Growing up in a South Kolkata apartment overlooking a busy street, Amartya would often see his mother, steal herself away from the daily household chores and spend a few moments in their tiny balcony, overgrown with an odd number of plants that she grew. From Tulsi (where she would unwaveringly light a lamp, come wind or hail), a crimson hibiscus, some speckled crotons, and the usual seasonal marigolds or rustic nameless carnations, Amartya’s mom had a special place in her heart, and her house for innumerable fauna — caressing their leaves, talking to them as they were her own children, coaxing them to bloom, against all odds.
Even as a child, Amartya knew that those few moments his mom spent with her plants, as the evening sun settled in behind the neighbor’s house, was something special. Moments that gave her mom respite from daily conundrums and energized her to face all odds while raising a family of three children. Looking back, Amartya would be insanely jealous at his mom spending her time with her plants, but somewhere understood that it was something his mother needed. And as years went by, her love for plants grew on him like the tendrils of the creepers that his mom kept, tangled their way up the veranda grills.
Thus, when Amartya decided to shift to the US, triggered by memories of his mother, he quietly packed in saplings of his childhood plants into the oversized suitcase that carried his meager belongings as he ventured out to start afresh. And thankfully, for him, hibiscus, tulsi, and speckled crotons helped create an oasis of sorts, in his rented apartment in East Village.
In March 2020, the COVID-19 pandemic struck. Amartya, a confirmed bachelor, was confined within the walls of his apartment along with the foliage, comprising of a few other South Asian varieties of plants he had amassed over the last 5 years. And truth be told, he admits that they provided him with a respite from all the turbulent news he heard outside. Much like his mom, years ago, Amartya says he quickly steals away some time from his daily work and house schedule to tend to his plants, talk to them, and disappear from the harsh reality of present times.
In fact, with physical distancing measures to contain COVID-19 having included closing beaches, playgrounds, and parks, adding to the challenges to our mental health, experts, too, opine that having a slice of nature at home does support human well-being.
For those who are lucky enough to have a backyard, a 2017 study, presented in Preventive Medicine Reports suggests that gardening can offer benefits such as reductions in stress, anxiety, and depression apart from improving physical fitness.
However, if one stays in an apartment, indoor gardening too has its own benefits. A volunteer, who participated in a study, published in Urban Ecosystems that highlighted the importance of nature in urban living said that having a small vegetable garden and flowers in pots makes him happy — a sentiment Amartya echoes, saying that seeing things grow in the city, even as everything around him is in disharmony is a beautiful and calming experience.
Scientists find that tending to one’s garden helps suppress the sympathetic nervous system activity and diastolic blood pressure and promotes comfortable, soothed, and natural emotions.
Experts have often hinted at the importance of nature in one’s mental and physical well-being, but it is only now that it holds even more truth as active interaction with indoor plants can reduce physiological and psychological stress compared with mental work.
While most people think houseplants are just a way to beautify an indoor space, having a few plants scattered around the home can also provide one with emotional wellbeing during the pandemic. Amartya, on his part, believes that apart from the scientific jargon associated with indoor plants, looking at those plants, not only evoke a sense of nostalgia, but watering, pruning, and caring for the vegetation helped him maintain his sanity even as everything familiar around him, suddenly dissipated into the unknown.
Umang Sharma is a media professional, avid reader, and film buff. His interests lie in making the world a better place through the power of the written word.
Sukham Blog – A monthly column focused on South Asian health and wellbeing.
Last month, we talked about what we should doif we were concerned about Amma’s recurring memory lapses. In this article, we explore options and describe the steps to be followed if Amma receives the diagnosis we were dreading – tests that confirm she is in the early stages of dementia. Her symptoms are consistent with an underlying progressive and irreversible illness that is causing damage to the complex system that controls cognitive function: the neurons or nerve cells in her brain, and the networks they form with other neurons. These symptoms could be caused by any one of a half-dozen diseases; Alzheimer’s is the most common one to affect older people. Parkinson’s disease also often leads to symptoms of dementia.
It is never easy to receive such a diagnosis. The news is earth-shattering, not only for the patient but also for the entire family circle. A vibrant individual will slowly but surely lose his or her identity, mind, and sense of self, and slowly forget all lived events; forget everything and everybody – as though that life never happened. Like a frame from which a precious photograph slowly fades until it is gone. The patient lives unaware in this wicked prison, while those around her agonize helplessly. These cruel diseases strike not just the patient, but the entire family. Perhaps we’ll find a cure one day. Perhaps we’ll find more ways to delay disease progression and reduce the symptoms, enabling a longer, meaningful life. Science and medicine have made progress in the past couple of decades, and there is hope of more to come in the future. In the meantime, what is the best we can do to cope?
Amma’s diagnosis calls for a mobilization of the immediate family to participate in a strategy session with her. You should look at Amma’s circle to decide if any of her close and intimate friends should be included. The objective of this effort should be to develop short and long-term plans that address several different issues, including: dealing with the emotional impact of the diagnosis on Amma and the rest of her circle, understanding the diagnosis and treatments available, making financial, legal, and personal plans, addressing safety and living arrangements, understanding all available support, and developing a comprehensive care plan that puts Amma at the center, and considers the impact on her family and very close friends.
Some excellent tips provided by the National Institute of Health and the Alzheimer’s Association serve as a guide and starting point for this strategy session. While the main focus is the newly diagnosed patient, much of this applies to his or her circle as well. I’ll describe in brief what’s available to Amma in these two resources. It is very important for all involved to be open and honest with Amma, and with each other about what lies ahead; to share and understand one another’s perspective.
When one hears of the diagnosis, the gamut of emotions covers a range that includes denial, anger, resentment, depression, fear, loss, grief, and a sense of isolation. These emotions will be with you for a while, and you’ll need to find healthy ways to deal with them. The Alzheimer’s Association provides many excellent suggestions. Know that you are not alone; that there is a large community out there living and coping with dementia and its impact, and you can draw on them for learning and support. Talk to the doctors to learn more about the disease and its likely progression and the available treatments. Find out if any clinical trials might benefit you. While a cure is still not in our grasp, the medical profession is learning more and more about the disease and how to handle it.
You will have to learn to live with this disease, and an important step is to share the diagnosis with those who matter in your life. Continued interaction with them is an essential part of your life, and knowing about your diagnosis and normalizing it is the healthiest way to maintain and grow your relationships with them. Be prepared for varying and unexpected reactions from others. Take your time doing this; the sharing will raise new emotions. Remember that there is no more stigma associated with dementia than with a diagnosis of heart disease or cancer. Know that this is not your fault! As the disease progresses, your abilities will change. Accordingly, you will need to prepare yourself for role changes, for gradually becoming more dependent on others. This reality can be very difficult for many; however, it is the new reality. Openness, honesty, and trust on all sides are essential.
Develop a detailed plan for your future that covers legal, financial, living, and end-of-life decisions. Make sure that those legal and financial affairs are in order, and prepare an updated Advance Health Care Directive as soon as possible. Get a good understanding of the resources that may be available to you. Take a deep look at your living arrangements. You live alone right now. Do you need to plan for a different arrangement, either now or sometime later?
Safety and the ability to take care of yourself should be prime considerations. Prepare to give up your independence, and accept that it is okay to get help from others. Make plans for a transition to living arrangements that best suit you and your family, one that will provide the support and care that you need. Proactively build your own care team that could include family, friends, neighbors, and medical professionals. Avoid isolation and stay socially connected. Learn about all the support services in the area where you live. Get educated on all the treatments and clinical trials that may be available for your particular condition. Understand what drugs are available to delay cognitive decline, and ease any symptoms that you have. Find out if any alternative treatments or medications are available.
Another source of support to consider is Palliative Care. This medical subspecialty is available in most large hospitals and medical clinics. A multi-disciplinary palliative-care team works alongside the medical care team to help the patient and family address their psychosocial, spiritual, and medical needs. They can help improve the overall quality of life, manage symptoms like agitation, poor or altered sleep, pain, and distress, advise families on what to expect over time, and provide guidance for decision making.
Amma, you have a life-changing diagnosis, but with a detailed action plan ready, with a good support system and a self-care plan in place, you can live well and look forward to a healthy life in which you focus your energy on what matters most to you!
Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder ofSukham,an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death, and bereavement. Contact the author at firstname.lastname@example.org
With sincere thanks to the Alzheimer’s Association and Tolga Ulkan at Unsplash for the use of their images.
When Shruti got the chance to relocate to the U.S. at the end of 2019, little did she know that her life-changing decision would be one of the hardest she ever made. Cradling a two-year-old and a teenage boy in tow, the recently-divorced IT professional shifted to Silicon Valley with the hopes of starting afresh in January of 2020. A few months down the line, everything came crashing down.
When the lockdown happened in the US, after the country faced devastation with the COVID-19 pandemic sweeping across states, Shruti had barely settled down. She had to get her elder son into a school and got a friend to help take care of her younger one as she geared up for office. Things did not go according to plan and suddenly Shruti found herself stuck at home with a teenager who had no friends in the new country and a youngster who needed constant attention as she tried to reshuffle her home and work-from-home environment. She was not the only one.
For 32-year-old single-mother Neha (name changed on request), life changed drastically when in March 2020 the COVID-19 pandemic swept across the world. Her younger son, Viraj, was 15 at the time and was studying in the 10th grade. Starting March 16, schools in Maryland were closed and the world descended into uncertainty. Her son was stuck at home, cut off from social life. The sight was uncanny and like us, everyone was unaware when the normalcy would return.
For Neha, seeing her son Viraj at home was especially difficult. Prior to the pandemic, Viraj used to meet his friends, played outdoor sports, and preferred engaging in co-curricular activities. Many like Viraj were forced to be in isolation indefinitely. Thankfully, Viraj had friends in the neighborhood, so despite having inhibitions, Lucia allowed him to play basketball outside with a few other youngsters from around her house.
There are thousands like Neha across the U.S. for whom the pandemic brought about fresh challenges. It has been particularly strenuous for single parents trying to work and care for their youngsters. Everyone has been more anxious and worried during the pandemic. Younger children may not have the words to describe their feelings but are more likely to act out their stress, anxiety, or fear through their behavior. This in turn can upset parents, particularly if they are already stressed.
A study published in the Canadian Journal of Psychiatry finds that lone fathers and lone mothers have higher rates of mood disorders and SUDS (Subjective Unit of Distress Scale) than their married counterparts, which is indicative of the disadvantages of this sort of a family structure that might have negative consequences for all parents.
Let’s face it, the ever-shifting demands of parenting in a pandemic are leading to stress, anxiety, and depression, not to mention economic hardship for those forced to leave their jobs to care for their children.
According to the American Psychological Association, home in the age of COVID-19 has become the office, the classroom, and even the gym. Parents are struggling to not only keep their children occupied, but also to oversee their education as they continue to do their daily chores, finish office work and take care of other necessities in their family life. Daycares have shut down amidst the pandemic and parents or a single parent has to simultaneously take care of their youngsters while they are online fulfilling their professional obligations.
Shruti, has since then, flown back to India with her children, thanks to one of the many government-sponsored flights bringing back ex-pats to their native countries. She looks back at those fear-riddled stressful months when she and her children were stranded within four walls, she notes that, while it is normal to feel fearful, anxious, or stressed given the current situation, there are ways one can de-escalate the mental-health issues of parenting amid the COVID-19 pandemic.
So what should parents do to ensure proper mental health for themselves and their children?
For starters, the APA suggests that parents should set boundaries within the home space since they tend to blur when work life and home occur at the same place. Setting specific boundaries that separate the work from the home environment helps the child and parent have a safe haven within the home.
Experts also opine that while it is impossible for either parents or their wards to put in normal hours during such stressful times, one has to maintain a routine, even if it entails a child to stay up later than usual to finish a particular work. Routines enable families to cope with stress and be more resilient.
Finally, relaxing screen time will allow youngsters to stay connected with their social circle and ease parental stress.
Hope these tips help you during this transitional time!
Umang Sharma is a media professional, avid reader, and film buff. His interests lie in making the world a better place through the power of the written word.
This article is part of the opinion column – Beyond Occident – where we explore a native perspective on the Indian diaspora.
A recent study by the US Centers for Disease Control and Prevention (CDC) showed that 20% of all teen hospitalizations in the US between January 1 and March 31, 2021, were due to psychiatric emergencies. In addition, a University of California San Francisco study found a “75% increase in children requiring immediate hospitalization for mental health needs” in 2020 over a year before. The study also found a “130% increase in the number of children requiring hospitalization for eating disorders” and a 66% increase in the number of suicidal adolescents (ages 10-17) in the emergency department.
The last 18 months have been one of the toughest for kids in recent times, no matter how we look at it. However, we can also argue that most of the pain and suffering inflicted upon them during this period have resulted from politics and unscientific policies of school closing. Kids stuck at home; not able to go to school for the whole year; not able to play sports, participate in tournaments, plays, and musicals; not able to visit family and grandparents; not able to see faces hidden behind masks; not able to attend or host birthday and graduations parties — they all have had a cumulative effect on children’s mental health and overall wellness.
Add to this the news of socio-political strife; violence; lawlessness; non-stop pictures and videos of burning funeral pyres being played on our TV sets, newspapers, and social media feeds; scarcity of oxygen and other medical supplies for COVID patients, including our friends and family. These combined, present a commentary of a stark, bleak, and gloomy situation of the world we live in.
How we explain what is going on around us depends on the way we look at the world. Most of our present-day ideas have been shaped by the Western worldview. This worldview is predominantly atomistic that uses binaries such as ‘either/or,’ ‘true/false,’’ ‘left/right,’ ‘for/against,’ ‘liberal/conservative. These antagonistic binaries are in constant conflict with each other. It is also a worldview of excluded middle.
The ordering of the world, in this worldview, is anthropocentric. Human beings are considered the central entity of the universe where only human life has intrinsic value. In contrast, other entities are resources that may justifiably be exploited for the benefit of humankind.
On the other hand, dharma is the universal law that connects the individual to the rest of the world in a quantum way — that is, it is the same righteous law that binds each element of the cosmos. The Mahabharata defines dharma in the following manner:
dharma is so-called because it sustains and upholds the people: hence whatever sustains is dharma.
dharma is propounded to secure the good of all living beings: hence, whatever fulfills that aim is dharma.
What comes from the love for all beings is dharma. This is the criterion to judge dharma from adharma.
dharma is the spirit of Indic culture. The very essence of a Dharmic life lies in maintaining the equilibrium of the opposites. The opposites, including good and evil, are seen as complementary. Neither can be denied or completely suppressed without running the risk of creating dissonance, both within individuals and in the world around them. This duality of opposites creates and maintains the equilibrium throughout cosmology.
dharma sees conflicts and dissonance as ‘burdening of the Earth,’ which is the disturbing of the equilibrium at multiple levels. These conflicts are a product of one’s relationship with oneself (not all conflicts are with others) and other elements of the cosmos. Hence a solution must also arise from that relationship. For inner conflicts, one has to look within oneself. Blaming others doesn’t help. Beyond self, as the dissonance and chaos get louder and stronger, the earth gets even more burdened. When the burden gets to unbearable levels, an avatar takes place to unburden the earth finally. Everything starts again afresh. The Dharmic time is circular (kalachakra), not linear.
The concepts of dharma, karma and klesha form the understanding of the cause of all sufferings. The doctrine of karma is defined as the result of an individual’s intentional action through body, speech, or mind. One of the most potent assumptions of the doctrine of karma is that one is in complete control of his/her destiny. Therefore, whatever happens to an individual is a predictable outcome of his/her own choices over time. The theory of karma also states that life does not end at the death of the physical body, and the result of one’s action can be felt in the next lives to come.
The ultimate goal of life, according to dharma, is Self-realization — the realization of one’s inner Self.
In the Dharmic tradition– Hinduism, Buddhism, and Jainism– meditation, yoga, and the interplay of philosophy and life occupy a vital place. Patanjali’s Yoga Sutra (2nd century BCE) explains the yogic techniques to overcome klesha (human misery) and achieve the desired union between self and Brahman, the Supreme Consciousness. The source of klesha is raga, the attachment to worldly desires, and dvesh, the repulsion we feel towards objects that give us unhappiness. The two, combined with avidya (ignorance), asmita (ego), and abhinivesh (attachment to life and fear of death), are the sources of all kleshas.
dharma has a lot to offer in every possible field and situation, including mental health. But, unfortunately, we tend to gloss over the basic Dharmic tenets and their profundity. However, these tenets take on new meanings when applied with conviction during extraordinary uncertainty and trouble.
Avatans Kumar is a columnist, public speaker, and activist. He frequently writes on the topics of language & linguistics, culture, religion, Indic knowledge, and current affairs in several media outlets.
Yoga has always afforded me a sort of mental vacation that helps recenter my focus and energy. It probably sounds a bit esoteric. But let me explain. I find the routine of a few sun salutations, twists, an inversion, the quiet heaviness of shavasana, and some full belly “Oms” revitalizing. After which I breathe deeply with renewed energy, ready to take on and make the most of the at times, challenge-filled fluidity of working from home and remote school, for instance.
More recently during this anxiety-inducing pandemic, as I worry about our family’s safety in India or read about the ever-spiking cases and crumbling health care system there, my intermittent and improvised yoga practice allows me to calm my nerves and think more positively. I hope for a happy day when we are able to travel to India with our two boys, so they may be able to see their grandparents, aunts, uncles, and cousins, in-person, and I, my folks.
I am by no means a certified yoga instructor – merely a yoga enthusiast who has turned to this ancient Indian practice every now and then at various stages of my life for over two decades now, reaping its wonderful benefits. Every time I surrender to my mat, I rise in a strange mind-body-soul harmony, gently yet firmly, reminding me ‘to just be’. To accept, be grateful, make the most of ‘now’, mindfully and intentionally going about my day.
While I am cognizant that everyone has their go-to activity or means to de-stress and relax, like listening to music, running, taking a short nap, or reading, yoga is mine. The reason I was drawn to it is because it made me pause and slow down my pace of life and mind. I also very quickly realized that yoga doesn’t have to be complicated or enigmatic. It doesn’t need much equipment, space, or time. It’s easy and beneficial. I can do it whenever I want and for as long as I want (or can).
So, over the years, I have devised my own ‘yoga toolkit’. It has helped me mindfully navigate the curveballs at work and as a full-time parent. And it continues to assist me today, as I, like millions of others navigate this global pandemic, making sense of it, praying for a better tomorrow.
To stay calm, centered, rational, and in control, I often resort to the following yoga tools. I don’t necessarily follow these sequentially or attempt to go through each of them. I simply do what I can.
Breathe deeply for that much-needed clarity.
We breathe all the time. Why not make it conscious and intentional? It’s cathartic and effortless. The two things we all value, especially these days. Focusing on my breath for a few minutes magically helps me hit that reset button. And we all know, taking a pause can help us rationally re-evaluate a variety of situations – personal and/or professional.
When under stress, do the downward dog.
You may end up doing it a LOT. It’s no secret that our current reality possibly fills the most formerly self-assured people with doubts: small, big, and huge. Often! But when has a bit of stretching, sculpting, toning, and blood flowing to the brain been a bad thing? It not only helps us all take that much-needed pause but forces us to see the world from an upside-down (different?) perspective.
Create space between the ears and shoulders.
This is something we don’t even think about but can do all the time – while sitting, standing, and lying down. Just pull your shoulders down and straighten your neck to create some space between the tips of your ears and the tops of your shoulders. Not only check your posture but also feel that stress release. You’ll likely feel taller, more in control, and will look graceful too. Tip – you can add to it by tucking in your tummy, working those abs. But don’t forget to breathe!
Relax in child’s pose.
Again, a little bit of flexibility and stress/ blood pressure reduction can’t be all bad! A time to rest, and reset, and secretly build flexibility and work those abs.
Massage the top of your head and the nape of your neck.
Isn’t that what they did when physically going for a massage was a possibility? Granted, it’s not the same as getting that divine massage, but it’s certainly something. Creating some scalp blood circulation apparently helps with hair growth too.
Lie in Shavasana for that divine sleep and mental reset.
A few minutes of Shavasana prior to a nap or hitting the sack for the night helps me breathe deeply and relax, setting me up for some quality rest time. Tip – a scalp massage with some meditation music prior only makes the sleep deeper and more restful.
Feel free to harness the power of this ‘Yoga toolkit’ alone or with kid(s), your spouse/ partner. It’s relatively simple and doesn’t entail much. Best of all, it’s iterative. Pick what you feel like. Add to it if you want to. If a backbend or headstand is part of your practice, go for it. If you want to just lay down, massage your head, and tune out breathing deeply in Shavasana, do it! It’s also indulgent. Remember to work with your energy levels and time commitments. Don’t endeavor for that perfect pose. These tools can be hugely gratifying, relaxing, and mentally and physically centering. Something we all crave and can benefit from.
Here’s wishing us all the very best, as we surge forward with positivity, gratitude, and mindful intention.
Om Shanti, Shanti, Shanti, Om…….
Nidhi Kirpal Jayadevan is an avid reader and a yoga enthusiast. Her pre-kids life was dedicated to the complex field of Communication Sciences. After choosing to be a full-time mother, reading and playing with her high-energy boys has been a fascinating journey. It has (re)kindled in her a sense of wonder in all things small. She constantly sees the world through little eyes, applying simple learnings to deepen life’s meaning for herself and her family.
Many Asian Americans say – we can wear a mask to protect against Covid but how can you protect yourself against racism?
The physical assaults are the stories that show up on the news. But the mental impacts of racism have been deadly for Asian Americans. They have experienced the highest mental health distress from both the pandemic and rise of hate crimes during pandemic while they are the least likely to seek help for the same.
“There are a lot of trauma reactions, similar to PTSD symptoms. However what makes racial trauma very unique is where PTSD is post traumatic stress disorder, a lot of racial trauma is not post. There is no ending to it right now. It is past, present and ongoing. So, it makes it very unique and tricky trauma symptoms to treat sometimes.” says Linda Yoon, a therapist and the founder of Yellow Chair Collective.
For many older generation South East Asians including Vietnamese, Cambodian, Laotian refugee immigrant population, the recent violent crimes have triggered their PTSD symptoms that remind them of war, genocide, displacement they experienced in their home countries.
Yoon says that there are a lot of physical symptoms in this trauma, including sleeplessness, nightmares, flashbacks, dissociation, confusion, loneliness, and a lot of anxiety and depression. And a lot of anger towards the injustice that they are experiencing.
A lack of understanding of the available mental health services as well as the cultural stigma associated with it, makes it even harder to reach this community.
The concept of mental health comes from psychology, which comes from the western culture and study, says Yoon and because psychology separates mind from the physical body, it feels alien to the eastern society. “In traditional eastern medicine and wellness, they talk about yin and yang – balance which also includes balance of your body and mind. And there is no separation between body and mind.”
So a lot of times Asian Americans will complain about their mental health symptoms in their physical somatic sense. “We talk about pain in our body, we talk about anger that lives inside our body, we talk about the shoulder pain that was caused by family stress, we talk about stomach issues that have been impacted by stress and anxiety.”
To address mental health issues and reduce the stigma, more integrative holistic approaches to mental health will make more sense to Asian populations in a culturally sensitive and linguistically competent manner.
But the good news is that they do not want to “shoulder the fear burden anymore” reports Anh Do at the LA Times. At the start, they “bent to cultural tradition” and kept quiet. They were taught to keep their troubles to themselves. And they wanted to avoid attention to their families. But then as assaults increased, they started reporting and creating safety plans for their loved ones.
“They gave their children mace.” “He makes sure his phone battery is always charged ready to be used in case something happens” and he needs to record it. “Never go alone, even for the smallest errand.” “Hyper vigilance, and avoidance of places”. These are some of the strategies ordinary Asian Americans are employing to stay safe, here in America, according to Do.
The potential for bullying, stereotyping and violence is so high that Asian American parents are afraid to send their kids back to school and generally go back in public.
Who are Asian Americans Exactly?
In 1968, UC Berkeley student activists Emma Gee and Yuji Ichioka coined the term “Asian American” to unite the different communities of Asian descent and strategically create more political power in numbers.
Then, in the 1980s and ’90s this classification was broadened even further via the addition of Pacific Islander and creating the term Asian American and Pacific Islander, or AAPI. While AAPI was meant to be inclusive, in reality it has often had the opposite effect.
According to Pew Research, this demographic marker includes about 19 million people, up 81 percent since 2000. 59 percent of all Asian Americans are immigrants, including 1.4 million of whom are undocumented. Asian Americans are the fastest-growing racial group in America, currently 5.6 percent of the county’s population but projected to be as much as 14 percent by 2065.
The income gaps among different Asian American ethnic groups are the widest of any racial group, and they are still growing. While Indian Americans have the highest median income of $100,000, for example, Burmese Americans have the lowest, at $36,000.By bundling over 50 ethnic groups that speak over a 100 languages under one broad AAPI banner, the aggregated data does a disservice to the individual communities.
In all these three cases, the immigrants came to the US as laborers but were framed as the source of economic problems, and in some cases public health ones, too.
The yellow peril is a racist metaphor for Asian Americans who are seen as outside threats that are invading the west with their diseases as explained by Professor Russell Jeung, Chair & Professor, Asian American Studies Department at San Francisco State University, at a USC Center for Health Journalism webinar titled “What Anti-Asian Hate Means for Mental Health, Safety and Justice.”
The “model minority” trope that suggests that all Asian Americans are well off, hardworking and successful and pit them against other minorities “masks the inequalities that Asian Americans face. The yellow peril is much more operative” suggests Professor Jeung, one of the founders of STOPAAPIHATE.org.
“Sometimes when we are on the inside, we are model minorities, we are white adjacent, we are crazy rich Asians. But in times of war, such as Japanese incarceration, or what happened to South Asian muslims and Arab Americans with islamophobia – in times of economic downturn and in times of pandemic, Asian Americans are framed as perpetual foreigners, or outsiders who don’t belong” says Professor Jeung.
Time and again, when diseases come from Asia, says Professor Jeung, “Asian Americans are perceived as the source of the diseases, policies seek to exclude them, and Asian Americans are met with interpersonal violence.”
AAPI Hate Crime on the Rise
#stopAAPIhate website tracker was created to collect individual reports, to document the issue, to figure out what’s happening, to track trends, and to provide policy interventions. The hate and anger directed against Asians was appalling, up to 100 incidents a day and that surge has continued.
Asian Americans report everything from being barred from ride shares, to being coughed and spat on, their businesses being shunned, their elderly being shoved and kicked, their children being bullied in person and online, racial epithets and slurs and the ever common curse – “go back to China”.
Almost unanimously, respondents named racism as their biggest stressor and greatest fear during the pandemic. Asian Americans are more concerned about other American’s hate than they are of a pandemic that has killed over half a million Americans. That’s how widespread and traumatizing the racism is.
Here in the Bay Area, there were higher incidents of hate crime against Asians in the beginning of the pandemic. This is likely because Northern California, more dependent on public transportation, the likelihood of different communities and different cultures interacting with one another is greater versus Southern California, which is very steeped in the car culture.
Help is At Hand
In Oakland, a volunteer service has been activated where a volunteer comes within 10-15 minutes of a call to accompany you to the bus stop, help you to a grocery store or back to your home.
Professor Jeung is angry and sad and distressed about the state of America although he is heartened that the Asian American community is standing up and “seeing our community really mobilize and working in unity with other allies.”
But he questions what healing looks like? And “as we experience racism, we might become racists – how do I stop this within my own self and how do I stop this for my students? What prescriptions do we have for our society so that we can stop that cycle of violence and racism?”
These are questions that do not have easy answers for us in the South Asian community either. Many of us faced stigmatization and violence in the aftermath of 9-11 but how do we become better allies and show support to our discriminated Asian brethren now?
A simple check up on your Asian American friends and neighbors, says Yoon, will go a long way. Her patients report feeling invisible and alone. Other strategies include intervening if you can when you see an incident, report what is happening and donate when you can.
Words matter, says Professor Jeung as the world watched Trump’s hate speech about the “China Virus” going viral, and normalizing hate towards the Asian American community. “We need official statements to normalize love and respect. It is sort of obvious but it is really needed.”
So, whatever organization you belong to or work at, pressure them to put out official statements about supporting the AAPI community because it helps them be seen and heard and acknowledge their pain and suffering.
President Biden’s new actions to respond to the increase in acts of anti-Asian violence have been celebrated in the community as a movement in the right direction. But in order to address the root case will require “ more education, more expanded civil rights protections and more restorative justice models”, says Professor Jeung.
Anjana Nagarajan-Butaney is a Bay Area resident with experience in educational non-profits, community building, networking, and content development and was Community Director for an online platform. She is interested in how to strengthen communities by building connections to politics, science & technology, gender equality and public education.
Edited by Meera Kymal, contributing editor at India Currents
A lullaby is as ancient as the hills. It connects a mother to the child, much like an umbilical cord, nurturing both. It brings about “an exchange of souls” as suggested by Bayartai Genden, a propounder of the lullaby. Although called a cradle song since its start, it may prove helpful even in serious adult illnesses and in hospice as discovered by modern scientists. Upon first hearing the sound of the mother, the baby gets hooked on to her. But when does the baby even start hearing? That is a fascinating story to unravel.
Embryological Roots of Hearing
At about 18 weeks of life in the womb, the baby perceives the first sound of the beating of her mom’s heart, her breathing sounds, her intestinal gurgling, and the stream of blood passing through her umbilical cord. No wonder the baby, later on, enjoys the sound of a stream or river, which is her deja vu experience! In the third trimester of pregnancy, the baby specifically recognizes her mother’s voice as evidenced by her heart rate increasing when the mother is talking outside. The baby, however, has to hear her mom’s voice through a fluid medium and has to develop a correlation upon her birth that she heard the same voice then and now!
A Lullaby Is More Than Just a Tune For a Baby
Scientific experiments show that the baby prefers hearing her mother’s own voice singing a lullaby rather than somebody else’s. The baby also prefers the subject matter of the lullaby to be infant-directed rather than non-infant-directed! Thus starts the story of “me and mine!” The topic of the lullaby may inevitably get modified as the mother employs it to express her fears, hopes, and prayers.
I learned in my school a lullaby attributed to Shivaji’s mother, Jijibai, who prepared her son to wage and win a war when he grew up. “Sleep now, but fight later,” she sang. This correlates well with the story of Abhimanyu in Mahabharat wherein he learns the art of war while in the uterus.
An Obstetrical Clinic in California teaches pregnant mothers to talk to their baby in the womb. I also learned a lullaby sung by the mother of a child laborer in the textile industry. She lamented waking up her child from a deep sleep of early morning to report to his daily hard work. A Syrian mother changed her soothing lullaby to a fear-stricken one when she was forced to migrate to Turkey to escape the brutal conditions in Syria. Highly toxic polluted air in Ulaanbaatar, Mongolia prompted a mother to shift her children to safer surroundings and sing a nostalgic song about how her beautiful country had so drastically deteriorated!
Thus a lullaby may often unfold an ongoing tale of changing conditions.
Lullabies: A Universal Blanket Covering the Vast Universe
Hannah Reyes Morales, from the Philippines, deserves special credit for reawakening our interest in the lullaby. She has reviewed the world history of the lullaby in National Geographic (December 2020) with accompanying eloquent pictures related to the subject. In fact, there is no part of human culture or province that the lullaby has left untouched. It is ancient but alive and needs to be nurtured to be kept alive. Every country from A to “Z”, so to speak, has its own synonym for a lullaby, the core remaining unchanged.
The French call it Berceuse, the Western musicians Lullaments, while a multilingual country like India has many names for it. It is called Lori in Hindi, Jola in Telugu, Thalattu in Tamil, Nanabaya in Odia, Angai Geet in Maharashtrian, Halardu in Gujarati, Ghum-Parani-Gaan in Bangladeshi. Some of our Christmas carols like “Silent Night, Holy Night” could have been a lullaby to baby Jesus. Dating even further back, a Babylonian lullaby about 4000 years old was found inscribed on a clay tablet.
Our Rich Heritage of Hindi Loris
Undoubtedly, there has been an inadequate exploration of the rich treasure of lullabies in multilingual Indian literature and folk songs. Loris of Indian film songs have a significant contribution to that wealth. They have expressed love, pathos, social adversities, abounding hopes, depressing despairs, panoramic nature, spiritual insightfulness, and a vast gamut of a mother’s powerfully emotional feelings. I was disappointed to see that an exhaustive article on the subject as in National Geographic did not make any mention of Indian lullabies. It also is noteworthy that some of the most outstanding lullabies have been written by men, who often distance themselves from the babies in our society. Yes, men too, can connect to this chorus at home and around. I remember many lullabies that my father sang before I slept.
Modus Operandi of a Lullaby
It is marvelous, mysterious, and miraculous! The baby gets reassured, the mother relieved, and both of them feel ready to sleep at its end. As proposed by Freud, the baby is not afraid of the dark but has isolation fear, while the mother herself also needs some privacy with the baby. As the baby wants to be lulled to sleep (that is why it is called lullaby), the mother also wants to feel the fulfillment of her maternal connection. It is therefore not uncommon to see a mother falling asleep even before the baby. A lullaby supports the spirit, psychology, and resilience in adversity, all of which have a therapeutic value. It is simple, repetitive, rhythmic, and soothing. A father or a sibling can subsequently substitute for the mother, thus widening the base of the bond. A joint presence of both parents at the sleeping time of the baby generates reassuring accountability and dependability in both parents. The baby needs this support to be self-supporting later in life.
Modern Science Extends Applications of the Lullaby Beyond Babies and in Covid-19
Based on the concept that a lullaby has a therapeutic value before sleep, it has been also applied in hospice patients as well as in premature or sick children. Childhood and old age are often placed on comparable rungs of the same ladder of life so a lullaby can bring extra comfort to both, from a state of wakefulness to drowsiness and even death as in hospice patients.
Laura Cirreli, Professor of Developmental Psychology at the University of Toronto who studies the Science of Maternal Song, has reported a decreased level of stress in both mother and baby induced by warm gentle rocking. There is also a lullaby project conducted by Carnegie Hall in New York City. Samuel Mehr, Director of Harvard University’s Music Lab, asked 29,000 participants to listen to 118 variegated songs to evaluate their healing power. “Statistically, people are most consistent in identifying lullabies,” he said.
During the isolation of children from working mothers as in the covid-19 period, mothers sang their lullabies from hospitals and working stations using zoom to comfort their children sleeping at home. What a wonderful use of technology to transmit continuing love and care to the young ones!
Going back to our own country India, Jagdish Chandra Bose (1858-23) proved the comforting effect of music even on plants. Amar Bose (1929-13), who fathered the wireless passage of sound, substantiates that a lullaby functions exactly on the same principle! The sound of music is ever so sound. We better keep our lullabies awake.
Bhagirath Majmudar, M.D. is an Emeritus Professor of Pathology and Gynecology-Obstetrics at Emory University, Atlanta, Georgia. Additionally, he is a priest, poet, playwright, Sanskrit Visharada, and Jagannath Sanskrit Scholar. He can be contacted at email@example.com.
A recentarticle in India West reported that a higher percentage of South Asian Americans, especially between the ages of 15 and 24, had been found to exhibit depressive symptoms and a higher rate of suicide among young South Asian American women compared to the general US population. Likewise,studies have spoken of how South Asian immigrants have high rates of mental health disorders that go unaddressed.
Asian American Connect
Otherstudies have shown that immigrants from South Asia to the USA and their children face numerous mental health challenges.
“This could be on account of acculturation, that is cultural or psychological changes that occur as a result of prolonged first-hand contact between two different belief systems or cultures. Stress predominantly originates from their attempts to incorporate ‘American’ traits in their own culture. This eventually shows up as a cultural conflict. Multiple other factors contribute to this stress, including alienation and separation from their families and loved ones, language barriers preventing true socialization, uncertainty around their immigration status, financial stressors, as well as in certain cases, overt or perceived discrimination, and more generally, barriers to cultural integration,” says Dr. Priyanka Thukral Mahajan, Consultant Psychiatrist,Masina Hospital.
Eventually, this cultural conflict leads to uncertainty around belonging. This is particularly more visible in the workplace. The effects of prolonged acculturation and discrimination result in a wide spectrum of psychological disorders over time. These include depression (primarily due to isolation, financial stress), somatization (i.e., self-interpretation of mental health symptoms as physical symptoms and not seeking help), anxiety (again on account of alienation), substance abuse disorders, especially alcohol.
“Such disorders have a dark underbelly, as they are one of the key reasons for increasing rates of suicides among South Asian immigrants in America. The tragedy is that all the above is neither widely known nor acknowledged. The issue is accentuated further by the challenges associated with seeking help from mental health professionals in the form of psychological counseling. If one gets into the weeds of the issue, one realizes that such immigrants have limited means of confiding their feelings with mental health professionals in the USA, given cultural barriers and differences. It is difficult for professional mental health professionals to understand their feelings and challenges, correlate with their culture and truly empathize with them,” adds Mahajan.
South Asian countries have been right in the center of the pandemic conversation throughout. Though the impact for South Asian Americans is even more convoluted. At the height of the pandemic, last year xenophobia gripped multiple countries and this community bore much of the backlash for no fault of their own. The lingering effects continue in a lot of pockets. The impact that it would have had on their mental health would be enormous.
“Personal stories shared by individuals across the world via my online counseling sessions gave me an insight into the South Asian American community and their fears. The last 14 months, we have seen an increased prevalence of nonpsychotic depression, pre-anxiety, somatic concerns, alcohol-related disorders, and insomnia in general. Parents worried about their children’s safety have given rise to psychological symptoms correlated more with physical complaints of fatigue and pain in older adults. This was directly related to social media use, misinformation, xenophobia, and social distancing. The resulting isolation made a lot of people see the bad rather than the good in a community. Frontline workers reported guilt, stigma, anxiety, and poor sleep quality, which were related to the lack of availability of adequate personal protective equipment, increased workload, and discrimination,” says Sahiba Sethi, Counseling Psychologist,Ummeed Healing.
Apps as a Tool
Apps are just a click away, so are easy to access.
“And some may already be socially isolated and experiencing loneliness which can worsen mental health. COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke,” says Nabhit Kapur, Founder President ofPeacfulMind Foundation.
Apps help people connect in their native languages to a therapist who understands their culture and can empathize with their situation. Some of these apps are powered in the background by Artificial Intelligence.
“These apps help such immigrant patients deal with their mental health issues in a much better way. Their biggest advantage is the patient’s perceived lack of being judged by a third person, resulting in lower stigma towards using them as against meeting a mental health professional in person. This stigma is a huge barrier especially in the South Asian community given the cultural background. A key issue with such apps, however, is in certain instances the patients may not feel truly connected with the device, which can result in a decline in their usage over time. A recently launched app for this purpose is SAMHIN (South Asian Mental Health Initiative and Network). Another one that has been in existence for a longer duration is SASMHA (South Asian Sexual and Mental Alliance). These apps can help connect people who need psychological counseling, with various platforms, to seek support and find mental peace,” says Mahajan.
Statistics reveal that only 23% of non-Americans in the USA seek mental health, against the 40% of Americans born in the USA. Patients from such communities find it arduous to find a mental health professional from their own community, who can understand their situation and truly support them. Covid-19 pandemic hasfurther worsened the above dynamic. As is very well known, the sheer incidence of mental health issues has gone up significantly through this pandemic due to heightened financial insecurity, lack of social contact. For the immigrants, seeking medical help in these times has become even more challenging.
Prakriti Poddar, Global Head for Mental Health at Round Glass, Managing TrusteePoddar Foundation says, “a 2018 study found out that stress related to acculturation, trauma, and discrimination has been linked with depression, anxiety and substance abuse among South Asian Americans. Also, the COVID-19 pandemic has affected South Asian American communities by increasing stress and anxiety levels in terms of health concerns and issues such as employment and housing. Due to the uptick in violence and hate against the South Asian American community, racism has also severely impacted the mental health of the community.”
In India, it is an uphill task to change perceptions related to mental health predominantly due to the stigma associated with it. The challenge lies in creating the right kind of awareness about mental health problems and encouraging people to seek the right kind of help from mental health professionals.
“Mental health crisis can be attributed to the outbreak of Covid-19 and resultant loneliness, isolation, fear of loss of life, financial insecurity, job cuts, salary cuts, and overall economic uncertainty. The common mental health issues associated with the COVID-19 pandemic are stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear reported among Indians. Stress, anxiety, and depression have been closely related with the COVID-19 pandemic,” says Dr. Aparna Methil, Vice-President, Operations,Mpower. Mental health issues faced by South Asian immigrants in the USA are immense and one of the ways to tackle the challenge is to take the help of technology. After all wellness in a click matters the most.
Bindu Gopal Rao is a freelance writer and photographer from Bangalore who likes taking the offbeat path when traveling. Birding and environment are her favorites and she documents her work on www.bindugopalrao.com.
Amanda Sodhi is a DC native and was previously an LA-based screenwriter, songwriter, filmmaker, and writer. This year she has launched a program titled Twelve Steps to Home to travel across twelve cities in India. Amanda Sodhi has taken an unconventional path, following her passion and encouraging women to do the same. She has built on her versatile talents and uses them to questions the ways in which women are bogged down by society. In this interview, she expands on her new project and what it means to be a woman on the road less traveled.
IC: You have a background in writing and music, what urged you to fuse them together and create your project Twelve Steps to Home, and what does it mean to you?
AS: I was born and brought up in Washington, DC. I’ve lived and worked in Los Angeles, too. I moved to Mumbai when I was 25. At 29, I moved to Kolkata, shuttling between there and Delhi. However, I kept outgrowing each city after a point, and it really felt quite isolating. I felt like I belonged both everywhere and nowhere. I couldn’t identify any one place as “home,” as a place to return to.
Often, people define home as where their family is. Since I am estranged from my family, the definition of “home” is especially blurry for me.
The lease of my Kolkata flat was anyhow expiring in December. So, I sold all my furniture, downsized to one suitcase, and began a brand new journey of uprooting myself consciously month-after-month – 12 months, 1 month per city. I will be documenting this journey in the form of a book. And, I intend to release my next song with a music video that draws from footage from all 12 places.
I have no idea what the outcome is going to be at the end of this path, if I will discover what “home” and “belonging” means or not. But, at the moment, I feel like I’m living my best life, indulging in all these new experiences and meeting so many new people.
IC: As an Indian, there are often challenges that urge us to take a ‘safe’ path in our career due to family or societal pressure. What brought you to find success in your passion and how do you cope in that environment?
AS: It was difficult. My family was neither able to accept that I wanted to pursue a creative career, nor were they were able to wrap their head around the fact I was going to move to India. Eventually, I reached a breaking point where I felt it was high time I lived my life fully, without any guilt. Therapy also helped. Sometimes it takes years of something building up slowly to make a person finally snap, not care about what society thinks and muster the courage to live life on their own terms.
IC: As a woman traveling in India, how is your artistic process impacted through challenges or obstacles you may face that other genders don’t? What has changed in your journey?
AS: It is challenging – often, people try to discourage women from traveling solo by instilling fear in them. Sometimes people feel resentful that you’re traveling freely when they have succumbed to societal pressure and are conforming to certain expectations of how life should be structured by XYZ age. Some people show sympathy that, “Oh, you don’t have a boyfriend or husband to travel with?” as if that’s even a prerequisite! A few people, however, feel inspired to also travel. It’s a mixed bag.
I remember when I was in Port Blair, one of the hotels I stayed at created random rules just for me because I was the only solo female traveler at their property. It was suffocating. Also, in many cities, I have faced eve-teasing. It can be really upsetting. But, I don’t let it discourage me. Why should a few assholes ruin my plans? My life has been enriched through all the travel experiences I’ve been blessed to have – I’ve learned so much about different places, different people, different cultures, different viewpoints, different lifestyle choices. So many stories to tell!
Regarding my artistic process, there are a lot of men with very fragile egos one comes into contact with; some of them do try to jeopardize your project(s). This is why I like to work alone as much as possible. And, this is why I don’t rely on artistic projects to pay my bills. I freelance as a social media consultant, content writer, and VO artist. This decision has enabled me to create art on my own terms.
IC: In the same manner, how has the pandemic impacted your journey?
AS: The travel guidelines for each state in India keep changing, so I have to pick places accordingly. And, I have to be mentally prepared that flights may get canceled last minute. Because not as many tourists are flocking to each city, I get to experience the best of the local vibe. With this crisis occurring in India right now, it seems I’ll stay put in Kashmir for another month. I will proceed with caution and be sure to monitor the situations carefully.
IC: What do you want to say to women, who also want to strongly pursue their dreams but are afraid to for different reasons?
AS: We are all going to die sooner or later…Marne se pehle, please thodda jee lo.
The fact we are all mortal should be the biggest motivation to pursue one’s dreams unapologetically. Better to try and fail in the process rather than be resentful or blame others for stopping you. Yes, everything comes with consequences. But, in the end, I firmly believe the only person stopping you is you.
IC: As a woman who has taken an unconventional path in life, is there a lot of emphasis on mental health? In India, where there is a strong barrier for women, and where mental health is a taboo, how do you cope with facing such challenges?
AS: I’ve been in and out of therapy for nearly a decade. I’ve also reached out to shrinks and life coaches, as and when I’ve felt it was required. A few years ago, I was diagnosed with Mixed Anxiety Depressive Disorder. Instability, for prolonged periods, is usually a trigger point for me, which mainly stems from a lack of a sense of what “family” is. Sometimes being open about your own mental health journey – especially if you seem high-functioning – inspires others to also seek help. It is best to lead by example.
I conduct writing therapy workshops through my startup Pen Paper Dreams and try my best to counter the stigma surrounding mental health at a smaller level. For example, one of the books I had my reading group explore is Maybe You Should Talk To Someone. It helped bust a lot of myths.
IC: You have traveled and lived in places that are on opposite ends of the world, adapting to cultures that may be completely alien to you. What is your support system in this process and how do you thrive in each city and culture to fully experience it?
AS: Indeed, every city is unique. But, at the same time, humans are also very similar, irrespective of their surface-level differences. When you are mentally prepared that you have to make the most of any place, any situation, it helps you adapt quickly. I’ve been lucky to make friends and acquaintances everywhere I go – they have all been an extremely important part of my support system. Humans are social creatures – we need interaction in healthy doses to thrive; that’s definitely one thing this pandemic has made crystal clear.
IC: How important is it to have an identity as a person separate from being a daughter, mother, sister, etc and in Indian society, how do women tackle that?
AS: Before being a daughter or a mother or a sister or a spouse, you are first and foremost an individual. A person is much more than just the role they play within a family. One’s identity is a mix of different elements at a personal level, family level, and social level. Do not let one role define your entire being.
Check out Amanda Sodhi’s music here:
Swati Ramaswamy is a recent graduate from UC Davis and is an aspiring creative writer who loathes speaking in the third person.
Are you ready to achieve your goals and ideal life? 2021 is the year to renew, refresh, revitalize and move towards achieving your goals. Visualization is a tool you can use to realize your goals and attract what you desire. I use this tool regularly and would like to tell you more about it.
A Vision Board is a tool that is used to represent your intentions and goals to create your ideal life with images, pictures, symbols, numbers, positive words, and affirmations. It helps you clarify your goals.
Define your goalsin your relationships, work, family, finance, or more by writing them down. To make it simple and more effective, let’s build yourself a Vision Board. Choose pictures and images that bring forth objects and experiences that you want to attract in your life. Take a board, or if you prefer things online, you could also use an online tool like a ‘Pinterest’ board. You can cut out pictures from the newspaper, magazines, and the internet which may speak to you about your goals, ideas, vision, and success.
Add a happy picture of yourself to this collection!
Try to organize your pictures to make them appealing to yourself. Bring forth your creative juices while working on your vision board. You can use markers or metallic pens to write quotes, positive words, and affirmations.
Your vision board could be oriented towards a short-term or long-term goal or a specific area. I tend to create different boards for the various aspects of my life; relationships, health, job goals, finance, travel.
Place your vision board in a place that is easily visible to you.You may like it on your nightstand, worktable, fridge, or even on the lock screen of your phone.
I have learned that seeing it for 5 minutes when you awaken and just before sleeping are the most powerful times of the day. Seeing the images the first thing in the morning helps in creating what you want to happen or have. In addition, seeing these images one hour before bedtime keeps these images running through your subconscious mind at night in a replay mode.
What is Creative Visualization? You start to create mental images vividly and repeatedly in your mind of what you want to happen, in order to help that event come about in real life.
We have all heard the quote, “ A picture is worth a thousand words.”
We picture the images we want as IT HAS HAPPENED. Our brain and subconscious receive the message of what it is we desire and set the wheels in motion to make that wish come true. When we learn how to visualize correctly, the images we generate become a reality.
Once you have created your Vision Board you can select and focus on one image. Find a comfortable place to sit or lie down, where you won’t be interrupted, and begin picturing in your mind what it is that you want. It could be an event you want to occur, a goal you want to achieve, or a personality trait, such as self-confidence or compassion, that you want to develop more fully. It may also be that you want to improve your health, relationships, or work life.
See it clearly in your mind’s eye and really get into the experience. Give your imagination free reign, Imagine all the sights, sounds, smells, tastes, or tactile sensations you would expect to be there when your dream finally manifests as reality. Picture yourself inside the story, not outside looking in
Feel as it has happened, not happening.
If, for example, you wish for your children to be healthy and well-balanced. Picture them in front of you – laughing, happy, caring, and loving. Listen to the sounds of laughter, the smell of the scent of the soap after the kids have showered, and the aroma of a home-cooked meal. Feel the joy of reaching out and hugging your children and the bonds of being together.
For instance, a Bharatnatyam dancer who wants to achieve her goal to be an accomplished dancer has to have ambition, dedication, and a want to achieve her dream. While closing her eyes she imagines herself on stage in front of people, dancing with confidence and grace. The dancer can hear her heartbeat and the elation of the crowd. She feels the swish of her colorful attire against her skin. Her ‘abhinaya’ or the expression in motion should be felt like a warm feeling coursing through her body. In the ‘tilana’, she explodes into leaps and jumps, moving in all directions with the fast tempo of the music. The Bharatnatyam dancer hears the three clangs of the cymbals and knows that she has given it all. The more she visualizes this with all her senses, the more she will be able to achieve her goal.
Athletes use visualization to help them achieve peak performance By picturing themselves flawlessly executing a difficult maneuver, they are more likely to execute the maneuver flawlessly when the time comes to actually do it. Speakers visualize in order to stay calm during speeches.
The more real and detailed the experience is in your imagination, the more powerful the visualization will be and the sooner it will happen in your life as a reality. Repeat this a few times during the day. For extra oomph, try combining an affirmation with each visualization. The practice of visualization will help you achieve your goal. Have patience, focus on this powerful tool, and learn to enjoy the beauty of this magical resource. Go on to try building your Vision Board and using Creative Visualization and see the results!
Sukham Blog – A monthly column focused on South Asian health and wellbeing.
My wife’s oncologist recommended a palliative-care consultation during one of her checkups. This was the first time we heard about it and my wife, subsequently, received beneficial palliative care alongside her ongoing treatment for cancer. Since then, I’ve continued to learn more about palliative care and how it helps patients living with various kinds of serious illnesses. I’ve also realized that most people know very little, or are misinformed about palliative care. We need to understand this relatively new medical specialty; it can do a lot for us and our loved ones in the event of a serious health issue.
Palliative care is specialized care for people living with a serious illness. It is a type of care focused on providing relief from the symptoms and stress of different kinds of serious and chronic, progressive illnesses, and is provided in addition to, and concurrent with, ongoing medical care. It supports the patient’s ability to feel better while undergoing treatments which could be intense and sometimes not well tolerated. The goal of palliative care is to improve quality of life for both the patient and the family.
To palliate is to make something – for example, a disease or its symptoms – less severe or unpleasant. Palliative Medicine is relatively new. It has its roots in the work of Cecily Saunders and Elisabeth Kübler-Ross in the 1960s. The term Palliative Care was coined in 1974 by Dr. Balfour Mount, a surgical oncologist at The Royal Victoria Hospital in Montreal, Canada. It was recognized as a field of specialty medicine in Great Britain in 1987, the same year that Cleveland Clinic started the first Palliative Medicine service in the United States. It became a board-certified subspecialty of medicine in the United States in 2006, just 15 years ago.
Let me repeat: Palliative care is specialized care for someone living with a serious or chronic progressive illness, focused on providing relief from the symptoms and stress of the illness, to improve quality of life for both the patient and the family. It is based on the needs of each individual patient and can be provided at any time during his or her illness, along with the treatment he or she is already receiving, regardless of the prognosis, expected trajectory of the disease, or age of the patient.
What, specifically, does palliative care do? It provides relief from pain, nausea, constipation, neuropathy, shortness of breath, or other side effects and symptoms caused by the illness and/or treatment. It helps when patients and their families have trouble coping with the illness and are anxious, depressed, stressed, or fatigued, and enables them to better carry out their daily tasks and do the things they want. Palliative care can also improve the quality of life for both the patient and his or her family.
What is meant by quality of life? That depends on the patient! He or she defines what is important at that moment and in the future. The palliative care team works with the patient and his or her family to understand what’s important and what matters most to them, and takes that into account to formulate a treatment plan and provide the best possible support to help realize those goals.
I used the phrase palliative-care team. Care is provided by a specially-trained, multidisciplinary team that typically includes doctors, nurses, medical assistants, social workers, chaplains, and other specialists. This is because palliative care extends beyond a patient’s physiological and medical needs and addresses other factors that may be affecting their quality of life, including psychological, spiritual, and social needs. These needs vary from patient to patient. In addition, they can vary over time for a given patient.
Needs could include: help with figuring out what medications should be taken and when; thinking things through, and weighing options when faced with decisions on a suggested next step in treatment; help navigating the complexity of a large hospital when referred to different specialists or when various tests are ordered. Sometimes stress can overwhelm the patient, caregiver, or another family member, and they could benefit from having a caring listener, or just a hand to hold for a while. The costs of treatment are a huge concern for many of us, so the assistance of a qualified individual to sort through financial questions might be valuable. When serious illness brings up existential and spiritual questions, trained chaplains could provide answers, solace, comfort, and a compassionate presence. Nutritionists who understand the patient’s diagnosis and condition can help address dietary concerns.
Palliative-care specialists treat people living with many types of serious and chronic illnesses, regardless of their age, stage of the disease, and whether or not they are still receiving curative treatment; these include cancer, congestive heart failure, chronic obstructive pulmonary disease (COPD), kidney failure, Alzheimer’s, Parkinson’s, Amyotrophic Lateral Sclerosis (ALS), and other life-limiting diseases. Pediatric palliative care is an upcoming specialty. During the current pandemic, it’s an essential part of treatment for those who have contracted COVID-19.
Many confuse palliative care with hospice and believe a recommendation for palliative care implies the patient has a condition that will imminently end his or her life. This is not correct. Palliative care can be very useful for those managing a long-term illness. Quality research provides evidence that the early introduction of palliative care provides all the benefits described above, and results in fewer hospitalizations, a reduced burden on the family, and greater satisfaction overall. Hospice is a form of palliative care for those patients judged to be approaching end of life – and typically have six months or less left to live – who decide to focus on comfort instead of prolonging treatments.
I hope this has helped you better understand Palliative Care and dispel any related misconceptions.
Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder ofSukham,an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death, and bereavement. Contact the author at firstname.lastname@example.org
Sincere thanks to Drs. Neelu Mehra at Kaiser Permanente, and Kavitha Ramchandran & Grant Smith at Stanford Health Care – Palliative Care Physicians who have contributed greatly to my understanding of Palliative Care.
With sincere thanks to Trung Nguyen at Pexels for the use of her beautiful photograph.
Loneliness is like a cold hand resting on your heart. It can tighten your chest, and make you desperate with longing for company and support. I have certainly felt it on many an occasion: while new to a place, recovering from a loss, a death, a fractured friendship. You may have too. It can only be shaken off by the warm hand of a friend, a loved one, or sometimes, even a stranger.
Vivek Murthy comes across in this book as a gentle soul, deeply understanding of the feelings of loneliness from his own life experiences. This understanding, coupled with his medical training, scientific bent, intellectual curiosity, keen powers of observation, and obvious commitment to public health makes this a very readable, thought-provoking book.
His tone, sincerity, and story-telling skills reminded me of another physician and author, Abraham Verghese, whose book The Tennis Partner is a beautiful account of friendship, addiction, and loneliness.
Murthy starts by laying out the different types of loneliness identified by research:
Intimate, or emotional, loneliness – the longing for a close confidante or intimate partner;
Relational, or social, loneliness – the yearning for quality friendships and social companionship and support;
Collective loneliness – the hunger for a network or community of people who share your sense of purpose and interests.
All three dimensions are needed for us to thrive; one may have fulfillment in one or two areas but still feel lonely.
Murthy makes the case for how loneliness has evolved, the scientific, neurological underpinnings. Throughout history and evolution over millions of years, humans have depended on community for survival. Together, humans were stronger and better able to withstand dangers, such as attacks by other groups. When one strayed or was separated from the group, one’s very life could be at risk. Hence, the importance of community is practically hardwired into us.
The science underlying loneliness, along with the implications to one’s health, is well researched by Murthy and presented with the requisite references. Dr. John Cacioppo, one of the founders of the field of social neuroscience, first likened loneliness to hunger and thirst, as an important warning signal with biochemical and genetic roots, calling it “a biological and social imperative rooted in thousands of years of human evolution.” The work of Dr. Julianne Holt-Lundstad, a health and social psychologist, showed that weak social connections can be a significant danger to our health.
There are fascinating accounts of research into brain activity during the times we are engaged with others. One of the most striking findings for me was to learn that the same part of the brain that responds to physical pain also responds to emotional pain. Connecting the dots, Murthy makes the connection clear: that people in emotional pain and despair often reach for a numbing drug or drink, as they might for physical pain. This is particularly insightful for the opioid epidemic, from which society is currently reeling.
Murthy’s relates several examples of how people’s lives have been affected by loneliness: children, young, middle-aged, and older adults, both men and women. His account of his own childhood, being bullied for looking and sounding different, will strike a chord with many who have struggled with fitting in and felt they didn’t belong. In a section of friendships among middle school girls, I paused to remember my own daughter’s deep sadness when a close friendship broke off. So many children go through this in middle school, a critical period in their social and emotional development. Support and love are essential to help them tide over such times, until they feel more secure in themselves.
Some of Murthy’s accounts of children subjected to toxic stress (from neglect and or abuse) were heartbreaking. He said studies that have shown, mercifully, that all it takes is one caring adult to prevent and reverse the effects. He gives the example of Big Brothers and Big Sisters of America, a non-profit which matches children with supportive adults in one-to-one mentoring relationships.
While the physiological underpinnings of loneliness are the same for all, circumstances may vary, and the effective countermeasure depends on individual inclinations, preferences, and reservations people may have. It’s no big secret or surprise that men are typically less inclined to openly share what is troubling them than are women. Their styles of communicating, and hence their preferred ways of seeking and finding comfort and support, are very different. For example,“Men’s sheds”, local non-profit organizations where men gather around a common activity, build trust, companionship, and community, is an initiative that was started in one locality in Australia and has spread to different parts of the world.
In the second section of the book, he speaks of the different ways we can connect with one another to preempt or assuage loneliness, and with that, be on the path to a healthier life and a healthier society. The circles of connection he describes track with the different types of loneliness; the friendship circles consist of:
an inner circle of close friends and confidants,
a middle circle of occasional companions, and
an outer circle of colleagues and acquaintances.
In a beautiful section on the importance of solitary reflection, Murthy encourages us to tune in to ourselves with an analogy to the heart pumping blood: while the heart pumps blood in systole, it is in diastole that the blood is supplied with oxygen. Hence, “pausing is what sustains the heart.” Art, music, reading, and being in nature are all experiences that can be enjoyed in solitude but make us feel connected with others. One shining example for me is that of Andrea Bocelli on Easter Sunday, singing “Amazing Grace” from the Duomo Cathedral in Italy at the height of the pandemic, bringing the whole world together as we all sat apart in fear and worry. Iwrote of this and other ways we have been able to come together during the pandemic.
Murthy describes the three-way relationship between service, loneliness, and addiction. He quotes Rabindranath Tagore, India’s Nobel laureate poet, and from the scriptures of Hinduism, Christianity, Judaism, and Islam, all of which have service written into them. I was reminded of a prominent scientist in the bay area, the late Nagesh Mhatre, who would exhort people “If you are feeling down, find someone who is suffering more and help them. You will both feel better.” The very act of helping someone makes one feel more needed, less lonely, adds a feeling of self-worth.
There are several inspiring examples of individuals, a college freshman namedSerena Bian, for one, who surmounted her feelings of loneliness and depression. Even with these inspiring anecdotes and observations, the second section doesn’t hold together as well as the first. There are newer problem statements: connecting kids in the digital age, seeking support from one’s community during parental crises. Parents struggle with childcare. When anything goes awry, a carefully constructed day can fall apart in minutes. While this book was written in pre-pandemic days, parents’ struggles have only become greater. Being responsible for months for children’s schooling from home has stretched many a family to breaking point. Those who must work outside the home have sometimes been forced to make a choice between work and caring for their children. Most of the time, the burden falls on women. The economics are sobering. There have been articles stating that in the workplace, the pandemic will set back women by decades.
While the last two chapters are filled with inspiring anecdotes, I am left wondering how all this can be formalized, how scalable the approaches are without a coordinated nationwide initiative. It requires effort, work, to build community, and it might take more energy than many have when they are burdened by their circumstances or depression.
In America, we live in a deeply individualistic society. Murthy seems optimistic of the ways in which we can build community even with everything that keeps us apart. I find myself less hopeful: since this book was published, we have had the most sobering, divisive period in American history since the struggle to end segregation. Building community seems harder now than ever. On the positive side, we have a new administration, of which Murthy is an important part, and perhaps there will be change for the better.
Towards the end of the book, Murthy’s states surprisingly that “as hard as we may work… the future will depend on our children. It’s up to all of us to teach them how to build a more connected and compassionate world.” Indeed it is, we must strive to be good parents. But are we to just kick the can down the road to our children? I was reminded ofGreta Thunberg’s outrage at the 2019 UN climate summit when she exclaimed to the adults who had left things to her generation: “This is all wrong. I shouldn’t be up here. I should be back at school on the other side of the ocean. You come to us young people for hope. How dare you?”
This book presents an important concept that leads to a policy focus on child development. How about assuring social-emotional development at the national level, instead of relying on countless non-profit organizations to pick up where schools and society have dropped the ball?
InAmanda Gorman’s powerful words, delivered at the inauguration of President Joe Biden.
“…our inaction and inertia will be the inheritance of the next generation.
Our blunders become their burdens.
But one thing is certain:
If we merge mercy with might, and might with right, then love becomes our
legacy and change, our children’s birthright.”
Vivek Murthy has used his pulpit to shine a light on a key contributor to our health and well-being. This book explicitly callout loneliness as a critical contributor to much of what ails us, our physical health as well as the health of our society. If the purpose of the book is to increase awareness and understanding, it has succeeded. If it is to show a clear path forward, it falls short. A diagnosis is the first step. A remedy must follow. In the UK, in 2018,an initiative to combat lonelinesswas started at the ministerial level. It is not clear what progress has been made. Perhaps the US needs to follow suit.
Dr. Murthy is in a position to chart out the role the government might play, now that he is starting his second stint as Surgeon General, this time in the Biden administration. With his deeply realized perspective on loneliness and health, perhaps we can expect to see more work on this front.
All the best, Dr. Murthy, and Godspeed.
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Raji Pillai lives in the SF Bay Area and writes at www.rajiwrites.com where this article was originally published.