Have you seen the recent hit movie “Kapoor and Sons”? It is winning accolades for its sensitive portrayal of how a gay man struggles to come out to his family, and what happens when the news comes out. If you were like me, you might have wondered what it would have taken the perfect son portrayed by Fawad Khan to play the act of the ideal conforming son, while keeping a long-term relationship secret. All those video chats and conversations with his partner, while pretending that nothing is happening. I imagine what it must cost for the person to be like that, and then I wonder how it must be for any LGBT person to hide themselves in the workplace and be the ‘perfect colleague’
It isn’t difficult to see why somebody would want to keep things secret. Even in Kapoor & Sons, despite everything being ‘out’, there is barely a scene with the partner and he doesn’t fit in the family portrait, even though the other son’s girlfriend is happily integrated into the family.
For most of us, we weren’t taught in our growing years that there is a natural variation amongst human beings in our gender and our sexuality. Words like ‘gay’ or ‘lesbian’ were taboo and we used them as if they were scandalous, and worse, used derogatory words to hide our ignorance, if not our prejudice. Lack of knowledge and a hostile legal system have only added to the problem. I am sure many of us have witnessed (if not actually did it) a person being called out for standing in a supposed ‘feminine’ posture, or for not wearing what we thought was appropriate for what we saw as their gender?
No wonder people with gender and sexuality differences then learn to be quiet about it and not speak about it, and take on all that extra pressure of having to keep up a façade.
We are now in a much more open space, we would like to think. Speaking of Kapoor and Sons again, I am sure many of you, like me, only experienced a warm acceptance when the ‘news’ broke. We would like to think we are not hostile towards any gender or sexuality, but we do tend to carry our biases and apprehensions into the workplace, even if it is in the small and everyday details – like making fun of a movie star’s gender non-conformance, or saying “That’s so gay!” for something we find silly, or passing on a ‘joke’ about Gayle and his incredible performance that unfortunately belittles both queer people and sexual assault.
As they say, everything is a joke till somebody gets hurt, and here, we often don’t even realize what we might be saying or doing is hurtful to somebody around us. You might say because you didn’t know – that the person didn’t tell you or you couldn’t see it. Let’s face it: You wouldn’t have imagined Fawad Khan’s character was queer till it hit you – similarly, there are very likely queer people amongst us, and why would they tell someone they think is hostile? And if the person was more visible in their difference, wouldn’t it have been so much harder in the face of these unintended hostilities?
For a society , it becomes important because all individuals are important. We want to create a space where everyone is welcome, no matter the person’s race, gender, sexuality, religion, caste, age or abilities. We want a world where we are more aware of the differences that exist or could possibly exist amongst us, and act accordingly so that more of us can be comfortable, and just be ourselves.
Kapoor and Sons has started a conversation all across India – let’s be more aware and make sure we are conscious of being as open and inclusive as we want the world we want to be!
As it happens at this time of the year, at InnerSight we often find ourselves facilitating discussions on a number of topics related especially to women in the work place, in the context of organisations celebrating Women's Day.
Last year, a company in Bangalore had made big plans for the day. They had planned a fashion show, a cookery contest, special shopping festivals and many other events over a three day period around Women's Day to really celebrate the day in a big way. We were a part of the event with a small workshop for interested participants to discuss gender roles, prejudices and perceptions in the work place. Given the rest of the plans, it was interesting to note how much the group talked about the selection of events to mark womanhood - cooking, clothes and shopping. Some of the women were livid at the typecasting, while others were talking of it just being for fun. The few men in the workshop, quite tactfully, kept mum!
It left me thinking then, and I am reminded of it again now, as to how deeply gender roles are engrained in our collective psyche, and how much of a struggle it is to break out of those roles to reinvent roles in relationships. Even now, the idea that cooking, cleaning, child-care and home affairs are in the women's domain is so deeply engrained, that for many working women, it feels like they are in two full-time jobs all the time. Some people, of course, feel they are making these choices themselves as free and empowered people - they want to do it all, and yet, when you scratch that surface, there usually are deep-rooted messages on what it means for them to be a 'good' person, and the costs they are paying, be it exhaustion, emotional and physical, resentments, anxiety and more become quite evident.
We don't have to dig far to see where it comes from. Our ads, movies and TV shows do a great job of reflecting the glorification of the working woman who slaves away at home as well - the villainous women are often the ones who are working outside but not at home, and the virtuous women are the ones who do everything.
Our new heroes are then the Super Woman who can do it all, and all that with a perfect smile while looking like she stepped out of a magazine cover.
A few months back, on Mother's Day, we wrote this. Today, as we approach International Women's Day, we are asking the same questions again, in a larger gender context: "Should we really be celebrating the 'super-woman' status? Can we look at the pressures and stresses that women go through, and actually make it easier?" (paraphrased). This International Women's Day, as we celebrate womanhood, let's also pause to ask ourselves what are we celebrating, and what could possibly change about it.
And have things changed at the organization we started this post with? This year, we hear they have fashion shows, cookery contests, a sack race through the office corridor, a hackathon - and all events are open for all genders :)
Valentine's Day 2016 is round the corner.
As is usual for this time of the year, we are inundated with constant messaging on how & where to celebrate love this special day, and equally, a counter-pressure to not fall prey to these marketing tactics.
Whatever your views about celebrating relationships on a specific date, it is still a great time to remind ourselves of some basic goals which are key to any loving relationship:
If you look at these goals closely, it then dawns on us how much work this is. It really is hard work building and keeping trust, to plan and have time together, and to communicate and listen. Phew.
It is the truth - all relationships take work. It takes work to find someone, love them through the ups and downs, and even - when needed - to let it go. The reward for all that hard work is not only a relationship with someone that you can cherish, but also a closer relationship with yourself, a deeper understanding of your own needs, values and desires.
Perhaps that is the true message of days like Valentine's Day - to recognize how much work we are putting into relationships, and that we need to celebrate it.
Whether we are in a relationship with somebody currently or not, let's celebrate this Valentine's Day as a recognition of how hard we work at our relationships.
Happy Valentine's Day! Here's to loving ourselves a lot more!
Here we are, close to the end of January of 2016. If you, like me, are thinking where the heck did all these days go, then perhaps it is time to take a short break and count your blessings. Quite literally, really. Some studies show that the sense of time passing by really fast happens when we are busy, happy and just quite engaged in our lives.
On the contrary, life can be such a drag when we are going through a tough time. If you think back, you probably can think of periods in your life when it felt so - that time when you were carrying for someone with a chronic illness, for example, or the few weeks that you were unemployed, or depressed. You may shiver at the memory of it and want to shake off that image, hoping it doesn't come again - and that's a good thing to hope.
Fact is, we experience time not just in hours, days and months, but for the emotional context it has for us - though of course, in certain other conditions (such as altered states of consciousness, sense deprivation, age etc) time feels longer or shorter, or just fungible, but under regular circumstances, it is our emotional state that decides how we feel the time pass by.
That said, what of it?
Think of living as a period of collecting life experiences. Imagine you are going through all your life collecting memories, sensations, thoughts, feelings, perceptions - the whole rigmarole of what it means to be alive. If the happy times seem to speed past and the not-so-happy times slow down, does it mean that the not-happy memories linger and stay on longer? Is that what one would want?
From an evolutionary perspective, one could argue that memories of not-happy times serve the more useful purpose as learning experiences for us to try and avoid such experiences in the future, but then, as people, we would really want to remember and cherish the happy times as well, because those are what we really live for and enjoy - not just a series of avoiding unfortunate times.
That brings us back to what we started with - if the month seemed to just rush past, remind yourself that you want to cherish it, you want to mark this period for yourself and keep memories alive and kicking about this period. Get proactive about it - be sure to spend some time thinking over the busy, happy times, make these memories concrete. Save some pictures, maybe a video or two.
May the year continue to be happy for all of us.
Did you make any resolutions for yourself for 2015? If you were able to stick with them and really make it count, congratulations. If you weren’t able to, don’t beat yourself up about it - statistics show that most new year resolutions fail in the first few months. In fact, only 40% are active in the second half of the year. It doesn’t mean that New Year resolutions are a waste of time, and certainly not that we are not capable of following through – it just means that we need to be smarter about it.
For 2016, you might, along with hundreds of others, be making resolutions about getting fitter, saving better, studying more, spending more ‘Me’ time etc. Any of them are doable, if you choose ONE specific goal, and are SMART about it: Make your plan Specific, Measurable, Achievable, Realistic and Targeted. If you are planning to get fitter, set a goal to run the 10K in Nov, work backwards through the year into smaller goals, such as three days at the gym, desserts only twice a week etc. Keep it simple and doable, and get a buddy to share your resolution – that helps.
Happy New Year to you and may your resolutions come true.
"Although no one can go back and make a brand new start, any one can start from now and make a brand new ending"
We in India are entering our peak holiday season - Ganesh pooja and Id are over, Dussehra is just about done, and it will be Deepawali in a few weeks and Christmas soon enough. Much of these holidays are based on religious occasions and come with their own rich and particular cultural flavour and heritage.
For many of us, especially those who have moved far from our home towns and original communities, it is a time to reconnect with our families of origin and extended communities, which explains why for almost all major modern cities like Bangalore, Hyderabad and Chennai, the festive season means a mad rush at the bus and train stations as thousands of us rushing to get to our home towns in time for the celebration.
All the loud, colourful and festive celebrations are great for those who feel celebratory, but it is an especially difficult time for those who are going through painful losses, have suffered the passing on of a loved one, or have not had such connections. Festive occasions and holidays are especially stressful for those in such circumstances. It can be depressive and a reminder of what one does not have and a source of pain, loneliness and suffering, as much as it is a source of joy to others.
Which brings us to the conversation: How can one protect oneself in festive times, when the whole world seems to be joyful and we just cannot?
Assertiveness is a skill, and you CAN learn to be assertive
What does being assertive mean to you? Does it mean exercising your rights every time, with every one? Or is it knowing when to let someone else or some other cause or outcome take precedence over your rights? Is the boss who piles work on an employee on a Friday evening being assertive? Or, is it when that employee tells the boss that the work will be done post the weekend?
It isn’t always easy to identify truly assertive behaviour. This is because there is a fine line between assertiveness and aggression.
Assertiveness is not necessarily easy, but it is a skill that can be learned. Developing your assertiveness starts with a good understanding of who you are and a belief in the value you bring – which is the basis of self-confidence. Assertiveness builds on that self-confidence.
Developing Your Assertiveness:
While some people are naturally more assertive than others, even if your disposition tends more towards being either passive or aggressive, you can develop your assertiveness by working on the following
Every fairy tale ends with a happy ever-after message, and in reality, we know that no such thing exists or is possible, or is even desirable. There will always be nature that does something - the flowers wilt, summer gets over, school reopens. Life and death continue their cycles.
Making ourselves believe that we should just not heed any such event, and try really hard to satisfy the social pressures to be happy, always and as much as you can, is only doing ourselves a disservice. Sadness associated with losses, either through natural causes or due to errors of judgement, or due to competitive losses, can help us develop better judgement, prepare for future events and motivate us.
"One of the primary reasons we have emotions in the first place is to help us evaluate our experiences." - Adler
We were given all these emotions because they do give us a real advantage. Being sad over having lost the 100m dash can help us know ourselves better - maybe we will get faster, maybe we will change our sport, maybe next time we'd sit in the rafters and cheer a friend, but we will get through it and learn from it.
Instead of trying to avoid or ignore sadness, a healthier alternative would be to:
Going through the temporary and event-driven sadness, as and when they occur, can be a life-enriching experience, if only we let it. The way to feel better is often through the sadness when it comes, and not around it or to just avoid it.
At the first instance, Cutting and self-harm may not necessarily mean the person is suicidal, though of course, it cannot be ruled out off-hand. Current thinking reflects that cutting behaviour, might be a way of expressing deep emotional pain that they don't have the full capacity to express, explore and process.
Usually, cutting is a secretive, and often obsessive behaviour that is in private. To know if a child might be cutting, look out for changes:: changes in clothing with a preference for full-sleeved shirts, increase in bathroom breaks, avoiding preferred activities and usual social groups or adopting small cliques that stay aloof from others.
When as an adult you come across a teenage person cutting herself, the first thing is to know that this could be serious, and to alert the immediate family for possible counselling and mental health intervention. You can let the teenager know that you have become aware of this behaviour, your concern and your availability to discuss things if they want to, but please do not insist that they disclose. You can help by remaining calm and patient, much more than becoming anxious or panicking.
What you may not want to do:
1. Don't make a hue and cry about it. Don't publicize it or make it a public knowledge. Certainly keep it confidential from other students and peers.
2. Don't demand that the child stop the practice, or threaten with adverse consequences
3. Don't probe, and don't assume highly traumatic events. Don't ask for any details on possible family issues, especially if you know of any dysfunction
4. Don't lecture them on how they should cope with life challenges, what is good for them or how they need to grow up
5. Don't make them feel guilty or shamed. Do not tell them they are hurting you, their family or school by this behaviour
At the same time, this is difficult for an adult to witness and feel helpless. Please don't make it your mission to change things, and if the child is not willing to discuss with you, please don't take it as a personal disappointment or get frustrated.
Even if the child doesn't want to discuss with you, you can still help by:
1. Keeping a watchful eye over the child, reducing alone time of the child
2. Helping the child engage with other activities (without making a project of it)
3. Staying open and available when the child chooses to try and express
4. Keeping the environment as predictable and friendly as possible
What to do when the child starts to talk about it:
When the child does begin to express, you can help by asking simple questions to try and understand. Gently look to help them find other resources for themselves, and to identify positive qualities about life and themselves. Try and maintain a non-judgmental attitude, and try to take an attitude that nothing is too shocking for you.
You need not agree with them or feel the same way, but you can express that you understand how difficult it might be for them. A key benchmark is to see that the child is speaking much more than you. Even if the child is not talking, just being with them in comfortable silence can be great for the child.
Please do not try and please the child so that she doesn't cut herself, as that might lead to manipulative behaviour.
Is this the 'in' thing?
Many children do pick up such behaviour from each other, popular fiction and the internet. Sometimes, they tend to form small groups which sustain each other, and that can have adverse effects on recovery as the support they got from each other when they needed it might be hard to give up.
Look out if small cliques are getting formed with other similar people, and gently reduce grouping possibilities - not by policing them, but by increasing attractive options outside such group.
Be discrete and take help when needed:
Above all, your discretion, watchfulness, patience and availability matter. Please do consult a mental health consultant, or a psychiatrist when needed. They will work with the children and as the children learn more effective communication and coping tools, self-harming behaviour does tend to go away.
Caring for your loved one with severe mental illness may take priority, but keeping yourself physically and mentally fit is important too
What is caregiver stress?
Caring for a loved one with a severe mental health disorder or psychotic illness can be challenging for the caregiver due to the various factors involved: having to accept that their loved one has been diagnosed with a mental illness and may not be able to function normally for a period; the intense emotions that arise while caring for their loved one, and the sheer practicality of having to balance caregiving with household chores or a job. To add to this, the stigma that surrounds mental illness in our society makes the task of the caregiver tougher in some situations.
The term ‘caregiver stress’ refers to the distress caused to a caregiver due to their loved one’s illness, or the strain posed by their caregiving duties
Experts use the term caregiver burden to refer to the distress and lifestyle adjudtments that a caregiver makes when they begin caring for their loved one. These adjustments could be practical: having more tasks to do as they assume the caregiver's role; Occupational (having to make significant changes at work, or quit their job if they are a full-time caregiver); financial (dealing with increased expenses and possibly, decreased income) and social (being unable to mingle freely with family and friends due to the stigma surrounding mental illness).
Conditions with distressing symptoms
Most people with severe mental health disorders such as psychosis or schizophrenia exhibit two types of symptoms:
Negative symptoms can come across as being more severe because they take something away from the 'normal' functioning of the individual; they are more easily observed by people around the person with mental illness, and mark them as being 'abnormal' in their behaviour.
Some people with mental health issues may be suspicious of their family and caregiver; this may be a source of stress for the caregiver, particularly when they do not want to be open about their loved one’s mental illness. The fears about being identified or found out could lead to lack of good relationship with friends, neighbors, family or community. The caregiver may have a sense of self-imposed isolation due to which they are unable to share their feelings or their challenges with the people around them.
Persons with some mental disorders – such as schizophrenia or psychotic disorder – may experience delusions or hallucinations. When a person has delusions or hallucinations, they may think that the caregiver is conspiring against them. They may get angry or laugh loudly in response to the delusions. This may lead to misunderstandings or mistrust between the patient and caregiver.
Persons with auditory hallucinations may be lost, withdraw into their own world, act out or speak to themselves. The caregiver may find this tough to understand or manage, especially in social situations. Sometimes, a person with delusions or hallucinations may lose their temper, abuse those around them, or get violent for no apparent reason.
Often, these behaviours can be observed as small variations of appropriate or socially-accepted behaviour. Unfortunately, the lack of awareness about mental health means that most caregivers wait until the behaviour becomes very pronounced or bizarre before they consult a mental health professional. Psychiatrists say that the earlier a person is brought to a mental healthcare center, the greater the chance of the person living an independent, functional life after treatment. Late diagnosis can lead to the development of certain behaviours that puts a strain on the caregiver, and could lead to caregiver frustration and burnout.
Stress caused by stigma
Very often, the stress caused by the person’s symptoms or behaviour becomes harder to manage due to the stigma surrounding mental illnesses. Take the example of Rajesh, who was diagnosed with paranoid schizophrenia.
Rajesh’s parents found it difficult to take care of him because he was always suspicious of them. The stigma made them hide the news from extended family and friends. Because they were afraid of the neighbours finding out about the illness, they began avoiding their neighbors and relatives, particularly when Rajesh had psychotic episodes. They were afraid of having to answer questions about Rajesh’s health or his changed behaviour. The fear of getting found out caused Rajesh’s parents a lot of stress. They also had to deal with the changes brought by Rajesh’s illness without any social support.
This narrative has been created with the help of mental health experts by taking into consideration symptoms and accounts from a cross-section of patients.
Other factors that make caregiving stressful
Sometimes, the caregiver of a person with a mental health issue has to make drastic changes in their own lives; they may need to quit their job and make some changes to their lifestyle. “Earlier, caregivers had more support due to joint family structure. Now, families are smaller, and everyone is working, so less support is available,” says Dr Santosh K Chaturvedi, professor of psychiatry, NIMHANS.
The stress can lead to the caregiver developing lifestyle disorders like diabetes, hypertension or other related health problems like diabetes.
Expressing distress through emotions
Expressed emotion plays a huge role in the recovery of a person with a mental illness. Very often, the caregivers; distress manifests in the form of expressed emotion. The caregiver may – consciously or unconsciously – express negative emotions, criticism or hostility while relating with their loved one. The attitude of the caregiver influences the course and the outcome of the illness. Very emotionally-charged situations can also lead to compounding the caregiver’s stress.
Expressed emotion plays a critical role in a person’s recovery. Experts say that in disorders such as schizophrenia, there is a direct correlation between the caregiver’s negative emotions, and the number of relapses. When a person with schizophrenia lives in a hostile atmosphere, their illness is more chronic, and they need more medication to manage it.
Seeking help for caregiver stress
If you are providing long-term care to a loved one with a mental illness, chances are that you will experience at least one of the stages of caregiver burnout at some point. Caregiver stress is a genuine mental health issue, and burnout is considered a long-term adjustment disorder.
Here are some signs of caregiver stress:
Stages of caregiver stress
Most caregivers go through these stages of caregiver stress:
The early stage or the honeymoon phase: where the caregiver is confident, sees caring for their loved one as a part of their duty. They take their duties positively, with the belief, “Let me look after my loved one. This will pass.”
The monotony phase: Where the caregiver feels there are ups and downs in their caregiving journey.
The brownout phase: where the caregiver feels exhausted, fatigued and disoriented. They begin to see caregiving as a chore or a burden.
The burnout phase: During this phase, the caregiver distances themselves from the person they are caring for because it can be emotionally exhausting. They continue to care for the person, but the caregiving is mostly mechanical. The caregiver may be depressed, cynical or emotionless during this phase.
Preventing caregiver burnout
If you’re a caregiver and are feeling the signs of stress, reach out for help at the right time to avoid a burnout. You could opt for one among several interventions to ensure that your ward is well cared for, while you recoup and gear up to care for them again:
Credit:White Swan Foundation, a knowledge repository on mental health. To know more please visit White Swan Foundation
Ajanta, Mahesh and other InnerSight counsellors and guest contributors are happy to share their thoughts here.