When children become our mirrors

[Music]

from my early childhood days i knew

intuitively that i was letting people

down i tried i really tried hard but

nothing seemed to work

therefore you can imagine everyone's

surprised when not only did i get into a

top medical school

but somehow managed to complete it too

after graduating in medicine came the

dilemma

what do i specialize in after much

discussion and anguish

i chose psychiatry to most people's

surprise and disdain

i remember my dhih my favorite

grandparent

exclaiming with deep disappointment

after all these years of hard work

is that all he could think of becoming a

pagola doctor

a doctor for the man

the stigma and shame around mental

illness was deep and continues to be

after all these years

yet i held on as there was something

about mental health that really

intrigued me

perhaps due to my own brush with it

while training in psychiatry i

gravitated naturally towards

child and adolescent mental health

working with children and their families

i discovered the joy of being

unpretentious and spontaneous again but

what struck me the most was the uncanny

knack

of holding a mirror to the adult world

where we could see our

own values and double standards our

dreams and disappointments

as well as as our challenges and

failings

it was in the so-called naughty kids

that i saw my reflection

particularly the ones that are bouncing

off the wall and getting into trouble at

home

school or the playground who ever so

often were written off by the world

i saw my troubled childhood in their

eyes my angst written adolescence in

their words

i'd grown up hearing my childhood

stories told and retold with a

combination of despair and amusement by

my family

as a toddler how my mother had to tie me

with a saree otherwise

i would run away or how i was ready to

take risky chances

from an early age i have experienced

being the invisible child in a

classroom due to my struggles with

academics

or being singled out as a failure

knowing these kids was like coming back

a full circle

it struck me that very much like some of

the kids i was treating

i too had adhd attention deficit

hyperactivity disorder

but just like i had resisted being

slaughtered into a single story of

being only a troublemaker i could not

allow these kids to slip into a

single story of adhd in my life i was

lucky to find people who could

see me in a more wholesome way and keep

faith in my abilities

and that is how i wanted to help the

kids i saw

not slot them into problem saturated

boxes but

create spaces for them to be seen heard

and to find richer stories for them

and for that to happen i had to see them

through different lenses

and not just through the traditional

lens of mental illness and treatment

and in this journey of being not just a

psychiatrist

but an advocate for children i picked up

different lenses on the way

which i want to share with you today and

reflect and why it may be important for

all of us

the first lens i discovered quite early

was that

do not write off people who develop a

so-called mental illness

they are much more than a cluster of

symptoms and label

indeed they carry many other stories

that can make their lives much richer

and meaningful if they find a space to

tell them

i remember 17 year old ajay who had come

from a

small town in central india he had been

labeled

as a psychotic patient and was taking

eight different

medicines in a day he had dropped out of

school

could barely step out of home had lost

all connection

with friends and cousins had put on

weight and had recently started losing

control

over his bowels he was virtually written

off by school his so-called friends

and extended family that's when his

parents decided to bring him to the

child psychiatric department of an

institute in bangalore

where he was admitted for the next

couple of months

the first thing our treating team

decided to do was to take him

of all medication and observe and what

emerged was refreshing

as ajay started moving and talking more

freely expressing his desires and hopes

about school and college

with less fear catching us by surprise

with his sense of humor

getting excited about his session and

his passion and cricket

and wanting to reconnect with his

friends

and suddenly the human being and

teenager in ajay

came alive although ajay did eventually

get a diagnosis which needed treatment

he and his family went back home with

hope and possibilities of a future for

him

my second lens we cannot hold young

people responsible for their mental

health struggles

which so often shows up as difficult

behaviors instead

we all need to come together to take

collective responsibility

this lens came to me in the next phase

of my journey

in an attempt to train further in child

and adolescent mental health

and to experience the workings of the

world outside india

my wife shelagh and i took off to work

in the uk

in the mid 90s and stayed there for the

next eight years

working for the nhs the national

national health service

though the nhs has its own struggles and

challenges we learned

how social structures can be created for

the best interest of the child

i saw how care can be rooted in the

community

with schools social work child

protection services

even police and and responsible citizens

can come together

to look after their troubled young

people another thing that changed our

lives forever

while we were in england was having our

children first nishat and then anya

they filled our lives with excitement

and meaning but challenges too

as they added an additional lens a

mirror another mirror

yes it is not easy when you are

surrounded by children at

work and at home they have sensitive

radars for and hypocrisy

i believe that our children helped us

grow and realize even more

that we had to do something to make this

world a better place for our own

and other children to thrive with that

determination we returned to india with

a single-minded purpose

of developing child and adolescent

mental health services

cams in short to which i'll refer to now

and then

friends and well-wishers advise us not

to pull up put all our eggs in one

basket you know as a society they said

was not ready for it yet some told us

that children in india

did not have mental health problems and

that child abuse

only happened in the west but we stuck

to our

child friendly guns doggedly and in 2004

under the ages of a welcoming

multi-speciality hospital

we started the first dedicated camps in

delhi

within two years we were struggling to

cope with the deluge of referrals

despite our growing multi-disciplinary

team

in another couple of years we were

bursting at the seams in the limited

space the hospital could

provide us and so in 2009 we took a

leap of faith to break away and form

children first

an organization looking after the mental

health needs of children and adolescents

placed within the community this time

i believe that children first was

waiting to happen

the gaping needs of young people in

today's times was demanding it

it was not surprising therefore that in

the next 10 years

it became one of the biggest stand-alone

facilities for

camps in india and it also evolved in

ways that we couldn't foresee which came

from our responses to the children and

families

we met and the interface with the larger

community

and it is in this context and

experiences within it

that i picked up another two lenses

take the case of 15 year old sahil a

bright and talented young man who had

started hating school

and studies since he was he came to

middle school

a voracious reader a deep thinker he

would question everything

especially the education system parents

and teachers had given up on him

as he was bunking classes failing in

exams arguing with teachers and

disrupting the class with his

so-called rude and defined behaviors and

more recently

worryingly he started experimenting with

substances of abuse

but sahil was not always like this do

you know as a younger child he was a

curious and imaginative playful and

affectionate

and wrote exceptional poetry although

quick learner

and clear with his concepts he was a

dreamer in class

and would often struggle to complete

academic work both in school and at home

things had clearly become much more

complicated by the time he came to see

sahil was diagnosed with adhd and it was

evident

with a lot of that a lot of his angst

and aggression

was in response to the judgment and

criticism that were thrown at him

from middle school onwards a time when

school becomes increasingly

uncompromising with studies and

academics he was on the verge of

slipping into depression

or serious substance misuse had it not

been for the timely intervention

one can imagine how his story could have

been so different had his parents and

teachers

recognize that he was wired differently

and responded to his talents and

abilities

rather than his failings or

consider the story of 12 year old

shannaz who was

brought by the police to a reputed ngo

that i work with closely

along with her 10 year old sister

shaina's now had disclosed that her

stepfather

had been sexually abusing her repeatedly

after their mother's death

from the time she was nine years old she

had kept quiet till she noticed that

this man's roving eyes

were increasingly falling on his other

growing daughter

and shaynaz could no longer bear the

thought of the impending doom

that was awaiting her little sister

the man was promptly celtic sent to jail

under the stringent law of

pogso which is the prevention of child

sexual offenses

act in india and the extended family saw

shahnaz's act of care towards a sister

as selfishness and blamed her for

breaking the family

and denounced both the children shania

and her sister

were accepted and nurtured in the ngo

and settled well in their new home

over the next few months till shannaz

was taken for a mandatory visit

to the state-run cwc or child welfare

committee which is meant to take care of

children's welfare as their name would

suggest

but instead they questioned her motive

and admonished her for bringing

disrepute to the family

shannaz plunged into depression plagued

with guilt

she made a serious suicidal attempt and

started getting disturbing nightmares

and

flashbacks from the days of abuse by her

own father

it took her many months to recover from

the tormenting symptoms

and for healing to begin it was ironical

that shania's attempts at saving a

little sister

from sexual abuse provoked such extreme

reaction from adults around her

the same adults who would be expected to

protect her damaged her further

working with children like sahil and

shanna's gave me my third lens

i realized that children can be wired

and inspired differently

and some might have the propensity of

developing

mental health difficulties under stress

but it is the reaction of adults and the

world we have created around them

that makes it much more complicated and

damaging for them

i have so often seen that in our apathy

and the callous responses

of our institutions that drive our young

people to despair

and disruptive or even dangerous

behaviors

and then last year covert 19 happened

which demolished some of the foundations

of our society that were

cracking up already we were all impacted

by it but it was the youth that bore the

brunt of this brutal blow

suddenly mental health became a crisis

and we were overwhelmed with stories of

despair and death

at children first we responded by

starting a brief therapy service for

young adults

hundreds of isolated young people

started reaching out to us for help

cut off from families and friends with

little access to activities

and spaces that breathe life and meaning

into our existence

many lost their fledging jobs and others

could not go to college

as their planned what struck us what

that

so many of them were considered capable

well-adjusted

and successful young people before the

pandemic took away all freedom

and agency from their lives my fourth

lens

came from this realization that mental

health problems do not

in any way indicate that people are

damaged broken or weak

given the same context and circumstances

any of us

would respond in the same way

in summary i would like to emphasize it

is not

abnormal it is not abnormal to feel

despair in hopelessness

or to develop symptoms of anxiety or

depression when you're completely

isolated from family and friends

and have no certainty about the future

as so many young people did in the

pandemic lockdown

it is not unusual to lash out with words

become rebellious and start taking

dangerous chances like style did when

you're judged criticized

and marginalized for having difficulties

in learning

and isn't it amazing that a 12 year old

gathered the courage to take a

definitive stand to protect her younger

sister from a sexual predator

and it is understandable when she

crumbles in the face of shaming and

ostracization

for those very acts of courage and

starts getting

terrifying nightmares of the sexual

abuse she suffered as a child

like shanna's did it is indeed the norm

both functionally and statistically

to go through mental health struggles at

some time in our lives

just like we all go through physical

health or financial troubles

it is therefore vital that we begin to

accept it as an integral part of our

lives

become more aware and equipped to deal

with it

so bringing together my four lenses

number one do not write off people who

develop

a so-called mental illness they're much

more than a cluster of symptoms and

labels

indeed they carry many more stories that

can make their lives much

richer and meaningful if they're

provided a safe space to tell them

we cannot and that's number two we

cannot hold young people

responsible for their mental health

struggles which so often shows up as

difficult behaviors

instead we all need to come together to

take collective responsibility

number three young people can be wired

and inspired differently

and some might have the propensity of

developing mental health difficulties

under stress

but it is the reaction of adults and the

world we have created around them

that makes it much more complicated and

damaging for them

number four mental health problems do

not in any way indicate that people are

damaged

broken or weak given the same context

and circumstances

any one of us could respond in the same

way

the pandemic has jolted humanity and

made us question the way we have

treated nature and our environment and

has raised doubts about the meaning of

success

the institutions that define it and our

mindless pursuit of the material

it has also given us an opportunity to

reconsider

our priorities in terms of mental health

and well-being

but the question is how much of our mind

space and resources are we willing to

devote to it

in the so-called new normal each one of

us can be a catalyst for this change

so i have one thing to say to you

whether you are a parent a teacher

mental health worker a young activist or

just a person who cares

together we can create a movement for

our children

and youth are you ready for it

you

{{}}

[音乐]

从我孩提时代就

直觉地知道我让人们

失望了

医学专业毕业后也遇到了

两难境地

，经过多次

讨论和痛苦，

我选择了精神病学，这让大多数人

感到惊讶和鄙视

可以考虑成为一名

医生

在接受精神病学培训时，我

自然而然地倾向于

与儿童和他们一起工作的儿童和青少年心理健康家庭

我再次发现了

朴实无华和自发的乐趣，但

最让我印象

深刻的

是拿着镜子照向成人世界的不可思议的诀窍，

在那里我们可以看到

自己的价值观和双重标准，我们的

梦想和失望

以及我们的挑战和

失败是在所谓的顽皮孩子

身上，我看到了我的反思，

特别是那些

在

家里

学校或操场上蹦蹦跳跳的孩子，他们

经常被世界

抹杀，我看到了我陷入困境的童年他们的

眼睛我的焦虑用他们的话写下了青春期

我从小就听着我的家人讲述和重述我的童年

故事，带着

绝望和娱乐的结合，

我的母亲如何不得不用纱丽把我绑

起来，否则

我会逃跑或我是如何从小就准备好

冒险的

经历

由于我在学业上的挣扎或被单身，我经历过成为教室里

看不见的孩子但是，作为一个失败，

知道这些孩子就像回到

了一个完整的圈子，

这让我很震惊，就像

我正在治疗的一些孩子一样，

我也患有注意力缺陷

多动障碍，

但就像我拒绝被

屠杀成一个单一的故事

一样我只是一个麻烦制造者，我不能

让这些孩子

在我的生活中陷入一个单一的多动症故事我很

幸运能找到能够

以更健康的方式看待我并

相信我的能力的人

，这就是我想帮助

我看到的孩子们

没有将他们放入问题饱和的

盒子中，而是

为他们创造空间让他们被听到

并为他们找到更丰富的故事

，为此我必须

通过不同

的视角来看待他们，而不仅仅是通过传统

的精神疾病和治疗

，在这个不仅是

精神科医生，

而且是儿童倡导者的旅程中

，我在今天想与您分享的路上拿起了不同的镜头，并

反思了为什么它可能很重要

对我们所有人来说

，我很早就发现的第一个镜头

是，

不要忽视那些

患上所谓精神疾病的人，

他们不仅仅是一组

症状和标签，

事实上他们还有许多其他故事

，可以让他们的生活变得更加美好

如果他们能找到机会告诉他们会更富有和更有意义

我记得 17 岁的 ajay 来自

印度中部的一个小镇，他被

贴上了精神病患者的标签，并且

在他辍学的一天内服用了八种不同的药物

几乎无法走出家门

与朋友和表亲失去了所有联系

体重增加，最近开始失去

对肠道的控制他几乎

被学校注销了他所谓的朋友

和大家庭那是他

父母决定带他来的时候

在接下来的几个月里，他被送往班加罗尔一家研究所的儿童精神病科，

我们的治疗团队决定做的第一件事

就是带他去

在所有的药物治疗和观察中，

随着 ajay 开始移动和更

自由地表达他

对学校和大学的

愿望和希望而出现的情况令人

耳目一新想要与他的朋友重新联系

，突然间

，杰伊的人和少年

活了过来，尽管杰伊最终

得到了需要治疗的诊断，

他和他的家人带着

希望和对他未来的可能性回家了

我的第二个镜头，我们不能年轻

人们应对他们的心理

健康斗争

负责

为了体验印度以外世界的运作方式

，我和妻子 shelagh 开始工作 k

在 90 年代中期在英国工作，并在

接下来的八年里

为 Nhs 工作，

尽管 Nhs 有自己的斗争和

挑战，但我们了解到

如何

为儿童的最大利益创建社会结构

i 看到如何

通过学校社会工作儿童

保护服务将关怀植根于社区，

甚至警察和负责任的公民

也可以团结

起来照顾他们陷入困境的

年轻人当我们在英国时，另一件事永远改变了我们的生活，那

就是让我们的

孩子成为第一个 nishat 然后

他们让我们的生活充满了兴奋

和意义，但也充满了挑战，

因为他们增加了一个额外的镜头

一面镜子另一面镜子

是的，当你被

工作中的孩子和在家中的孩子包围时，这并不容易，我相信他们有敏感的

雷达来检测废话和虚伪

我们的孩子帮助我们

成长并更加

意识到我们必须做一些事情来让这个

世界对你来说变得更美好 r 自己

和其他孩子带着这样的

决心回到印度

，一心一意

地开发儿童和青少年

心理健康服务

凸轮，简而言之，我会不时提及这些

，

朋友和好心人建议我们不

要这样做拉起把我们所有的鸡蛋放在一个

篮子里，你知道，作为一个社会，他们说

还没有准备好，但有些人告诉我们

，印度的孩子

没有心理健康问题

，虐待儿童

只发生在西方，但我们

坚持我们的

孩子友好的枪支顽强地在 2004 年

，在一家受欢迎的

多专科医院

成立的时候，我们在两年内在德里开设了第一个专门的营地，

尽管我们的多学科

团队

在接下来的几年里不断壮大，但我们仍在努力应对大量的转诊。

在医院可以

为我们提供的有限空间中，我们的接缝处已破裂，因此在 2009 年，我们实现

了信念的飞跃，首先脱离并组建

了一个照顾儿童的组织这次

将儿童和青少年的心理健康需求

置于社区中

我相信儿童首先

等待发生

当今时代年轻人的巨大需求要求

它并不奇怪因此

在接下来的 10 年中

它成为了印度最大的独立

营地设施，它也以

我们无法预见的方式发展，这

来自我们对我们遇到的儿童和

家庭的反应

以及与更大

社区的互动

，它是在这种背景下和

体验

我又拿起了两个镜头，

以 15 岁的萨希尔为例一个

聪明而有才华的年轻人，他

从上中学就开始讨厌学校

和学习

一个贪婪的读者一个深刻的思想家他

会质疑一切，

尤其是教育系统的家长

和老师都放弃了他，

因为他在

考试中不及格和老师吵架，

用h扰乱课堂。是

所谓的粗鲁和明确的行为，

yReaders

英语演讲, 学习英语。

When children become our mirrors

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