Guiding the confidential into public discourse

Abstract

In recent years, popular media has made several attempts to allow its audience to be privy to interactions within the therapy room that are otherwise considered private and confidential. Some examples are Treatment (2008-2021), an American television drama series, or popular Indian films like Dear Zindagi (2016) or Kaasav (2017), among others. And How Do You Feel About That? Breakdowns and Breakthroughs in the Therapy Room is a compilation of 50 short fictionalised conversations that transpire between the psychotherapist and their patients during the process of therapy. Authors Aruna Gopakumar and Yashodhara Lal adopt a similar approach that involves fictionalising experiences and conversations that are inspired by real life encounters. The authors, both practising therapists, use a conversational style of writing while alternating between their individual and unique narrative experiences during clinical practice. The 50 vignettes are written from the perspective of the therapist and involve recreation and fictionalisation of the voice of the patient. The genre and the style, therefore, bring to light conversations that are otherwise hushed in India, largely due to the stigma that shrouds the process of seeking help for mental health concerns. In addition to puncturing existing social stigma, such an approach enables the demystification of mental health, making it vastly accessible and welcoming for those who wish to engage with such dialogues (p xiv). This approach, in turn, respects the larger ethical principles of privacy and confidentiality that remain sacrosanct to the treatment and study of mental health concerns. Gopakumar and Lal rely on the psychoanalytical theory of Transactional Analysis (TA) — a term coined by Dr Eric Berne — which becomes the common thread that sews the individual stories together. Such an approach aids the authors to highlight and communicate the multifaceted nature of mental health concerns and their treatment. In this process, the patient is seen to create alternative meanings to concerns they face — by revisiting past discomforting experiences in new ways that make them feel safe (p xvi). By using such a method, the patient learns to address, empathise, and resolve concerns, by placing themselves in the shoes of others; or in this case, by confronting concerns by imagining the involved parties sitting across on empty chairs.