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Wednesday 14 November 2012

A Client's Therapeutic Journey from the Inside

My interview with Amandeep Sandhu (author of Sepia Leaves and Roll of Honour) published in the November 2012 edition of the Journal of the International Council of Professional Therapists


A client’s therapeutic journey from the inside
-       An interview with Amandeep Sandhu by Maullika Sharma

 View Aman_0025.JPG in slide show
Amandeep Sandhu’s first book, Sepia Leaves, is a bold, moving, autobiographical account of living under the shadow of schizophrenia in India. His second book, Roll of Honour, also autobiographical and deeply disturbing, is about an adolescence wrought with the trauma of bullying, sodomy, and terrorism in a boy’s hostel in Punjab (India) during the mid-80s. Both these books left me numbed by his courage to tell his tale. As counsellors, we often have clients come to us with stories of a similar nature. But, they are happy if they can just make some sense of the confusing events of their life, for themselves. Hardly anyone, ever, goes on to tell their story publicly, like Amandeep has. This is what touched me about both the books and so I sought him out for this very candid interview about his personal journey.

Q. Amandeep, what gave you the courage to tell your story, to the world at large?

I never felt I was doing anything special. I just wanted to tell the stories. I wrote Sepia Leaves because I felt that in the triad of patient-doctor-caregiver, both the patient and doctor have spaces for some kind of articulation and expression, whereas the caregiver mostly bears the cross silently. I wrote Roll of Honour to explore the myth of a macho man by bringing out the unspoken sides of the horrors of strife and identity politics in our formative years. My submission is that if we want to understand violence and bullying in our societies, which bothers each of us, we need to understand how its seeds take root in adolescent minds, we need to look at how adolescents are educated.

To me, the self and the world are witnesses, mutually reflecting each other. One can’t exist without the other and if stories are told then they should be about the interaction of the two. If they are to be told truthfully then there is even more so a need to examine each of them as closely as possible, and write about the reality that transpires. Yes, in my particular space the reality was tough, but if I want to be a teller of tales, then I need to tell it the way I see the space.


Q. What was your motivation to make your story public?

The motivation for Sepia Leaves was that through my growing up years the society called me a ‘mad woman’s son’ and hence unworthy of equality but worthy of a lot of sympathy and even some pity. I asked myself: is there no space in the world beyond our home where our family’s story can make sense? Is madness truly as dehumanizing as it is made out to be? Can’t we live in a world, or even inside a story?

In 2001 my parents came to stay with me in Bangalore. This was after my father had moved me away from the family about 25 years ago. Though we remained connected and in touch, we had to find ways of living with each other. I needed to understand my parents. Through my teenage years I asked myself why my father had not divorced my mad mother; at least he could have had a better life. The desire to explore my family, and the discovery that we were all utterly human, led me to share the story with the world. I wanted to hear back what the world had to say about our story.

If Sepia Leaves was about one person’s mental illness, the second one Roll of Honour is about a society’s mental illness. In this I explore violence on the basis of labels we adopt for ourselves or in which we find ourselves born: gender, caste, religion, language, and so on. If we think the mad should be dehumanized, locked up, stigmatized, what will we do with normal people who behave in abnormal ways?

Q.  You mention in both your books how you got support from various mental health professionals. Would it be okay for you to share what kind of help you got?

Yes. I remain grateful for the immense support and kindness from mental health workers, some friends, and many strangers. When I was a child I noticed how medicines dulled my mother. I missed my mother and felt the doctors and nurses had put her in a prison where I could see her, maybe even touch her sometimes, but where we could not connect with each other. I felt the hospital had snatched her from me. That led me to develop distrust for mental health work.

It is when my father started exhibiting behavior which was bi-polar that I met Dr Ajit Bhide. Dr Bhide helped me come to terms with the practice of psychiatry by showing me links between how we stigmatize, to how power dynamics work in social situations. How the lack of other resources - money, familial warmth, friendships, and avenues to release pent up emotions - play a role in how madness plays out. He became a friend. He showed me how next to the blazing sun of my mother’s madness, which had turned our family topsy-turvy, we had failed to recognize my father’s slow social withdrawal and his small light ebbing away. My father’s illness burst because he had finally in Bangalore acknowledged and written about his deep hurt from being a child witness to the partition of India and Pakistan. We had got late with my father, and were already very late with my mother. Still I took her to him. When she entered his chamber he stood up in his seat to greet her. He addressed her with respect. She felt human. This was the first time she allowed herself to take medicines which were no longer prescribed by her earliest doctor. The line of medication had vastly leaped ahead in the past quarter century and my mother benefitted from the new drugs.

I read more, saw other patients, asylums, ordinary fractured people, the homeless and the destitute and learnt how my own or my family’s problems were small in comparison. I also realized there was more to psychiatric aid than mere medicines. The practice of mental health help rests on the pillars of trust and insight into the patient’s condition by the patient himself. I learnt that human kind’s miseries are many, too many, and the only effort we can make is by taking steps to alleviate fellow beings’ hardships. The only space where God lives is where affirmative action can take place. That place can be anywhere, faith is a cardinal stone.

This was 2006. My book Sepia Leaves had been accepted but the publisher was delaying printing it. I had started writing my second book. My mother’s cardiomyopathy was aggravating; I was tired and weary, that is when I started hearing voices. I started noticing people stare at me at bus stops, on the roads. It was a sign to me that what I feared since adolescence had finally showed up. My genetic imprint had revealed itself – I could be schizophrenic. I went back to Dr Bhide, this time as a patient. He counseled me, we practiced a form of cognitive therapy, he listened and put me on anti-depressants. In a few weeks I started feeling better. Yet, more than that was his mandate to me: sit every evening and write. So I would sit, just sit, whether writing came or not. Then writing too came. When I recovered I went to him and said now you can stop my medication. He reduced it, but since my mother was very critical by then, Dr Bhide knew how I was my mother’s only support so he still prescribed a lower dose. ‘Your car is on a rocky mountain track; keep the pressure up in the tyres.’ A very simple, earthy reference, but it made sense to me. Then after a few months he stopped the course.

The next is Dr Alok Sarin in Delhi. During my adolescence my father used to talk about him. He reviewed my book in the Indian Journal of Psychiatry (http://www.indianjpsychiatry.org/article.asp?issn=0019-5545;year=2009;volume=51;issue=1;spage=71;epage=71;aulast=Sarin)  It was an honour.  I was completing a circle. From moving away from the discipline I had moved back in. He has become a guide, a friend. Alongside, he got me to meet other psychiatrists. I discovered their humanity, the possibilities of them even being wrong at times, the difficulty of the field of psychiatry not having had its watershed moment unlike Darwin in Biology or Newton in Physics, the lack of empirical clinical data to make theories, its theories still open to being reinterpreted, and hence fraught with issues.

Dr Shekar Sheshadri helped me with writing Roll of Honour which is about adolescence. He was my sounding board to check if I was depicting them right. Dr Anirudh Kala helped ground me into modern Punjab from a psychological point of view.

Then there are many others, many others to recount. Each of them has shown me with their commitment to better health, irrespective of which position they occupy on the debate on psychiatry, that good work can be done. Whether it is by being counselors, by running counselor trainings, by opening rehabilitation centers, working in or out of state systems, as long as the drive is to provide a healing touch, to help fellow beings recover their lost dignity and mind, not play power politics, eradicate stigma, and create equality, they all have my respect and I have learnt from each of them and I continue to learn.


Q.  What, in therapy, did you find the most helpful? As a counselor we have a perspective on what is helpful for clients, but we hardly get to validate that with clients telling us what they found most helpful. I was wondering if you had some insights on this. What led to what we call “aha!” moments in your therapy?

Kindness and acceptance. Owing to our notions of normalcy and caregiver fatigue, mental illness becomes most characterized by a lack of sensitivity. I feel, the struggle in mental health is for a sufferer to not feel abnormal - to gain insight into his or her condition, and yet not be affected by notions of normalcy. Let us start with normalcy - normal, in any age is a construct born out of the intersection of social and cultural forces. It changes from place to place. As I explained earlier, no one has yet been able to articulate a nature of madness that holds good in all societies and cultures. It is not like if one’s leg is cut off one becomes challenged, or if the body temperature goes high up beyond normal one is sick. Sufferer insight is the fulcrum on which mental health can be balanced but it is the job of the doctor or counselor to facilitate it by creating an environment of trust that comes from deep emotional responses which cannot be manipulated by either the system, the caregiver or even the sufferer.

My ‘aha’ moment was Dr Bhide working with me at two levels:

      By believing that I could write, pushing me to write, insisting that I write or attempt to write each day. That insistence by him gave me a channel to let out my thoughts and feelings, it also gave me a routine which helped me sit down and write and give myself an ‘aha’ whenever I wrote what I thought was good enough to get into a book but since it was personal and because this was open therapy, it remained honest and I did not play to a gallery.
         Opening his heart to me from which I gained a sense of acceptance. Something clicked between us. I would sometimes go down to meet him after he finished seeing the last patient for the day at his clinic. It would be 9.30 pm. He won’t come out before 10 pm. He worked hard, really, really hard and I would ask myself why I couldn’t deal with one patient when he deals with so many, that too out of choice. We would meet, talk a bit about this and that and then he would get another call and have to make house visits. His being human opened to me my own recognition of me being human.

There was one more ‘aha’ moment. In the middle of the last decade I was looking for people in Bangalore who shared my issues, a support group. I found AMEND. I went for their meeting. Each of the members was above 50 years of age. I was the only one caring for an older relative; they were all caring for their sons or daughters. They were sometimes even beaten up by the sufferers. Their physical frailty made it difficult for them to assert themselves. These members were all like parents to me, parents who had worked hard through their lives whatever be their jobs, and now deserved to retire but were instead thrown back into the fires of domestic crises. I was so much better off. That was an ‘aha’ moment for me. Not a rejoicing ‘aha’ but a humbling ‘aha’.
Q.  How did the idea of writing your story into a book come about? Was it something you planned on doing, or was it something that came up in therapy? At which point in your journey did you decide to do this?

When I was little and my parents used to fight in the bedroom I would hide behind the sofa in the drawing room and read comics. I was maybe 5 years old. That is when I would replace them as the comic characters and build stories around them. In one the hero died in another the heroine. That is when I knew that someday I will try to write about them.

The inspiration for the second book came when I was 13 years old and marching to school and the School Prefect gave us punishment for no known fault of ours. We crawled on the road and I decided that someday I would write about this senselessness of corporal punishment.

I spent my 20s reading the masters of literature and trying to write, but unable to write. I spent it crying at blank pages. Therapy helped in affirming my faith that I could write. Initially I was worried that the medicines will addle my brain and I won’t be able to write. My doctor’s personality and inclusive participation in my case alleviated those doubts.   


Q.  Have you faced any negative fall out of your books from friends and family? Did it build more walls, or did it help break walls in your relationships?

Yes there has been some negative, and I anticipated that. In fact, it was the possible adverse reactions which forced me to take time on my writing, dwell deep into the pain points, learn how to articulate them well, and then dare to lay them out on paper. Some of my larger family members felt offended by my talking about how my mother was physically beaten so she could be reformed. Come on, they did it; they can face up to it. No? Why do things prick only when they get on to paper? Beyond that the walls between the society and me have just shattered. This interview is an instance of it. How the world has welcomed me, how the book has travelled all over the world, into policy making processes, among caregiver communities, among students of psychology and just ordinary people … I am humbled and feel I was in so much error that I felt the world won’t listen to me. They listened and responded so beautifully. The book has also created a world of rich interactions for me. A world where readers respond and I learn, and do newer work and present it to them, thus earning more readers and friends. To me this is home.

For the second book, to by surprise, my school alumni have exhibited great grace. I had worried and wondered what they would say but many of them, most of them have felt that my writing the book has helped a generation or two of us (Between ages 40 and 65 years) to look at how excellent systems have now corroded and I hope we take steps to improve our educational spaces.

Roll of Honour is not an innocent book. It is a document fraught with undertones and as the separatist movements (Lt. Gen. Brar was recently stabbed in England, the radical Sikhs are building a memorial in the Golden Temple to what they call the martyrs of Operation Blue Star) continues overtly and covertly, I am hoping people would find meaning in the book.


Q.  While growing up, while you were struggling with all the issues you talk about in your books, in retrospect, what kind of support would you have liked to receive from the adults in your world? What kind of responses, and behavior, would have been helpful to you to make sense of the world?

I feel life would have been different if I had found genuine kindness and a sense of safety. Someone who could give me care and protection knowing I was vulnerable. My father tried, some neighbours tried, many other friends and well wishers helped me along my journey, some even pointed directions. That is all a weary traveler wants, a glass of water and a safe bed when his eyes close at night.


Q.  Do you think having a counselor in your school would have helped? Would you have gone to him/her?

Yes, of course the school having a counselor would have made it a very different place. Yes, I would have gone to the counselor. More than that, a counselor, or even regular teachers, could have helped by not letting the situation at school go so out of hand. The problems occur because the age old tradition of honour in the school accrues violence. The counselor would have plugged the anomaly, or the teachers could have plugged it. 


Q.  I thought I knew about bullying, and how to help children deal with it in school. But after reading your book, I don’t know what to say. I feel I don’t know anything at all. What message do you have for the bullies, the victims, the parents, the teachers, and the counselors (who are now present in many schools)?

Anyone who becomes a bully suffers from a deep sense of being victimized. The bully justifies the bullying as a behavior in which he or she is getting back at the victimizers. In order to deal with bullying, this has to change. Parents and teachers have to start with working at helping the bully deal with his or her own perceived or real victimization. Then curb his or her desire to pay the violence forward and make more victims. Be firm with them but practice kindness. In order to do that, start by being kind to your own self, by treating the bully with compassion but not allowing the bully to demean you. That aware, conscious and mindful kindness can be a starting point to tackle the menace of bullying. 


Thanks, Amandeep, for these great insights. It is very validating for us in the healing professions, when a client has healed. And, you seem to indicate that the real healing happened in your journey as a result of basic things like kindness, acceptance and a belief in your capabilities. They seemed to have made all the difference. As professional therapists this is what we believe, and being able to provide ‘unconditional positive regard’ to clients is the cornerstone of all training. It is great to hear this validated from a client. Here’s wishing you all the best for your next book, but hoping you have not had to live through any more such tales that are yet to be told. Good luck and thanks for your time.



Sepia Leaves can be bought on Amazon at :http://www.amazon.com/Sepia-Leaves-Amandeep-Sandhu/dp/8183860079/ref=sr_1_1?ie=UTF8&qid=1349937820&sr=8-1&keywords=Amandeep+Sandhu
Roll of Honour can be bought on Flipkart at http://www.flipkart.com/roll-honour-8129120232/p/itmdcfczhfnkt5m2?pid=9788129120236&ref=83c7d6db-b905-4fcb-87b3-5ba860a3064f&srno=m_1_1&otracker=from-search

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