by Sudhir Kakar
In the first three years of our return, the lack of intimacy with Apeksha and its discontents took a back seat to the demands and exhilaration of caring for the new lives we had brought into the world. These and the excitement, mixed with apprehension, of beginning a life in Delhi with an uncertain future, drew my wife and me together like a beleaguered host fighting for survival. Our marriage became like countless others, focused on the children, caught up in the exigencies of everyday life and the diversions offered by the goings-on of a lively social circle. All of these sought to mask the fact that the marriage lacked any real intimacy where concealments had fallen away with time and we had entered an emotional space where we could fuse our identities without fear of being hurt or losing something of our individual selves. It was in my daily experience of intimacy in my psychoanalytic practice—of which I, as the analyst, was the recipient—that kept reminding me painfully of its absence in my own life. It kept the mask from becoming my face. The longing for passionate love, I am convinced, is no more than an intense craving for intimacy, a fusion of souls of which the two bodies are but joyous containers. It promises relief, even if temporary, from the disquiet of inner divisions that are our human fate.
I began my clinical practice in a ten-by-ten foot cubicle formed by plywood walls and a low wooden ceiling in a large commercial office on Barakhamba Road, just off Connaught Place. My house was far from the centre of the city and given the poor state of Delhi’s transport system, I felt I needed an office that was centrally located. This expensive space for which I paid no rent was due to the generosity of Vinay Bharat Ram, the grandson of Sir Sri Ram, my surgeon-grandfather’s friend and benefactor. Vinay, who I had met as a child but had now become a friend, seemed to be continuing the benefactor–beneficiary pattern between our two families. Like the third-generation scions of many great business houses, Vinay’s interests ranged beyond business into arts and literature. Besides running the Delhi Cloth Mills, the cornerstone of the family’s fortunes, he was an accomplished singer who had received his musical training from the sitar maestro Ravi Shankar and he wrote Hindi poetry. He exemplified the ‘Buddenbrooks Law’—after Thomas Mann’s novel on the rise and fall of a merchant family in Luebeck—that seems to govern the lifespan of large business houses. The first-generation patriarch is only interested in the creation of wealth, the second generation’s interest widens into public service and patronage of activities serving the common weal, while members of the third generation are seriously engaged in the pursuit of one of the arts or sciences, often to the detriment of business. The Sarabhai family of Ahmedabad was another exemplar of the Buddenbrooks principle.
The large staff of Vinay’s office, clicking away on their typewriters and poring over accounts and balance sheets, must have been mystified by what I was doing there, especially when they saw all kinds of people, including unaccompanied women, disappear into my cubicle next to the office entrance, and then re-emerge after an hour with their faces registering expressions ranging from the vacant to the deeply thoughtful. I wonder what they made of the occasional sounds of sobbing that came through the wooden walls that, for all my efforts, could never be soundproofed to a satisfactory level.
At the beginning of my practice, most of the patients who came to consult me had been diagnosed by their families and traditional healers as being possessed by evil spirits. They had made the rounds of neighbourhood exorcists, healing temples, Ayurvedic physicians and drug-dispensing psychiatrists. I was a new kind of ‘brain doctor’, with the prestige of Western medicine behind me, and for some I was their last hope of cure. My failure rate was around ninety per cent and my feelings of mortification were much greater than the disappointment of the patients’ families. I was touched when a family member would try to console me, ‘It is not your fault, doctor, this is an especially difficult case.’ Another would add, not without a measure of pride, ‘Her possessing spirit—bhuta—is singularly strong.’
These consultations, however humiliating at the time, had an unintended benefit. I began to acquire a rudimentary but first-hand knowledge of how mental disorders were experienced and made sense of by a vast number of my countrymen. I also began to get acquainted with the wide variety of possessing spirits, none of which I could control or even influence. Of these, the devi-devtas—minor local deities, and the spirits of departed relatives were relatively benign. Whenever an exorcist succeeded in summoning one of them up for a dialogue, the spirit either complained of the possessed person being ill treated in the family or of certain obligations towards the dead not being fulfilled by the living. These spirits were easily satisfied and would agree to leave the patient, most often young people in their teens or early twenties, if remedial measures were undertaken and atonement rituals were performed. Much more malignant were the demonic spirits who had the power to make a person seriously ill and stubbornly resisted an exorcist’s efforts to make them quit the patient’s body.
The malignant spirits of which I speak here are collectively known as bhuta-preta, though Hindu demonology distinguishes between various classes of these supernatural beings. The bhuta, for instance, originate from the souls of those who meet an untimely and violent death, while a preta is the spirit of a child who died in infancy or was born deformed. A third class, that of pishacha, derives from the mental characteristic of the dead person: a pishacha being generally the ghost of a man who was either mad, dissolute or violent tempered. In addition, to complete the malignant pantheon, there are a few female spirits of which the best known is the churel—the ghost of an unhappy widow, a childless woman or, more generally, of any woman who lived and died with her desires grossly unsatisfied.
The bhuta-preta are said to exist in a halfway home between the human world and the world of ancestral spirits (pitri-lok). Until they have been judged and have paid their karmic debts, and are allowed into the world of ancestral spirits, they continue to yearn for a human body which they can enter and contrive to make sick through their nefarious activity.
Muslims give an additional gloss to the world of demonic beings which, they say, have their origin in jinn—spirits, one of the three classes of beings higher than humans, the other two being farishta—angels, and shaitan—satanic beings. ‘Each human being has its own jinn who is born with him and stays with him till he dies,’ a Muslim exorcist had explained to me. ‘When the angels come to take away the soul of a good man, they kill the jinn. This is the reason why we Muslims bury a dead body and you Hindus cremate it—to ensure the death of a man’s jinn. Sometimes, however, especially in the case of a sinful man, it happens that the jinn escapes by hiding in the organs of elimination, which are impure and cannot be reached by the angels. He then becomes a demonic spirit and is on the lookout for a victim in whose body he can find a home and whose blood he can drink.’
Whatever their origins, demonic spirits were, and continue to be, a tangible, living presence for many Indians. Even without being possessed, a person may have occasional encounters with the spirit world, and not only in her dreams, without these encounters being necessarily regarded as auditory or visual hallucinations. I had no difficulty in understanding, however incompletely, cases of spirit possession in the psychoanalytic idiom of unconscious and unacceptable wishes straining towards conscious awareness and the consequent inner conflict that was resolved in symptoms of possession. My problem was that the possessing spirit, which also represented the patient’s cultural conviction that an external agent was responsible for her distress, was impervious to my Freudian method of exorcism: introspective self-reflection.
Although I consistently failed with patients who were convinced that they were possessed by spirits, it does not mean that psychoanalytic therapy is not possible with traditional Indians and has therapeutic uses only for their modern, Westernized counterparts. Not all traditional Indians believe that emotional distress is caused by outside agents such as planetary constellations or demonic spirits of various kinds. Psychotherapy is eminently suited
to relieve emotional distress in many other Indians steeped in their traditional culture. These are patients who may be traditional in their lifestyles but are psychologically modern. It is important to remember, first, that psychological modernity is not identical with historical modernity and, second, that it is not a product of post-Enlightenment Europe. Psychological modernity is the individual’s recognition that he/she possesses a mind, with all its complexity. It is the acknowledgement, however vague, unwilling or conflicted, of the mind’s subjectivity that fates one to episodic suffering through some of its ideas and feelings (in psychoanalysis, murderous rage, envy and possessive desire), together with the knowledge that the mind can help in containing and processing disturbed thoughts and emotions. A Hindu who is literate in his tradition would agree, saying that human suffering is caused by the five passions of the mind: sexual desire, rage, greed, infatuation and egotism. Similarly, a Buddhist too would ascribe suffering to causes internal to the individual, a clouding of perception due to anxiety, greed and envy which form the cluster of ‘grasping attachment’. Whether in traditional India or in the modern West, psychoanalysis is only possible with persons who are psychologically modern in the sense that they believe it is not an external agent—an angry god, a malevolent spirit, the karma of a previous life—but their own mind which is both the fount and the potential healer of their emotional suffering.
The setting up of a psychoanalytic practice in Delhi was both easy and difficult. It was easy because on the supply side there were only two analysts, one of them non-practising. This was Shib Mitra, a gentle, unassuming man who had presented the paper on Tagore in Erikson’s Ahmedabad seminar in 1964 and was now the head of the National Council on Educational Research and Training. (He also became my supervising analyst for the two cases I needed to graduate as a full-fledged member of the Indian Psychoanalytic Society.) The start of clinical practice was difficult because the vast majority of my prospective patients had never heard of psychoanalysis even though Freud’s thought had arrived early in India. In fact, the Indian Psychoanalytic Society, formed in 1922, became a member of the International Psychoanalytic Association before such recognition was accorded to organized psychoanalysis in most European countries.
Freudian thought had encountered a good deal of hostility from the Indian intelligentsia. The Marxist intellectuals rejected its emphasis on the individual while the more ‘idealist’ philosophers decried its materialism and its penchant for looking for clay feet in all gods. They were uncomfortable with Freudian iconoclasm, with its ‘hermeneutics of suspicion’. Sri Aurobindo, an influential mystic-philosopher, exemplified this trend when he wrote, ‘one cannot discover the meaning of the lotus by analysing the secrets of the mud in which it grows . . . [Psychoanalysis as a science] is still in its infancy—inconsiderate, awkward and rudimentary at one and the same time.’1 Many Indian intellectuals, even those who are not professionally engaged with Indian philosophy (and its partiality for what I would call a ‘hermeneutics of idealization’) continue to echo this attitude. In addition, following a contemporary trend within Western psychiatry, there is an ill-informed dismissal of psychoanalysis as being obsolete, a judgement that ignores the fact that irrespective of theoretical orientation, whether cognitive, behavioural or any other, the essentials of psychoanalytic therapy constitute the core elements of all psychotherapies.
Not that psychoanalysis as a universal theory of the human mind does not have some grave problems when it is applied to non-Western cultures. In my travels through Europe and the US I am often asked whether psychoanalysis is at all possible in a traditional non-Western society such as India with its family system, religious beliefs and cultural values different from those of bourgeois Europe in which psychoanalysis had its origins. I do not give the easy answer that Indian analysts practise in the enclaves of Western modernity in Delhi, Mumbai, Kolkata and Bangalore. Here, among the upper and upper middle classes, there are enough patients—mostly from the modern professions of advertising, journalism, medicine, law, the academia and so on (a clientele with a sociological profile that is not dissimilar to one seen in other parts of the world)—who have felt powerfully attracted to the pleasures of individuality, ‘of living life on one’s own terms’. Living in a society where the bonds of family and community are the most valued part of human existence, these are people who have felt suffocated by the weight of family expectations and obligations, and look to psychoanalysis as an ally in their struggle for individuation. Clinical work with this class of patients is not radically different from that in the metropolises of Europe and North America. Psychoanalysts from outside the culture, encountering the strangeness of the cultural mask rather than the similarity of the individual face, may get carried away into exaggerating differences. However, if they could listen long enough and with a well-tuned ear, and pay close attention to the patient’s symbolic and linguistic universes, they would discover that the voices speaking of imperious desires, the stabs of searing, burdensome guilt, and the voracious hunger to merge with the beloved and the despair at their absence, are as much evident here as in the analysis of Western patients. I hasten to add that in spite of the similarities between the Indian and Western clientele for psychoanalytic psychotherapy, I do not mean to imply that there is no difference between patients from Mumbai, Madrid or Munich. Middle class, urban, educated Indians, although more susceptible to the siren song of individuality and closer to their Western counterparts on this dimension in their experience of the self, are nevertheless not identical with the latter. They share with traditional Indians their world view and many of the broader social and cultural patterns that are fundamental to the formation of the self.
But I know that the questioner is seeking an answer to the relevance of psychoanalysis for the majority of Indians who are still firmly rooted in their civilization. My answer is that, yes, traditional India is indeed very different. There is an emphasis on the extended rather than the nuclear family, mother goddesses are more important than a father god, the nature of a person is not viewed as individual and instinctual but as inter- and trans-personal. Further, there are fundamental differences between traditional India and the modern West on the nature of human experience and the fulfilled human life. And yet my experience with traditional Indian patients teaches me that psychoanalysis is still possible, if (as the Indian astrologer said on being asked how he cast horoscopes when new planets have been discovered which are absent in his ancient system) ‘one makes the required adjustments’.
Some of these adjustments were related to analytic technique which I found difficult in the beginning because when starting out as an analyst, one tends to be more orthodox than the pope. I realized quickly enough that like my own unconscious demands on Dr De Boor, my training analyst in Germany, my patients too regarded me more as a guru than a doctor. I needed to interpret and practise the commandments of the psychoanalyst being a ‘reflecting mirror’, maintaining ‘neutrality’ and ‘abstinence’, in the cultural context of an overtly compassionate guru-disciple relationship. The analyst’s humaneness, sympathy and therapeutic intent could not be subtly conveyed in an atmosphere of reserved formality as in the West, but needed a more open and active expression. I constantly struggled with the contrasting demands of my culture and those of my profession, making such compromises as agreeing to meet the family of patients for a single interview but refusing to take their sister, mother and father as patients or accepting their insistent invitations to dinner at home with the family.
Another adjustment to analytic technique had to do with how active or passive an analyst should be in the analytic situation. For the traditional Indian as for the modern Western patient seeking psychoanalysis, introspection is the royal road to the healing of emotional distress. Yet traditional Indian introspective methods, the meditations of various psycho-philosophical schools of ‘self-realization’, are not the same as the introspection required in psychoanalysis. A Western discipline, psychoanalysis has built on
the introspective elements of later Greek thought where the definition of the self became contingent upon an active process of examining the events and adventures of one’s own life, as typified by the Socratic phrase ‘Know thyself.’ Indians, or rather the Hindus, too, have a similar injunction, atmanam vidhi—know thy self. However, the atman or self they are talking about is very different from the one referred to by Socrates. It is the metaphysical and not the biographical self, uncontaminated by time and space, and thus without the life-historical dimension that is the focus of psychoanalysis. A traditional Indian is thus psychologically modern but he or she may not be psychologically minded in the psychoanalytic sense. Quite apart from the introspective capacities of an individual patient, European or Indian, biographical introspection may then have to be taught and Indian analysts are thus necessarily more actively didactical at the beginning of an analysis with a traditional Indian patient than their Western colleagues. This was at least my experience over the years when I often felt helpless as patients resisted travelling on the path leading to the biographical self. But then, I always consoled myself with the thought that Freud himself had called psychoanalysis one of the impossible professions. With almost all of my Indian clients, I soon learnt that I had to make some changes to the analytic techniques I had learnt in Germany. I had to confront the fact that for most of these patients, emotional problems did not have a biographical dimension. I had to be more active, even leading, in the sense of often asking the patient ‘When did you first feel that way?’ in order to direct her attention to the life-historical antecedents of a particular emotion or problem. Or, when someone attributed the disorder to the karma of a previous life, then I would convey that early childhood is also a forgotten, early life whose karmic effects on the patient’s current situation we were exploring together.
