Kamna Chhibber is a clinical psychologist and heads the department of mental health and behavioral sciences at Fortis Healthcare. She not only indulges in therapy-related work, but also engages in the non-clinical spectrum that involves developing training programmes, community outreach programmes, etc., The Voice of Woman presents Dr. Kamna Chhibber’s views on the right parenting technique, how to abstain from suicidal thoughts, and what are the warning signs of depression that one should be aware of. Read on to find out more. What hurdles do clinical psychologists face daily? The profession of being a clinical psychologist is an extremely rewarding space to work in. But like any other occupation, it comes with its own stresses and pressures, which to a large part emanate from the fact that we don’t necessarily always have control over outcomes. There are a lot of strong boundaries that we need to adhere to and these give us the right structure and framework, and allow us to function with the people that we are working with, in a way that it facilitates their own attainment of skills, coping abilities and strategies which could facilitate living a better life for them. And maintaining those boundaries along with ensuring that there is a clarity of rules can sometimes pose its own challenge. I think the other aspect is that there is a lot of responsibility in working with someone; its not completely easy to distance and disconnect yourself from taking all ownership of the kind of work that you are doing. There are a lot of ethical considerations that must be kept in mind at all times and we cannot allow those to become blurred in our minds at all. I think another aspect is that there are immense responsibilities that we do take on and along with that, when clients are going through their difficult periods, it can create immense stress and pressure, wherein ensuring that you have the right kind of peer and professional support systems along with supervision available plays a very large role in ensuring that you take care of your self. Many people without any checkups, believe that they suffer from depression. We would like to know about the signs that imply depression. Depression is a term which has entered our everyday language and people tend to use it very loosely, often, not understanding that depression is also a clinical illness and like any other physical health-related ailment, it requires its own signs and symptoms, and criteria that you must fulfil before we diagnose someone with the illness of depression. And primary, among those symptoms and criteria that we look at, is for an individual, just experiencing a regular low mood cannot qualify it as being called depression. That “low mood” needs to persist consistently for a minimum period of 2 weeks. If it’s not present for those 2 weeks and the fluctuations in the moods come and go, then it might not be depression. It may still warrant that you speak to an expert, especially if you are experiencing a lot of distress. The signs and symptoms which can indicate the presence of depression include having a combination of the following aspects. One of course is the low mood which is the most easily understood aspect. Secondly, people, a lot of times can experience crying spells. There is also a tendency to not be able to enjoy the things that the person typically had an interest in or would derive a lot of pleasure from. Having a difficulty in concentrating is commonly seen, as is tiredness or fatigue. We can also see changes in appetite and sleep patterns, wherein an individual may end up eating less or more and sleeping less or more. Concurrently, oftentimes, we end up seeing thoughts where an individual feels increasingly helpless or hopeless, that there is no way that things are going to turn around for them. They can also develop feelings of worthlessness where they start viewing themselves in a rather negative light, and this can often lead to thoughts which may even pertain to self-harm. How do you boost your mental health after dealing with your patients? Like any other professional, we go through our own stresses and strains. As a mental health professional, it is very important to be mindful of boundaries; it’s essential that one understands where and when the stresses are building up so that one can engage in good and solid routines which lead to unwinding and relaxation. One of the things which I have seen that works extremely well is learning to switch off. Sometimes, it’s very important to get off the gadgets and disconnect from social media and just get that complete mental break that allows one to be able to recuperate and to kind of restore one’s reserves of energy. I think the other thing which works really well, at least for me personally is doing a lot of reading, and reading which does not relate to my profession alone. I like to read a lot of non-fiction books and that’s something that really helps me feel a lot better. I have started listening to music, something which I previously never used to do, but it is a habit that I’ve inculcated and developed over time, and which actually indicates that you may not always have had certain routines in place but if you would work on them, they could really help to ensure that you are being able to take care of your mental health and well-being. I think its also very important as a therapist to give yourself space to be able to experience emotions on your own. A lot of times, therapists can end up holding themselves to very high standards and stringent expectations of their own self and it’s very important to understand that there are times when you would also struggle and that it is okay for you to go through your own emotional ups and downs, and it’s not that just because you are working in a space of mental health, you would not be having your challenges to work through. And when you do experience these, then like we advise everyone else that we work with that you need to have a support system in place. I think those are the things that could really work and ensure that as a therapist, one is able to take care of one’s own mental health. Image courtesy: Fortis Memorial Research Institute What are some mistakes that most parents commit while raising their child, which eventually hampers the child’s behaviour in their life ahead? Parenting never was, and still isn’t an easy area for any individual to operate in and I think parenting comes with numerous challenges, and there are certain things which parents inadvertently end up indulging in, which can negatively impact the child. Some of the things that I think parents should keep in mind is that it is very important that you keep on modelling the right kind of behaviour; children learn maximally through observation and whatever it is that you do, is what your child is going to absorb. So, if you want your child to inculcate certain habits, it is very essential that you too, follow the same rules. I think another aspect is that a lot of times parents aren’t sure of how or what kind of boundaries to set, sometimes they end up being too firm and at other times, they become too lenient. In the situation where they’re being too firm, they end up using too much punishment instead of utilising other mechanisms like trying to explain things to the child or help them understand that their behaviour is not okay. Whereas, when they end up becoming too lenient, they may be over indulgent and allow the child to make many kinds of choices that the child wants to make. That becomes a problem as well because the child is then not learning how to play and behave within the rules, and that can be problematic especially when they are going to enter spaces like school, and when they need to be working in teams or groups. I think parenting also involves a lot of transition. Initially, when children are young, the do’s and don’ts work very well because you do need to keep on directing the child and their attention and behaviour, but over a period of time, your approach needs to keep evolving, and that can be a very difficult aspect because it’s not easy to transition from being a directive parent to someone with whom the child can have more interactions with, or negotiate and bargain with, developing their own understanding in that process, become mature in their own thinking as a result. Developing that communication is very critical as a parent because only when you have good communication patterns in place, would you be able to ensure that your child makes the right choices in the future for themselves. I think another area where parents can often go wrong is when they become too over-involved and don’t allow their child to make choices for their own self. Or sometimes, they become very overprotective, wherein they may not allow the child to fully explore the environment and try to understand how things are and what they are like. And their own anxiety can sometimes get projected to their own child which may prohibit the child from having the kind of experiences which could allow them to develop cognitively, socially, or emotionally, all of which are very critical aspects. The diagnosis of social anxiety commonly goes undetected. Your advice as a psychologist to our readers in this case? A lot of people end up experiencing anxiety within social situations and often, one of the primary mechanisms that they utilise to be able to cope with it, is to try and avoid being in the situations where they have previously or they anticipate they might end up experiencing any kind of anxiety. One would expect from a logical standpoint that avoiding the situation would help reducing anxiety but what people often don’t realise is that inadvertently it is only contributing further to the anxiousness because it only ensures that later on when you do come across similar or at times the same situations, you would be even more apprehensive or fearful of being within them. So, that avoidance mechanism really does not help at all, in fact, it only tends to worsen the problem. So, one of the first few things that we do encourage people is in a healthy and safe manner, not overextending yourself, but in whatever way that you consider comfortable, is important to try and not avoid the situations where you are feeling that you could get anxious in. I think the second aspect is that often, people end up engaging in some sort of negative coping strategies besides avoiding the situation. It could involve consumption of things like alcohol or substances and that is something which we say that you should not indulge in at all because these negative coping mechanisms only reinforce the idea that you do not have the ability, the will, or the motivation to be able to cope with the situation. And it’s far more important that we try to find mechanisms that can create those healthy coping systems and can put those in place which can allow you to function in a better manner in the very same situations. So, what would instead work would be trying to figure out how you reframe your thoughts, how you are trying to reappraise the emotions that you are feeling in a situation. Understanding that what you’re experiencing in terms of anxiety in those moments is something that would certainly be helpful if you’re able to just sustain yourself in that situation for a little while. And its also about getting the mind habituated to the notion that its anxiety, its something that could go away, is going to be self-limiting in many ways, and if you’re able to work through it, it would settle down. And in all likelihood, over a period of time, repeated exposure to that situation would not trigger that same level of anxiousness. But I think, this comes with caviar, that if you are experiencing immense anxiety, it gets out of control, its something that is coming spontaneously to you, then my suggestion would be that you must meet an expert because your experiences are very unique to you, generalised strategies may not always work, and it could be more helpful to work with someone individually to figure out what could be the best approach for you. Whether this involves taking therapy or trying to work through certain mechanisms as I suggested, or creating other mechanisms which are individually more tailored to you, or if we need to look at a medical intervention, it could be far more beneficial in that particular situation. The social stigma related to mental health is real and that stops people from seeking help from mental health experts. What can we do to destroy this? There is a lot of stigmas which surround mental health-related problems, and it’s very important that we take active measures to start taking care of this aspect because it is the stigma that prevents a large majority of people from seeking help for their mental health-related issues that impact their lives. Also read: Anjana Sukhani Opens Up About Handling The Stigma Associated With Mental Health Issues Image courtesy: Sheroes To ensure that people’s well being is restored, I think the first and the most important thing that we need to do is to start talking about and having conversations about mental health, where we try to normalise the understanding that mental health-related illnesses can happen to any individual. Just like physical health-related problems, they too can affect our sense of well-being and can impact the lives that we are leading, and that there are treatment options which are available. The next point, that another very important aspect to start taking care of the stigma that surrounds mental health issues is busting the myths and misconceptions that people harbour in their minds. It is very essential that we try and take care of the misunderstandings that people are holding onto. And we must do this, not just by putting out more media messages, but I think it’s very important for us to also start pushing this understanding of mental health, towards the young minds; we need to try and talk about it in schools and colleges. I believe that is very helpful, even include mental health as a part of the curriculum and encourage young people to engage with it. What is the actual definition of a person with good mental health? Is it possible to have good mental health in today’s time? Mental health is often thought of as indicating the absence of a mental health-related illness, but that’s not all that it is. Mental health relates to your psychological, emotional, and social well being. It is your mental health that determines how you think, feel, and respond to situations. Your mental health well-being is very intricately related to the ways in which you look at situations, the way you understand them, how you end up problem-solving your difficulties, the manners in which you would end up reaching certain decisions, how you maintain relationships, the ways in which you would cope with problems, and also, how you are adapting to challenging situations. So, your mental health encompasses a lot of aspects which are going to influence your overall sense of well-being. It’s very important that we start focusing on, learning to first understand what is it that we experience, our thoughts and feelings, learning to understand that there are situations which can impact us and affect our well-being, and so, it’s important that once you are in the midst of certain situations, you learn to talk about them and reach out for help if that is warranted in that situation. Secondly, what’s important is that you start focusing on your lifestyle; we have immense stress and pressure, there is a lot of competition around us, oftentimes, our relationships are not the strongest, so its very important that you start focusing on even the basics. Exercise regularly, focus on your diet, stay away from substances, make better choices for your sleep patterns, and implement that in your daily routine. Thirdly, it’s also very essential that you focus on building good and strong relationships; I think that’s something that goes missing for many individuals. It very essential that you try to inculcate a good and strong bond with the people that you connect, and make an active effort to do so. Build relationships, not just with your family members or with someone you’re in love, but also with your friends and neighbours, even your peers and colleagues with whom you are working in your organisations. That’s something which is very essential and something that would stand you well in the long run. The rate of suicide cases is increasing at an alarming rate among students. What could be the possible reasons for such extreme decision making? There is a lot of stress and pressure that young people tend to experience. I think there is a lot of competitiveness, also immense comparisons that they tend to engage in, and there are a lot of lofty expectations, a lot of which emanate within themselves, wherein they have set these high standards which tend to compromise, sometimes their own assessment of how well they are doing. I think as a society, its very important for all of us to come together to keep reinforcing, that it’s very important for individuals, especially for young people, to keep focusing on their strengths. It is very important for them to look at what is it that is good within them and to look at the assets that they possess so that they can utilise them in the best manner, in the areas that they’re working in, and its importance for individuals to keep reinforcing the good, instead of getting stuck with what they feel may not be best within them, That approach is something that we need to start inculcating in a very conscious manner. It’s about maintaining the positivity and building the optimism which allows people to be able to cope with difficulties, navigate through very difficult situations, and to maintain their resilience in the face of hardships. It’s very essential that we regularly talk to people, especially youngsters around us, and try to help them understand, what could be the various ways in which they could cope with difficult situations. Building these skills is something, I think, is a must; its something that we must start at a very young age within schools itself. I think it’s very essential that we focus on encouraging children to develop life skills like assertiveness, negotiation, decision-making, problem-solving, communication, empathy, and emotional understanding. I think its also very important that we focus on helping children and adolescents develop media literacy so that they are also able to develop a good understanding of the kind of media messages that they are bombarded with. I think it’s very important that we keep on looking at these aspects and reinforce that focusing on the self, is what is very important. Building their self structures, maintaining their self-esteem, confidence, and a positive self-view is what we need to focus on as a society, as a collective. What message would you like to share for our viewers through the Voice of Woman? My message for people viewing the Voice of Woman is very simple; I think it’s very important that we learn to prioritise our mental health and well-being. If nothing else, in this pandemic, we have all learnt that how easy and how fragile our mental health and well-being can be, and how difficult situations can come in and make us feel completely at loss. I think it’s very important that we start taking proactive measures to ensure that we are building our sense of mental health. For this, I think it’s important that we start taking cognisance of the fact that it’s not looking at mental health only today, its about mental health in the long run. This debate, this narrative, and discourse should not stop; it’s very important that we keep pushing this topic to the forefront, repeatedly and regularly, and each of us chooses to unmute ourselves, and talk about what it is that could be impacting you, seek help, make sure that if there is a problem in your life, you don’t just bottle it up and keep on withering from inside. It’s far more important that you understand that for mental health-related issues, there are available treatments and help; you must reach out and seek help and support at the right time because if you do so, you will always be able to take care of yourself and your well-being.