Friday, 19 December 2008

My deviations from professional boundaries; the stories of XYP

I have always wondered since childhood, why a particular lady, let us call her lady X at this instance, known to me and you created such fear in me. Her appearance on the lane would often freeze me and if anyone, said her name she would respond with fear inducing gestures.
With a qualification in my pocket which gave me the right to diagnose mental illness, I wanted to diagnose her and of course was intent on helping her to change.
But this was all in the back of my mind, and did not trigger until I saw her near henveyru boalhadhandhu one fine day.
I now knew which ever mental illness she suffered from, there was no need to have any fear, people with mental illness were just very vulnerable people who needed our helping hands.
So I began to follow her around the boalhadhandhu and soon she realised this, and started calling me names and gesturing at me. But I walked behind her with a smile on my face, and she started to run. Well, I think that was one of the most hilarious moments of my life. My secretary who was watching this said afterwards,' that was just so funny’. Well, I ran behind her (and we both ran for some time ) until I finally caught up with her and said,
‘I just wish to talk to you, would it be possible for you to walk up with me to the place I work?’
She looked at me rather suspiciously and said;' are you not afraid of me?’.
Well, I replied, ‘not at all, and infact would like to be your friend’
Perhaps she has never been in a situation like this and did not know what to do, so just walked with me to my clinic.
When I entered, I offered her one of the big relaxing chairs to sit immediately she looked at me and said,
‘I cannot sit on a nice looking chair like that, if I did sit on it then noone else can sit on it, I have never sat on a nice chair like that’
I shook my head and said, ‘but that is where I think you should sit’
She sat down and began to feel the chair. I gave her time to enjoy this moment and once she settled down I began to communicate with her. I explained that I worked with the so called people with mental illness, and I would like to ask her a some questions.
I was shocked with her response. Her eyes immediately became filled with tears and asked me whether she could say a thing or two first. She told me that in her case being mad was a mechanism for survival. And then she told me tragic tales of her life, stories of limitless levels of abuse and explained to me that this behaviour of hers was based on a need for her to protect herself from further abuse, now she terrorise others before others could, and gradually all this has become a habit and this was her identity now and she no longer wished to come out of this state.
At that moment I realised that she did not suffer from any mental illness, she was one of the most intelligent and sane women I have ever met and there was nothing I could do to help her.
She smiled at me and said, she would leave now, but she was so happy that someone at least bothered to treat her like a human being and listened to her story. Perhaps she wanted me to tell the world about her life, she shook hands with me and said, she will never repeat this story, the real story to anyone. It was far too late for her to change now.
I watched her walk away. I had a heavy heart as I thought about the high prevalence rate of abuse of all forms in our society.
I felt very guilty, for having had a secure and protected life, felt guilty that I too had called her names, once upon a time and knew people will never know this side of her....and the sadest thing was there was absolutely nothing I could do to help her
(to continue..story Y)

11 comments:

Anonymous said...

That really is tragic! I just can't understand the attitude and the treatment most Maldivians seem to afford to the mentally ill - or to those that appear "different" from the socially dictated norms...

Hussein Ihsan said...

This is a very interesting story. I have felt a sense of empathy whenever I used to see these so called "moya" people, self dubbed or otherwise.

It would also be great to hear from some one of your expertise about depression in Maldives. I believe the awareness of depression in our society is very low. I have very close people who are going through this. And I recognize the symptoms often on recovering addicts, after countless detoxification and drug substitution programs like Suboxone or Methadone, eventually behavior shaping programs like Therapeutic Communities are ineffective on such people.

Our society has all the necessary mechanisms to lead especially young people into depression. And a visit to a psychologist inevitably get you pills that make it worse in the long run. It seems that way when I look at the people I know who have depression.

Anonymous said...

Karma,
I hope to write a series of articles of my experiences of working with people with different forms of mental illness in the Maldives and actually am in the process of writing a handbook for free distribution. With your query i think i will write about depression in general and substance abuse and comorbid disorders soon.
Thankyou

Jasmine said...

I’m running out of adjectives to describe what I read here. Once again it touched my heart and moved me. May Allah reward you.

I thank Allah for giving us people such as you who not only have the empathy towards those who need it most and perhaps even more important in the long run - takes the time to induce other people to open their heart to these great problems we have in the Maldives.

In Mental illness are we not, mostly dealing with other than mental retardation or mental disorders with a specific, organic aetiology? In Lady X’s case your observations & conclusions are disturbing. You point out..

“At that moment I realised that she did not suffer from any mental illness, she was one of the most intelligent and sane women I have ever met and there was nothing I could do to help her”. Also ……
“It was far too late for her to change now.” And finally you wrote..

“I watched her walk away. I had a heavy heart as I thought about the high prevalence rate of abuse of all forms in our society.
I felt very guilty, for having had a secure and protected life, felt guilty that I too had called her names, once upon a time and knew people will never know this side of her....and the saddest thing was there was absolutely nothing I could do to help her”

I must admit that all this disturbed me. Something is really wrong here. I just cannot put a finger as to what and where? It’s as if it’s too HOPELESS.

It need not be so. It cannot be so. Are we not seeing the forest for the trees?

Something keeps niggling me at the back of my mind that there is plenty that can be done for X, and the society that produced Madam X.
But what?

Anonymous said...

Jasmine,
Thankyou.
Sexual abuse, physical abuse, domestic violence is very high in Maldives, those that get reported are just a few. This lady had undergone all that. But when it happened to her, there was noone to assist her, to give her a different set of coping skills, so she adopted these behaviours which mimic 'MAD' behaviour as understood by our society. This was done deliberately by her and now she is happy to be this way and have no intentions of changing herself.
Anti psychotics or therapy will be of no use for her..
I agree with you, there is a lot we can do to help people who have undergone abuse, and prevent them from taking extreme measures as in this case.
And yes, the reason I have decided to write all this is to create awareness about these critical issues in the society, and stir people to action so that another Madam X will not be created by our ignorance.

Anonymous said...

A. A. Naaz, thanks for sharing. There are limitless such stories in out society.

One main reason is the form of parental control with added dozes of only one-sided "Dheeni Naseyhaiy!" (religious sermons).

Abused kids are taught not to question the words and actions of parents and elders.

Would you please write an article on this and explain that it does not have to be so. It would make a difference coming out from a professional like you.

Looking forward to your free book. Please make it available on the internet services such as your blog or http://www.scribd.com.

Anonymous said...

I just came across your blog during one of my internet lurking sessions. I've read a few of your posts (including this one), and i must say, this is most surprising. A part of me is refusing to believe that you're Maldivian.

Interesting blog, with wonderfully interesting posts.

Maldiveshealth said...

hehe.. mental health issues. A taboo. nice blog.

Jasmine said...

Thank-you.

Looking forward to the next case study. May Allah Bless you.

Ismail Khilath Rasheed - journalist and blogger from Maldives said...

Very tragic. But I can understand. People adapt to different modes of defenses depending on the kind of abuse they had undergone. So it makes sense. But can we ever forgive ourselves for the society we have created that produces such tragic consequences for human beings who have real feelings and emotions? This is what makes me so depressed and angry at the same time.

Anonymous said...

hi naaz,
ur articles r really touching ones especially this one. m happy that even as a kid i never call ppl such names...i too feel guilty for not being able to help...n i wonder always what i can do to help such ppl in the society. ainthu