PERSPECTIVES- Short story

Client’s perspective-

Hi, my name is Sheena and I’m 13 years of age. I love shopping for clothes and like pink everything. I was doing quite well around till a year ago; at school, at home.  I don’t exactly remember when things started going downhill. I guess soon after I started getting my periods? I’m not sure. But this was when I started gaining weight and became taller than most of my classmates due to which they started making fun of me, saying that i looked older than them and must have failed a grade. I used to feel so embarrassed by this and soon stopped talking to others. Around this time I also had a fight with my best friend in school, soon after which I didn’t feel like going to school anymore. Whenever I was asked to go to school or talk to other people, or whenever my brothers teased me, or when my parents get angry with me (which was a lot by then!) I started having something called “panic attacks”, which my psychologist later explained to me. To me it was more like this feeling as if I was going to die. My heart used to soar like the time I saw the boy I used to have a secret crush on; only this time it was faster, scarier. I would start to sweat, have difficulty breathing, my body used to tremble and words would scarcely come out of my mouth. This would last a few minutes which felt like hours then. Then I would sleep 10-20 minutes. I became moodier as the days passed by; I lost interest in everything even shopping! And I soon started feeling tired all the time.

Due to all this my family ended up taking me to a priest who told them I was possessed and hence needed an exorcism. This priest used to beat me up, shout at me, god knows why. He used to make my parents do the same, and ask the bhooth (demon) to get out. It seems (I found it out later though) that my family was instructed to keep scolding the bhooth in me. But I felt that they were scolding me, because they used to use words like-“leave us alone.” Get away from us”. I live in a joint family set up, and my best friends were my cousins, however now cause they think that I was possessed they avoided talking or playing with me and used to talk about me behind my back in hushed tones which made me very uncomfortable. These exorcism sessions went on for many months and were based on my father’s initiative, but my mother supported him nevertheless and both of them didn’t pay heed to what I felt or said. I started having nightmares about the exorcism rituals. Some days they just came back to me even during the day even while I was at home. I hated the visits and started dreading/hating religion or anything associated with religion. And to think that, I was a religious person to start with. (I have regained my faith now, I understood after a while God had nothing to do with what I went through, it was people) I started becoming more and more depressed, lost interest in everything and started to have suicidal thoughts and soon I even started cutting myself. Thankfully now to think back, the cuts were not deep. Sometimes when my mother doesn’t pay attention to me or when I don’t get what I want, I started getting very, very angry. I would often end up shouting and go back to my room, stops talking to others, starts threatening them that I will cut myself and eventually start cutting myself. My parents would often end up by pacifying me and giving me space. Sometimes I liked the space. But sometimes I wished they just understood me. I couldn’t control doing what I was doing then, somehow it helped me release my frustrations and the anger I felt for my parents especially my father.

One fine day, I was admitted into a psych center subsequent to my attempts to cut myself on the wrist again. I hated it; I hated them for taking me there. They were always forcing me into things I didn’t like. But this time it was different.  The doctors there, well they were very nice, actually. They assigned a clinical psychologist to me. Yep- ‘clinical’. Hope I got it right this time. I know I sound all intelligent and all, but then I was like what??!? They explained to me that a clinical psychologist is someone who will try to understand me and help me figure out my problems, via certain tests and therapy. At first I thought what the hell!? This sounds absurd, and I didn’t want to talk to her. But then, she was very gentle, and didn’t shout at me, order me around like my parents, she didn’t even ask any questions in the first session! She just well let me do all the talking. She let me talk about my hobbies, my dreams, my wishes, my friends, and my life. She didn’t even bother to correct me when I was wrong, or when I used bad language. She genuinely tried to understand me. At first I thought she was faking it, but then how long can one fake?  Cause I was admitted for around 2 months first, and by  the time I felt less suicidal, they discharged me I was back only for my therapy. The clinical psychologist saw me for an entire year on a weekly basis. She remained the same person, someone who understood me, spoke up for me, my dreams.

A team of doctors, actually a senior psychiatrist (for those who do not know- that’s an actual doctor who treats people who have psychological issues mostly by prescribing medicines and sometimes by using therapy) and the clinical psychologist I just told you about; over a few days helped me calm down, talk to them about my problems, and one fine day in the wards when my parents were not around called me separately from the friends I had made by then, asked my permission, if I was willing to have a chat. I went and then both of them told me they have a name for what I was going through, and were willing to share that with me, if I was ready.  I said I was. After all I wanted to know what they were thinking about me after all that tests and interviews I had with them. They told a big name- something like Post Traumatic Stress Disorder with moderate depression and social anxiety (with panic attacks), with underlying emotionally unstable traits. I felt confused again, a little irritated as well. But then they explained to me it was just a name, which helped them communicate between themselves, and to help me understand that better. They told me how anyone may end up with this, and that’s perfectly fine. They also told me all that matters is how I take it and with their help sort it out so that I can get better and be happy.

I felt a little better hearing that I can be happy. But I was worried what if my friends come to know about me? They would call me crazy then. What about my parents?

I guess my clinical psychologist noted my discomfort and immediately asked whether anything was bothering me. I felt quite uncomfortable with sharing the fact that I was more bothered about what others would think of me and talk about me, than the fact that I had a problem. I had by this time accepted that. Anyways I did share it with her nevertheless, and she ensured that there are confidentiality clauses to therapy and they are not supposed to share this, without my permission. I felt quite relieved.

They then offered me the option of undergoing therapy. I was reluctant at first. I felt like I had no other option, then what the heck; why not give it a try? I said yes and that was the best decision I made in some time. Granted it was no joy ride. Therapy is difficult but worth it. I became better, smarter at handling people and situations, and felt better about myself than ever.

Time just flew I guess, by the time I realized it was already a year. I had grown used to the idea of meeting my clinical psychologist every week. Sometimes I looked forward to it, other days while we were processing more difficult stuff, or if I couldn’t do my homework, I had my apprehensions. But I went anyways. Till the day she said- “It’s about time now, what do you think?” I said – “YES”, and then moved on to embark on my journey on my own.

I do follow up every now and then, but now I’m pursuing my engineering and aim to get into IIT. I have a loving family, and a lot of friends. I feel more adept at handling my emotions, and difficulties. There are good days and then there are bad. But I get it now. That’s life.

Clinical psychologist’s perspective-

Sheena was initially diagnosed to have Moderate depression with somatic symptoms and social anxiety. The diagnosis was reviewed later after assessments and sessions with her revealed how she had low mood which was exacerbated by the multiple exorcism rituals she underwent. The diagnosis made was Post Traumatic Stress Disorder with moderate depression and social anxiety (with panic attacks), with underlying emotionally unstable traits. She was put on medication in order to alleviate her depressive symptoms and was referred for therapy to learn to handle difficult emotions more adaptively.

An eclectic approach (a mix of CBT, DBT and Family therapy) was followed; DBT strategies were used predominantly (DBT-dialectical behavior therapy) for the child, considering she had emotionally unstable traits.

OUTCOME

Therapy served the purpose of catharsis, awareness raising, learning new skills as observed in sessions and follow up. Child was feeling happier and participating all the activities in the ward and made many friends as well. There were lesser anger outbursts or other self harm behavior when patient went home after the initial phase of therapy though there were situations which used to provoke her at times. She was still refusing to go to school, because of which it was negotiated that she be ready for home schooling to which she complied. Overtime she learnt manage her emotions better, communicate it effectively to others and her family, her family started listening to her more often and via graded exposure she started going to normal school.

REFLECTIONS

The experience of working with children and adolescents made the therapist ponder about trust as a crucial element in any relationship, and how fragile it is, it also helped her understand how peer and parental pressure and cultural factors can interfere with healthy development. Working with them made the therapist to ponder about the need for imparting parenting style education to the general public as a preventive strategy .There is high need for parents to allow their child to express who they are in a safe conducive environment without any fears. The constant relapses in sheena’s case were difficult to manage and the therapist felt lost at times. In such situations, constant support and peer/senior therapist’s supervision helped a lot. As the therapy progressed, supervision helped the therapist look back and reflected she felt the case could better understood from a eriksonian perspective as the child in her adolescent years currently, she is going through physical changes which has a bearing on her body image and her sense of self. In this state of vulnerability when herself /identity is being formed, she faced traumatic experiences of exorcisms, which left her identity fragile, coupled by also the fact that she ended up losing trust in her significant others- parents. This helped her understand how different perspectives can be used to understand the same issues.

Disclaimer-

The above mentioned story is fictitious, sheena doesn’t exist in reality.

However she is a conglomeration of multiple cases and my imagination.

The reflections are though very real, and ,my personal accounts on how I felt after seeing multiple adolescents’ over the years of my training and my current practice.

India has a rich religious and cultural heritage. It adds beauty to it. And I’m proud of it. But there are downsides to it as well, as with any thing. The exorcism mentioned is one simple example of the same.

This doesn’t mean I’m against religious beliefs. I personally am of the notion “To each his own” and am a believer myself.

#Therapy #Awareness #Clinicalpsychologist #Adolescents #fiction