Sunday, January 25, 2009

Adjusting to Feeling Constantly Disoriented

Presenting to the Bombay Psychiatric Society

The last few days have been a bit of a whirlwind. Dr. Siddharth Shah and I have been working hard to develop a one day training for the Bombay Psychiatric Society, and we compiled an updated curriculum with an introduction to Disaster Psychiatry, a section on Interventions, a section on Working with Children, a section on Interagency Collaboration, and related sections on Trauma Theory and Vicarious Trauma. The day unfolded well, and some powerful material was evoked, I believe especially around drawings from children affected by Mumbai’s recent attacks. The Piramel R & D Center was a lovely setting, and there were scupltures, a figure which was striking in the morning light, and the interesting lighted installation below.

On the Beach
In addition to working on this training for the last few days, we met with Udayan Patel, a psychotherapist living and working in Whorli. We had an opportunity to see photos from the terrorist attacks - they were graphic and brutal. His office and home were wonderful; in particular his office is very placid, and has views on two sides overlooking the ocean.

Birds wheeling outside his window only add to the therapeutic feeling. Naturally, this reminded me of the view from my office on 13th and Broadway. Leaving Udayan's office was characteristically not as pastoral. A constant juxtaposition of seeming opposites.

We also got haircuts in a local barber shop, "with A/C" (code for a decent place). The haircut was good, not hard given my coiffe requirements but sometimes nothing seems reliable or consistent here except unreliability and inconsistency. Of course, just when I thought I was in the clear I asked him to trim around my ears and he shaved weird little bald spots on the side of my head. My annoyance at these constant things is palpable... I'm scared because it is starting to shift toward reassuringly familiar if things go awry when they seeemed ok at first. As if to have a haircut go off as expected would now freak me out.
I believe this is the germ seed of understanding an important component of how trauma interacts with culture here. Perhaps it is a form of a talismanic warding off of something more dire?
Although I’ve been to India twice before, this is the first time I’ve gotten a traditional head and face massage. It was a very relaxing experience, much needed as a break. The sense of things being unfamiliar here both in terms of relatedness and mindset, as well as simply physical environment and procedures, is quite striking. Everything feels a bit decentering and there are constant interpersonal happenings which complete elude my understanding; for instance, the younger barber and the owner started arguing heatedly around my head massage. I began to feel uneasy.
The owner appeared to want to step in and do it, and they kept grabbing one another's heads and talking rapidly and clandestinely, almost like a dance or at times a wrestling match. It didn't help that the owner had been intently staring at me in the mirror all along. Then without any explanation, they became calm and the massage resumed on its original course. I accepted this as if nothing had happened as well, with a bit of mental effort, and odd dissociative flip, and the ensuing bliss of ignorance-by-self-design.

Disaster and terrorism are strongly interactive with culture. This comes up powerfully when interacting with audiences and groups about individual and collective trauma, especially when negative feelings are directed toward authorities for failure to protect.
On one hand, there is a dramatic display of respect for expertise and a great desire to listen and learn. On the other hand, there are a million social cues and standard exchanges which completely elude me, even more than my usual cluelessness. There's this kind of British colonial internalized aggressor which is implicit and hard to deal with, at least for me. Speculatively.

The learning part has been extremely rewarding though quite draining and even painful and humiliating at times, and interacts with the cultural level, and the cultural level in turn is intimately connected with the complex history of multiple traumas, individual and collective, which are a part of this city’s tapestry.
Social issues represent a potential stressor for most here, and what people have told me over and over again in many different ways that the basic approach to dealing is to not talk about things. One hypothisis is that while being protective, this may also prevent interpersonal and collective linkage and meaning-making, while preserving internal understanding. There's more to elaborate on this point.

Yet today at the Bombay Psychiatric Society training, I started to feel some commonality. A week is not very long at all.

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