Tuvan shamanic revival and shaman clinics

Domain XI · Traditional medicine & indigenous healing · Mongush Kenin-Lopsan, Dugar-Syuryun Oorzhak · 1993 · Kyzyl, Tuva

What it is

This is a living religious and healing tradition with its own practitioners and its own sources of authority. It is not a psychotherapy, and a psychotherapist does not practise it. Tuva's 1995 law on freedom of conscience named shamanism, alongside Buddhism and Orthodoxy, as one of the republic's…

Format

• Phase 1, cultural assessment (sessions 1–2). Goal: the core CFI with the client, an informant version with family if the client agrees, and the relevant supplementary modules. APA states the modules can be used at the first evaluation, later in care, or repeatedly. Move on once you know the…
• Phase 2, formulation and differential (sessions 2–3). Goal: a cultural formulation that separates culturally normative experience from disorder and identifies medical red flags. Move on once risk is assessed and any urgent medical or psychiatric need is routed.

Who practises it, and how they are trained or regulated

• Legal form. Societies are registered as local religious organisations, first under the 1990s republican law and later under the federal law of 1997. Kharitonova argues that former healers accepted religious status largely "in exchange for tax exemption" (в обмен на освобождение от налогов). She also states that under the federal health law spiritual healing is not medicine and needs no licence, and that healing…
• Number of organisations. Several more societies appeared between 1998 and 2001, and by 2009 there were eight. Radio Svoboda reported in March 2006 that six shamanic religious organisations were officially registered in Tuva and that more than 300 shamans practised legally. Stelmaszyk reports that three remain: Dungur (the oldest, in central Kyzyl), Tos Deer and Adyg-Eeren. Kharitonova also names Tos Deer (headed by…
• Membership and certification. Dungur introduced membership identity cards to mark its members as legitimate in contrast to independent shamans. FOBOS reports a card in a red case, 34 registered shamans and more than 100 in training at that time. Stelmaszyk reports that applicants once had lengthy training and a practical healing exam, but that membership now rests on verbal confirmation of skills. Kharitonova states…

Evidence status, as the guide reports it

• Phase 4, ongoing work and integration. Goal: standard evidence-based therapy for the presenting problem, adapted to the explanatory model, with integration of any shamanic consultations the client chooses. Revisit CFI modules when the problem, the help-seeking or the family situation changes.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the client agreeing politely and then disengaging. It is working when the client voices disagreement with you directly.
• isolation, or remote services that charge large fees (4.11). It is working when the client has meaningful support networks.
• an interpreter who softens or explains away spiritual content. It is working when the client's own terms appear in your notes.
• withdrawal risk, co-occurring depression and suicide risk. It is working when drinking-related goals are set in the client's own terms.
• sleep loss, grandiosity, or the conviction of having been called to become a shaman. It is working when the client stabilises and can reflect on the experience.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.