Throughout the 1930s, psychiatry and psychoanalysis had been gaining wider acceptance among medical professionals in India, and Jung had made an extensive tour of India in 1937–8. In October 1942, Edward Bennett, a highly respected Jungian analyst, arrived in Delhi to advise the military from the progressive environment of London’s Tavistock Clinic. The number of qualified psychiatrists serving the Indian Army increased from four to eighty-six during the war, including some Jewish refugee doctors, and a number of junior medical officers also received training in psychiatric care. Specialist wards were developed in General Hospitals like Ranchi, Moradabad, Poona and Comilla. Nurses were reading the latest works on psychoanalysis, pavement bookstalls sold the works of Jung and Freud, and the role of domestic, emotional and childhood neuroses and their contribution to an individual’s ability to withstand the tensions of battle all became more thoroughly understood.
Needless to say, Indian soldiers did not benefit from these medical innovations in psychiatric care to the same extent as their British comrades, despite psychiatric cases accounting for 10 to 15 per cent of all casualties in the Indian Army. In the forward areas of North Africa and the Western Desert, neuroses ranged from exhaustion and homesickness to fear of battle. The Indian Army’s approach was less nuanced and responsive than the British Army’s. The ‘trick-cyclists’ of the psychiatric profession still tended to believe people had predilections towards certain mental illnesses; this might be because of an individual’s background or childhood but might also be predetermined by ethnicity or by race. The idea persisted that Indians were peculiarly predisposed to certain types of mental ill-health, particularly hysteria. This idea had gained currency in the First World War and continued to inform the treatment of Indian soldiers, even among the more liberal and progressive psychiatrists.
Wilfred Abse, an eminent psychiatrist from Cardiff, worked with patients suffering from mental health issues in the Indian Military Hospital in Delhi. He wrote emphatically about the differences in hysteria between Indians and westerners, convinced that it was a peculiarly Indian phenomenon, and something to which Bengalis were particularly prone; indeed, he argued, it was the illness ‘second only to malaria in Bengal’. There had been a long suspicion that Indian soldiers had a particular susceptibility to hysteria and among the nervous disorders Abse saw in Delhi, he detected hundreds of cases of hysteria – convulsions, paralysis and sensory disturbances – among Indian soldiers who had been hospitalised. Psychiatrists from Europe rarely knew Indian vernaculars and they had to interview patients using a translator, often failing to grasp the subtleties of the social and economic strains on the Indian soldier.
Wilfred Abse included photographs in his case-notes of patients manifesting physical symptoms because of their mental distress. One patient’s limbs had been studded with thorns (‘Hysterical anaesthesia of legs. Thorns plunged into the skin were ignored by patient’), other sepoys were pictured with bloated stomachs or bent perpendicular with bad backs. He saw convulsive attacks as ‘frequent manifestations of hysteria in Indian soldiers’ in addition to amnesia and abdominal pains. In one case, a soldier had not been able to sleep for two months and his insomnia was so severe that he had been hospitalised. Abse’s notes give a slender glimpse into the multifarious tensions weighing on some Indian soldiers and in particular their strong sense of responsibility towards their kin and the burden of responsibilities back home. In the case of the insomniac soldier, ‘Questioning revealed that two months earlier his mother had died. Owing to his absence from home in the Army, he had been unable to carry out the appropriate religious ceremonies. He felt that he had insulted his mother and that in consequence the divine power had rendered him incapable of sleep.’ In this instance the patient responded well to sympathetic discussion of his concerns and to the use of hypnosis but also, not remarkably, to some home leave.
In another case a sepoy, identified only as a twenty-five-year-old Muslim soldier, was under observation in hospital for muteness. He did not utter a sound for two months but the doctors could find no physical explanation. The patient scribbled in notes that the cause was the intervention of a malignant spirit and that he could only be cured by returning home and seeing the local hakim, ‘though he thought even this would take a long time’. When he was told firmly that he would have to stay in hospital until he spoke, the patient continued to beseech for release in his handwritten notes, before he finally began speaking. While the doctor found a convoluted explanation for the muteness as ‘a fear of the homosexual instinct’, the modern reader is tempted to wonder if the sepoy was using desperate measures to try to acquire home leave. Dr Abse stayed alert to the fact that his patients often felt homesick, missed their wives and grieved over lost parents whom they had not been able to see. However, he was unable to fully articulate the difference of the Indian sepoy’s experience of war, or to fully navigate his way to understanding the complex social pressures on the shoulders of many sepoys.
Nonetheless, treatment was more successful than during the First World War and about a quarter of psychiatric casualties in the Indian Army returned to active duty. There was far more recognition of how physical and mental symptoms might be interwoven and how soldiers with malaria or dysentery might fall into a depressed state. There was greater understanding of the mental impact on soldiers in Burma who saw their comrades killed or injured or who endured long weeks of uncertainty, waiting for the apparently indefatigable Japanese, struggling with the heat, mosquitoes, monotony and alienation of the war. Sepoys on the Burmese front were anxious about injury and apprehensive of the peculiar cruelties and persistence attributed to the enemy. On one three-day boat-trip from Gauhauti to Dacca on a medical steamer of 172 Indian casualties, half of the passengers were classified as pagals – or mentally ill sepoys. ‘Most were sad quiet men suffering from depression’, recorded the nurse Angela Bolton, who was charged with accompanying the hospital ship as it slowly navigated the river. ‘Those who were a danger to themselves or others occupied the large wire-mesh cage at one end of the deck which was otherwise used for prisoners of war.’
~~India at War: The Subcontinent and the Second World War -by- Yasmin Khan
No comments:
Post a Comment