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Post-Mumbai anxiety taxing for mental health workers

India's few psychiatric specialists are in great demand, even in a culture that favors traditional treatments.

December 17, 2008|Mark Magnier

Hargovind had seen the man next door, a foreigner wearing a beard and black clothing, walk through their neighborhood a few times. And once, on his toddler's birthday, he'd given her and her sister some cake and a few rupees. "They used to cook food in the basement," she recalled.

Little did she and her family realize until the fateful night of Nov. 26 that they were living next door to the Chabad center. Militants killed Rabbi Gavriel Noach Holtzberg, his wife, Rivkah, and four guests there; the Holtzbergs' toddler survived.

Many have looked for someone to blame, with Pakistani and Indian elected officials high on the list. "Real Terrorists are our Politicians and Babu," or bureaucrats, read a front-page headline in the Times of India.

The anger is a predictable response to trauma, experts said. "Any time you feel hopeless and vulnerable, you want someone to blame," said Lakshmi Vijayakumar, a psychiatrist and vice president of the International Assn. for Suicide Prevention.

Psychiatrists must grapple with their own anger, which can hamper their ability to help others. Recognizing this, hundreds of counseling professionals across India started an e-mail "anger discussion group," including some who expressed wishes that the attackers could be tortured or die a violent death.

"Psychiatrists are human too, so we express our anger and try to heal ourselves," said Harish Shetty, a social psychiatrist with Mumbai's Hiranandani Hospital, who was out counseling traumatized police officers and journalists before the shooting stopped. "It's not always politically correct to admit anger, but in our epics -- the Ramayana and Mahabharata -- good kills evil. It's part of our ethos."

Mental health professionals say their treatment must factor in the strong role that fatalism has in Indian culture, including the view that whatever occurs is the result of karma or God's will.

This has certain benefits. There's often no particularly good explanation of why your loved one died in an attack, so fatalism can help people cope.

But it can also sap people's will and leave them numb, said Shetty, part of the reason he sometimes encourages patients to embrace their anger and take more responsibility for their own fate.

"India can be a very fatalistic place," he said, "even among the educated."


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