Therapy for the desi mind | Chennai News
Komala’s auditory hallucinations became louder day by day, triggering her worst fears of abandonment that experts say is common among Indian middle class single mothers from patriarchal households after their children grow up.
On the one hand, the Madurai-based government employee was crumbling under the obligation of getting her son married. And, on the other, as someone who was widowed almost two decades ago, she was crippled by the probability that he could abandon her after marriage.
After months of cognitive behavioural therapy (CBT), one of the most popular, evidence-based approach, Komala came to Dr Balaji who took her through Acceptance and Commitment Therapy, a technique advocated by American clinical psychologist and professor at University of Nevada, Steven Hayes. This form of mindful psychotherapy works on ways to bring acceptance of the present — including all the emotions that arise out of trauma — instead of trying to fix or evade it.
This is among the techniques that find resonance in Indian spirituality and societal living where inequities exist. “After following western concepts of psychology, I realised they worked only with a small group of privileged individuals, whereas a chunk of clients from lower socioeconomic and lower middle class backgrounds were not responding to it,” says Balaji, a member of the American Psychology Association, who also teaches psychotherapy at TN Open University.
The dichotomy Dr Balaji is expressing is stirring young mental health professionals with solid psychotherapy and psychology backgrounds to question why popular therapy around concepts like ‘triggers’ and ‘boundaries’ doesn’t cut in in the Indian context, where displeasing someone is enmeshed with class and caste systems.
Instead of viewing mental illness as an individual issue that could be ‘fixed’, they look at conditions such as anxiety, depression and multigenerational trauma as a long-term effect of Indian society’s caste, class and genderbased inequalities and use community-based activities such as in-session art, meditation and storytelling as tools to empower the individual to rise above issues caused by systemic challenges.
“I began taking a deep dive into Indian spiritual texts like the Upanishads and Buddhist philosophies and found a whole lot of metaphors that could be used to convey the idea of self-empowerment through the ACT modality to someone struggling with anxiety or depression,” says Dr Balaji. “Komala, for instance, was a nervous wreck when she came to me because her son was spending more time with his fiancé and embracing her views.
Instead of telling her how her fears were counterproductive, I directed her to observe her internal conflicts and see things for what they are. I also used metaphors to explain such as how struggling in a quicksand will only pull you down deeper,” says Balaji. “And by the third session she had started taking control of her emotions. ”
Among the most pioneering approaches is to make mental health help relatable to brown contexts is decolonial therapy, which works towards finding ways to make therapy relevant to populations at the receiving end of systemic inequities and the trauma of oppression.
The idea is to decolo- nialise western concepts that use the privilege of the individual to make autonomous choices, and instead look at ways to build an individual’s resilience to engage with family and societal structures and emerge empowered.
“Decolonial therapy work is humanistic approach to consciously put the power in the per- son’s hands,” says art-focused sex and trauma therapist, Neha Bhat. “Soon after graduate school, when I started working with communities on the ground, I was made to realise that Instagram pop therapy or conventional western therapy would tell you that if someone causes stress in your life, take a step away from them. But what do you do in households where one does not have the financial tools to move into an apartment, or create divisions in the house?” That is when she decided to work with familial structures and marginalised communities to help them stand up independently within these systems.
A client of Neha who is in an inter-caste marriage told her that his mother-in-law (from a dominant caste background) is picky about her space and vegetarianism, while he and his wife are meat-eating folk and they have to navigate these boundaries within a one-bedroom apartment. “The further complexity here is that the mother-in-law has helped fund my client (dalit background) in his MBA, and so she is also this couple’s safety net,” says Neha.
So how could this situation be dealt with? “There are a lot of rewards that come with being married into the same caste through the festivals, the first child, etc. In an inter-caste marriage, there is already so much opposition. My job is to step in and say, let’s empower the family to create their own rituals,” says Neha. “We looked at how to diffuse the idea of religious trauma that comes with their inter-caste marriage, did discussions on what religion and spirituality means to each person, and they ended up coming with a much better understanding after undergoing family therapy. ”
Among those pioneering a rounded mental health access to marginalised communities is Blue Dawn, a support group and facilitator of mental health services and sponsorships for bahujans (scheduled castes, scheduled tribes and other backward classes across religions). Viewing mental health as a social issue rather than an individual one, they work on community healing, arts, music and connect marginalised people to affordable and accessible mental health services. They also hold workshops for people living with mental illnesses, students, activists and social workers.
“The family unit is the most basic social system in India, followed by larger community groups — a place of worship, school, college and work. These have the properties of a family system,” says Aditi R, organisational psychologist. “This can be traced back to the joint family system where the patriarch made all the decisions, the women were below him and the child came last. With nuclear families, the structures have changed, but not the rules of engagement,” she says.