What will you do with our stories?

Last week I began my weekly counseling at the prison, by meeting with all the women inmates there. I was told their number is around 59-60, though I do not think that many came to meet me, in the open lawns, where we all met.

It was an unusual scenario for me – to sit and share with the ladies what my ‘job’ or presence in their midst meant. Most could not make sense of the word -counseling. For a moment I thought whether it was all a needless effort. There are a few non profits working among prison inmates, mine may be the third or fourth. I do not have a correct estimate of numbers yet. One of them is running a training program in several vocations- such as beauty culture, tailoring, adult education and even a creche for little children. On the whole the population is not very motivated, at least on a cursory glance.

As I sat there mid a whole lot of women from Haryana (the first time I was seeing so many together myself) I was just wondering in what language and expression to share the purpose of my work. Then I just began talking as we all sat in a gathering of nearly 35-40 women. I explained to them that I was here to share their lives with them and to help them cope better with the challenge of living life in a jail. I cannot imagine a bitter tragedy than imprisonment, and the seemingly futile effort of counseling those there.

Yet, not one to give up easily and wanting to make sense of life everywhere I feel I have to offer courage, the way I was offered courage by life and people in the years of my own suffering and solitude. I always believe that humans can be united in the idea of our shared or otherwise suffering- I have taken this from the Dalai Lama- the mindfulness that we all suffer, and that is the root of our common heritage as living beings.

To see so many people with hearts full of suffering, writ large on their faces is an experience of becoming humble, because you do not approach them with any solutions, nor wisdom, outcomes or legal advice- which they actually need. You just go empty handed, with a heart full of stories and ears willing to hear more. Your humility comes from the knowledge that possibly a whole lot of these in the jail are actually just innocent victims.

I spoke for awhile and then invited the women to say something if they would like to. Most did not, but some said they were trying to understand why I was there and what was the offer from me. Then one, who I find particularly bright and quite clear in her mind, asked me, “Madam I have understood why you will be here. You will hear our stories and may be note them somewhere. But will you keep our stories with yourself or will you do something more?

I thought may be I would do something later in research or write about the conditions of jails or how difficult it could be to live a life in jails for years altogether. But right now the agenda is only to work together with the women and understand what is happening in their lives. The truth is that nothing is happening- their lives are all frozen for now, and they live removed from the world in an artificial world of the prison, where nobody comes to meet them (barring stray family members when they can make the journey) and they live lives in their mind, missing loved ones, missing lives left outside the jail, lamenting the loss of what life leaches from them everyday.

What will you do with our stories, she asked me insistently. Not once, but many a times. Will you write them down and share them with the world or publish them in a newspaper? Will you write about us cropped-2014-006-2.jpgand tell the world about our lives here? Will you? Will you not?

I kept quiet for that moment and told her I appreciated her question and may be I would have to think about it. I came away and the question kept floating in front and her fierce, bright, challenging face questioning…till I arrived at a response. This is the response of me the human, the counselor that I find emerging from the recesses of my soul.

I will listen to your stories like a friend, not a judge and possibly witness their transformation, wherever possible help while you go over the difficult passages. I come in support and acknowledgement of your suffering. I am not a lawyer, nor court, nor judge- I am just a human who understands human suffering, and I am here because we all suffer. That is all. I hope to share this with her when I meet her again.

Juveniles, justice and anguish: roots of mental suffering

As October ends, two new beginnings have been made- both among populations of people in ‘prisons’. I am saying that though technically juveniles are not seen as criminals and neither is the facility where they are housed called a prison. It is called an ‘observation home’. My reading of it tells me it is nothing short of a prison

As part of laying the foundations down for the non-profit, Hansadhwani we are currently activating its mental health arm (Antardhwanee) in multiple domains- one of them of course is the counseling work done in private. But the other two ventures, viz counseling of juveniles and counseling of prison inmates is more in the public domain. In other words, we are moving forward on a social turf now.

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Both facilities are government operated and in both, sadly enough I found the same problem- a large number of innocent people, forced inside in a system which defies logic and perhaps where the head fits the noose, the head is pulled in, irrespective of whose it is!

The boys’ home

In the home for the boys, I have till now interacted with two individuals in a longer talk and with a group of nearly 20, together. Barring the first two, who I met on a separate day, I met the group and spent nearly two hours with them this past Monday (24th October 2016). All of them had a charge of attempted rape, Section 376 of the Indian Penal Code. Before I met them I thought I was going to see a big group of sex starved teenagers, who had been cruel and sadistic, committing crimes against known or unknown girls and women. But life is such a learning.

I heard the stories of all of them individually, after a long interactive discussion with them, in full view of the authorities of the ‘home’. Of course nobody talked to me within earshot of another, and yet i found in all just children who wanted to be heard and given justice. There was NOT A SINGLE RAPIST over there- that became clear. I do not think they could have made up the stories. Whether or not they had wronged another, they had been wronged by a system which empowers society and families to charge anyone with a crime of rape, and then the burden of proof lies with the accused. He has to prove he is innocent. What can he prove? He does not know anything!

Most boys were school going youngsters. One (17 years) had eloped with a girl his age and lived with her for a month and upon returning home the girl had been forcibly married to someone and he condemned to the jail. There were a couple of other cases like that. But they were love tangles with few, but extortion rackets with most.In a majority of cases the accusers (girls or their families) were demanding money from the boys and their families to drop the rape charges. Money to the tune of a couple of lakhs in the least.

I kept thinking in what manner I could do anything for them, for these were not boys who were in a correctional facility for they needed correction. They are just caught on the wrong side of the law and someone has framed them. They cannot get bails, because their families are often too poor, and lawyers egg the women/accusers to extract the money, to teach them a lesson! In a few cases the girls wanted to marry the boys, by framing them first! Often

My only concern was that the system should not make them into more hardened criminals and that is the hope I go in, that by talking to them as human beings and respecting the truth of their stories, I will at least acknowledge their reality at my level. I cannot see how a person in their situation would not be mentally disturbed, and yet I can see their dreams, hopes and prayers- that someday they would be bailed out and go home free, and never look back at the prison again. I also felt very deeply that instead of psychological or emotional support, at this juncture they needed legal aid, and people who would stand up for them.

Though that does not mean that we would stop going there, but one hopes that considering these are not children facing the easiest of life’s challenges (trial for a crime not committed), the system would not end making permanent and hardened criminals out of them. Perhaps keeping their sanity and humanity alive in the abysmal conditions of their life (which are truly dehumanizing) we would jointly keep burning the flame of inspiration which all humans carry and need to remember during adversities.

The innocent are caught and the guilty go scot free- this is the reality of modern civilization where it is money, connections and lies all the way. I am sure nobody forgets that in India, especially with the likes of…

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Vijay Mallaya still in our midst and whose steam never cools, and the law or police too feeble to get his hand/head in the noose, where it deserves to be!

Caregiver’s stress or psychiatric emergency

On Saturday, the past week, a woman in her early forties, came with her mother and child to see me. The person who needed a counseling intervention was her mother, who came in with a deeply disturbed state of mind. I felt her inner fabric had been suddenly jolted due to a shock and catapulted her into a state from which she could not recover, with her own means.

According to the description of the daughter initially, and later corroborated by the mother herself, possibly two significant events in her life had lead to that. In the distant past, she had lost her spouse, in 2009, which possibly triggered off a grief which could not be duly addressed, or if it was it was not assimilated properly. However, the lady lived a fairly active life despite that, with one of her other daughters, in Bombay. In the recent past, the daughter who accompanied her to meet me, moved from Bombay to Goa, with her family, in response to her husband’s need for better work prospects. That set off another degree of anxiety in her heart, which remained unarticulated.

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All of a sudden the daughter became unwell (she had a bipolar diagnosis) due to adjustment stress in a new situation, whilst otherwise she had been quite stable for long years and off medication of any sort. The news of her daughter falling sick made the mother panic, and her anxiety took a turn for the worse- pushing her off the brink and rattling her fragile balance significantly.

When she came to meet me, for her daughter thought the next intervention required would be counseling/therapy, her discomfort and constant talk made me immediately decide that this was not someone who needed counseling support but immediate relief from her ‘symptoms’. The talk was ceaseless, she was frantic, tearful, anxious, repetitive, and kept saying that she would not take any medicine. The daughter was trying her level best to seek out any intervention that would work for her. I decided within five- seven minutes of listening to her that she would not have any effect of counseling, and requested her to take homeopathy, which she had been taking earlier as well.  But it had not been effective of late. I even referred my own doctor to them, lest their doctor have a limited repertoire, which is mostly the case with homeopathy. Before coming to meet me they had tried other ‘treatment’ options of reflexology, possibly reiki and other things.

I called up my doctor and also made her talk to him, and requested him to intervene, give a prescription which would be followed here in Goa. This is not something that we do frequently- because every doctor needs to meet their patients face-to-face. Doctor sa’ab was kind enough to relent, seeing the lady hysterical, and reporting lack of interest in anything in life, suicidal ideas, and several other indicators.

However , the catch in the whole picture was that she kept saying, that, if my daughter (indicating to the woman with her) comes back to Bombay I will be fine. This was a peculiar situation, because her deepest attachment seems to be with her daughter who is already married with a child of her own. The mother is so deeply attached to her, that it is almost like a parasitic attachment.

They stayed with me for over an hour, but since I had decided earlier, I did not put a bill on the exercise. What is the point of taking money when the recipient is not ready for what you have to offer- I cannot be a mercenary like a ‘professional’ if I remain untouched by human suffering, and focus just on the money that my practice can bring me. The more I thought about it, the more ethical I thought my decision was. Of course I could have told them to leave quickly, but considering they had come a long way, I just let them stay and talk about how to go about it and of course explaining to the daughter the medicines the doctor  had prescribed, since it was me who had spoken to him not her.

The Next Action

Today is Monday, and according to me today the whole routine would have fallen in place. However the daughter called me up today before noon and said her mother was refusing to take the medicines and had gone back to her earlier prescription of homeopathy. She reported a further hardening in the head and was unstoppable. I felt anguished to hear that. I had seen the mother to be a headstrong lady and I could see she was making it difficult for everyone around her to deal with the situation and only making it worse, in every possible way.

That brought to mind the last resort of psychiatry. I thought there was no option but to sedate her to calm her down. It is a very sad thing when I myself have to recommend psychiatric medication to anyone, because I try the best that nobody should be pushed into it. But if there is no alternative left and the person is adamant, what else can the family do? Her behavior must be causing a great deal of stress to her daughter also, poor girl, who was bravely facing it, both in front of her husband and in front of her mother- keeping a calm exterior.

I thought for the time being the best option was to anyhow medicate the lady and help her calm down. Over time when things stabilize and she has had some sleep due to sedation, possibly she would look for other ways to deal with her stresses and the triggers. For now her franticness would only make others spiral into the same. Her daughter said she was herself thinking of the same, as nothing else seemed to be working for now. In other words, the difficulty a family faces, pushes a person into forcible psychiatric intervention. The only trick is that at a suitable time the person has to be weaned away from psychiatric medication, because psychiatrists themselves will never prescribe it!

On that note we parted over the phone- me with a resignation that only when people are willing to get well and be compliant to recommendation of any sort, does an intervention work. Some people make difficult patients- they resist everything, for they know the better of it. I cannot but feel sorry when people have to be administered psychiatric medication, but I always hope that it would be a short term measure. Of course if the patient is complying, like me myself, homeopathy can work very well.

I do not see any recourse except for a devious manner of giving the medication or per force- which actually amounts to a human rights abuse. So that brings in the ethical dimension, as well as the dilemma- what could have been done alternatively? What can be done now? I am not sure today and I leave this post with this query.

Everyone will have a different response to this situation, but how does one decide. I do not know if they will come back to me, because they need not. But I will be around to support them in future, if they choose to. The mother certainly needs counseling to help her deal with the sense of loss that she is suffering from, and to help her focus on what is present in her life, rather than clinging on to adult children, who need to fly away from the nest, towards greener pastures.

I also hope that the daughter would not be unduly troubled by her mother’s suffering, as it creates a scope for her own suffering to surface once again.

On the last note, I am also wondering whether the mother’s suffering is not another face of the caregiver’s burden of looking after a child with bipolar and being tuned to her needs in an obsessive, fussing manner. But there is no way to find out about that, because I had no time to talk to them about their life together. Only this much could be ascertained within the scope that we had, once I felt it would not be proper to dig further into her psychic matrix. Whether this is an ’empty nest’ syndrome, a psychiatric emergency or another form of caregiver’s hyper-reaction to her daughter’s situation, piercing through her own frame, it is difficult to ascertain at this stage.

The power play in university departments

I ought to have written this blog post longer ago, but spinal pain did not permit me to sit at the computer, to last as long as a blog post (naturally the priority is always the emails first of all)

I want to share my dismay at the sheer play of power that I got wind of from a recent dialogue with a graduate student pursuing a masters’ course in psychology in a prominent university in India. As part of the course they are also being offered a six-monthly exposure to counseling (I pray to god, they don’t become counselors after that- it would be a great disaster). As part of that course, they are also invited to undergo their own analysis for the briefest possible span of time. I asked the student how much the time was and who was doing the ‘analysis’.

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I was told that one of their professors, (who is known to me as an academic and not a therapist) listens to their dreams and interprets them. So what follows is the memory of my dialogue with the young scholar, that left me troubled and anguished for many days afterwards, but I will share the reasons of that after the dialogue that I quote. I represent me as M and the student as S.

M: So your teacher went through a dream analysis session with you? And what was the outcome of that?

S: The outcome was nothing specific, he gave me an explanation based on symbols, which he said were universal symbols, and which were part of his repertoire.

M: By talking to him, did some clarity emerge in the picture or put is differently, did you benefit from his dream analysis?

S: Yes mam, I gained some clarity in some respects about the dream?

M: What does that mean? Did it leave some unexplained things as well?

S: Actually it opened up some unexpected parts, which were left unattended to.

M: Really?! But there was no further dialogue with the teacher on them?

I was angered, because an academic who is not an analyst is not supposed to interpret dreams out of context for a student. Just because they have the power to demand from students a certain accountability does not mean they can pry open the lives of their students.

Unfortunately, Indian students are very vulnerable and docile by temperament, more so women. They would never think of raising their voice against this sort of an intrusion, which has no accountability. How can a university professor demand that his students tell him their dreams in a sporadic manner and then leave the dreams with whatever interpretation he knows best? There is nothing universal in dreams, except for the imagery. A dream has to make sense and have relevance for the person who sees the dream.

I remember in years of my own analysis with my therapist, we barely discussed dreams on more than two three occasions. It was never the centrality of our dialogues- if I had a dream that I wanted to talk about we did. There was never a nudge from her to share dreams. But whenever I did, the explanations that emerged were very deep and meaningful. I always felt it had been worthwhile to talk it out with her.

But look at this blatant misuse of a teacher’s power in the classroom. Of course he did not publicly hear the student out, but nevertheless when he was not an analyst, did not know what all it takes to unearth the symbolism inherent in a dream, by simply interpreting it in some universal way, he just showed for once again the patriarchal nature of our education system…where the souls of students can be cut open without due regard to their humanity and suffering, without a qualm or a guilt as to what pandora’s box you are opening up for them. SHAME ON HIGHER EDUCATION in India. Will we ever become sensitive towards our fellow human beings?

Why family support is NOT WORKING in mental health

This article can be downloaded from here, and is one of the resources offered by Antardhwanee. In this location, this article is titled, Families and Recovery.

In societies where social resources in health are limited, families play a crucial role in the illness and recovery of people. In mental health the case is even more so. For long periods, it is the family alone that bears the brunt of people’s illness and disabilities. Sometimes this may amount of a lifetime, and then the parents/siblings, who are the primary caregivers end up with the massive concern of who will look after their loved one[1], after their own demise.

Here is a brief list of findings, that research leads me to conclude, in the context of roles that families are playing, which ensure that people remain mentally ill, rather than recover and reintegrate back into society. This list is not exhaustive and as study is an ongoing process more thoughts will get added to this. Here are the beginning ideas.

Learning to be helpless together

Sometimes when one person is given a mental illness diagnosis, the whole family is paralyzed by a fear that mental illness has crept into their gene pool. They feel  extreme pressure due to the diagnosis and the social stigma associated with it. They all feel helpless about it and the infirmity or sense of loss that accompanies mental illness diagnosis of one person, in fact impacts everyone deeply. Secretly, they all start analyzing their own behaviours to see whether some traits of it are also lying within them!

In such a case if another member of the family faces anything of a similar nature, they are very quick to take action and take them for a ‘check up’ as well.

Protecting the loved one interminably

I have seen personally families being so defensive about their loved ones, that they keep protecting them from the world around. At times it amounts to the extreme case of hiding them from view, or not letting their loved one engage in any social milieu by themselves or without supervision. It aids in chocking both the people or set of people very severely, as no new ideas can come into the ecosystem, which does not interact with the outside world in any significant ways.

I have even seen another extreme, which surfaces in scenarios of marriage. I am not sure if this happens in India, but I have seen it here only. I have seen multiple families ‘hiding’ the mental illness diagnosis from the partners of their loved ones. As a result people are not able to remain truthful in relationships, and the trust that could be there between married partners never develops fully, because one partner knows they are not honest. This protectionism of the parents does not allow the partners to be one another’s greatest support systems, which marriage was traditionally meant to be.

Hero worshipping

Paradoxical as it may sound, I have found in many families that parents or siblings talk about their loved one, with a great fondness and regard, often attributing their mental illness to a ‘high IQ’, superior intelligence, artistic abilities or anything else like that. Though there are studies that have proved that mental illness is more positively linked to artistic creativity, the reverse is not true. Artistic creativity does not appear out of the blue, just because you are mentally ill and therefore your intelligence is also more than the average person.

By making their loved believe they are ‘smarter than the average’, families bestow them with a sense of entitlement, which means, just because they are more intelligent, they have a right to have moodiness, depressions, or any other attribute. This even inflates their ego and self belief that whatever they do or not do is well deserved, because now they are ‘mentally ill’.

I have seen in many cases that these loved ones, even when they come into counseling are so cocksure of themselves that they do not believe they will gain anything from counseling. They don’t. Their own intelligence is such a barrier, which their parents have created around them, that they are unable to use that intelligence for their own betterment by seeking help from anyone outside the circle.

Families ensure compliance to Medication

Since families have a great amount of faith in modern medicine they do not believe that psychiatry does not have a cure for mental illness. In fact, I would go to the extreme of saying that in families where parents or siblings are doctors or scientists, the possibility of anyone recovering from any serious mental illness is quite remote. Due to their unquestioning faith in modern medicine they keep medicating their loved ones, without ever probing into whether medicines are really bringing any tangible outcome.

Families may become human rights violators

Nobody ought to be coerced or forced into psychiatric treatment, especially electroconvulsive therapy (ECT). Families often believe doctors so blindly and rather innocently, that whatever the medical professional recommends is to be taken as a rule. ECT  is a very controversial procedure which has long term repercussions for a person. There is no need to administer ECT to anyone, but doctors do not educate families enough, who are anyways only too willing to follow what psychiatrists say.

Often people are given psychiatric medication against their will and in spite of having no need for it, even on the sly (by mixing in food for instance). Those with mental illnesses are not allowed to choose their treatments, because their families believe they cannot decide for themselves. As a result they keep medicating them and pushing them towards the edge, for the rest of their lives, till they reach their end! Sadly, the human rights violations in mental health are the most in any category of health, and the most part of it comes from families.

Fractured Communications

In  a whole lot of families people do not talk to one another- either properly or at all. As a result whatever support could come to all of them due to interpersonal communication, does not come about. Everyone lives in an emotionally marooned state, spiritually shrunk, cold, deeply fatigued, restless and wounded.

Even if one of them finds a solution to a problem, since their inherent communications are flawed, they are not able to convey that to others. In my own work I have seen many a family member, including people with a diagnosis, have been enthused to either meet me, encounter my work or hear about the sort of work we do. However, they have not been able to convince other members in their families due to a long term loss of trust, in one another and in the fact that any other ways could appear, leading them out of mental illnesses.

Not only in my case, but often due to lack of communications, people do not seek any other social mechanism to deal with mental illness, apart from free resources that the internet offers them.

[1] Throughout this writing I have used the phrase ‘loved one’ to refer to those who have been given a mental illness diagnosis, rather than calling them someone with a mental illness.

Therapy is not common sense- trust me

If everything could be achieved by common sense communication, then people would easily learn a few skills and resolve all their problems. But that rarely happens.  A vast array of problems start from communications, but to solve those problems we cannot often fall back on our own communication skills or abilities only.

People, particularly in India, often have a mistaken notion that someone who is therapist/counselor is talking from common sense and giving advice based on their intelligence. Yes, I agree, it seems like that, but reality is that is never the case. Let me start by saying that whoever has whatever level of intelligence, they have reached there in a complex distillation of ideas, study, immersion and of course years of work in the field.

I am giving this prelude to a recent encounter with a family that I want to talk about. It was the brother who approached me through a social network, upon seeing my work in mental health in some way. He asked me a few things and over time that set the ball rolling. His concern was for his older sister, a woman in her early thirties, who had been given a diagnosis of schizophrenia. In due course when I traveled to Delhi, they came nearly 300 kms to meet me, all the way from UP.

The woman, let us call her Sarita, came energetically and seemed charged with ideas, and full of enthusiasm and verve. I could see she was excited, and ‘high’ in some way. I would not want to see this ‘high’ as a psychotic high but there was a case of being sure of one’s self, and a bit of grandiosity- what would be seen as the classical ‘symptoms’ of a disturbance in the psychological wellbeing of a person. However, I never want to look at people through the lens of pathology or illness and therefore despite seeing the ‘symptoms’, which were truly subtle, I noticed her emotional fragility, anger and inner disturbance. After all I am not a peer for nothing, if I cannot discern how subtle the emotional fabric is.

At the end of the dialogue, which lasted a good two hours, I figured that the young lady had come to take a clean chit from me, that she did not have a mental illness and therefore did not require medication. Of course, I do not believe that anyone requires medication. But to move away from that stage where you do not have to take medication, you have to be cognizant  enough to move into the behavioural domain. I mean to say, that certain behaviours of those who are classified ‘mentally ill’ is ‘not normal’ by the standards of those around them. That is why they are taken to a professional- psychiatrist, therapist or counselor, or any other doctor.

Each one of these professionals acts in accordance with their  training. A psychiatrist believes that the ‘symptoms’ are due to a chemical imbalance and if the proper chemical is given, the person will become ‘normal’ or ‘fine’. Psychologists come with various kinds of training but they are mostly informed by the same set of principles as psychiatrists, especially those who go through clinical psychology courses.

I have a diploma in counseling. But more significantly also a lived- illness/recovery experience, to fall back on.  I fall back on my lived experience based knowledge pretty regularly to understand the suffering of others. People, like me, often work in the domain of social psychology and self experience puts my knowledge at an altogether different level. I am not arrogant about it, but trying to capture the difference. Just imagine a dentist who has never known a toothache. How can they understand the pain of a patient? Contrast that with a dentist who has had dental caries, been through root canal treatment, got a tooth extracted in teenage and has two cavities. How much more the latter would know about the suffering of their patient?

The Story I was referring to…

Coming back to Sarita’s story. After one set of dialogues the duo went back. There was a lot of friction with the father and that seemed to be a dominant motif that emerged. The younger brother played the balancing role in the family. Sarita was happy that I was willing to look at her beyond the psychiatric label of schizophrenia. After that assurance, she was sure that she did not need any medication, which in any case, she had been flushing down the commode.

A few days later, she befriended me on the social network, and I noticed a sudden spike in her activity. In a way Facebook serves me very well, especially for watching what is going on in the lives of those I counsel or generally engage with, because it warns me if something is going wrong. (I recently also caught another friend getting into the spiral of PTSD, and warned her, told her to go to sleep calmly for a few days. It seems she tided over that. She her admitted to all the ‘symptoms’ that I had seen, which made me raise the question with her in the first place). I found her trailing me on every forum and posting her own posts there, by joining a whole lot of fora where I was involved. I found this a very unusual behaviour and I asked her brother, if everything was ok.

He informed me that things were not good and Sarita was too excited about a certain new thing in her life. She was going on talking about it to everyone, in a manner which raised suspicion about her. I told him, to tell her to talk to me, if she would like to. She did, through a facebook or WhatsApp message! In what way can a professional help a client via a message?

Few days later, on the occasion of the World Mental Health Day, I sent a message to her brother again, hoping all was well. It wasn’t. Sarita was clearly ‘high’ by now and aggressive, offensive and charging her family, particularly father, with all sorts of things. All my exchange happened with the younger brother alone, via messages only. When it seemed she would not be interested in counseling, I told him to seek recourse to psychiatry, which I inevitably know, would forcefully drug her, sedate her and possibly give her ECT. I shudder to think of that!

The brother understood what the way out was, since the sister was unwilling to talk to me, or seek any insights into her life, or have any other way, but her own. She left a job that I had encouraged her brother to help her hold on to, because she wanted to float her own entrepreneurial venture. I told him how to win her over take up the government job, as she was adamant, that it was beneath her dignity to do so.

Upon my recommendation, the brother took her to the psychiatrist and sure enough, the forcible drugging, the sedation and the ECTs followed suit. Families will never know how they become the chief arm of psychiatric coercion and the biggest reason why people become permanently disable due to mental health conditions, that they can easily recover from. What could I have done in this case, even if the brother trusted me completely to guide them? If the person who needs to talk to me, and understand the situation does not understand it herself, what recourse can the family take?

My advice to any family would come from two options. One is the biomedical way, which is often forcible and therapy/counseling. The latter is difficult, and requires patience. No matter what medication they take, if you do not want to incapacitate your loved one for the rest of their life, they will have to seek therapeutic guidance and support, to deal with their situation/s. If you forcibly medicate them or give them ECT (which should be made illegal immediately), you are actually infringing on their human rights. Yes, you got it right- it is a human rights violation, which you are committing within your own home, with your own loved one. Sorry to say that, if it hurts your sense of justice, but I cannot fool you or me about this.

How could therapeutic work have proceeded after the first meeting with Sarita?

Ideally the first meeting is where anyone assesses a situation. You hear the two points of view or sometimes even one person, if they have come alone. First meeting or even a few meetings should be the ground that people have to understand one another. Entering into therapy is entering into a relationship and both people need to know another. Would you not like to know who your therapist is after all?

In family counseling it is always better to listen to everyone and talk to everyone concerned, because ultimately everyone in the family is impacted by one person’s condition, whatever it is. Narrative therapy goes even a step further to include even the next level of people, and open dialogues mean involving even the kinsmen!

In the subsequent meetings, one sets an agenda for action and a modus operandi. No therapy work cannot get over in one, two or three meetings. Often it takes many a meeting with clients, for someone to truly understand where the roots of suffering lie in their life.

In Sarita’s case, this could have happened-

  1. Sarita could stay in touch with me and talk to me, not more than once in two-three weeks. That would really help us understand what is going on in her life, which causes her frustrations and anguish, and which periodically boils up as temper tantrums and then accusations against her parents.
  2. The way to deal with any behavioural issue is to address the behaviour directly. I increasingly prefer to bring families into dialogues early, so that whatever we are talking with one person, could be known to others who would help in accomplishing the goals of that one person. Often family communications are deeply fractious due to forcible handling of psychiatric crises. Families need help with talking to one another gently, without causing further rifts.
  3. Ultimately, it is Sarita’s journey towards her individuation and she needs to understand that whatever expressions she has to express her anger, frustration and moods is not working with others around. She would have to develop a more reasonable and non-threatening communication which does not make her family and herself a social nuisance and laughing stock. Part of the anguish of her brother stems from this responsibility towards his parents and neighbours.
  4. Any journey towards finding one’s balance takes time. Most will not even attempt it in their lifetime. Only the ones who are deeply fractured seem the most appropriate ones to require a therapeutic dialogue. In reality everyone needs help, support and guidance.
  5. Equally as much as Sarita, her family needs the support, help and collaboration. That is why family therapy is the need of the hour, not individual therapy.
  6. Assuming that a client like Sarita would speak with me once a month, it will easily take her between two -three years to understand her issues in a more clear way. Though it may seem a lot, but what is two/three years compared to a life of psychiatric medication and who knows how much disability due to them? I must add here, that every meeting between a therapist and their client, has long term effects. So though once a month may seem very small a time, in reality it has a long lasting effect, almost like a butterfly effect, which touches many chords in their lives.
  7. In family therapy literature, it is said that within 20 sessions, most outcomes of a long term nature, would emerge. I agree with this. (In due course if we can create reflecting teams, that would be even more empowering and faster). 20 sessions can happen over a couple of years…is that not truly remarkable? I am not sure India is ready for it yet! Sad, but this is what I am seeing from multiple families.

What follows are some general ideas about therapy-

  1. Till those who are given mental illness diagnosis do not feel the need to seek help to change their outcomes, no change can happen with a dialogue between any member of their family and a counselor, like me. I have seen many a person in a family wanting to bring their loved ones for counseling, but find that they do not have enough trust between one another, to accomplish that!  It is truly sad for them.
  2. Therapy is not a day long affair. It is a reflection on our lives and how we have come a long way, with our behaviours. Therapy does not mean I am a therapist and you are a patient. Therapy is your attempt to heal yourself through dialogue and understanding that emerges from it, by learning to look at your life in a more balanced, philosophical and calmer way.
  3. Therapy means someone is helping you change your behaviour and assisting you become what you always wanted to- by holding your hand, while you gain that wisdom. It is not about guiding you at all. It is about letting you become the expert in your own life. But until you want to change your behaviour, nothing about your life can ever change.

antardhwanee- one at a time, towards better mental health

It is a great challenge to work towards mental health of others and deal with the challenges of your daily life, which do not diminish just because you have recovered from mental illness. Life does not give you a respite- it gives you more and more…suffering, challenges and obstacles, with courage if you can muster it,  just because you have dealt with something serious in the past. I think most of the time I derive courage in my situations remembering how bad it was when I was totally depressed. Today when I encounter others in that state, I know from so much experience that they can also recover. The hope of recovery is what my counseling is all about, as of course the knowledge gained from decades of study and research.

It all began with research, because while researching in mental health, I realized a whole lot of things,which were not of a psychological nature at all, but of a social one, impacting mental health. By understanding my recovery more and more, I started gaining insights into how more become ill and can become well. That is the USP I have in counseling.

 Life begins on wasteland

Anyhow, this blog post is to share the work that I had started long back, but is now in the domain of the public, to offer my services in counseling. I am relieved and hopeful that more will recover, also with some of the insights that would emerge in the counseling process.

Here is the website– and I am happy that I have at last gained the clarity to bring all my mental health ideas, concerns, and research into one pool. Onward from here. This is the page we maintain on facebook about the same.