The middle-aged Sandhya complains of hearing voices in her head. I was in my clinic with my patient, when she insisted that I speak to her immediately, as she claimed those voices were almost killing her.
We started with casual talk. Sandhya, aged 42, had been married for 17 years and is childless. A look at her education says she is a BCOM and also has a Diploma in business management. The couple did try for IVF but had failed to conceive. Sandhya says when they had gone to the gynaecologist way back in 2003, the medico at that time, had referred her to a psychiatrist. She could not recall the reason why she was asked to approach a mental health professional. I had not met the husband during our first session but when I met him on the second day he had laughed off saying Sandhya is confused and ill, there was no reference of a psychiatrist at that point of time.
Sandhya’s Story
The only sister to three brothers, Sandhya says her parents had an inter-caste marriage, and her mother’s matriarch strongly disapproved of that marriage. Her mother was never accepted by her matriarch, and unable to bear the trauma, she committed suicide when Sandhya was a young woman of 24. Upon the demise of her mother, in no time, Sandhya got a new stepmother, and to her surprise, her biological mother’s matriarch forgave everyone. Her new mother, along with her father, was welcomed wholeheartedly by her maternal uncle, whose harsh words had once pushed Sandhya’s mother to suicide.
Sandhya herself had an inter-caste marriage and during her first session with me complained a lot about her mother-in-law (MIL). She revealed she was scared of her and so was her husband. The former is a pensioner and though capable of handling all domestic chores, doesn’t extend a helping hand to her.
Sandhya made a statement that she possesses evil powers and is capable of casting a magic spell on her. She also said that she was accused of poisoning the food. They have a maid to do the sweeping and washing, but the remaining chores are handled by the unwell Sandhya. She is not even spared of this burden during her dark days. MIL watches television all day and is very fond of the TV soap “Savdhan India” but Sandhya is denied access to watch TV.
Sandhya was once employed with a jewellery shop, and she enjoyed her job but had to quit. She heard voices in her head which abused her. It is a male voice which addresses her as a prostitute and asks her to remove her Mangalsutra. This is what she narrated to me in the first session, and left to see the psychiatrist Dr Bharati Patil. She asked me to accompany her to the doctor’s chamber, as she was scared that the voice was still abusing her, and requested me to wait till she gets an auto, and leaves for her house. I complied with her wishes.
Hardly a week passed when I received a call from the distraught Sandhya, weeping on the phone and begging me to get her hospitalised, as she was scared to stay in her house. The voice had returned with its volley of abuses and as usual, the MIL had not extended any sympathy to this ailing daughter-in-law. Sandhya complained that her MIL had phoned her sister-in-law (husband’s sister) and had made a mockery of her illness. She was desperate to meet me at that moment, and I had a tough time calming her down. I advised her to leave her home, and visit a neighbour or just sit at the train station, just anywhere, but not to stay alone. And I also said that I will be meeting her the next day at Dr Patil’s clinic.
The next morning, she came, accompanied by her husband. I chose to speak with her alone and then assured the husband that I would be talking to him separately, once I finish with the wife. I had doubted sexual abuse and my worst fears came true. I asked her the eternal question, “Tell me Sandhya, have you ever been a victim of sexual abuse?” Breaking down, the frail Sandhya admitted that she indeed was a sex slave to a rich businessman, who had exploited her sexually for three long years.
As mentioned earlier, she worked with a jewellery shop and had been in sales. She had to quit that job as they did not increase her pay for two years. She joined some other reputed jewellery house, and during her commute from home to the workplace, made a new friendship with some woman on the local train. Sandhya trusted her friend so much, that when she asked her to accompany her for a movie, Sandhya agreed.
At the theatre, Sandhya realised that her friend had also brought along with her a man whom she claimed to be her best friend. As the movie started, Sandhya’s friend left the hall saying she would be right back. Inside the darkness of the movie hall, the man had grabbed Sandhya’s hand and taken her out saying that her friend is waiting for her. The gullible Sandhya had trusted him and had left the hall where this man had taken her to a secluded spot and forced himself on her. Sandhya confessed that she had enjoyed this act of forbidden sex.
That man was married and so was Sandhya but that did not stop the duo in entering into an extramarital affair. Then the saga of forbidden sex continued for three years. Each time the man had sex, he abused Sandhya by names – slut, bitch, and whore. He not only physically abused her but also robbed her emotionally by using nasty, filthy and disgusting adjectives. Though they had several sex escapades, Sandhya unable to bear the ceaseless physical inflictions, decided to call it quits. She left her job and also got rid of the pejorative man but by then Sandhya had turned a victim of Paranoid Schizophrenia and suffered from anxiety bouts. She started hearing a male voice calling her by names of a slut, bitch and whore. Sometimes the voice is so severe that she turns suicidal.
What Is Paranoid Schizophrenia?
Paranoid schizophrenia is a mental ailment attributed by anomalous behaviour, bizarre speech, and constant doldrums and reduced capacity in conceiving realty. Like Sandhya, people afflicted with this malady experience spells of hallucinations with most of the patients complaining about hearing voices, deception and muddled speech and sensibility. Isolation, poor hygiene, lack of stimulus are some of the common side effects of schizophrenia.
What Happened To Sandhya Next
During my third session with her, I questioned why she entered into such an illicit relationship with a complete stranger? She revealed she shared no active sex life with her husband. Though she had a love marriage there was no love at all. A victim to domestic violence, Sandhya cried as she said that though her husband had never raised a hand on her, yet he had robbed her of all happiness. At home, he preferred chatting/texting on his mobile phone with all his boy/girlfriends. Often, he returned from his work in a drunken stupor saying he had partied with his friends while this poor woman suffered in silence at home. Also, he frequently left for tours and Sandhya shuddered at the thought of staying alone in the house with her MIL. Please note: this excessive suspicion/hatred towards the mother in law is also a symptom of schizophrenia. Like all other victims, the patients tend to lose trust in others, with Sandhya as no exception either.
Sandhya’s illness had not stemmed in a day. Sandhya had experienced everything a person would like to avoid – she had witnessed her mother’s suicide, she was childless, a victim of unhappy marriage/domestic maltreatment and also a sufferer of tremendous sexual abuse. Sometimes I do get frantic calls from Sandhya during odd hours pleading for help as she is unable to bear the voices and is scared to stay in the house alone with her MIL; to which I can only advise her to take her medicines and do a bit of counselling but nothing more.
My emotional attachment with her has reached to such an extent that each night I enquire if she has taken her medicines, if she has had her dinner, if she has been hearing those voices and if she has managed to sleep and many other ‘ifs’.
I know Sandhya has none to call her own. Back at her matriarch, she doesn’t have the emotional love/support which a daughter/sister would like to have from her father/brother. And here, in her own house, she is deprived of love from her husband and in-laws. The upshot of the mental trauma has been so awful that she has now turned in to a chronic schizophrenic struggling to survive and in the process, she is drowning. Sometimes she sits next to me in the clinic doing nothing but simply watching me as she says that with me the voices are no more to be heard. Yes, I get a feeling I am mothering a helpless 42-year old who needs strangers to reach for help but has no support from her family to lift her from the dungeons of her mental distress.
In conclusion to this poignant tale, I request people to understand that mental illness is for real and that the patient needs immediate support from the family to recover.
Disclaimer: Based on a true case study. Name of the patient changed to protect identity.