Mythical and supernatural creatures in psychiatric symptomatology: Thokolosi in Southern Africa

ABSTRACT

Although there are some universal themes in the nature of psychotic psychopathology, like delusions and hallucinations, the content of the symptoms is often shaped by cultural beliefs and personal experiences and thus may differ from place to place. The mental health practitioner needs to be aware of the prevalent cultural myths and beliefs in their geographical area of practice. The increased globalization and migration of individuals makes it important for mental health practitioners to be aware of other culturally influenced symptomatology from areas far flung from their geographical area of practice, hence the need to report such in the psychiatric literature. This paper presents and discusses four cases of patients seen in psychiatric practice in Botswana, Southern Africa, who presented with delusions and/or hallucinations involving a Thokolosi. Thokolosi is a mythical creature in the local people’s folklore, which is alleged, amongst other attributes, to have the ability to harm one’s enemies, bring wealth to its owner and sexually molest both men and women. The paper argues for the need to explore a patient’s explanatory model of their illness and recognize the role of alternative methods of treatment.

KEYWORDS:

• Cultural beliefs
• cultural psychiatry
• Botswana
• psychotic psychopathology
• Thokolosi

Acknowledgements

The authors will like to thank Professor Michael Blank, Department of Psychiatry, University of Pennsylvania for his comments on the initial draft.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Dr Philip R. Opondo is the current acting Head of Department and Associate Programme director in the Department of Psychiatry at the University of Botswana. Although he completed his Psychiatry training in Kenya, he has vast clinical experience in Psychiatry in Botswana. His areas of interest include, among others: transcultural psychiatry and forensic psychiatry.

Dr Keneilwe Molebatsi is a lecturer at the University of Botswana in the Department of Psychiatry and specialist psychiatrist at Sbrana Psychiatric Hospital.

Dr Anthony Olashore is a lecturer at the University of Botswana and consultant at Sbrana Psychiatric Hospital.

Dr James Ayugi trained in mental health in Kenya, the UK and South Africa. He has worked in the military and also for the UN. He is currently a lecturer at the Department of Psychiatry, University of Botswana, and consultant at Sbrana Psychiatric Hospital.

Mr Ari Ho Foster is an Adjunct Assistant Professor of Medicine and Epidemiologist, currently in Botswana as Operations Director for the Botswana and University of Pennsylvania Partnership Program.

David Ndetei is Professor of Psychiatry at the University of Nairobi, Kenya, and founder and Director of the Africa Mental Health Foundation, a mental health research organization. He also founded the Nairobi Psychotherapy Institute, which promotes psychotherapy in Kenya.