Wassup with the mind today?

Illustration/ Uday Mohite

Delhi-based engineering student, Anmol Singh admits he has experienced bouts of anxiety while at home during the national lockdown. The pockets of calm that the 19-year-old would seek in the past, whether through conversations with friends, or a walk in the park, are no longer available. The blurring of boundaries of space between family members is making it particularly difficult. "I identify as queer, but I haven't come out to my family. It gets overwhelming when I have to answer questions like, 'who are you talking to?' and 'why at this hour?'" he says.

Recently, when scrolling Instagram, he came across text-based therapy and some reading up later, he realised it was tailored for someone in his position - quarantined and unable to use traditional in-person therapy or virtual intervention.

Two weeks and four sessions later, Singh is in a better place. "Of course, it does not match the comfort of an actual session, where you are making eye contact and have a face to connect with the therapist. But, when you have nothing else [to rely on], it does help," he says. It's new and unfamiliar territory, but he is slowly warming up to it.

Over the past two months, Kanika Agarwal, founder of mental health platform MindPeers, has seen a gradual, but growing interest in chat sessions. After requests for text-based therapy increased by 17 per cent during the lockdown, she and her team quickly made arrangements to get the service streamlined. Now, she says, eight per cent of the total therapies that they conduct fall in the chat category. "For young professionals and college students, chatting is a regular pastime anyway, which is why chat therapy becomes an easy medium of expression. It's private too, given that they are surrounded by family all the time," she says of the platform launched this year to conduct holistic mental health programmes for schools and corporates.

Kanika Agarwal, founder, MindPeers

Here's how chat therapy works: A user makes a booking with a therapist on the system. They are given the option of using the internal dashboard for chatting, or WhatsApp. After making the appointment, the user receives a privacy statement. The sessions begin once you hit, 'Agree'. The therapist initiates the session with the same questions they would start with for in-person or video and phone consultation.

It took a while for Agarwal and her team to iron out the glitches. "Clinical psychologists in our country are not trained to conduct chat therapy. At MindPeers, we have set a standard operating procedure for it and we conduct mock sessions on how to run chat therapy for emergency days like the lockdown. Sometimes, when users would share their concerns via chat, our therapists would record their videos, introducing themselves for a more trusted relationship."

Rashi Maheshwari is the co-founder of Alternative Story, a mental health service that offers offline and online counselling, group therapy in multiple formats, and organisational solutions. Agarwal says that research has shown that alternative forms of therapy are just as effective, but slower to take effect. "For instance, if you take four in-person sessions to achieve your goal, you might have to take 10 chat sessions to achieve the same." Maheshwari believes chat is effective when a patient is dealing with an extremely traumatic experience, especially in domestic violence or sexual abuse cases. "Writing about it is easier than talking it out." The homework that Singh was assigned included daily journaling. He has chosen to continue with the practice. "The act of writing itself provides relief," he thinks.
While the chat sessions are held at designated time slots, users are free to message the therapist if they feel compelled to reach out.

Tarana Jain, Clinical psychologist

According to Maheshwari, many patients eventually transition to phone or video calls. A 28-year-old Benguluru-based artist, who did not wish to be identified for the story, is one of them. She discontinued chat therapy after four sessions. "In-person and telephonic conversations were more effective for me. If you want long-term issues to be resolved, it's important to feel a connection [with the therapist] and enjoy accessibility," she says. Another downside that users are wary of is confidentiality and the fear that private information can quickly become public. "It does not feel secure since not all platforms make the protocols clear," adds the artist. At Alternative Story and MindPeers, users are asked to go through company agreements, before signing up.

A chat session's efficacy also hinges on how articulate the patient is, says clinical psychologist Tarana Jain, who has conducted chat sessions at MindPeers. "There are patients who are confused and unable to articulate their feelings and fears in words. That makes it difficult for us as psychologists to analyse. In such cases, we have to think of alternative ways to soothe them, or tell them to hang in there and meet us once the lockdown is over." Jain warns that chat therapy should not be encouraged for clinical interventions, because in the end, nothing can replace face-to-face interaction. "Apart from just listening, there are other cues that are available to the patient such as a safe environment to open up, body language, shared intimacy and honesty," she says.

Some names have been changed or withheld on request.

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