For a safe space...

While much is spoken about depression, anxiety, and suicide, one needs to dwell on an important link between relationships and mental health. Traditionally, close relationships have been viewed as ‘safe spaces’. A safe space is an environment where an individual can express themselves without fear of judgement. Such relationships are nurturing and enabling. Healthy relationships in turn have positive mental health benefits.

Being in a healthy relationship has been shown to be associated with lower rates of depression, suicide and drug use. Children from stable family environments have also been shown to perform better in comparison to peers from troubled backgrounds. Moreover, even amongst persons with psychiatric ailments, having family support has been shown to help with their recovery. However, recent media reports of gore intimate partner violence/ partner homicide highlight how not all relationships are safe spaces.

The recent National Family Health Survey-5 (NFHS 5) showed that domestic violence was prevalent in roughly one-third of those surveyed. Oftentimes, cases of domestic violence are under-reported, so one may guess that the actual reality is bleaker. The fact that abuse, especially spousal abuse, is normalised in a lot of families makes it harder to reach out and help these victims.

When one considers violence in relationships, physical, sexual and verbal abuse is what one thinks of. While these are particularly concerning and dangerous, one mustn’t overlook the other kinds of abuse, namely emotional abuse and financial abuse. These latter forms of abuse play out subtly and may not be obvious initially. Behaviours such as controlling a partner’s activities, restricting their interactions/access to family and friends or deliberately behaving in a manner intended to humiliate the victim are a few different examples of emotional abuse. Financially exploiting a partner or restricting their access to financial resources is also common. Stalking, and now, cyberstalking, is another such form of abuse.

Elder abuse is yet another form of abuse in relationships that people don’t notice. The innate vulnerability associated with ageing makes the elderly a vulnerable population.

Such forms of abuse in relationships are a harbinger of adverse mental health and form a risk factor for illnesses including anxiety disorders, depression and suicide. Children who grow up in such families are also at risk. Research has established that children who grow up in settings of violence go on to develop anxiety disorders, behavioural disorders, drug abuse and have poorer academic performance. In fact, such children have also been shown to be more likely to be perpetrators of abuse later in their lives.

Professional help to deal with abuse and work on problematic relationships is available. Most psychiatric facilities have counselling services. The government and various NGOs run domestic violence helplines, including the Vanitha Sahayavani (080-22943225). Legal recourse is also available.

While post hoc solutions are available, emphasis should be given to cultivating healthy relationships. We can start early. Teaching our children to respect not only elders but everyone alike is an important first step. Promoting gender equality in homes is another obvious step. One way to do that would be for both parents at home to take up household chores disregarding traditional gender stereotypes.

In relationships, one must work on communication. Relationships where there are open and accessible lines of communication tend to fare better.

While negative emotions are natural, one must learn to express that hurt in a constructive manner sans any aggression. Its best to avoid saying things in the ‘heat of the moment’. This could be done by way of communicating in a calm manner and focusing on facts.

For the receiver, a key would be to practice empathy, i.e. put yourself in the other’s shoes and see why they ‘re saying/ feeling the way they are. Remember that it takes a lot of effort and trust to express these emotions and this must be met by a sincere effort to redress this on the other end.

Finally, it’s essential to acknowledge that healthy relationships are not devoid of conflict, but the goal would be to overcome these challenges in an honest and respectful manner. And despite this, there may be times when things don’t work out, and that would be the time to look for professional help.

Families can also focus on fostering happy and healthy relationships. Today, much of our lives are run by the clock. But spending quality time with a loved one can help build a good relationship.

One can focus on making good memories through positive interactions. It can be as easy as taking a daily walk with your partner, or sharing a hobby with your parent/child. It’s important to always seek for new ways to communicate with those with whom we have a close relationship. Ensuring financial independence is of utmost importance — be it in the elderly or women. 

Finally, it’s important to remember that counselling and professional help need not be only for problematic relationships. Professional intervention can help better any relationship. Healthy relationships can in turn nurture healthy minds.

A universal human right 

October is a special month for mental health advocacy as October 10 is observed by the World Health Organisation (WHO) as World Mental Health Day. This year, the theme for the day is “Mental Health is a Universal Human Right”.
The idea behind this theme is two-fold: the first is to ensure that quality mental health care services are available and accessible to all those in need, and the second is to advocate for the rights of persons with mental illness (PWMI) and ensure they have equal opportunities made available to them.

Over the past few years, advocacy by organisations and individuals has ensured that the spotlight is on mental well-being vis-à-vis mental illness.
The Covid-19 pandemic has had a significant role to play in this regard. On the one hand, it has shown us that all of us are vulnerable to mental health problems. The emotional impact of those long days of social isolation and lockdown combined with the fear of the deadly virus is still quite fresh in our memories.

But one positive fallout of the pandemic was the widespread use of telemedicine. Telemedicine, and in particular telepsychiatry services, has made quality mental healthcare accessible to a larger chunk of the community. Moreover, the luxury of accessing psychiatric services from home has helped negate the stigma that still rides with walking into a psychiatric facility.

Ways to address abuse in relationships

♦ Be aware of the forms that abuse can take in relationships. ‘Being in love’ or respecting a partner doesn’t entail putting up with abuse.

♦ Do not normalise abuse in relationships.

♦ It doesn’t ‘get better’ with time, so seek help at the earliest. Encourage friends/ family members who are victims of such abuse to seek professional help.
If a family member has a mental health condition, encourage them to seek professional help. Remember that mental health conditions can affect anyone, regardless of their personality or background.

(The author is a consultant psychiatrist and can be reached at [e-mail])