Monday, December 13, 2021

Challenges faced by counselors in helping their clients due the COVID19 global pandemic in Sri Lanka ~ W A Imali



Decades of civil war and natural disasters like a tsunami hit Sri Lanka socially, politically, economically and psychologically. When the country struggles to settle with its past losses Covid-19 viral has attacked physical and mental health as well as the well-being of individuals.

Sri Lankan communities have been threatened with this pandemic which has required long-term lockdowns, quarantine, social distancing and hospital treatments. Duration of the impact is continued since its spread is continuing worldwide and it could damage the social conditions, mental and emotional health of people. When people are facing a crisis, it is natural that the first thing that gets negatively affected is their mental wellbeing. People are experiencing distress due to the deep economic crisis with unemployment, financial difficulties and loss of loved ones. Quarantined individuals may experience long-term consequences such as alcohol dependence, stress, anxiety, poor concentration and other depressive disorders. The pandemic has produced alarming increases in domestic violence, intimate partner violence and gender-based violence as well. In the meantime, COVID-19 may adversely affect patients who have prior psychiatric illnesses and they experience greater psychological distress than the wider public.

This crisis has affected mental health care workers such as counselor’s well-being as well. Counselors’ roles and responsibilities have changed since they also experience similar fears and frustrations same as their clients. Counselors have to manage stress in their professional and personal lives during this crisis. They must cope with losing clients, family issues, financial difficulties and emotional stress that the virus has brought. To manage these difficulties they have to develop new methodologies and adapt remote technologies to provide proper care within social isolation and safety guidelines.

 “Counselling Psychology is an active, collaborative relationship which can both facilitate the exploration of underlying issues and empower people to confront changes” (Sims, 2010, p.454, as cited in Open University of Sri Lanka, 2018). Counselor is a profession that allows diverse individuals, families and groups to accomplish mental health, wellness, education, and career goals (Gladding, 2017, as cited in Open University of Sri Lanka, 2018). Counselors in Sri Lanka attached to many local and international non-governmental as well as governmental organizations are trained on how to offer service to an individual who is undergoing problems and needs professional help to overcome them.  Counseling centers are developed around the country to improve the overall well-being of the respective communities.

                Due to the spread of COVID-19, it increased the demand for counseling worldwide. In Sri Lanka, some teams of counselors who are working under the supervision of the Ministry of Women and Child Affairs and the Ministry of Social Services do their best to help anxious Sri Lankans (Ferdinando & Jayawardena, 2020). People seek help from counselors for a variety of reasons. Some may enter counseling to adapt to major life changes such as divorce. Others may seek help in handling mental health conditions, like depression and anxiety. But many of the issues that clients bring to counselors now are relating to day- to-day problems and they have forgotten the primary concerns that originally brought to counseling. Even if the counselor has been working with a client for some time, the counselor cannot assume the client’s current situation as this pandemic may be a huge obstacle for them. Most of the psychological issues that clients have been suffered are already changed to day-to-day crises. As an example, a client who visited his counselor to seek help to overcome his relationship issues with co-workers at the workplace now has lost his job. He may now suffer from financial difficulties and visiting a counselor with a new set of daily issues which are hard to solve by counseling. The counselor cannot always save his clients from unhappiness and guide them to unrealistic expectations since most of the opportunities are hard to access during this pandemic.

When counselors are navigating their client’s issues they also have to manage their own anxieties during this extraordinary situation and its potential impact on the counselor’s health, their loved ones. Counselors have the chance of developing those psychological consequences when they experience some devastating threats such as the risk of COVID virus infection, feeling of helplessness, stigmatization, financial issues and worries about family. If the counselor's boundaries are not stable, he or she is more likely to have difficulties controlling himself/herself and may respond to a client's transference reaction with countertransference. Most of the Sri Lankan counselors assigned to the government cannot access a proper working environment which makes both counselor and client feel safe during this pandemic situation. Work-related traveling also becomes a huge burden due to safety precautions. The vast increase of recent client base counselors have to do more documentation and their workload also goes up. The transition to remote technology has required many counselors to adjust their counseling methods and routines. When they have to work from home it requires proper and private spaces free from family disruptions and external noises. With time being those adaptations make them depressed. However, these overwhelming drawbacks make the counselor dissatisfied with the counseling process and it becomes a challenge to overcome his anxieties and stress during this COVID period.

Because of COVID-19, life won’t just go back to normal. All the crises are going to disappoint people’s routines. Therefore counselors should have prepared to take a more directive position with clients and focus on their life skills during the transition toward a “new normal.” Counselors may need to provide guidelines, instructions, demonstrations or have to help clients to identify new skills. For example, some clients who have been dismissed from work need a new job search or applying. And else may need guidance on how to get back to their workplace safely. When dealing with a trauma crisis it is essential to develop new plans and strategies to facilitate the grieving and healing process. This is called crisis counseling. To make sure the clients are safe, counselors should have kept them connected to the resources and social support. After that, to reduce the crisis impact, the counselor should immerse into the client's life and assisting in the development of resources. (Miller, 2012, as cited in Open University of Sri Lanka, 2018). Therefore Sri Lankan counselors need specialized training, some policies and tools to handle client’s sensitive issues that they face during this pandemic.

In many countries, clinical supervision or mandatory therapy sessions for mental health professionals such as counselors are common. But in Sri Lanka, however, support systems for state counselors, to provide guidance and ensure that they have somewhere to turn when the job gets overwhelming, didn’t exist (Ferdinando & Jayawardena, 2020). Therefore all the burden of rectifying counseling job-related issues would eventually fall on the counselors. Counselors should consider their own feelings when protecting their clients and study more about them. At the same time, the counselor should keep in mind that the feelings clients evoke in a counselor are likely to be feelings that clients are repeating in their daily interactions with others. Counselors need to apply the same surviving strategies and tools to themselves that they offer to clients such as having proper sleep, exercising, make networks with others, taking breaks and handling their emotions. Set up of peer-support mechanisms may give counselors a safe space to meet in small groups and discuss difficult cases and share the pressure they endure. Those supervision help counselors to achieve a sense of safety to redirect on their work with clients and the impact it has on themselves, to challenge their own biases and beliefs (Ferdinando & Jayawardena, 2020). Stress and burnout of counselors due to the overload of work can be mitigated by sharing with supervisors and peer groups. However, counseling in Sri Lanka needs more standardization in supervised training and practices with a national code of ethics.

                     The main objective of counseling is psychological growth. Counselors feel they have to present themselves to the community as strong, competent and self-confident professionals. Therefore sometimes they carried their burdens silently and rarely share their difficulties with others due to the stigma. During this pandemic, counselor’s service is needed more than ever. In Sri Lanka there several ministries and institutions conduct guidance and counseling programs to help people. However, the counselors need to remember that they are affected directly or indirectly by this pandemic too. While counselors focus on addressing their patients’ mental health needs, they must also follow and recognizing their own vulnerabilities and making time for self-care as well. It is highly recommended that counselors seek out professional supervision support during this stressful time. Counselor’s personal values and beliefs during this hard time are more important to carry out therapeutic procedures. Therefore core conditions such as congruence, unconditional positive regard and empathy can be used as attributes of a counselor to understand the situation and client in a deep manner.

 

                                                                 References

Ferdinando, M., & Jayawardena, K. (2020, September 16). Counseling the Counselors amid Covid-19. The Asia Foundation. https://asiafoundation.org/2020/09/16/counseling-the-counselors-amid-covid-19/

Open University of Sri Lanka. (2018). Introduction to Counseling Psychology. Faculty of Psychology and counseling, Department of Health Science.

 

 

  

Thursday, April 8, 2021

"A Beautiful Mind" _ Movie Review ~ W A Imali

 

Figure 1. The Movie Poster (https://thatsmaths.files.wordpress.com/2015/06/beautiful-mind-poster.jpg)

“A Beautiful Mind” movie is based on a true story about Doctor John Forbes Nash Jr. (June 13, 1928 – May 23, 2015) and directed by Ron Howard. This movie was released in 2001 from DreamWorks Pictures and Universal Picture starting Russell Crowe, Jennifer Connelly and many other well-known actors. This movie won 4 Oscars, 32 other awards and received 58 nominations. The source material for the movie was the biography which is written by Sylvia Nasar, also called "A Beautiful Mind”.

Our Main character mathematician Dr. Nash was arrogant as well as brilliant in his graduate school at Princeton. He has only one friend and roommate, Charles who helps him in all the time. Nash meets Alicia, falls in love with her and marries her. Nash began having mental problems in his early 20's. Similar to his real life, the film captures the suffering of a person from this disorder as it affects his education, profession, social, and family life. He was hospitalized for paranoid schizophrenia. Later, Nash became a mysterious, creepy man at University. But through the support of his beloved wife and his friends he experienced a dramatic recovery. In 1994, he won the Nobel Prize in economics.

As in the movie, Nash begins to hear voices and becomes unable to differentiate them from real voices. The movie is somewhat overstated in the extent that these voices affect his life at the university. However, it is comparable enough to his real life as to illustrate the reality of the disease in its damage of 30 years of his life.

Other than the main character, Alicia is playing an important role as the woman most attached to Nash. When Nash begins to weaken due to mental illness and weird behavior start to disturb her severely. It’s true that her patience and concern played a critical role in his recovery from mental illness. Nash confesses this in his Nobel speech: “I have made the most important discovery of my career, the most important discovery of my life. I am only here tonight because of you [Alicia]. (Howard, 2001). But there were some more personal issues with them in reality that didn’t discuss in the movie.

Dr. Nash was suffering from schizophrenia which is a severe mental disorder that affects the way a person thinks, acts, expresses emotions, sees reality and relates to others. Schizophrenia isn’t as major, common mental illnesses but can be the most chronic and disabling. Schizophrenia can be found in approximately 1% of the world’s population regardless of national, ethnic or economic background. (WHO, 2019). These are the evidence in the movie that was proved Nash has schizophrenia. (Cadabam's Group, 2017).

 Incident 1: “There has to be a mathematical explanation for how bad that tie is” said by Nash to one of his peers.

Delusions of Grandeur

Early warning sign of schizophrenia. Not noticed. But mistook as genius act

 

Incident 2: Nash have been in university library for two days without going to his room and spent whole time drawing mathematical explanations on library windows.

Reduce Daily activities

Stay away from daily activities, neglecting own sanitization purposes and isolated from social world. These are negative signs of schizophrenia.

 

Incident 3: Nash believe that some government spies are chasing him.

Suspiciousness

Nash think that he and his family is in a danger of harm from someone persistently.

 

Incident 4: Nash meets an imaginary friend called Charles and his niece Marcee and talking to them.

Hallucination

Nash seeing and hearing things that are not real. * In real world Nash never had visual delusions figures such as Charles. And he suffered generally from auditory delusions only.

 

Incident 5: Nash cut his hand during the stay at hospital

Self-harm

People with schizophrenia are often into self-harm other than hurting others.

 

Incident 6: Nash listening to what his imaginary soviet spy man said and trying to stop his wife calling to doctor.

Lack of Insight

Failure to recognize the need of treatment and they are unaware of their illness.

 

Nash would have positive hallucination of people like Charles and his niece Marcee. And his negative hallucination would include people such as government spies and Russian soldiers.  Both his roommate Charles and Charles' niece Marcee and government agents are all treated as real people instead of hallucinations. Only when John realizes that Marcee has not aged over several years is he able to admit she is a hallucination. And viewers also able to find out them as illusions at the same time Alicia finds out. Nash began to ignore the hallucinations and taught himself to realize that his imaginary people are not real. The movie is showing how Nash's acceptance of his illness as he is able to recognize that the voices are not real and letting them run his life.

He engage in society more often to normalize his world. He started teaching math and try hard to live like a normal mathematician. Finally he got a better feeling. And that is the wonderful turning point of this movie.

              The shots of A Beautiful Mind consists of mainly medium, high and low angles. The film uses golden shade colors to show happy and positive moods. Blue and gray tone uses to show the darkest moments in Nasha’s life. The moment that Nash accidentally try to kill their child the movie shows even climate of that day is also changed to rainy and windy day.

              Overall, A Beautiful Mind is a cinema masterpiece. With realistic soundtrack and enigmatic orchestral score pieces; smooth and fluid cinematography; excellent acting and direction; superb screenplay. (Chris, 2017). The target audience of this movie are adults who like movies based on exceptional true stories, those who like biographical movies and those who are interested in mental illnesses especially schizophrenia.

A Beautiful Mind tells not just the story of a schizophrenic but it also represents the effect the disorder has for the family, how it causes the breakdown of one’s reputation and the ability to overcome schizophrenia and become a genius. This has surprised the viewers as it was based on true story. This movie gives hope who are suffering from mental illnesses that they are not alone and they can do anything that they want.

 

 W A L S Imali

References

Cadabam's Group. (2017). Symptoms of schizophrenia Explained by - A Beautiful Mind (2001), Retrieved from https://www.youtube.com/watch?v=QUFe7M55NP8&t=2s

Chris, N.G., (2017). Overcoming Insanity within A Beautiful Mind. Retrieved from http://chrisng.hubpages.com/hub/beautifulmind

 

Howard, R. (2001). A Beautiful Mind. Dream Works Picture. Retrieved from https://123movies.email/movies/a-beautiful-mind/

 

Nasar, S. (1998). A Beautiful Mind: A Biography of John Forbes Nash, Jr. Simon & Schuster. ISBN 0-684-81906-6, Retrieved from https://archive.org/details/abeautifulmind_201912/mode/2up

 

Ranna, P. (2017), Schizophrenia, American Psychiatric Association

 

WHO. (2019, October 9). Schizophrenia. Retrieved from https://www.who.int/news-room/fact-sheets/detail/schizophrenia