Mushtaq A Margoob is an internationally recognised expert on disaster psychiatry. A faculty member in the department of psychiatry, Government Medical College, Srinagar, and honorary director, Advanced Institute for Management of Stress-related Disorders, Margoob spoke to Humra Quraishi .
Srinagar , Aug 04,2010
A decade ago, you said 90 per cent of the Kashmir valley's population suffered from emotional distress due to the persistent violence in the region. What is the condition today?
The amount of emotional distress, caused by the perpetual state of uncertainty, insecurity and moment-to-moment living, is hard to imagine. More than 58 per cent of the adult population has experienced or witnessed traumatic life events. The disabling disorder PTSD is currently prevalent in more than 7 per cent of the population. More than 19 per cent of people suffer from depression. Women and children are the worst affected. Take the children between 5 and 12 years living in orphanages. More than 40 per cent suffer from PTSD, 25 per cent from depression and more than 12 per cent from conversion disorder. Kashmir is today among the world's worst medicinal opium preparation abuse places.
What could be the impact of the death of young boys and teenagers?
Harm deliberately caused by others can lead to shifts in societal conventions and processes, including an increased sense of rage and entitlement to revenge when mourning loss or reversal of feelings of helplessness and humiliation. Under such circumstances even a fully-grown up adult's brain automatically shifts operations from highly evolved reality-based action processes to instinctual/emotion-based reactions. Since the young brain is yet to fully develop psychological mechanisms, children/adolescents are much more vulnerable to emotional actions and reactions. When they assume that they are getting pushed against the wall they get dominated by their emotions and stop caring for the consequences. Youngsters identify with the group rather than with their individual identities and can accordingly get heavily involved in activities that essentially had been nonexistent in the society earlier. Young Kashmiris reflect the above-referred psychological processes in more ways than one. The recent developments of defying law and order could also be a manifestation of the ever-increasing indescribable levels of frustration and anger among this 'trauma generation', who have hardly seen a minute of complete peace or tranquillity in their lives.
Could there be some relief or emotional cushions for the affected?
The specific issues pertaining to children and adolescents need to be understood with the appropriate psychological perspective. They can't be treated as miniature adults. Of the many people exposed to stress, although only a minority ultimately develops full-blown psychiatric disorders, a significant proportion suffers from a dissatisfied life on account of unrecognised emotional issues and different psychosocial problems/adjustment difficulties. Post-disaster survivors are charged with a mix of disbelief, anger, grief and frustration, which they need to ventilate. Supportive listening without excessive probing into the event is extremely helpful to relieve survivors of their emotions. Appropriate psychological support can remarkably enhance the capacity of the affected to regain the power to resolve problems. This can be achieved by helping survivors to get back their psychosocial skills, which can be of immense help to prevent future emotional complications and associated disability. Spirituality is also a strong tool to reinforce resilience among the survivors and cope with various difficulties through the course of trauma.