Wharenui: A Look Inside the Meeting House, Always from the Outside

Te Whare Marie Ki Puketiro is a specialist mental health service for Maori located in the lower North Island of Aotearoa (New Zealand). This setting includes elements of both a traditional marae and modern medical facilities. Here psychiatrists—none of whom are Maori-- practice alongside Maori cultural therapists, kaumatua (elders) and consumer consultants. In Aotearoa, those who care to look around--instead of only ahead-- cannot help but notice the fragmentation of the things that connect people to the language, the land and one another. Still, we are at home at Te Whare Marie, where the meeting house and clinical offices sit side by side, where we begin the day with acknowledgement, prayer and song. . . and checking the fax machine. And so it is that this gerrymandered mental health service picks up the pieces, mending with whatever is at hand: a prayer, a comforting word, a safe place to sit, a meal as often as a medicine.

The concepts of mental illness and wellness, as understood in Western culture and subsequent medical training, bear little resemblance to the increasingly lost ways of the tohunga. Because the work of Psychiatry, however skilled or virtuous, bears the indirect scars of colonialism, No pakeha (person of European descent) practicing psychiatry in a Maori setting possesses the honour, mana tupuna, to give formal oratory, or whaikorero, on Maori Mental Health. In our practice at Te Whare Marie, we struggle sometimes to reconcile the different processes by which Maori and pakeha "heal.” As we interrogate the space between these models through our narratives, I have asked our kaumatua to extend his korowai (cloak) so that we may move briefly under its shadow as we pass through the wharenui-- for its protection, and ours.
There are now many didactic resources available to define Maori words and concepts. This is not one of them. Rather, it is an attempt capture a sense of the healing narratives of those who work, train and seek care in this one small corner of Te Ao Marama.

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Ko wai koe?[i] For the people of the land, te tangata whenua, the first question is where do you come from? The mountain, the river and the bloodlines that live and die upon them, these are the markers of one’s place in the larger world, te ao marama. Accordingly, a complex set of protocols, tikanga, governs the movement of strangers and visitors, manuhiri, onto the marae. The land of the marae and the meeting house that sits upon it, te wharenui, are sacred, living places. Here you must take care, inside the body of the tupuna (ancestors) for whom it is named.[ii] The ceremony of bringing new people onto the marae, or powhiri, is carefully orchestrated, and includes a call and response (karanga), challenge (wero, haka), song (waiata), invocation of the sacred (karakia) and speeches (whaikorero) of acknowledgement to the ancestors (tupuna) and purpose of the engagement (kaupapa). All of this before introductions, before each person in attendance shares whakapapa (geneology).

The powhiri serves the functions of welcome and familiarization, but also of safety. For Maori, this is not simply a matter of ensuring physical safety, but also on a spiritual plane moving from state of tapu to noa.  And while the ideas and functions of creating a safe interactional space are not unique to Maori, the powhiri serves an example of a uniquely Maori way of achieving a lowering of tensions so that those who were previously strangers may share food, disclose secrets and resolve conflicts. As such, it is a natural model for therapeutic engagement, and while for practical reasons we certainly do not powhiri each and every client who enters our service at Te Whare Marie, we routinely acknowledge this tradition with mihi whakatau, or introductions, in which karakia is offered, genealogy is shared (whakapapa) and kaupapa Maori mental health care is explained.

But just what is meant by kaupapa Maori mental health care? Maori models of narrative-based therapy, such as Te Tuakiri and Te Pounamu, do exist and are doubtless of great value. When practiced in mainstream clinics, however, they can feel awkward, or worse, segregated from the “normal” work of the clinic. This goes back to the broader question of place and process embodied in the wharenui, the powhiri and the question: ko wai koe? The clinic treatment room has no analogue in Maori tradition. Before method then, the answer to the question of defining kaupapa Maori starts with a setting and context in which culturally informed care feels natural. In its physical design, Te Whare Marie is a hybrid of marae and community clinic, and functions as both. In practice, there exists a collaborative tension between Maori and Western Medical concepts of illness and wellness. That is, it is a place where the possibility of cultural recovery is woven into every aspect of care. Still, evidence based medicine is practiced here. We do not have traditional healers (tohunga) or medicines (rongoa), but we do want to know if our clients have used—or are using—these.[iii] As the doctor, then, I have to accept that for many patients, mine is often the “alternative” medicine.

A more blunt answer was given when I posed the question to our cultural therapist, Tua Hekenui, two years ago. Without pause he stated, “kaupapa Maori means by Maori, for Maori.” I have come to understand over time that this is not meant to imply cultural exclusivity, as there are as many non-Maori as Maori working at Te Whare Marie. Rather, it refers to the vision and struggle for self-determination, tino rangatiratanga, in a world where the erosion of tikanga and cultural alienation are as real as any disease. The complex cultural détente and ongoing land and water issues, embodied in the 1840 Treaty of Waitangi, are beyond the scope of the present narrative, but the legacy of colonialism and wound it has left for many Maori would be difficult to overstate. Tua passed suddenly in April 2012, but not before giving me many treasures. Among these taonga were my first karakia, my pepeha and the beginning of a conversation that has continued since the day his body was taken from the wharenui at Te Whare Marie to the whenua of his tipuna in Taihape. It is my hope that this korero honors, and does not offend, his memory. But Tua would be the first to point out that it is not tika for me to speak alone about te whanau o Te Whare Marie. I have therefore humbly asked colleagues (kaimahi), elders (kaumatua) and clients (tangata whaiora) for their help.  Nga mihi nui.

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[i] Literally, “what are your waters?”, and as good a place as any to comment on the use of Maori language, te reo, in this narrative. Acknowledging centrality of language and te reo preservation for Maori, along with the imperfect nature of translation of complex words, I have retained the Maori where I feel it is necessary and have avoided italicizing it. Te Wera’s whakatauki says it better than I ever could: Kei te aahua o te reo, Kei te wairua o te reo, Maa to taatou reo e mirimiri te wairua me te hinengaaro, (“There is healing within our language it is the way we speak and the spirit in which it is spoken. Let us use our language to massage our spirit, our soul and our emotions”)

[ii] Our whare, for example, is named after Rongo ma tane, atua (god) of peace.

[iii] We also have a tradition of very active cultural therapists, who use Maori concepts to guide many of our clients through losses, family conflict, life stresses and even culturally-bound transient psychoses. I am indebted to Dr. Allister Bush and Matua Wiremu NiaNia for sharing their manuscript of case studies with me.