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The Chatter Inside a Therapist

The Chatter Inside a Therapist

One woman’s bumpy journey from journalism to art therapy may have lessons for other mental health practitioners during the ongoing pandemic.

What do you call someone who takes six sessions daily, runs three online courses simultaneously, and works an average of 14 hours a day? That’s a psychotherapist during a mental health crisis. In particular, it’s Anshuma Kshetrapal, a young, Delhi-based mental health practitioner who has diverted all her energies to give as much as she can during this time of the COVID-19 pandemic, characterised by different kinds of loss, uncertainty and fear.

While the rate of unemployment, indebtedness, domestic violence and substance abuse in India has increased quite visibly as a result of the pandemic, the number of people with mental health issues is invisibly trudging along, too, to rise with these others. And Anshuma seems cautiously ready to handle the expected influx.

She is already fielding up to five new queries a day alongside her team and is conducting more group sessions in order to accommodate more people. But something she’s learnt during this pandemic, both literally and metaphorically, is to put on your own mask before helping others with theirs. So, she has begun to take it at a slightly more manageable pace, especially considering this is going to be a long-term situation. She has made it a point to take two days off every fortnight, apart from reading, studying and teaching to better equip herself and others for the circumstances.

“I saw that people really wanted to help and provide listening spaces for those who are struggling. But therapy is different from psychological first aid and not every therapist is trained in the latter. To take a client deeper into the process when you’re not there to hold physical space for them would be unethical. Providing psychological first aid at this point of time is something I am now teaching other therapists, apart from courses in dance therapy. And this process of teaching and learning is helping me cope as well.”

Even though holding someone’s attention and enabling them to externalise their vulnerabilities through a screen can be quite a task, the COVID-induced switch to tele-counselling has been fairly easy for Anshuma to adapt to. However, it hasn’t been as smooth for some of her clients. Some have stopped coming, while others are now using asynchronous ways of communicating.

For example, they make an artwork or write a poem to express themselves and send it over to her so it can be discussed from an objective point of view later. What we’re living through right now is not easy, but it is important to remember that it is also transitional. We need to be wary of attaching permanence to it, no matter how normalised it gets, because that sense of despair is what causes heartbreak, she warns. 

“This pandemic has changed and shifted something big, although I do not know exactly what it is. Maybe when I look back at this period, I will discover and find value in it,” she says. Like this one, Anshuma has seen many turning points and big “shifts” over the course of her almost 10-year long relationship with mental health, shaping her in different ways and bringing her to this point.

From Journalism to Psychotherapy

Her story doesn’t begin with a typical love-at-first-sight moment. In fact, she initially pursued mass communication at the undergraduate level and went on to work for a couple of big ‘those-that-must-not-be-named’ media houses. It was a deep disillusionment with mass media and its meaninglessness that eventually led her to her true passion. “I wanted to be a therapist because as a journalist, I couldn’t go to sleep at night.”

She entered the media industry because she had something to say and wanted to reach a larger audience. But it is this same wide reach that, according to her, diluted the message since she no longer had control over its reception. To make the desired impact, she decided she needed to understand human psychology. Initially, there was no plan of becoming a clinician. However, once she engaged with the discipline and saw the one-to-one impact it could have, there was no looking back. Where journalism only allowed one-way communication, psychotherapy opened up dialogue. She switched gears completely and found herself in a new world.

Her initial rendezvous with the media did, nonetheless, prepare her for advocacy work she would later do in the mental health field. “Even some of my really experienced colleagues just do not know how to talk about the issue, approach stakeholders or raise funds. That kind of training, for me, came from journalism school.”

Anshuma believes that most people in mental health end up there because something happens at some point in their lives that forces them to look outside of the regular. It leads to a diagnosis of the fundamental illness in a society that embraces an inherently capitalist notion of self-worth. Once spotted, the symptoms of this malaise cannot be ignored. In her own life, she has encountered trauma a fair number of times, even at a young age. 

“Back then, these discussions around mental health, trauma and how the system contributes to it simply weren’t possible. All of this went unnoticed. Let’s be honest, it’s become an attractive conversation to have right now. Ten or more years ago, I wouldn’t be getting a call from a media house to talk about this. But there was a chatter that happened inside of me then. I could have chosen to ignore it, allowing the trauma to manifest in other unhealthy ways later in my life. Or I could listen to it and create a space for healing with it. Due to my privilege, that is what ended up happening with me and I am thankful.”

From Psychotherapy to Art Therapy

As if one major switch to a relatively offbeat career path was not enough, she went on to specialise in an even more unconventional subset of psychotherapy. Distilling into arts therapy, which is defined as the usage of creative arts in the context of therapy and counselling, was the turning point in her career. While working at a psychiatric facility, she was struck by the feeling that something was missing when the body was not engaged – just talking could not be enough. There is something deep and reflective about the individual which is outside of language and articulable speech. She believes a lot more information about a person can be extracted when they speak in images, similes and metaphors. 

To better understand this visual language, she decided to do her second Master’s, in Creative Arts Therapies. With more and more people engaging in different forms of art as a way of coping with the current situation, this kind of therapy is the most conducive right now. 

Recently, one client, sitting in her balcony and free of most worldly distractions, wrote a huge creative piece that somehow managed to bring together seven years of the work she had done and progress she had made in therapy.

But being an art therapist, as enriching as it is, brings its fair share of challenges, too. When she first entered the field of psychology in 2011, she was told that her work could be done by nurses, was non-essential and a waste of hospital space. And when ‘art’ joined ‘therapist’ in her designation, the stigma became dual in nature because the arts themselves are generally considered “frivolous.” Even within the already small community of mental health professionals, she found herself having to constantly justify her existence. To this day, she is asked questions such as “Do you dance for your patients?” and “Do you put up shows in hospitals?”

“I welcome the questioning, but I just think it’s unfortunate that we cannot simply be taken as a serious field. We have to constantly defend our space and that is exhausting,” she explained. “On account of being considered ‘soft’ and ‘feminine,’ I have often found myself and my field dismissed entirely by people outside of it.” But her experience as a woman in mental health has predominantly been powerful and incredibly rewarding, particularly in her teaching avatar. 

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Of course, every once in a while, the typical “mansplainer” will come along and make her want to pull her hair out, but that probably can’t be completely avoided anywhere. 

“I’ve had men who have nothing to do with mental health explain mental health to me. A few days ago, as a response to recent events, I had put up a post on Instagram about using more sensitive, people-first language and avoiding the verb ‘commit’ when talking about suicide. A male fitness coach reached out to me and said, ‘Instead of this bullshit, if you had put out more positive thoughts on your page, then maybe he would’ve still been alive.’ Of course, I replied in a calm manner, but I was enraged. These positivity pundits basically just want the person to resolve their problem quickly and go back to being productive, as though thinking happy thoughts is some kind of capitalist chaabi (key). Instead, therapy offers perspective, honours the individual’s experience, and is truly inclusive.”

Self-Care

But therapy can, at some levels, be taxing for the therapist. There are days when Anshuma wakes up and wonders why she does what she does. Everybody’s saddest stories are, after all, a lot to carry. 

“Sometimes I wish I was a florist so people would come to me when good things happened in their lives. Or someone who sells stationery, because that’s neutral. But I have to be the reservoir for humanity at its worst, and that can be hard. I treat both the victims and perpetrators of abuse, for example. Having said that, it takes just one client having one shift in perspective for everything to be worth it. Every morning I hate my job, and every evening I love it,” she laughs.

Creating watertight boundaries between personal and professional lives is not easy, and she finds that her work has percolated into her individual relationships, too. She is often expected to be the most understanding, Zen person who will always make a mature decision. There is very little room, then, for her to have off-days and fly-off-the-handle moments. Conversely, she too has unfairly high expectations of sensitivity from all those around her, and often finds herself disappointed. “I expect better out of humanity and humanity expects better out of me!”

But all said and done, her job is more empowering than emotionally draining. The day the scales tip in favour of the other side, she will know she needs to take a break because then she won’t truly be able to help anyone else. Mental health professionals are responsible for checking in regularly and setting standards of self-care for those they treat. Apart from being in therapy herself for the last 11 years since she started her journey, Anshuma relaxes and recharges by spending time with herself, binge-watching mindless shows, creating visual art and dancing.

In her opinion, allowing yourself access to help of any sort – therapy, art, and so on – is the most courageous thing you can do. “I always take a moment in my first meeting with any client to offer them gratitude for taking a step for themselves. It is the most important.” 

She believes taking that kind of personal responsibility is something that, when expanded, has the potential to change the world. Anshuma is changing the world around her, one conversation at a time.

StoriesAsia, a collective of independent journalists from 16 South Asian and Southeast Asian countries, seeks to replace the present-day parade of faceless numbers with humanising narrative nonfiction – a largely ignored journalistic genre in the region.

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