Miasma and the Mentally Ill

Miasma: ritual pollution or defilement.

Is mental illness, and disease in general, inflicted by the gods as punishment for hubris and other “sins”? Are we punished for approaching the gods when afflicted by Miasma (ritual impurity), or simply ignored? Or, is Miasma the result of physical and mental illness, which when afflicts us, bars us from approaching the theoi (gods)? If so, what can we do to seek Their help when we most need it (when ill) and yet do so with respect?

How did the ancients approach this issue?

The quote below is controversial. But bear with me here, it presents the questions that lingers in the back of our minds. The emphasis in bold below is mine:

Still in the sphere of values, a question arises about the relation of pollution to morality; the irrationality of the former, perhaps, makes it hard for a rational system of the latter to develop. The religious historian may wonder how pollution relates to ‘sin’, prime source of religious danger in a different tradition; this question becomes of central importance in the case of those alternative
religions of the Greek world whose goal was salvation and principal route towards it ‘purification’. The subject is not irrelevant even to the historian of science, since the Hippocratic doctor, in seeing ‘impurity’ as a cause and symptom of disease, is an heir to the prophet or oracle. The origin of disease raises the more general question of how the early Greeks, individually and collectively, responded to the afflictions that befell them. Miasma: Pollution and Purification in Early Greek Religion, pg. 2

Here is my answer based on research and discussion with others of the same faith…

The general idea is not to approach the gods while you’re exposed to miasma; that is, when you’re likely to be distracted (by intercourse, being ill, dirtied, having spilled blood, or associated with the ill) at formal gatherings and rituals.

Although, it seems that the ancients were also concerned about miasma spreading, carrying with it disease. The implication in that old belief, now, is how stigmatized the ill (physically and mentally) are. Such belief would cause the good Hellenic practitioner to avoid the ill, and those who treat them, to avoid offending the gods by approaching Them. Is this an antiquated view of the ill, one that should be cast aside like misogyny and human sacrifice.

I worried about this for some time as I work in Psychiatry and see the mentally ill nearly every day. What we know of miasma for formal ritual settings would imply that I am ritually dirtied every day I work and interact with patients. Theoretically, I couldn’t honor the gods until after a full day had passed and I’d bathed. If I were simply dirtied from the day’s work, or from being intimate with my husband, that’s another matter. A simple bath, shower, or washing my hands would be enough. But not if I’ve encountered a murderer, prostitute, a house in which someone has died, a corpse, or the severely ill.

Yet, I dedicate my work to Asklepios (god of doctors) and His family (Hygea, goddess of good health among them). When acting on the gods’ behalf to help the very people who need it most. Surely it’s not unreasonable for the ill or medical professionals to approach him. Right?

Yet, many people I’ve encountered believe that the cleanse-and-avoid protocol only applies to very formal settings (as in, the demos or polis holiday sacrifice, or a rite of passage) and based on what I’ve read about certain gods (Asklepios as the chief example) there are some for who – it seems – it was expected you’d approach when you need that kind of help one needs most.

We can be confident in this conclusion, as those who were ill and injured came to Asklepios’ temple in order to receive treatment through divining the cure. He is a very gentle, tolerant, and accepting god. There is the story of him once receiving a boy’s offering of dice in exchange for his cure. Quite a break from protocol, isn’t it?

Also, I am doubtful that we can honor Hestia in the kitchen or Demeter in the garden (through doing actions that honor them – like cooking or nurturing plant life) without getting our hands dirtied. Can it really be that one should avoid all the gods at all times when tainted by miasma? I don’t think so.

Let me emphasize again: a big part of the issue for the mentally ill approaching the gods is being distracted in Their presence. If one is conflicted by psychosis (preoccupied with mental affliction and unable to focus) at a formal event, then one isn’t paying proper attention to the gods.

The solution? I suggest that this can be countered by being stable on medication. If for example, a schizophrenic patient is cognizant and focused on the ritual because they have the right treatment (rather than distracting others with outbursts against paranoid delusions or hallucinations), then there should be no offense to the gods.

In addition, usually unstable patients want relief and release from the mental affliction above and beyond anything else. In that case, the best gods to approach are Asklepios, Hygea, and Their family anyway; who would be accepting of “their patients”.

And the implications for health care professionals? Well, it’s about putting the gods first for this formal context, place, an time – not my worries about the patients I work with, not my own emotional conflicts (unless that’s what I’m praying for help with), not feeling dirtied by the sweat from the day’s work, but focused on the deity who I am tying to approach and honor. The separation between mundane life and spiritual life by washing my hands and time “decompressing” after a hard work day helps me focus on the gods.

The substance part of the issue is a symbolic act of leaving those distractions. Ritual hand (and sometimes face or space) washing is a powerful act in and of itself, which can help to focus one on the libation or ritual sacrifice to come.

This subject often comes up in dicussions of miasma. I won’t reinvent the wheel by covering this topic in detail. Instead, I’ll refer readers to Rhudian’s excellent article on how menstration applies to Miasma here: Miasma & Menstration.

* Miasma: Pollution and Purification in Early Greek Religion by Robert Parker. Highly recommended for further reading.

In your modern opinion, what do you think causes miasma (ritual impurity)?   When is it inappropriate to  approach the gods and is it different for each god?  Do you think mental illness is a form of miasma, or caused by it, or the product of it?  How can the physically and mentally ill ask for help from the gods without offending them?


10 comments on “Miasma and the Mentally Ill

  1. Labrys says:

    I admit, while I honor more than one Hellenic deity; my interpretation of miasma tends to a more modern (and possibly, some might say Christian-tinged) interpretation. While I have read a great deal on the classic definitions, since I am not a Reconstructionist, and I find some of the actions taken in Hellenic days were based on fear of contagion and the like—those definitions are empty for me. I live in the 21st century; I can kill germs. And I know mental illness is not contagious.

    Miasma for me, is more personal. It is more a spiritual pollution. Do I come to my labyrinth with the names of the honored dead in hand, but with a dirty SOUL? Am I walking with a murderous hatred in my heart? Am I stained with unjust anger? Am I singing and carrying a libation up, but balancing my checkbook in my head? Or have I allowed some profanation of my grounds, however unwittingly, that I need to cleanse and repair?
    It speaks of my personal fitness to offer my services to the dead.

    So far, I don’t find anger greeting me…..

    • Very good points and interesting thoughts. Although, I find that the act of physical cleansing helps me to set aside negative feelings and distracting thoughts and to focus on the ritual. It’s more symbolic than literal for me.

      I also take an antidepressant/antianxiety medication in part because I ruminate over things that make me feel anxious. It’s a problem because I can’t set these thoughts aside completely. So being stable on medication helps me approach the gods properly.

      Also, it’s difficult to know how the ancients perceived mental illness. They may not have perceived it as an illness per se (something contagious), but rather, as punishment for something done wrong (seizures were attributed as Apollon’s curse). Therefore, in that time, perhaps the thought was that one shouldn’t associate with people who’ve incurred His wrath.

  2. Tim says:

    Labrys is not as Christian-tinged as some may think. Miasma is not just caused by being physically dirty or disease, but also Vice and spiritual issues. The most talked about examples are violence, and specifically murder. Spiritual impurities can be perceived as a barrier, preventing us from receiving the favor of the Gods. A New Agey way of describing purification is as washing away negative energy. In the book you reference (probably the best book on the subject, btw) Robert Parker makes the statement that Miasma is associated with shame… shame of being unclean, and shame of committed wrong. I believe he also makes mention that an even greater crime, is not being ashamed approaching the Gods in a Miasmatic state.

    We may have evolved from the days of believing our crops will fail if we are found in disfavor, but it is obvious that negative actions and thoughts attract negativity into our lives, and the lives of those around us. Miasma (in my opinion) is simply that, the “negative energy” we attract into our lives that we then must acknowledge and work to cleanse ourselves of.

    • And what of mental illness?

      • Tim says:

        Aristotle spoke to this in his Nicomachean Ethics, that those with mental impairments who work to over come them live with Virtue. Therefore, I believe your assessment is correct. If a person is in therapy and/or taking medication, and they are are not allowing their condition to negatively affect themselves or those around them (are are really working toward that goal) then then it is not an issue.

        I do think it is an issue for the health-care provider though. I believe that dealing with the medical issues of others does weigh on people, I’ve seen it, and can be a source of Miasma requiring you to cleanse, recenter and refocus daily.

      • I loved his Nicomachean Ethics!

        Agreed on health-care workers. That’s why I suggested performing ritual cleansing to refocus before approaching the gods. But I don’t think it’s necessary to wait a day before attending or performing formal group rituals.

        Aside: of course, obsessing over miasma (as one with OCD might) could itself be a source of miasma because it is in excess and leading towards vice. Everything in moderation.

      • Tim says:

        That is very true. Over-thinking Miasma can be Miasmatic in the form of anxiety. Being overly religious was interpreted as being superstitious, therefore negative and (I believe) can be considered a source for spiritual pollution as well. It is just a whole lot of common sense really.

  3. mamiel says:

    Thanks for this thoughtful post. I also work with people who have psychiatric disabilities- most of them also have entrenched addictions to crack and heroin and some also do sex work. Nearly everyone I come in contact with has a history of trauma.

    It never even occured to me that this would be causing miasma to my person, though for sure it has impacted my mood and thought process.

    I agree that rituals of washing and “cleaning the space” can help bring the focus to a more elevated place and leave the profane behind. I have shared with you before that I feel in particular that if I am not focused when honoring Hestia I will literally get “burned”.

    As far as my clients go, I have no idea why they are so afflicted, but they are very cosmological in orientation. Is some part of madness :divine madeness”? Who knows. The sad part is the disfunctionality and the low self esteemt that results. I would like to think that such people would do better in a tribal shamanistic culture, but I could be completely wrong about that.

    I don’t blame clients who refuse psych meds or push it on them, though I can become exasperated with them at times. Psych meds aren’t for everyone. Some people rightly feel that psych meds extinguish their divine or creative spark.

    I, too, have taken SSRIs for anxiety and found it to be a useful experience. I learned a lot about myself from that experience and wouldn’t be surprised if I take them again when I go through a rough patch.

    • Very thoughtful words.

      I agree with not pushing medications… except if the individual has become violent. Then it’s a matter of protecting them from themselves and others, until they are stable. This is my general opinion. On religious ritual in particular…

      …my thoughts in the article concern those who are mentally ill and want to participate in Hellenic public rituals. In that context, the ritual may be ineffective if the person who is ill is distracted from the ritual. Hesiod has very specific things to say about attentiveness and decorum at ritual, and I think this falls under the same category.

  4. […] taught in my tradition is the the real problem with miasma is distraction, not being able to focus on and give the gods their due.  Depression can make concentration […]


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