Philippines

PHILIPPINES

The U.S. dominance of the university educational system in the Philippines in the early decades of the twentieth century meant that Filipino doctors looked to that country for its medical models. Several physicians studied in the United States and imbibed psychoanalytic theory from the American tradition.

One of the first was Virgilio Santiago, who completed his medical training at the University of Santo Tomas in the Philippines in 1949. This medical training led him to psychoanalytic training under Robert Waelder, a student of Freud's. He then went on to study at the Menninger Clinic in Topeka, Kansas. This was an unusual route to follow, since most psychiatrists were trained in the dominant organic school of psychiatry. In the 1950s psychoanalysis was strictly forbidden by the conservative Catholic clergy. Santiago was also discouraged by his colleagues from pursuing the field. Nonetheless, in a private practice he found a clientele among the expatriate population, and a small minority of Filipinos suffering from psychosis also consulted him. Santiago's general criticisms of the poor quality of Filipino health care suggest that the average Filipino was unsuited to psychoanalysis (Santiago, 1966).

Two other early pioneers were Baltazar Reyes and Rudolfo Varias. Reyes graduated from the University of the Philippines and then did postgraduate training at the Langley Porter Institute in California before returning to the Philippines to teach and research. Varias trained in classic psychoanalysis in New York. He returned to teach at the institute of public hygiene (now the College of Public Health). In the 1970s he returned to New York. His departure meant no further development of psychoanalytic psychotherapy at that time.

Not until the end of the 1960s, with the appearance of Lourdes Lapuz's A Study of Psychopathology (1969), was orthodox psychoanalytic theory again taken seriously. This groundbreaking book influenced a whole generation of psychiatrists, psychologists, and counselors, who remodeled the original psychoanalytic theory in which they had been instructed to suit the Filipino cultural mold. As in other Asian cultures, people's social and cultural expectations led them to view the doctor as an authority figure, and this required a more interactive role of the analyst. This book was followed by Children of Oedipus (Lapuz, 1973), which deals more fully with these issues. In her succeeding works she dealt with marital counseling and couple and family therapy (Lapuz, 1979).

In spite of these developments, however, the modern mental-health system remains poorly understood in the Philippines because of the low level of medical awareness of the population and the prevalence of alternatives to modern medicine, be they indigenous forms of herbal healing or even cult healing practices. These factors, coupled with a poor health-insurance system and a social need for gainful employment, have reduced the need for formal institutes of psychoanalysis and explain why the Philippines at the moment has no training analysts practicing psychoanalysis. Freud's work has not made a big impact in this predominately Catholic culture, where even today, teaching human sexuality from the point of view of psychology has not gained much ground in the academic world. Sex education consists largely of lectures on population control.

Geoffrey H. Blowers

Bibliography

Estrada-Cristanto, T. (1997). Interview with Virgilio Santiago. November. Manila, Philippines. Unpublished.Lapuz, Lourdes. (1969). A study of psychopathology. Quezon City, Philippines: New Day Publications.

Lapuz, Lourdes. (1973). Children of Oedipus. Quezon City, Philippines: New Day Publications.

——. (1979). Marriage counselling. Quezon City, Philippines: New Day Publications.

Santiago, Virgilio. (1966). Psychopathology of Sisa. Acta Medica Philippina, 2 (3), 140-145.