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.

Understanding our vulnerabilities toward achieving stability

I have a question for you if that’s ok. When you mean you recovered, do you mean you understood the root of your depressions and manic states, your bipolar disorder? Was there meaning, trauma in your life that led to that? And do you not suffer from that anymore? I hope these are ok questions to ask you. (E.L.)

My present blogpost is a response to this query from someone. I think it is befitting that I should answer to an earnest question in an honest manner. I am writing this post specifically so that I can share it with others and not have to make the effort again.

In response to the first question, whether I understood the roots of my depressions/mania- Yes indeed. As well as the triggers.

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This dog knows it can get attacked by its fellow dogs, and so it chooses to sit on someone’s wall and jump inside the house, if other dogs came after him. He knew he was vulnerable and kept the distance from the rest of the mongrels. Why not learn from animals?

What our triggers are – are our vulnerabilities. If one can isolate that it is a great victory and the best way to identify that would be a therapeutic dialogue with a therapist who is kind, wise and non-leading. It is not so easy to find such a person and that is the greatest challenge really.

Dear E. suffering is a part of our human destiny- but it does not have to annihilate us completely- we can live with it peacefully, we can make sense of it on a day-to- day basis and we can find better ways to make sense of things, alternative worldviews and conceptualizations.

Let me explain with an example. I currently suffer from a lot of spinal issues- which is quite painful. But I try to not let it affect me all the time in the day. yes some part of the day it certainly pins me down and when I lie down it just comes over me like a flood. I cannot even sit on the computer for any reasonable length of time that a doctoral reseracher would be expected to. And since spine is affected- so are my arms, legs and feet! I could be a ball of pain- but then I decided I cannot let it have the better of me. I cannot NOT do anything. 

SO, I am not going to compete with another phd candidate who can possibly study eight hours a day- but I will certainly try to do my two today and possibly a little more tomorrow, if tomorrow is not the same as today. This is how we build up our mental muscle- you don’t do it in a day. You do not become another person, you just learn to live with yourself a little more peacefully, more centered, greater equipoise. 

I hope you get the picture- if not please feel free to ask further.

(For those who read my blog with any regularity, pardon me I am not able to write however much I may want to thanks to the cold and my bone issues. But hopefully with summer coming soon, the months ahead would be better. Thank you for staying connected)

 

A good 24 years later

It was in November 1992 that I got a diagnosis of bipolar in disorder, and the calamity that followed had to be lived to know. I cannot imagine why depression should debilitate people, but I mostly think it is the diagnosis that does so. It freezes you to the point of stoniness- you cannot think there is life beyond the diagnosis. You just cave in, hopelessly, stoic and resigned, as though nothing at all in the world can change any longer and this is the final judgement on your intelligence, capability and achievements. When the whole world around seems to be joyfully straddling along, notwithstanding how much joy anyone is really experiencing, a depression diagnosis simply hollows you out from within. It does not stop, it keeps on doing it- hollowing you out. You waste away, and life passes by around in a haze as though you are watching it in a dream state.

However many times I would try to get well something or the other got me down and kept me so. Life passed by, friends passed by, careers never took off, people stopped believing in you, and the loss of face one experienced kept one automatically away from the world. With what face can you go and tell the world that you do not do anything of any consequence because you suffer from depressions.

At least today I know that even if depression are a part of life, they need not incapacitate someone permanently- people have a lot of strength in them, if they can develop the capacity for changing what is not working, to what could work. When relationships do not work, either we leave the relationship or recreate it. Remaining in an unhappy relationship with anyone- even with a job, or a partner, friend, birth family, neighbour or colleague makes a person anxious, troubled, irritable, withdrawn and perform far below one’s capacity.

Anyhow, long years did not bring changes- only more of the same. It was time for a change. I changed practically every aspect of my life, and it happened a great deal due to the entry of my dogs. Thereafter, a move to staying alone made me realize that a lot of my conflicts were due to family life- understanding oneself from the solitude of one’s existence offers the scope to question many assumptions we carry about ourselves. It was a great though tough experience to live alone from the time I was 35 years old, with four dogs, yet this leap was the pivot of change.

I turned on that axis of change to such a wide degree that I turned my life upside down or inside out, whichever sounds more realistic. In 2016 it would be 24 years that I had a first brush with bipolar. But today my life is not what it was then, or what it was at any time in the interim. Every step I took in these 24 years, with 18 years of drug dependence for bipolar, fortified my tenacity and willpower to deal with suffering- whether real or imaginary.

On 14th April 2016, I am starting PhD research in mental health and law, at Nalsar- it is a long journey at every step, even making it through the phd was not foreseen until a few months ago, due to certain issues of marks that I had during my MA years.

The reason for writing this post is nothing if not sharing with anyone who reads it that change is the nature of life and the universe. If you want to change anything about your life which is not working for you, you just got to be sure about it- life will give you chances from unexpected quarters. My experience of getting admission into the phd program is testimony that anything can happen to those who are standing in the queue. If you are sitting at home or sleeping away feeling disabled then you are the biggest impediment in your struggle.

If I, who had no hope whatsoever to do anything in life, can get into a phd program, I believe anyone who has a mental health issue can recover and reclaim their life. IT is my firm belief and conviction. And the sort of work that I do in counseling is ensuring that this is happening. Life is a big mystery and we all need to continuously reinvent ourselves, in response to the environment, our bodies, our minds and our resources. Change is ever ready to welcome us- and so should we be. Finally like the woodpecker in this picture, I pecked at it until it changed- whatever it was- fate, destiny, my life or my options.

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The greatest lessons usually come to me from nature, birds and animals

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.

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.