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|Year : 2021
: 63 | Issue : 2 | Page
|Kapur, M. It's Okay: To Reach Out for Help
R Srinivasa Murthy
Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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|Date of Submission||09-Jan-2021|
|Date of Decision||11-Jan-2021|
|Date of Acceptance||13-Jan-2021|
|Date of Web Publication||14-Apr-2021|
|How to cite this article:|
Murthy R S. Kapur, M. It's Okay: To Reach Out for Help. Indian J Psychiatry 2021;63:196-8
Author: Malavika Kapoor
Publisher: Vitasta Publishing Pvt Ltd.
Year of Publication: 2020
Number of pages: 136
The current pandemic has affected everyone in the community. There are reports of increasing mental needs in the community:
“COVID 19 has seen a large number of people suffering from depression, tension, nervousness, anxiety and stress, besides having emotional backdown or experiencing sleep disturbances. The vulnerable ones also suffer from a compulsive need to hoard groceries,”
In a recent webinar, professionals made the following observations: “lots of care occurs at home;” “lots of care occurs in the community;” “we professionals have to work with others to provide care;” “professionals have to utilise all the community resources;” “we have to go the extra mile;” and “we need to look for alternate resources.”
It is against this background of enhanced need for emotional health support, to a large section of the population, the recent book by Prof. Malavika Kapur is important. The book, It's Okay to Reach Out for Help deals with several self-care measures that can be employed to help oneself in dealing with the current global pandemic, making use of India's own indigenous and time-tested method, s with ample illustrations from our own heritage.
Humanity is experiencing one of the biggest challenges. The life situation of the total population of the world has been disrupted in the personal, family, social, and economic aspects. Going by the past epidemics, like the 1918 Flu, it can be expected that the world will not be the same as it was before the epidemic. Many professionals have predicted a “mental health pandemic” in the near future.
In the Indian context, the initial surveys of the population and the frontline careers have already shown high levels of distress, anxiety, depression, and sleep disturbances,,,,,, along with the inadequacy of the mental health-care systems to meet the needs.
It is against this background of massive social changes and its impact on mental health, the book by Prof. Kapur and her team of counselors is very special. The book has 12 chapters covering, psychology of East and West, life cycle approach (childhood, adolescence, adulthood, middle age, and old age), providing social supports, enhancing mental health, silver linings, and afterword.
There are many special features of the book.
First, this is specially addressed to the immediate needs of the pandemic (There will be enormous need for psychological support).
Second, the focus is on self-care, what the author refers as, “Helping Ourselves is the Key.”
Third, feature of the book is the strong rootedness of the book on the foundation of Indian spiritual, philosophical, and cultural wisdom (Kashyapa Samhita).
Fourth, the book covers the whole spectrum of life, adopting a life cycle approach/samskaras and addresses the needs during childhood, adolescence, adulthood, middle age, and old age.
Fifth, the book provides multiple examples of psychological problems and their care with detailed record of the interventions. This aspect makes a book as something which will empower the people and the care providers from lay counselors to trained professionals to benefit from the book (They can be sensitized to become counselors for self, the family, and the community).
Sixth, the book presents a new approach to “counselling” by identifying the core aspect providing help “with psychological problems across India, supportive therapies are the most widely used, yet it is the least reported approach.” The book provides examples of challenges of common occurrence in each of the life stages and how it was addressed using a specific example. In this help providing, instead of suggesting - give support - as usual in many similar books, author and her team have presented in great detail the process/what can be done to provide support and change of behavior. Examples how to use techniques such as Reassurance, Suggestion, Environmental Manipulation, Psychoeducation, Parental or Spousal Training, Remediation for attention and learning problems, Strengthening adaptive responses, utilizing Talents and Strengths, Emotional Abreaction (Catharsis), and Setting the limits. This is the core of the book.
Seventhly, the emphasis is on using the stories from the epics and popular stories to bring about understanding of the life situation as well as changing the responses toward recovery.
Eighth, the book recommends to choose different levels of intervention, depending on the capacity of the person seeking help. The decision as to what techniques to use with what kind of client is based on ego strength and emotional maturity of the individual. Three levels are described as follows:
“At the first level, when someone is mature and has the strength to face one's distress, they can be empowered by the varieties of techniques capitalised on one's talents, introspection and cultivating spirituality. The second is (for) persons faced with difficulties, which they are unable to cope with like ADHD or learning difficulties, rather than need to be helped with methods of helping oneself. The third group is that of an adult who is disabled, sick or autistic or a child who cannot help himself. In this case, as one can only marginally bring about change, very strong support should be provided in the physical environment and social support as well. Supportive therapies have no limits; they can offer physical, psychological, social or even economic support.”
Finally, the book has a section, on measures to achieve, “universal wellbeing.” (“The aim of Indian psychology and philosophy is to transcend all these desires and understand the world as it really is”). Specifically, the value of detachment, equanimity, value of relationship between the therapist and client, bringing a balance in life, yoga and meditation, for personal growth, along with relief from distress.
In the current situation of pandemic, lockdown, resulting in different degrees of disruption of personal, family, social and spiritual lives, the need is for a nonstigmatizing way of understanding the “distress” and measures to master the situation by personal, family, and community efforts. Such an approach has the advantages of greater acceptance of the interventions, “counselling becoming for the people, by the people and of the people” as well as addressing the population level emotional needs of the pandemic utilizing all the community resources, in addition to trained professionals. I can see that such an approach, presented in the book, with illustration of its practicability, would be Indian contribution to the rest of the world.
Prof. Malavika Kapur and her team of lay counselors have presented an important approach to achieve the above goal. The book has been written within 2 months of time, during the pandemic reflects the rich experience of the team and their commitment for the “mental health of the people.”
The choice of title is most appropriate, as reaching out for help is “normalised.” Further, by making self-care the starting point, the stigma of seeking help is minimized.
I expect this book to go into many revisions and reprints, as we continue to learn from the current epidemic. In the coming editions, it would be valuable to see the following additions. First, experiences of community level interventions relating the pandemic. Second, a more detailed section, detailing the scientific evidence and personal application, on the importance of emotional self-care measures, namely, exercise, adequate, healthy food intake, yoga/meditation, and spirituality. Third, a greater focus to overcome distress using measure, namely, utilizing the all available supports, sharing of feelings, journaling, use of art and music and spirituality to make sense of the new life.
This book is an important resource during the pandemic. I strongly recommend this book primarily to people and paraprofessionals. The book also meets the specialist professionals who work with the earlier mentioned groups to train and supervise. The approach is in line with the view expressed, about 30 years back, by Prof. N. N. Wig, “mental health is too important to be limited to mental health professionals.”
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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R Srinivasa Murthy
553, 16th Cross, J.P.Nagar 6th Phase, Bengaluru - 560 078, Karnataka
Source of Support: None, Conflict of Interest: None