One Sunday afternoon, after I finished work at my rural clinic in Anantnag, a friend asked me to accompany him to Zain Shah Sahib’s shrine located on a hill top in South Kashmir’s Ashmuqam village. I sat down near the holy cave, enjoying the cool breeze, when I heard a woman wailing. I could hear her address God. She would pause after each cry, as if waiting for an answer to her pleas. “Why did you take him away? You knew he was the lone support of my family. You knew how poor we are. You knew how weak I am,’’ she said.
She cried for a while and finally I saw her walking away from the cave. She was smiling. It looked as if her prayers have already been answered. Her son Riyaz had fallen victim to what we call “enforced disappearance” in the early 1990s. She came to the shrine every week to plead for her son’s return.
In June 2000, I was in the hospital OPD, seeing patients. A woman from downtown Srinagar was being carried by a group of women, her neighbours. She was crying and the other women were trying to console her as they ushered her in. Her son too had disappeared, never to return. I had been a practising psychiatrist for only a month. Somehow, I gathered the courage and asked her why she was crying. “How can you help?” She asked. “Can you return my son?” I didn’t know what to say. “You cannot. You too are a part of the same system. You will give me a few pills, talk to me for a while and then leave me to deal with my own pain.” “Instead,” she said, “I will go to the dargah (Hazratbal shrine, situated close to the hospital) and ask my God why he is not returning him”. She kept talking, and I kept listening. Once she left, I thought she won’t return. But she came back, and each time, demanded that I talk to her. Masa (aunt in Kashmiri) became my first patient for cognitive behavioural therapy and undertook several sessions with me. She told me that my nose resembled her son’s and that is why she comes to the hospital. Besides, the hospital is on her way to the dargah. Her condition improved and I knew it was because of her cathartic visits to the shrine. Soon, she stopped coming to the hospital.
I have been practising psychiatry for 17 years now. When I began, there were only seven psychiatrists and the load of patients was unimaginable. There were more than one lakh patient visits to the hospital where I worked. All these years, like my colleagues — though the number of psychiatrists in Kashmir has risen to 35, we are still unable to cope with the rush — I have realised the only reason we have been able to avoid a mental health catastrophe caused by the unbelievable levels of stress, pain and grief in Kashmir is the unflinching faith of people in God.
In the third year of my residency, a woman would come to my OPD, every Monday, with her daughter. The daughter had clear conversion symptoms (severe psychological distress presenting as neurological symptoms). My initial assessment was that she had depression of moderate severity. I put her on medication and she starting feeling better. But her symptoms did not abate.
We realised that her current ordeal started when a cousin accidentally revealed how her father had died. Her mother had hidden the fact for years and even asked her not to reveal it to us, her doctors. But that day the daughter decided to talk. Her father was a militant who had died in a gun fight with forces and her mother and other family members had witnessed it. Earlier, her maternal uncle too had been killed in the course of the encounter. The daughter was too young then to realise what had happened. The family, instead of telling her the truth, thought they could help her by concealing it from her. For six years, they had told her that her father was working in West Asia. But one day her cousin revealed the truth to her. “Ever since that day”, she said, “whenever I go to sleep I see my father’s blood-soaked body. I am scared to fall asleep.”
In our next meeting, I asked the mother how she coped with such grief. She said it was her destiny, and that she was waiting for God’s benevolence to return. She said she has no doubt that God will eventually make her daughter well again.
Masa returned in 2008 and told me that one of her neighbours had been killed in police firing and ever since she wasn’t able to sleep. She had reverted to her previous condition. A week later, she told me she felt better. I did not see her until October 2010. This time she was in a very bad state. She talked about the many boys from her neighbourhood who had been killed in the firing. She was angry with everybody. She talked about the death of humanity, she remembered her own son and talked about him. But most importantly, she talked about God and how we need to collectively plead before Him for solace. In 2016, I saw one of her neighbours at SMHS hospital (one of the biggest general hospitals in Srinagar) where his son was admitted with pellet injuries. I enquired about masa. She couldn’t bear the pain anymore and had died recently, he said.
Bessel Vander Kolk, while teaching me about trauma, had said that all biological problems don’t have biological solutions. In my 17 years of psychiatry practice, I have found this to be most relevant: Faith heals. It gives hope because its foundation is eternal justice.