Monday, February 27, 2012
In all societies, it is the children who are most vulnerable and therefore most at risk. Parental anxieties are usually two fold, one is about losing their child and the other is about sexual abuse. However parents themselves are in a dilemma to deal with this and often feel helpless and dismiss it off. The important thing is to realize that your anxieties are not unfounded. This is quite evident in India. Consider the facts given below:
• The national average rate for crimes against children was 2.3 per 100,000 people; In Madhya Pradesh 18.4% of all crimes were crimes against children; Delhi, 13.6%
• Kidnapping and Abduction cases represent 40.3% of crimes against children
• Rape cases represent 20.5% of crimes against children
• The states of Madhya Pradesh and Maharashtra accounted for35.2% of child rape cases.
• 8.9% of all rape victims (women and children) were girls under the age of 14 (p.83)
• In 97.3% of all (22,172) rape cases, offenders were known to the victims (family members, relatives, neighbours)
Two glaring factors are that kidnaping and sexual abuse constitute majority amongst the crimes against children, confirming general anxieties experienced by parents. But what parents do not know is that this is often because children are uninformed of what to do in a given situation. Although it is primary concern of parents, parents themselves are not sure whether their concern is justified or not. Well the statistics atleast clears off that confusion. Secondly parents do not want to unnecessarily inhibit or alarm their children, often not knowing how to broach the uncomfortable subject. Well, can you imagine how uncomfortable or confused a child may feel when he/ she sense something amiss. Infact often we feed to our children ‘parents know the best’ or ‘you will not understand as you are a kid’. Information, if provided in a right manner can be the best defense that you could provide for the child. Remember self-help is always the fastest in such situations.
So here are some eye openers for you parents, children are much attuned to their emotions and often ‘sense’ danger although they may not have reasoning behind it. If you as parents have developed an environment where in the child is able to convey his or her feelings with complete trust that you will listen and empathize then the child is likely to warn you. This is especially true in case of sexual abuse as revealed in the statistics most offenders of sexual abuse are often known members or people who have access to the children. However children are unable to protect themselves or inform their parents in advance because they haven’t been taught to think on their feet in a novel situation like this, its never been discussed. Or because they are scared that the parents will either dismiss their concerns or get angry at them, especially if the person concerned is someone known to the family and it so appears that the parents trust them around their children. Children are not taught to trust their own emotions of discomfort, something that begins in little things like ‘you will not feel hungry, you must eat when its time to eat’ or ‘you don’t know whats good for you, we have much more life experience than you’. These messages convey the message to the children that they should not trust their feeling but must rely on the judgment of the parents. Often these abuses continue for a long period of time as children feel responsible for what happened to them and come under threat or black mail of the offender, unable to stop further abuse.
Parents therefore need to talk to their children about their emotions and give them respect in day to day situations. Parents also need to convey trust to their child by informing them in advance that they will at least get a listening ear no matter what the situation or who they are talking about. They also need to help child differentiate between good touch and bad touch and also about who is a stranger and who is not. Often in cases of kidnapping the kidnapper stalks the child for a while and the child may even see you talk to the stranger. They are unable to differentiate between acquaintance and strangers.
Younger children may get alarmed if spoken to directly so parents can use the help of various non direct tactics such as stories or role plays to broach the topic. Parenting sessions with a therapist also helps parents discuss ways in which the child can be approached taking the individual personality of the child into consideration. Schools having an active counseling department also have such talks / workshops with their students.
That such great numbers of children in India continue to be victimized by crime is a pointed reminder that we have not fulfilled our duties as protectors and caregivers. Taking care of the above mentioned solutions can go a long way to protect our children.
The recent suicide pact between a couple who were involved in an illicit relationship threw the entire media into a frenzy. What could have prompted them to take such drastic steps. Were they not aware that this relationship had no future?
Ofcourse they did, but for the moment let us put that aside and look at this in depth. Maybe there is a dichotomy in the evolving social norms and the legal system. The answers to this are not simple and will not be achieved in a short span of time however a thought has the power to bring about change.
Hinduism does not favour illicit relationships and adultery is considered a moral sin. Those who get caught in illicit affair have to face the wrath of the society. These actions, especially for women are rarely forgotten or forgiven. The Indian laws show a gender bias, not surprisingly as many of the laws have their basis on ancient Indian scriptures of Manusmriti. Women are considered property of a man, before marriage that of father and after marriage that of a man. It was believed that a woman will go astray because of her passions if the man is ‘weak’ and unable to control her. Certain customs and rituals such as kanya daan also reflect similar belief system behind the role of a woman.
“Day and night a woman must be kept in dependence by the males (of) their (families), and if they attach themselves to sensual enjoyments, they must be kept under ones control “– Manusmriti (http://www.hinduwebsite.com/hinduism/h_extramarital.asp)
It is no wonder that the current Indian law thinks it suitable to punish a man who is involved in an illicit relationship with a woman but the woman goes scot free. As the law stands today, adultery is only committed against the husband of the adulterous woman. A man cannot level an adultery charge against his wife but can do so against the "other man." The Indian law treats wives as their husbands' property and considers adultery is an offence that a man commits by trespassing upon the property (wife) of another. That is why she is not liable as an abettor.
Women cannot be accused of adultery as the law considers the position of a married woman “almost” as a property of her husband, ruled the Supreme Court in a recent judgement.
Let us look a little further into the social structure of marriage. Hinduism believes marriage is obligatory duty and sacrament. Marriage is not meant for sexual pleasure but to perform ones duty and for the purpose of procreation. A couple marries each other because they are soul partners in fulfilling their respective karmas on the way to salvation. This association may span over seven or more lifetimes, and has little to do whether they like each other or are in love with each other. During these life times husband and wife may interchange roles but remain entwined in their destiny to help each other attain salvation. Therefore the couple relationship is essentially the relationship of souls and emotions, lust and love have nothing to do with the union.
For a woman, marriage ends her relationship with her maternal family. It is symbolized by kanya dana where the brides father gives away his daughter and fulfils his karmas. The relationship with her maternal house is then formal and minimal. She also needs to behave in a manner wherein she will be accepted in the husband’s family, therefore marriage is a great stress for a woman. Often women in illicit relationships whether under duress or choice have no support from the maternal side. The societal pressure is tremendous on the partner who is engaging a married woman in an affair, which is punishable by law. Under such social and legal pressures, such relationships have an extremely difficult time ahead.
The issue gets more complicated if either of them have children out of wedlock or children from their respective marriages. The importance of parental fidelity to the psychological well-being of children cannot be underestimated. While an affair is taking place children sense that the parent is expending emotional energy outside the family. As a result the children may become anxious or frightened, or they may sense rejection and feel they have done something wrong. Moreover experts found, such children are prone to have affairs themselves when they marry. The child, eventually, after witnessing the hostile environment at home and the parental animosity resulting from the extra-marital of either of the parents, breaks down under the strain of conflict. The child’s distress may take the form of school related problems, anxiety, depression, bullying, victimization and sometimes even health related illness. This only adds on to the guilt of breaking away from society, family and children.
With the advent of the western influence, where one celebrates valentine’s day emotions such as love in a relationship are given increasing importance. Along with this the financial independence of a woman in today’s world seems to directly clash with the traditional role chalked out for her.
Often in counseling we come across couples struggling with betrayal of their spouse but do not have the strength to go ahead in the relationship. Living with a compromise with the spouse only gets emotionally dragging. There is a deep feeling of hurt and anger, which they individually express in the sessions and resolve them within themselves before they can communicate with each other and give a listening ear. Family and friends are unable to help because they are too close emotionally to either of them. A neutral and objective listening and perspective provided by a non-judgmental therapist goes a long way to accept themselves and the spouse.
Monday, February 20, 2012
While Sachin has dismissed the hundredth 100 as just another century, the Indian diaspora is keenly awaiting this one. And with the over zealous aspirations of 1.2 billion riding high on the bat of this young master, pressure is bound to build on him? Suddenly Sachin is out of form and the runs off the bat have abruptly dried up. In our opinion, we do not believe that the lack of form is at work here but certain certain self sabotaging behaviors are preventing him from achieving the much awaited milestone. In this article we explore the psychological impact of self sabotaging behaviour and how it emanates in daily walks of life.
Consider the following self-sabotaging behaviours which are commonly observed: Why do we wait till the last minute to leave for a place? Why are some people perpetually late for something important that they have really desired? Why do we remain employed in a company although we know we deserve and can get a better job? Why do we repeatedly get into an abusive relationship? We've all seen this in our friends and even, regrettably, in ourselves.
However bizarre as it may seem, we must derive some benefit from these problematic behaviours of ours. These problems may appear maladaptive on surface but if we give it a closer look, we will realize that in some way, we benefit from them. In other words, in some way we are protected by our problems. One can't usually explain the "real" reasons for ones behavior because the reasons are outside of their conscious awareness. So although we may consciously strive for something, it is possible that our unconscious mind works in direct opposition to it, self-sabotaging our resolves leaving us frustrated and helpless.
This is precisely the reason why an obese person is unable to stick to the food diet regime. Maybe unconsciously becoming fitter would draw more attention from the opposite sex or make the person more successful than his loved one and thereby lose love of her spouse. Or getting into an abusive relationship is ones way to remain in agreement with the unconscious belief that one is not worthy of love. Or becoming more successful than ones parent will in some way unleash the wrath of the parent who may abandon them. These fears of abandonment or of a loved one getting angry are deeply rooted in one’s childhood experiences and are extremely anxiety provoking. They continue to strongly influence our current behavior unless we bring this conflict into consciousness to be worked on in therapy.
I was approached by a manager at a very senior level for marital counseling. The couple was batting infidelity in their marriage. While his outward behavior seemed very protective and caring towards his wife, his unwarranted affair had a devastating effect on his marriage. During sessions when I enquired about how the affair started and what the other woman meant to him, I was not surprised to hear that she meant nothing to him and that he himself couldn’t justify the need to get into this one night stand and risking his marriage. Worse still he made no effort to hide it from his wife and in fact seemed relieved when she got to know about it. This seemed to fit the bill of the maladaptive behavior perfectly and we looked for further clues on the possible benefits. As we explored the childhood and some of his current behaviours things crystalized further. He was a neglected child and grew up with a feeling of not worthy of love. This feeling remained entrenched in his unconscious although he gained good marks and then went on to become the most successful of all his siblings, taking care to help them settle in life and therefore much adored too. When he got married he started facing difficulties in developing intimacy with his. His wife found him very appropriate however lacking in demonstration of love and affection. She however was deeply in love with him and found his aloofness disturbing. This became an issue when she discovered that he had had a one night stand with a woman. What was disturbing her further was that he could not furbish any justifiable excuse nor did he even attempt to hide the truth from her. It was almost as if he wanted her to find out and thereby punish him by withdrawing her love. This was in line with his unconscious belief that he was not loveable and now he had proven to himself once again that he is not worthy of love.
Sachin Tendulkar too seems to be having this mal adaptive behavior which appears repetitive wherein he gets out just as he is touching his century or when there is tremendous pressure on him to perform. It’s almost as if, if he does meet with the expectations of the country then something terrible will befall on him. If he is successful then maybe he will be abandoned / not loved? Or worse still he will become somehow bigger and stronger than the father whose oedipal complex may still haunt him. It isn’t uncommon to be unable to perform at peak capacity or self-sabotage once life and career to tag the line of one’s unconscious oedipal fears of the opposite sex parent or the belief system of not being good enough/ not loveable/ not worthy of. Our actions are mainly governed by this unconscious dictum and efforts are made to keep it unconscious and seeking more and more proof through experiences that match these beliefs. It is kept unconscious precisely for this reason that it produces anxiety while conscious life experiences seem to fall in line magically with these beliefs.
Most people find the notion that all behavior, no matter how self-destructive, has an adaptive function difficult to grasp. So, how do you go about learning more about the advantages to maintaining your current (purportedly unwanted) situation? A first step is to examine the advantages to maintaining the status quo. To do this, ask yourself the following questions.
Describe a longstanding difficulty with which you have struggled. Describe the ways in which it is maladaptive. How does this difficulty hurt you or hold you back or make you unhappy? What is its impact on your relationships at work, at home, and socially? Ask yourself the following question:
1. Have you attempted to change this difficulty? If not, why not? If so, describe the nature of your efforts?
2. In what ways have your efforts been successful? If they have been unsuccessful, why?
3. In what ways have your efforts been thwarted? How were they sabotaged?
Most people never come to the stage of seeking out professional assistance because they are not aware that they are sabotaging themselves. Those that do seek help often wait until well into adulthood. In life, we all aspire to both conscious and unconscious goals, but often there are psychological barriers that we may cling to and be haunted by, which block our aspirations. Projected envy and terrors of the actual envy of others can block motivations to succeed, when dissociated and/or repressed primal rage intensify the intimidating power of projected hostility and envy, and of perceptions of others as rivalries in areas of competition. Desire can be blocked by oedipal level fears of rivalry and hostile completion, but more primitive and primal fears of abandonment can also be at play, when developmental arrests have taken place in the preoedipal years of separation-individuation and self-integration. How we address these psychological blocks in a clinical situation is critical to helping patients to overcome all their inhibitions and intimidations, as they attempt to motivate themselves to succeed in life.
Monday, February 13, 2012
What makes Priyanka Chopra rejected by the wives of her co actors? Is there really a flaw in her character or is she a victim of the wives’ insecurities. Decide yourself in the article dealing with rejection.
Rejection is experienced as a deep blow to self esteem as it involves blaming you as a person. It is difficult to deal with it because it conveys the message of non-acceptance and that there is something wrong with you and you are not good enough or worse still there is something wrong with you, that you will never change and that you do not belong to this group and you’ve done something wrong or unacceptable. This leaves you with a deep sense of helplessness. There is nothing that you can do to change another person’s biases and perceptions and you are left to deal with all these emotions yourself. More often than not, these perceptions are often backed by societal or religious norms justifying the persons rejection.
Often people who are a victim of rejection keep going in circles feeling victimized and angry and are unable to get over it easily. Psychotherapy helps such individuals to differentiate between what is intrinsic to themselves and that which is not. This goes a long way in handling difficult emotions of rejection. By understanding ones ownself and how one uses psychological defense of projection and introjection one realizes that the emotions thrown into him by the person rejecting actually form the dark and unknown side of the rejecting individual’s personality which is unfortunately being flashed onto your character screen. Although not aware, the person has sense that he can succumb to these very biases and therefore fights it externally whenever he sees it. Unfortunately in the process does not cure himself and accumulates greater fear of the same biases. Therefore no logical argument is able to convince the person to give them up. The reason being, if they give up these biases, maybe there is a fear that he will have to face it within himself. After all isn’t it much easier to fight the devil on an external screen than to have him within yourself.
Equipped with this understanding by experiencing it within ones ownself, the individual is able to detach oneself from the influences of these negative emotions projected on him by the world and is able to restore his self esteem. Of course talking about these emotions forms the initial part of the cathartic therapy but psychotherapy does not stop at that alone. In fact if the therapist is unable to take the client beyond catharsis, the client keeps experiencing the wound in his mind but is unable to come out of it.
Understanding the mechanisms of rejection and knowing that it is never, and I repeat, never warranted or earned are the most fundamental keys to safeguarding your self esteem and sense of self worth. This is a choice. You have to make a choice about how you are going to understand the messages of rejection you receive everyday, and how you are going to, or not going to, integrate these messages into your psyche.
Remember that facing your fears, expressing and sharing your experience, no matter how shameful, is vital in overcoming the aloneness that rejection creates and which sustains its impact.
Make a choice today to focus on the dynamic you and your untapped potential and you will be unscathed by any experiences of rejection.
Sunday, February 12, 2012
With the recent incident of the Ministers, watching pornographic film has brought about much ethical debate in the media; however the psychological impact has not been discussed. Sexuality is an issue which profoundly impacts not only an individual but also the family at large. In my experience, with only several exceptions, pornography has been a major or minor contributor or facilitator in the acquisition of their deviation or sexual addiction apart from complete psychological isolation from family. Treatment (psychotherapy) of the same is necessary as it tends to recur as all other means of control used by individual and society fail without an insight into the urge.
I found four factors common to nearly all of my clients, with almost no exceptions, especially in their early involvement with pornography.
A porn movie becomes an addiction as the material provides a very powerful sexual stimulant or aphrodisiac effect with powerful imagery as a base of further fantasies, followed by sexual release, most often through masturbation. Once addicted, they could not throw off their dependence on the material by themselves, despite many negative consequences such as divorce, loss of family, and problems with the law (as with sexual assault, harassment or abuse of fellow employees). Interestingly my clinical experience, education is positively correlated with sex addiction; that is to say higher the education and intelligence greater is the person’s vulnerability to sex addiction. Reason being, their finer ability to use their intelligence to fantasize.
Like drug addicts, sex addicts with the passage of time require rougher, more "kinky" kinds of sexual material to get sexually aroused. If their spouses or girlfriends were involved with them, they eventually pushed their partners into doing increasingly bizarre and deviant sexual activities. They often preferred this sexual imagery, accompanied by masturbation, to sexual intercourse itself. This nearly always diminished their capacity to love and express affection to their partner in their intimate relations. In many cases, this resulted in a fall out in the relationship when the woman refused to go further-often leading to much conflict, separation or even divorce.
Material (in books, magazines or film/videos) which was originally perceived as shocking, taboo-breaking, illegal, repulsive or immoral, though still sexually arousing, in time came to be seen as acceptable and commonplace. There was increasingly a sense that "everybody does it" and this gave them permission to also do it, even though the activity was possibly illegal and contrary to their previous moral beliefs and personal standards.
4. Acting Out Sexually
There is alarmingly increased tendency to act out sexually the behaviors viewed in the pornography including compulsive promiscuity, exhibitionism, group sex, voyeurism, frequenting massage parlors, having sex with minor children, rape, and inflicting pain on themselves or a partner during sex. This behavior frequently grew into a sexual addiction which they found themselves locked into and unable to change or reverse--no matter what the negative consequences were in their life.
PORNOGRAPHY AND ITS IMPACT ON THE FAMILY
However, in my clinical experience, the major consequence of being addicted to pornography is not the probability or possibility of committing a serious sex crime (though this can and does occur), but rather it’s disturbance of the fragile bonds of intimate family and marital relationships. This is where the most grievous pain, damage and sorrow occurs. There is repeatedly an interference with or even destruction of healthy love and sexual relationships with long term bonded partners. The most important negative consequence is that it isolates one from one’s own self. The ‘real’ world no longer appears appealing and the individual prefers to be in his own world ultimately severing emotional ties that gives meaning to his own existence. No amount of ‘knowing that its bad’ helps to reverse this habit. It’s like a latent cancer, it almost never disappears on its own or reverses its course unless there is some psychotherapeutic intervention.
PARENTING ISSUES AND PORNOGRAPHY
With the explosion of internet usage parents need to keep in control on the internet usage of their young ones. Their curious mind and age is bound to take them in this direction if left unattended on the net. Pornography films are often dismissed off as ‘educative’ or seen as rebelliousness by care givers. However parents need to be aware that there is tremendous peer pressure on the young adults and they often resort to pornography to be a part of the ‘in’ group or for the purpose of self education. When parents provide scientifically correct and age appropriate sex education to the child from a young age, they squash this curiosity and the chances of their child being misinformed via porn films. In fact sex education classes are conducted in many schools for the same purpose. It is a myth that imparting sex education will increase sexual activity in young adults. Rather as parents and caregivers it is your duty to ensure that the child is well informed about the sexual boundaries and the consequences. In fact in many of the abuse cases that I have handled in my practice, children were unable to protect themselves from further abuse because they felt responsible and guilty of the abuse and were unable to convey their feelings their parents whom they thought they could not talk as it’s a taboo topic or worse still would blame them. Because the topic was never raised by their parents they have nowhere else to talk about but their peers or left on their own for further experimentation.
Watching porn movies has a far outreaching psychological impact, especially on a young adults mind. Most of the porn films are made by men and are often extremely sexist in nature often debasing or humiliating a woman. Therefore children at a very young and impressionable age learn to disrespect women in general and treat them as object of sexual pleasure, have distorted perceptions about sexuality, destroys confidence, commitment and responsibility of an intimate relationship and institution of marriage in particular and making polygamous relationship an acceptable idea. In addition, pornography portrays "unhealthy" or even antisocial kinds of sexual activity such as sadomasochism, abuse and humiliation of the female, involvement of minors, incest, group sex, voyeurism, exhibitionism, etc.
Watching pornographic films over an extended period of time raises a fundamental question of who you become as a person watching it.
Tuesday, February 7, 2012
Being diagnosed with cancer affects a patient not just physiologically but also psychologically, and has a deep impact on the emotional status of the patient and his family for an extended period of time. And while there are treatments for the physiological symptoms of the patient, dealing with the psychological trauma associated with cancer is another story altogether. Cancer is an experience of repeated traumas and for undetermined length, unlike an accident. The patient may experience posttraumatic stress disorder (PTSD) symptoms anytime from diagnosis through completion of treatment and cancer recurrence.
As is seen in the case of our Indian skipper Yuvraj Singh how the misdiagnosis and then the reconfirmation of the cancer must have been a series of highs and lows. Especially for a sportsperson who works under tremendous pressure to be fit and putting out an outstanding performance, trauma such as this can be doubly difficult psychologically rather than physically. Any ones guess would be whether he will be able to return to the stadium fit enough to play his best innings. Here is a glimpse of what he might be undergoing…
Although, the end of treatment is often marked with a sense of relief, accomplishment, and even joy in having gotten through a difficult experience. Yet for many cancer survivors, it is also a stressful time filled with new routines to learn, as well as mixed feelings about what they’ve just gone through. Many people find themselves unsure of how to move forward, wondering, “Now what?” Therefore, effects of PTSD are long-lasting and serious. It does not end with the end of the treatment. It may affect the patient's ability to have a normal lifestyle and may interfere with personal relationships, education, and employment even after the patient is ‘cured’. Because avoiding places and persons associated with cancer is part of PTSD, the syndrome may prevent the patient from seeking medical treatment or psychotherapy. It is therefore important that cancer survivors and their family receive information about the possible psychological effects of their cancer experience and early treatment of symptoms of PTSD.
Also, as a patient, they may have been so busy learning about their diagnosis, working with the medical team, and going through treatment that they didn’t fully feel the emotional impact of the diagnosis until after end of the treatment. It’s common for many cancer survivors to have a variety of complex and often conflicting feelings about their diagnosis, treatment, and recovery. It is normal to feel relieved that treatment is over, yet angry or sad about having gone through such a serious illness. Or, they may feel guilty about surviving a diagnosis that other people do not. The patient may also feel anxious and fearful about the cancer coming back, or worried that the treatment didn’t work. It is normal, too, to feel confused about what they’ve been through and to be concerned about the future. Family and friends can provide much comfort and support during this time. However, survivors often feel a bit isolated from loved ones and the world around them. Loved ones usually mean well, but they might not be fully aware of all the emotional challenges that can arise for you after overwhelming, interfering with your day-to-day activities and even your health.
Another concern faced by many cancer survivors is the realization that life after their diagnosis and treatment never really goes back to what it was before cancer. Many survivors find they are not able to return to their old “normal” life but must adapt to a “new normal.” Understanding what your new normal is can take time. This process may involve: Reflecting on what you’ve been through. Identifying changes you might want to make in your life. Recognizing what you’ve learned and what’s changed about yourself. Re-evaluating personal relationships or professional goals.
Discovering new ways of finding meaning and fulfillment.
In India, we find that patients usually resort to prayer, fasting, performing ceremonies in order to deal with their illness as against proactively seeking information from the doctor, reading up on the net and medical journals, exercising, eating healthy, meditating or seeking professional help to deal with their emotions. (Stress and Coping amongst infertile women Research conducted by Dimple Shah for Mumbai University, 1994.). Although these actions mimic active coping mechanisms, in essence it is passive coping mechanisms resigning pessimistically and blaming fate for their misfortune and instilling deep fear and helplessness, therefore unable to relieve the person of stress. Patients and their family needs to be informed of these inactive and potentially stress inducing coping mechanisms and be guided to utilize proactive coping mechanisms mentioned above from the beginning.
Therapies used to treat PTSD are those used for other trauma victims. Treatment may involve more than one type of therapy. Feelings of sorrow, grief, hopelessness; coupled with mood swings, fear of losing life, leaving behind loved ones and anxiety and depression are very common amongst patients fighting against cancer. Serious psychosocial distress was seen 40% more among cancer survivors of 5 years or more than in those who have never had cancer. About 10% develop major depressive disorder; others experience an adjustment disorder. In young adult cancer survivors, one small study found that 20% of participants met the full clinical diagnosis of post-traumatic stress disorder (PTSD), and 45% to 95% displayed at least one symptom of PTSD. Survivors of adult cancer are at an increased risk of suicidal ideology (having thoughts about suicide), while as many as 13% of childhood cancer survivors experience suicidal ideology.
The prognosis of cancer it is proven scientifically that an emotionally stable person reacts better to the medication and treatment modalities of cancer. This is where a person’s inner strength becomes paramount. Yet it is expected that the person who has been diagnosed with cancer will initially at least crumble under the stress of the trauma. Here the key is, the support system that has a tremendous impact to help the patient bounce back to fighting cancer is the family and friends. Psychotherapy from the time of diagnosis to surgery and post treatment is crucial in providing this supporting network. When one member of a family has cancer, the whole family is affected and, in fact, psychotherapists consider these family members to be "secondary patients." Cancer affects an entire family, not only because there are genetic links to cancer and cancer risk, but because when one member of a family has cancer the whole family must deal with the illness.
The therapist focuses on solving problems, teaching coping skills, and providing a supportive setting for the patient. Some patients are helped by methods that teach them to change their behaviors by changing their thinking patterns. Some of these methods include helping the patient understand symptoms, teaching coping and stress management skills (such as relaxation training), teaching the patient to reward upsetting thoughts, and helping the patient become less sensitive to upsetting triggers. Therapist may also use group work and introspective art therapy help the patient express their emotions. Sometimes having someone paying attention to the painful emotions itself is healing and patients show tremendous resilience once they are able to confide in someone who can demonstrate strength to listen to their pain, which family members are unable to do so at that point of time.
Most importantly cancer trauma, like other life threatening traumas bring back the past and often unconscious hurts and losses and therefore the psychological effect appears long lasting and compounded. Often people close to the patient find the person overreacting and are unable to understand where they are coming from. They feel hurt, angry and confused. But if you make an effort to understand that these emotions of hurt, anger and confusion that you are experiencing are not really incident related or even yours; that they belong to the person who is suffering from cancer you will be better able to deal with both the patient and the emotions thrown into you. Doing this is not as easy as it sounds and this is also where the psychotherapists step in. Psychotherapists help the family to experience and deal with these emotions that are thrown into them and also help them make better response choices. Therefore the psychological treatment on which the prognosis of cancer depends is strengthened using multifaceted psychotherapy approaches. It is beneficial to start with these sessions from the time of diagnosis and continue till post treatment; as although we expect psychological reactions to emerge within the first three months of diagnosis, there is no fixed rule and if not brought into the forefront of therapy may remain suppressed and resurface later on after many years, often with unconceivable strength.
Saturday, February 4, 2012
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In a male chauvinistic world, woman is considered to be the property of man. Be it a spurned lover, a suspecting husband or a man who is shooed away when he wants a relationship, each feels humiliated and wants to take revenge against the woman. The easiest way to hurt the woman in such instances is throwing acid on her. It makes the man feel immensely and rather sadistically satisfied if the woman is disfigured. Experts believe that the foremost reasons behind this barbaric act are easy availability of acids and illiteracy among the masses. The overwhelming majority of the victims are women, and many of them are below 18 years of age. These attacks are often the result of family and land dispute, dowry demands or a desire for revenge. There are umpteen instances in history of how women were treated in times of war or conflict. With the advent of industrialization and inventions, acid has come handy to these egotists in their bid to disfigure women. Acid throwing could well be described as the attempt to control or subjugate women.
Victims of attacks not only undergo severe physical trauma but also traumatic changes in the way they feel and think. Psychological trauma is caused by both what the terror victims suffer during the attack, as they feel their skin burning away, and what they suffer after the attack with respect to the disfigurement or disabilities they have to live with for the rest of their lives. Victims suffer psychological symptoms such as depression, insomnia, nightmares, paranoia, and/or fear of facing the outside world, headaches, weakness and tiredness, difficulty in concentrating and remembering things, etc. They feel perpetually depressed, ashamed, worried and lonely. Usually, acid burn victims suffer severe psychological symptoms for years, if not forever, because they are constantly reminded of the violent act by their physical scars. The feeling of lack of hope and worth may never leave them.
Social and Economic Consequences
Acid burn victims face a lifetime of discrimination from society and they often become lonely. They are embarrassed as they think people may stare or laugh at them, and may hesitate to leave their homes fearing adverse reactions from the outside world. Victims who are not married are not likely to get married and those who have suffered serious disabilities because of an attack, like blindness, will not find jobs and earn a living. Discrimination from other people, or disabilities such as blindness, makes it very difficult for victims to fend for themselves and they become dependent on others for food and money.
It has, therefore, been argued that acid attacks need to be classified as a separate offence and harsher punishment needs to be prescribed. It has been further stated that the new law must include guidelines for handling/supporting victims economically, socially and psychologically, and provide compensation. In fact since acid is so readily available across the counter in medical and other stores, acid attacks are a relatively cheap and effective way of committing acts of violence against women. Buying hydrochloric acid is as easy and cheap as buying a bar of soap; a litre of acid costs anywhere between Rs. 16 and Rs. 25.
There is, however, no law to regulate acid sales except for the Manufacture, Storage and Import of Hazardous Chemicals Rules, 1989 (amended in 2000), and this only applies to industrial situations. Furthermore, there are no regular inspections and stock checking for acid sales as there are for explosives. It has been argued by some that controlling or regulating acid sales is an impossible task, as acid is used for many things including car batteries, etc. Thus, the deterrence should come in the form of stringent laws that punish the perpetrators. However, Bangladesh, a country with the highest incident rate of acid attacks, has passed a law in 2002 to control acid sales. Thus, acid violence can be tackled on both fronts simultaneously with harsher punishment on the perpetrator and control over the sale of acid to stop it from getting into the hands of criminals. International commerce of sulphuric acid is controlled under the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988, which lists sulphuric acid under Table II of the convention, as a chemical frequently used in the illicit manufacture of narcotic drugs or psychotropic substances.
Nitric or sulphuric acid has a catastrophic effect on human flesh. It causes the skin tissue to melt, often exposing the bones below the flesh, sometimes even dissolving the bone. When acid attacks the eyes, it damages them permanently. Many acid attacks survivors have lost the use of one or both eyes. But the scars left by acid are not just skin deep. In addition to the inevitable psychological trauma, some survivors also face social isolation and ostracism that further damage their self-esteem and seriously undermine their professional and personal futures. Women who have survived acid attacks have great difficulty in finding work and, if unmarried (as many victims tend to be), have very little chance of ever getting married. In a country like India this has serious social and economic consequences. The New York Times (Dec, 26, 2001) reports that kerosene as well as acid has fast become the weapons of choice for attacks on wives in India. The major victim of attacked is Women(47%) and Men(26%). Children(27%) could not escape from the attack. Sometimes domestic animals or birds are also victimized. The sad fact is that women who have been victimised by these attacks are mostly at the hands of someone known and close to them.
Referring to the compensation to acid victims, the Law Commission, headed by Justice A.R. Lakshmanan, quoted the landmark judgement of the Honourable High Court of Kerala in the State of Karnataka in the Jalahalli Police Station vs. Joseph Rodrigues case (decided on 22 August 2006) wherein the accused was convicted under Section 307 of the IPC and sentenced to imprisonment for life. A compensation of Rs. 2,00,000, in addition to the trial court fine of Rs. 3,00,000, was to be paid by the accused to the victim’s parents. The acid attack deeply scarred the victim’s physical appearance, changed the colour and appearance of her face and left her blind. However, in many cases throughout India, punishment often did not take into account the deliberate and gruesome nature of the attack but only rested on technicalities of injuries. It is apt to recall here that the Law Commission also proposed a law known as ‘Criminal Injuries Compensation Act’ to be enacted as a separate law by the government. This law intends to provide both interim and final monetary compensation to victims of certain acts of violence like rape, sexual assault, acid attacks, etc., and should provide for their medical and other expenses relating to rehabilitation, loss of earnings, etc. Any compensation already received by the victim can be taken into account while computing compensation under this Act.