Dial ‘D’ for ‘de-stress’
By Nonika Singh

PICK up your phone and unburden yourself, vent your suppressed feelings, satiate your ‘forbidden curiosities’. Indeed way back in 1876 when Alexander Graham Bell, a Scottish-born American, invented electromagnetic telephone, who could have imagined that one day his invention would not only usher in a communication revolution but also find usage in psychiatric counselling. Yet in today’s jet-set pace when stress has spread its tentacles far and wide, telecounselling has become a vital tool to reach out to distressed souls and to provide a balm to their frayed nerves.

Tele-counselling made its presence felt on the global map roughly three decades ago. In India it is a recent phenomenon. It has filtered down from metros to relatively smaller cities like Chandigarh which now boasts of a round-the-clock voice response system available on telephone number 1097 and answers queries related to AIDS. Sponsored by NACO, the AIDS hotline (only the third in the country) is being run by the Chandigarh AIDS Cell and the Servants of People Society (Chandigarh chapter).

The Servants of People Society, founded in 1921 by martyr Lala Lajpat Rai, has been involved in philanthropic causes like drug de-addiction and senior citizens’ welfare. According to Onkar Chand, secretary of the society, the hotline is a testimony to the fact the government and a non-government organisation can work in tandem for public welfare.

While the enlightened amongst us are acutely conscious of the HIV threat, India’s ignorant and illiterate populace is oblivious to the burgeoning number of HIV-infected people in India. As per the AIDS control programme, there are nearly 3.5 million HIV-infected persons in India. By the year 2000, India might have the unenviable distinction of possessing the largest number of HIV- infected persons if concerted efforts are not taken in the right direction. Tele-counselling is one way to disseminate information and quell myths which abound in plenty. Though the requisite software developed at a cost of Rs 2 lakh is designed to answer eight routine questions — What is AIDS, how does it spread, delineation between AIDS and HIV, relation with STD et al — the counsellors with the help of medical experts had to devise 1500 new answers. Renu Sharma, a counsellor with the hotline,says: "Lack of awareness about the disease has led to many a misconception. Only recently someone enquired whether a chimpanzee bite could cause AIDS. Then there was a query-- ‘whether meat eaters are more susceptible?’ Our job is to clear the cobwebs shrouding the dreaded disease". Though the system is guided by experts, one wonders about the effectiveness of pre-fed answers? As it is doubts exist about this faceless mode of counselling. In the USA and Europe, doubts were voiced when tele-counselling was introduced. But later the interposition of media between the counsellor and the counselled was widely accepted. Computers came to occupy an independent status in psychotherapy.

The lack of direct interaction in tele-counselling is its biggest strength. Rekha Gupta, the other counsellor in charge of the hotline,remarks: "It deters pranksters from making crank calls as there is little fun in playing around with a computerised voice." Group Captain (retd) P.S. Soni, honorary administrator with the society, adds: " A counsellor’s voice might betray emotional nuances when prodded with an uncomfortable question, thus desisting a caller from making a call. So pre-fed answers have an edge as those desirous of seeking information can question without any qualms or inhibitions. "In a nation like India where a visit to a psychiatrist can leave you branded ‘insane’ for life, tele-counselling is bound to elicit tremendous response Small wonder then that Chandigarh’s, first tele-counselling service Dost (also under the auspices of the Servants of People Society), evoked enthusiasm. In one year alone, Dost handled 541 queries. Predictably and ironically in this land of Kamasutra where today sex has become a dirty word, a large number of queries were related to one or the other sexual problem. As AIDS too is inextricably linked to sex, the response to the AIDS hotline has been overwhelming to put it mildly. When the service became operational in January, 1999, the callers numbered 3361; and in the month of March (by 17th), the tribe totalled a staggering 8525 --- which means roughly 500 calls a day. While Dost turned out to be more of a ‘a friend in distress’ for the so-called stronger sex, at the AIDS hotline too the majority of the callers have been male. The raison de etre for this gender anomaly could be the fact that women have their own empathy groups and crying on each other’s shoulders is quite in line with gender expectations. For men however any expression or emotional outburst remains ‘un- macho’. As Dr Avneesh Jolly, co-ordinator, AIDS hotline, says: "I have always been tickled by the blank calls so rampant in our country. Behind those blank gaps, I can sense an insistent urge of the callers to lend a voice to their thoughts."

So whatever happened to the traditional support systems built in our social cultural fabric which for ages have served as proxy shrinks? Dr Jolly feels, "Today, peer group is breaking up. Friendship has been replaced by rivalry and jealousy. Besides Nani and Dadi, excellent counsellors of yore, are conspicuous by their absence, thanks to division of joint families." So now faith healers and soothsayers have stepped in. But instead of guiding their bhakts, they end up exploiting them. For that matter even tele-counselling is not a panacea for societal ills. It serves little purpose if it is not followed up with face-to-face counselling. Besides in the hands of amateurs, it could become an instrument of personal aggrandisement. A counsellor might be tempted to impose his own prejudices, thus confounding the caller further.

Onkar Chand says that the second phase of the service would include face-to-face counselling as well. Though so far the hotline has been just an awareness line, he insists that those in dire need will most certainly be guided by the service.

With the psychiatrist-patient ratio in India being so lopsided, the significance of such services can’t be ignored. But as Dr Jolly reflects,"Apart from roping in barefoot counsellors and volunteers tele-counselling has to be supported by pressure groups on the lines of say Alcoholic Anonymous. Only then can it become truly relevant."