Mourning: A Healing
A grieved person may go into depression if not treated properly, tells Dr KK Aggarwal.
In the antim yatra most relations join and after that the grieved person is made to sit for 90 minutes every day as a part of the ceremony which either ends on chautha or tervi where again everybody known gather together to end the ceremony. Thereafter, normal activities of life are resumed.
In some sections of the society there is also a custom of shaving the head or doing 'daan' of hairs and or wearing white clothes.
The plausible explanation are many and are based on the observation that a grieved person may go into depression which if not treated properly may last for months together, or even for ever.
The acute stress after the death of somebody very close is called acute traumatic stress and the condition is called Post-Traumatic Stress Disorder (PTSD).
From the psychiatric point of view the treatment of acute PTSD involves any of the three methodologies. Firstly cognitive behaviour therapy which is based on proper counseling involving analysis of thoughts, emotions and behaviour, secondly, it involves the principles of "morrer two stage conditioning" where repeated exposure therapy is used to avoid any type of avoidance, thirdly, the principle of "narration exposure therapy" is used to prevent any type of depression.
The Indian traditional concept of mourning involves a combination of all three classically time tested allopathic principles of counseling.
The grieved person is given continuous one-to-one counseling by the near relations and friends which is a form of cognitive behaviour therapy. The same lasts for 12-13 days till tervi or till the chautha, as the case may be. It helps in preventing any major depression in future.
The affected person freely expresses emotions by weeping, relations help in initiating the weeping and the grieved person is made to meet the relations and friends again and again for the next 13 days. It is a form of exposure therapy. If the exposure therapy is not done there are chances the person will go into two-step conditioning with avoidance and the person will end up into depression of a type where particular stimuli will make him avoid a particular action. For example, if a person has died after eating a particular food the grieved person may develop aversion towards that particular food.
During mourning process lasting for 13 days the grieved person repeatedly narrates the situation of events leading to the death of his or her beloved one. That event narrated again and again and over the time helps in de-sensitizing the acute stress. And this is the narrative exposure therapy in psychology. By talking again and again the grieved person develops more forbearance against the irreparable loss suffered. During this period he or she also develops a new inter-personal world through interaction with a lot of known people.
If these rituals are not performed, there is a strong possibility of the last memory of the beloved one to get converted into flesh bulb memories and comes back to the mind whenever there is a trigger. Shaving off the hair or wearing white clothes help identification of the one who needs sympathy and counseling.
A big gathering during antim yatra or during chautha or tervi also signifies social support to the grieved person that he or she is not alone during the time of grief. Chautha or tervi which one is a better ritual? Scientifically, tervi, as in most situations it takes 12-13 days for any type of counseling and desensitizing.
Even in Bhagwad Gita when Arjuna was in acute depression (serious indecisiveness), Lord Krishna had to take 18 sessions of counseling him. Continuous counseling over a period of time helps eradicate flesh bulb memories and reduces mummification of memories.
(The writer is a senior Physician, Head Department of Cardiology and Deputy Dean Board of Medical Education-Moolchand Hospital, President-Heart Care Foundation of India, President Elect-Delhi Medical Association and Member-Delhi Medical Council.)
