections and therapeutic concepts that must address and integrate family structures and ancestry for much longer than Western family therapy. Wiremu, can you say something about the importance of family energetics for healing?

Wiremu: We have a term called whānau ora, which means family wellbeing. In order for someone to be well, they need the family to be well. So it is about bringing that into place and also instilling that knowledge in somebody that for their wellbeing their family needs to be healthy. For us working in a holistic way includes the physical, the spiritual, the mental and psychological and also the relational domains.

Allister: Wiremu thinks of family differently than I do. When we meet with a family quite often I would ask about the parents’ generation and the grandparents’ generation. But Wiremu is often thinking in up to seven generations. I’ve come to know that he perceives it quite differently and that he often thinks of problems coming down the generations. So he might be looking for a cause to the problem, which dates back a few generations. And the family might not even know it, but then they might go investigating and find out what Wiremu is talking about.

What if you don’t know about your family history from the past seven generations? Is there still a possibility to find out about your ancestry and root problems that have been inherited from past generations?

Wiremu: Sometimes the relevant ancestors appear to me in the room when we are meeting with the family. That is not easy for me to express but someone from another generation might appear and give me a message for the family. When you are looking at the root causes of problems within the family, these ancestors come and reveal something significant. So if I share that information with the family about someone that has been dead for 10 years, it puts a faith in people that something can be done, because how could I possibly know that if that ancestor or person didn’t turn up and share it themselves?

In the beginning of a session do you talk to the ancestors and make clear that the session is about the healing of a certain person within the family or do you pray?

Wiremu: Well, we always start with a prayer acknowledging our creator and the fact that everything will go well and stay safe, spiritually, physically and in all domains. But these ancestors sometimes just turn up in our sessions.

Allister: And sometimes this will lead the family involved to make changes that they otherwise wouldn’t have made because suddenly they can see the point of it. And maybe with unresolved conflicts that have been going on for ages they realize that they better do something about this. Whereas if a psychotherapist or a doctor says: “Hey, maybe you should heal your relationship”, they might not take any notice. So there is a certain kind of persuasive aspect from the shocking realization that maybe some ancestor is putting this forward.

Modern psychotherapy also has an understanding of transgenerational diseases or conflicts that are passed on. Correct?

Allister: Yes. In modern psychotherapy there are traditions like object relations in which you focus on your relationship with your parents for example. Or it might be with other caregivers like grandparents. And then in family therapy you are often looking at previous generations. But usually you would not look much past two generations.

How can this traditional understanding be communicated to a modern medical system, for example that more generations may influence us?

Wiremu: I prefer to make my point through the changes that come about in people’s lives from this work. The results of positive change are more convincing than arguing the point that you have to take into account more than four generations.

Allister:  Naturally many of us as medical practitioners and other health professionals are skeptical about ideas that we are unfamiliar with, and which fall outside our usual ways of thinking. And so the way we have chosen to communicate this is by telling stories of therapy, so that people can read the whole story and make up their own minds. For me as a psychiatrist, just because Wiremu said that he is working with up to seven generations, doesn’t necessarily mean anything to me because I wouldn’t know what he is talking about if what he is saying is out of my range of experiences.  

Do you find there is still a huge gap between science and holistic healing approaches or are there also meeting points?

Allister: I think there are people that understand about science and are also open to a spiritual framework. But there are still a lot of people that believe science is the only way, and the only ‘truth’ is that which can be verified scientifically.

Wiremu: For me again the stress should be in watching the changes in people. And I am talking of noticeable changes. One example is a young boy that had attempted suicide several times. He would always come into the center with his hoodie on, looking down, he wouldn’t look up at anyone, he just turned up to go see the doctor and get medication. I had seven sessions with this guy and suddenly it was noticeable that he was coming in with no hoodie, saying ‘Hello’. Soon after, his mom came in to say how astounded she was, he was buying new rugby boots and running shoes and he was opening up and getting back into society.  

Allister: One of the things Wiremu does really well is lift up the mana (sense of spiritual authority) of the person. He makes them feel good about themselves and through enhancing their mana; they begin to take some of these steps that he is talking about. Mana is a sense of pride, but not in an ego kind of way, it is more about self-worth, which is just as much in a collective sense as in an individual one.

Wiremu: Science is finding out more and more of what we have known for a long time. There is this research on water for example by a Japanese scientist who proved that water actually has memory. We Māori have known this for centuries. We call the spirit Wairua, which means two waters, the external and the internal water. As you know 65 percent of the body for example is water, and 70 percent of the brain is water. During the conception of a child the water of the parents comes together. And then during pregnancy in the placenta 80 percent is water. So the child is picking up the memory that is saved in the water.  So whatever the parents are doing before the child comes into this world is stored and picked up and will show later in life.

What other intangible parameters are you accessing in a healing session?

Wiremu: The most important is Mauri, life force. The word consists of ‘ma’, ‘by’ and ‘uri’, ‘kinship’. So it is about relationship. I would explain it as the relationship to the creator, the relationship to your family, the relationship to your genealogy. So that is the life force, and the life force is that which is driving someone.

Then the next important factor is tapu and that means sacred. The Syllable ‘Ta’ means ‘engraved’ and ‘pu’ ‘the beginning, the source’. So it is beyond sacred. It refers to the fact that we have all been held spiritually in the hand of the creator.

And the last is Mana, authority, respect. If I split that word up, it consists again of ‘Ma’, ‘by’, and ‘Na’, ‘that’. So it means ‘by that’. We have the authority ‘by that’ or from our creator or our source, over everything that walks, creeps, crawls, flies and swims. And this mana means that we have power over our circumstances. We don’t have to be in any situation that we don’t want to be in. We can address these situations and change them.

I am always telling people that I am not the expert but that they hold the key to their healing inside of them. And I am just helping to facilitate that.

All these terms are connected to spirit. Would you say that if a person doesn’t have a connection to the divine, then their life force is suffering?

Wiremu: In a way, but I also connect people to their families, to their genealogy and immediate family and all of that is also life force.

How do you work with people that have no spiritual roots and no understanding of spiritual concepts?

Wiremu: If one of the ancestors turns up in a session, a person that has been dead for ten years for example and that I have had no knowledge of before, then that reignites faith and hope and the knowledge that there is something intangible. But I would say most indigenous cultures and European cultures have that connection to spirituality. It is more about helping to facilitate getting in touch with that spirituality again.

Allister: Also if Wiremu feels like he is in a room with people that don’t believe in the spiritual dimension, he won’t push it on them. He might just talk about real world relationships.  

Wiremu: And I can also talk about internal structures that I pick up on. I can identify with someone’s suffering, with one element of it, like problems in the kidneys or an irregular heart beat. And so I would ask: ‘Excuse me but are you feeling anxious about anything because I can feel my chest and I am suddenly feeling short of breath”. And so I would talk about anxiety and I can guarantee that somebody in the room is anxious about something and that they are actually experiencing this.

Do you think this skill can be learnt or not?

Wiremu: I think everybody has that skill. I think spiritually everybody has it. It is just that some people develop it and some people don’t. Like there were times when I was able to name people I have never met. That would even surprise me. It is about growing that faith in oneself that there is something that is looking after us.

How was the knowledge of healing transferred to you?

Wiremu: It is difficult to explain but it just happened to me when I was three years old. I could see things in people and luckily my nanny would guide me through this. She was a woman of prayer and she was a healer herself.

How did your collaboration look like on an everyday basis?

Allister: For the first five years we were working together on the same team, I would be working with the family and as a result of the conversation with the family I would wonder if there was a spiritual cause alongside other causes. We would discuss it in our team and decide if it would be beneficial if Wiremu saw the family. And then after I discovered that Wiremu’s work was really helping some families, I asked if I could sit in on his meetings with the family. So this is what we have done for several years. And so I learnt a lot from actually observing how he would go about things. And over the years I would also know better when it would be good to involve him. For example when the young person had quite a lot of spiritual experiences when they were growing up or if they had family members who have had spiritual experiences. Or if the problems they are having really don’t fit well with a psychiatric diagnosis. So there are symptoms and signs like that which would make me think of asking the family if they would like to consult with Wiremu.

But the other way round would also happen. Sometimes Wiremu would say: “I don’t think this is primarily a spiritual problem.” So for instance there was this young person who said that he was hearing the voice of his grandmother. And that she was telling him to commit suicide. And Wiremu’s conclusion in meeting with him and his family was that he couldn’t detect that particular grandmother. He could detect another grandmother, but not that one. So he concluded that this young person could be mentally unwell and due to various ways that they were putting themselves at risk, he supported the idea that they needed to be admitted to hospital. And so that was organized. So often times Wiremu’s assessment might be really helpful and productive in defining the next steps.

But are problems really so one-dimensional, that you can say, ‘oh this is only mental’ or ‘oh, this is only spiritual’. Are these layers not always influencing each other?

Allister: I agree with you. Wiremu would say everything has a spiritual basis. But it is also useful sometimes to make a distinction and say that it is primarily a spiritual problem or not primarily, even though it is always spiritual to some degree.

What do you value about each other’s work?

Wiremu: Allister and I both have our own forms of spirituality and I felt that our spirits could connect. Concerning the work, just as there are similarities in mental health problems, spiritual problems can also have similarities in different parts of the world. My work process is a process of elimination, an elimination of a spiritual disease. But what is so valuable in this collaboration is to have the clinical back up, so that if something doesn’t appear to be mainly a spiritual problem, I can turn to Allister for his expertise.

Allister: There are quite a few things I value about Wiremu’s approach. One thing is that he is a very effective communicator. He is able to help me understand Māori concepts that are very hard for me to understand by using concepts that are familiar to me. So I remember one time he was trying to explain a spiritual problem that was affecting a young man and he said: “This person has a spiritual germ.” So he was using a medical metaphor to help a doctor understand the concept. So for me, part of the value has been about learning how Wiremu sees things. Another aspect is that he is often able to be quite clear about whether he thinks there is a spiritual problem going on primarily or not.  So this can very helpful in helping the family decide the best therapeutic path forward. And last but not least, families very frequently like him. When they are in a room with him they come out feeling good and they are always happy to see him again if possible, even when everything is fine. To me that says something about his spirit and the way that he works and of course he uses a lot of humor, which is also very enjoyable.  

Do you know of any other such collaboration in New Zealand or do you think it is unique?

Allister: I don’t know one that is very similar. Obviously there are other healers working in healing situations so I imagine there could be.

But are there many Māori healers working in clinics in general?

Allister: I don’t think there are many Māori healers openly working for hospital boards but I imagine there may be a few that we are unaware of.

Why is that? Because obviously such a collaboration is functioning so well!

Wiremu: I think crucial is not only to have an understanding of the spiritual side, but also to have an understanding of the mental side. And I am always asking if a fellow healer who is working inside such a service or clinic had the training to recognize if a person is actually psychotic. I think it is really, really important that we don’t discard the possibility that someone is having a chemical imbalance or some brain disfunctioning that causes them to lose touch with reality. It is important that healers are aware that there can be such things as chemical imbalances in the brain or something that is not functioning right because of a deficiency. Drugs and alcohol for example can cause such an imbalance.

Were there any challenges in working together?

Wiremu: I can’t recall anything like that ever happening, but we were always recognizing and respecting each other’s skills. And we were always trusting that we work well in our own disciplines.  And what we would do a lot is sit down and talk and discuss cases, which also helped a lot in our work.

Allister: Well in the beginning Wiremu would quite often come up with something and I would think I can’t even get my head around that! And then I would just have to leave it. And often what I discovered is sometime down the track, sometimes even months later, I would discover that he was right but at the time I couldn’t understand how he could know that so I just let it go. So it has been challenging in these kinds of ways but that is a form of learning as well.

What are the typical problems of classical family therapy?

Allister: Conventional family theory is secular and grew out of secular cultures. Psychotherapy and psychoanalysis came from Europe and valued the mind and thinking separate from spirituality. So that has affected family therapy. Family therapists usually focus on their specific techniques and maybe factors that have to do with relationships but they don’t necessarily consider the spiritual aspects. And that is what Wiremu brings in, he is always thinking of the spiritual first. And then he would work at the level the family is up to and able to understand. Or he would find a gentle way to help them broaden their thinking so they would understand what is going on.  

Allister, has your perception of healing changed since you are working with Wiremu and if so, how?

Allister: Beforehand I would have liked the idea that spirituality is important but I wouldn’t have known how it could make a difference. Now I feel I have been fortunate enough to be in quite a lot of situations with him where it has made a huge difference. I guess for me it has become more practical now, the whole idea of spirituality. Before it was just a theoretical idea that spirituality was important.  

If you could advise other medical practitioners, in which other medical areas could you imagine similar collaborations and synergies and what are prerequisites for a positive collaboration?

Allister: If you talk about a positive collaboration between an indigenous and a non-indigenous person, then the non-indigenous person should always know about the history of the indigenous people. Not that it has to come into everyday work life, but you need to understand the background of history of the relationship between the cultures that you come from over centuries. Because many of the colonial countries have tried to render indigenous traditions invisible. So you can’t enter such a relationship by just being ‘nice guys’. It is important for me to acknowledge Wiremu’s voice, not just because we are friends, but also because of the history and because the indigenous voice has been suppressed so often in New Zealand, just as it has been in many other countries. There is a moral obligation to create space for that. And the more we have been writing together the more we have attempted to give space for Wiremu’s voice and less so for mine, because psychiatry has always dominated and now we want to hear from the indigenous cultures.

Can you say a little bit more about your book?

Allister: The book has not been published yet. The current name is Tātaihono- Stories of Maori Healing and Psychiatry and our co-author is David Epston. So basically these are stories of our work and Wiremu’s work with families and the family’s view is included in the stories. What we are hoping is that it gives a chance for mental health practitioners as well as families and Māori health practitioners to hear more about the kind of work Wiremu does and think about how spirituality could be relevant for young people with mental health problems. And I suspect it will be interesting for people beyond that.