Mythical and supernatural creatures in psychiatric symptomatology: Thokolosi in Southern Africa

ABSTRACT Although there are some universal themes in the nature of psychotic psychopathology, like delusions and hallucinations, the content of the symptoms is often shaped by cultural beliefs and personal experiences and thus may differ from place to place. The mental health practitioner needs to be aware of the prevalent cultural myths and beliefs in their geographical area of practice. The increased globalization and migration of individuals makes it important for mental health practitioners to be aware of other culturally influenced symptomatology from areas far flung from their geographical area of practice, hence the need to report such in the psychiatric literature. This paper presents and discusses four cases of patients seen in psychiatric practice in Botswana, Southern Africa, who presented with delusions and/or hallucinations involving a Thokolosi. Thokolosi is a mythical creature in the local people’s folklore, which is alleged, amongst other attributes, to have the ability to harm one’s enemies, bring wealth to its owner and sexually molest both men and women. The paper argues for the need to explore a patient’s explanatory model of their illness and recognize the role of alternative methods of treatment.