When I was in my college, I had Psychology as my pass subject along with major in English literature. Studying the mind has been very intriguing to me always. Knowing what people think; what they go through; why they need to be essentially in turmoil and what is the proper cure were my interests. Hence I loved the subject especially the practical classes.
Once in such a class, we were taken to a mental health clinic where counselling was professionally done, so that we could understand the procedure and get some hands-on experience with the thing.
First we were made to view a counselling session, which a practitioner and medical therapist was performing with his patient.
The patient was from Nasik; he had come to Kolkata for a few days, because he wanted to get a psychotherapy; he was away from hometown with some excuse on the name of work, I heard him saying,
“I had to come here, because therapy was not possible there, everyone knows me there, and I am afraid, this news will spread like wild fire, that I am with a counsellor, and then there will be lots of questions from my relatives, neighbours, and may be my parents won’t accept the thing so simply.”
He was in anxiety for six months, and he felt he was having physical issues because of his mental set back. He had already been diagnosed with high blood pressure problem, and he felt sometimes, he was hallucinating almost real situations during sleep.
Now he was in depression too, because he had had a bad break-up with the person he was engaged to for marriage.
What I had to focus on was the questions the therapist, Dr. Shukla asked the patient.
“How old are you now? Since when are you having the thoughts? .... Tell me a few things that you have seen……. What was the atmosphere like? Dark? How much dark? Did you see any light? What was the colour of the light?.........”
The questions had already started terrifying me. I wondered if I had to answer such things in detail, would I be able to recall!
“How was your ex-fiance? How was your relationship with her? How long did it last? What was the reason for the break-up? Did she move out? What was her complaint? What did you feel like the first day she declined the relationship? What have you been doing since then? How do you actually feel?..........”, and such multitudes of questions followed. I found the patient answering some of them with a grin, but at times, he was quite uncomfortable; at moments I thought he would break into tears. I really felt for him, and I developed an assumption that the therapist was a heartless man; he was just making him feel more miserable by recalling the dark days; how can this man get better, if he keeps thinking of his break-up and his fearful thoughts? Will he ever come back again to this doctor if this is his first experience?
Anyway, the session went on for an hour or so, and then the patient got up, took his coat and walked out shaking hands with Dr. Shukla.
We were led to a conference room, where Dr. Shukla would come to guide us through the session that we witnessed; we could ask questions about any doubts we had.
Many of my friends, asked about the technicalities of conducting a counselling session- what are the words to be used with a patient; how to make him/her comfortable; how to make him/her answer as we want to get information etc. etc. When it was my turn, I raised my hand in disdain and questioned, “Why does anyone come for counselling? To get relief or to be plagued more?” Dr. Shukla never asked the meaning of my question, but just laughed.
“I know why you are asking this. You must have felt that the patient is being disturbed further when he was in a session with me. We are doctors, and we have to do what is best for our patients. If I do not ask him about his past, if I do not know what he actually thinks or visualizes, then how can I treat him? A doctor has to expose and see the cut of the patient, in order to apply ointment which will heal, isn’t it? If he doesn’t refer to his pain, what will I treat?
Proper diagnosis is important before any treatment and that is what I do in the first session.
Making a patient speak about his pain and trauma is also a part of the treatment; if he brings up his difficult emotions and cry over them, at least we know, he will be free and light at heart at the next moment; he will not go home with a burden. If I don’t make him speak, he will continue to bear the pain of repressed emotions in his brain, and that can be very dangerous for his mental health in future; he can be prone to serious disorders. I need to relieve him of the repression first; I know he has not been able to speak about these to anyone, so I need to be that friend whom he can entrust in; he will not admit his feelings on his own, I need to push him, and help him through with my questions….”
The explanation was very precise and I received my answer.
“Yes, counselling sessions can be emotionally draining, in fact, for some rigorous therapies, you may feel tired after sessions, but once you are free of your hidden pain, you can accommodate much better with your environment; you feel more healthy and comfortable; you have no guilt or fear of being judged anymore once you have spoken about it all.”
It was amazing that such a simple thing, which I could not understand initially, was described so well with example. The doctor needs to know whether we have flu or fever through our symptoms, in order to prescribe the respective medicine, hence a psychologist and therapist needs to know our mental dysfunctioning through our pain and experiences in order to treat it and counsel it.