Psychotherapy? You want me to see a shrink
? No way !! I'm not crazy!
This is, almost always, the first response to a suggestion
that professional help may be required, in order to
deal with personal problems, or heal the wounds inflicted
by traumatic life situations. Feelings of shame &
inadequacy arise instantly, because the persons in distress
have to admit to an inability to solve the problem on
Add to that, the social stigma attached to visiting
a psychiatrist or psychotherapist, and most people prefer
to live with their problems, & stay mired in distress,
in an endless cycle of denial, fear, blaming self, or
blaming others, rather than seek professional help…often
seeking it when it is too late.
This resistance appears to be a hang over from the days
when the bizarre and irrational behavior of the "insane"
was taken as evidence that they were possessed of evil
spirits & demons. They were treated as social outcasts…objects
of morbid curiosity, fear & contempt…mindless
beasts who could be controlled only by chains. They
were locked away in prisons, where they often lived
in conditions of intolerable misery, subjected to taunts,
physical abuse & ridicule.
"At a famous hospital in London,
Bethlehem, [pronounced Bedlam] which
was built to house lunatics, it became a public amusement
[for a fee] to taunt & watch the weird behavior
of the inmates ! The word bedlam remains in the English
language to describe chaotic confusion…"]
"Treatment" took the form of exorcism, beating,
torture, & bartering with the evil spirits.
Somewhere along the way, changes began …mostly
in Europe, & spread to America as part of the renaissance
of rationalism & humanism. In France came Phillipe
Pinel [1745-1826] a scholarly &
humane man, who believed that the insane were "sick"
people, whose sorry state deserved all the consideration
due to suffering humanity! He strongly believed that
medical attention, along with dignity and freedom could
help restore sanity. Gradually, shackles and chains
were removed, & hospitals became places of treatment
& care rather than imprisonment.
"Asylums for the
insane" were set up as places of
refuge, rest & recovery. Here, there was an emphasis
on a combination of benevolent care, spiritual guidance
& study. Unfortunately, these soon regressed to
the same de humanizing conditions from which they had
arisen! Bedlam lives on, & beneath the public attitude
that views the insane as physically sick, there seems
to persist the view of the mentally disturbed as subhuman
or possessed, or both.
In any case, the concept of the insane as sick, became
the Medical Model of mental illness & led to extensive
research, investigatory methods, drugs, shock treatment,
& other medical therapeutic methods of treatment.
Psychiatry came into its own, in the early 1900's, with
the work of Emil Kraepelin
[1855-1926]. In his classic text book on psychiatry,
with extraordinary patience, he classified the many
manifest symptoms of mental dysfunction, according to
patterns of occurrence, & thus identified &
labeled types of mental diseases, or "Psychoses".
This made possible the development of specific drugs,
& treatment strategies.
The medical approach brought freedom from evil spirits
!! And helped to reduce some of the terror & dread
that surrounded mental disturbance. It did not, however,
take into account, social & psychological factors.
Attention turned to non-hospitalized "patients"
who state seemed to reflect, not a sickness, not a disease
of the brain, but a "psycho-biological reaction
to life stress". This triggered a search for psychosocial
causes of "neurotic" behavior, & non -medical
cures and interventions.
[1856-1939] Psychoanalysis, transcended the
medical mould, to create a thoroughly psychological
theory of human motivation, bridging normal and abnormal
behavior. He established that psychological problems
were often created by unconscious fault lines etched
deeply into the in the psyche, by traumatic experiences,
and conditioning in childhood. Treatment required the
uncovering of the buried trauma, [which was being expressed
through the symptoms].
Psychotherapy was ushered in…& the "demons
of the unconscious"-guilt, fear, shame, rage, bitterness…
became the focus of interest. Purely psychological techniques
like hypnosis, free association, & dream analysis
gained wider acceptance. The work moved from hospitals
to the consulting room 'couch' &' patients' became
This was a time of discovery, research, & scientific
Wilhelm Reich explored
& mapped body armor, & Alexander developed "movement
therapies" to explore body-mind connections.
masterfully blended all these, together with Sufi practices,
in a pioneering effort at combining the strengths of
Western & Eastern medicine, psychology, & spirituality.
Simultaneously, there began, a 'Behavioral engineering'
orientation, with the famous experiments on conditioning,
conducted by Pavlov,
& the work of B.F.
Skinner. Therapies based on association,
& de-conditioning developed from this, widely used
in the treatment of phobias, & obsessions, sexual
problems, & social inhibitions.
A little later, in the fifties and sixties, began a
'Humanistic' & 'Existential'
stream of thought, in which the work of Abraham
Maslow, [Hieirarchy of needs] & Carl
Rogers,[Non-directive therapy] is significant,
as well as that of Frederick Perls,
[ Gestalt Therapy], & Eric
Berne, [ Transactional Analysis.] These
systems viewed human beings as having a purpose, options,
rights, & the capacity for self determination, rather
than as just hapless victims of the unconscious, or
All these positions coexist today, with considerable
overlap. Although they appeared sequentially, one did
not supersede the other, and a judicious mix in the
hands of a competent practitioner, is often highly successful.
The bio-medical model represented a big step forward
from the demonological concept, and continues to be
most appropriate for work with deeply disturbed, hospitalized,
psychotic, people who are unable to function in a social
The psychological model is most appropriate for use
with persons, who are able to function in a social environment,
but may be experiencing emotional difficulties…confusion,
worry, anxiety, depression…who would hardly consider
themselves, or be considered, crazy !!
The humanistic, existential models are most appropriate
for people who don't have major problems, but want to
know themselves, take responsibility for themselves,
and seek greater meaning & fulfillment in their
lives, using psychological insights as tools for growth
& change, in a group setting.
Overall, in the West, as new techniques continue to
evolve, there has been a steady increase in the range
of human problems that come within the ken of psychotherapy.
From the visibly disturbed "lunatic", at one
end… to people with personality difficulties,
addictions, relationship issues, family traumas, anxiety,
psychosomatic health problems, uncontrollable emotional
outbursts, depression, marital conflict, an inability
to cope with everyday issues…… to a desire
for enhanced self awareness, at the other.
In India, there has not been much visible change. Evil
spirits are still believed to inhabit the bodies &
minds of the mentally disturbed, & they are still
chained & tortured, instead of being given medical
attention & care.
Mental Asylums remain largely custodial, where the unwanted
languish for years.
Among the educated, there is a leaning towards the medical
model & psychiatry, but not much awareness of the
benefits of psychotherapy…& a stigma attached
Family & religion are still expected to provide
relief from all problems.
Our rich spiritual heritage has not been channeled into
healing practices that are accessible to people living
[1931-1990] in his lifetime, in an incredible stretch
of effort and imagination, put together a blend of modern
western psycho-technologies, & meditation, which
are effective, & are gaining in popularity. Awareness
about these is limited, often overshadowed by fears
& myths about the methods, & the 'cult'.
Some awareness has started to filter in… "New
Age" movements are gaining momentum…heady
cocktails of energy healing techniques have surfaced,
in a sort of quasi psycho-spiritual format, offering
cures for every thing !! Pop psychology & self -
help, 'how to' books are stacked in every bookshop,
spreading information on all subjects…causing
Despite all this, psychotherapy still remains suspect,
& there are very few trained practitioners. So,
there continue to be people who may be suffering…who
are painfully shy, fearful, or irrational, feel depleted,
or worthless, or drink too much, or are confused about
their sexuality, or are stuck in abusive relationships,
or stressful life styles, or unable to recover from
the shock of losing a loved one… or in a thousand
other ways, live joyless lives, a burden to themselves
& others…unwilling to get help because they
may be considered 'crazy' !!
You don't have to be crazy to seek therapy. It is as
ok to seek professional help for mental & emotional
problems, as it is to go to a doctor when you have a