About the Author: Vineet Gairola, a student of Ambedkar University, Delhi, talks about his internship experience at a mental health institution and his learnings from the same.
“One day, in retrospect, the years of struggle will strike you as the most beautiful” — Sigmund Freud
In our field of psychoanalytically oriented dynamic psychotherapy, doing an internship is an absolute necessity. We are supposed to visit a mental health institution in the city for a month and observe the doctor-patient interactions. It can be in a hospital setting, in an NGO, or in private clinics. After discussing with my peers and professors, I came up with a list of places where I could intern. The list looked like this-
1. Sir Ganga Ram Hospital, Delhi
2. IHBAS- Institute of Human Behavior and Allied Sciences, Delhi
3. Salaam Baalak Trust, Delhi (NGO)
4. G.B. Pant Hospital, Delhi
5. Safdarjung Hospital, Delhi
The objectives were simple. We had to get comfortable with the clinical setup, understand some common disorders in mental health and how they affected the patient, and to build communication and trust with their family members. In the pursuit of a place which would provide me such a clinical experience, my journey began. With my Letter of Recommendation (LOR) from my university office (Ambedkar University, Delhi), a manually written application, a passport size photograph, and my college ID card, I went to the above-mentioned hospitals for applying for the internship. For Salaam Baalak Trust, I only had to fill an online form and was allowed to volunteer. However, I preferred hospital setting as it allowed me to see the actual reality of mental health institutions in India.
IHBAS hospital was the one which allowed interns to engage with patients in their wards extensively and in OPD too. I was asked to submit a photocopy of my ID card and a letter describing the field that I wanted to intern in. I wanted to intern at Clinical Mental Health Unit, Department of Psychiatry. In physics, we learned that current flows and there is resistance too. When the current of your thought process flows, try to overcome the resistance and ask your friends, seniors, and teachers for help! There was no interview, and I was directly selected on the basis of my application. My shoes, which had traces of my travel, symbolizing itself through dust and scratches demanded from me a revival as if to form new memories, new dust, and new scratches, so I cleaned my shoes in affirmation.
The internship started and I took my first step into the real psychiatric world. The campus was huge and well maintained. There was a sprawling manicured garden right at the center of the main building with a fountain. Numerous patients and their family members could be seen enjoying a tranquil conversation there on most evenings. I tried to visualize myself sometimes as a patient, or a caregiver, or a resident doctor, or a nurse, or sometimes even as an attendant doing daily shifts. I tried to understand what could be going through the minds of each of them. There were many “restricted” areas with guards manning locked doors. The corridors had a distinctly unpleasant smell that bullied us constantly by refusing to go away. And then there were the patients; some shouting obscenities, some wailing in distress, while others who wouldn’t say a word and just stared at us blankly. Many patients, we were told, had been relinquished by their family members and would never get out of the institute all their life, even though they were doing much better with prescriptions.
I was assigned the task of observing and engaging with the patients. At IHBAS, the Clinical Mental Health Unit is divided into two subunits- I and II. I was allotted unit I on Monday, Wednesday, and Friday. I had to observe patients and listen to them while junior residents of the unit I took their follow-ups, work-ups, and prescribed the medication. We had to arrive at the Out Patient Department (OPD) at 9 am and it ended around 1 pm followed by a discussion with the director of IHBAS, Dr. Desai. On Tuesday, Thursday, and Saturday, I was asked to engage with patients in different wards – male open ward, dual diagnosis ward, female semi-open ward, etc. from 9 am to 1 pm. Every day from 2 pm to 4 pm, I was asked to go to Saksham; a halfway house where people, who didn’t have anyone to depend on, with undifferentiated schizophrenia lived. It was a critically stimulating experience as this side of life, which is at the margins, often gets ignored. I went to many places physically but the patients only went to places in their own mind. We learned how to care for our patients, educate their family members, and made the most of our clinical duties and ward postings. I believe that was the secret which kept me going at the end of the day— the process of evolving into an adult from an adolescent, of experiencing mental growth in what is so often unthinkingly labelled and stigmatized as a ‘mental hospital’.
The 1-month internship ended with its fair share of teachings. I learned the art of communicating a diagnosis, and also the fact that we do not have to arrive at a diagnosis too soon. Emphatic listening resembles dew drops on a leaf; attached and detached at the same time. It helps to create a space for DE-centering, a possibility where we have to arrive. Arrivals are a necessity and the beauty is the metamorphosis which we undergo to reach the arrival of arrivals. Life is not like lying on a hammock in a forest for us too, but the fact is that ordinary is still difficult for people suffering from mental health issues. Sometimes they speak and sometimes they make us feel their story. Sometimes, our experiences put blinkers on our eyes, and gradually, blind spots come out of theory into our own life. Not becoming a victim of those blind spots and learning to use expertise not to demean but to open more windows is what I took back from my fieldwork.
Are you also interested in learning what makes people tick? Apply to these cool psychology internships and enter the realm of psychology!
Editor’s note – If you also have an interesting story to share, you can now participate in Your Internship Story Contest 2017 and win cash prizes and goodies worth INR 1 Lac!