Talking Through Life

A TALK BUBBLE POPS UP ON THE SCREEN. “We’re going to look at some of your thoughts that cause stress, and try to replace them with more useful thoughts… This is like a mind gym and we’re now on ses­sion no. 1! Ready to start?” You can either answer ‘Sure’ or ask ‘How does this work?’, and Wysa, the AI-based pen­guin chatbot on the eponymous mental health app that claims to have helped over 500,000 people in India, will tell you more. Wysa also has an SOS section that can help you plan ahead for mental health emergencies and even talk you through a panic attack, play­ing relaxing audio or asking you to practise breathing techniques. For a fee, you can ask for a human therapist to have a conversation about your mental health with. For those unsure of seeking help, AI chatbots and mindfulness apps can be gateways into the rapidly expanding world of psychotherapy.

Much of this growth happened during the course of the pan­demic, when social media was the only tool we were left with to deal with the dysfunction we were experiencing all around us. Instagram both triggered us and taught us about triggers. It told us to practise mindfulness, yet bombarded us with mental health in­formation and psychobabble—words like ‘boundaries’, ‘gaslight’, ‘check-in’, ‘trauma’ and ‘self-care’ that we freely use in our everyday lives now. Therapy lost some of the whiteness associated with it and came to be seen as a bumpy road to healing wounds from the past and the present, and even to self-discovery. Although normalcy had supposedly returned to the world, looking at it through a psycho­logical lens there was nothing normal about it: we were plumb­ing the depths of loneliness and self-worth, succumbing to peer pressure, body image issues and financial stress, and navigating complex relationships. We were now being encouraged to embrace our humanity, warts and all—and to work on being better human beings. In a country that has struggled to dispel the social stigma surrounding mental health, therapy was suddenly woke.

A 2021 study by the LiveLoveLaugh Foundation, ‘How India Perceives Mental Health’, found clear evidence of an attitudinal shift towards mental health interventions, with 92 per cent of those sur­veyed saying they would support a person seeking treatment for mental illness—a big jump from 54 per cent in 2018, when the first edition of the survey came out. According to the study, it wasn’t so much social stigma that was preventing people from getting the help they needed, as the cost of treatment and the lack of access to it due to socio-economic conditions. Quantifying India’s mental health burden, the National Mental Health Survey conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) has revealed that nearly 150 million Indians are in need of mental healthcare services, but less than 30 million are seek­ing them. Last year, recognising the need to urgently improve access to quality mental health intervention across the country, the Indian government announced the launch of the National Tele-Mental Health programme, including a network of 23 tele-mental health centres of excellence with NIMHANS as the nodal centre.

Two years ago, Srinidhi Chari, then 22, found herself crippled by anxiety after failing to clear chartered accountancy exams on her second try. “I had a massive panic attack. My parents and I went to a doctor to rule out an asthma attack and he was like, you need to see a therapist right away.” She sought help just in time and cleared the exams on her next attempt in December 2021. Now an analyst at a venture capital firm in Bengaluru, Chari says that it was when she began to ask around for a good therapist that she realised almost all her friends were in therapy. “Therapy is for everyone. It is not just a quick fix for when you are in distress. I sought therapy for anxiety but ended up working through deep-rooted issues. I am very close to my family and friends but I could not have opened up in that way to anyone else.” Chari’s therapist helped her address body hate and taught her to be kinder to her­self. She also gave her a lot of homework, including practising meditation and breathing techniques to deal with anxiety.

MANY YOUNG PEOPLE crave the catharsis of therapy and find comfort in the spilling of buried secrets. Others seek it for unquestioned validation. A vast majority see it as a way of “working on” themselves. “The stigma around mental health has fallen like a curtain post-Covid. More people today are seeking therapy to reflect on their patterns, to learn from their mis­takes, so they can make better decisions in the future. This was not the case before,” says Shrradha Sidhwani, a 42-year-old therapist with a private practice in Bandra, Mumbai. Pre-Covid, Sidhwani referred a majority of her clients to psychiatrists for added medical intervention, but now, less than 25 per cent need psychiatric help. “You can now go to therapy for issues like not being able to bond with friends or for gaming addiction, and not have people judge you for it,” Sidhwani says. While millennials most commonly seek therapy to overcome work stress and pressure to build a family and sustain complex relationships, Gen Z is plagued by self-doubt, fear of failure and social anxiety, Sidhwani says.

A therapist equips you with tools to refresh your perspectives in life, says Trisha Ramesh, a 27-year-old who works in marketing at a Bengaluru-based realty firm. Even looking at oneself in a mir­ror and saying something self-affirming—what’s called mirror work in therapy—can help, she says. While many of the popular tools used in therapy, like mindfulness, yoga and journaling, are hardly new, having someone to check in with about the state of one’s mind makes all the difference, says Ramesh, who sought help post-Covid to address her self-worth issues. She has since switched three therapists and explored hypnosis and other alter­native therapies. Her relationships with friends, family and col­leagues are now flourishing, she says; she is more empathetic and sure of herself. “I am a different person today because of therapy,” she says. “For my grandfather’s generation, a strong belief in god saw them through life. We all need to believe in something, at least in ourselves.”

Therapy is not, however, the opiate of the privileged that it is often made out to be. “It is a lot of hard work and the rewards may not come immediately,” says Srijan Mahajan, founder of Pause, a Delhi-based mental health startup. Mahajan, 35, started Pause with his friend Ankur Kampani after the pandemic when they both struggled with mental health issues and failed to find the right therapist. They built an algorithm to match clients with therapists with the relevant area of expertise. With 20-plus psychologists on the platform today, Pause has served about 300 clients and processed 2,000 inquiries. When Mahajan started seeing a therapist, he didn’t scratch the surface of what he needed to talk about for six months. “I kept talking about the here and now. But then she asked me some­thing and the floodgates opened. Therapy is not easy. You are con­fronted with a lot of yourself that you have pushed under the rug.”

In AppleTV’s Shrinking, a therapist who finds his clients not making any progress, turns vigilante and starts to make their decisions for them, forcing one to separate from an emotionally abusive partner and dragging another with PTSD to a boxing ring. “Sometimes the therapist becomes a life coach, and you know you have to switch,” says Vardhman Jain, the 34-year-old founder of Bonomi, a coffee startup in Bengaluru, who goes to therapy to man­age his anxiety. “It is especially hard to find the ideal psychologist-psychiatrist team for your specific needs,” he says. With a session of therapy costing anywhere between `1,000 and `5,000, there is a lot of inertia built into the system. The idea of starting afresh with a new therapist can be daunting to someone who has already built an archive of their life with another. For Jain, the change has been well worth it. His new therapist and psychiatrist have enabled him to come off his anti-anxiety medication and live a fuller life with fewer sessions of therapy.

With the surge in demand for therapy, online counselling startups have mushroomed overnight. Many peddle buzzwords like past-life regression and inner child healing to reel in clients for `2,500-`3,500 a session, likely conducted by a hip young woman fresh out of college. Then there are the smiling Instagrammers, asking us to turn off our phones, to ditch the friend who is “drain­ing” us and to reject toxicity, and quote-bombing us with “positive vibes”. “Aside from registered clinical psychologists, who must obtain a licence from the Rehabilitation Council of India (RCI), there are no regulations for the qualifications of practitioners in the mental health space who call themselves therapists, counsel­lors, psychologists, counselling psychologists and so on. All you need to call yourself a psychologist is a masters’ degree in psychol­ogy,” says Aditi Kumar, a 32-year-old clinical psychologist and the chief clinical officer at Pause. Kumar admits therapy has become a crutch for many people. “While we are happy about the awareness and the demand for therapy, we are also very scared, as therapists, about why this is happening,” she says. “As a country we are at a crossroads where we often have to choose between our traditional value systems and evolution informed by the information overload of today’s internet age. Families are changing from within and par­ents are overparenting, leaving children with little room to think for themselves as individuals. As a result, there is angst among the young towards authority figures. They are often too quick to turn to therapy for answers. At Pause we often get discovery calls from 22-to-25-year-olds who have just had a breakup, and we have to tell them that it is important to give themselves some time and space before coming to therapy.” Young people also come to therapy with unreasonable expectations, says Kumar. “There is this huge misun­derstanding that therapy will make you find the right person. I tell people that it might actually make you more single now that you are self-aware and okay with your own company.”

“Therapy hasn’t worked for me,” says Sonisha Kukreja, a 23-year-old suicide survivor from Faridabad who is an investor with Blume Ventures in Bengaluru. Growing up in a crowded household with four grandparents, Kukreja battled depression and suicidal tendencies from an early age. She missed school for a year-and-a-half after surviving her suicide attempt in Class 9, and was kicked out of a new school she joined in Class 11 for being physically unfit to attend all classes. Her mental health has needed constant attention—as a student at the highly competitive Shri Ram College of Commerce in Delhi, and now as a young partici­pant in the VC ecosystem of Bengaluru. “After having seen three-four therapists, I am very self-aware now. I know that the key to my problems is always inside me —whether it is establishing a morning routine, or meditating, or checking in with my mom who has effectively become my therapist. Still, I am open to the idea of going to therapy, especially since the company reimburses therapy bills to the tune of `25,000 a year.”

Corporates are increasingly prioritising employees’ mental health, and with good reason. A recent Deloitte study among work­ing Indians found that more than 80 per cent of the respondents reported being affected by at least one adverse mental health symp­tom, while more than 65 per cent reported at least two symptoms. “I had someone who is 22 come to me and say, ‘this is my budget, this is how much I am saving for therapy, can you accommodate me?’” says Deeksha Bala, a 29-year-old therapist practising in Bengaluru. About 40-50 per cent of her time slots are reserved for clients who cannot afford to pay full price for therapy. “Almost all therapists do some extent of pro bono work, but we also have to earn a living. Corporates covering therapy is a welcome change, now it is time for the government to subsidise mental health intervention.”

Going to therapy, however expensive it may be, is the new nor­mal for Gen Z, which, in a recent survey by Tinder India, revealed a preference for matches who prioritise their mental well-being. “Eighty-five per cent of respondents in Kolkata say that having a partner who values self care is critical to a happy relationship… 81% say they will never compromise on self-care practices or boundaries for a relationship, highest amongst all cities in the country,” says a Tinder India report based on a study of 1,000 18-25-year-old dating singles across 10 Indian cities. Trauma bonding is passe; a new age of bonding over therapy is here.

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