Reader's Corner

Last time we discussed Analytical Counselling. Another type of counseling is Humanistic – This emphasizes people’s potential for growth and self-fulfillment rather than concentrating on conflicts or self-defeating behaviour. The goal is to help patients develop personal awareness, self-understanding and an appreciation of their own worth. Realizing her goals, capabilities and potentials helped Reena. The counselors help people appreciate what they have and are not utilising properly.

Counselling plays a major role in almost all-emotional disorders including depression. In cases of Depression its role is of paramount importance. In the case of secondary (reactive) depression, where the patient is going through self condemnation and self-devaluation, his return to the struggle of life can be made very easy by proper counselling.

Suresh, merit list scholar at Xth, 95% at XIIth, student of the best medical college of Mumbai, failed in his 1st MBBS exams. He was shattered. His confidence, self-esteem took a beating. Suresh went into severe depression and tried committing suicide. He had struggled all his life but now he wanted the easy way out through suicide. Almost 6 months of counselling with awareness of newer learning methods helped Suresh, once again come out with flying colours in all his exams.

In Primary or Involutional depression, where the patient is more rigid and perfectionist, older and facing what he evaluates as a hopeless future, counselor too faces an uphill task as the patient has little or no incentive to get well.

Mr Sivaraman, Asst GM, one of the nationalized banks, retired after enjoying an extension of 2 years. He was almost certain of another extension which did not materialize. Mr Sivaraman’s world changed overnight. The constant stream of visitors dried out, no phone calls, no gifts, no invitations to parties. All this was too much to take and was the perfect push to send Mr Sivaraman in the chasm of Involutional depression. Mr Sivaraman gave a tough time to his therapist. No rosy picture of his future could be painted. No promises, no dreams to be fulfilled. Mr Sivaraman just did not want to face the world which had so unceremoniously dropped him. Mr Sivaraman is still under counselling but the improvement is very slow.

Another very important area where counselling is of importance is Chronic Stress. This was very evident in the aftermath of communal riots and the series of Bomb blasts in 1992-93 in Mumbai. People who had witnessed the killings, who had lost their next of kin, people who were living in sensitive areas, people under constant threat from another community all showed symptoms of chronic stress. Commonest complaints were nightmares, panic attacks, depression and children showed signs of violence at slightest pretext. Local GPs initially tried treating with common tranquilizers but to no avail. Most of them required counselling but could not take due to prohibitive cost. In such cases group psychotherapy or group counselling is the method most likely to succeed, as the stressor is common. This group treatment can only be offered by voluntary organizations.

Another important type of counselling worth mentioning is Behavioural. Commonly used in children to handle behaviour problems like temper tantrums, sibling rivalry etc. This uses Rewards and Punishments to change their behaviour rather than telling them why they are doing it. Increase their confidence in themselves. Behavioural therapy uses such diverse techniques as

1. Play Therapy

2. Relaxation Technique

3. Emotive Imagery & Relaxation

Apart from clinical psychologists who are professional counsellors, help can also be obtained from teaching institutions, For e.g.:

1. Dept of Psychology – SNDT University, New Marine Line, Mumbai.

2. Dept of Applied Psychology- Kalina Campus, Mumbai University.

3. All major Municipal and Government Hospitals.

Here, the counselling charges may be nominal or none. But then one is to one privacy between the patient and the counselor may not always be assumed.