Recovery Oriented Blog for Mental Illness

I have recently started a new blog, because I felt that I needed to strictly focus on recovery in serious mental illness, as a theme by itself and calling it any other name would not do justice to my commitment, engagement and research. I have, in the past, tried writing on this blog about mental illness related encounters I have had. However the purpose of the new blog is slightly different.

The new blog is committed to one single theme. All my mental ‘illness’ oriented work would go on that blog as it is also my desire to share with the lay intelligent reader whatever knowledge I interact with, in the course of my phd research. Since a researcher by definition tends to be looking into a vaster expanse of information, data, analysis and study than someone who is not a researcher, for reasons of social good and making research accessible, people could routinely offer small chunks of that knowledge to the wider audience. This is my attempt in that direction.cropped-website-hope-image

However research is not an easy journey to make, for it is largely solitary and a tough act of balancing one’s financial needs, professional goals, study commitments, family responsibilities, domestic routines and you name it. I cannot say I am in any enviable position except that to reduce the monotony of my work, I have started teaching classical music to a few youngsters- it is a breath of air for me. Of course I continue learning with my own guru also- another breather!

This blog post is basically to re-direct anyone who is connected to me for the above reason, to redirect their gaze in a more appropriate corner. You can well imagine that I am likely to post little on this blog, while my focus lies in recovery. However peace is close to my heart and at the heart of all my efforts. If one can help even a single person come into their own center, attain a little peace- they will gradually create their own peace and spread it further as well. I call the new blog- recovering self, because only in re-covering ground that people lose due to setbacks which are called mental illness, do we become our WHOLE SELF again- the self that we were intended by Mother Nature to be. The recovery blog is only meant to be a little offering in wholeness, a testimony to the work I am doing as well as a knowledge sharing blog- diminishing stereotypes about mental illness, challenging convention and offering alternatives.

Hope it accomplishes the intention of its birth.

Advertisements

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.

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.

Self talk, and embracing the enlarged Self

The purpose about communication about one’s own self can only be towards enlarging the scope of possibilities of human endeavour, hope and courage. So though I usually do not like to speak about myself, unless the reason be very compelling, I did accept an invitation to talk about myself for once, in a detailed manner in the Department of Psychology, at the Delhi University, on 4th Sep, 2015, at the behest of a professor, who has been a collaborator on many issues of mutual interest in the past as well.

IMG_2459
Dr. Suneet Varma, is to the extreme left in the picture here

Dr. Suneet Varma carries out the tough act of introducing the new paradigm of Indian Psychology to his graduate students and as part of that exposes many a scholar, practitioner and academic to students to drive home the point of the various threads that contribute towards the ethos of India’s myriad cultural, artistic, spiritual, aesthetic and philosophical traditions. In that context, he has exposed his students to many aspects of Indian music as well, particularly those strands that interest him deeply. My interest with him coincides on the page of Kabir. My article about Kumar Gandharva is also something that he has shared with his students in the past.

When I shared with Suneet, about my article – Making Song, Making Sanity, being purely in the context of Kabir, he was interested in having me come and talk to his students. I took up the option, even though it meant talking about myself, which I find extremely difficult, because of my shy nature. No, do not get me wrong– I am not shy the way one would think the ‘shy’ word- I am shy to talk about myself (a great irony in the times we live in). That is it! The paradox is that my own life has many a hint for many to think about in the context of illness and recovery, or in fact human capability. On the other extreme, in research I have frequently written about myself, which is a very difficult thing to do. But I cannot explain the complex thought behind that is this blog post- it would take a full research article, about my motives.IMG_2435

Illness of the spirit is not an ordinary somatic illness, because everyone’s spirit can be troubled, just like Arjun was in the midst of the Mahabharata. The troubled Arjun can remain troubled until a discerning Self in the form of Krishna does not appear. Krishna is actually the ‘Viveka’ in the human, that awakens by complex ways. I cannot go into details here. The journey of what is classified as mental illness is something that I see as the search for an authentic self- the self that cannot connect with the falsities and facades of modern living. Various people reject the world around for various ways in the which they do not sync with the possibilities inherent in the experience of daily living. To come to the point of a ‘breakdown’ is a real amplification of those incongruous situations and the rupture of the psychic fabric.

Of course it is another thing to experience, what students in Psychology would understand as PEAK EXPERIENCES, and another thing to be able to harness the waking power of the sleeping serpent- that is where madness emanates. Naturally life is too short to explain all that I have understood in journal articles and I have no use for any further academic writing. But yes, there is a need to write about the consciousness and how it originates and how it diversifies and whether it really achieves the dimension of the transpersonal or whether it is only a theoretical possibility.

IMG_2345

So I gave a talk in the department, which was received with an unprecedented appreciation, for me. I have spoken about myself in guarded ways, in the past as well- particular in conferences. The prime reason for my shyness does not stem so much from the stigma of mental illness, as much as it does from the self-centred, attention seeking attitude with which those who share  illness narratives, often end up representing themselves with.

For me, there is no self that remains to be represented, if not the past self of an immature mind, that goes through a process of maturation, by its dive into the IMG_2416underworld of its unconscious and by integrating knowledge both from the personal to the collective human history, which lies in each of us as the collective unconscious, emerges from the experience a tired, centered being- no longer dazzled  by anything at all in the world, not interested in any trappings of scholarship, spirituality or a desire to attract attention. It is just like coming home to oneself- there is no one there, but silence- and all noise is outside now. And yet we have to constantly guard against the outside noise, which is only too close and will catch one unsuspecting.

But I am happy and surprised to note, that though my narration of my past was to a group of young women and men, who were perhaps on an identical inquiry in their own ways, with the tools that they have at their age, the response I got from this lot of young people is by far quite unusual, for it brings to mind another interaction of another nature, whose context was directly mental health. That was in the Ambedkar University, and a panel discussion on the subject of mental illness- in which a number of people were invited to be part of the panel, including me. The year was 2013. However, the response I got from the students there, who would perhaps be directly dealing with the subject of mental health, was markedly lukewarm as compared to this experience of Suneet’s students.

Even in the past many students have filled their seminar room, including having more senior professors too hearing me talk, but this time the students lingered on IMG_2464much longer, after the talk got over. Not just a couple of them, but many actually. This is surprising, and made me self reflect what was the reason? Is it because they are hearing a self narrative of recovery? Is it because it gives them hope and courage to deal with whatever they are dealing with at present? Do they see a possibility out of mental illnesses for others as well? There are questions galore in my mind too, as to why the story of one person interests another.

However, the reason for this post is partially to note the experience and partially to invite the young women and men to comment about what was it really that they felt connected to, which they can openly articulate for everyone to read. So this blog post will go to all the students, with a request for their footprints here, and their thoughts, reflections and insights. That may give me the scope to look for further possibilities to connect with them, via another talk/lecture/workshop or collaborative research- the way I had initially mooted about the ‘musical self’ but which the time constraint did not permit an articulation of.

The young man who has taken these pictures, was astute enough to note that if someone can overcome something as difficult as a mental illness, then possibly overcoming the struggle of doing a master’s degree would not be so bad! Well, they do not even occur on the same page Rishi. And on the last note, knowledge which is gained from universities is just an introduction, which is no substitute for lived experience based knowledge. Perhaps you would agree as also several of your friends understand.

IMG_2355Thank you my dears, for helping me deal with the hesitation of self narration, so that though I have attained a certain level of triumph over my past self that suffered so much, I still have to move myself towards a larger self, in which I am not hindered by what others conceive of me, upon hearing about a past of mental illness. Your feedback, appreciation and generous ideas certainly give me hope and courage that the youth are not impervious, indifferent people but sensitive and looking for authentic encounters- to express their own authentic selves.

I invite your comments and the same ideas or new ones, on this blog post, to save it for all our future references. Thanks to Rishi for the efforts, as of course we all must thank your department, and Suneet in particular. Eric there is a lot of Jung in me, so perhaps the next collaboration could be with you ?!! 🙂

Ah yes, I muIMG_2366st mention how difficult it is to talk and sing at the same time, to illustrate some of the ideas that I am discussing, but I try not to fight shy of the challenge. The voice from talking, becomes tired and is then made to flip over to the singing side. I hope to master this challenge, if someone can! IN any case, I seem to be doing this quite a bit, in talking on the subject of music all over the scope of my work.

I could add here that the title of this post is a trifle misleading, because ‘self talk’ is what happens inside a person’s mind and not in the public domain. But when the inner self talk, which arises due to a disturbed state of mind is more or less over, then the talk about the ‘self’ which is not an individual but universal self is what the post title could be seen to imply. Self is not the focus, but the SELF, which is common to the whole of humanity and its awareness- that is the intent.

This post has an unusually large number of photographs because the photographer was generous enough to not only shoot many, but also send them to me. Thank you for that.