In conversation with Akshita Panwar, Counseling Psychologist and therapist at Folisaa
WAbraham Maslow once wrote: “I can feel guilty about the past, apprehensive about the future, but only in the present can I act. The ability to be in the present moment is a major component of mental wellness.”
With the idea put forward by this quote only, the mental health start-up based in Delhi, Folisaa functions to provide therapy, counseling, wellness training, etc. to people in times when mental health has gained a lot of importance and is being considered of utmost importance by people.
Unlike other mental health centers whose primary aim is to provide therapy to clients, Folisaa moves one step ahead and takes care of people in a holistic manner. Their aim is to not just provide therapy but also provide wellness training in the form of dance therapy, art therapy, yoga, etc. in order to protect people from the relapse which often occurs after therapy.
In a country like India where mental health is progressively yet slowly gaining importance, it was hard to shift the therapy mode to online sessions. People are already apprehensive about meeting a stranger and talking to them about their problems in a physical mode, and then, thinking of talking to another person in front of a camera, that must have been dreadful.
In order to clear our doubts about mental health and virtual therapy sessions, we invited Akshita Panwar, a Counseling psychologist at Folisaa for an engaging conversation.
1. Did you ever give or attend any virtual therapy session prior to the pandemic, 2020? Or did you even hear about it much?
Virtual therapies existed before the pandemic as well but it wasn’t as popular. As offline therapy or in-person therapy became inaccessible, virtual or telephonic therapies gained momentum. People have always been hesitant in India to seek professional help when it came to mental health and adding on to it the concept of virtual therapy was even newer so it was hard to introduce the concept to the public. But the severe mental or psychological effects of the pandemic left people with little choice and slowly the virtual therapy is being accepted by the Indian population.
2. What were your initial thoughts about giving online therapy?
It wasn’t easy for me because I am a fresh graduate who just completed her post-grad in psychology. I had very little experience working in the field and I was supposed to start working online because well that’s the new normal. Studying psychology for 5+ years didn’t make it easy for me or other professionals who have been working for decades in the field and have years of experience to make that shift from offline to online, so it made no sense to expect other individuals who have no connection or little knowledge of psychology or mental health to be comfortable with it. When I began working and set up Folisaa it was by the intention of providing the right help to the people, the help that is worth their money and what they actually deserve.
There are many frauds in the market who are charging people in the name of counseling and are not qualified for it. Even the people who are not charging anything but are not qualified enough to give therapies are adding insult to the injury. Such incidents provide no long-term benefit to the client and they end up losing their faith in the process, their symptoms start to become worse and if not provided with a proper intervention at the right time it might even lead to some harsh complications such as suicide.
3. Do you think a virtual means would disrupt or affect the therapeutic relationship between the client and the therapist?
As I said before, it was new so the change takes some time for the therapist and the client to get comfortable with it. There are technical issues that arise, there is non-familiarity with the applications and websites that are used as the medium to provide therapy so that needs learning on the part of the therapist. So to answer the question initially it was uncomfortable yes, but does it hamper the therapist-client relationship? No.
Even in an offline setup, body-to-body interactions like consoling or hugging are discouraged. As the therapy sessions are also conducted from a distance in a formal structure, taking it online does not affect the therapist-client relationship to a great extent. But yes, if the sessions are conducted over audio calls or texts it does take away the chance of non-verbal assessment being done by the therapist. Various processes like eye movements, body posture, and the behavior of the client that tells us if the client is really present in the therapy or not and for the overall mental status examination. This is the reason we only take sessions over video calls at Folisaa.
4. Many therapies require body movement and some kind of exercise. Did such methods face a problem with the sudden shift of physical to virtual sessions?
Dance Movement Therapy or DMT uses movement as means of the mind-body connection that we have been providing in our organization to promote emotional, social, cognitive, and physical integration of the individual, for the purpose of improving health and well-being. Our therapist has faced little to no challenge providing the therapy virtually. But yes, patients who are diagnosed with Alzheimer’s or other neurodegenerative diseases need support with movement therapy that can either be provided by a family member or a social worker in the virtual therapy.
5. What, according to you, were the major challenges for a psychologist in India to conduct online therapy sessions?
The most challenging part for psychologists in India is their dialogue with the technology. Experienced psychologists were not familiar with the modern-day technology that had to be used to provide virtual therapy. They needed assistance with it to a great extent and found themselves to be unable to take sessions in the absence of that help. On top of that getting clients on a virtual setup was a big task as we have discussed before.
6. People are usually hesitant to talk to anyone about their personal issues. Did going online and talking in front of a screen increase this hesitance of clients?
As a matter of fact, it has both increased the hesitance in some and decreased the hesitance in others. People are taking virtual therapy in the comfort of their homes. When the environment at home is such that it encourages personal space and has clear boundaries it helps the client to be more comfortable with the therapy. But the flip side of the coin is when the family does not provide safe, personal space to the family members especially to the children they feel hesitant to take the therapy. They are often interrupted between the session and are interrogated about it. This makes them drop the intervention and not complete the recommended therapy sessions.
7. What kind of problems did people mostly come up with during the pandemic? Was there any specific pattern or category?
The most prominent problems that have been seen are anxiety, depression, family conflicts, bereavement, and survivor’s guilt. Humans are social animals, being forced by the virus to stay at home and not socialize interferes with our biological and psychological wiring. We were never meant to stay like this and yet this is the need of the hour so the two contradicting situations overlapping each other will result in some kind of maladaptive characteristics in a lot of people. On top of that, the uncertainty of when it will end increases the anxiety. Students are not sure about their exams; the lower and middle class are worried about the economic crisis that might destroy their savings and almost all are worried about the health of their loved ones. People are in collective grief and bereavement, they are unable to meet the family and friends they have lost for the last time. It takes a huge toll on mental health.
8. What were, in case there were, some advantages associated with virtual therapies?
Virtual therapy has made it very easy to access. Therapists have lowered their charges, people don’t have to travel far-off places to seek therapy, it is all available at your home, just a click away. The pandemic has also made people realize the importance of their health and a lot of awareness has been created around mental health and virtual therapy has made it possible to work around that awareness and take therapy to those ‘not so developed’ places of the country that previously had no access to this service.
9. If given a choice, which would you prefer as a psychologist – virtual sessions or physical ones?
Personally, I believe I am a person who does not believe in making rigid preferences and caters to the demand of the clients and the situation. If today my clients need virtual therapy that is what I would prefer. And tomorrow if they ask to see me in person and provide offline therapy I’d be happy to do that too.
10. Lastly, what message would you like to give people regarding mental health and the importance of seeking help in distress?
I just want people to understand how normal it is to take therapy, you do not even have to be distressed to be taking advantage of it. It is as simple as going to the gym where you work on your physical health; the same is with therapy, the only difference is here you work on your mental health and emotional well-being. As for people who are distressed, have faith in the process, do not lose hope if you do not see miraculous changes in yourself after the first few sessions. It takes both time and effort but it is so worth it.
So, this was our amazing conversation with Akshita and she surely made it clear for all that therapy-be it virtually or physically- its aim remains the same. Betterment of the client.
Although on a very side note and a concluding note, I wonder how Mr. Freud (the famous personality of Psychology who made the couch and chair sessions famous) would have felt about such a change.
We leave that to our audience to think about!