Therapy for the Desi Mind | Chennai News

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Komala Selvaraj (name changed), had been hearing voices in her head for over a year. Her doctor, Dr. Veera Balaji Kumar, calls them auditory hallucinations triggered by extreme anxiety about the future, often created by the mind referring to trauma from the past.
Komala’s auditory hallucinations grew stronger day by day, triggering her worst fears of abandonment which experts say are common among middle-class Indian single mothers from patriarchal households after their children grow up.

On the one hand, the Madurai-based government employee is overwhelmed with the obligation to marry off her son. And, on the other hand, as a widow almost two decades ago, she was paralyzed by the likelihood that he might abandon her after marriage.
After months of Cognitive Behavioral Therapy (CBT), one of the most popular and evidence-based approaches, Komala came to see Dr. Balaji who guided her through Acceptance and Commitment Therapy, a technique recommended by the American clinical psychologist and professor at the University of Nevada, Steven Hayes. This form of mindful psychotherapy works on ways to bring about acceptance of the present – including all the emotions that stem from trauma – instead of trying to fix or evade it.
It is one of the techniques that find resonance in Indian spirituality and life in society where inequalities exist. “After following Western concepts of psychology, I realized that they only work with a small group of privileged individuals, while a portion of clients from lower socioeconomic and middle class backgrounds didn’t respond to it,” says Balaji, a fellow at American Psychology. Association, which also teaches psychotherapy at TN Open University.
The dichotomy that Dr. Balaji articulates makes young mental health professionals with strong backgrounds in psychotherapy and psychology wonder why popular therapy around concepts like “triggers” and “boundaries” doesn’t fit into the Indian context, where displeasing someone is intertwined with class and caste systems.
Instead of seeing mental illness as an individual problem that could be “solved,” they view conditions such as anxiety, depression, and multigenerational trauma as a long-term effect of caste, class, and gender inequalities. of Indian society and use community activities such as session art, meditation and storytelling as tools to enable the individual to overcome problems caused by systemic challenges.
“I started to dive deep into Indian spiritual texts like the Upanishads and Buddhist philosophies and found lots of metaphors that could be used to convey the idea of ​​empowerment through the ACT modality to someone in need. struggling with anxiety or depression,” says Doctor Balaji. “Komala, for example, was a nervous wreck when she came to me because her son was spending more time with his fiancé and embracing his opinions.
Instead of telling her how counterproductive her fears were, I asked her to observe her internal conflicts and see things for what they are. I also used metaphors to explain, for example, how struggling in quicksand will only sink you deeper,” says Balaji. “And by the third session, she had started to take control of her emotions. ”
One of the most pioneering approaches to making mental health help related to Brown contexts is decolonial therapy, which strives to find ways to make therapy relevant to populations who experience systemic inequalities and trauma. of oppression.
The idea is to decolonize Western concepts that use the privilege of the individual to make autonomous choices, and instead look for ways to build an individual’s resilience to engage in and out of family and societal structures. autonomous.
“Decolonial therapy work is a humanistic approach to consciously putting power in the hands of the person,” says Neha Bhat, a trauma and sex therapist. “Shortly after grad school when I started working with communities on the ground, I was made to realize that Instagram pop therapy or conventional Western therapy would tell you that if someone is causing stress in your life, stay away from them. But what do we do in households where we don’t have the financial tools to move into an apartment, or create divisions in the house? It was then that she decided to work with family structures and marginalized communities to help them position themselves autonomously within these systems.
A client of Neha who is in an inter-caste marriage told him that his mother-in-law (from a dominant caste background) is picky about his space and vegetarianism, while he and his wife are meat eaters and that they have to navigate those limitations in a one-bedroom apartment. “The added complexity here is that the mother-in-law helped fund my client (Dalit background) in his MBA, and so she’s also the safety net for this couple,” Neha explains.
So how to handle this situation? “There are a lot of rewards to being married in the same caste through the holidays, 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 accompanies their inter-caste marriage, discussed what religion and spirituality means to each person, and they ended up having a much better understanding after going through therapy. family. ”
Blue Dawn, a support group and facilitator of mental health services and sponsorships for bahujans (Scheduled Castes, Scheduled Tribes and other backward classes across all religions), is among the pioneers of comprehensive access to mental health for marginalized communities. Viewing mental health as a social rather than an individual issue, they work on community healing, arts, music, and connecting marginalized people to affordable and accessible mental health services. They also hold workshops for people living with mental illness, students, activists and social workers.
“The family unit is the most basic social system in India, followed by broader community groups – a place of worship, school, college and work. These have the properties of a family system”, explains Aditi R, organizational psychologist. “It goes 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 changed, but the rules of engagement did not,” says -she.

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