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Acta Psychiatrica Scandinavicaz
 





Boon for mental caregivers :

Updates on mental disorders and their treatment is now readily available to those working in related fields, thanks to a tie-up between the NGO Turning Point and International Society for the Psychological Treatment of Schizophrenia and other Psychoses (ISPS).

The first seminar of ISPS-India was held at Park Palace Hotel on Monday. Though director Ishita Sanyal described the theme as ?how professional hazards influence mental health?, the discussion generally remained confined to the ?hazards? faced by caregivers and parents of patients suffering from the disorders.

The panel provided certain interesting insights. Sanyal, for instance, stated that rural society is more open to ideas and willing to accept disabilities. In an urban society, a patient is likely to face hostility and stigma. That causes delay or disruption in treatment.

Shukla Bhaduri, one of the founders of the NGO Mentaid, spoke of how her own personal anguish (as the mother of an autistic child) had propelled her to join others in forming a self-help group.

But age is catching up with us and we need others to take our place. The need of the hour is closer networking among the existing groups,? she added.
-By a Staff Reporter. |  Friday, April 21, 2006 |
 


IOS Press Books Online - Empowering the impaired through the appropriate use of Information Technology and Internet


Medical and Care Compunetics 3


Reducing emotional parental overload & emotional burden by formation of self help group & taking part in fighting stigma.

Empowering the family members to form self help & taking initiative in reducing stigma in their neighborhood.

Objective- In Indian Society family plays a key role in providing help & support to the mentally ill. This is also facilitated by our culture which places family at the centre of all activities. Lack of institutional facilities & due to non – affordable cost families have to play a key role in the treatment & maintenance of the mentally ill.

But due to tremendous stigma attached to mental illness & immense guilt attached to mental illness parents are often overloaded with emotions & are susceptible to emotional outburst themselves. Instead of helping their children & accepting the reality, denial plays a key role & there is a tendency to hide the fact. This results in either over protection or over expectation from their affected child which cannot be fulfilled leading to high EE of parents. Parents, specially mothers feel guilty as society often points out their fingers towards the mother who is believed to be the cause of all illness & negative behaviors of their child.

As a result parents, specially mothers become overburden in their effort to hide their guilt, giving full effort for the well being of the child without modifying their expectation. This often causes frequent relapse & mental illness in parents too.

Parents, specially mothers getting psychoed & taking part in self-help group-development –the self confidence, rationality understands the situation & gets satisfaction while helping their own child with others. They got a moral support & come out & security. When they fell that the group there to look after their child often their demise or when they found their child is doing a regular job.

Result-The quality of life of the parents is seen to improve which has an impact on improving the quality of life of the patients. The feelings of utter despair change to a ray of hope & support for their children. Self help group improves the functional status of the parents as well as the patient leading to low relapse & higher performance of the patients.

  EXPERT EYE COLUMNS

Ishita Sanyal's Expert Eye Columns in Telegraph as a Specialist Consultant Psychologist .

"Don’t be a male chauvinist"

The Problem: Six Month ago, much against my wishes, my wife took up a job in the US and left our two year old son and me and went off. She is now insisting that we join her. But I don’t want to do that and have asked her to return, which she refuses to do. My parents want me to divorce her and remarry. What do I do?

You are facing a dual-career conflict. You seem to have taken it for granted that your wife will be a workingwoman but you won’t have to face the problems associated with it. But in a dual-career lifestyle there are bound to be few disadvantages for both the partners.
When it comes to relocating because of a promotion or a job change, dual-career couples are very often faced with a dilemma – shall the husband move or the wife? It is well accepted by our society that married men can keep both work and family roles intact without trading one for the other. If a man gets a job abroad, his wife, if working, is expected to follow him and hind a new job for herself.

But inevitably, there are problems when a man is expected to join his wife where she is relocating. Men need to understand that in the changing social scenario today either of the partners might need to shift base for the sake of career advancement. Especially, professionally
Successful woman appear to have a greater sense of independence and for them, career-related success can be more important than other aspects of life.

It seems that your wife is interested in keeping the relationship alive. So discuss your grievances with her openly. Most importantly, think about your child. Understand each other’s needs and priorities. You can take professional help if necessary.


"Go Ahead and divorce him"

The problem: I got married recently. Before the wedding we were told that the groom was a doctor. But later I found that my husband is a medical college dropout and does not work anywhere. I am considering divorce now. But the problem is that I have become pregnant. Should I go ahead with the divorce?

Being betrayed is one of the most heartbreaking things one can face in a marriage. However it is also a fact that you and your family should have checked the credentials of your would-be husband.

We all know lying is a major part of human nature. But telling a lie while building a relationship can spoil the relationship itself.

Men often lie to build themselves up or to conceal something. They usually have a hard time admitting failure. As psychologist Michael Lewis has pointed out in his book Lying and Deception in Everyday life, men are more likely to lie to enhance themselves than women are. Normally, as trust builds up, a man drops these lies. But this type of lies unglues any relationship.

By now you must know if your husband is a habitual liar or if he lied about his qualifications just to impress you. Find out whether he feels guilty about it or wants to change himself.

Often, giving a chance to a person who feels guilty about his past misdeeds can change the life of both the partners. Communicate freely with your husband, express your feelings and tell him how important trust is in a marital relationship. If he wants to change himself you can give him a chance, unless, of course, you feel that your trust, understanding and respect towards your husband have been eroded beyond repair.

“Sack the maid at once”

The Problem : I am a 19 year old girl and my sister is 18. Two years ago, our mother passed away. Initially our father was grief-stricken. But of late we notice that our maid acts very familiar with our father and he too is indulgent with her, which I and my sister don’t like. We tried to sack her but he didn’t want that. What should we do?

The death of a lived one is always heart breaking. Each person experiences grief in his or her own way and the length of the mourning period varies from person to person. Your father too must have felt the grief initially. But since men can sometimes be over-dependant on their wives for emotional support, they often try to get it from someone else once they become widowers.

I know it must be tough for you to accept the fact that your father is developing a weakness for another woman, especially when you are still grieving for your mother. It is more difficult se she is your maid.

But probably it is actually his way of coping with his own grief. It’s important to remember that your father’s weakness for the maid does not diminish his love for your mother or for you.

The death of a spouse is one of the most stressful events in a person’s life. Social support has been shown to be widely beneficial in moderating the effects of stress. So, don’t hurt your father’s feelings as he may then try to create a distance from you.

Try to be supportive to your father. Let him know how much you care for him. Ask him whether he wants a partner in life, and if his answer is yes, help him to select his partner rationally. Take the help of friends if necessary. If you cannot handle it, take the help of professional.


"Look for someone else "

  The Problem: I was to be married to a girl in January next year. It was an arranged match. Now she has suddenly called it off, saying that I am not the right person for her. Should I try and change her mind? I am angry, confused and depressed. Please help.


  From the way you are feeling, it is clear that though this was to be an arranged marriage you have actually fallen in love with the girl. But remember, although it is a lot more difficult to live happily together.

Before marriage we often tend to overlook our priorities. Questions like “ Why do we I need to marry?” or “ What do we expect from each other?” remain hidden in the subconscious. But these questions need to be addressed prior to marriage. It is important for both partners to look deeply into how they relate to each other and to Explore their respective views on issues that are important to them.

It the girl has given this a thought, appreciate her endeavor, discuss with her why she Things that you are not suitable for her. Share with her your needs and expectations from marriage and also request her to disclose her opinion clearly. In this way you will be able to find out whether or not you are ideal partners for marriage.

It is better not to marry a person who is not suitable for you than to end up with a broken marriage. However, if you discover that both of you share the same feelings and Can meet each other’s needs, then she will definitely change her and mind and agree to the marriage. You could also seek the help of a pre-marital counselor to guide you in this Matter.


"Tell her you need space "

  The Problem : my father died when I was four and since then my mother's life has centered around me. I'm 18 now, yet I can't have a life of my own. When my friends drop in, my mother sits with them and monopolizes the conversation. She makes all my decisions for me, like what I should wear or eat. What should I do?

  Being human is all about being in relationships, Relationships can provide us with love, understanding, but can also be a source of unhappiness and uncertainty. Due to the sudden vacuum in your mother’s life after your father’s death, Her needs and wishes were satisfied through you and you were her only source of interaction with Society. You too must have been dependent on her then.

But as you are growing up, you are developing a new identity. Unfortunately, your mother fails to understand this or denies it. You may have developed a co-dependent relationship with your mother, and over the Years, it has turned into a pathological dependence. All human beings are born dependent.
Becoming self-reliant is the result of a developmental process. Normal progression begins with “symbiosis” moves to increasing competence, then to independence and finally, to interdependence. In co-dependent relationships, these normal shifts get “stuck” leading to an incomplete sense of the self.

Try to provide support to your mother and tell her that your identity is at stake. Project mature image of yourself to your mother. If you can point out your difficulties, then she May understand. You can take the help of an elderly relative or a family friend. Professional help may be needed, too, if you cannot handle the situation tactfully.


At times, even caregivers need to be looked after

PSYCHOLOGISTS SUGGEST A FEW TIPS TO HELP MANAGE CARE GIVING BURDEN ( from The Telegraph,  Kolkata)

Case I: Sujata and Anup Sanyal were a happily married couple. Today, they are separated and undergoing treatment. They have a son who suffers from server obsessive-compulsive disorder.

Case II: Sriparna sen left a corporate job when her daughter was diagnosed with schizophrenia and took care of her for 20 years. One day, Sriparna went missing and has remained untraced till date.

Case III: Nidhi, a young mother of two, brought her paralytic father home and nursed him back to health.Today she is being treated by a psychiatrist for depression and suicidal tendencies.


The cases may be varied, but they are united by a common thread-the caregivers have, over time, become patients themselves.
A caregiver is a person who gives care to another person who has a chronic medical condition. Some of the basic types of care are helping with bathing, toilet functions, dressing, feeding and medication.

As Karen Henderson, founder/ CEO of the Canada-based Caregiver Network Inc puts it, Care giving is a are responsibility that usually comes with no choice, little warning, no preparation and no training.

Arunima, a 30-year-old teacher, says that when her mother was diagnosed with cancer, she resolved to be the best caregiver possible. But she ignored her own health and ceased to have a life of her own. The stress, coupled with her own fears and mounting medical bills led to a nervous breakdown.
Psychologists and counselors say that for caregivers, life-changing illness can be similar to bereavement many of their feelings and experiences are new and frightening. While trying own fears. Psychiatrist Dr.R.Ghosh Roy explains this as caregiver burden or caregiver stress.

Caregiver burden is an all-encompassing tern used to describe the financial toll of providing care. The following is a list of symptoms and signs that indicate caregiver stress: fatigue, weight loss or gain, decreased energy, insomnia, inability to concentrate, hypertension, distractibility increased gastro-intestinal problems decreased memory, increased alcohol, yearning for the past, mood swings chest pain abdominal pain isolated joint pain and depression or anxiousness. Given the wide range of physical and mental disorders sometimes refer to them as ‘hidden patients’.

In western countries, caregivers have the advantage of a host of caregivers’ support groups, organizations, journals and websites, which provide not only helpful information and tips, but also motivation and a reality check. In India, Dr.Ghosh Roy points out that though there has been a lot of theoretical research into practice on a significant scale.

In Kolkata, one of the pioneers of the care for caregiver movement is Ishita Sanyal, who started an organization, Turning Point, in 1996 to which focused on the problems faced by caregivers. At Turning Point, frequent workshops are held involving mentally ill patients and their families. They organize sports
Meets, excursions and picnics, where families facing similar problems come together. This helps parents realise that their problems are not unique and it gives them a more objective approach.

At TP, they also deal with something, quite unique to Indian families with chronic patients-High Expressed Emotion (HEE) which leads to overprotection, having a negative impact on the patient. TP helps Families and caregivers reach a balance. They counsel families to understand that their patient may not show remarkable improvement the best care possible. A caregiver’s problems are compounded by the fact that they usually do not receive the support and understanding that patients do. (Some names have been changed to protect identities)


Admit that you are stressed out.

Begin to realise that you have a choice between remaining fixed in “what should have been” and choosing to accept what is. Establish open and honest communication with the patient (where he/she is capable of understanding the problem) and your family to help face the many changes that are inevitable. Here the guidance of a professional counselor may be helpful.

Sort out finances and try to make arrangements for medical contingencies. Worrying over medical costs is one of the biggest reasons for caregiver stress.
Weed out unrealistic expectations. Gather information about the disease and do not set impossible target.
Its is impossible to not feel resentment when one is living his or her life solely for another person. But caregivers are unaware of this because of the idealized picture that society has painted.


HELP AT HAND

Turning Point. 27 Jadavpur East Road, Kolkata - 700032
Ph- 2414-3660

Manovikas Kendra Rehabilitation and Research Institute for the Handicapped.
482, Madudah, Plot I-24, Sec J Eastern Metropolitan Bypass, Kolkata – 700017
Ph: - 2442 8275/3305/3306

Indian Institute on Cerebral Palsy (Formerly The Spastic Society of Eastern India)
P-35/1, Taratola Road, Kolkata - 700088
Ph:- 2401 3488/0240


 

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