Most newspapers these days deem fit to run columns on child rearing, marital relationships and other aspects of human life. For my part, I view most of these attempts with suspicion. While I do acknowledge and appreciate the wonderful work that is done by hundreds of trained psychiatrists in helping patients with serious mental illnesses, my quarrel is primarily with the psychotherapists or counsellors whom we reach out to 'for help.' Or who thrust their services upon us.
My main contention is that they try to find explanations for the unexplainable. I have never seen one therapist till date who takes off his specs, lifts up his arms to heaven and mouths “Trust in God,” in true filmy fashion. They feel compelled to show that they know causes and provide band-aid solutions for everything.
Unlike doctors, who can show “real” results and hence don't feel the need to give long-winded explanations, these counselors seem to get by on the glibness of their tongue, jargon and the guilt felt by families of their 'cases.' Illnesses which need psychiatric support – such as schizophrenia, for instance – are much more tangible – both in terms of symptoms or cure. When we enter the field of behavioral problems, on the other hand, we are moving into a much more greyer zone.
Is the child who refuses to sit still in class, simply acting up because he is bored? Or does he have ADHD? Does he come from an abusive or neglectful home? Or is he hyperactive? Or is he trying to show off because he is hopelessly in love – as only a seven-year-old can be – with the pretty girl in the front seat with shining eyes and lustrous hair?
Now I was recently called to Ken's school to talk over his inattentive behavior with the school counselor. His biggest crime – apparently – was to finish his work before everyone else and distract the others. Was his work messy? No. Was his work done wrong? No. Is he doing poorly at school? He's a straight A+ student. Then can you please explain to me why the fuck I am here.
That, of course, is what I should have asked. Instead I fell into the counselor's trap and answered highly intrusive and biased questioning and left convinced that Ken was on the path to perdition and this was the direct result of the neglect he had suffered when I left him for 6 months to go study abroad – when he was three. This encounter, which happened on my birthday, totally ruined the day for me.
I was left in a dangerous cocktail of emotions. There was shame - for sharing extremely private information with a complete stranger who picked out samples she wanted to put into her little notebook, judged my life and tossed it back to me like so much trash. There was anger – because I felt invaded, violated. There was guilt – because in the end, all of Ken's problems at school were penned down in my list of failures. Why did I leave him for 6 months? Why? Why?
In her little list of “Single Mother. Child left in grandparents' care when very young. High pressure job. No family support. Remarriage. New sibling.” there was no room for Ken's real life. The fierce love and protectiveness I feel about my son that makes him almost the central being in every breathing minute of my life, was discounted. The pride and fondness and protectiveness my parents feel for him – despite all the differences we have had about his upbringing was negated.
The absolute integrity and devotion with which the mate spends hours of every day exclusively with him – teaching him, playing with him and sharing so much Dad-son time that most fathers don't have, was viewed with suspicion. The sister who so adores and worships the ground he walks on, that she spends every waking moment of her life tailing him was trivialised and she was cast as the intruder who took his parents away from him.
And all of this was dismissed by the therapist and her little notebook. In her mind, Ken was just one of the hundreds of “difficult children” she met in the course of her life. And she had to pigeonhole his distractedness into one of the numerous permutations and combinations that she knew, so she could point to a cause - however remote - and offer offhand solutions.
And I had sat back and let her talk me into believing that my child was suffering the ill effects of my "neglect." I felt like I had "Bad Mother" written all over me. It took well over three weeks for sanity to return; for me to stop looking at myself as a criminal and at my son as a potential juvenile delinquent. The mate, of course, went to school and insisted that Ken never be allowed to meet this counselor alone. And that, in the end, was our choice. It is, after all, our child's mind that is being examined and perhaps screwed up here – unsupervised by the people that know and love him most – his parents.
In the end, I could see no difference between face readers and palm readers who make educated guesses and co-called counselors who manage to neatly package a human mind into a catalogue of symptoms, causes and management methods. The other day I came accross a tongue-in-cheek observation on an American website that said: You're more likely to be diagnosed with ADHD if you're a rich, white American. If you can't afford ADHD therapy, you're just a naughty child.
This is not to say that behavioral problems and learning disabilities don't exist. They do. But we need to make sure that they're not over diagnosed. As a nation, we are becoming wealthier and have more access to health care – both mental and physical conditions and illnesses. We just need to know where to draw the line when it comes to operating in the grey zone. Don't believe everything your therapist says. The economics is simple. The more sessions, the more she gets paid.
In my long ago past, I once met a marriage counselor, who gave 16 one-hour sessions at Rs 500 a session, for counselling on marital problems. At the beginning of the hour, you dropped your 500 bucks into a crystal ashtray on the table. He listened as you poured out your pain and your innermost thoughts, offered platitudes, affirmed that you needed to resolve your problems one way or the other. You offered some solutions, he came up with some and at the end of the hour when his little timer rang he'd cut you off mid-sentence and hustle you out.
At the end of the sixteenth session, it didn't matter whether your marriage was up and running or not. You were done. If you wanted more help, another 16 sessions were lined up. In the end it was your ass on the line. You had to count to 100 or buy a punching bag or go for a 6-kilometer run or dump the marriage and move on. In the end, you decided what to do and you did it - after paying him 8000 bucks. That was the going rate in the good old days when he had only one book out. By now, he's had about 5, so rates might have gone up.
Just as most weight-loss programs require you to go on a diet and follow an excercise routine, in order to be effective, most psychotherapy leaves the onus on the person and the family. The therapist or the counselor can only give you a general guideline and charge you for it. And if it doesn't work, she'll offer another route and charge you again. And so on until you either give up or find something that works. Most of this information and help is available in your own mind – for it is commonsense dressed up in jargon. For the rest, the Net is an almost bottomless source of free information. And it doesn't judge you.
There are millions of children across our nation who come from impoverished or dysfunctional homes and still make it. Children, from villages so small and remote that they don't even merit their own school, walk for miles and pursue academics so ardently that they end up in IITs and RECs across India. Working children from alcoholic, abusive households who carry their books in their pushcarts and study in between customers. Children who are born with disabilities or debilitating diseases and find some way to make their life useful or happy and fulfilling.
When you're drowning, you cling to the wreckage. To sit in a luxury yacht and refuse to steer because the air-conditioning isn't working, and have a therapist support you in your stand and blame your family for failing to provide you with air-conditioning, seems absurd to me. I know in my mind that if my son wants to steer his boat and get somewhere in life, he will, regardless of what the rest of his family is like. And if he doesn't, that's his choice. I won't sit back and watch any professional create a market for her services by encouraging him to whine over the little things he doesn't have and lose sight of the big things he does.
2 comments:
One small incident, not related to psychiatrist but to general therapy... When I came to USA in August, I came with my two nephews who live here and were returning from a visit to India. One is about 8 and the other not yet 3. Both upset their stomachs somehow after coming here, probably catching something from India, and were very sick. Now diarrhea is something very common in Indian kids, and we don't think much about it. However, the doctors here refused to treat them until an expensive pathological test had been done and the exact cause ascertained. The pathology lab refused to give the report until they had performed the complete test which takes about 7 days. After that they returned an all negative report, and the doctor simply refused any medication saying that since he could see no cause, he couldn't do any treatment. In the meanwhile, my nephews got weaker and weaker, and at one point we thought of admitting the younger kid to the hospital. Luckily they healed by themselves after about a month of sickness. So much for the healthcare in the US! So you are very correct in ascertaining that a diagnosis is dependent on the economic status of the patient, and costly tests/treatments are recommended for people who can afford it. The poor can do without it and do very well.
it's simpler, isn't it? to tell the parents that the kid has "troubles". saves the teacher from having to think of ways to keep the smarter and faster kids busy like teachers 10 years ago did...
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