This will assure those with mental illness that seeking help is acceptable
Mental health problems are not recognized as problems as they are unseen and take place inside the mind. In a conversation with Manoj Chandran of White Swan Foundation, India's foremost psychoanalyst, thinker and writer, Dr Sudhir Kakar, says that not only the individual but also their close ones should recognize it as an illness and seek help soon. Edited excerpts:
What are the thoughts that come to the mind of a common man when you utter the words 'mental health'?
I would say the first thing that would come to the mind of a common man is fear. But if he's approaching a mental health practitioner, then it would be a combination of fear and hope. Therefore, the task is - how to make the hope more than the fear, through communication by a doctor, or by a mental health portal like yours, and switching to the notion that the hope is greater than the fear. I think that is the major point.
Why is it difficult for us to connect aspects of mental health to the physiological world of the brain?
That’s because ‘brain’ is a very modern kind of term. People have always been talking about mind, which is not really linked to the brain. The linking of brain with the mind is a very, very new thing. So people are not used to the fact that this mass of grey matter, the brain, can mold or have such a big influence. So the way to approach it is to say it is the mind, because the brain really is a part of the mind or all that which makes the mind, so ‘mind’ would be a much better word. ‘Brain’ is much too new and much too scientific for the common man.
Mental health is always linked to serious disorders but not to common mental disorders such as stress and depression, as we feel that they are part of life. How can we spread awareness about the fact that these problems can be addressed and treated?
Difficult question to answer, mainly because mental health problems are problems which are unseen. They take place within the body, in your mind; unless of course, they become very serious ones and then they come out into the open, in which case they are seen as problems. So they (common mental health problems) are not seen as problems because they are invisible. In society, they don't point out and say – here, that is the problem. For anything to be a problem, it's not only that I feel the problem, but also that my social group identifies it as one. It is like identity – it doesn't matter what I say I am; others have to say, yes you are that. Mental health problems, when they come out into the open, they become very florid, like schizophrenia or huge depression, and then they would be recognized as a problem. So unless your social group is affirming your illness, you are not going to get it to be seen as a problem.
So you were saying that there is a huge contribution made by the environment and the close ones of the individual, in making sure that the person can lead a better quality of life, seek help.
I think that is probably the vital form. The vital contribution is from the social group to encourage the individual and say – yes you can deal with it. The individual himself or herself won’t be enough.
You have been practicing psychoanalysis for several decades now. What are the major paradigm shifts that you have seen in the mental healthcare sector in India over the last few years?
Mental healthcare sector is, you can say, both half-full and half-empty. Half-empty because given the size of India and the size of problems, nothing much has really happened. You can also say half-full, because there are people who are much more knowledgeable about it. Especially in metropolises, the knowledge that there is something such as mental health or mental illnesses is much more. So I would say, the situation is 50-50. There's something which has happened in the metropolises with the educated class, but it (mental health) still remains outside the ken of most people, including the government and other agencies.
We have several notions of denial when it comes to mental health; we think it's not a big problem, we think that we know about it, and because we’re not suffering from it and we don’t know of somebody who's suffering from it, it’s not a matter of concern. How do we get everyone to see mental health as a priority?
I think my previous answer touches upon this point. Mental suffering is looked upon as part of life. People believe that everyone suffers through life so you go through it, what's the big deal? Unless, as I said, it becomes a completely in-your-face problem. Now, to convince people that this is really affecting your efficiency, your social interactions and your success, the idea can be strengthened if more and more successful people who have gone through mental illness come out in the open and become role models.
We have some big actors going for six-pack abs, so they are role models for physical body strength, but we have no role models for mental strength. Though there are some who have come out in the open about it (mental health issues), for example, actor Dilip Kumar went through 10 or 20 years of psychotherapy. So more such stories of very, very successful people who have also gone through mental illness and sought help should come out into open. Also, the role models need a lot of encouragement. I know, from my practice, that there isn't anyone in the highest reaches of any kind of profession, business, social or entertainment that hasn't had problems; lots of people have gone through those problems and sought help. But to say that I have had a mental health issue, that needs to improve. We need more ambassadors, champions, role models coming out into the open.
What role can psychoanalysis play in ensuring that mental healthcare is made available to people?
The role of psychoanalysis is to get people to look at problems which they are not aware of. Lots of our problems arise in the unconscious mind which we are not aware of, but need to be. Also, a lot of problems form in our early relationships, childhood relationships with family and parents; that's what we need to observe. So an introspective mental health treatment, that is, looking into one's self and one's life is very helpful. And, this is not very different from what our tradition also teaches – that introspection, it's a different kind of introspection, but introspection is one way of getting over mental problems or disorders as you call it.