Ukuthwasa

Ukuthwasa is a Southern African culture-bound syndrome associated with the calling and initiation process to become a sangoma, a type of traditional healer. The journey, also called intwaso, is a spiritual process of rituals, teachings and preparations that begins with a calling, idlozi, from ancestors, often received through dreams or altered states of consciousness; initiates, known as ithwasane or ithwasa, undergo formal training under a mentor, gobela, lasting months to years, and the process is believed to entail physical, psychological and spiritual manifestations that cleanse and prepare the initiate for transformative rebirth. Scientific studies have found ukuthwasa associated with varying types of psychosis, and the process can lead to intense psychosocial and mental health experiences, with some cases of disorder or fatality; it was stigmatized under colonialism and apartheid but is increasingly respected and has been integrated into South Africa's health system under the Traditional Health Practitioners Act 35 of 2004.