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Interpreter of maladies

Dr. Nighat Ara, Psychiatrist,
Counsellor and Therapist

I have a friend who keeps doubting everyone around him and thinks that there are people in a room when no one is actually there. He leads a normal life most of the time but suddenly reverts to being this completely paranoid person.

He used to take drugs but then he left the country and stopped. All his friends are worried about his condition and would like to know how we could help him.
- Milon

Dear Milon,
Paranoia can be a symptom of quite a number of mental conditions. Organic Illness, Bipolar Disorder, Schizophrenia are among the common underlying causes. According to Freudian psychotherapy -- paranoid symptoms could arise in predisposed people through the defence mechanisms of denial and projection.

Under normal circumstances a person with paranoid personality traits does not usually manifest the symptoms though stressful conditions can blow it up and bring it to the surface. Here the source of stress could be in the internal world (e.g. depressed mood, fear of being bullied, negative mind frame etc.) or in the external world (e.g. judgemental or aggressive people, gossips etc.).

People sometimes get hooked to addictive drugs as it gives them transient relief from uncomfortable thoughts and feelings. Sometimes these thoughts and feelings are associated with some kind of mental disorder. The symptoms surely creep back as the action of the drug wears off.

Prolonged abuse of substances can also alter the brain chemistry and trigger a mental illness in a genetically predisposed person in whom it could have remained dormant for the rest of his life. Paranoid feelings can also be artificially induced by certain group of drug intakes. In this case it is hard to conclude what is actually going on with your friend.

Geographical change is a kind of quick fix for substance abuse problem, it doesn't cure the disease. In absence of any real recovery going on, the abstinence from drugs doesn't usually last long just by sending the addict abroad. Besides, there is a huge risk of relapse as soon as the person comes back to the previous environment.

The most common triggers of relapse processes are people (e.g. old using buddies, drug dealers etc.), place (e.g. old sites of use, spots where drugs are easily available etc.) and situation (e.g. social gathering, funeral, wedding etc.).

There are many ways you can help a friend. Teasing, tormenting, criticising, blaming doesn't help. Non-judgemental active listening is of great help. Let him know that you do care but at the same time refrain from being his caretaker.

Don't enable his dysfunctional behaviour by controlling him or by compensating for him. Make him aware that some of his behaviour concerns you. At paranoid moments, help him with reality checking without condemning or colluding in him.

When he is acting more rationally, give him the phone number or address of a professional and encourage him to seek help.

Mental illness and substance abuse stigma often stop people from seeking help at the right time. Do some advocacy on behalf of your friend to free this society from this stigma. In my opinion that would be a wonderful gift to your friend and many others.

Accept your limits in helping others. Even the Almighty has said that He helps those who help themselves. Legally nobody can force treatment/change on an adult unless that person is a threat to self or to others (e.g. suicidal or homicidal tendency or if there is risk of violence).


Sleep soundly

"Do you snore? Are you tired when you wake up in the morning?”

When I first learnt to Google, I found these questions and a few more on a site. They seemed to fit my condition so I clicked on the site. I answered positively to all the questions that were asked and then the inference was that I, most likely, had sleep apnea. I read about it on different sites and I was positive that I had it. So on a subsequent visit to Singapore I took a sleep test or polysomnogram as it is called. Yes, I had sleep apnea!

Sleep apnea is a serious sleep disorder. The most common type of this ailment is obstructive sleep apnea which is caused by the blockage or collapse of the airway.

Breathing stops abnormally from time to time during sleep which causes the person to snore loudly. Interrupted sleep leaves the person very tired during the day.

Sleep apnea often goes undiagnosed. People usually ridicule the patient for snoring loudly but in actual fact, the poor person struggles hard to avail the first and foremost fundamental right of any human being -- breathing. Untreated sleep apnea can cause hypertension, heart attack, stroke, diabetes or even death.

The easiest cure is a CPAP or Continuous Positive Airway Pressure is therapy. This is possible with help of a CPAP machine, a small box like a jewelry box to which a large flexible pipe is attached. The other end of the pipe is joined to a mask for the nose like an oxygen mask. The mask has straps to hold it over the nose. This machine blows air at high pressure through the nose into the airway and the airway is kept open during sleep causing the patient to sleep uninterrupted.

I didn't get the machine in Singapore because during the trial period I kept taking it off in my sleep. As a result I got more and more tired and had to make a great effort every day to stay awake. I would doze off often during the day. Each day seemed extremely tedious and gradually my muscles became weak. I would have heart palpitation to such an extent that at times I felt like holding on to my heart to stop it from beating so fast.

One day I felt terribly ill and went to see my doctor. He heard a few words from me and shot back questions. He told me to get a CPAP machine immediately. So I went to Dhaka for a sleep test at Japan Bangladesh Friendship Hospital and consequently got my machine from Dr. Sardar-e-Baki. The air pressure was adjusted according to my need so that I don't take the mask off while sleeping.

I had forgotten what it was like to sleep soundly and wake up refreshed. I must be quite a sight to behold...my mask and all!

And by the way, I sleep soundlessly soundly now!

By Fahmeena Nahas


Raising a reader

Many families enjoy a 20-30 minute read-aloud time just before bedtime. Start reading aloud to your children on a daily basis when they are babies. Keep reading to them up till they become independent readers. My parents believed in this theory.

As I walk down memory lane, I can still hear my mother reading me Aesop's fables and fairy tales. I go back to those days, well over four decades back and hear my father asking me to read “Cinderella” to him before I retired for the day. Actually it was a test of my reading skills.

He encouraged me all the way till I could read “A Tale of Two Cities” and beyond. He guided me to read most of the famous stories ever written to enlighten every soul. He made sure that I know the names of each author and often had a quiz for me to solve with a view to record every data in my mind's computer till it crashes.

My father passed away on 24 June, 1993 but every day and specially on every Father's Day I thank him silently for being the perfect father he has been to me and my two siblings.

Raising a reader is very important dear parents. You have to be persistent about installing the knack of reading in every child and pursue aggressively till the reluctant ones transform into eager readers.

Become a member of a library so that you can take your child/children there, surely once a week during the summer break. If your children have special interests (favorite subjects, authors, etc.), make sure they ask the librarian how to locate those books.

Spend enough time at the library so your children don't feel rushed. Moreover it's inexpensive to borrow books and the Library is the venue which should have all the books you could ask for each stage of your child's life. Just teach the children to take care of the books they borrow.

It's hard for children to believe in the significance of reading if there are few books at home or when they never see their parents reading or when they never go to the library. My parents never stopped buying books for us. They practised what the preached. So should every parent.


Images through a theodolite III: The Shrine

21 June, 2003
The Present

22 steps to The Shrine. I counted each as Binty and I climbed the stairs to the cubic room, where one could find Anita's picks from the world of art -- vibrant watercolours, abstract oils, perplexing wood cuts and gaudy serigraphs -- some supplied by Binty herself, others persuaded by dealers like her and some by artists themselves.

Anita was a rare breed -- she had taste and a deep pocket to keep up with her growing artistic sense. She was not a living-room art collector. Anita's selections were backed by her background in drawing, a passion that was fuelled by her high school art teacher. She even fancied it as a profession but eventually responded to the higher calling that was medicine.

She was often found debating art with her guests at the parties, or speaking with academicians and critics on an equal footing. Her art room possessed marvellous Sultans and Qamruls, and little known Hossains. She was as comfortable buying works by master painters as she was endorsing little-known names, works that she realised too well will one day gain acceptance.

A smiling prince, riding what appeared to be a tiger, or maybe an oversized cat, welcomed us. A pot chitro hung on the wall over the door; an astute placement of rural art done in its familiar, simplistic form. It created the right feel for The Shrine, which after all was a dedication to Bangladeshi art.

“Not one of mine,” she smirked, pointing to the Pot.
- That tiger beats your drawing skills.
I chided, maintaining the air.
“We haven't finished decorating the room as yet, but the display…,” Binty paused to take a breath while attempting to unlock the door, “…should be something, quite extraordinary.”

“Before you say anything, just don't be a smarty-pants. 'Look' before you 'leap'.”

I failed to share her enthusiasm but was a patient listener. I was more amused by the swaying of her hands. The way she moved them while speaking. Like a student trying to explain a chemistry experiment to an examiner. She had a pair of gazelle eyes that sparkled when she spoke, conveying the excitement and emotion lacking in her speech.

Binty was full of life. She oozed energy -- a fact that I found charming but failed to match up to. In parties of the art fraternity, you could see her snake her way through people, always switching groups, maintaining a perfect balance all the way. She could and did use her ways to coax a buyer into making a purchase. But she was honest in her opinions. She sold what she endorsed.

Some said it was her eyes, others spoke openly about their admiration of her black curls. She could spin men on the top of her index and she had them mesmerised.

I simply liked her company, or maybe something more.

After two failed attempts Binty opened the door, “Finally,” she said and switched on the lights. The large Shrine was before me. Frame upon frame of pop art glitzy colours, mastaans in violet shirts and heroes in blue, each depicting the fantasy of the mind.

“I present to you the world of cinema!”

Like a child showing her prized dolls, she pointed at the frames: collages of Bengali film magazines, rickshaw paintings and large-sized oil paintings.

“There you have the posters.” She pointed at a few life-size frames, scattered randomly, but somehow in an orderly fashion, on the four walls of the room. “And there's Bahana! Na…na…na!” she burst into a song. And danced in her ecstasy.

“What say you? Like it?” And broke into laughter and took her seat on the solitary black couch placed at the centre of the room.

- Me says “Nice! Not bad.”
“Nice. Not bad?!” she exclaimed. “Come on. Even you can do better.”
I chuckled.

“That's more like it.” She smiled. A little embarrassed by my laughter but enjoying the moment to the fullest.

“Isn't it wonderful? This is where Shishir meets a road side painter; a newspaper cartoonists meets a printer -- all in the celebration of the life and the colour that is Dhalywood.”

She spun the revolving chair as the words got out of her. There was a sense of pride in her expression, the pride of assembling something unique. Something she could have afforded herself but it was the pleasure of sharing her enthusiasm with another art lover that drove her to the careful execution of the display.

I was, however, more busy with a casual observation. As Binty spoke, my mind drifted away from the conversation and focused on the black chair. There were no tables in the art room, no other seating arrangement. Just one black, revolving chair. I had been to this room on countless occasions and that the presence of the solitary chair escaped my mind, was something I found, only now, to be quite extraordinary.

“So tell me O Great Writer, how is the book coming?” Her query interrupted my stream of thought.

- You mean: O Failed Writer?
I mocked myself.
- Being written as we speak.
“Clavicle and… You Know…was not bad. Don't be so hard on yourself,” she comforted me.
“As we speak you say, where is your pen and paper?” She continued teasingly.

- The quill and the paper are all in the mind. You shall see it in print. If I live long enough. As they say -- if you sit by a river long enough, you'll see the body of your enemy float by.

“Oh so I am the enemy now! That was rude.”
- Hahaha! I didn't say that.
“You did say that. Now she was stern. I am your enemy…so who is your friend. Nina?”

- You know you are being ridiculous. I was quoting a Japanese proverb. When did I ever hint that you are my enemy?

I was a little serious now.
“Yeah! Yeah! Nina, Nina. Always Nina and never…” she swallowed her own words. “You know you should go see Dr Azim.”

I could feel my jaws tighten.

“Time is something you don't have on your side. This has happened before. You told me yourself. Stop this before it stops your life once again.” Binty seemed genuinely concerned.

- In my own time.
I said softly, just barely audible. As if to mock her compassion. And she picked the vibe.

“You know, forget that I brought up the subject. It is your life. You cling to people who don't give a **** about how you are or what you do and push away people who genuinely have feelings for you. You are not worthy of being loved…**** you!”

I gazed at her as she blurted the words of rage. I kneeled down in front of the chair and held her arms with my two hands.

“Let me go” she said, trying to shake off from my clasp. “How dare you touch me?”

She looked straight at me, without a blink of an eye. And I saw warmth, affection and maybe at the spur of the moment, even love.

- Binty, I am married. There is Nina. There will always be Nina.
“Go to hell! Who said I even liked you?”

I looked at her face. Her lovely face. In her eyes, I saw the brewing of a wild chemistry, an untamed fire. Her quivering lips, now moistened by perspiration seemed irresistible.

She reacted fervently. “What in the world was that?”
I kissed her again but the clasp of my lips now firm. This time, she kissed back.

We were starved, famished and greedy. Within the four confining walls of the cubic room, a new chapter was opened in our lives.

As we climbed down the stairs from the shrine of Art, I looked at the images on the walls actors, actresses; the good, the bad and the beautiful -- now witness to a secret, all laughing behind me and my coloured existence.

Binty asked me to put the lights off. “Can you please also lock the door behind you?” she uttered before disappearing in the crowd. What had just happened in the Art Room, should remain there for life, we both decided. Looking back at it, or dwelling on it will open a Pandora's Box, the consequences of which we both shuddered to conceive.

The black couch was facing the wall, where Manna and his band of armed men laughed at the onlooker. I walked towards it in the darkness and touched the leather covering. I gave it a spin, and the chair revolved as I walked away from it.

“My Son!”
I heard the voice. My hands chilled, and the stomach hollowed. I walked away, paying no heed.
“Look at me, My Son.” And I did, I had to. He was back.

(To be continued…)

By Mannan Mashhur Zarif


Liquid darkness

By Iffat Nawaz

In a land far, far away, she walked out right before the storm. There were thunders scratching through the sky and the wind blew through the willow trees, brushing the pine and honeysuckle leaves. No flowers fell on the ground, the fireflies stayed low, near the fresh cut grass, dancing, waiting to get soaked so that they can glow in liquid darkness.

Little did anyone know, not that there was anyone in sight here to begin with, that it was she who brought this roaring rain over the otherwise calm city. A city where people carry water bottles and cigarette buds, where people are embarrassed on the ground, the owls are free to scream from early evenings and the season brings green after green after green.

No one peeks, there are no peeping Toms, no curious neighbours, no intrusive relatives, no small talks, no stealing glances. So no, no one knew that it was she who brought the eastern monsoon wrapped in a tissue paper.

It was one of those Bangladeshi tissue papers which have that obnoxious scent. The scented ones which leave an invisible stain on your hand of some pseudo rose-petal stench.

Well the smell was gone by now, and if someone were to look at the scrambled up tissue they would want to throw it in the trash. Unless they opened it up and saw the drops, the dry drops, melted into the soft layers and folds, fitting into a palm, resting to be released.

In the past, from her room watching the Dhaka monsoon skyline, a ball of lightning thunder would always travel up her throat. “What if this is the last monsoon for me? What if there are no more? Will I have to be satisfied with the memories of the kaal boishakhis, how they invaded me madly? Will I have to surrender to the drizzles that fell and kept on falling when borsha came, around my heart, to my veins? What if it's the last?”

Tears would roll down, songs would play in the background to bring the sorrow to an ultimate climax and she would cry herself to sleep.

And then the day came when she really had to leave. Without a proper full monsoon, leaving thirsty, leaving hungry, she looked everywhere to take a bit of it. But nothing could hold the depth of each drop, the weight of each splash. But then someone knocked on her window, shapeless, faceless, cold and warm.

When she opened her window a tissue paper hung on the railing. She looked around to figure out who left it, was it monsoon herself, or the season in between seasons? She had no voice to ask, and no voice was there to answer.

Then suddenly, uncontrollably monsoon poured out of the sky and her eyes and the tissue got drenched with a million drops, a few clouds came into her room and thunders roared like they were being set free. When the tissue had completely soaked all of it in, the window shut itself slamming backward and forward.

She carried it over oceans, lands, skies. And then she let it free. Out of her purse onto the windowsill. And it's been raining since, thunders and dancing streets, love and madness, soil and sand, washed away, brought back. No one saw, no one knew, a purse and a tissue paper, a mad girl and her half-sipped dreams.


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