I have written much about the pain and heartache that we see in mental health programme here, but I have neglected to share the stories of recovery. Hearing a client describe the cessation of their nightmares, the improvement in their relationships, or the lifting of their mood is like music to a counsellor’s ears. These comments come often here in Quetta and Kuchlak. Counselling and psychotherapy is a relatively new concept in this part of the world, and many were and still are, sceptical. But the programme has worked well so far and I am hopeful that it will continue to grow.
As a psychologist, a fundamental component of my work is confidentiality. For that reason, I’m not sure I’ll be able to fully articulate the profoundness of this one experience in the following few paragraphs, nor describe the details of the conversations. But the impact it had on me was too great not to write about.
I previously wrote about a woman who I believe is the definition of generosity and resilience. She came to us with depressed mood, having experienced multiple traumas, and currently living in conditions of great poverty. She continued to attend counselling at the clinic when she could. Today I, with another counsellor, had yet another follow-up session with this lady. She came with three of her children.
I realised in my interaction with her today just how powerful the human connection can be for healing. We don’t speak the same language, and so the local counsellor is our go-between, but I feel a bond with this lady with a power that I find difficult to describe. Today she talked about how much strength she got from the counselling sessions, and how much the care and support meant to her. “I feel my burden disappears when I talk to you”, she said. She is the one who said, with much sadness, that she was considering to have her very young daughter marry so they could obtain a dowry to feed the other children.
Today, she told the story of a recent proposal to wed her daughter. When she reflected on how hard her daughter’s life would be if she did marry this man, she decided not to accept the proposal for her daughter. She did not want her daughter to suffer any more than she had. This might sound like a normal mother’s protective instinct to many, but in this context, this was an extremely brave and insightful decision for her to make.
Her eldest son has attended a couple of the sessions and feels responsibility well beyond his 11 years. He talks of his sadness when he hears the other children playing cricket outside, as he must work to support his family. I want to allow him to be a child and encourage him to play as he deserves to, but I know he can’t do that.
Her youngest daughter has a beautifully sweet smile, and calm and placid nature. Her eyes tell a story of sadness, but just like her mother she fights through the pain. I want to tell her that it will all be ok, but I honestly don’t know if it will.
Her youngest son is feisty and is in constant survival mode, knowing exactly what he wants. I watched him eat biscuits the other day with a vigour and hunger that made me think he hadn’t eaten for a while. I tried to encourage him to share with his sister. He didn’t want to, but did so in as gracious as manner as a hungry one year old could do. His sister was clearly so hungry too, but she was as graceful as her mother, not once complaining or trying to snatch any of the biscuits from her brother. I don’t want this young boy to have to think about when he will get his next meal, but his hunger doesn’t allow him to have very many other thoughts.
The children talk about wanting to go to school, but their mother painfully talks of not being able to afford it. Education really is a source of empowerment, and I reflect again on the inequality in the world.
It’s hard to know your limits, but I quickly realized it is an essential skill to have in this line of work. There are limits to how much I can care. I can’t feed this family or house them; and most of all, I can’t protect them from the daily trauma. But I can listen though. And comfort. And play. And show them that love and compassion does exist in some form. It doesn’t seem like much. But not much is better than nothing. And according to this lady, the “not much” that we could give her was exactly what she needed. What she didn’t realise is that she probably gave me more than I could ever give her.
Saràh is an Australian mental health officer working in Quetta and Kuchlak, Pakistan.
Find out more about Saràh and the MSF Pakistan blogging team.
MSF Field Blogs reflect the views of the author alone and not necessarily those of Médecins Sans Frontières
