Ukuthwasa

Ukuthwasa is a Southern African culture-bound syndrome associated with the calling and the initiation process to become a sangoma, a type of traditional healer. In the cultural context of traditional healers in Southern Africa, the journey of ukuthwasa (or intwaso) involves a deeply spiritual process marked by rituals, teachings, and preparations. It begins with a calling, idlozi, from ancestors, often received through dreams or altered states of consciousness. Ukuthwasa process entails physical, psychological, and spiritual manifestations, which are believed to cleanse and prepare the initiate. The term ukuthwasa meaning "come out" or "be reborn," signifies the transformative nature of the experience. Both men and women can become traditional healers through this calling.

This article is about South African Culture-bound syndrome. For South African term for bride kidnapping, see Ukuthwalwa.

Initiate, known as ithwasane or ithwasa , undergo formal training under a mentor, gobela, which can last months to years. Training covers traditional healing practices, ceremonies, herbal medicine, and divination tools. The process includes metaphysical transformation, symbolised by specific garments and ceremonies, where the old identity dies to be reborn as a healer. The process also involves humility to ancestors, purification, and the use of spiritual medicines. The graduation ceremony culminates in testing the initiate's abilities and insight.

Ukuthwasa is perceived in the community of traditional healers to hold cultural and spiritual significance, preserving traditions, and bridging the human and spirit worlds. However, the process can lead to intense psychosocial and mental health experiences, with some cases of disorders or fatalities. While ukuthwasa was historically stigmatised, it's increasingly respected and being integrated in the health system as outlined by the 2004 Traditional Health Practitioners Act. In addition, the initiation process has influenced literature, cinema, and popular culture, reflecting its importance in African societies.

Scientific studies revealed that ukuthwasa is associated with people having varying types of psychosis. The coexistence of traditional practices like ukuthwasa and modern healthcare and education can pose challenges.

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