Lessen your anxiety by sharing
40-year-old Rustom Ali (alias) used to earn his livelihood by driving a truck in Narayanganj. In a cold night in 2010, his truck faced a grave accident while returning from Dhaka. Rustom escaped the accident very narrowly. But the incident had shaken him to the core. Since then, his regular life has been considerably curtailed.
"It was a near-death experience and I am still traumatised. The fear of death chases me everywhere. I cannot do anything without the help of others. I am afraid of doing a single thing on my own, even to go anywhere alone gives me the creeps," Rustom said while his face carried real signs of the fear when he was talking.
Rustom was sharing his traumatic experience sitting in the room No 143 with some 45 people at the National Institute of Mental Health and Hospital (NIMH), Sher-e-Bangla Nagar, Dhaka. A "group therapy" session was being held in that room as part of the treatment. Most patients came there seeking a cure for anxiety disorder.
In response to Rustom's problem the conductor of the session asked for suggestions from others which is an important part of all such sessions. Accordingly, another participant, Md Suman (alias) said, "Dear brother, death can come at any moment. And when it comes, none can resist it. So do not be afraid. Start by walking to the nearest lane of your house alone and increase the area little by little every day. Just think that you have survived that deadly incident, something worse could have happened."
Similar encouraging suggestions poured in and it visibly boosted Rustom's energy. The sense of relief brought by sharing his problem manifested in his smile. He promised to follow the suggestions.
These sessions take place every Sunday, Wednesday and Thursday at 11:00am. In room No 143 of the hospital, group sessions are held for anxiety disorder, obsessive-compulsive disorder or OCD, and on parenting.
The corridor of psychotherapy unit gets busy with the presence of patients who come for this treatment. The therapies provided here, all kinds of them, are the cheapest in the country – a Tk10 entry fee would lead a patient to a doctor and the doctor would suggest whether to go to a regular group therapy or individual therapy. NIMH is Dhaka's only government facility, and the country's largest, for mental patients.
Each session is held for two hours and conducted by the assistant professor of the clinical psychology department, Md Zahir Uddin, with the help of students of master's and MPhil from the same department of the University of Dhaka.
Group therapy is a relatively new inclusion in the arsenal of treatment of the psychiatric patients at NIMH. "Starting from January 01, 2004, group therapy began in full swing. Every day, the number of patients is increasing. This type of therapy is very beneficial to the patients as by coming here, they can realise that they are not the only victims, and there are others out there with similar emotional crisis," said Professor Zahir, who hastened to add that "most importantly, when someone who has made some crucial improvements gives suggestion to the others, it becomes more encouraging for those patients."
Attending to fragile minds
The process starts from seeing a doctor in the outdoor section. Only when patients are referred to group therapy, they begin attending group sessions in the designated unit.
Each session begins after patients take their seats. The conductors then ask for one volunteer among them to run the rules by all who are attending the session. After that, they are told to sit in a relaxing posture taking their shoes off, with their hands freely resting on their laps. Then, following the instructions from the conductor, some light physical exercises are done ending with a breathing exercise.
A chosen number of patients are then asked to share their problems with the group. And suggestions are also taken from other patients. The conductor makes the suggestions more precise by extending on them.
Afroza Yasmin (alias) was speaking at a quick pace about her problems, "I overthink so much. I am always anxious about any kinds of social gathering. If my son is five minutes late while returning from school, I panic."
Hearing this, another patient Nazma Akhter (alias) suggested, "I went through the exactly same situation. Try not to think so much. Remain in the present moment. Start adding extra time in your mind to the exact time your child usually comes back home. Just think that, it is normal to get delayed on the road."
Nazma has been coming for the sessions for seven years. "It helped a great deal to reduce my anxiety! I still come here as it makes me feel good to converse with others," said Nazma.
Though the authority tends to ensure services to not more than 20 people at a time, each session is usually attended by almost 30 people due to the increased demand. This number increases in the sessions arranged for anxiety disorder.
An effective way to cure depression
Besides group therapy, an individual therapy is also given here if the patient wants and the doctor feels it necessary.
These services are also provided by the MA and MPhil students.
"The number of patients is on the rise as our treatment method is very effective. But we are still lagging behind as lack of resources is still our prime concern. Besides, the number of therapists against the number of the patients is also inadequate. We are trying to improve by adding more resources," said Zahir.
"Group therapy is effective in many ways. When a patient gets to know about another one, she or he realises that it is not something occurring to her and him alone. In such therapies, they get confident and also realise that every problem can be analysed and treated," said Professor Dr M A Mohit, director, NIMH.
"According to the most recent survey conducted by NIMH, in 8 divisions and 64 districts, the percentage of adult respondents having any mental disorder is 16.8 per cent and the percentage of having depressive disorder among the same group of people is 6.7 per cent. So, keeping all this in mind, we are working to develop our therapeutic methods," Dr Mohit clarified.
The same survey shows that 5.9 per cent of the child respondents are suffering from neurodevelopmental disorder and there is a treatment gap of 94.5 per cent among those respondents.
Dhaka's government facility dedicated to mental patients is playing a crucial role in treating patients in group therapies.
Group therapy is also being provided at the psychiatry department of Bangabandhu Sheikh Mujib Medical University (BSMMU). The sessions cost Tk100 here.
Professor Dr Jhunu Shamsun Nahar of psychotherapy and psychiatry department said, "Group therapy as a tool is more effective than the individual therapy considering the remedial aspect. Group therapy was introduced 1992. There are different aspects to such therapies like relaxation, on OCD, social skill training, parenting, developing skills in controlling emotion, tolerating distress etc. Besides this, under psychiatric sex clinic, individual and group both type of therapies are provided."