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self help

Rediscovering Ivan Pavlov

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Daniel Todes’s massive tome on physiologist Ivan Pavlov (1849–1936), the man who, our textbooks tell us, trained dogs to salivate to a bell, transformed almost everything I had come to learn about that towering figure over my twenty-year career as a psychologist. For one thing, Pavlov rarely ever used a bell in his experiments. Instead he preferred devices that he felt were more precise, such as a metronome, a harmonium, a buzzer and even electrical shock! Indeed, he viewed the discovery that dogs could be trained to salivate on cue as a trivial byproduct of his more important, but less glamorous, research on digestion and psychology, an area of work that finally, after several nominations, won him the Nobel Prize in 1904. And although lumped in with behaviourists for purportedly denying the role of the inner experience or the psyche of his subjects, nothing could have been further from the truth. In fact, Pavlov even recognized the subjectivity of his own experimental animals, identifying them, accordingly, as “heroes and cowards, intelligent and obtuse, independent and compliant,” etc (Todes). But misinformation has a way of going viral, and once gone, hard to correct.

A surprising source of misinformation about Pavlov was his own English-translated works, which were published, in many cases, under the coercion of the Soviet government. Threatened by the withdrawal of scientific dispensations, including food rations during a period of shortage and economic depression, Pavlov, a perfectionist at heart, begrudgingly agreed to turn a blind eye toward the translation of his work and the misinterpretations it led to. Take, for instance, the term “conditioned reflex,” a term that, although now synonymous with Pavlov’s work, he never actually used! The term he used would be more accurately translated as “conditional reflex” (uslovnyi refleks). This mistake, which Todes brilliantly traces to an issue of the Lancet that included an anonymous translation of Pavlov’s 1904 speech honouring TH Huxley, may appear insignificant, but trust me, it makes ‘al’ the difference. Let me explain.

Pavlov postulated that digestive secretion occurred in two phases. The first was termed as “psychic” secretion in that it was governed by the appetite, mood, and individual psychology of the subject. It also occurred before food was consumed and so was initially described by Pavlov’s research assistant Ivan Tolochinov, a psychologist, as “reflex at a distance” (later termed “extinction”). The second phase of digestive secretion was neural chemical and occurred only when food was present in the stomach. Psychic secretion was often larger and stronger than the secretions that were produced after food was already present in the stomach. Hence, Pavlov concluded that in the case of the salivary glands, “psychology over-shadows physiology.” However, unlike neural chemical secretion, psychic secretion was inconsistent and capricious. It was influenced and dependent on particular conditions that signalled food delivery. But these conditions varied greatly and needed to be investigated by strictly objective methods. It was because of this observation that Pavlov elected to replace the term psychic secretion with conditional reflex.

Although Pavlov was born into a family of priests and even studied for the priesthood himself at the Ryazan Ecclesiastical Seminary, he was, like Freud, Skinner and Ellis, a proud atheist. He believed that “the battle against religion” was “ an emblem of modern rationality.” I am partial to atheists myself, so I would like to believe that Pavlov’s atheism contributed to his success, and that it was the source of his staunch commitment to the highest scientific principles. “Shouldn’t all scientists be atheist?,” I sometimes wonder. Nevertheless, I realise that being anything, an atheist included, does not make one infallible, despite the flawless impression that one gets of Pavlov and all the other “fathers” of the field from our textbooks!
In connection with both Pavlov’s shortcomings and the factors that contributed to his success, I would like to make a special mention of Pavlov’s wife, Serafima. Although Serafima was an extremely talented school teacher, Pavlov did not permit her to work outside of the home. And so the once “vivacious, gay and clever” young woman whom Pavlov had married in 1881 became by the mid-1890s a “stolid matron who sacrificed all her interests for the happiness of her husband and children” (Todes, citing Pavlov’s former lab assistant, family friend, and biographer, Boris Babkin). Serafima sacrificed a lot for her family. But she forgave more. She looked past the extreme outbursts and temper tantrums that Pavlov was known to have both at home and in his laboratories. She also eventually accepted Pavlov’s lover, Maria Kapitonovna Petrova, a woman who was 25 years younger than him and, ironically, a working physician. She was a brilliant researcher and one of Pavlov’s most important co-workers. Petrova pursued her doctoral research in Pavlov’s lab and thereafter became a mainstay in the Pavlov family right up until Pavlov’s death. She eventually became director at the Physiological Institute of the USSR Academy of Sciences.

There are many other things in Todes’s book that help readers humanise the mythological Pavlov. During his 20s, for instance, Pavlov was diagnosed with a “disturbance of the nerves,” which caused him to experience low energy and an inability to concentrate. This condition re-occurred several times during other periods in his life, notably during his second year of study at St. Petersburg University, which caused him to skip his exams. But Pavlov’s biggest vulnerability was probably his aversion to the uncertainties of life, the sluchainosti (chance events, accidents, randomness), as he called them, which were always negative and frightening, and for good reason. Pavlov grew up in poverty. He lived through the Bolshevik Revolution and its aftermath. He lost one brother in a hunting accident and another to death in a communist prison. He saw the demise of three of his sons. There is so much more that could be said here. But for Pavlov, the counter and cure for this chaos was regularity and discipline in his personal life. His routine kept him sane. And as a matter of routine–I find this particularly instructive–Pavlov would spend a whopping three months out of every year at his summer home or “dacha” where he did no scientific work whatsoever. Surrounded by the sea and the woods, Pavlov worked with his hands and went on long walks and swims. He played a kind of bowling game called Gorodki. He stargazed and led his family on expeditions for berries and mushrooms. Pavlov’s intense productivity during 9 months of the year was complemented with 3 months of intense leisure; in short he epitomised the saying “work hard, play hard.”

Like most students of psychology in India, neither I nor my teachers had access to material on Pavlov, Skinner or Thorndike, save our one prescribed textbook. We might have paid more attention in our classes had we known Pavlov more holistically. He would have seemed “cool” to us coming-of-age young adults had we known that he was a contrarian, spoke fearlessly against communism, had met Fyodor Dostoevsky, loved gardening and despite all that he had done, including winning a Nobel at 77-years old, he incessantly had self-doubts for which he sought frequent reassurance. Todes, through his 880-page biography on which he worked for almost three decades, rescued Pavlov’s life and its lessons, and for that, we should all be grateful to him.
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self help

Need solutions? Start Playing Seriously

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The hand is my feeler with which I reach through isolation and darkness and seize every pleasure, every activity that my fingers encounter. With the dropping of a little word from another’s hand into mine, a slight flutter of the fingers, began the intelligence, the joy, the fullness of my life. Helen Keller, “A Chat About the Hand” (1905)
We may never be able to think and feel as deeply with our hands as Keller did. Having lost the ability to both see and hear before the age of two, Keller had more reason than most of us to develop her extraordinary sensitivity. But we all undoubtedly think with our hands, even if this largely goes unrecognized or uncultivated. Researchers call this interaction between the body and mind—with the body sometimes leading the way—as embodied cognition, and their insights are changing the way we live, from our work to our play, and even the existence of a line between them.
It is common knowledge that children learn by manipulating things. We buy them the world in miniature (kitchen sets, dollhouses, cars and figurines) and they use it to imitate real life. Through play that is both fun and engaging, the uninhibited child learns to solve problems, and this has far-reaching consequences in the real world.
But this form of learning is not reserved for children alone. Born in 1878, Frances Glessner Lee, who was denied a college education, but who nevertheless went on to establish the first chair in forensic science at Harvard, miniaturized 18 rooms that were identical, down to the tiniest details, to actual crime scenes. These exquisite works of art were used to instruct and educate police detectives on how they should analyze evidence. Called the “Nutshell studies of unexplained death,” Lee’s method, as well as the original rooms that she built, continue to be used for training today. Her genius lay in harnessing the power of play.
A more familiar example of changing scale and working out problems with our hands is the game of chess. Originating in sixth-century India, this aristocratic game, which was known then as chaturanga (catur meaning “four” and anga meaning “limb”), used miniature representations of the four army divisions mentioned in the Mahabharata—infantry (pawn), cavalry (knight), charioteers (rook) and elephantry (bishop)—to engage in a battle of wits. This 64-squared board game later became known in Persian circles as shatranj, and even later as chess among Europeans.
The beauty of games is that they cultivate a sense of fun even as they require us to work out solutions to complex problems. Indeed, it is the very state of spontaneity and creativity afforded by games—or what Hungarian psychologist Mihaly Csikszentmihalyi described in a different context as “flow”—that enables us to reorganize our knowledge, move beyond our own cognitive rigidity and, without necessarily intending it, come up with inventive solutions.
Creativity, however, can sometimes be disparaged. It can be seen as reflecting “ a neglect of technical competence” or a “lack of methods or systems.” Similar things have been said of play. Yet creative thinkers, insist L.L. Thurstone and J.P. Guildford, the original purveyors of the idea of multiple intelligences, are among the best problem-solvers out there. Unlike obstinate bosses, orthodox companies, fundamentalist teachers, paleoconservative governments or biased news anchors, people who possess fluidity and flexibility in their thinking can easily redefine an object, situation or concept. Most importantly, they demonstrate a capacity to retain a sense of wonder in the face of a problem, or to accept the internal conflict that a problem creates.
For years I have worked hard to come up with creative solutions for my clients’ problems. Of late, however, I have begun to think that the best solutions are actually ones that my clients come up with themselves, as those are the ones they hold most dear. But how was I to facilitate originality and ingenuity, i.e. creativity, to help others help themselves get unstuck?
About a month ago I became an accredited facilitator of a relatively new methodology for learning and reflection called LEGO® SERIOUS PLAY® which I will refer to as LSP (intellectual property is a touchy topic for them). Here is a method that checks all the boxes for me. First, it is haptic; participants see and feel with their hands. A key difference from normal LEGO® play, however, is that the objects being manipulated represent participants’ own mental representations in physical form i.e. they are metaphors. As a result, complex thoughts and emotions can easily be dissected, interconnected, reshuffled and altered. Second, LSP is, well, playful. This is something one might expect from the name LEGO®. But unlike games like chess, LSP has no fixed number of moves. Instead each brick is built to interlock with other bricks that are part of the “system,” making the number of combinations—and thus solutions—virtually unlimited. Third, all of this happens spontaneously thereby being physically and mentally present. This satisfies the conditions needed to induce a state of flow. In flow, inhibitions are averted and creativity awakened, often beyond what participants thought was capable.
As the roster of organizations utilizing LSP shows—from global corporations such as Coca-Cola, Google and Unilever, to governmental agencies such as NASA and the World Bank—creative solutions can, in fact, be cultivated. As Hungarian legend George Pólya rightly said, “ It is better to solve one problem five different ways, than to solve five problems one way.”
LSP offers elegant solutions to a messy problem.
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self help

The art of disagreement

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“Everybody gave parties. And there was a lot of drinking. Some visiting literary celebrity would show up, Partisan Review would make a party or I would make a party. Everybody came. And it was a really passionate intellectual life. It’s hard to imagine today, but people actually came to blows over literary disagreements,” said Norman Podhoretz in this 2017 interview with John Leland for the New York Times.
It’s not hard to imagine coming to blows with friends and family–and not just over literary disagreements. Often we put our faith in a system, an arrangement, a technique, a gharana or one guru whom we then defend or assert as the best. This mode of disagreement has no shortage of proponents, from anonymous social media trolls, to television news commentators, to our own sermonizing relatives, and most of all to ourselves. What tends to be missing in these interactions is an openness to comprehending different views, or worse, to behaving with civility. But what if the joy we derived from discussions was not in the “winning” or “converting,” but in coming to a better understanding of how our own beliefs have formed? What if the ultimate reward was changing our own point of view, or coming one step closer to some greater truth? How could we approach discussions less like a battle or crusade and more like an artform?
One venerable form of argumentation that goes back to the 3rd century BCE in India was known as “Śāstrārtha” (शास्त्रार्थ). Śāstr stood for ideology or science of and ārtha for meaning or insight. There was no bloodshed and there were no crusaders. The tools used were wit, prudence, logic and reasoning. The debate included four tidy steps. The first was Pratijñā (प्रतिज्ञा), which required stating “the fact” one wanted to establish by the end of the debate. The second—and most important because it is the most lacking today—was Pūrvapakṣa (पूर्वपक्ष), where one put forth the oppositions’ point of view, the view of “the former” (pūrva) “side” (pakṣa). This required the arguer to not just echo the opposition’s pitch or manifesto, but also provide proof, and to faithfully follow the logic and reasoning the assertion as if it were their own. This ensured that the opposition was convinced that you actually understand what you were opposing. In Pūrvapakṣa, if a debator was unable to accurately demonstrate this understanding of the opposing opinion, they would be corrected and would have to demonstrate again that they understood the position in question. The debate could not move forward without this insight. Khanḍanam (खन्डनम्) was the third stage of debate, where one had to substantiate the opponent’s assertion as logically flawed or inconsistent with proof. The last and final step of the debate was Siddhāntam (सिद्धान्तम्). One had to now voice one’s own postulation, which would open up the debate for the opposition to challenge. Underlying all this would be the condition that the postulations would be debated, but never the intent behind them. A debate of this nature enabled deeper insights for not just both speakers, but also the audiences. Rudimentary conflicts were replaced with a more advanced meeting of minds.
Of course, we’d never impose such a high degree of methodological rigour on our family discussions or WhatsApp group exchanges, but this ancient precedent may prove both inspiring and instructive. Holding polarized beliefs is being human. Evolution requires diversity. Constructive dissent scaffolds learning. The pursuit of truth is hard and the truth is a dynamic thing. Civil disagreements, in the words of noted Indologist Arthur Basham, “imply a full realisation that the world is more complex and subtle than we think, and that what is true of a thing in one of its aspects may at the same time be false in another.”
As a clinical psychologist, I have spent the last 20 years mediating disagreements between family, friends, lovers, and leaders of organizations, most recently using the new methodlogy of LEGO® SERIOUS PLAY®,which incorporates hard fun into the process of arbitration. More generally, I find “leaning in,” listening and reflecting to be indispensable tools in the art of dissent. I ask of my clients to look to the Munk debates , my favourite being between Tony Blair and Christopher Hitchens, who debated the idea “Religion is a force for good in the world.” The next time you disagree with a friend of a lover, remember this quote by Albert Einstein : “There is a way to critique intelligently and respectfully, without eroding the validity of your disagreement. It boils down to manners.”
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self help

Is Gifting Therapy to Someone You Love Helpful or Insulting?

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“He is my best friend, a resilient chap – we have known each other since we were in pre-school. The pandemic at first took a toll on his business, next his family – he lost both parents. I called him to check-in on him every-day. That 5 minute check-in turned into 45-60 minutes and before I knew it, I felt overwhelmed. I decided to have a conversation with him and asked him how he felt about therapy. He said he had never tried it before but would be open to it. He also said he didn’t have the bandwidth to look for someone who would “fit” his personality. So, I did my background research and found someone that I thought he might like. I gifted him 5 therapy sessions and last I checked he has continued to go and felt considerable relief from his ongoing stressors. It has also eased my burden and his dependence on me”

Therapy gift-cards have been something of a new trend during the pandemic. Several regular clients of mine (and my colleagues) had a hard time paying for therapy in these years 2020-2021. I offered free services but after 6 months of that realised it would not be sustainable for me to continue free private therapy sessions.  This is when somebody suggested to me offering therapy gift cards that I called “Vent” posing me with an ethical dilemma. How would I feel if someone gifted me a therapy gift-card for a session with a therapist that they liked? The answer is certainly not straightforward.

For starters, it would matter to me who this person was, how well they knew me, if I had expressed to them an openness to see someone, if I was lost and didn’t know how to go about setting a first appointment or if I would actually appreciate any help at all. It would also matter that I did not feel pushed when I was not yet ready for therapy. Furthermore, what if I liked the therapist but I was unable to afford continuing the process by myself due to financial constraints? A gift card can backfire if it makes the person being gifted feel disempowered. If the underlying implication is “you are not okay, go get help”(but I am okay) – it is an outright violation of boundaries. If it is used maliciously to devalue a person it is contemptible and malignant. So the considerations are many. 

But then, the reason why many colleagues, businesses and I added the option of therapy gift cards on my website was our first hand experience in the last two pandemic years. I had employers and colleagues gift therapy gift cards to their workmates who had admitted being under significant stress and requiring therapy but unable to afford it (with no company coverage).  I had friends and family in better financial positions gifting other friends and family therapy sessions because of the significant financial stress that Covid had put everyone under. I preferred that they do it along-with an expressive and handwritten note that said something to the effect of “Dear …, I love you very much and this year has been difficult for all of us. I have been seeking help myself and thought to share with you someone who’s approach has helped me personally. Sometimes venting can just ease a little bit of the stress and strain, and burden of life. With a lot of love,…” There were those who gifted their friends “psychological first-aid” sessions after the loss of someone they loved. These were usually accompanied with handwritten notes such as, “Dear…, I am so sorry for your loss and feel sad that I cannot be with you because of the present restrictions. I cannot imagine the pain of losing (name) … I fondly remember (them/her/him)… I am sharing with you this gift card for (name of therapist) that I know of and believe in, in the hope that it might help ease your burden of grief and suddenness of how things unfolded. With a lot of love…(name).” There were also friends who knew that their friends wanted to see a therapist but just couldn’t afford one at the present pandemic moment. Instead of gifting them Diwali hampers and Christmas treats, they paid for 10 or 15 sessions of therapy. One note that particularly touched me (I took consent before posting it here) said, “Dear…, I don’t think you remember but in fourth standard I could not afford to pay for our class picnic. You paid for me and asked Miss (class teacher) to not take any money from me. I found out later that you had offered to pay for me and that Miss had refused to take the money from you, the whole class kept this secret. From fourth standard to tenth standard not one of you told me that class picnics were not free. This taught me that there is so much goodness in this world. People who don’t know me see me as this intimidating boss and leader; what they don’t know is that I actually belong to Class 4B. Everything that I learned about being humane was from class 4B. Please don’t see this gesture as me returning the favour, but rather, as an emotional investment by me in our relationship. I have no doubt in my mind that you would do the same for me were our roles reversed. Your buddy (name).”

Therapy in a private setting can be a huge financial burden when it is not covered by insurance. French President, Emmanuel Macron announced that the French government would cover the cost of therapy sessions for any citizen aged three and older starting in 2022 in response to the “historic demand” for therapy highlighted by the mental health crisis and increasing suicide rates during the pandemic and its fallout. A large-scale study conducted by them revealed shocking indicators of problems that needed immediate addressing. Thoughts about suicide, sleep problems and use of alcohol to cope with lockdowns were on the increase as a result of this unprecedented isolation, confinement, loss of salaries and grief. 

Recently, India passed the National Mental Health Act (2017) which mentions provisions of health insurance for people with mental illnesses. In it’s attempt to be inclusive it has also adopted mental health coverage In its universal health coverage scheme Ayushman Bharat although private healthcare and therefore most psychotherapy is completely excluded.

The insurance regulatory and development authority of India, in June 2020 encouraged all insurers to “publish on their respective websites the underwriting philosophy and approach with regard to offering insurance coverage for (a) Persons with disabilities and (c) Persons affected with mental illness diseases” with effect from 1 October 2020. HDFCergo, a private insurance company, published their plans online, but sadly excludes OPD (out-patient) costs from their plans, which basically means any conventional therapy provided by therapists like me. This makes it futile for those who come to me, even for short-term therapy of 15 sessions. For the moment and given the present circumstances, gifting someone mental health care could bridge this treatment gap, up until the government or at least private players step up. 

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self help

The Power of Imagery In Our Lives

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In Bill Watterson’s comic strip “Calvin and Hobbes” Calvin is a 6-year old child whose blithe spirit in the face of overwhelming reality helped many of us cope with our own horrible-terrible-no-good days. Calvin is accompanied by Hobbes, a stuffed animal to the rest of us, but a very alive and sentient bipedal tiger to Calvin. Every time a human enters a scene in the comic, all they see is an animal blankly staring into space. Calvin, however, sees Hobbes as a faithful confidant, a partner in crime, and also a voice of reason, albeit one that’s rarely heeded. Imagination is a splendid thing.

2021 was the year when we were trapped inside of our houses with little or no access to green spaces or other humans. Children, however, were able to transcend the boundaries of space and time by engaging with fictional characters and make-believe hereafters. One dreary work-from-home morning I chanced upon my nine-year-old son projecting voices and creating this fantastical and wondrous world with his Lego figurines. At first, it sounded two-dimensional. You had to listen very carefully to light upon the incredible details, minutiae – including very particular constructions of backstories, some of them intensely suspenseful. One superhero that peeked my interest was called “Lego Minute Man.” Minute man was not only Lilliputian but he also stayed in the “here and now.” Unfortunately, this meant that Minute-man forgot pre-arranged dates unless he was reminded that very minute to leave. This annoyed his other superhero friends. Our son anthropomorphised the various cats that passed by the window during his play including them as twists in the plot – sometimes undercovers, sometimes gate-crashers and at other times lookouts. He eventually enlisted my whole extended family to participate. What started off as engaging a lonely child ended up helping us escape the tedium of our own mundane lives.

Psychologists know for a fact that children’s imaginative activities play an important role in their emotional life and help them endure troubles and everyday drudgeries. In fact, a lot of their motor development including climbing, swinging balancing, jumping, skipping, and coordinating develops during imaginative adventures. It is delightful to see a child personify animals and greet them “Hi Mr.Dog, how was your dinner? Did mom shout at you? She can do that sometimes, don’t mind her, she’ll come around” or use magical concoctions to achieve the fantastical, “pass me the whatchamacallit and let’s add some doodah to it because I’m making a flying rocket that will take us to space.” This unique ability to indulge in make-believe situations and self-soothe, “it’s a car, now it’s a train, now it can fly and go over the hills and the big blue ocean” greatly simplifies their quality of life. Another example of children coping with fears is through wishful thinking and self talk such as “Woof. Woof. You cannot hurt me darkness, I am a dog and my fur protects me.” Sadly, as we grow older we are encouraged to let go of our make-believe worlds.  Not everyone does it, though. Did you know that many famous writers report vivid experiences of engaging with the fictional characters in what would become – their future books ? These writers become “expert pretenders,” knowing fully well their indulgence is phantasy and visualisation.

In fact, mental imagery is a prescribed tool and mechanism of psychological intervention that is frequently used in mood and anxiety disorders. A whole new science of neuromodulation, which is cross disciplinary and involves exposing a client to repeated positive imagery has started showing promising results. When used with clients who are depressed and who suffer from pronounced negative biases, this practice helps to moderate the negative biases i.e. position their worst-case scenario estimates to be less negatively skewed. The manner in which this is done is still being refined. The basic premise is that each time we imagine something, it makes us feel a certain way. Non-invasive functional imaging is used to study the neural substrates of these feelings. You can now “see” the feelings.

Emotions that arise from poetic (verbal) descriptions of a rose are less strong than emotions that arise from asking you to visualize a beautiful rose, smell and all. A review of this data has been undertaken at the school for Mental Health and Neurosciences at Maastricht University, Netherlands by Drs.Leon Skottnik and David Linden. The implications of such data for a practising psychologist are limitless. Can you imagine the many ways one could integrate visual imagery with inventive play and fantasy and use it to modulate emotional states, in the body, the mind and the spirit?

 

Guided imagery as a healing tool has been used for centuries in indigenous traditions all over the world. This tool is immersive and incorporates all your five senses of sight, sound, touch, taste, and smell. We see examples of the use of visualizations through oral traditions and stories. Take for instance the famous Indian folk tale “Birbal ki khichadi.” Birbal was known to be a wise and witty adviser to the Mughal emperor Akbar in the 1500s.  On a cold winter day the Emperor and Birbal are engaged in a passionate discussion on how poverty and the need for money could motivate a man to go to extremes. The Emperor Akbar dips his finger into the ice cold lake and opines that no living human can spend an entire night in this lake for money. To this Birbal asks that they hold a public contest, the winner of which would receive 1000 gold coins and see for themselves. The short version of the story is that one poor man achieves this task. Guards are posted near the lake to make sure they no one cheats. The poor man Is taken to the Emperor. In the presence of the court, Akbar asked him how he achieves this impossible feat? To this the old man replies, “I gazed upon the image of a street lamp that was far away, and felt warm.” He has used his imagination to conjure up and simulate the physical sensation of warmth. The Emperor is upset and claims that this is a form of cunning. He withholds the reward and sends the poor man away. The next day Birbal, is absent from court. The Emperor sends for him but is told that he would arrive only once his Khichri (rice) is cooked. Although the Emperor waits for hours his adviser does not arrive. Perplexed, Akbar decides to pay Birbal a visit at his home. He finds Birbal sitting on the floor next to a burning charcoal pit. Way above him, close to the roof is tied the pot of Khichri (rice). Akbar exclaims how ridiculous this is, and asks how in the world is Birbal expecting any heat to reach the Khichri. To this Birbal replies, “the same way the poor man received heat from a street lamp that was more than a furlong away” – the Emperor at once understands his error, recalls and apologises to the poor man and gives him his reward. The power of mental imagery should not be underestimated. 

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self help

Self-care Exercises That Help Me Manage Stress and Pain

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Virginia Woolf said of pain, “English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache… The merest schoolgirl, when she falls in love, has Shakespeare and Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.”

Growing up, I was often told of the mythical story of beloved Karna, the spiritual son of the Hindu sun-God Surya and princess Kunti. In the Mahabharata, it is said he offered his lap as a pillow to his guru, Parashurama, when an insect bit him causing him to bleed but he endured the severe pain silently and without moving an inch so as to not disturb his teacher. Karna’s ability to endure endless physical and emotional pain is salient throughout the epic and struck the young me as so very unfair.

What is pain?

Pain is unfair. They say that pain is a feeling-state. It can manifest physically and then emotionally or vice versa. Scientists have found that pain is basically a flow of sensory information from the site of injury to the brain via a “gate” in the spinal cord. This gate, controls how and how much we experience pain. More importantly, this spinal gate can be opened or closed by several factors. For example, if her grandson bumps himself while playing, my mother would put jaggery in his mouth and the crying would stop as he resumed playing. Another way to do this is to rub the spot that he has bumped himself at. The pleasurable sensory jaggery distraction temporarily blocks the pain signals before they reach the brain or the nerves that register rubbing override the nerves that register pain! Alternatively, this is what I call magic. 

Stress makes everything worse

We know that stress has taken on endemic proportions from the statistics of what are called the modern “deaths of despair.” These include opioid overdose, alcohol-related liver cirrhosis and suicide. When more stressed, the pain is greater and dependence on substances to deaden the pain is also excessive. The irony is that the role of pain is to alert you to danger in order to survive it and therefore pain gates are wide open when you are stressed and less open when you are relaxed.

Where medicines fail and chocolates work

Having been a chronic sufferer of an old sports injury and resulting lower-back pain, I heard more often than not “what doesn’t kill you makes you stronger.” NOPE.  When medical science has no solutions for your pain and all it offers is a “grin and bear it” approach. Naturally, you do a Cochrane review and scan every peer-reviewed article on chronic pain and what science has to offer other than deadening your senses.

Anandamide plays a role in the generation of motivation and pleasure. I like chocolate and anandamide is found in chocolate (just saying). So, while drinking cups of hot cocoa, I decided to start my journey to manage my own pain. I was armed with the knowledge that my brain actually DOES control the perception of my pain rather directly and can thereby be “trained” to turn off forms of pain that are “useless” (such as in my case). There were things that I actually could do, that would help but now I knew how and why (mechanisms of action). This is extremely important. I need to know the magician’s tricks in order to really enjoy magic. 

Like me, if you suffer from chronic pain, you need to start worrying less about your future, India’s future, your future finances, your client’s/bosses’ well-being, the political future of the world, terrorism, world poverty and so on. The worry will worsen your pain which paradoxically will affect your productivity (you get less done). 

Ask yourself what makes the pain less (other than medicines).

1. Do warm baths or does a cold compress work ?

2. Does it help to massage yourself with aromatic oils and nice-smelling baths?

3. Do walks in nature help ?

4. Is gardening and your hands full of earth healing for you?

5. Do you love and appreciate silence? Will noise-cancelling headphones reduce the pain?

6. How about a diet modification? Naturopathy greatly helped me

7. There is yoga and chiropracty, but make sure you go to someone sound

8. There is also touch – going to a spa or for a hair wash and cut with that added head massage.

9. Creative work helps me – do you have a hobby you can obsess over? Whether it’s a Pinterest board of visually appealing images or a pottery course, they all help 

10. What about abstinence? A forced abstinence from screens and work (yes, work)

Apart from this, to make the life of those you love easier, it is essential to label the irritability arising from pain as such (“I am irritable because I am in pain” – rather than, “stop making that ruckus and irritating me”). It was highly inconvenient for me to take days off of work, so I took the rather radical decision of quitting as head of department after 11 years of working at the only place I ever worked at in my life. This was probably the best decision of my life (although it seemed devastating at the time).

This last year of lockdown saw a bit of a relapse in my pain, but I feel better equipped to moderate my reaction to it. My tolerance for pain was always high but now I find myself more accepting of it. This, in turn, magically makes it more tolerable and less painful. When in extreme pain, remind yourself that you have every reason to dislike pain and want it out of your life but once you know its inevitability, your suffering becomes slightly more optional.

The future and “far out” interventions

Dr Devjit Srivastava, who specializes in anaesthesia and pain medicine, famously diagnosed the case of a Scottish woman with a rare genetic mutation who was unable to experience fear, was completely insensitive to pain and whose wounds healed quicker than the average human. In her, they found a genetic condition that resulted in elevated anandamide levels.

 

Anandamide is a fatty acid neurotransmitter (a sort of messenger that takes information from one cell to another) and gets its name from the Sanskrit work “ananda”, which translates as “joy, bliss, delight.” With the discovery that there are genes that mediate the (non-)experience of pain, it’s implications for future interventions in chronic, intractable pain and quality of life are stupendous and “faah-out.” Until then, we stick to good ol’ fashioned magic.

Categories
self help

The Ex-factor

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Oscar Wilde was twenty years younger than the great artist James Whistler with whom Wilde was awed. Both travelled in the same aristocratic circles and had become fast friends despite their differences. Whistler was an elitist and had a strong personality. Wilde was a populist and milder in his manner. Eventually, Whistler tired of Wilde and in a public lecture obliquely ridiculed Wilde implying that he was a dilettante. Wilde didn’t take this lying down, and so their verbal sparring continued until, it is said, Wilde had the last word when he based the character of a murdered artist in The Picture of Dorian Gray on this former friend

Humans can be very unforgiving. They can be unforgiving to friends, lovers, peers, strangers, and even to themselves. This is especially true when it comes to matters of perceived inequality and injustice, a theme that has fuelled stories and myths from time immemorial. In the Hindu epic The Ramayana, for instance, Lord Ram, the seventh reincarnation of Vishnu and the preserver and protector of the universe, is crowned King of the kingdom of Ayodhya.

In my work as a psychologist over the past 14 years, I have witnessed several stories about friendships, marriages and work unfold before me. I have come to conclude that life is not always about what is right or wrong, just or unjust. Sometimes we have to accept that someone wants us out of their life, whether we agree with it or not. But how does one cope with a decision that one does not agree with? How does one maintain mental stability and not feel low self-esteem when facing rejection of this kind?  The mind and heart want what they want. And what if you are the one who wants to leave? Can you do it in a manner that causes minimal damage? While not analyzing the reasons behind the “why” of things – psychology does touch upon two concepts, the first is loving-kindness for the one who wants “out” and the second is radical acceptance for the one at the receiving end.

Loving Kindness, choosing to leave

Without questioning your reasons to leave or to ask someone else to leave, How you communicate your desire to leave a relationship has consequences on how people perceive you and indeed, how you perceive yourself. Incorporating kindness and compassion to your demeanour has been known to enhance your overall well-being. It also allows you to evolve over time, so that someday, if you feel you were wrong in your decision, you can still maintain a healthy relationship with your ex-friend, ex-lover or ex-employee. The fabric of human life depends on growth and strong bonds.

The Panchatantra, a collection of Indian animal fables, says of friendships:

If loving kindness be not shown

To friends and souls in pain,

To teachers, servants, and one’s self,

What use in life, what gain?

Loving-kindness is a form of meditation practice that also helps with regulating your mind and body. It cultivates top-down mental processes that are known to stimulate creativity, help you meet challenges and resist temptations. It gives you better mental flexibility.  This meditative practice has as its goal the abandonment of all judgment or fault-finding. It starts with learning to be considerate to oneself, people you love, acquaintances, strangers (remember that fellow who cut you off while you were driving to work the other day?) and then towards someone with whom you are having a falling out. The idea is to take actions that would otherwise hurt another and mindfully execute them. It calls for an ethical sensibility. This minimizes the damage done to yourself and “the other.” While it may not fix a broken relationship, it allows for “moving on” aside from making the world a better place to live in.

Radical Acceptance, Tolerating outcomes with dignity

Carl Jung said “the curious paradox is that when I accept myself just as I am, then I can change.” The same goes with life circumstances; you don’t have to like them, but you can accept them with wakefulness. You can make space in your body and mind for emotional pain. You can accept not always being in control of where a relationship goes. This does not in anyway suggest being OK with abuse or putting up with it. In those situations, protect yourself and do what you have to in order to be safe and stable. What it does however mean is –not judging yourself just because you are not accepted. It means tolerating a break-up or rejection or being fired from a job and not cursing yourself or the other or your situation. The rationale is that negative judgments of others or your situation will hurt or anger you most and negative judgments directed towards yourself will make you depressed and immobilize you. Healthy negative emotions are an important part of organic living and one need not fear or avoid them. But they must not become unhealthy negative emotions that incapacitate or disable you. Radical acceptance helps you moderate these emotions. They no longer control you. Rather, you have more control over your life, and therefore more freedom.

And to be free from… and free to do is where your power and your peace truly lie.

Categories
self help

What Olympians Can Teach Us About Resilience and Mental Health Let us not forget the person behind the performer.

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Arnold Guttman was thirteen years old when his father drowned in the Danube River. From that time the heartbroken Arnold swore to himself that one day he would become a good swimmer. Five years later, while still a student of architecture in Hungary, he accomplished much more: he won two gold medals in the inaugural 1896 Athens Olympics by swimming in freezing temperatures of 13 degrees Celsius in the Mediterranean Sea with 12 foot waves crashing down on him. Cold water can kill you in less than a minute. All he wanted was to finish the race, to hell with winning. When asked how he did it, he replied, “my will to live completely overcame my desire to win.” 

Most Olympians, however, medal winners included, have not come to their game with the same deep sense of purpose and emotional balance as Arnold, or Alfréd Hajós, as he came to be known. (Hajós means “sailor” in Hungarian). Instead, the competitive rush to become an Olympian tends to start with parents, who subject their very young children to a gruelling schedule aimed at obtaining greatness. In the process, these future Olympians miss out on being with friends, going for socials or birthday parties, and just generally having a fun childhood–the absence of which is contraindicated for emotional and social resilience i.e. “mental toughness.” Young children are not cognitively ready to process complex information that comes from their parents or coaches (eg. We are training to win but you must gracefully learn to accept losing) and exposing them to such rules (eg. sacrifice your playtime for a greater purpose; you are meant for great things ; you must win and you cannot lose, but at times you will lose; if you don’t qualify it is all for naught) will tie their sense of identity completely to their winning a game, and nothing else. In games with only one winner all the other athletes by necessity must lose. Nevertheless many still believe so deeply that “failure is unacceptable” because they had been always treated like commodity goods themselves – i.e. economic and social currency for adults, that they suffer from low self esteem and self doubt after losses. They do not automatically tell themselves “I have lost this match.” Instead, they start doubting their capacity to play at all, “Am I good enough? I am a loser”

What about the winners? Are they standing tall? Take a look at this photo of seven-time Olympic medalist Amanda Beard. Aged 14 at the time – the year is 1996, she is holding a teddy bear in her arm and has won silver at the Atlanta Olympics, you cannot but stop and think, “What is the emotional cost of winning?” (not just losing).  We get some clues from her memoir ‘In the water they can’t see you cry’ where she opens up about her parents getting divorced that very year, her struggles at high school living with dyslexia and her later body dysmorphic disorder – triggered by her pictures being photo-shopped for magazines, and her need to live up to these photo-shopped images. Beard struggled with self-mutilation, addictions and depression. What about Michael Phelps, winner of 28 Olympic medals, the most decorated Olympians of our time? He is considered the greatest swimmer and athlete of our times. His documentary “the weight of gold” discusses in detail the mental health challenges of athletes. He has confessed to suffering from depression and contemplating suicide after the 2012 Olympics. He is not alone. The latest in this list of athletes is young Naomi Osaka, four-time grand slam winner who declared openly that she has been suffering from bouts of depression since 2018 and wished to take time out to recover. She was fined $15,000 by the French opens tournament referee and the leaders of the four grand slam tournaments after she skipped a news conference that she had earlier announced she would not go to because questions about how she played affected her mental health negatively. The women’s tennis Association (WTA) stuck to their position while overtly empathizing with her mental health – lip service, it seemed like. Their take was that elite athletes absolutely must speak to the media as a way to communicate to their fans about their game and the competition. 

Athletic careers involve “progressions, stagnations, and decays.” Mental health Is not just the absence of mental illness. It has been defined as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” The consensus statement of an international think tank on athlete mental health distinguishes between (1) clinical mental health disorders, (2) subclinical mental ill-health, (3) the human condition, and (4) the athlete condition. They define the human condition as periodic experiences of adversity and unpleasant thoughts and emotions as a consequence of living a full life. And they define the athlete condition as periodic experiences of unpleasant thoughts and emotions, such as performance anxiety, as a consequence of engaging in athletic pursuits.  This has many repercussions for how we write about and treat our athletes. We must end this mental health stigma and do it together, as parents, coaches, journalists and the public in general. There ought to be an ethical code for children being trained for an athletic career, just like there should be one to protect adult athletes from economic, political and media decisions that go against their thriving as full humans. An athlete is much more than their game.


Let us not forget the person behind the performer

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self help Uncategorized

What is an Emotion? And five ways to regulate them

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An essay in my 6th grade Hindi textbook was titled “Shok Sabha” and narrated the scene during a Hindu bereavement ritual. In it was described the life of a “Rudaali” (“one who cries”) or a professional mourner from Rajasthan. She was a peasant woman who wore black and was hired to mourn at the untimely death of a young aristocratic man from a wealthy family. She cried aloud and thumped her chest while tears rolled down her cheek and her disheveled hair gave the reader the appearance of someone angst-ridden, inconsolable and overcome with sorrow.

For the first time in my life, I remember asking myself “How is it possible that she could grieve for someone she didn’t know? What is a real feeling and what is manufactured? Can you choreograph a feeling?”  It also led me to forming my own personal reaction to intense pain. I started fearing public displays of emotion because of the meta-thought “What if they think I’m like herthe one who fake-cries for money? ” This often led to my pretending to be okay, when In fact I wasn’t.

It was only after I was introduced to these lines from Lord Alfred Tennysons poem :

Home they bought her warrior dead:

She nor swoon’d nor utter’d cry:

All her maidens, watching, said,

“She must weep or she will die.”

that I started working on “allowing myself” to feel sad when the situation warranted it, although I still greatly struggle with displaying any negative emotions outside of my inner circle. We each have our own reasons for reacting or responding to pain in our lives. There is no right or wrong, good or bad. Luckily for me, my undergraduate degree was in psychology, which allowed me access to books and readings on the psychology of emotion. Here are some of the answers that I am happy with, alongside the questions that I constantly struggles with.

1. What is an emotion?

Psychologists look at an emotion as both a state of strong feelings and a physical sensation, although we can’t pinpoint its exact location in the body. Modern technology allows us to see emotions as brain activity, but we only still know very little and have a long way to go. Would

2. What do emotions do for us?

What emotions do is allow us to see life in colour and sound. They play a very important role in highlighting major life events – positive and negative, and they can be very transformative. They may motivate a person to behave in certain ways and they facilitate your taking certain decisions in your life apart from allowing you to remember important life events.

3. Is the way I feel an emotion the same as another person?

Each of us experiences an emotion differently. We experience it in our body and our mind. Our age matters. Our experience matters. Our context matters. Our emotional experiences evolve with time. No one is spared from the entire gamut of emotions.

4. Is there a magical way to escape feeling sorrow?

The Buddhist story of Kisa Gautami answers this question. This was a young wealthy woman who lost her only son and was struck with grief. She took her baby to the Buddha and asked him to help bring the child back to life. The buddha listened with compassion and asked her to find him four or five mustard seeds from any family that has never seen such grief. Kisa Gautami felt hopeful and went from door-to-door looking for a family that was spared from death and grief. She saw what the Buddha had wanted her to see for herself and was finally able to come to terms with her pain.

5. Can I experience an emotion cerebrally without my body “feeling” it?

The famous psychologist William James said

…the intellectual emotion, if such it can be called, pure and undefiled. And the dryness of it, the paleness, the absence of all glow, as it may exist in a thoroughly expert critics mind, not only shows us what an altogether different thing it is from the “standard” emotions we considered first, but makes us suspect that almost the entire difference lies in the fact that the bodily sounding board, vibrating in the one case is in the other mute.

6. Is there a right or wrong way to emote?

No. It is subjective. What is more important is emotional regulation.
Overindulging an emotion is equally harmful as denying an emotion.

7. What helps in regulating intense emotional pain?

In individuals who are not suffering from any neurological or psychiatric condition emotions can be regulated in magnitude and emotional trajectories can be influenced in any one of the following five ways

a. by avoiding or engaging with situations that have the potential to cause unwanted emotions, whenever possible.

b. by modifying or changing the properties of the situation that may cause these emotions, if at all possible

c. by modifying your attention towards and away from the situation that is causing an unwanted emotion (distraction), at least temporarily – allowing you to buy time to adjust.

d. sitting with the thoughts, evaluations, and appraisals that lead to this emotion and actively reorganising and adjusting to them, trying to look at the bigger picture, and working on your thoughts.

e. Directly working with and influencing emotional responses – by modifying bodily responses including breathwork and modifying facial expressions of emotions.

Categories
self help

Ring Around the Rosie Meaning-making for children in a global pandemic

· ·

The British Version

Ring-a-ring o’roses,
A pocketful of posies,
A-tishoo! A-tishoo!
We all fall down.

The Indian version

Ringa Ringa roses,
pocketful of posies,
husha busha !
We all fall down

This popular childrens rhyme dates back to the Black death or bubonic plague of the 1300s. It was popularised during London’s great plague of 1665. Usually, children hold hands and sing the song in a circle and when the last line is sung, they imitate the gesture of falling down. The symbolism of the song while macabre–“we all fall down” indicates collective death–it was used to make meaning of tragedy through the medium of rhyme and play. The present pandemic has become so much about big people and our big problems in this big bad world that we might have neglected little people and their narratives altogether. They too, afterall, live in the same big world as us.
Much like Antoine de saint-exupéry in his book “The little prince” writes a dedication :

Much like Antoine de saint-exupéry in his book “The little prince” writes a dedication : 

“To Leon worth

I ask the forbearance of the children who may 

read this book for dedicating it to a grown-up…

I will dedicate the book to the little boy 

from whom this grown-up grew.

All grown-ups were children once – 

although a few of them remember it. 

And so I correct my dedication : 

To Leon Worth when he was a little boy” 

I, likewise, dedicate this article to the child in all of us.

The longest I ever (against my will) stayed at home was in the summer of 1989. I had just contracted a particularly bad case of the chicken-pox. My little sibling and parents left me with my grandmother. I could not understand why I was not allowed to leave home or meet with other children. My absolutely devoted grandmother whose heart was full of abundance dropped everything that was a priority to her, and gave me preference before all else. She had no house-help. The “big-me” would call that “brave” and unnecessary. The little me however, was thrilled to be told this story – “Rinku (as she lovingly called me), the chickenpox magically affected only you, because you are special, and I always wanted to have you all to myself, so that we could do things together without any rules. Just you and me. NO RULES. You will remember this time you have spent with Ati (my grandmother) and Ravi mama (my uncle) for the rest of your life.” Here I am, at 40, narrating the story of the “best” worst Summer vacation I ever had, to you. A vacation without rules.

Storytelling.

Human existence revolves around storytelling and play. Camp elders in some indigenous tribes who are skilled storytellers can recount tales that engage and when needed uplift the human spirit. While stories are a powerful pedagogic tool, they are also a beautiful therapeutic tool. They give vent to childrens curiosity and playfulness while building hope and resilience, but most importantly can heal trauma. For hundreds of years stories, narratives and poems have helped heal the memories of previous massacres, genocide, dislocation and displacement. One such example is the book “Hiroshima No Pika” written in 1980 by Toshi Maruki. In it, he calls the Atomic Bomb “the flash of Hiroshima” and goes on to narrate the happenings of 6th August when a little girl and her parents are eating breakfast and “it” happens – the flash. The author tells of a great tragedy, beautifully, in the hope that it will never happen again, anywhere. Then again, there was the1997 Oscar winning Italian movie La vita è bella with Roberto Benigni where he plays a Jewish waiter named Guido who uses magical storytelling as a way to soften the blow of the Holocaust for his young son. The narrative dares to laugh in the face of the unthinkable. It both hurts and heals at the same time, and at this time in history, when a big thing has happened and now everything is different, it inspires.

What stories will you tell your children about COVID?

Will they be racist? Will they be political? Will they talk about freedoms being taken away? Will they ask for them to fear the unknown? Will they complain about how birthdays and travel were missed?

Or, will they be about how the whole Big world – big and little people – have come together to solve a problem. How science is helping protect us. How medical workers are being hero’s. How little people are being brave and how the children of the world are ultimately triumphing over this not quite red, neither yellow, nor green but entirely colourless thing. And how, together, in the end as always —

We shall overcome.