three therapies of south india 57
excessive anger, and manassinu vishamam (sorrow, mental troubles). After
asking about the history of Hamid’s illness, his family and social life, and other
therapies he had tried—a set of topics that resembled my own inquires with
patients—Dr. Abdu gave Hamid some pragmatic advice accompanied by a
reminder of his familial responsibilities:
You have not been able to look after your mom, right? Th at’s a big responsibility,
right? You need to support her. Th at got neglected. Th at’s an important
responsibility/great blessing, right? Later, when you get married and all, if you
are living in a family, all problems will be solved, right? Th en there’s the matter
of a job. Besides tailoring, you’re interested in masonry work, right?Th en, concerned that Hamid is melancholic and spending too much time
alone, Dr. Abdu advises him to be more socially engaged:
Speaking about humans, they are social beings, not meant for sitting alone. We
can live only through contact with others. Without that, you know we cannot
live. We cannot move a single step without the help of others. Everyone wants
people’s help. Otherwise, nothing would be possible, would it? If we need a job,
if someone doesn’t give us one, how will we get one? Nothing will work if one
does not get involved with others.Allopathic psychiatrists and psychologists are normally trained to avoid
giving advice in this manner. Th e aversion to advice and the ideal of equality
in the doctor-patient relationship—which one fi nds in psychiatric texts but
less often in practice in India—fi ts a more individualistic orientation to the
self inherent in Western psychological epistemologies. Th e therapist should
assist patients to develop their own insights rather than impart the therapist’s
views and moral judgments. In India, where the self is not exclusively socially
oriented but is more embedded in social ties, it is acceptable to give advice,
and it is appropriate that the doctor should act as an authority who can guide,
even admonish, the patient. While allopathic psychiatrists and psychologists
in Kerala are trained according to a putatively universal approach to the psyche
that assumes an individual self, they adjust their practice to the more socially
oriented local context and to their own instincts of appropriate social inter-
action. For example, one psychiatrist stressed to me the importance of the
involvement of the family in therapy in India and explained that he normally
tries to enlist a family member as an ally in his treatment of a patient. Likewise,
Langford (2002) has shown how an authentic, interior, individual self is elu-
sive in a psychotherapeutic practice she examined in India. Th e naming of an
emotional state, such as anxiety, by the therapist appears as an end in itself, and