Count on counselling
By Taru Bahl

l Antara and Kartik after 11 months of a whirlwind romance and marriage were ready to sign on their divorce papers. Grounds ? Charges of infidelity and mental abuse. How did the picture perfect story go bust ? His good looks combined with a demanding job had made her insecure. She was obsessed with the thought of his being unfaithful. She began keeping tabs on him and demanding a minute-to-minute account of where he went and whom he met. Constant fights and ugly scenes became the norm. There was a complete breakdown in communication. He stopped explaining, reassuring and reaffirming his love for her and she believed the worst about him. They turned into strangers. Could this marriage have been saved ?

lSudhir was at the wheel when the car they were travelling in met with an accident killing his wife and maiming his 6-month-old daughter for life. A decade later and he is yet to exorcise the demons of his past. He carries the guilt and blames himself for the disaster. He is unable to shoulder responsibility and has become a nervous wreck. Can talking to a professional counsellor who specialises in post traumatic stresses have helped him lead a more normal life ?

l Rashid is an anxious man. He has provided his daughter with a Pentium, a multi media programme, the complete Britannica Encyclopaedia set, enrolled her in the best school of the region and arranged for private English-speaking lessons. However, he fears that she is a slow learner, moreso since her kindergarten teacher complains of her not picking up the right way of doing cursive writing. She is all of five years of age. Could Family Systems Therapy or a few sessions with a child counsellor have helped him have more realistic expectations of his child?

COUNSELLING has been a part of everyday life for most people in the western world where even a psychoanalyst with a flourishing business has his own shrink to whom he can turn to when he is suffering from the moody blues. Nobody laughs or denigrates his mental ‘weakness’. For him visiting a psychiatrist is as natural as going to a neighbourhood doctor when he is down with viral fever. Development, progress and education have brought about changes in lifestyle patterns. Spending levels have increased and so have awareness levels. Thus, women stormed male bastions, New Age Men arrived, the single child nuclear family became a choice and fashion/beauty invaded middle class homes. On the flip side, stress levels increased and people of all age groups and backgrounds began to experience more frequent moments in their lives when they were unable to cope, when nothing seemed to be going right and they were not in control any longer. But given our aversion to anything which even remotely connects us to mad, neurotic, crazy, nutty and abnormal behaviour makes us avoid the entire breed of psychologists, counsellors, psychiatrists and family therapists like the plague. Along with the fear of turning ourselves into social pariahs most of us suffer from the "nothing- is- wrong-with- me" syndrome. Its either the other person’s fault or the problem doesn’t exist. We have this uncanny ability of ignoring and shutting out issues, confident that they will then go away.

NGOs, individuals, social and behavioural scientists today are a worried lot. They see a lot of angst, pain and unexpressed anger in youngsters, married couples and professionals. Since there are no legitimate outlets and practically no help expected from home they become confused, not knowing whom to turn to. Lonely and unhappy, they generate similar vibes creating in the process an atmosphere charged with negative vibrations. This is why an increasing number of help lines are being established by concerned institutions. These help lines comprise committed individuals who are putting their expertise together to formulate specialised counselling services. Home visits are undertaken and awareness talks and workshops organised at different levels and fora. The objective is to reach out to distressed people and help them come to terms with their problems.

Abroad, there are counsellors offering specialised services which help people deal with juvenile delinquency, panic attacks, learning disabilities, reduced attention span, adjustment problems relating to separation, divorce, step- parenting, alternate sexuality, non-cooperation at the work place, low self esteem, eating disorders, shopaholism, frequent job hopping and an inability to carry relationships forward. In India, however, the concept of approaching a counsellor and baring one’s heart and mind to him/her is still an alien thought. Some feel it would be a betrayal to the family or person concerned. Others feel that when they themselves are helpless how can strangers offer workable options and solutions. Still others feel it’s below their dignity to expose themselves and their negative traits. They feel safer keeping the problem under wraps and within the confines of the house.

Prof. Vidhu Mohan, eminent psychologist who teaches at the Panjab University, feels that awareness levels have gone up with parents, adults and even adolescents admitting that they are facing behavioural, emotional and adjustment problems. But when it comes to seeking professional help they clam up and turn wary. According to her, "When parents bring ‘problem’ and ‘difficult’ children who are in their late teens or early twenties, little do they realise that the problem has got exacerbated. From a simple case of counselling, it has become a full blown psychiatric case." Incidentally, she feels there are no problem children, only problem parents ! Her department had conducted a survey of 900 parents out of which 90 per cent admitted having some problems with their child. These could be related to communication, delinquency, aggression, violence, passive behaviour, temper tantrums etc. On their repeated pleas when she structured a two-day workshop to address individual issues in batches of 25 each, charging a token Rs 300 as programme fee to cover her costs, only 10 parents confirmed participation! And when a parent requested her to offer advice across the table she happened to notice the child’s expensive shoes. The parent could afford to pay Rs 1500 for a pair of shoes but to enroll for a counselling workshop which would have benefited all of them was not on the priority list.

Dr Mohan with her vast research and experience in the field is disturbed at the angst in society and the complete breakdown in relationships, the family unit and the excruciating emotional pain bottled up in people of all age groups. The increasing rate of divorce is one such area of great concern to her. She strongly feels that pre marital counselling imparted to engaged couples would help them enormously in handling their new roles, equipping them with the maturity and wisdom to make their marriage ‘lovingly solid’.

According to Suman Gupta, who is a counsellor at the Lala Lajpat Rai Bhawan, "People have a mental block going to the psychiatric unit of hospitals. They feel more comfortable coming to places like ours or other similar NGO bodies where they can sit and talk of their problems, share specific experiences and jointly seek answers."

Similarly, Neeru Dayal along with three of her teacher- colleagues set up DIVA (Deep Inner Voice Awakening) offering counselling to parents, children and families. They plan to involve many more experts in the next six months and turn it into an NGO hoping thereby to broad base their reach. Neeru is convinced that counselling can "help one experience more fulfilment in life, enhance communication skills, improve inner awareness, make healthier life choices, increase self love, learn to understand and express feelings and experience more support".

It requires a great deal of effort to accept that there is something wrong with us and that some of the problems we are facing could be because of our attitudes and behaviour. Once this initial hurdle is overcome, most people move to the "what next" stage. They want to seek help. They are enthusiastic about bringing positive changes in their lives and relationships. But to carry through a prolonged counselling session or therapy requires not just willingness but also grit and determination to make conscious fundamental changes in the way we think, behave and act.

Over 5 in every 100 Indians have some psychiatric problem. These don’t necessarily have to have fancy medical names. Simple things like stress, inability to cope, flying off a handle at the slightest provocation, overtly suspicious behaviour, illogical obsessions (shopping, lying, eating related disorders like Bulimia and Anorexia Nervosa) and phobias (height, water, fire, reptile, darkness, death) could cook in the brain. And when the pressure cooker bursts, the fumes could suffocate, poison and scald. Relationships could be ruined, physical health could turn for the worse, emotional and mental stability could be at risk and professional competence could slide drastically. Irritable, snappy behaviour could embarrass initially and, later, alienate. Maybe even push the person towards substance abuse for temporary relief.

According to psychiatrists, "rapid social change like breakdown of support systems, be it families or marriages, faulty role models, dwindling social network, demolition of an ethical framework, competition and harassment at the work place or an unending obsession with material gains could hasten the journey into mental illness for those who are genetically prone to it. What is important to note is that these acute pressures and stresses could trigger certain chemical alterations even in the brains of those who aren’t biologically vulnerable. And it is this category of disturbed people which is increasing at an alarming pace. They remain invisible because they remain confined to their little worlds. Miserable, disturbed, helpless and terribly confused they watch their rapid decline into nothingness.

Wittingly or unwittingly, people have sought help in ‘less harsher ways’. Women have turned to satsangs, kirtans and bhajan mandalis to come to terms with the grief of losing parents, children, spouse or to understand the larger spiritual issues of life, handling post retirement blues, children flying the nest and getting old. Couples approach family astrologers, mendicants, babas and sadhus for the answer to their queries or just for solace. Singer-actresses like Madonna lug their personal psychoanalyst along with them, consulting them on every little decision.

In Chandigarh, Brinder Aulakh, tarot card reader and Gaitri Singh, cartomancy expert, opine, "People are so disturbed today. Whether it is extra-marital relationships, property disputes, wayward children or backbiting at the office, they are desperate to unburden themselves and talk to a compassionate person who can listen, soothe and offer advice." The fact that they are lonely and unconnected to their families makes things worse. This is perhaps why some of them continue coming to them, paying their fees dutifully, much after their problems have ceased to bother them. All that they want is someone they can talk to.

Similarly, the "agony aunt" columns in newspapers and magazines are full of people who are distraught, some of them with the most unimaginable stress-related problems. Alternative mind, spirit and body therapies like Reiki, meditation, Buddhist chanting and even yoga are pursued to calm nerves and help create some semblance of peace, harmony and normalcy in lives.

‘Healthy minds and healthy bodies make healthy nations’ is no lofty rhetoric. An individual’s mental health cannot be isolated from his social well being. It has a direct bearing on his environment, family and society. Most suicides, murders, rapes, homicides and other ghastly violent crimes reveal minds which are terribly disturbed and sick. Had they received help earlier, they might have been able to cope with the lows in their life better. The government and state machinery has to do their bit by strengthening their clinical apparatus, by training and absorbing many more psychologists and specialists and most importantly by using the mass media to explode the myths surrounding the profession and making counselling more accessible.

Figures released by the Ministry of Health in 1998 revealed the pathetically inadequate infrastructure which puts the number of qualified psychiatrists between 3,000 and 3,500; 700 and 800 psychologists, 400 and 500 qualified psychiatric social workers, a similar number of nurses and only 37 mental hospitals.

Dr Savita Malhotra, who is Additional Professor Psychiatry at the PGI and Consultant and In-Charge of Child Psychology Services, feels that with the increasing tension in daily life the medical fraternity has to gear up and there have to be many more trained experts in the field. According to her, "The PGI has a diagnostic and treatment centre. Severe psychosomatic cases are referred to it. Counselling is a part of the treatment plan here which includes medication, psychotherapy, intervention with the family and the individual patient." She feels that most people who do approach a counsellor have been prompted by either the media or a teacher, friend, social worker or someone who has found counselling useful. There is no doubt that counselling is an effective tool where the counsellor and therapist help people think for themselves, discover conflicts, understand feelings, realise potential and, finally, attempt to solve problems.