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ramblings of an unknown psychiatrist

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Archive for the ‘personality’ Category

Marital Conflict: an abstract painting

Posted by Dheeraj Kattula on December 2, 2011

Marital Conflict

Title: Marital conflict

Watercolor on handmade paper

24 x 32 cm

2.12.2011

Realistic art is technically challenging and abstract art is ‘technically challenged’, so I thought and refrained from abstract art till now. Art need not be technically complex and simplicity may not be meaningless.This painting has taken a lot of thought and very less time.I call it ‘Marital Conflict’.

Any marriage is attacked by strong emotions and deep passions as represented by the red. It can be shielded by patience, serenity and wisdom as represented by the cool blue. In that love lives on, represented by the form of heart. There is peace, represented by white.In that context partners experience growth, as represented by green. Due to stressors, personality factors and rarely mental disorder this buffer is lost. Peace is found in separation as seen in the inverted funnel.Partners may grow but not to the level they together could as shown by the sizes of green blots.The blue drops above offer hope that outside forces can increase the buffer to protect love, peace and growth through social support,therapy and God’s enabling.

 

Posted in art, love, marriage, personality, psychiatry, psychotherapy | 2 Comments »

Bollywood, Brothel and Being Born Again: a story

Posted by Dheeraj Kattula on September 25, 2010

This is a sequel to the story ‘A Dirty Job’ that I had written a couple of weeks ago. You can read it by clicking this.

It was the story of a girl who had very traumatic childhood. She landed in a brothel at an early age. She was rescued from there. She was given therapy to overcome her problems. She was also trained to live a decent life. She chased a dream to dance on film sets after she gained majority. She ended up having an affair and mothered a girl child. Hunger and desperation pushed her to the streets to solicit men.

The story was harshly realistic, reflecting lives of scores of women who land in brothels having chased a Bollywood dream. Is life over for them or is there any other way? Please read on…This story reflects a hope that I believe in.

Bollywood, Brothel and Being Born Again

Bollywood dream is over. I was not getting chances as expected. I made a new choice- to do the dirty job. I had detested it. I always had maintained that I would never do it. I was warned of this by few people. I wonder how they saw this possibility. I do not even want to think about where I went wrong. I always had prided in living in the present. No one knows what the future holds and no one can change the past. So why bother about these things which are not in one’s control. This is how I always thought. The doctor I had met used to advise me of being mindful, but my mind was full of ‘never mind’ philosophy. I think when one crosses boundaries and chooses to go far away from the previously set boundaries; it becomes easier as one moves along.

Having slept with a man once again to satisfy my hunger pangs, I was willing to continue this to sustain myself and my child decently. I went to Kamathipura and joined a brothel. I was given a small room. There were four others with me sharing the room. There were times when two of us were servicing our clients with only a cloth separating us. In the beginning I was a bit disturbed when I used to hear my daughter cry when I was engaged at work. I could see her through the diaphanous cloth which was to shield my shame. I have since gotten used to it. It is all right for a child to cry once in a while, especially if the tummy is getting filled thrice in a day.

I do not know why, but many of my clients come back to me for more. I had a record for this in our brothel. Mohammad Altaf was a local goonda who used to come for me frequently. He looked terrifying. He always carried his revolver with him. Another such regular client was Inspector Chogle. Chogle used to even bring biscuits and milk for my kid. Chogle had apparently recommended one of his bosses an IPS officer Mr Tripathi. He too came regularly. My status in brothel increased. I was given some freedom of movement. Moreover, I was voluntary here. Other girls who were trafficked from Nepal and Andhra had no contact with outside world except the clients.

One day Chogle came and told me to dress well for an outside engagement. He took me in a taxi to Bombay Orchid Hotel. He told me that it was one of the best hotels in India. The hotel looked astounding. He took me to a room more luxurious than the hotel. It did not require me to be an intelligence officer to know that I might have to service a big-shot.

I was shocked to see him. He was a minister. Everyone in the country knew him. Xavier Francis was his name. I had seen him debate on TV on issues of women like rights, dignity and self- reliance. He always wears Khadhi and speaks desi stuff. This is his real face- sleeping with young women in star hotels. After the job was done, he threw two bundles of Rs 100/- notes. I had earned Rs 20,000/- in one hour! I was thrilled. Suddenly he asked me to return the money. As I was giving him back, he tore few pages from a book that was placed near the table lamp. He wrapped the money in those papers. He then secured them with my rubber hair bands that I had left on the table and gave back the money to me with a smile. I liked his gesture.

When I went back to my brothel, I unwrapped the covers to take the money out. I was about to throw the papers, I thought I could as well read them. It was long since I read something in English. I might forget it fully if I did not read on and off. One sheet was the first page of a book. It had a seal stating ‘placed by Gideons International’. The other sheet had a story.

It went like this,

“But Jesus went to the Mount of Olives. At dawn he appeared again in the temple courts, where all the people gathered around him, and he sat down to teach them. The teachers of the law and the Pharisees brought in a woman caught in adultery. They made her stand before the group and said to Jesus, “Teacher, this woman was caught in the act of adultery. In the Law Moses commanded us to stone such women. Now what do you say?” They were using this question as a trap, in order to have a basis for accusing him.

But Jesus bent down and started to write on the ground with his finger. When they kept on questioning him, he straightened up and said to them, “If any one of you is without sin, let him be the first to throw a stone at her.” Again he stooped down and wrote on the ground.

At this, those who heard began to go away one at a time, the older ones first, until only Jesus was left, with the woman still standing there. Jesus straightened up and asked her, “Woman, where are they? Has no one condemned you?”

“No one, sir,” she said. “Then neither do I condemn you,” Jesus declared. “Go now and leave your life of sin.””

I got shocked. There were many things that I did not understand in the story like what are olives, who was Moses, what is this trap thing for this man Jesus etc but I did understand one thing. I am like that woman. I could be caught by police and tried according to the law. This would not happen as people like Chogle sleep with me. This man Jesus was different. He could have condemned that woman but he did not do that. He did not use this position in any other way too. He just told her to go and leave the life of sin. “Go now and leave your life of sin”- that statement rang in my ears for few minutes. I was so lost in these thoughts that I did not even notice that brothel keeper and my co-workers came and took away my money.

When I came to senses, I did not even feel the loss of money. I was awakened. Something was new in me. May be like a sapling. It was alive and growing. I was beginning to see things a bit differently. I do not know how to explain this. I could no longer enjoy the services I rendered. I was lost in some other world. My regulars also noticed a difference. Many of them asked me if I was not well. In fact I was feeling more than well. I realized that there is a thirst in me that needed to be quenched.

A few days later I was on my way to a beauty parlour. I was on an over-bridge near railway tracks. A drunkard walking with a cup of tea on the bridge spilt some tea on my shoe. I looked around for some waste paper. I saw an old man stand in a corner of the over-bridge giving away some booklets. I took one and tore a sheet from it to wipe my shoes and threw the rest of the booklet away.  Just as I was about to throw the sheet off, I realized I could read some English like I did on and off.

The passage went like this:

“Now he had to go through Samaria. So he came to a town in Samaria called Sychar, near the plot of ground Jacob had given to his son Joseph. Jacob’s well was there, and Jesus, tired as he was from the journey, sat down by the well. It was about the sixth hour.

When a Samaritan woman came to draw water, Jesus said to her, “Will you give me a drink?” (His disciples had gone into the town to buy food.)

The Samaritan woman said to him, “You are a Jew and I am a Samaritan woman. How can you ask me for a drink?” (For Jews do not associate with Samaritans.)

Jesus answered her, “If you knew the gift of God and who it is that asks you for a drink, you would have asked him and he would have given you living water.”

“Sir,” the woman said, “you have nothing to draw with and the well is deep. Where can you get this living water? Are you greater than our father Jacob, who gave us the well and drank from it himself, as did also his sons and his flocks and herds?”

Jesus answered, “Everyone who drinks this water will be thirsty again, but whoever drinks the water I give him will never thirst. Indeed, the water I give him will become in him a spring of water welling up to eternal life.”

The woman said to him, “Sir, give me this water so that I won’t get thirsty and have to keep coming here to draw water.”

He told her, “Go, call your husband and come back.”

“I have no husband,” she replied.

Jesus said to her, “You are right when you say you have no husband. The fact is, you have had five husbands, and the man you now have is not your husband. What you have just said is quite true.”

“Sir,” the woman said, “I can see that you are a prophet. Our fathers worshiped on this mountain, but you Jews claim that the place where we must worship is in Jerusalem.”

Jesus declared, “Believe me, woman, a time is coming when you will worship the Father neither on this mountain nor in Jerusalem. You Samaritans worship what you do not know; we worship what we do know, for salvation is from the Jews. Yet a time is coming and has now come when the true worshipers will worship the Father in spirit and truth, for they are the kind of worshipers the Father seeks. God is spirit, and his worshipers must worship in spirit and in truth.”

The woman said, “I know that Messiah” (called Christ) “is coming. When he comes, he will explain everything to us.”

Then Jesus declared, “I who speak to you am he.”

I got excited as I read this. This is the same man Jesus. I had difficulties in understanding everything. Of course I was reading a passage out of a story book and I cannot get an understanding reading a small portion. I asked the man distributing for another copy. He gave piercing looks and looked at the booklet I had thrown away. It had landed open and face down on the railway tracks. I knew what I had to do. I ran as fast as I could and got there before a train came and destroyed it. I sat in the platform and read through this booklet. It was called ‘Gospel of John’. It was about Jesus. It says a lot of things about love.

It said that “God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life. For God did not send his Son into the world to condemn the world, but to save the world through him.”  It also said, “Light has come into the world, but men loved darkness instead of light because their deeds were evil. Everyone who does evil hates the light, and will not come into the light for fear that his deeds will be exposed. But whoever lives by the truth comes into the light, so that it may be seen plainly that what he has done has been done through God.”

What I had read earlier was also in this booklet. I realized that I was living in dark. In reality brothels are dark places. Many of our clients want their visits to Kamathipura to be kept in dark. I was living in dark and I was doing evil. Do I have a choice? Can I make a living for my child and me in a way that is not evil? Even if it were to be possible, was I willing to come into the light?

I realized that if I could do it, it would mean plainly that I have done this through God. I prayed to God to help me know the right thing and do the right thing. I went back to my brothel. Life was never the same. I could not enjoy my work at all. It was seen by my clients and soon my brothel keeper would know it. I could fake being happy, but I could not bring myself to do it. There was a discomfort welling within me about being untruthful. I could not even fake it for my survival. I was happy acting in line with my feelings.

I decided I must leave this brothel and this life style. I can work as a maid servant and life a truthful life. I should not let my daughter enter this dirty world if I really love her. Usually the brothel keeper never lets me out with my daughter alone. I had to find the right reason to take her out. That very week Chogle gave two passes for an amusement park nearby. One was for an adult and one was for a child. I had the right reason to go with my daughter and no one else would be with us.

Where would I go with my kid in Mumbai? Whom could I trust? I just wondered. I remembered that things are possible with God. I phoned Mohammad Altaf from a phone booth. I knew Altaf was a goonda and was a ‘bad guy’. Anyway, I decided to trust him, as he was on the wrong side of the law and was faithful to people on the wrong side. Chogle, Tripathi, Xavier etc appear to be on the right side of the law and are unfaithful to the ones on their own side.

Altaf came in about 15 minutes. I told him, “Altaf, I want to leave this trade. I need money to leave this place. I know that you are a tough guy, but I also know you are a good guy. So I have trusted you. Please help me. I want to do the right thing.”

“Laila. Come let us go to ATM…How much do you want?” he asked. “How much ever you can offer”, I answered. He gave me Rs 10,000/- and said, “Leave Mumbai. It is not safe here. They will be able to get to you. Wait for a minute… I will buy you a burqa from the shop near the mosque. You can cover your face.”

He came within five minutes and gave me a burqua. He told me to go behind the pan shop to wear it. In the meantime he took my daughter behind a barber’s shop and cut off the hair of my daughter and dressed her up like a boy. I was so happy for his resourcefulness. We had a chance to escape in nice disguise. As we were about to leave, he got emotional, “Laila, I wish I was a good guy. I would have given you a new life. My life has no future and so I can never commit. I would always love you.”

I always had this intuition that Altaf was a good guy at core but had life had built this tough shell around him. What else can you expect? His mother was also a worker like me, who died of HIV few years ago. He never knew who his father was. I was glad at least he realized there is something called love. I prayed that he too understands God’s love and power to change our lives.

I took a train to the place where I was treated as a teen-ager. I still remember the doctor who cared so much for me and gave me so much of advice. I hoped that he was still there. The hospital had not changed much. Extensions had been made in existing buildings. I went to the room where he used to meet me. I peeped in. He was there. His hairs have greyed a bit and he has put in few kilos of weight. His assistant wanted me to show the appointment card, which I did not have. All of a sudden the doctor came out, probably to grab a cup of tea in between few sessions. I called out for him. He took a couple of seconds, but he recognized me by my name. I was so happy. I was Laila, Lovely or Darling to many men according to their choice, but to the doctor I was, who I really was. He told me to wait till he finished his appointments. He asked me if I had eaten before he went in and resumed his work. I knew I reached a place which had some concern for me.

The wait felt very short. I told my whole story to him. He was not amused. He took it in as if he knew it all. He made some phone calls and then told his assistant to take me to the destitute home. He told me this was a short term arrangement till we could work out a long term plan. The home had 20 destitute women who were old and infirm. They had been deserted by their families. I enjoyed work in the home. Those ladies took good care of my daughter as well. I began to learn their language. There was a nurse who visited us twice in a week. She used to sing songs of Jesus at the beginning and at the end of her work. I shared with her my story. She got excited. She started praying with me for future of me and my child. I began to realize that this place was not my long term home. I wanted to move back to the brothels and help rescue many little girls and young women who are forced in to this trade.

I discussed this with the doctor. He bore the same expression he had when I had shared about wanting to be a dancer in Bollywood. He was true in believing that sparks should be kept far away from fuels. He thought it was intrinsically risky with the promise of earning powerful enemies. There was also the risk of me falling back into the trade. He encouraged me to stay at destitute home to help in the daily chores. He also encouraged me to complete my schooling.

I found a new love for books. They told me about how the world operated, a world created by God. This love made me learn with enthusiasm unlike the way I studied earlier. In a couple of years, I finished my XII standard. I even appeared for the Nursing School Admission test in the hospital where I had got treated. I got selected. My doctor and his friends supported me by paying my fees. They were also supporting my daughter’s school education.

In five years I completed my Nursing course and accumulated two years of experience. My daughter finished her VIII standard. It was an easy choice for me to wait for four more years till my daughter finished her XII standard and secured a seat in Nursing School. I continued to feel the pull to go and rescue girls who were caught in the dirt of flesh trade. I discussed with my doctor. He felt I was a mature woman now. He had developed links with NGOs who are trying to rescue girls and women who were trafficked. He said he would put me in touch with one of those NGOs. I put my daughter in hostel attached to our destitute home. My daughter knew the importance of my work. She was glad to release me. There was a mobile in the home. I could contact her anytime in the evenings.

In the first one month of my job, we were off on a raid. My job was to provide support to the rescued girls. We had social workers, volunteers and police in the raid team. The vehicle’s windows were covered. When the door opened and we alighted, it was like a déjà vu for me. The scent was familiar, the landscape, the building…everything. In fact it was not a déjà vu-It was all real. We had come to the place where it whole thing had begun for me about 20 years ago.

We rescued 15 girls that day. On our way back, I had tears in my eyes. I too had been rescued once, but I had fallen back. I needed a saviour. I knew these girls need a lot of love and a lot of grace to make this rescue meaningful. In our journey back, I prayed for each of these girls as they slept around me in the van. Maybe I lacked someone’s prayers and therefore I got back into the mess. I would not let that happen to these children. I have received love and it is time I share it.

Epilogue:

I became 50 years old few weeks ago. My daughter has become a nurse. She is a nursing tutor in the hospital that took care of us. Her husband is a Physiotherapist. They have a beautiful daughter Raksha.

I chose not to marry again though I had few proposals. I dedicated my life to a mission to rescue girls and I did not want any other engagement in my mind.

I have had my own share of problems too. I have been assaulted numerous times during the raids. I have had fractures a couple of times. Once I had a gunshot wound in my thigh and I lost a lot of blood. I was reminded of my saviours shed blood for me. Without sacrifice of some body, no good would come to this world.

I have been part of numerous rescue operations. Hundreds of girls have got rescued under my eyes. I do not know what has happened to each. I am sure there may be quite a few who have gotten back to the trade. I also know of numerous examples of those who get a new life after a rescue. I have seen them marry and establish homes and families. It is such stories which keep me moving forward. God has been faithful. He always gave me the needed strength. I would carry this on till my death. That is what I am called for.

******

Goonda- Ruffian/ Hooligan

Khadi- Indian fabric usually made employing rural populace

Desi-Refers to people, cultures and products of Indian subcontinent

Burqa- is an enveloping outer garment worn by women in some Islamic traditions to cover their bodies in public places which includes woman’s loose body-covering, head-covering and the face-veil.

Posted in children, christian, distress, education, emotion, fiction, gender, indian society, love, marriage, parenting, personality, prayer, psychiatry, psychotherapy, religion, social, spiritual, stigma, women's issues | Tagged: , , , , , , , , , , | 11 Comments »

The Dirty Job: a story

Posted by Dheeraj Kattula on August 27, 2010

My mother was admitted in the hospital. She had burnt herself. We went to see her every day. Our grand mother took us there. The doctors in the Government Hospital were not friendly. They would not let us stay in the burns ward for long. My mother suffered from burn injuries, which I still think were not very serious. I have seen many with worse burns make it to life. She died within a week of her admission. It was the doctors who killed her with their treatments.

Ramesh took Choti and left the village just after my mother’s admission into the hospital. Choti was born to my mother and Ramesh last year after they started living together. I think my mother knew she was going to die, even though she was conscious in the hospital. She wanted her family to take custody me and my other siblings Babloo and Moti. Her family is big. My grandma and her other children promised to take my brother. They did not want me or my sister. After all we were girls and they were afraid that we would grow up to be like our mother. I was seven years old and my sister Moti was four. An old lady in our village took sympathy on us and took us in. We addressed her respectfully as an aunt.

I missed my father and mother. My father was an alcoholic, but he loved us. He visited us every alternate day and gave us stuff to eat. My mother had wanted to keep him away from us. She used to shout at him, when she saw him meet us. I realize she too loved us. She was beautiful. We all look like our dad. Choti looked like our mom. I missed Choti too. My father never took another woman. He loved our family. A few months after mother’s death, I heard his body was found in a gutter in the neighbouring village.

This aunt who took us into her home was old. She found it difficult to control me. I was indeed naughty when I was small. I was always in the street playing with other girls. I did not help her as much as I troubled her. She put me into a hostel. I like school. I studied for five years.

In the summer holidays, I came back from hostel to be with my aunt. She was taking us to her native village. I refused. It was a dirty little village. We would have to share our room with two buffalos that they have. The smell was horrible. Instead of going I could stay alone in our village. She told her friend who lived few streets away to take care of me.

Her friend whom I called as Padma mausi took me to her house for a couple of days. She fed me well. I liked her. She took me to her aunt’s place which was few more streets away. The house had many young girls. They were all involved in dirty work. I knew that. My aunt too was involved in it, when she was young and able. There are no dirty little secrets in our village. Everything was open. Even primary school children knew what happened behind closed doors.

Our village had night school. It was where all children slept, when their mothers were busy with dirty work in the night. I knew it all, so I could tolerate it. I could accept the girls in the brothel. We played in the free time. I got good food there. It was better than what my aunt gave.

After a month, the care taker of the house called me into her room. A young man was there. She showed me to him and left the room. I was afraid. I screamed. He was strong. I could not fight. It was painful. I wept. He abused the care taker for giving him such a lousy girl like me. The care taker smiled and said, she is fresh to the trade. I was beaten that night for having shouted. Padma mausi never came again. Neither did my aunt. I was stuck there. I am now a 14 year old prostitute.

I could not leave the brothel. I was confined to the indoors. I had freedom inside. I could wear anything. I could eat as much as I pleased. I had the company of many girls, though many were older than me. Once you get used to everything you begin to enjoy what you once detested. I enjoyed the company of men. I liked the sensations of my body. When I lived in hostel, I liked Abdul. I dreamt of marrying him. His memories have got erased now. I lost the fear of men. I have seen them all. The rowdies who come and demand us for free, the police who are supposed to protect us, young men contemplating marriage, middle aged men who lost fancy for their wives and old men whose wives have died.

I was kept hidden for the fear of a police raid. I was moved from one brothel to another for protection. Indeed there was a raid and I was rescued. I was kept in a home run by the Government. Apparently my brother Babloo contacted a NGO and they had organized the rescue operation. I hate Babloo for having done this. I had adjusted to a new life. I was even enjoying it. I did not have to go to school. This rescue screwed my life up.

I was kept in this Government run home. I was not yet 18 years old, so I did not have right to be involved in this business. There were many girls like me in that home. Many of them were forced into it, just like me. They too began to enjoy their new life, just like me. They too were not getting any money, just like me. The men who came to us gave us money. We were to hand it over to the caretaker. She would give back a small amount to the older girls. The younger ones would only get food, clothing and accommodation.

After I joined the new home, they did some blood tests on us to check if I had contracted any disease namely HIV. I did not get it. The new home had a teacher who came to teach us some basic stuff. I was best in my class, as I had completed my primary school. Most other girls were dumb. I was getting irritated with their fixed schedule. I used to shout back to the teacher and the warden. They would beat me at times. They also taught us moral ways to live. I could see from the lives of our teacher and other staff that there are better ways to live.

I get confused at times about what is happening? The past and future flood me with irritation. I get tensed and do things that I later regret. I just cannot control it, when I get into that rage. Last year I broke the TV, Computer and telephone in a fit of rage. They thought I became mad.

They took me to a doctor. He admitted me in their hospital. He was a young man. He looked respectable. I saw him joking a lot with his friends in the hospital canteen, but he was serious with me. He looked straight into my eyes. He probably was mystified with my story. He had sessions with me regularly.  I avoided his eyes in the beginning. I became more comfortable with him and shared more freely. Of course I avoided many areas which were uncomfortable for me to discuss with. In fact I do not remember much of those either. He was interested in those things, as if they had a key to a treasure.

He asked me one afternoon, “You did not go to your aunt’s village because you would have been uncomfortable. Am I right?” I thought it was obvious. He then asked me, “If you had gone off to your aunt’s village, would you have gotten into this mess?” I was shocked. It is true; I would not have gotten into this puddle of shit if my aunt was around. She was old. She was in the dirty trade herself, but she was strong enough to protect us. He then said,” There are many things in life, which are uncomfortable. If we run away from them, then we would get into situations which are even more uncomfortable. Isn’t it?” I agreed.  He then added, “Can you see a difference between what feels good and what is good?” I did not understand that, but I nodded. He smiled and said “Good!”

He taught me how to relax my mind and how to ventilate my anger in acceptable ways. The day of my discharge grew nearer. He asked me of my dream. Of, what I wanted to be. I told him what I always desired, “A dancer, in the movies.” I could see his eyes sink. He was not happy. He tried to tell me that it felt good to be a dancer in the movies but it might not really be good. He said that the movie industry had risks for girls like me. He said it is likely that vulnerable people may get into wrong things.

I am sure I am not getting into bad things. I detest the dirty work myself. I would never do it to get a chance to be on silver screen. There is something called talent in this world and people would recognize and reward it. The doctor is educated. He can know what is in books. He cannot pick dancing talent. He has stereotypical beliefs on movie industry. Other girls in our hostel have danced on movie sets. They have told me that they did not have to do dirty work to get dancing chance. They told me the heroines do it not dancers.

When I got discharged, I could see that the doctor smiling. His smile was empty. It looked as if he knew something dangerous was lurking around. More knowledge spoils the mood for everyone.

Next year, they will release me from the home. I still am unable to love my brother Babloo, though he had done everything in my interest. It is probably because I fomented hatred over him just because he caused me the discomfort of moving me to the Government home from the brothel. I don’t care about Choti and Moti too. It has been many years, since I saw them. I have lost feelings for those whom I can call as a family. I can be a free bird with no restraints. I can chase my dreams. I can go to Mumbai and try my shot in movies.

Epilogue:

"The dirty job is always available."

After discharge from home she went to Mumbai to become a dancer. She fell in love with a light-boy. He left her after a year, leaving behind a two month old daughter in her hands. She was hungry and her baby had no milk to feed. She came to know why her mother sought Ramesh despite having a husband and three kids. The main roads are busy and side lanes are dark. The dirty job is always available.

PS: (added on September 25th, 2010) There is a sequel to this story ‘ Bollywood, Brothel and Being Born Again’.You can find it here.

Posted in behavioral therapy, bussiness, distress, economics, emotion, fiction, gender, indian society, personality, psychotherapy, social, stigma, women's issues | Tagged: , , , , , , , , , , , , , | 5 Comments »

“Normal”, “Abnormal” and “Label”

Posted by Dheeraj Kattula on June 26, 2009

Warning:

The post might have a lot of jargon,which you might not enjoy. It might be written in a fashion, which may make you feel that author and his thinking is complicated. Don’t worry. He is ‘normal’ only. If you want to stop reading the post mid-way, It might be absolutely ‘normal’. So, no problems with that too. If you call this post bad, I would say you are a ‘label-er’ but not ‘abnormal’. If you say this is written splendidly in Sanskrit, it is only then I could consider you abnormal. Assuming normalcy of some sort I invite you to read the post:

“Normal”, “Abnormal” and “Label”

There would always be debates on defining, what is ‘normal’. There are many models to define what is abnormal.

‘Statistical infrequency’ is one of the models to define what is abnormal. If some thing is rare then it is abnormal. If that be the case gifted people are abnormal as they are rare!

‘Failure to function adequately’ is another model to help not labeling gifted individuals as abnormal. But, who defines what is adequate and what is functioning? Is there a consensus?

‘Deviation from social norms’ is another such model. Social norms vary with culture, context, situation, age, gender, development and historical context (time).

Identifying parameters that are abnormal, considering the possible causes and treating them is a part of routine medical practice. In psychiatry, the parameters are more behavioral in nature.

Is “normal” a dichotomous construct (yes/no), a continuous construct (0-fully dysfunctional, 100-Mahatma Gandhi), or a dimensional construct (Einstein- professionally a genius, politically eccentric, interpersonally deficient)?

If we observe, we might find ourselves in different areas of the normal curve in different aspects. For example when I dance (as I sometimes do), people don’t see me in awe but rather laugh in amusement :-/ ( not so sadly :-)) Dancing Dheeraj

Or when I play cricket, I know the timing of my shots is awful. I might discuss the physics behind ‘reverse swing’ but would never be able to read its trajectory and time a ‘square-cut’ to the boundary. This just shows that I probably am low in Body Kinesthetic Intelligence. A not so sophisticated ‘labeler’ might call me ‘Kinesthetically Retarded’! (Ops! I labeled him a ‘labeler’ :-)) .The more specialized psychiatrists have even a diagnosis for it ‘Developmental Coordination Disorder’. “Diagnoses for all by 2025” seems to be the motto of some psychiatrists.

It is interesting that though we draw clear lines and cut across the parameters as normal and abnormal, most parameters are distributed normally. There are individuals very close to the line drawn but on different sides of it. They end up with different labels/ diagnosis and probably different treatments. Is this not quite terrifying?

Not just that, if the line is drawn somewhere close to the mean, then we have more problems. Take for example Complicated grief, Atypical PTSD (Post Traumatic Stress Disorder), High-functioning Asperger’s syndrome, Developmental Coordination Disorder etc. Besides, some conditions that are abnormal in a majority of settings become desirable in very narrow contexts. For example Anti-Social Personality Disorder in politicians and businessmen, Histrionic Personality in actresses and performers, Schizoid Personality in mathematicians and physicists and so on.

Good news is that most medical researchers consider these statistical issues before formulating guidelines and are not keen on labeling everything and everyone as abnormal. Most Clinicians go by patterns of symptoms, signs, laboratory results and diagnostics not isolated laboratory findings. Clinicians are not bothered, so thankfully not confused about statistical issues!

A good doctor picks up most of the abnormal parameters in his history taking, clinical examination and diagnostic work up, logically thinks through and explains these with the most judicious explanation, considers rarer possibilities and tries to rule them out or in and treats appropriately covering for most possible causes and always tries to relieve symptoms and is less bothered about the ‘label’ he gives to his patients.

Posted in Diagnosis, grief, medicine, personality, psychiatry, statistics | 4 Comments »