Archive for the Medical Category

“The Cane are my Eyes”

Posted in Analysis, Bangalore, Bathroom, Colour blindness, India, Medical, People, social networking, Society, Welfare with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on April 10, 2012 by Poonam Vaidya

This article Is divided into categories, so if one sounds boring, just skip to the next subtitle, I promise it gets more interesting as you go along…

Introduction To The Cane:

Today, I went to EnAble India for training in mobility.  going there was easier than a walk in the park for me,   I had the support of my mother, who I joked was my “fat cane”, who could drive me to the building,  walk me in, and sit there until I was done, at least for the initial week. I have been there for about a week.

On the first day, my trainer, Geeta H.S., who is also visually impaired, showed me how to use the cane. The parts of the cane are as follows; the top, which has an elastic band, which I used to loop around my wrist. The middle is called the shaft, and the end the tip. The cane is white, and folds into 2, 3, 4…depending on height.

The cane is held in a fist, with the index finger guiding it.  In only two days, I was able to find my way around the building with my eyes closed.  The hand holds the cane at the stomach level, and the wrist moves in two ways…in an arc, which involves tapping the cane from left to right. The other is used indoors, where the cane tip moves from side to side, not leaving the ground, as the cane makes a tapping sound when it hits the ground, which can disturb people. The ground indoors is also smooth; therefore, one can glide rather than tap. Both movements are made at the distance between two shoulders.

The cane is held together by elastic, and costs R.S.100, but the training at EnAble India is completely free. Apart from teaching mobility training, computer classes are also conducted.

Though located on a narrow, busy road, the training for mobility is done outside the institution. I was taught how to climb a flight of stairs (with the cane held like a pen, dangling) pre-cane skills included keeping your hand a few inches away from your forehead, and the other diagonally at the stomach, in order to avoid hitting things at both levels. Trailing involves running the hands along the walls.

Need For Encouragement:

On the fifth day, I was told to leave the building, which I put off, as I was simply too afraid to walk on that horrible road. My mother refused to allow the trainer to take me out, so I practiced in the building, which I was already able to walk around in, without a cane. Even. So I was quite bored. I guess the pointlessness of the endeavour showed on my face, and I was glad it did, as what happened has inspired me to write all of this.

The computer classes had just ended, and Geeta called around four mobility-trained blind students, and along with me, the six of us formed a rough circle. The four of them, Noor Jahan, Dhanya, Mahandra and Neetu, told me about the daily problems they faced, and how they had more or less come to terms with them. I have acquired their on-the-spot permission before writing this.

Dhanya’s Story:

The first to speak was Dhanya, a girl of roughly twenty five, who had recently lost her vision due to a neurological problem, a condition similar to mine. Perhaps it was the similarities between us, or the way she told her story, or possibly how hard her life had become after she had become visually impaired, where as mine had only changed in terms of independence and freedom.

Dhanya, who lived in Kerela, had a supportive family, she and her brother were very close, and her family was proud of their beautiful daughter. After being struck by an unknown neurological problem, she lost her sight. Her life changed drastically. At first, the family support was given without a second thought. She would hold her father’s or brother’s hand and go everywhere.

Things started going downhill when the questions began to pour in. social norms are different in smaller cities. In India, people know each other and don’t hesitate to ask passer-bys personal questions, or comment on out-of-the ordinary occurrences. People would stop her father and ask about his daughter when spotted walking along the road, hands linked. A detailed explanation would be demanded, followed by a sympathetic sentence or gesture. “Why has god done this?” Or “such a beautiful daughter, now how will she get married?” Or the clichéd “don’t worry, things will be okay”, something I have heard so many times. I sometimes retort, “no, they won’t, but that’s okay”

At first, her family members would go through the routine of explanation and patiently listen to the sympathetic comments of strangers. But this monotonous and embarrassing occurrence began to greatly affect Dhanya’S freedom, her confidence and the family’s behaviour towards her.

They stopped taking her out. She would spend hours alone at home, helpless and stranded. Her house was now her prison. She told us she felt alone and abandoned, “Like an animal, my family began to hate me”

In family functions, where all members were required to attend, the family would grudgingly bring her along, but after showing her face, they would banish her into an empty corner, or if possible, a dark room. She remembers sitting there for hours, waiting. She related to us the incident, when she was dying of thirst and she heard her brother, and begged him for water. Not wanting to be troubled, he told her he was on the phone and walked away. “I came to know a thing or two about human nature on that day” she remarked sadly.

Incidents like this caused her to fall gradually into depression. “Why am I alive?” she thought. She was frustrated with life and tried to end it all, but the will to live within her was strong, and made her determined to somehow become independent.

At around this time, she learnt about EnAble India and the mobility training it offers. She decided to travel to Bangalore though her family was dead against it. The fact that she was using a cane instead of taking the help of a family member would not look good to the world, and they were worried about the family’s honour. But she was determined to be independent, and finally, her brother and her left for Bangalore, and are living here for some time now.

Dhanya describes her training as a very slow process. She was a slow learner, and would refuse to move at times, and she walked very slowly. Today, however, she says, with laughter in her voice, that she walked to the recharge shop and recharged her phone all by herself, with her trusty cane, hence, depriving her brother of his twenty rupee tip.

Mahandra’s Story:

The story of Mahandra is of a carefree, jovial and fun-loving youth. He lost his sight, but refused to use the cane, a sentiment I’m fully familiar with. He was terrified of being singled out of the crowd, or being looked upon with pity, or recognized by the few relatives he had in Bangalore. Being originally from Chennai, he used to live with his uncle and took the support of his friends when he had to go out. Almost three years later, when he was sick of the continuous dependency, he forced himself to get over the social fear and learnt to use the cane at EnAble India. He told us, with what could have only been a sheepish grin,” the cane are now my eyes, it is my friend, my wife, my life.” Mahindra now travels across the city with the help of his cane. He uses the local bus, walks around and goes to eateries and shopping malls. “I can’t believe that the one thing I hated is now my saviour” he says, humbly.

Noor Jahan and Neetu’s Story

Next, It was Noor Jahan’s turn to tell her side of the story. She was a girl from a small town, blind from birth. She moved to Bangalore, and is now independent and can use the computer to its full advantage.

Neetu was the last one in the group to speak. She told us that she, too was blinded recently, but she, like me, had a family that supported her. She has now acquired a job at Accenture, a very famous I.T. company. When she was blinded, her father was very distressed, despite this, he immediately found out what she should do about her future. “his efforts have definitely paid off” says Neetu,  pride in her voice. Her father found EnAble India and she has learnt everything she needed to cope with her life there.

Progressing:

It has been almost two months since that week, and since then, I have come a long way. I now can walk on the road, (main road, even, with no shoreline) cross smaller ones, and hopefully, find out which building I want to go into, from ‘clues’. I have walked on several kinds of roads, as one is spoilt for choice around the training centre and the main office, the two places I’m practicing from. Roads without shorelines (footpaths), roads with a row of cars, motorcycles, and even buses, roads with piles of leaves, stones, trees, mud…I’ve done it all. Especially the uneven, uphill road with sudden ditches and craters, which is an uphill and downhill climb, is especially difficult.

The things I find really difficult are finding turnings, walking straight in the middle of the road, finding out where the cross-roads are and also knowing where I am. In order to find a building. When things are noisy, or my concentration is divided between walking, like for example, walking and talking, or listening to someone or something like that, I am less able to manage by myself.

A Lesson in Dealing With Nosy People

A lesson on dealing with society was unintentionally given, as well. It was almost like my trainer had planned it all, it was so unreal. I had practiced for almost a month at the training centre. I knew almost all the basic rules, stick to the left side of the road, wait until there is no sound of a vehicle before crossing a road, raise your hand before beginning to cross, keep walking even if a car suddenly seems to be coming towards you (very, very scary) and how I should never hesitate to ask anyone for help (easier said than done) I joked to a friend that raising my hand looked like I was enacting how I answer my attendance.

My training centre had moved to the main office of EnAble India, and I was walking off the side of the main road I had never walked on before. It was a bright and sunny day, the worst weather for my vision. I was using the cane to walk, as usual, when a woman streaked something in Kannada, the local language of Karnataka, which, though I have been living in for twenty two years, have never been able to learn. My trainer, Geeta, told me that she was freaking out about the cane, saying “She’s blind, she’s blind.” I was quite embarrassed. At least she went away, I was glad. But things were about to get much worse. A man approached us and began to interrogate Geeta.
“What has happened to her?”

“She can’t see”

“What is she doing outside. Then?” he demanded. An edge in his voice.

“She is training, I’m her trainer”, Geeta said, calmly. I was getting more irritated. This was reminding me of Dhanya, and I had thought, when she was telling me about those nosy people in Kerela, that if I was in her place, I would have told off those people. Now I was in her place, and I found it was a very difficult one to be in. however, I wanted to stick to my words, so when the man said, “training? On the main road?” incredulously, with reproach in his voice, I could not hold my tongue any longer.

“Yes,” I told him, “I am on the main road. And I know I am. If I wasn’t okay with walking here, I wouldn’t. no one is forcing me to be here, I am training here by choice, so you needn’t worry” the tone I used was highly sarcastic. Maybe it was going too far? Could he help it if he was such a curious soul? Anyway. Though I couldn’t see his face, I knew he was insulted, and went away, saying “thank you very much” in an equally sarcastic tone. Oops. At least we had gotten rid of him, though I’m sure he was saying something like “I’m glad you can’t see, you deserve it” or something like that.

If this much wasn’t enough, a watchman, on realizing my condition, instantly appointed himself my guardian angel. Though he didn’t ask any difficult questions, he was as bad as the previous one, though his sin wasn’t curiosity, but helpfulness. He failed miserably in his ‘good deed of the day.’ In fact, if led only by him, I would have been standing in the middle of the road. We were facing opposite directions, and he would say “left” when I was supposed to go right, and visa versa, and Geeta would say “right”. So I had two people telling me to go different directions at the same time. I get distracted easily, so I froze and tried to listen to Geeta’s instructions, who told me to ignore the watchman, who just spoke louder. I began to wonder if he had a sadistic side to him, after all. Luckily, after we passed him by, he didn’t rise up from his seatgn and attempt to help any further, or else I would have told HIM OFF, AS WELL. Thus, ended my training of the day, as well as an introduction of how people will react to me when they see me walking around with a cane. I used to always hold my companion’s hand and walk around, and no one lifted an eyebrow. They probably thought I couldn’t walk properly, or something. They never asked.. Now,I said to myself, welcome to ‘the world of the cane’

To the post office and back

It has been almost four months since I have started my mobility training. I have moved from walking around in a small room to travelling to the post office every day. I think that’s an achievement, but my trainer doesn’t think so. She has told my mother and brother that they are no longer allowed to join us, as she believes that they provide me with a sense of security I must not get too familiar with, especially if I truly want to be independent.  In these past months, I have moved from ‘anti-cane mode’ to the ‘cane mode’, the latter i employ  in training, where I am facing the outside world without any social pressure about who is watching me, and what they will think when they see the cane, to the former, where I’m hyper-ventilating about even bringing the cane.

Barking dogs, parked vehicles and nosy people are the most common irritants I face on my daily training routes. I have always loved animals, particularly dogs, but when these friendly, domestic animals bark and growl, I can’t help picturing a rabid dog, teeth barred, saliva dripping from its mouth, a menacing glint in its eye, running towards me, ready to pounce. The rattle of the gate is the most reassuring sound in these situations, though my heart still pounds until I know I am a safe distance away.

I recently encountered a particularly disagreeable car on my way to the post office. It just stood there, innocently, until I touched it with my cane. The  car burst out in a loud protest, complete with police and ambulance sirens, plunging the relatively silent street into the  catastrophic atmosphere of an urban crime scene.i froze, and my trainer told me to ignore the noise, and continue, so I turned my back to the car, and pretended like nothing had happened, the sirens fading with distance. On my way back, I did not have another embarrassing incident, as  my arch enemy had fled, ‘with its tail between its legs’ I imagined, with morbid satisfaction..

Help me cross the street, NOW!

I think this, as I stand on the main road, and try to find a person who will help me cross, but if you can’t see, how will you ‘find’ anyone? My trainer does this for me, and I cringe with unease, especially when some refuse. Generally, the victims of this question are people I can hear, like a conversing couple, a large lively group, or a person on their mobile phone. Them, or someone with a broken slipper. Now, take your pick…you don’t want to ask anyone of them, do you?

Where the hell am i?

The biggest problem I face is knowing where I am. When there is no sidewalk, how does a blind person figure out what is a straight line?  It’s something you have to learn, and I am terrible at it. Especially when there is no shoreline (footpath), I begin to drift towards the middle of the road. My trainer warns me, though, and I haven’t died yet, right?

How do you find a house? You first familiarize yourself with the gate, the porch, and the road it’s on. If in doubt, go up to the building’s gate and feel around. So if you see a person with a white cane, feeling up your gate, don’t panic, they are just trying to figure out whether this is the house they are looking for. Preferably, ignore them.

How do you know that there’s a cross-road? The cane tells you, the ground feels different. Though, it is very hard for me to figure out. I prefer to use my ears to detect a vehicle turning off, or the trusty pole that’s at the end of most cross-roads,boards, ditches, and smells help us figure out where we are placed, even if I still don’t know what straight is.

Photo shoot

enable India keeps a file of all the candidates. To show other people interested, a day was kept aside for a photo session, where a camera-man took shots of me in training. I have never looked more artificial in my life, and I pray that those photos never see the light of day. Perhaps, if I practiced some poses…

Public Help

A few days ago, I finally managed to make the trip to the post office, three out of three times, without any problems. Asking people for help to cross the road has become easier. I somehow only choose users of strong and fragrant deodorants wait—that’s hardly a mystery. A good Ax advertisement, many I have told have commented.

Asking people is difficult, even more so, as you aren’t an old lady with a walking stick, who can bend her back, and look at you beseechingly, but, to society, you present a formidable figure, who is difficult to approach. If for no other reason, because they sometimes have an image of the blind as someone violent, and the cane, if used is a weapon… Some have just seen too many misleading movies, where the blind person is the mastermind of some evil scheme, or else is actually a sighted person who uses the cover to steal.

I have felt more than half the people tremble whilst holding my hand, cursing themselves for accepting my request to help me cross, probably as at that time, they feel the burden of being blind.

I know it sounds implausible, but that’s the truth. They are solely responsible for you for those few seconds. They realize that if they aren’t careful, for themselves as well as the blind, they can easily be in danger, and it will be solely the helper’s fault,.

And, of cause, the old woman has the luxury of being able to choose her helper. Will it be the cute ten-year-old boy, or the young, pretty lady? We will never know how our helper looks, well—the completely blind, anyway. They’ll only be able to figure out if they are male or female. I can generally figure out most of the details about these people

Now coming to the biggest problem regarding people, where are they? One can’t just shout out “help me!” on the road. Probably, above the noise of the vehicles, they won’t even hear you. “Listen to the sounds” says Geeta, my trainer. “Hear that slap-slap of those chappals? Or the swishing of a skirt?”
“but these sounds are so soft!” I wail. How am I supposed to hear them with these idiots horning in my ear?”
I finally squint at the shadows moving to and fro.
“Um…uh…” I work up the courage, but before I can say more, they have gone.
Some helpful souls purposely walk slowly, anticipating the question. They really want to be of assistance, bless them; a soft clearing of the throat can instantly bring them to your side.
“Yes?” you can actually hear the enthusiasm in their voice. Things will always go smoothly from there. After you have crossed, they will direct you to the place you are seeking to find, and usually offer their help, which is best avoided, especially in training, if you wanted someone to help you all the way, why even use the cane??

I know I sound angry at these people, but really, I’m not. It’s only the ones who make a fuss, like the woman who ran around, screaming in Kannada that I was blind, who really get on my nerves. In fact, my mother watched as a young girl crossed the street to help me cross it again. Some people will wait for you to ask, some will approach you, some will help you only if they can’t help it (it’s very difficult to tell a person in need you can’t help them, when they know you can) and those very few, who will refuse to help, because they are too scared of the responsibility or just have their own problems.

My Last Day

The last day of my training was on June 14th, and it was a really difficult day to forget. It started with Geeta’s plan to walk only one way, that is, from the main block to the training centre. I hadn’t told my mother this, who was going to pick me up. We reached, and I sent a message to my mother that I was at the training centre. We waited. Geeta started to have coughing fits, and couldn’t get any water from the training centre, as it was closed that day. We just sat on the stairs. Finally, I called my mother, and my brother’s voice came on the other line, and told me that mom had left her phone at home, that meant that she was waiting at the main block. We decided to walk back really fast. Geeta had to leave to Hyderabad the next day, and half way, it started to rain. I even suggested that Geeta call the main office, but she told me that everyone went home at six o’clock, and it was six-thirty already.

Half way there, however, Geeta got a call from her colleague, informing her that my mother was waiting. We rushed even faster, and finally reached the car. Geeta had invited us home, so we took her through winding lanes; it had started to pour in earnest now. Through the rain, my mother squinted at the road, and finally found Geeta’s house. We went inside. We met her mother, and I spoke to her as a friend, realizing that she was no longer my trainer, though she invited me to drop in for training anytime I was free. Geeta has always been so patient and good-natured. I will certainly miss walking down the road with her, and asking her random questions, some very difficult ones. “You have learnt most of what I could have taught you, the rest will come from practice. Always be confident,” were Geeta’s parting words to me.

I have thought many times of quitting. Many blind people don’t know mobility, I tell myself. Why should I know? I have a good support system. Where ever I go, I’m sure there will always be someone to help me walk around…

But I kept at it, and today I’m glad. I know that there’s only one really reliable person in this world. And that’s me. Being independent is the first step to looking your troubles in the face. Sometimes, it is difficult or embarrassing to walk with the cane. I myself must admit here, that I use it very less. But I know, if in any emergency, I can whip it out, and find my way around. So I suggest this to all. We visually impaired can never learn to use a car or bicycle (though, there is a man who has designed a car that can help a blind person drive, so never say never.) But, mobility training for a blind person is like learning to drive for a sighted person, except that there’s no license involved.

Going out

The following is written for sighted as well as the visually impaired. It gives examples of a blind person’s experiences after he has learnt mobility.

If someone did a survey, I’m sure they’d find that most of the visually impaired don’t really go out that often. We tend to stay at home, as we know the ropes there. Outside, in the big, bad world, everything ceases to be secure. We may not like to admit it, but we have more need for security than the spirit of adventure. But, I must say that ever since I became visually impaired, things have actually got a bit more exciting.

I am not saying that I am glad that this happened, but seeing the bright side of things is something we all can do, even if you can’t actually see, and you don’t know bright from dark.

Lets give an example. I am a sighted person, walking to the bus stop. I stand, waiting for it. I look about, people are huddled around, most of them waiting for the bus in silence. You see a friend, a not very close one, and spend five minutes contemplating whether you want to approach him or her. Finally, he comes over and asks you some random questions, after which, you see the bus with the correct number, get into the bus, fumble to pay the driver, and go home.

Now picture it from a visually impaired person’s point of view. I know it’s definitely a longer and harder journey, with people always telling you to go right, or left. Anyway, you leave a little early, as you always do, and reach the bus stop. You hear several voices, and overhear a girl talking to her friend on the phone, and you suspect it’s the same one you heard talking the other day. “Oh, we finally bought a dog…” she is telling her friend. “Dad said okay after ages…” She goes on to tell her, and indirectly, you; about the dog.

“hey,” a voice cuts through the girl’s ramblings.

I wonder who that is. You wonder. It could either be Keshav from my class, or Andy, my senior. (These are not real people; I just made them up for the example.) Some can see this as an embarrassing situation, but at least it’s an interesting one. Most people forget to introduce themselves, forgetting we don’t know who they are. So we get to be unsure about the person, as he keeps talking, and finally, through detective work, we figure out their identity. Or we could ask who they are, but I think it’s more fun this way. You could later tell him about not knowing who he was, and even have a good laugh about it. Since you need help to find out when your bus is coming, you will have to ask people, who otherwise, would have never talked to you. So, instead of standing alone on the bus stop, silently, you get to meet and talk to various people. And, you will never be able to be superficial, what they look like will not shroud their personality. Oh, and we will never have to pay for the government bus.

An exciting and fun filled day well spent, where you had some new experiences, spoke to new people. Less boring, don’t you think? We will never have to go anywhere for adventure, it’s always around, whether we want it or not. A sighted person may live his whole life as a shy individual, not speak much to anyone, stick to his studies, and later his job. He may always be worried about what others think of him, and hesitate to put himself in the limelight.

A visually impaired person is already in the limelight, whether he wants it or not. Everyone notices him; they may not approach him to help him, but he is already more well-known than others. A blind person may feel awkward about it, but he has to ask people for help. He can’t walk around, speaking to no one.

This process gradually becomes a daily activity, and soon forces you out of your shell. This may change your personality for the better.  In the beginning, however, you will be afraid, nervous and very insecure. But, after a while, you will realize that life as a visually impaired isn’t that different from life as a sighted person. You can do almost everything; only, you’ll have to find another way to do it. This adaptability will help you in life and work in the future.

When your World Shrinks

When I was first faced with this problem a year ago, I was shocked, and was very sad for awhile,. But that was it. The only thing that really changed for me was the outside world. I stopped going to malls and coffee bars, for shopping, and friends’ houses. My friends would always come home, and I sometimes felt like there was nothing out there.I was always at home, listening to audio books and sleeping a lot. The only place I regularly visited was the hospital, firstly to get my second surgery, and then for regular checkups. When your world shrinks to your house, anything else becomes very interesting. You can have experiences a sighted person will never be able to have.

I thoroughly enjoyed my stay at the hospital; it was like a vacation, except nurses would keep coming to take away my blood every day. I spoke on the phone to my friends as I always do, listened to music throughout the night, and making jokes with the doctors that came to visit. Since I was bed ridden for three days almost, a lot of people came to visit me, and I got to eat hospital food and the chocolates they bought. I drank almost two and a half litres of juice in those four days (Four Season’s Mixed Fruit Juice.) I still remember the operation, going under general anesthesia, and feeling dizzy. It was a lot of fun; I enjoyed every moment in the hospital, but was glad to be home.

Things definitely got boring at times, but I would find something to do. I was told to get JAWS, and through a slow, steady process, learnt everything about it. Well, enough to use the computer. But I have a long way to go, and I keep learning more as the days go by, as more things become necessary.

I booked a slot in EnAble India almost four months after the surgery, and that became something to do.

My last word on Disability

Your disability is only a disability if you think it disables you.

A disability prevents you from doing something in the way other people do it, it doesn’t disable you, at least that’s what I think. We all have our problems, some large, some small. Sitting around moping will not help.

So know this: a general misconception today is that you need eyes to survive in this world. A misconception both on the side of the sighted and the blind.

The world is modeled around people that can see; therefore we find it a little hard to cope. However, if you think about it, if we all get together, we are a world by ourselves.

A Visit To Cadabams

Posted in Analysis, Hospitals, India, Medical, psychology, Society with tags , , , , , , , , , on March 9, 2010 by Poonam Vaidya

Introduction to Cadabams

The center is dedicated to the memory of  the late Amita M. Cadabam , daughter of Smt and Sri. C. A. Mannar Krishna Shetty .

The place is located on the southern outer fringes  of  Bangalore city at the address –

Cadabam’s Home for Mentally Disabled Trust ( Regd.)

Gulkamale Village , Near Kaggalipura ,

Post : Taralu , 17th Mile , Kanakapura Road , Bangalore – 560062 , INDIA.

Phone : 080 – 28432841 / 843 / 844/ 867 / 985 / 986.

Fax: 080 – 2843 2840 E-mail : cadabams@bgl.vsnl.net.in

Vision

To set up a “Home Away from Home” offering solace to the suffering individual and family alike, where the atmosphere would be of a large extended family in which the residents would get the comfort, security, love and kindness of the family, with psychosocial Rehabilitation Programmes and medical care administered by experts in respective areas.

Not content with the achievements, Cadabam’S vision is to renew the hopes of its residents, and their family members, re-kindle their life, and bring back its residents to social mainstream and integration with their families, “Towards Excellence” being its motto.

Mission

“To respond to the needs of families requiring long or Short term Residential Care and Psycho social Rehabilitation Service for their wards suffering from mental disability of varying degrees and Types.”

Services provided

  • Dignified community living in a well designed and equipped campus
  • Regular Psychiatric and general medical intervention
  • Counselling and Psychosocial rehabilitation activities

Charitable Trust

CADABAM’S charitable trust was established in the year 2003 to make psychosocial rehabilitation affordable and accessible. It has conceived health care, education and community service as its 3 main focus areas for functioning. in its many endeavours ARPITHA stands out stretching hands of help to those needy people who would require quality mental health care that is affordable and reliable.

Experience has shown that even by keeping CADABAM’S AMITHA affordable to middle class it had become unaffordable for some sections. Responding to their needs CADABAMS’ started ARPITHA a 70 bedded rehabilitation centre in which 24 beds has been set apart for providing free treatment and rehabilitation to really poor and destitute for one year under certain conditions.

Administration

Psycho social rehabilitation at CADABAM’S group of centres has range of multi component programmes like Pharmacological management, living and social skill training, psychological support to resident and his carers (family), vocational guidance, recreational activities and Supported education.

Patients on admission are evaluated by a psychiatrist and a counsellor (professional with psychology back ground) considering various factors like the illness expected recovery and expectation of the family therapeutic interventions are planned. Counsellors regularly interact with residents (patients) and a psychiatrist evaluates at regular intervals.

The general health of the resident is also given due importance. CADABAM’S has a full time doctor managing and co-coordinating the clinical services with visiting professor of medicine for quality physical healthcare. The team of nurses will ensure that the residents get the prescribed medication, also nurse will attend to the resident in case of simple illnesses at CADABAM’S. The Centre also has an Ambulance to commute and transport patients to hospitals where the need for either specialist consultation or for admission arises.

Investigations advised and those required to be done on regular basis are carried out with local laboratories and diagnostic centres. CADABAM’S also has understanding with hospitals and tertiary care centre to ensure emergency medical help in case of emergency.

Admission Procedure

The patients are accepted for short/long term residential care and rehabilitation/de addiction based on the recommendations of the psychiatrist, who has been treating him/her, with the consent of the family and the person needing such care. Request for admission should be made by the parents / guardian / person concerned in the prescribed application form, obtainable from the office of the Administrator. On receipt of completed application from, the Admission committee will review the request. On approval of the committee the patient will be admitted as short or long term resident as the case may be, after fulfilling the other terms and conditions stipulated by the CADABAM’S. A thorough psychological and physical check-up of the patient is done at the time of admission.

Mental Health Scenario

Mental illnesses are the most devastating and disabling of the diseases, affecting the mankind, giving it’s victims and their families a life of suffering, trauma and travail. They totally destroy the victims personally, sap his capacity to lead a normal family and social life, and drive him to a life of isolation from the family and society.

Nearly one percent of Humanity is suffering from this malady, of which nearly 20% would become chronic. In the context of our country it means nearly one crore of our people are victims of different forms of Mental illness and of whom 20 Lakhs are likely to become chronic. For this formidably stupendous number the facility available for their treatment and rehabilitation is deplorably poor and does not touch even the fringe of the problem.

Often the victims’ entire personality becomes shattered due to dysfunctioning of their mental faculty. They drift from social mainstream, remain castigated from immediate neighbourhood, as well as the society at large. What they need is not just medical intervention but a multiple therapeutic approach to bring them back even to a semblance of normal functionality. They require along with psychiatric treatment a scientifically planned and organized counselling and Rehabilitation Programme,

While the illness affects the individual, the families, who are the chief caregivers, suffer equally because of lack of skills to handle critical situations, inadequate knowledge of the nature of illness, dismally poor facilities to treat the illness. Particularly in mofussil centres and villages, and also unfortunately the social stigma attached to the illness.

DSM IV Criteria for Panic Schizophrenia

Diagnostic Criteria for Schizophrenia

A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

  • delusions
  • hallucinations
  • disorganized speech (e.g., frequent derailment or incoherence)
  • grossly disorganized or catatonic behavior
  • negative symptoms, i.e., affective flattening, alogia, or avolition

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.

B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

C. Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

D. Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive Episode, Manic Episode, or Mixed Episode have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.

E. Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

F. Relationship to a Pervasive Developmental Disorder: If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

Subtypes

1. Paranoid Type

A type of Schizophrenia in which the following criteria are met:

  • Preoccupation with one or more delusions or frequent auditory hallucinations.
  • None of the following is prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect.

2. Catatonic Type

A type of Schizophrenia in which the clinical picture is dominated by at least two of the following:

  • motoric immobility as evidenced by catalepsy (including waxy flexibility) or stupor
  • excessive motor activity (that is apparently purposeless and not influenced by external stimuli)
  • extreme negativism (an apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved) or mutism
  • peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of inappropriate or bizarre postures),
  • stereotyped movements, prominent mannerisms, or prominent grimacing
  • echolalia or echopraxia

3. Disorganized Type: A type of Schizophrenia in which the following criteria are met:

* All of the following are prominent:

  • disorganized speech
  • disorganized behavior
  • flat or inappropriate affect
  • The criteria are not met for Catatonic Type.

4. Undifferentiated Type

A type of Schizophrenia in which symptoms that meet Criterion A are present, but the criteria are not met for the Paranoid, Disorganized, or Catatonic Type.

5. Residual Type

A type of Schizophrenia in which the following criteria are met:

  • Absence of prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior.
  • There is continuing evidence of the disturbance, as indicated by the presence of negative symptoms or two or more symptoms listed in Criterion A for Schizophrenia, present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

Associated features

  • Learning Problem
  • Hypoactivity
  • Psychosis
  • Euphoric Mood
  • Depressed Mood
  • Somatic or Sexual Dysfunction
  • Hyperactivity
  • Guilt or Obsession
  • Sexually Deviant Behavior
  • Odd/Eccentric or Suspicious Personality
  • Anxious or Fearful or Dependent Personality
  • Dramatic or Erratic or Antisocial Personality

MSE –Mental Status Examination

Patient’ s Name : “ANONYMOUS SUBJECT”

A Gujarati Muslim, aged 50, “ANONYMOUS SUBJECT” seemed cold and distant at first when we met her. She told us to go away, but later, when we didn’t leave, she opened up and began to talk to us.

Physical Appearance: “ANONYMOUS SUBJECT” was interested in her appearance, though the nurses told us she had poor personal hygiene. She wore bangles and anklets, and told us where she had got them from, or who had given it. She also commented on my personal appearance. Her hair was grey, she seemed quite old, and said she was tired. The entire time we talked to her, she lay in a horizontal position on her bed.

Speech: “ANONYMOUS SUBJECT” took time to answer questions, and her answers were sometimes slurred. She spoke slowly, but speech as a whole was normal.

Thought Process: She took some time to answer the questions, and her thoughts were random, and didn’t connect to what she was saying before.

Perception: “ANONYMOUS SUBJECT” had some distortions in thinking. Every family member held some unusual and unbelievable posts. He father was a teacher in a school for all subjects, husband owned a pen business, her mother a chemical company, one son was a beautician, the other an engineer and doctor. She had various degrees, in MBA and Science. It was clear she was either making it up, or thought so actually.

Insight : On asking “ANONYMOUS SUBJECT” why she was here, she was silent for a long time, so we continued to ask her random questions. We the repeated the first question, to which she said that heR son had left for UK, and left her here. She clearly did not have knowledge of her condition. She probably thought Cadabams was an old age home.

Bibliography

http://www.cadabams.org/index.html

http://counsellingresource.com/distress/schizophrenia/dsm/schizophrenia.html

16 Personality Factor Questionnaire (16PF)

Posted in Education, India, Medical, Projective Test, psychology, R.B. Catell, Random with tags , , , , , , , , , , , , , , on March 5, 2010 by Poonam Vaidya

Consistency of the Test

The Consistency of the Test can be defined as “the reliability or agreement of factor scores overtime.” reliability is based on two factors. a) Dependability, which measures the test’s reliability over a short period of time. and b) stability which measures the test’s reliability over a long period of time Several tests were conducted over several samples of population to verify the credibility of the 16 PF Scale. these tests, ranging from a two week period, to a 4 year period, noted the coefficient correlation between the subject’s initial scores and scores after a given time period. the correlation coefficient was seen to be high in most cases, showing that the test had a good consistency.

Validity of the test

The validity of a test is generally defined as its capacity to measure what it claims to measure. since the 16 PF Scale was designed to measure personality, the evidence of the validity of the test lies in the fact that the individual’s score on all 16 factors truly reflects the individual’s personality. The validity of the scale lies in 10 successive factor analysis on different samples, verifying the existence and natural structure of the 16 personality factors and has been cross validated based on different samples of the adult population. The questions asked in the test have been found to be appropriate to measure personality factors, as these factors represent research analysis. However, we can always question how valid a test that measures personality can be. the test is one easy to administer and score, which measures the complicated concept of personality. personality is measured in the test by a wide range of personality factors or traits, broadly classified. The M.D. or Motivational Distortion score acts like a lie detector, which identifies whether the subject is consciously or unconsciously distorting his or her answers. The test could be wrapped up with the following lines. “at the end of the day, the test does not give a concrete view on the personality of the subject, as the experimenter and subject are as confused about the subject’s personality, as they were before its administration and the only realizable information received through he test is the tendency of the subject to distort his results through the M.D. Scale”

Summary – Is the term “Pain” Disorder a Valid Diagnosis?

Posted in Education, Hospitals, Medical, psychology with tags , , , , , , , , , , , , , , , , on September 20, 2009 by Poonam Vaidya

The essay essentially talks about the controversy—should ‘pain’ be considered as a symptom or as a disorder? Pain; in General Medicine usually indicates that a disease is present, but what is happening is, when there is an no organic disease found in the patient, they are diagnosed with ‘pain disorder’ or ‘somatoform disorder’. The article argues that the diagnosis for pain disorder is unsupportive and deceptive because it misleads the patient into thinking that the reason for pain is understood even though it’s not the case. Just like we consider headaches, or diarrhoea as symptoms to an illness, even pain is a symptom and not a diagnosis. The author states that pain can be caused due to psychological factors and that there is a strong relationship between psychological events and physical symptoms, like sometimes unhappiness causes a headache. The author repeatedly states that pain is not always cause by physical disease and can be caused by inner emotional conflict. He also talks about the disadvantages of a broadened knowledge of Medicine being increase number of possible causes for a symptom and the inability to quantify psychological influences as we do for organic causes.

The debate continues as to whether pain originates from purely physical factors(as believed by the psychodynamic perspective) or if it can stem from psychological causes, as well.

With regard to treatment of pain disorder, a lot has been tried and tested, with little success. Cognitive behavioral therapy, relaxation technique, anti depressants, acupuncture and multidisciplinary pain centers have been suggested, but none of these have lead to a remarkable cure. Three separate studies were conducted on immigrants in different countries to check the validity of cognitive behavioural therapy, which reinforced the strength of the psychodynamic theory, as well as the psychological theory, as immigrants, who were subjected to many hardships, learnt to cope better. Studies regarding relaxation techniques and acupuncture have shown a positive effect, but with insufficient evidence. Antidepressants were found to have no effect. Multidisciplinary pain centers are said to be the most cost effective treatment, which focuses on improving functioning rather than cure of the disorder.

Recent literature shows that no defined etiology or pathology for chronic pain has been found, nor any specific treatment, there is little difference in experience of pain between those patients who have an organic disease and those who don’t, and many persons who develop chronic pain have personality disorders.

The DSM VI criteria measures pain disorder in 5 criteria- intensity, hindrance in normal functioning, psychological reasons, ‘real’ pain and causes not attributed to mood, anxiety or psychotic disorders. Its major shortcomings are that pain is subjective, expressed differently and can’t be measured scientifically. Tucker criticizes the DSM VI criteria, as it “treats the disorder, and not the patient.” This article supports this view, as, once given the label of a disease, patients would think of the disorder in physical terms, thus doing away with the psychological aspect, which, if used in early stages can greatly benefit the patient, thus lessening the unnecessary use of health care services, generally used excessively by these patients. Furthermore, clinical observations have found that the symptoms are exaggerated, making them undeserving of medical compensation, causing jealousy and resentment in the society (especially among coworkers) and a drain on the economy. Lastly, as it has no cure, it is extremely frustrating to the patients and physicians, lowering their moral. Therefore, this article suggests that pain disorder is a socially accepted way of getting out of work, and should not be compensated.

Rorschach Inkblot Test

Posted in 1, Hospitals, India, Projective Test, psychology, Random with tags , , , , , , , on July 20, 2009 by Poonam Vaidya
To determine cultural validity, especially in the Indian Context
An assignment which evaluates the Rorschach Inkblot Test
as a Projective Tests, gives general information about
the test and evaluates its use in the indian context.

ACKNOWLEDGEMENT

I would like to extend this sincere and enthusiastic acknowledgement to Father Viju Painadath for giving me the wonderful opportunity to accomplish this project and for giving me the freedom to select the topic of my choice. I would also like to thank the other people involved – whether directly or indirectly, who have made this project a possiblity.

Poonam Vaidya,

07D2345

CONTENTS

  1. Introduction………………………..4
  1. Theoretical Framework…………… 5
  1. Review of Literature……………… 7
  1. Conclusion…………………………11
  1. Bibliography…………………….…12

INTRODUCTION

Most personality tests are based on the occurrence of projection, a mental process described by Sigmund Freud as the tendency to point to others way of thinking or personality that are difficult to accept. Because projective techniques are relatively formless and suggest only a few indications to help in defining responses, they tend to bring out concerns that are extremely private and important. The best-known projective tests are the Rorschach test, popularly known as the inkblot test, and the Thematic Apperception Test; others include word-association techniques, sentence-completion tests, and various drawing procedures. The psychologist’s past experience gives the structure for analyzing individual responses. Although the subjective nature of interpretation makes these tests principally susceptible to criticism, in clinical settings they are part of the standard battery of psychological tests.

Projective tests, with their complicated scoring methods and own share of controversies, have always been a subject of great interest for me. Rorschach Inkblot Test, being one of the many fascinating tests, is the second most commonly used projective test after the Minnesota Multipurpose Personality Inventory (MMPI). With its colourful, black and white inkblots, complicated scoring and analysis procedure, along with the evident controversy of the test’s validity made it a remarkably good challenge to undertake.

THEORETICAL FRAMEWORK

Personality tests “are instruments for the measurement of emotional, motivational, interpersonal, and attitudinal characteristics, as distinguished from abilities.” Some types of personality tests are called “projective techniques.”

Probably the best-known and most idolized of the projective techniques is the Rorschach inkblot test. Swiss psychiatrist Hermann Rorschach developed this test, which has been used for more than 80 years. The test consists of 10 cards. Each card has a bilaterally even inkblot on it. Five cards are black and white and the other five are colored. An examiner shows the cards to the individual and asks him to describe what he sees. The examiner then evaluates the person’s responses according to specified guidelines.

A subject’s interpretations of ten standard abstract designs are analyzed as a measure of to determine emotional and intellectual functioning (diagnosing underlying thought disorder) and integration, and differentiating psychotic from non-psychotic thinking in cases where the patient is reluctant to openly admit to psychotic thinking. The test is considered “projective” because the patient is supposed to project his or her real personality into the inkblot via the interpretation. The inkblots are purportedly ambiguous, structureless tests which are to be given a in clear sequence by the interpreter. Those who believe in the effectiveness of such tests think that they are a way of getting into the deepest recesses of the patient’s psyche or subconscious mind.

Using the scores for these categories, the examiner then performs a series of calculations producing a structural summary of the test data. The results of the structural summary are interpreted using existing research data on personality characteristics that have been demonstrated to be associated with different kinds of responses.

A common misconception of the Rorschach test is that its interpretation is based primarily on the contents of the response – what the examinee sees in the inkblot. In fact, the contents of the response are only a comparatively small part of a broader group of variables that are used to interpret the Rorschach data.

Critics of the test have raised questions about the extraction of objective meaning from responses to inkblots; the objectivity of psychologists administrating the test (to be truly projective the inkblots must be considered ambiguous and without structure by the therapist.); inter-rater reliability; the verifiability and general validity of the test; bias of the test’s pathology scales towards greater numbers of responses; the limited number of psychological conditions which it accurately diagnoses; the inability to replicate the test’s norms; its use in court-ordered evaluations; and the proliferation of the ten inkblot images, potentially invalidating the test for those who have been exposed to them.

Hence, the therapist must not make reference to the inkblot in interpreting the patient’s responses or else the therapist’s projection would have to be taken into account by an independent party. Then the third person would have to be interpreted by a fourth ad infinitum. Thus, the therapist must interpret the patient’s interpretation without reference to what is being interpreted.

Every culture is distinctively unique, and people brought up an socialized through a culture are evidently going to have differences in thinking, learning, perspective on social situations, religion and a whole array of unique differences in selection, background and culture. Projective tests like the Rorschach are supposed to overcome many of these difficulties, this is an attempt to verify the objectivity of the Rorschach Inkblot Test in the context of different culture, especially in the case of India. Indians have a different perspective than people of the West, whom this test is supposed to cater to. Will the Rorschach Inkblot Test be valid in the context of Indian culture and other cultures that are significantly different from that of the West?

REVIEW OF LITERATURE

Review of Literature -1

Title: PSYCHOPATHOLOGY AND MENTAL RETARDATION: A STUDY USING THE RORSCHACH INKBLOT TEST.

Authors:

di Nuovo, Santo F.

Buono, Serafino

Colucci, Gerardo

Pellicciotta, Anna

Source: Psychological Reports; Jun2004 Part 2, Vol. 94 Issue 3, p1313-1321, 9p

Document Type: Article

Abstract:

The aim of this research was to study the psychological effects of disorders such as schizophrenia and depression associated with mental retardation. The Rorschach Inkblot Test and the Wechsler Adult Intelligence Scale were administered to a group of 97 subjects (52 women and 45 men) ages 15:10 yr. to 36:6 yr. (M=21:5, SD =5:3). The subjects were divided into four subgroups according to the presence or absence of mental retardation and psychiatric diagnosis (schizophrenia versus depression). The quality of the perception in Rorschach responses and the Eriebnis Typus scores differentiated psychotic and depressed subjects well. These disorders, when associated with mental retardation, make impairment of perceptual performance worse. The interaction between Axis I mental disorders (according to DSM-IV diagnosis) and mental retardation, an Axis II disorder, is discussed. [ABSTRACT FROM AUTHOR]

Review of Literature -2

Title: PREDICTING SUICIDE USING THE RORSCHACH INKBLOT TEST.

Authors: Kendra, John M.

Source: Journal of Personality Assessment; Oct79, Vol. 43 Issue 5, p452, 5p

Document Type: Article

Subject Terms:

*SUICIDE

*RORSCHACH Test

*PROJECTIVE techniques

Abstract:

Three hundred and seventy-five Rorschach protocols were scored blind and then divided into three groups: psychiatric controls, suicide, attempts, and suicide effectors. Using the stepwise procedure of multiple discriminant analysis a trio of formulas, composed of six weighted variables each, and a constant, were constructed to apply to each of the three groups based on a test sample of 100 subjects in each group Cross validation results on a new sample of 25 subjects in each group predicted classification with 52% overall accuracy at step six (chance .33). Internal reliability tests showed all values significant beyond .001. Discussion integrates the test data into the literature on suicide, and attends to the problem of overlap of predictability which occurs with most prediction scales. [ABSTRACT FROM AUTHOR]

Review of Literature -3

Title: HOMOSEXUAL SIGNS AND HETEROSEXUAL SILENCES: Rorschach Research on           Male Homosexuality form 1921 to 1969.

Authors: Hegarty, Peter1

Source: Journal of the History of Sexuality; Jul2003, Vol. 12 Issue 3, p400-423, 24p

Document Type: Article

Subject Terms:

*RORSCHACH Test

*HOMOSEXUALITY

*MALE homosexuality

*RESEARCH

People: RORSCHACH, Hermann

Abstract:

The article details research on male homosexuality using Rorschach inkblot test from 1921 to 1969. The lifelong research of the Swiss psychiatrist Hermann Rorschach was published in 1921 in a volume entitled Psychodiagnostik. In this volume, Rorschach presented his conclusions about the inkblot test of personality he had developed. Most of Rorschach’s work involved clinical patients and psychiatric diagnoses, but some included social research. In the decade after Rorschach’s death, his test inspired little active research. However, by the mid-1930s researchers in the U.S. had begun to re-examine the test and form a network of practice around its usage. Psychologist Bruno Klopfer conceived of the test subject in phenomenological and holistic terms. The nascent Rorschach network developed further when it became implicated in military work during World War II. Homosexuality became grounds for psychiatric exclusion from the military for the first time during World War II. In the 1930s psychoanalysts had developed accounts of male sexuality as both a transitory neurosis and a deep-rooted permanent psychosis. At least three research teams tried to develop the Rorschach as a means of detecting homosexual men among the troops. Rorschach researchers insisted that the test could clearly discern a pattern of responses among genuine chronic cases that was not shown by simulators. After the war Rorschach research speeded up enormously. The publication of William Marshall Wheeler’s Ph.D. dissertation in 1949 enhanced the legitimacy of using the Rorschach as way to detect homosexuality in the postwar context.

Author Affiliations:

1Yale University

ISSN:

10434070

Accession Number:

12514131

Review of Literature -4

Title: Norms of the Rorschach Test for Indian Subjects

Authors: Lt Col S Chaudhury (Retd)*, Lt Col M Augustine (Retd)+, Col D Saldanha#, Mrs K Srivastava**,Mrs SM Kundeyawala++, Surg Capt AA Pawar##, Surg Capt VSSR Ryali***

Subject Terms: Rorschach test; norms; schizophrenia; neurosis

Abstract:

Background : The clinical utility of the Rorschach test in Indians is hampered by the absence of reliable normative data.

Method : The Rorschach by Dlopfer’s method was administrated to 1256 subjects consisting of 300 normal army personnel, 300 normal civilians, 250 schizophrenics, 300 neurotics and 106 patients with organic disorders.

Results : The Rorschach protocols of normal Indian army personnel and normal civilians showed significant differences from one another and also from the western norms. These differences are culturally determined and are not indicative of low intelligence or psychopathology. Patients with schizophrenia, neurosis, head injury and epilepsy show significant differences from the records of normal subjects. The protocols of army schizophrenics show significant deviations from those of normal army personnel and these changes revert to normal with clinical recovery.

Conclusion : The Rorschach test is not a culture free test as claimed earlier. In view of the differences from Western norms,Rorschach protocols of Indians should be interpreted using the norms for Indians. In the case of army personnel the norms for army personnel should be used. While the use of the Rorschach to study the personality patterns of normal individuals and as an aid to clinical diagnosis was strongly supported, the findings of the study indicate that the test can also be employed to assess therapeutic response of patients with schizophrenia.

CONCLUSION

The Rorschach Inkblot Test is according to me, a very good way to find out abnormalities in personality of individuals, although it might me a little towards the subjective side in its method of analyzing, it still takes into consideration the emotional characteristics of an individual, and gives them complete freedom to decide their answers, rather than be forced to select one out of a predetermined set of answers. Projective tests have also been used successfully on children, the CAT, or Children’s Apperception Test and Group Zulliger Inkblot Test, are examples of this, though it is still uncertain whether the Rorschach Inkblot Test may be administer on children and yield the same results.

The main objectives of the Rorschach Inkblot Test are to determine emotional and intellectual functioning (diagnosing underlying thought disorder) and integration, and differentiating psychotic from non-psychotic thinking. Through the innovative method of inkblots, it reveals concerns that are extremely private and important for the psychiatrist and researcher alike, paving the way for a solution to the problems that are extracted. The subject unknowingly admits the various biases and fears he hides from society and sometimes, even themselves.

In order to use the Rorschach properly, professionals need an authoritative source of advice and guidance on how to administer, score, and interpret it. Available evidence indicates that the Rorschach Inkblot Test is a psychometrically sound measuring instrument that provides valid assessments of personality characteristics and can facilitate differential diagnosis and treatment planning and evaluation. The Rorschach Inkblot Test continues as in the past to be widely used by both clinicians and researchers. However, the esteem in which it is held by practitioners, who are generally agreed that clinical psychologists should be competent in Rorschach assessment, is not universally shared by academicians, many of whom presently question the future place of Rorschach training in graduate education.

Most psychological tests are said to have limited value because they depend on the subject’ selection, background and culture. Projective tests like the Rorschach attempt to overcome many of these difficulties. But recent research has revealed that norms cannot be used from one country to another and differences within the same cultural group are also to be found. The Rorschach norms established by researchers in India differ considerably. Faced with the lack of reliable norms, mental health professionals in India are left with no alternative but to interpret Rorschach on the basis of own experience, which results in subjective bias.

Therefore, it can be concluded (with the help of the Review of Literature, part 4) that the Rorschach Inkblot Test, though a projective test, is still not as culturally free as we hoped. In view of the differences from Western norms, Rorschach protocols of Indians should be interpreted using the norms for Indians, which should be developed based Indian sensibilities by a reliable group of scientists, rather than various individual researchers giving their own bias interpretations as norms, which would render the test unreliable, unscientific and invalid in India.

BIBLIOGRAPHY

  1. Introduction

Projective techniques http://encarta.msn.com/encyclopedia_761564236_3____10/Psychological_Testing.html#s10

16th July 2009

  1. Theoretical Framework

http://www.psychoheresy-aware.org/inkblot95.html

http://www.skepdic.com/inkblot.html

http://www.absoluteastronomy.com/topics/Rorschach_inkblot_test#encyclopedia

16th July 2009

  1. Review of Literature

Part 1

http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=14234145&site=ehost-live

Part 2

http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=6383307&site=ehost-live

Part 3

http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=12514131&site=ehost-live

Part 4

http://medind.nic.in/maa/t06/i2/maat06i2p153.pdf

16th July 2009

Therapeutic Clowning and Play Therapy

Posted in Analysis, Bangalore, DNA Newspaper, Hospitals, News, Revathi Suresh, Sutradhar with tags , , , , , , , , , , , , , , , , , , , , , , on May 28, 2009 by Poonam Vaidya

Poonam Vaidya

Sutradhar, a non-profit educational resource centre, will hold a  seminar on ‘Play in Hospitals’  on 28th May at 4 pm at Ashirwad, St Mark’s Road. “The Open Forum has been held since 1996 to bring people involved in childcare like parents, teachers, NGOs, researchers and people from the government together. A range of issues on early childhood have been discussed in past forums,” says Revathi Suresh. ”Early childhood is a neglected period,” she adds.  Sutradhar lays stress on importance of play in education and believes that a large variety of play materials allows children to learn concepts and make connections , the foundations of early learning.

It is often a great challenge to take play to children in institutional settings like hospitals. The forum seeks to look at chronically ill children who spend long periods away from home, under intense medical care. Though play therapy is relatively new in India, there are now organisations that are trying to make a difference to affected children and families by exploring ways to help them cope with the stress brought on by the hospital environment, and focusing on their emotional health and well being. In this Open Forum, individuals from two such organisations will be sharing their experiences.

Doctor Clown India is India’s first Therapeutic Clowning group. It was brought into India from France by Severine Blanchet. These clowns are very different from the ones at the circus. “Therapeutic Clowning is where they make children comfortable in hospitals, sustaining a cheerful environment.” Says Revathi. “Therapeutic Clowning aims to offer unconditional love through non violence or ‘ahimsa’ clowning.” says Nazu Tonze, a.k.a. Dr. Gladys, the first professional female therapeutic clown in India, who will be speaking at the Forum.” We make kids laugh so they don’t feel afraid. Even though many people call me a clown, I love my job. It is not easy to ‘clown about’ as it seems.”

Play therapy is generally employed with children ages 3 through 11 and provides a way for them to express their experiences and feelings through a natural, self-guided, self-healing process. Says Meera Oke, who will speak at the Forum, “Play Therapy is the use of theoretical model of role play to help the child adjust to a stressful situation, in the hospital, it is used for chronically ill children. We have evolved our own bedside model, where we go to the kids instead of them coming to us.”

Play Therapy in India was started in Pune by the Deenanath Mangeshkar Hospital and Research Centre. It is now being used in Manipal Hospital, Bangalore through the Priyanka Foundation.” We plan to share our experiences of two and a half years in Play Therapy and train people who are interested.” Says Oke.

“The doctors in Manipal took a while to get used to the idea of Play Therapy, but now they fully support the idea and say it is an important part of care, especially in chronic cases like cancer. It makes a child feel ‘at home’, even in a hospital.” says Oke. “We familiarize kids through medical play where we use small play models of the hospital equipment so the child knows what will happen to him. There is also reversal of roles, where the child pretends to ‘operate’ on a doll.”

Sanjokta Malgonda, who works directly with the children at Manipal says, “At first, there was no response from the kids, but soon, they understood the concept. Thanks to Play Therapy, we were able to establish rapport with the child and they seemed to enjoy themselves.”

We asked the mother of a five year old patient in Manipal Hospital, what she thought about Play Therapy. “I think Play Therapy is a good thing. My son was able to enjoy even in the dreary surroundings. Every day, he responded joyfully when a new toy was given to him. I recommend Play Therapy for all kids in hospitals. It helps them keep their mind off the pain.”

Says counselor Usha Shinde “Play Therapy is an essential part of the treatment of a child, especially if hospitalized for a long period of time. Children don’t generally like the hospital atmosphere and 40 minutes of play per day have proven to have a therapeutic effect on the child.”

Colour Blindnes

Posted in Colour blindness, Conal Dystrophy, Earth, Females, psychology with tags , , , on February 12, 2008 by Poonam Vaidya

Colour blindness….it’s not a curse. I am one of the few FEMALES on earth who has the problem, I’m totally color blind (not going able to see anything but black and white). It’s not even genetic, so I don’t have the advantage of blaming my parents and getting stuff from them.

I have this strange problem called Conal Dystrophy, which is a condition where the eyes can’t see in bright light. This damaged my ability to see colors, so I could once but now I can’t because of that , I know in my mind how green and blue and other colours look, and can mostly differentiate between them. I came to know of this problem in my pre university college, when I’d find it hard to match my salwars and kurtas with appropriately matching earrings and dupattas (college dress code)
I serious thought I was color blind and learnt in psychology about the ishihara colour blindness test. I finally convinced my skeptical mom to accompany me to the eye doctor. When the doc showed me a group of dots and asked me to find a no. in them. I could see only no.12 the last one….which confirmed what I had been thinking all along.

I was first a little stunned to realize that what I had been thinking all along was true. It rarely happens. my I got over myself when I realized how unique this made me…..girls are hardly colourblind , less totally and very few may have been able to see color once and now can’t. true…I can never get a driver’s license ( a bribe would solve that, I’m sure I can remember red is on top, green below and orange down) or get into fashion industries or paint-making companies, but heck….I probably couldn’t drive a car anyway and I never cared much for the fashion industry…..

The only problem is matching my clothes in the morning!

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