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Reflection: Thinking Behind Practice – post-structuralism, culture, individualism
Readings provided are supposed to help us plan and reflect in our work. This month’s readings for me were also a clarification of some of very old questions about Religion and spiritual beliefs. I clearly remember a time when a person who was presenting emotional distress was given a positive history of depression in family on her case sheet as her mother was too much into religious activities. According to the professional experience of that mental health practitioner, too much involvement in religious activities was a sign of escape from painful reality and hence depression. The lines in ‘Post-structuralism and therapy’ coordinated by Leonie Thomas, “Through engaging with poststructuralist ideas, I am coming to realize that my understandings are never objective, neutral or value-free. This is encouraging me to examine my own perspectives and to prevent imposing my ideas on others. It’s keeping me on my toes and I think this is a good thing!”, Religiousness of a person termed as escape and the person labelled as depressed can only leave the person more labelled, shamed and confused about one’s identity. While I was very sure that this type of diagnosis (Depression) was not verifiable by any diagnostic criterion, the importance to respect the religious and spiritual beliefs I understand is an ethical, professional responsibility of mental health practitioners. So I can only re-emphasize for myself the value of supervised practice so that such subjectivity is monitored.
I can think of so many instances where religious beliefs and faith were questioned rather than seen as practice that needs respect. Another insight about beliefs came from Stories from Sri Lanka. The readings say that religious and spiritual beliefs are often an integral aspect of the wellbeing of local people. How locals understand their experiences are powerfully influenced by cultural and religious meanings.
“Services need to be informed by the cultural understandings of the populations which they are designed to serve.” Tamasese 2002, in the chapter avoiding psychological colonisation reminds me of all those times we decoded the DSM disorders to the families bluffing their beliefs and trust on the faith healing methods. Whereas in the paper written by Charles Waldegrave, it states that ‘It could be said, there is no evidence to show that exorcism, traditional healing, or faith healing is any less successful in its work within the communities embracing such practices’. What exactly is the meaning of panopticans became clearer with each story shared in the papers. So to unlearn the fact that it is only my knowledge and training that has all the answers is important. Relying on faith, wisdom and knowledge of the client and the community of which s/he is a part of is a huge leap of faith which one needs to take.
While working in school with children and families, we come across situations when families do not find problems in behaviours like underage driving and drinking. Idea about masculinity in certain cultures shapes up thinking of the children and guides their actions. What would well-being look like in a school which has visions very different from the families? And which double story development will actually help the students? Narrative approach has lot to offer here. In such cases my approach is changing towards consulting the client about the problem story around them in a way that the problem gets externalized. Having known the children for so many years I am aware of the alternative stories of their lives. Bringing out those narratives and checking on their values behind the actions flips the conversation into a more therapeutic tone. In one such situation a student was being questioned and made to realize all the problems that were there in her actions. Bringing out the alternative narrative by informing the disciplinary in-charge about the child’s helping nature changed the flavour of the conversation. The child had volunteered so many times to be the amanenusis. During the times of Covid when students were not coming to write their own exams, she was writing for others who needed a writer for their exams. In the past an incident had happened when a child had attempted suicide. That student lost most of her student but she was the only friend who was there for her. The child was referred for the counselling rather than facing disciplinary action. We are working on the alternative story and the child is part of school choir.
Another reading that was synchronous to a case which was referred to me was the case of Sarah given in the chapter, ‘Decolonising identity stories: Narrative practice through Aboriginal eyes by Tileah Drahm-Butler’. The client came with a self-diagnosis of derealisation. The impact of absent but implicit questioning was seen when I tried to assess the effect of derealisation on her.
Sarah’s story of grieving and saying Hullo again was surprisingly similar to the client’s story of having lost her grandfather and also her dog after 2 months of the demise of her grandfather. The girl told her parents that she was disturbed due to the dreams she was having. She also used terms like hallucinations, de-realizations and depersonalization. For her all that was happening around her was like a 3-D movie. Her experience, she said, was similar to wearing 3-D glasses and watching her life through those and feeling that whatever was happening around her was all part of a movie. I used the portion written in the chapter as my exact guide and started with externalization, saying hullo again and absent but implicit questions to work with her.
When asked what her problem was? She said that everything around her was unreal. When I asked about the effects of the ‘unrealness’, her first answer was that it saved her from feeling too intense emotions. She said that when her dog passed away after 2 months of her grandfather’s death, she did not feel too much grief due to the unrealness. She had studied that derealisation and depersonalization happens when the emotions are too much for someone to handle. When asked her about the thing that unrealness was trying to save her from? Her answer was stress.
She shared that the death of her grandfather was such a sudden incident that everyone at home was disturbed for very long. So now she doesn’t show her sadness as everyone gets disturbed. To keep her grandmother from feeling sad and lonely all the kids in the family take turns to be with their grandmother and never leave her alone. It looked like that the girl was trying to be strong even when she wanted to express her grief and also talk about her grandfather.
She shared how she was ‘obviously’ the most loved child of her grandfather. Her face lit up whenever she gave answer to the questions about her grandfather. She explained the time of mourning when whole family for 13 days was sitting on white sheets was the best time after grandfather’s demise. Everyone who would come and sit on those sheets shared stories of her grandfather. She said that she may sound weird but somehow she wanted that time back. We talked about the concept of saying hullo again through the type of questions I was asking. I asked her if there was a possibility of using the metaphor of sitting on the sheets, and actually asking her grand-mother and rest of relatives to share stories about the grandfather. If all of them could think of creating a wall, a scrapbook or an album to celebrate the kind of life her grandfather had lived. When I asked her what are two things that she would like to remember from our discussion. Her responses were: I don’t have to escape the feelings and there is no surprise that I am feeling that way and I want to talk more when we meet next.
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