62 chapter
eating, and suspecting that foods have been poisoned. I cannot claim to be able
to explain this diff erence in eating behaviors, but I suspect it may be useful to
investigate the degree to which they relate to issues of control over oneself as
opposed to concerns about the behaviors of others, although surely both orien-
tations are involved in all types of eating disorders.
Some have claimed that a guru-chela relationship, a hierarchical relation
wherein the knowledgeable and authoritative guru teaches the disciple, exists
between therapist and patient in psychotherapeutic practices in India. As
mentioned earlier, this style of encounter marks ayurvedic psychiatric consult-
ations, as in the case of Dr. Abdu’s consultation with Hamid, and Vaidyanathan
has even asserted that this relationship is “the paradigm of all relationships in
India.”^17 Although I observed this style of relationship in ayurvedic therapy, it
was less frequent or less explicit in my observations of allopathic psychiatric
and clinical psychology consultations. Some older male therapists, however,
did occasionally assume this style of relationship, which led me to wonder
to what degree the guru-chela interaction is implicated in gender relations.
I frequently saw older men engage in this teacher-student dynamic in conversa-
tion, in therapeutic and other settings, while women of many ages and levels of
prestige appeared more interactive in their conversational style.
Allopathic psychiatry is more widely available than ayurvedic psychiatry
in Kerala and throughout India, although it is diffi cult to quantify how much
care is provided by general practitioners of ayurveda who occasionally treat
mental problems. Most large cities in Kerala have a government-sponsored
Medical College that provides psychiatric services. In addition, there are three
large, state-run Mental Health Centres, primarily for inpatient care of people
suff ering serious psychopathology, as well as a number of private psychiatric
clinics and hospitals located throughout the state. In terms of health expend-
itures for the State of Kerala, allopathic medicine receives the greatest amount
of government funding followed by ayurveda and then homeopathy (although
homeopathy is rarely used for psychiatric problems). Government information
on the availability of health services in Kerala, which is reproduced in Table 1,
reveals that allopathy has far more beds and doctors but about the same num-
ber of facilities as ayurveda in the public and private sectors.
I interviewed patients and healers at three allopathic psychiatric centers:
Trivandrum Medical College Hospital, Peroorkada Mental Health Centre
and JJ Hospital. Most of the research on allopathic psychiatric therapy was
carried out at Trivandrum Medical College Hospital, a large government-run
teaching hospital in Trivandrum, south Kerala, which serves several hundred
patients in its outpatient facility and has a small, 10-bed female-only inpatient
ward. Peroorkada is a large state-run facility on the outskirts of Trivandrum