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Friday 30 November 2012

Exams are not the end goals - Ask Our Counsellor Q&A column


Exams are not the end goals

(the following column answered by me appeared in the Deccan Herald of November 29, 2012)
Dear Madam

I am studying in Class X. I am not able to concentrate while studying. Please give me some tips to improve my concentration level. I have only three months left for my public examination. Please help me plan for my exams so that I can do it well.
Anonymous

Dear Anonymous,
Increasing concentration while studying for your exams is something I have addressed many times in this column, over the years. At the risk of sounding repetitive, I will put down my thoughts again.

Firstly, remember that the 10th Std. Board exam is not your end goal in life. It is merely a necessary stepping stone towards achieving your larger goal, whatever that is. While studying for an exam we often make the mistake of thinking that doing well in that exam is our end objective. The exam, therefore, in our mind, starts assuming disproportionate importance. We start believing that if we do well in the exam, our success in life is assured. And, therefore, if we do not do as well, we are doomed to failure. This extreme importance that we attach to the role exams play in our success and failure in life, make appearing for an exam a very stressful and frightening event. And, the stress is what keeps our mind from concentrating. So, my first point is, to learn not to attach disproportionate importance to exams. Success and failure in life is not dependent on exam marks. It is dependent on several other qualities like your self-esteem, your communication skills, and your ability to think creatively and out-of-the-box, your ability to work in a team, your ability to lead a team, and so on. So give exams only the importance due to them, not more.

Secondly, be clear about why you want to do well in the exams. Is it because it will help you achieve what you want, or is it something you are doing for your parents, to make them happy, and keep them quiet. Remember, if it is something you are doing purely for your parents, then it will always seem to be a chore in which you don’t gain anything. And, so long as you view it as a chore, you are not going to feel motivated to put in the effort required.

Thirdly, put in your best effort and don’t worry about the marks. Which means study sincerely, and make a genuine effort to learn what you are studying, so that even if you don’t get the marks, at least the learning stays with you?Ultimately, it is the learning that will take you closer to your life goal, not the marks. So, if you are studying something, make sure you understand it.

Fourthly, remember, that if one door closes for you, in life, because you did not do as well as necessary in an exam, another door will open. Allow yourself the freedom and permission to find it and open it. Failure in one exam does not mean failure in life. There will be other options and opportunities.

Having talked about the larger issues of why you are studying for your exams and why that need not be a threatening process, but an enjoyable one, let’s talk about certain techniques that may help you actually concentrate more while you are learning. Identify how much you need to study, and do an honest assessment of how much time you need for each topic. Then allocate this on a time-table so that you are clear about how much you should achieve in a day, to stay on track and finish your portions on time. Use this time-table as a guiding principle, adjusting it as you go along, to account for unforeseen changes that may be needed. This will free you from the overwhelming feeling that you have not studied ‘enough’ during a day, and allow you to relax once your assigned portion for the day is complete. This will also give you a sense of control over the work you need to do.

Some people like to study with music, some without. Some like to study in a quiet place, some in the midst of everything. Some like to study on their desk, others on the bed, and still others on the dining table. Find out what works best for you. And, make sure your cell phone and social networking tools are switched off. It is nice to stay connected, but the world will not collapse if you do not know what is happening in a friend’s/acquaintance’s life for a few hours, or you don’t respond to a message immediately. These things are meant to be our tools that we control. Not something that we become a slave to and allow them to control us. They encourage a state of constant partial attention to anything that we are doing. Needless to say, when you are studying you need full attention.
You can also use concentration exercises like deep breathing, relaxation and meditation to help you. And make sure you keep time for exercise and play.

I have given you a rather long answer to a very short question. Hope it helps.

Wednesday 14 November 2012

A Client's Therapeutic Journey from the Inside

My interview with Amandeep Sandhu (author of Sepia Leaves and Roll of Honour) published in the November 2012 edition of the Journal of the International Council of Professional Therapists


A client’s therapeutic journey from the inside
-       An interview with Amandeep Sandhu by Maullika Sharma

 View Aman_0025.JPG in slide show
Amandeep Sandhu’s first book, Sepia Leaves, is a bold, moving, autobiographical account of living under the shadow of schizophrenia in India. His second book, Roll of Honour, also autobiographical and deeply disturbing, is about an adolescence wrought with the trauma of bullying, sodomy, and terrorism in a boy’s hostel in Punjab (India) during the mid-80s. Both these books left me numbed by his courage to tell his tale. As counsellors, we often have clients come to us with stories of a similar nature. But, they are happy if they can just make some sense of the confusing events of their life, for themselves. Hardly anyone, ever, goes on to tell their story publicly, like Amandeep has. This is what touched me about both the books and so I sought him out for this very candid interview about his personal journey.

Q. Amandeep, what gave you the courage to tell your story, to the world at large?

I never felt I was doing anything special. I just wanted to tell the stories. I wrote Sepia Leaves because I felt that in the triad of patient-doctor-caregiver, both the patient and doctor have spaces for some kind of articulation and expression, whereas the caregiver mostly bears the cross silently. I wrote Roll of Honour to explore the myth of a macho man by bringing out the unspoken sides of the horrors of strife and identity politics in our formative years. My submission is that if we want to understand violence and bullying in our societies, which bothers each of us, we need to understand how its seeds take root in adolescent minds, we need to look at how adolescents are educated.

To me, the self and the world are witnesses, mutually reflecting each other. One can’t exist without the other and if stories are told then they should be about the interaction of the two. If they are to be told truthfully then there is even more so a need to examine each of them as closely as possible, and write about the reality that transpires. Yes, in my particular space the reality was tough, but if I want to be a teller of tales, then I need to tell it the way I see the space.


Q. What was your motivation to make your story public?

The motivation for Sepia Leaves was that through my growing up years the society called me a ‘mad woman’s son’ and hence unworthy of equality but worthy of a lot of sympathy and even some pity. I asked myself: is there no space in the world beyond our home where our family’s story can make sense? Is madness truly as dehumanizing as it is made out to be? Can’t we live in a world, or even inside a story?

In 2001 my parents came to stay with me in Bangalore. This was after my father had moved me away from the family about 25 years ago. Though we remained connected and in touch, we had to find ways of living with each other. I needed to understand my parents. Through my teenage years I asked myself why my father had not divorced my mad mother; at least he could have had a better life. The desire to explore my family, and the discovery that we were all utterly human, led me to share the story with the world. I wanted to hear back what the world had to say about our story.

If Sepia Leaves was about one person’s mental illness, the second one Roll of Honour is about a society’s mental illness. In this I explore violence on the basis of labels we adopt for ourselves or in which we find ourselves born: gender, caste, religion, language, and so on. If we think the mad should be dehumanized, locked up, stigmatized, what will we do with normal people who behave in abnormal ways?

Q.  You mention in both your books how you got support from various mental health professionals. Would it be okay for you to share what kind of help you got?

Yes. I remain grateful for the immense support and kindness from mental health workers, some friends, and many strangers. When I was a child I noticed how medicines dulled my mother. I missed my mother and felt the doctors and nurses had put her in a prison where I could see her, maybe even touch her sometimes, but where we could not connect with each other. I felt the hospital had snatched her from me. That led me to develop distrust for mental health work.

It is when my father started exhibiting behavior which was bi-polar that I met Dr Ajit Bhide. Dr Bhide helped me come to terms with the practice of psychiatry by showing me links between how we stigmatize, to how power dynamics work in social situations. How the lack of other resources - money, familial warmth, friendships, and avenues to release pent up emotions - play a role in how madness plays out. He became a friend. He showed me how next to the blazing sun of my mother’s madness, which had turned our family topsy-turvy, we had failed to recognize my father’s slow social withdrawal and his small light ebbing away. My father’s illness burst because he had finally in Bangalore acknowledged and written about his deep hurt from being a child witness to the partition of India and Pakistan. We had got late with my father, and were already very late with my mother. Still I took her to him. When she entered his chamber he stood up in his seat to greet her. He addressed her with respect. She felt human. This was the first time she allowed herself to take medicines which were no longer prescribed by her earliest doctor. The line of medication had vastly leaped ahead in the past quarter century and my mother benefitted from the new drugs.

I read more, saw other patients, asylums, ordinary fractured people, the homeless and the destitute and learnt how my own or my family’s problems were small in comparison. I also realized there was more to psychiatric aid than mere medicines. The practice of mental health help rests on the pillars of trust and insight into the patient’s condition by the patient himself. I learnt that human kind’s miseries are many, too many, and the only effort we can make is by taking steps to alleviate fellow beings’ hardships. The only space where God lives is where affirmative action can take place. That place can be anywhere, faith is a cardinal stone.

This was 2006. My book Sepia Leaves had been accepted but the publisher was delaying printing it. I had started writing my second book. My mother’s cardiomyopathy was aggravating; I was tired and weary, that is when I started hearing voices. I started noticing people stare at me at bus stops, on the roads. It was a sign to me that what I feared since adolescence had finally showed up. My genetic imprint had revealed itself – I could be schizophrenic. I went back to Dr Bhide, this time as a patient. He counseled me, we practiced a form of cognitive therapy, he listened and put me on anti-depressants. In a few weeks I started feeling better. Yet, more than that was his mandate to me: sit every evening and write. So I would sit, just sit, whether writing came or not. Then writing too came. When I recovered I went to him and said now you can stop my medication. He reduced it, but since my mother was very critical by then, Dr Bhide knew how I was my mother’s only support so he still prescribed a lower dose. ‘Your car is on a rocky mountain track; keep the pressure up in the tyres.’ A very simple, earthy reference, but it made sense to me. Then after a few months he stopped the course.

The next is Dr Alok Sarin in Delhi. During my adolescence my father used to talk about him. He reviewed my book in the Indian Journal of Psychiatry (http://www.indianjpsychiatry.org/article.asp?issn=0019-5545;year=2009;volume=51;issue=1;spage=71;epage=71;aulast=Sarin)  It was an honour.  I was completing a circle. From moving away from the discipline I had moved back in. He has become a guide, a friend. Alongside, he got me to meet other psychiatrists. I discovered their humanity, the possibilities of them even being wrong at times, the difficulty of the field of psychiatry not having had its watershed moment unlike Darwin in Biology or Newton in Physics, the lack of empirical clinical data to make theories, its theories still open to being reinterpreted, and hence fraught with issues.

Dr Shekar Sheshadri helped me with writing Roll of Honour which is about adolescence. He was my sounding board to check if I was depicting them right. Dr Anirudh Kala helped ground me into modern Punjab from a psychological point of view.

Then there are many others, many others to recount. Each of them has shown me with their commitment to better health, irrespective of which position they occupy on the debate on psychiatry, that good work can be done. Whether it is by being counselors, by running counselor trainings, by opening rehabilitation centers, working in or out of state systems, as long as the drive is to provide a healing touch, to help fellow beings recover their lost dignity and mind, not play power politics, eradicate stigma, and create equality, they all have my respect and I have learnt from each of them and I continue to learn.


Q.  What, in therapy, did you find the most helpful? As a counselor we have a perspective on what is helpful for clients, but we hardly get to validate that with clients telling us what they found most helpful. I was wondering if you had some insights on this. What led to what we call “aha!” moments in your therapy?

Kindness and acceptance. Owing to our notions of normalcy and caregiver fatigue, mental illness becomes most characterized by a lack of sensitivity. I feel, the struggle in mental health is for a sufferer to not feel abnormal - to gain insight into his or her condition, and yet not be affected by notions of normalcy. Let us start with normalcy - normal, in any age is a construct born out of the intersection of social and cultural forces. It changes from place to place. As I explained earlier, no one has yet been able to articulate a nature of madness that holds good in all societies and cultures. It is not like if one’s leg is cut off one becomes challenged, or if the body temperature goes high up beyond normal one is sick. Sufferer insight is the fulcrum on which mental health can be balanced but it is the job of the doctor or counselor to facilitate it by creating an environment of trust that comes from deep emotional responses which cannot be manipulated by either the system, the caregiver or even the sufferer.

My ‘aha’ moment was Dr Bhide working with me at two levels:

      By believing that I could write, pushing me to write, insisting that I write or attempt to write each day. That insistence by him gave me a channel to let out my thoughts and feelings, it also gave me a routine which helped me sit down and write and give myself an ‘aha’ whenever I wrote what I thought was good enough to get into a book but since it was personal and because this was open therapy, it remained honest and I did not play to a gallery.
         Opening his heart to me from which I gained a sense of acceptance. Something clicked between us. I would sometimes go down to meet him after he finished seeing the last patient for the day at his clinic. It would be 9.30 pm. He won’t come out before 10 pm. He worked hard, really, really hard and I would ask myself why I couldn’t deal with one patient when he deals with so many, that too out of choice. We would meet, talk a bit about this and that and then he would get another call and have to make house visits. His being human opened to me my own recognition of me being human.

There was one more ‘aha’ moment. In the middle of the last decade I was looking for people in Bangalore who shared my issues, a support group. I found AMEND. I went for their meeting. Each of the members was above 50 years of age. I was the only one caring for an older relative; they were all caring for their sons or daughters. They were sometimes even beaten up by the sufferers. Their physical frailty made it difficult for them to assert themselves. These members were all like parents to me, parents who had worked hard through their lives whatever be their jobs, and now deserved to retire but were instead thrown back into the fires of domestic crises. I was so much better off. That was an ‘aha’ moment for me. Not a rejoicing ‘aha’ but a humbling ‘aha’.
Q.  How did the idea of writing your story into a book come about? Was it something you planned on doing, or was it something that came up in therapy? At which point in your journey did you decide to do this?

When I was little and my parents used to fight in the bedroom I would hide behind the sofa in the drawing room and read comics. I was maybe 5 years old. That is when I would replace them as the comic characters and build stories around them. In one the hero died in another the heroine. That is when I knew that someday I will try to write about them.

The inspiration for the second book came when I was 13 years old and marching to school and the School Prefect gave us punishment for no known fault of ours. We crawled on the road and I decided that someday I would write about this senselessness of corporal punishment.

I spent my 20s reading the masters of literature and trying to write, but unable to write. I spent it crying at blank pages. Therapy helped in affirming my faith that I could write. Initially I was worried that the medicines will addle my brain and I won’t be able to write. My doctor’s personality and inclusive participation in my case alleviated those doubts.   


Q.  Have you faced any negative fall out of your books from friends and family? Did it build more walls, or did it help break walls in your relationships?

Yes there has been some negative, and I anticipated that. In fact, it was the possible adverse reactions which forced me to take time on my writing, dwell deep into the pain points, learn how to articulate them well, and then dare to lay them out on paper. Some of my larger family members felt offended by my talking about how my mother was physically beaten so she could be reformed. Come on, they did it; they can face up to it. No? Why do things prick only when they get on to paper? Beyond that the walls between the society and me have just shattered. This interview is an instance of it. How the world has welcomed me, how the book has travelled all over the world, into policy making processes, among caregiver communities, among students of psychology and just ordinary people … I am humbled and feel I was in so much error that I felt the world won’t listen to me. They listened and responded so beautifully. The book has also created a world of rich interactions for me. A world where readers respond and I learn, and do newer work and present it to them, thus earning more readers and friends. To me this is home.

For the second book, to by surprise, my school alumni have exhibited great grace. I had worried and wondered what they would say but many of them, most of them have felt that my writing the book has helped a generation or two of us (Between ages 40 and 65 years) to look at how excellent systems have now corroded and I hope we take steps to improve our educational spaces.

Roll of Honour is not an innocent book. It is a document fraught with undertones and as the separatist movements (Lt. Gen. Brar was recently stabbed in England, the radical Sikhs are building a memorial in the Golden Temple to what they call the martyrs of Operation Blue Star) continues overtly and covertly, I am hoping people would find meaning in the book.


Q.  While growing up, while you were struggling with all the issues you talk about in your books, in retrospect, what kind of support would you have liked to receive from the adults in your world? What kind of responses, and behavior, would have been helpful to you to make sense of the world?

I feel life would have been different if I had found genuine kindness and a sense of safety. Someone who could give me care and protection knowing I was vulnerable. My father tried, some neighbours tried, many other friends and well wishers helped me along my journey, some even pointed directions. That is all a weary traveler wants, a glass of water and a safe bed when his eyes close at night.


Q.  Do you think having a counselor in your school would have helped? Would you have gone to him/her?

Yes, of course the school having a counselor would have made it a very different place. Yes, I would have gone to the counselor. More than that, a counselor, or even regular teachers, could have helped by not letting the situation at school go so out of hand. The problems occur because the age old tradition of honour in the school accrues violence. The counselor would have plugged the anomaly, or the teachers could have plugged it. 


Q.  I thought I knew about bullying, and how to help children deal with it in school. But after reading your book, I don’t know what to say. I feel I don’t know anything at all. What message do you have for the bullies, the victims, the parents, the teachers, and the counselors (who are now present in many schools)?

Anyone who becomes a bully suffers from a deep sense of being victimized. The bully justifies the bullying as a behavior in which he or she is getting back at the victimizers. In order to deal with bullying, this has to change. Parents and teachers have to start with working at helping the bully deal with his or her own perceived or real victimization. Then curb his or her desire to pay the violence forward and make more victims. Be firm with them but practice kindness. In order to do that, start by being kind to your own self, by treating the bully with compassion but not allowing the bully to demean you. That aware, conscious and mindful kindness can be a starting point to tackle the menace of bullying. 


Thanks, Amandeep, for these great insights. It is very validating for us in the healing professions, when a client has healed. And, you seem to indicate that the real healing happened in your journey as a result of basic things like kindness, acceptance and a belief in your capabilities. They seemed to have made all the difference. As professional therapists this is what we believe, and being able to provide ‘unconditional positive regard’ to clients is the cornerstone of all training. It is great to hear this validated from a client. Here’s wishing you all the best for your next book, but hoping you have not had to live through any more such tales that are yet to be told. Good luck and thanks for your time.



Sepia Leaves can be bought on Amazon at :http://www.amazon.com/Sepia-Leaves-Amandeep-Sandhu/dp/8183860079/ref=sr_1_1?ie=UTF8&qid=1349937820&sr=8-1&keywords=Amandeep+Sandhu
Roll of Honour can be bought on Flipkart at http://www.flipkart.com/roll-honour-8129120232/p/itmdcfczhfnkt5m2?pid=9788129120236&ref=83c7d6db-b905-4fcb-87b3-5ba860a3064f&srno=m_1_1&otracker=from-search

Thursday 8 November 2012

Don’t aspire to control - Ask our Counsellor Q&A column


[The following column written by me appeared in the Deccan Herald Education supplement of November 8, 2012]


Dear Madam
I have a daughter who is doing her BCA, and a son who is in Class 7.  My son was only five months old when I lost my husband. I have a problem with my son. He has been losing interest in studies for the past three years. He keeps finding excuses when I ask him to read his lessons. He only writes notes and passes his time. Many times, he does not do his homework.  He has failed in most of the subjects in his last test due to this. I send him for tuitions. But he is only interested in singing and passing his time joking and playing outdoor games or on the computer. I also have a problem with his behaviour as he does not answer people properly and clearly. He doesn’t listen to any of my instructions, or those of my family. I stay in a joint family, with my in-laws. He doesn’t seem to mind that he has failed.  Even when I take him to task I find no change in him. I am unable to control him, hence I request your suggestions.
Vijaya

Dear Vijaya
You say you are unable to control your son, and my feeling is that that may be where your difficulty originates from. You don’t need to ‘control’ your son. You need to guide him and motivate him to achieve his potential. Your son is not like a forest fire that needs to be controlled and contained. He is a lamp that needs to be lit, and the oil needs to be poured in every time the light is fading out. Or, he is a fire that needs to be ignited and stoked to keep it lit.

It must be hard on you to be a single parent with two children, and I can understand that this may be having its own set of challenges and pressures. Living with your in-laws, while it may have its advantages, may also be pressurizing you to ‘perform’ as a ‘good mother’. Your anxiety about this, and what others will say about you, and your parenting, if your son does not perform well, may be something that is driving you to somehow control your son. I am just suggesting these as possibilities and if you don’t agree with my observations, please feel free to disregard them. However, if you feel that, at a subconscious level, that is what may be happening, then it is important that you become aware of these dynamics so that you can manage them. Get help from a counsellor or a trusted friend, if this is the case, because you need to deal with your anxiety. Only then, will you be able to appreciate your children’s strengths and not view them as problems. I would like to remind you of an oft-repeated piece by Kahlil Gibran:

"Your children are not your children. They are the sons and daughters of Life's longing for itself. They come through you but not from you, And though they are with you yet they belong not to you.

You may give them your love but not your thoughts, For they have their own thoughts. You may house their bodies but not their souls, For their souls dwell in the house of tomorrow,which you cannot visit, not even in your dreams. You may strive to be like them, but seek not to make them like you. For life goes not backward nor tarries with yesterday."

Having said that, it is possible that your son currently does not feel that studying is his responsibility, because he may be seeing it as something you want him to do, with no benefit for him. Also, he may have different aspirations from the ones you have for him. And, he is at the adolescent age where he will be trying to carve out his own identity. 

During this stage of life, it is natural for him to withdraw from adults, identify more with his peers, be defiant, and answer and do as he pleases. I think if you recognize these changes, and understand that they are a normal part of growing up, then they will be less threatening to you. That is not to say that you don’t need to define limits and set rules. You need to do all that, but the techniques that would have worked with him as a child, will not work with him now.

Communication, nonjudgmental acceptance and understanding are really the key to reaching him. Hope this helps.

Dear Madam,
I am studying in 1st PUC. I have taken up Science, PCMB. I took Biology because I used to score well in it till my 10th, but now I find it difficult. I want to become a doctor but I highly doubt if I can achieve my goal. I am not very interested or dedicated towards studies. I am always in search of something new and enjoyable; I would prefer such an occupation. I would like to be a journalist. I want to take up singing and many other activities. But, I do not know what I have to stick on to. I still have hopes that I can get into Medicine but my parents don’t. They think it’s high time I think about something else.

I feel depressed right now, and I feel that I won’t be able to achieve anything. I will be highly obliged if you refer any good career counsellor for me. Can you also tell me what I should do about my career?

Anna

Dear Anna
The best career for anyone is one in which you have a genuine interest and which plays to your strengths. I want to think about your reasons for wanting to become a doctor.

From whatever you have told me in your email, you do not like Biology, and you are not really interested and dedicated to studying. I don’t want to discourage you, but if you don’t like Biology, then it will be torturous for you to study Medicine for 8 to 10 years, maybe more. Besides, Medicine will require studying and dedication and long hours of pouring over your books. So, while you feel discouraged that your parents feel you can’t do it, they may be recognizing your interests and trying to steer you towards something that you may enjoy more. You may end up thanking them for their foresight in the future. 
At least they are not pressurizing you to do something that you feel you are not good at, or interested in. It will be a good idea for you to consult a career counsellor to help you settle this dilemma, but since I don’t know where you are located, I will not be able to recommend anyone.