Mental Illness

Understanding BipolarDisorder, depression and other illnesses

Connection of Care

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What did I miss most when I retired from being a doctor?

Patients.

The dignity with which they put up with so much angst and uncertainty constantly inspired me. They smiled. They tried to be gentle, often through pain. I felt a deep connection of care with them. When I stopped working, I missed my patients most.

Over the last 15 months, I have been studying the principles of Hypnotherapy and learning the skills of Solution Focused Brief Hypnotherapy. Anaesthesia is to Medicine what Hypnosis is to therapy. The parallels are clear to me. The course was enjoyable and insightful, and the practice is deeply satisfying. I can now work online with my clients from this remote little village where we live. Once again, I have that caring connection with people.

The fundamental physiological principle on which Hypnotherapy is based is that of Neuroplasticity – the ability of the brain at any age to grow and morph in response to repeated use of certain neural tracks. Cells that fire together, wire together, states Hebb’s law. This essentially means that the repeated use of certain pathways strengthens them and disuse of others, weakens them.

The belief at the root of this practice is that all the resources we need are already present within us. The art is to have access to them, to be self-aware and make decisions from a place of strength, not fear.

Insomnia, weight loss, depression and anxiety, stopping smoking, grief, getting over a phobia, relationship issues and stress are the most common presenting complaints. I am fascinated with the process as I see people identify small steps for themselves that add up over time to produce the big changes they want in their lives. One or two bonus ones as well.

One of my clients was mainly concerned about her weight. She didn’t like her photos and hated shopping for clothes. Otherwise, her life was good. She shared it with her husband of 28 years. After 6 weeks in therapy, she started to comment on her relationship with her husband, which seemed to be improving. She was responding differently to the things he said and did. That really helped. By Week 8, she was enthralled by how famously the two of them were getting on. At our 10th and last meeting, the weight wasn’t even mentioned. She had taken charge of her life.

“I think I have been more positive since we started. More considered, certainly.  My responses have become calmer. This has helped many of my interactions, especially with Mike. There are people who trigger me, however, that I still find it difficult to respond in a calm way (my mother). My activity levels have been steady. I rate my confidence as being a bit improved. I am trying to value myself more and my body. I am still a very organised person, but I suppose I am ‘letting things happen’ a bit more. I find that the small improvement in my levels of confidence and interactions have made a difference.  My reactions and responses help me.

As far as happiness is concerned, I often rate how I feel and think about what little thing I could do to improve how I feel. In general, the sessions have helped me view how I act and interact with others. I can ‘hear’ your voice calmly in the background when I take time to consider how I feel. I am also good at scoring myself. 

There have been some difficult moments recently (regarding my mother), and I have managed to step back for a few days and recharge.”

I feel fortunate to have found this new line of work that is essentially a series of creative conversations.

Resource: An international School for training to be a Hypnotherapist: https://inspiraology.com/

Let there be colour.

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In this land of limited resources, every day we see ingenious use of everyday things – old saris stitched together to cover a car, old tyres reused as planting pots and old t-shirts repurposed for dusting or cleaning.

When I moved to the UK, I was horrified at the amount of paper that was binned for the smallest of reasons – a slight crinkle, a minor misprint, a tiny smudge. People failed to notice that there were two usable sides to every A4 sheet. If one side was unusable, the other was there to jot down a list, play knots and crosses, or simply, create a doodle. It is refreshing to return to a place where hardly anything is discarded as useless, unless it really is. The inventiveness of the people is inspiring, even though it is motivated by saving money. They probably don’t know it, but they are also helping save the environment.

Limitations can serve creativity. That is why deadlines work. They push you to finish. It is easier to write in response to a writing prompt as it focuses the mind. Newton came up with the Theory of Calculus in quarantine. Faith Ringgold was born in Harlem. She was an arts teacher who wanted to paint large canvasses but didn’t have the space needed. So, she started stitching themed pictures into quilts, which she could carry and display with ease.

Recently, I’ve been wondering if my creative efforts at teaching Spoken English to the local kids will be of any use to them in the long run. The school’s modus operandi is cramming. They have a verb for it – by-hearting. I believe corporal punishment is forbidden on paper, but you wouldn’t know that in practice. The rule remains stuck to the paper.

If nothing else, we create a few light moments in the day. Some colour, some play, some laughter, some movement. Maybe that’s enough for now.

Resources: How to be more creative: https://youtu.be/oTAdkDyVa9s?si=xFA3h5PEaZ-fIiuN

Hope?

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The old ones have not finished and today we have a new one. Yes. The world really needed another war. We, ordinary people needed to be shown the mirror again, as if we didn’t already bemoan our powerlessness. Impotent bystanders. Burning, yet totally ineffective. Quietly sitting, gazing at our phones, pretending to be immune to the bombs, the aggression, the assault on the Earth and its children.

This is not the first time, but it may be the last. History is revisiting, ringing the death knell, foreshadowing another erasure, another devastation. The imbalance of power in our world is showing us its ugly face again.

Vietnam. Cuba. Nicaragua. Libya. Syria. Panama. Iraq. Afghanistan. Venezuela. Now Iran.

I wonder which country starved, besieged and damaged generations across the world. The one that is quick to label others as a ‘Rogue state’.

Three years ago, Al Jazeera reported that 9 out of 10 Syrians were living under the poverty line. In a country that was once stable, diverse and culturally rich, many breadwinners were and still are unable to provide for their families. Young suicides are on the rise.

Abdul Hayy, a psychotherapist in Idlib says, “People in Northern Syria face conditions such as displacement, losing their homes, living in camps where they lose their privacy, as well as unemployment, poverty and an inability to adapt to the difficult conditions. This then leads to people losing hope and fearing the future, which appears as if it were getting worse.”

Humans are responsible for the extinction of many species. We might be next.

“Two things are infinite, the universe and human stupidity. I’m not sure about the universe.”

– Albert Einstein.

An Irish Legend

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Most of his stories are based in small towns and villages of 1950s Ireland. He writes about the underdog: small men and hard-done-by women. He has a deep concern for sexual exiles. His writing is true to that time in history because he normalizes silence, evasion and ambiguity. His fiction reads like truth. It reminds me of the time we lived in Northern Ireland. Almost every day I was flummoxed by the response I got on asking a colleague, how they were.

“Not too bad.”

I was never sure what that meant. Were they well? Or not as well as before? Or not as unwell as before? Not as well as they could be? Bad, but not too bad? I soon came to accept that as normal. In time I came to understand it as a safe answer – not giving away too much. It was historical.

William Trevor was a genius at talking about the unknown known, of knowing and not knowing at the same time. A cognitive disjunction. A common social ailment.

Yes. Mary Louise is in a loveless marriage to an older man and everyone in their small town knows but they pretend like they don’t.

Yes. Everyone knows that Elmer is becoming an alcoholic, but they act like they don’t.

I lately read ‘Two Lives: Reading Turgenev & My House in Umbria’ – a book with two artful novellas by Trevor. Reading Turgenev was shortlisted for the Booker Prize in its time. My House in Umbria was made into a film in 2003, available on YouTube. I haven’t watched it but apparently Maggie Smith is brilliant and the end has been changed for Hollywood.

For me, the protagonists of both these stories exemplify how hidden and unacknowledged grief can escort one to the thin red line between sanity and insanity. Both women are poorly understood even by people who claim to love them, their coping labelled as unacceptable, erratic and bonkers. Judged, condemned and outcast for simply managing their losses. Punished for somehow managing their loss. And finally, put away.

What’s in it for me?

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When we moved from the frantic chaos of London to the quiet serenity of Sakleshpura, we didn’t have much to do. We didn’t speak the local language, had no local friends or family and no real work. I offered to start volunteering as a Spoken English teacher at two local primary schools for an hour per week each. They didn’t ask me for a DBS certificate or for any evidence of appropriate qualifications. Not sure I am qualified, but I was sure we would have fun.

Within a few weeks of starting, my students would smile and wave at me if they spotted me in the market. Some of the older ones would offer to carry my bags. Kushil is seven. His uncle told me that he shampooed his head twice on the morning of the class as he knew I would kiss him on the head. He is one of 5 students at one of the tiny schools in a tiny local village.

I bought hairclips for the girls from ‘Accessorize’. Kavya wore them on the very next occasion she knew she’d see me.

Tanushree lives near one of my new-found friend’s houses. She stood by the roadside when she saw my car coming. I stopped the car and lowered the window. “Miss, books.” She said. I sent her a few age-appropriate story books by Indian authors to read, strictly on returnable basis.

Praapti presented me with a lovely little handmade Diwali card which I did not expect. Such joy! She also enclosed two pens in the envelope – one with dots and the other with bunnies, one writes in blue and the other in black.

After the class we walked to our farm nearby and played with cows and dogs, ate laddoos and fed peanuts to the birds.

Some of the locals cannot fathom why I teach the kids for free. What’s in it for me?

(Resource: Health benefits of volunteering: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/3-health-benefits-of-volunteering)