Yousuf Raza – PoliticoEconomic Trauma and Mental Health
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Alright, Bismillah.
Assalamualaikum everyone and hello and good morning, afternoon,
evening, wherever you are.
Assalamualaikum Azam.
Walaikum Salam.
Yusuf Bhai, how are you?
I am fine.
How are you?
I am fine.
So, today we have a guest with us.
She is an assistant professor.
And her work is in India.
She works in the US.
and when if we can explain a bit
about her work.
how the social and political and economic conditions
affect the mental health.
Right.
So, without further ado, Dr. Yurdita.
Hi, everyone.
Good morning, evening, since we are sitting at
different places.
So, you know, all of those work.
I hope all of you are doing okay,
especially given what is happening at this time.
So, like Azam said, my work is fieldwork,
at least research work was mostly in India.
And part of the theory work was looking
at schizophrenia or psychosis.
And its historical roots and emergence.
And I did that theoretical work because if
you place something in history, you see its
emergence, you find out that it is not
a natural and given thing.
Because usually psychology tends to pretend that it
is given, it is right.
This is the only way to do things.
And my entire undergrad and master's were in
Delhi University.
And no one ever, you know, in undergrad
taught us to question those things.
No one said, okay, let me give you
an example.
I don't know, psychology people are here.
Mary Ainsworth's experiment was a strain situation test.
Put the child in the room.
If the mother leaves and the child cries,
it means the child is nicely attached to
the mother.
And there is a stranger in the room,
right?
No one told us to think, does this
work in other cultures?
Where a child is used to, for example,
grandma, grandma, the uncle next door will also
grow up.
My friend once told me, she was on
the bus.
There was a tiny baby.
So, the mother got on the bus.
To buy a ticket, she caught a stranger
who caught another stranger.
And by the end of the whole bus,
the baby came back to the mother.
Why should a baby be wary of strangers
if he's so used to all of these
other people?
So, for me, looking at those cultural things
was important.
I mean, you know, where did the emergence
of schizophrenia and psychosis come from?
And part of my work then, which is
called empirical, actual fieldwork, that happened in India,
in the mountains, in Uttarakhand.
Trying to understand how people talk about, I
see things or hear things.
But when I don't tell them that this
is a hallucination, this is a delusion, so
how do they think about it?
And I found some amazing things like, they
have much better rates of, you know, recovery,
if we call it recovery.
Because our language is in that.
Than we do.
When I was doing my clinical internship in
Vimhans, which is like a top-notch institution
in India, in Delhi.
People, for 20-30 years, like, schizophrenics used
to come to the rehab center.
And those people in the mountains were just
like, yes, I saw the whole procession today,
which no one else saw.
I danced with them, then I left and
started working in the fields.
That's it.
So, that was understanding how culture, politics, the
economy of a place, depreviation, exploitation.
You will see that I don't use the
word trauma, because trauma is also very heavy
with psychological meaning.
How these actually affect people, how it changes,
who gets distressed, who doesn't, what helps them,
what doesn't, has been kind of my life's
work at this point.
10 years of work, that's my life's work.
So, Ayuti, you yourself used the word trauma.
If we go to the basics, we have
heard the terms emotional trauma, physical trauma, but
we also see this in your work, and
in the last few years, in psychiatry, this
has become very popular, that there is something
as social and cultural trauma.
If you could explain that a little bit,
what is it, what are its roots?
Yeah, sure.
So, trauma, first of all, is not a
thing that always existed as a psychological category.
In the 1990s, it became really popular, but
even before that, like Jinnah and Sharko's work,
they used to call it railway spine syndrome
at one time, that there used to be
these big railway accidents, and if no one
was physically hurt, they would still have nervous
symptoms.
So, trauma theory came from there.
So, it didn't exist as a universal given,
always.
And then, of course, trauma theory became really
popular, and a lot of it was dividing
trauma in physical and emotional trauma, which we
don't know anymore, if that makes sense.
But cultural trauma and economic trauma came, at
least from a few different places.
If we look at cultural trauma and economic
trauma, a lot of it started as a
criticism.
When the global mental health movement came, which
said that India and Pakistan and all these
third world countries will go to the global
south, we will solve their trauma, we will
help them a lot, they were like, okay.
So, a lot of decolonization experts came in
and said, replicate your experiment first, come back
later and help us.
Because we know, in psychology, the replication crisis
is very big at this time.
These basic experiments, on which the whole discipline
is based, are not getting replicated.
So, from there came the idea that exploitation
and violence and depreviation are causing a lot
of these problems, which we always think of
as internal.
You know, because of someone's parents.
Because psychology is essentially Euro-American.
In terms
of cultural
trauma, Diana Kopua in New Zealand, she works
with the Maori population, the indigenous people of
New Zealand.
Joseph Kahn, who is a Harvard psychologist, he
works with the Native American population in the
US.
And these are the people who have seen
how colonization and exploitation leaves a lasting impression
on people.
And it's very easy for us to think,
colonization is over, what's next?
And many people think like that.
And in a way, they are right.
But you know, I think, Bulhan had said
that colonization can end, but coloniality is still
there.
You can see it in the fact that
my speaking in English is supposed to be
a marker of my class, my caste in
India.
It's supposed to be a marker of sophistication,
intelligence.
It has nothing to do with it.
It's a language.
My mother speaks three languages.
But because she cannot speak in English that
fluently, suddenly it becomes a marker of all
of these things.
So coloniality has stuck around.
And it still does that kind of violence
on us.
But the problem is, sometimes when we think
of trauma happening through all of these external
things, right?
Economic depreviation, poverty.
For example, research shows that therapy does not
work as well for people who are poor.
Because, you know, you go to a session,
you do this work, you come back to
the same thing in which there is no
food at home.
It doesn't work like that.
So class has a huge thing playing into
whether therapy works, whether antipsychotics or antidepressants are
helpful.
Those things have been thankfully, in the last
three years, there is research that has shown
that.
So given all of those things, sometimes when
we take a look at economic depreviation, political
violence, sometimes psychology can actually really harm you.
Because it takes these external realities and takes
them inside a person.
What happened to you is inside you.
It's in your individual.
The way you can come out of it
is through personal resilience.
And trauma theory will keep saying that the
only way to come out of trauma is
to talk about it.
Who said that?
Like, you know, where is the evidence that
says this is the only way to deal
with horrible things happening to people?
It's one way to deal with it.
Absolutely.
But we prioritize language in psychology.
Verbalization is essential.
And psychology has a part to play in
that.
So psychology is becoming the new opium of
the masses in that sense.
It's justifying, in a sense, it's allowing the
political economic trauma to hide behind our etiological,
these theories that locate everything either in the
family or in the person, or his genes,
or all that.
And everything political, economic, just simply gets...
It doesn't come in our zone.
It's out of our scope.
Because then where do you intervene?
Exactly, like you said, it hides these things
behind it, right?
It's a good way to put that.
Because when it says that, when psychology comes
in and says we've seen in your brain
scans, by the way, that poverty changes the
way people, you know.
And that is true.
We have seen that.
It tells you that the point of intervention
should be individual.
That you either take medicine or go to
therapy.
Don't change the structures that are around you.
Focus on what you can do.
And feminist psychologists have fought against that for
a long time.
They've said, you know, maybe it's the people,
the structures around that are sick and we
need to change them.
Rather than tell this person how to adjust
to their surroundings, how to be a good,
you know...
How to be productive at work.
Maybe you should not.
Maybe work stress is not a normal part
of living.
Maybe we're not supposed to be constantly stressed
out about work.
But psychology helps capitalism and says, no, no.
It's normal to work 80 hours a week.
Here is what will help you sleep in
the night.
Take a Xanax, right?
Rather than...
This is very exploitative.
This should not be happening.
Yeah.
Yeah.
If we can translate this into our day
-to-day issues, is this the same thing
that it is all in the individual psychology?
Isn't this the same thing that is used
in our terms, in our clichés?
That this is your own weakness.
Why are you thinking like this?
This is the weakness of your personality that
all this is happening to you.
And absolutely.
So many theorists...
Ian Hacking has said, it's called the looping
effect, right?
If you give someone a language, that language
can change their being.
Right?
I think Viva Luce has...
There is something called Haslam's concept.
It's called concept creep.
Again, we give somebody the language and it
changes the way they think and feel about
themselves.
So even the word like personality, we assume
that it is a given universal.
Actually, personality is a cultural...
This thing, right?
When we give personality tests to people in
Europe and America and we ask them to
take these tests around other people, their result
is always the same.
I am this.
I am introvert.
I am extrovert.
I am outgoing.
But when we give them to people from
Asia, their own sense of my personality changes
depending on You are giving them the test
with your parents.
You are giving them the test with your
professor.
And these people don't even have to look
at...
But you're right.
In our everyday cliches, psychology has entered and
entered very swiftly, very deeply.
And it's entered because of us.
In a place like India, I am a
high caste, highly privileged person.
My voice is so loud.
So when I go around telling people, mental
illness is just like any other physical illness,
people listen, right?
They don't want to talk about the fact
that that narrative mental illness is like physical
illness, has been consistently attached to alienation, dehumanization,
higher stigma, higher levels of feeling that I
can never be okay because it's like a
physical illness.
So, yeah, it's in our everyday language when
we tell people that this weakness is inside
you or think a little differently.
And not just with bad things, with good
things too.
There should be resilience.
Resilience is a thing that is inside a
person.
Where is it inside?
Resilience is something that comes from...
For many people, it comes from their support
systems.
Right?
I mean, we know people can undergo traumatic
incidences.
Depending on who is around them, their response
to that trauma changes.
You can see it in the PTSD level
in American troops.
And the lower amounts of PTSD level in
Israel and in India.
Right?
In troops, again.
And I come from a military family, and
so just talking to a friend, the PTSD
in Indian troops is usually seen when you're
away from your family, rather than when you
come back, which is the opposite of what
you see in American troops.
So, yeah, we have done this.
We have changed the language of a whole
culture, thinking that we're doing it for the
better because it's not like people are evil
and we're like, ha ha ha.
Right?
But, yeah, we thought it's for the better.
We just don't know if it is.
That's the thing.
It's not a bad thing.
It's just there is no good evidence saying
that this is the right way to understand
yourself, your emotions, your feelings, your trauma, your
absence of trauma.
So, yeah.
And, Ayurthi, it also affects how that family
will support that person.
Because in one case, that family will just
tell them that they only have two options.
Either take the medicine or stop thinking about
what you're thinking about.
And secondly, that family will become that person's
partner and try to solve their problems and
hands-on problems.
So, it makes a big difference towards family
also.
Yeah.
It makes all the difference, actually.
When I was doing my clinical internship in
Vimhans, there was a boy, I think, 17
-18 years old, who had what we call
pseudoepilepsy.
He would have epileptic seizures, but there was
no physiological reason.
He was brought into a high-anxiety state.
It started with a choking feeling.
His uncle died.
That kind of triggered a lot of things.
Every day that that boy was there, from
morning to evening, someone in his family was
there in the ward with him.
Right?
And that boy left.
Within five minutes, he was out of the
hospital.
Right?
And as opposed to that, when I'm here,
I see like family is not even allowed
to come and see the patients.
It's the same Euro-American pathologization of family.
If there's a family problem, we separate that
person from their familial surroundings, and they'll be
fine.
Which never happens.
There is a revolving door in mental hospitals
in the U.S. People who go in,
come out, go in, come out.
I'm sure about that.
Maybe you have these healing temples, right?
And like when Westerners come, they see abuses
and human rights violations, which is true.
It's very rough to watch.
Very rough.
But I went to Balaji, where a lot
of people who are psychotic kind of are
taken and all of that.
We call them psychotic.
They call them different meaning systems.
Of all the horrible things that I saw
there, the one thing that was there was
Sabki family was with them.
It doesn't matter if a lady was breaking
her head on a thing because she was
in a state of trance.
Her family was still with her.
We've used brief psychiatric scales in places like
this to see how their symptoms move.
Going to places like this, as awful as
it looks like to us, and I was
very scared being there because it's a very
scary place.
People's symptoms on the brief psychiatric scale, there
is a really good lowering of symptoms, especially
hallucinations and delusions and stuff like that.
It's different meaning systems.
People believe this will help them.
It helps them.
The family.
Criticize.
So that verbal bullying that we see, I
think the effect that that has depends on
the context.
For example, I know this is desi cultures,
but this is a very common thing in
which we...
We don't have a boundary.
It's not censored.
If someone has put on weight, they'll go
and say, you've put on weight, what are
you doing?
Or they'll come and say, there's a pimple
on your face.
For many people, especially here in Euro-America,
that's a huge boundary.
So it's a very boundary existence here.
And this...
in a desi culture can be very hurtful.
But it can also be taken as for
some people, again, depends on what their context
is.
That's just something you do when you're friends.
Like with your closest friends, what do you
do is you make fun of them and
they make fun of you.
You don't do that with normal level friends.
It's only with your best friends.
But you do the same kind of bullying
to a child here in the US.
And it will shatter them.
So context really matters.
Because here, that bullying is seen as...
Firstly, the level of bullying is also completely
just scary out here.
It can be completely what we call traumatizing.
It can affect their mental health and all
of those things.
So it depends on the context.
Even in Indian places, verbal bullying can feel
bad.
But is it shattering?
Does it completely turn you into someone who
now has anxiety symptoms or it tends to
become more depressive?
Depends on the context that you're in.
Are we doing this to each other?
What is the cultural value system here?
Is this a normal thing or is it
a horrible thing to do to someone?
It's the same with beating, right?
If you slap an outsider, that will be
a very...
It's a big deal because the culture tells
them it's a big deal.
So it can be...
It can create shame, guilt, sadness, all of
those things.
For a long time, if we used to
get slapped, it was just something that you
cry about, and then you get up and
go.
It's something you laugh about.
So it's the same thing.
Should we hit kids?
Should we not hit kids?
Never a good idea, sure.
But the effect that it has on kids
depends on the culture that they're brought up
in and the context that they're brought up
in.
So how do we understand my being hit?
Is this something that happens to my friends
and then we laugh about it?
Or is it something that never happens to
anyone around me?
And now it's abuse.
So context, yeah, really matters there.
So when we talk about the Indian or
Pakistani culture, the segment of our society which
is more influenced, and that would be the
segment which is more educated, more westernized, would
take to these as abuse.
They are more likely to respond, Okay, this
is a no-go area.
This shouldn't happen.
He's been abused.
And they're then more likely to respond, Okay,
this happened to me.
I should be anxious.
I should be depressed.
So it's kind of like now we are
being told what should make you depressed.
Now you should be depressed.
You have been through abuse.
It's almost natural for you to have all
of these mental illnesses.
Absolutely, yeah.
It's the looping effect, right?
You've been given a language.
And it's not like people are lying.
They truly think that this is the meaning
system that I'm given.
And like you said, educated elites, city-going
people, that's where it exists more than anywhere
else.
And it changes who we are.
Language changes the way we see colors.
Language can change the way our very perception.
Up till a certain point, we used to
think that Mueller-Lyer illusion, which we read
in psychology, is a universal thing.
Mueller-Lyer illusion happens It doesn't.
It only exists in cultures where carpentered corners
exist.
So your perception changes with the language and
the culture you are.
We have experiments done with the Himba tribe
whose blue-green, the way they see blue
-green is different than ours because language again
influences that.
And usually when a culture sees a certain
way of doing things, it goes, this is
biological.
This is the natural way.
So yeah, but the educated elites, they truly
believe that because those are the movies we
have watched.
That's the literature we have grown up on,
right?
By doing this, there is an individual meaning
system.
And yeah, so it becomes abuse for them.
Very much so.
And it's very traumatizing.
And then they think that because of this,
like you said, these depressive symptoms now tend
to make sense.
These anxiety symptoms now tend to make sense.
As opposed to like, in the Uttaranchal mountains
where, you know, I remember somebody talking about,
this is really weird, but his anxiety symptoms,
what we would call anxiety symptoms, started because
this kid was walking back home and he
could hear his footsteps behind him, like the
sound of anklets.
It's a very common, what we would call,
hallucination.
But what people there would call like, And
it's not my job to come and go
and tell them, no, this is not it.
This is a hallucination.
So I was very careful never to use
psychology words.
But yeah, his anxiety symptoms started because he
could hear the sound of anklets, but when
he turned around, there was nothing.
Again and again.
So yeah, it's the meaning system that he
has, that is going to cause this thing.
And that's going to get better because then
he woke up, the whole community came.
All the relatives had to come.
After waking up, he got better.
He applied vibhuti.
But for us, that is like, that is
so unscientific and it's so illiterate and barbaric.
These are the words we use for other
people who don't agree with, you know, our
meaning systems.
Without realizing that much of our research is
just as faulty.
And just like, especially the ones coming out
about antipsychotics and antidepressants in the last one
year is just terrifying research.
So, Ayurthi, in this, you have used the
word meaning system again and again.
And it comes to my mind again and
again that what we have has become a
fashion.
I would say it has become a fashion
at least in Pakistan to read the psychological
self-help books.
The subtle art of not giving a f**k.
Seven Habits and all that.
Yeah.
So, for example, the self-help books are
one example of that, right?
Then there is the media.
Every other...
Sorry, I just heard my dog.
Are you sure that was there?
Yeah.
Trust me, I was in the mountains and
I was very scared at one point.
Like leaves rustling there and I was like,
I'm going.
Was it in your head or outside of
you?
I don't even know if there is that
distinction anymore.
I was talking to someone about the internal
-external distinction that we've created and whether it
makes sense.
Now that is loosening, of course.
Do you think your illness is mental or
physical?
I'm going to go take it in a
stride and not even call it illness.
I'm going to just go with the people
in Uttarakhand and say, it's a changing thing.
So she has no insight also.
No insight whatsoever.
No insight.
That is a strange place, right?
No insight outside.
Sorry.
Self-help book.
Self-help book is a part of this
whole nexus of things that has brought in
psychology.
There is your media and your TV shows
and your everything.
All of them, which I watch and love.
But through these, you always see someone as,
okay, he has a problem.
He went to therapy or he took a
pill and they're suddenly better.
They're fully treated.
And a subtle way of doing that is
through the self-help books.
I have made a collection on Instagram of
things my friends post that have that psychological
tint to them.
But they're basically cliches.
When trauma happens, it is natural to get
silenced because of it.
And it exists deep inside.
And people who are traumatized need to verbalize.
No one knows.
But these ideas come from self-help books
very often.
They even come from very influential psychologists sometimes.
This is the only way to deal with
it.
Self-help books just dilute them.
What I find really interesting about self-help
books, especially out here in the US, is
that at one point, I would think, this
is nothing.
But now I realize the way psychology looks
at self-help books is also interesting.
That no, we are the experts.
And these are all like pop-psych experts.
But the truth remains that people are helped
by all sorts of things.
When they are in pain, when they're suffering,
when they're in distress.
Some of them are helped by their families.
Some need therapy.
Few need pills.
And some read a nice, happy quote.
But as psychologists, we keep saying, depression is
not like you can tell someone to start
exercising and they'll be fine.
There is research that shows that it actually
has a pretty decent effect on some of
the things with depression.
But we don't want that.
We want this to be our expertise.
Right?
That doing yoga doesn't cure depression.
Who knows?
There are people who have actually tried it.
There are studies that show that it actually
helps some people.
Much like pills help some people and are
devastating for others.
The withdrawal effects of antidepressants, we didn't even
know until the last few years, can last
for years.
And now...
We call them discontinuation.
Yeah, we call them discontinuation.
Don't say they're withdrawal effects.
You will not get your degree.
You're not going to get your license.
We just pretended that half of our control
group is drug-naive patients.
And we're giving them What do we call
them?
Placebos.
They're not drug-naive.
They're going through withdrawal.
But...
Discontinuation.
Discontinuation.
Yeah.
So, the more...
Like you were saying, it seems that as
specialists, as academics, as experts, we have some
inherent tendencies in which we have to reduce
things into a structure and this is it.
And there's nothing other than this.
And if something else was proven or something
else was claimed, then our integrity as specialists
is being challenged and we have to rise
up and respond to it.
That becomes something of a professional responsibility.
And more and more it seems that we
as specialists and we're barely becoming specialists.
Like we're barely...
There's like 500 psychiatrists in Pakistan in total.
10,000 needed, etc, etc.
And little do we realize that how we're
part of the problem and how the copy
-pasting of Western models is actually deleterious for
our indigenous population and we don't seem to
have the tools to relate what to bring
and how to bring it.
What are the existing resources that have been
putting mental health challenges at bay for centuries?
How can we be so arrogant to completely
ignore what our culture has been?
Demonize them.
Yeah, absolutely.
So the whole Indian or Chinese civilization or
Arab civilization has all grown without any mental
support at their disposal.
And that is the thing.
Psychology has a history of doing that, right?
But we don't learn about that.
In undergrad courses no one teaches you that
the founder of APA, G.
Stanley Hall was super racist.
That psychology for the longest time believed that
women's low biological variability makes them a certain
way.
That's the truth, by the way.
Yeah.
It's my low biological variability.
Masters may, you know, they start sometimes talking
about it.
Depends on where you are.
But yeah.
And then there is such a danger in
India right now.
The moment you talk about indigenous ways, there
is a nationalist fundamentalist discourse that will break
you.
Yeah, we are the best.
We are the best.
India is the best.
But not in India, you know.
A specific religion and a specific this thing.
So you have to stay away from that.
You have to be so cautious.
The moment you talk about indigenous resources, there
are going to be fundamentalists and nationalists in
India who will come and be like, ha
ha, you know, you become our flag bearer
of...
The second party will try to hijack you.
The second party has no chance.
There is no chance So...
But...
There is no way that we can test
any one standpoint on the standards of another
standpoint.
And we are not even a common standard.
That has been pointed out recently by...
I was reading an article about Ayahuasca, which
is becoming popular again.
It's a psychoactive substance.
And in the U.S., in the scheduled
substances, it's a completely on-fuck-all thing.
Scheduled substances For some reason, things that can
be super addictive are lower on the level
than marijuana and stuff like that.
But...
That's what people are talking about.
How legitimate is it to look at other
local epistemologies, their forms of knowledge, and then
say, because we are so cool and liberal
We're like, No, no, there's culture bound syndrome.
We should take But then we're like, now
we're going to test their epistemology on our,
this thing.
Like you said, we will test it on
our criteria, on our methodology.
And not their own methodology and not their
own set of criteria, which is basically people
saying, for a thousand years this has worked
for me.
I would like to do this.
This helps me.
No, no, you have to do a randomized
control trial, let alone the fact that there
are a million things that have that have
been problematized about the RCTs themselves, right, which
is our gold standard, which is a really
good standard.
I love RCTs, but they have their own
problems.
There are examples of people doing this using
indigenous epistemologies, right?
I talked about Diana Kapua in New Zealand.
So the way she is doing it is
they're using LA.
She was a psychiatric nurse and she created
with her husband, Marco, who is an art
therapy expert, which is a form of helping
people in mental distress and psychological distress and
all sorts of distress, and they use their
creation myths.
People use them and be like, I feel
like I'm this God right now, going through
this problem.
And through that, people are really helped.
She was a psychiatric nurse when she developed
that.
I was telling them this is really helping
people.
The Maori are really suffering with years of
colonization, land taken away, language taken away, destroyed
completely.
Psychology has not helped them one bit.
Their outcomes are some of the worst in
the country.
But this is helping them.
No one listened to her.
She came back as a psychiatrist, said the
same thing, and they were like, wow, very
nice.
So she has done that, how to use
indigenous epistemologies to help people in distress.
They have done the best
they can to help the best they can
to the best they can they can to
So trauma can only be and not the
loss of another person.
I wonder if I'm going in and out.
People have done this in the past.
They're doing this right now.
Western I'm if we can culture.
We don't give importance to our family sharing.
Can you say that again?
Because I can.
The resources we have in our cultural system,
that the way in which our family can
be helpful in many ways, that small slap
from the mother, that small scolding from the
father, that I'm doing whatever I'm doing, do
it quietly, that sitting with friends, that sharing
in which when you are talking about something
like this, two or three friends make fun
of you and you stop doing it.
How is that helpful?
Or is it helpful at all?
Mayurthi, I think we've lost you.
Yeah.
You were just...
Okay, am I back?
Yes, you're back.
You were just looking like a catatonic.
America, the internet is a...
No, not at all.
But you know what?
Catatonic, now that you say that, is also
a historical category.
It emerged at one point in schizophrenia and
then it completely died away.
And Carl Jung said it a long time
ago.
He's like, when you put people in the
hospital, then it becomes catatonia.
But yeah, it's one of those categories.
We think of mental health categories as universal
and natural.
Catatonia shows it wasn't.
There was something called insurance schizophrenia at one
point, by the way, in which people were
thought to be obsessed with their insurance claim.
There was DREPTOMANIA, which is the name...
The internet in America is not good.
Yeah, the internet in America is racist.
The internet in America is racist?
It's still better than the medical care system.
Anything here is better than the medical system.
But yeah, what you were saying, Azam, anything
that helps people is helpful.
If I go and my friends make fun
of me for...
I read this meme the other day.
It's said in India or in basic cultures,
when you tell your brother, get into the
corner of PR.
So that idea of what is helpful depends
on, again, where people are, what they find
helpful.
But like you guys were pointing out earlier,
as educated elites, we've come in and said,
this is the wrong way of dealing with
your emotional distress.
People telling you, get over things, is a
problem.
No, no.
You have to emotionally process everything.
You have to verbalize.
Good enough.
But not everyone needs that.
Some people are helped by verbalization.
Others are not.
We know that because...
Literally a few months ago, they did a
meta-review of all the empirically supported treatments
from APA.
And they found that the strongest treatments in
therapies were no better than the ones that
were classified as weak and moderate.
So that whole empirically supported, what empirical support?
The ground has been shifted beneath our feet.
But we come in and say, talking to
friends is not talking to experts.
You have to go to therapy.
Mom and dad saying this is the wrong
thing to say.
And then we're changing the way people feel
about these things.
Then when a kid hears their parents say,
it's okay, it will get better.
They're like, they don't understand what I'm saying.
At some point, that could have been really
helpful.
We're changing it.
Then we do our research on those changes.
And we produce the results that we want
to produce.
This is Joseph Conaghan talking about Native American
communities.
We tell people what is the right way
to feel.
We give them the language to feel like
that.
Then we do our research on them and
find the results that we wanted to find.
Ayurthi, in the context of COVID, if we
can talk about suffering, suffering and loss, and
bereavement.
We see that there are some psychotherapies that
teach us that you have to adjust with
your suffering.
You have to bear with it.
You just think out of it.
But some psychotherapies have some possibilities that teach
us that you can create a meaning out
of this suffering.
And this suffering can be a chance to
grow and give something back to the world.
What do you think about these?
So, the kind of therapy that I usually,
I mean, all sorts of therapies can help
people, number one.
The ones that talk about acceptance can be
really helpful for some and for other people
it is terrifying and it does not work.
The one that says create meaning out of
it, again, very helpful if you can create
some meaning out of it.
We are meaning makers as people.
But then the question becomes whose meaning is
important, right?
Giving a diagnosis is a meaning system, right?
Now I am a depressed person, it gives
me meaning.
It can be really helpful, it can be
terrifying because now I am only a depressed
person.
It depends on who you are dealing with.
My friend who is a therapist, she does
this really good, the way she started doing
therapy is using critical theory.
Part of it is, of course, containing people's
emotions and their distress but part of it
is also challenging the structures that are around
them.
Maybe my job as a therapist is not
to turn you into a person who can
go back to work and create more of
this thing, right?
In some cases, meaning making is helpful.
In some cases, maybe it is more important
to challenge the meaning making process around you.
So, yeah, and again, then there are cases
in which people don't need therapy.
They can go and talk to their families
or their community what people in Uttarakhand did
and play cards with each other, right?
Women would be working in the field and
men would sit and play cards and with
that they would keep talking about things.
That's enough.
So, yeah, I used to really be a
fan of the meaning making side of things,
right?
The meaning that we give to people until
I became a little cautious and wary of
whose meaning systems are privileged in this context
and what is the meaning system of the
therapist?
Psychodynamic, humanistic, existential, biological, all sorts of things.
Cognitive, you know.
So, since then I've started thinking about what
is the importance of meaninglessness and it sounds
like such a bad thing, right?
Trauma is often defined as the death of
meaning, as the break of meaning in someone's
life.
I'm not sure how accurate that is.
And there is no escape from language.
It's not like you can escape a discourse.
But I've started thinking more about that.
What would it mean to be slightly free
of meaning?
To not jump on one discourse or the
other.
This is me as a depressed person.
This is me as a critical theorist.
This is me as a rebellious this thing.
What does that even mean?
Meaning systems have been very highly distressed.
All sorts of them.
Each and every one of them sometimes.
Ayurthi, you have been working in India and
now you are in the US.
So, our Eastern families and cultural meaning systems,
how do they play their role in coping
with these kinds of bereavement and suffering and
loss?
There is a section of my dissertation in
which the quote on top is my mom's
quote to me when I was a teenager.
Which is, we couldn't even think like this
in our time.
Any time I would do something that was
just horrible, we couldn't even think like this.
Kittu is me.
And I realized at some point in my
life that what she was saying is very
Foucaultian.
Michel Foucault has been talking about that for
a very long time.
That the forms of thinking, the ways of
thinking in different epistemes are different.
So, the forms of thinking that, for example,
existed for my mother were that distress happens
and then you go through it and then
it's over.
The idea that distress is something that enters
you and becomes a part of you and
is a complete fracture within you, which is
called trauma theory, was not there.
I'm currently writing a paper I'm very worried
about.
I've actually submitted it.
I'm very worried about it because it's a
little political.
But I saw that happening with the Kashmiri
migrant discourse.
We are Kashmiri migrants.
And in the beginning, the thing was that
sometimes we cried about Kashmir because we missed
it.
Sometimes we laughed about it.
Sometimes when we met at a wedding or
at a funeral, when we met our relatives,
we would just talk about it.
But there wasn't a trauma inside me that
has been silenced.
I actually know many of my relatives saying,
because look at how well we've done for
ourselves.
The Kashmiri Pandit community has done very well
for itself.
There are still some people in migrant camps
who are suffering, definitely.
But overall, in India, given our upper-class
and upper-caste status, given the amount of
help we had, we've done very well as
a community.
You're breaking up.
Hey.
Yeah, you're back.
So when you don't speak, you're back.
So the internet wants to mute you.
Yeah, mute you.
It's a sexist, racist internet.
So, during my mother's time, that massive trauma
of refugee-ness and migration was a thing
that happens and then it unhappens.
It's over.
But psychology, mixed with fundamentalism and nationalism has
come back and said, wait a minute, you're
still traumatized on the inside.
It's okay that you have money and family
and you're doing really well.
Psychology is the one that bridges that gap
that says it doesn't matter how well you're
doing, you still have trauma.
It's invisible.
It has no biomarkers.
So it's really easy for nationalists and fundamentalists
to use psychology and they have.
They've come to us and we have become
a symbol now in the country of what
happens if people live with, let's say, if
you live with Muslims, because you know our
fundamentalist narrative in the country, look at what
happened to these people.
We have been made a symbol and psychology
has been used for that fundamentalism.
It doesn't matter if these people are doing
really well, they still have trauma inside them
which will never go away until these things
happen, until they verbalize it.
When we were kids, we were really sad,
we cried, there was loss.
But then it was not there also.
That dynamic flow of emotions that happens and
then unhappens, psychology doesn't allow that.
Because it freezes you.
You are a frozen thing now, perpetually pinned
down by the horrible thing that happened to
you.
There is no biomarker.
There is no way of getting out of
it until an expert tells you that you
have recovered.
You don't want to talk?
There are defenses.
You don't feel bad?
These are also defenses.
What should I do?
Where should I go?
But a cigar is only a cigar.
It's never.
A cigar is never a cigar.
So, this reminds me that my grandmother, during
her family partition, she was killed on the
road.
Her brother was martyred.
When we asked her if she was sad,
she said, it will be over.
There you go.
Exactly right.
It's also the graveyard.
But people do that.
People are doing partition research in India in
which they ask questions.
It's so exploitative.
How did you feel at that time?
How do you feel now?
Don't you remember?
A group of people are making it much
worse than it was.
Because for many Indians, it's that.
It happened and now it's not happening.
Bad things happen.
The time was bad.
But that we think is simplistic and is
the wrong way to think about it.
The time was bad and now it's good.
We call that in psychology having an external
locus of control which is supposed to be
a bad thing.
You're supposed to have an internal locus of
control.
I'm in control of everything.
The idea is called fatalism.
Yeah, exactly.
Everyone is inside and everyone is an individual.
The locus of control that you mentioned, we
see many times in our clinics that all
the decisions of my life are made by
the whole family whereas we see that the
decisions that I make are the decisions that
I want to make.
And when you ask them where did you
learn all this?
We see that the decisions that you make
Many decisions are good but it doesn't mean
that every decision that you make is wrong.
There's a lot of people who come up
to you and I remember one patient in
particular she was like, when I become independent
when I don't need anyone then I'll get
married.
You do this and make me independent and
I don't need anyone.
How is that even?
How do we do that?
And that is a western ideal.
It is a value system and I personally
love my independence but I think the important
thing is to understand that it's not important
for everyone.
That I should not be as a therapist
pushing that on people so in your case
it was the patient and maybe for her
independence it would make her really happy but
there's a really good chance that people who
come in and say arrange marriages it's a
bizarre idea to them of course they care
for you but so yeah we tend to
pretend that psychology is value free but it's
not.
It values certain things and all those values
have been made to enter inside us.
They're not bad values but they're just one
set of values and they're not the only
thing so things should come from me sure
maybe that will really help you and go
for it if that will really help you
our choice, our agency but remember that in
many places there are parts of the world
where people have agency and choice and independence
and for example here where I am right
now most of them are on antidepressants it
is no marker that you will suddenly be
happier than anything else you can be independent
of people and dependent on drugs yeah absolutely
right but it's a thing that can instigate
alienation it's just me and my choice and
my agency which is great in many ways
it can also lead to a lot of
alienation and loneliness which is what I see
in most of the people around me here
the boundaries that they set up that we
are now trying to set up in India
with Instagram memes going it's important to say
no cut out toxic people in your life
it sounds amazing but there is no one
who is perfect some people are gonna be
toxic in different ways you keep them around
for the goods and the bads you cut
some, you keep some you are just gonna
be an alone person at the end of
the day so let's come back to yes,
it may help you in many cases but
in certain other cases we don't have to
project our own values and coming back to
what was coming to my mind the new
idea in self-help books which has been
popularized you have a will you should have
a will to duty to be happy you
have a duty to be happy whereas in
our culture it has always been more important
than happiness that how satisfied are you from
your life how satisfied are you yeah
thankfully that has been one of the recent
criticisms of psychology it fetishizes happiness anytime you
are not in a state of happiness is
immediately pathologized look at DSM 5 there was
bereavement exclusion till DSM 4 if someone dies
and you are sad for a long time
it's okay, you are not depressed, you are
grieving but we removed that from DSM 5
now if someone dies and you are sad
So yeah, that fetishization of happiness has been
a huge problem.
There's a very narrow way of being, according
to psychology, that is normal.
You can't be codependent.
The idea of happiness is very attached to,
very often, how the time is going.
If the time is going well, then these
things are happening.
If the time is going bad, then it's
a relief to many people to think about
it like this.
That, okay, this bad time is going on,
but it will also end.
Happiness should always be in your hands and
should always come from within.
Happiness is a problem.
So you have to be agentic, independent, resilient
and happy.
You have to do all of this yourself.
There's no one else.
No change in your structures.
No change in poverty.
No change in racism.
No change in casteist dialogue.
Forget the structures, right?
If you're feeling bad, get up, pill-pop,
go to therapy.
Be resilient on your own.
So yeah, I'm hoping that positive psychology was
the big one that tried to fetishize happiness.
Stay positive.
Yay!
But there have been many critiques now of
that way of thinking.
So I'm hoping that kind of dies out.
Most of the conversation that we've had, right,
and most people listening, it's not something that
can be popularized.
It's not something that will have mass appeal.
Like, do this for happiness.
That has mass appeal.
Strengthen your faith.
That has mass appeal.
Do yoga.
That has mass appeal.
It's like a simple one thing.
When we're talking, we have to give qualifiers.
We have to give exceptions.
We have to tell you what's good and
what's bad.
I mean, and you would think that the
more you study or the more you become
a specialist, you will become so nuanced.
But unfortunately, even though we are educated, we
perpetuate the same kind of slogans only with
the authority of a speciality behind us.
Mental illnesses are just like physical illnesses.
And that leads for us to think that
when we have limited resources in India and
Pakistan, limited people have to reach this level
of education.
After that, when you become a specialist, you
become capable of providing some service.
And then you're like, no, I have to
go to the research side.
I have to study theoretical things.
You're like, you've lost your mind.
What are you doing?
You've invested so much money in your country
and instead of providing service, this is like
a luxury of the West to go into
the theoretical research side.
We don't have that.
We can't afford stuff like that.
But clearly we're suffering for a lack of
it.
Yeah, I think there are two things that
can happen there.
Right.
Going into the theoretical part can be very
self-involved.
Right.
You feel very smart about yourself.
Right.
Happens all the time.
Academics are known.
Barely like two people can understand.
Getting into the theory part, at least historically,
I have seen really useful.
Because then when you come back to through
critical work, you have a really good background.
So, for example, for me, going into theory
was helpful because when people would tell me
about, but, you know, mental illness like this,
I could say things like, yeah, but psychology
also thought that to me as a mental
disorder, you know, we just went to like
Cairo with trauma theory to help street children.
This is an article in Swiss.
We went to Cairo, helped street children, used
trauma theory as psychologists, ended up doping the
shit out of all the boys because we
did not understand their concept of masculinity.
We don't understand what these children have been
through.
So when we see these young boys who
have lived on the streets all their life
as psychologists, we only saw pathology and trauma.
Right.
Eurocentric American psychologists.
So what did we do?
We ended up doping the boys.
We went into rural Malawi to teach them
gender equality.
What did we do?
We turned girls into feeling guilty and shameful
about leaving school and getting pregnant.
We went in to help.
And in the end, now girls that are
like shit, you know, I got pregnant in
school and now they have to pay a
fine if they get pregnant in school.
That fine in a country and a place
that is has no money is a huge
thing.
We went to post-apartheid.
We went to Trauma Reconciliation Commission.
We sent them as psychologists to help people.
And people living in post-apartheid Africa were
like, this is useless.
Why do you want me to talk about
my trauma and do something that helps me?
I want to eat.
I want to talk about my feelings to
make themselves feel better.
Going to theory can do it and pompous
or help you be really good critically.
It's the same with working with people.
If you actually listen to people, you can
either go in and put your specialization on
them without listening.
But I've also heard of like colleges, like,
for example, went to North Manchester to work
with a really poor population.
And when they went and talked to the
psychologists there and said, you know, I guess
they helped cover the homeless population.
They were like psychology.
We have real work to do here.
So they understood.
They learned from the population around them.
The psychology was useless for them.
They had them at home, you know, getting
them shelter, getting them food, how to make
sure they could get like out of the
poverty that they were in.
Those were the legitimate concerns.
And they realized that psychology was useless for
all of this.
So, yeah, I think it depends on how
open you are to what other people have
to teach you.
And psychologists tend to be so insecure.
The way the field started out, psychology started
psychologizing everything other than itself.
Are we working?
Is it working?
Are we causing harm?
Are we causing benefit?
Are we?
What?
How can we?
Where do we not need to go?
Where do we go?
This is not my area.
Knowing this is not my area.
There is no need for psychology here.
There is a need for culture here.
There is a need for religion here.
There is a need for political effort here.
There is a need for material things here.
There is a need for material things here.
All right.
Great.
As I'm over to you for the question.
So, the questions that have come in, we
will take them.
I can't see them.
Here comes one.
When we are studying cultural differences and meaning
systems.
I'm an American graduate student in psychiatry because
of lived experience.
OK, perfect.
So some resources to read at the beginner
level for understanding these cultural differences.
For the resources, maybe we can reply in
the comments later.
I can also do this thing.
If you I can give me give you
my email address and then I can send
you the resource because I have so many
of them.
I mean, that's absolutely I would be happy
to do that.
She said entry level, please.
Entry level.
Yes, absolutely.
Entry level 101.
101.
Yeah.
Yeah.
Maybe she can approach you on Facebook or
my email address.
You can give it to her.
Yes.
Or you can reply to that comment.
I just saw comments.
OK.
Hi, Zainab.
I will send you some really good resources
through email.
My email address is let me put it
here.
Faculty email address.
OK, it's not allowing me to comment.
Yeah, you can log in from your Facebook
and then in the comments.
Yes.
You can just give him my email address.
OK, I will.
I will.
One thing, though, I would suggest reading this
really good piece of research by Lerman and
Haru about the.
Yeah.
Tanya Lerman.
And she researched Ghana, Chennai, which is in
India and Ghana in Africa and San Francisco
in the US.
Differences in the way people hallucinate like hallucinations.
And found that the ones in Ghana and
India were actually not horrible.
You know, like one lady was like he
mommy.
He was a dead mummy.
He told me to adjust to life.
But the ones in in the US were
terrifying.
They were telling people to hurt themselves, harm
themselves.
You are useless.
So that's a really good research on how
our culture even influences the things that we
hallucinate.
Whether we feel distress or don't feel distress,
whether we suffer.
Never don't.
Yeah, that's never a question.
I mean, it's not going to happen.
And people will tell you that like I
gave a little talk and a student in
the US came up to me and said,
I didn't tell anyone that I hear voices
because I knew they would put me in
a psychiatric setup.
Right.
But my voices are really nice.
They help me.
They tell me to do good things, to
choose the right thing.
Why should I tell them?
They don't disturb me.
And now we know many more people hear
voices and are perfectly OK with it than
we earlier assumed.
I can't help but think that if our
psychiatric community hears that we are doing this
interview, they'll say, son, you don't even have
my license.
I can actually send you.
Thankfully, because we work on the margins.
Literally everything I've said has to be backed
up by really strong research.
That's what I do.
I'm a science news writer for Madden America
sometimes.
And I have to do it because I
when you say things that are so on
the margins, you cannot just say them.
You have to make sure that you have
really strong research for everything.
So, yeah, if that ever happens, you get
back to me if somebody attacks you.
And I will send you like a different
thing that will shut them down.
When scientists start developing the cultish mentality, research
evidence doesn't work.
Nothing you say.
Nothing you say.
They're more rigid than the most rigid.
You know, it has become like that.
It becomes like religious fundamentalism.
A comment from Shiba Ansari.
Number one treatment for depression in desi culture.
Get married.
Number one treatment for depression in desi culture.
Well, OK, so let's let me say something
about depression first.
Right.
In psychology, we have no way of finding
out if somebody is depressed or not.
Because blood tests don't have a biomarker.
So the only way we know someone is
depressed is by looking at their symptoms.
Right.
That feeling of hopelessness, feeling of helplessness.
All of these things.
Right.
But when you look at research, that is
actually something that is specific to the Euro
-American people.
In Asian-American populations, a symptom of depression
is agitation.
It's a very tricky thing now, because first
we are saying the only way we recognize
you're depressed is through your symptoms.
When you say OK, then we say we
have changed your symptoms.
It's a bait and switch.
Right.
First we make you agree to something and
then we change the agreement.
So there the first question becomes, what is
depression?
Right.
Is it just something that sometimes people go
through a really.
And they cry, cry, cry and then they
get over it.
Sometimes people are helped by that.
By going to a temple and praying.
Some people talk to their parents and friends
and leave.
Some people just need time.
So the number one treatment in desi culture,
like you guys said, very often, get married,
have a baby, or, you know, it will
go away.
It will be fine.
No problem.
Nothing happens.
Sometimes these things work.
Sometimes they don't work.
The problem is assuming that medication always works,
because at this point, the research is very,
very dangerous around antidepressants.
And we are seeing that people who are
actually given antidepressants have withdrawal symptoms.
So we don't even know if they work.
Because when we give a placebo to a
control group, that control group is already going
through withdrawal.
Right.
So at this point, all our research on
antidepressants and antipsychotics has become really, really problematic.
Mostly because we now know that antipsychotics can
actually increase your psychosis.
It's called drug-induced psychosis.
So if you give antipsychotics to someone, their
D2R receptors are completely flourished in the brain
because they don't get enough dopamine.
Stop the antipsychotics.
They get flooded with dopamine and psychosis comes
back.
Full blown.
The outside world thinks, look, I stopped their
antipsychotics.
But what has happened is that the antipsychotic
over a long term has caused you to
have that kind of a psychosis.
So now researchers are beginning to look at
how to take people off antipsychotics.
Right.
Keep it maybe for a few days, for
a few hours.
Open dialogue approach in Western Lapland.
They have amazing results with first break psychosis.
They use some Xanax to calm people down.
They don't even use antipsychotics because of the
long term effects that they have.
Literally, three days ago, I read research that
said that antipsychotics can like.
It was an RCT.
So it's an experiment that actually shows causality
and showed that can actually cause brain damage.
Right.
So, yeah, the depression, it's the same thing.
There are many things that can help people
in desi cultures.
It can.
You basically are good enough if you have
a support system.
If you have friends or family or just
workers you can talk to, you will more
often than not be OK, whether it's trauma.
All the PTSD trauma to American troops.
They come back home.
They have no support system.
You take a look at Indian troops, same
wars.
They come back.
Right there.
They come back to the unit.
They don't have the same PTSD symptoms because
after all of that horrible things, they still
have people around them.
They have a support system.
So a great way would be to have
a support system, family, friends, whatever it is.
Even a group of even therapy.
That's what's something that helps you.
Absolutely.
So there would be no more questions.
You've learned a lot.
People ask you a lot of questions.
Let me definitely read.
Yeah.
Race.
I don't think they are American.
I didn't say, OK.
Edward Tichner, too, had problems with women.
So did Kondike, by the way, and Stanley
Hall, and Cyril Burt, who basically said that
intelligence is.
Why not Freud?
I mean, Freud is a different league.
But Cyril Burt was the guy because of
which we still think that intelligence is hereditary.
And then we found out that his whole
research, he created numbers.
He faked his old data.
But he was the biggest name in intelligence
research for his time.
We don't study that.
We don't study that he faked his data.
But he said, no, intelligence is hereditary.
And now we believe that intelligence is hereditary.
If a psychiatry resident does that now, then
he's just living up to the legacy, right?
Yeah.
Exactly.
OK, I think that's what we have.
What is NLP?
I don't know what NLP is.
Neuro-linguistic programming.
I don't know much about it.
I'm sorry.
So it aims on improving your confidence, communication
skills, and all that.
I can tell you that the most recent
research in neuro scans that came out just
a month ago was terrible.
It showed that we took 70 experts of
neuroscience.
We showed them scans of psychological stuff.
And they had completely different answers on what
was happening.
So you know, neuro is our last word
on, neko yeh hora hai because neuro scan
bol raha hai.
That's the way we are now.
We have these really cool tools.
And jab tum bachcho ko tools de do,
they want to use those tools.
Turns out, we've given 70 experts of neuroscience
same scans, and they have different things to
say about usme ho kya hora hai.
Yeh humne exam mein tariqa nikala tha.
Jab puchhe na ke phalani psychological illness ki
brain correlates kya hota hai, sab kuchh likha.
Har ek mein sab kuchh aata hai.
You don't have to waste your time memorizing
separate lists.
Oh, yeah.
All right.
So we wrap up?
Yes.
OK.
Thank you, Ayush.
Thank you so much for having me, guys.
I hope I answered it.
Thank you so much for coming.
It was such a stimulating conversation we had.
There was so much for us to learn,
especially as psychiatrists.
And we hope to carry this forward as
well.
We hope to have you again.
Thank you, guys.
And thanks to everyone who came here and
listened.
Some really nice comments here.
So email.
Razan, would you send Zainab my email address?
Yes.
Yeah.
Definitely.
All right.
Bye, guys.
We have some.
Yeah.
There's this.
I'm glad you're doing it, especially the idea
of happy.
Oh, yeah.
The being happy and that happiness is the
goal.
It's a very problematic and scary idea because
you're always following something.
And it just, it's so elusive.
It's almost like.
I once tried to tell.
OK.
Yeah, well, I do idea of happiness to
a donkey.
My donkey, a donkey, and she was like
to me.
Uh, so I guess it would have been
just a matter of which rest of the
world, but I didn't have to look at
it.
It's come up with the old man, the
man, but you might have to put it
in a moment.
He could have been a national official.
I said, come on, let's get high.
And why are the other emotions like pathologize
like that?
Right.
He might have to be there.
Do you call it a time line?
Right.
Those they will get up to get out
of the best of your time.
I'm depressed.
Oh, yeah.
And.
Who?
On with such emotional suppression amongst Japanese and
Asian communities does not lead to physical health
problems.
It does lead to physical health problems amongst
Americans.
So yeah, the idea that emotional suppression is
always bad is also problematic.
It's not true.
Depends on where you are from.
So you have, you got your first fan
in the heart with time.
Somebody's also asking when there are no specific
ways to identify depression, then how can we
recommend therapy or anything like that?
Exactly.
That is a really good point.
There aren't any specific ways to identify depression
except some symptoms that we have.
We are told that BSM and ICD are
the only two ways to do it, but
there are many other diagnostic criteria.
British Psychological Society's PTM.
I think the confusion that's arising is because,
are we trying to say that there could
be no pathology at all?
Good point.
I think what we're trying to say is
pathology is bound by the tenets of the
culture, right?
So, for example, bulimia and anorexia are not
found everywhere.
It's not found in places where food is
difficult and their ideas of beauty are also
different.
You have your, there are many other things
that are called culture-bound syndromes, which is
a problematic term in itself because it says
that what happens in Euro-America is not
culture-bound.
Anorexia should be a culture-bound syndrome.
And now people are basically talking about that
it is a culture-bound syndrome.
Anorexia is not found everywhere.
PMS is a big one.
Premenstrual syndrome.
Which has become PMDD.
Premenstrual dysphoric disorder.
You have these hormonal things that make ladies
go crazy and then they have, ask your
mom and grandma if there are mood swings
with this.
And they'll be like, what?
What are you talking about?
And talk to younger people who have heard
about PMS and they'll be like, yes, definitely
there are.
I can feel it.
There's an entire vocabulary on PMSing.
Yeah, it does.
And it's true because there is a language
that has told them that this is something
that's supposed to happen to you.
You're the second fan.
Oh, thank you.
Absolutely.
So that's all I have to say.
All right.
Thank you so much for being here.
Azam, can you sum up and then we
end?
Yes.
I think she has summed up herself.
Thank you.
So we'll have her again, depending upon when
she's available.
So, will it be possible to answer any
more questions later in the comments?
I'll tag you on Yousuf's page.
Absolutely.
So that you can answer your own questions.
That sounds perfect.
Great.
Bye everyone.
Thank you everyone for watching.
Allah Hafiz.
Allah Hafiz.