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Development of the approach towards abnormal behaviour in India

 Arihant Hemendra 

Mental illness and more broadly; abnormal behaviour have been extensively portrayed but often misunderstood in records since not long after the human race started keeping records in the first place. The earliest archaeological evidence of trepanation - a common ancient and mediaeval “surgical intervention” dates back to 6500 B.C. (Capasso, 2002) Naturally, owing to the interactive nature of human existence, abnormal behaviour can seldom go unnoticed or impactful on the functioning of human society as a whole and thus it is obvious to have documentation of interaction and remedies to such behaviour. This blog post aims to trace, analyse and predict the approach towards abnormal behaviour and psychiatry in India. The development is grouped into three stages: Ancient, Medieval and Modern.


Ancient:

The earliest noticed evidence of; and attempted reasoning for abnormal behaviour dates back to the Harappan civilisation which possibly attributed such behaviour to the occult. This reasoning can be socio-culturally explained by the flow of ideas and intellectual property along with material goods via early trade that inhabitants of the region had with contemporary civilisations in Mesopotamia, Crete and Egypt  (Mishra et. al., 2018). This confluence of ideologies was seen in a continued pattern, as can be seen in the Indian Charaka Samhita which attributes mental functioning to three bodily fluids or tridosha with an excess or lack of any of the fluids causing erratic behaviour - much like the Hippocratic approach which attributed the behaviour to four bodily fluids. (Hooley et al., 2017, 59) The advent of Jainism, Buddhism and more spiritual beliefs in general along with their propagation by influential rulers led to a new, philosophical view towards mental illness as a result of the sins of man and his detour from what fate has in store for him. King Ashoka reportedly had many asylums built for the mentally unstable while Chola inscriptions mention isolation of patients. (Nizamie et. al., 2010)


Medieval:

Mediaeval times brought with them new cultural influences in the form of Islamic dynasties, the first of them being the Delhi Sultanate. Unani medicine began to gain prominence and Najabuddin Unhammad - a famous Unani practitioner divided mental illnesses into seven different types based on their symptoms, including a “delusion of love” along with the usual depression, schizophrenia and paranoia. (Mishra et. al., 2018). There is also some evidence of the establishment of mental asylums in various places in the latter part of the Delhi Sultanate era, along with a few prominent hakims who were known specifically for the treatment of mental illnesses. Western medicine was, however, yet to come to India. (Nizamie et. al., 2010) The Portuguese came to India and according to some sources, brought with them a somewhat primitive form of Western medicine, while the Mughal rule was established in North India around a somewhat similar timeframe in the early 1500s. While not particularly known for developments in the Indian outlook towards mental health, these periods helped set up important socio-economic changes that would soon change the way the Indian subcontinent viewed abnormal behaviour.


Modern:

Socio-political events of the later Mughal period led to the influx of the East India Company along with other European colonists into India who brought with them their own medicines and related thinking. Focusing on the British East India Company being the elephant in the room here, we trace the establishment of the first modern mental asylums in Kolkata, Chennai, Munger (Nizamie et. al., 2010) and Mumbai for the footsoldiers of the company (Mishra et. al., 2018). Treatment in these asylums was still very primitive compared to today’s techniques, as patients were treated with, among other things, opium. The general public still relied on Ayurveda and Unani practitioners who hadn’t undergone any significant development for a long time. The later colonial (British rule) period saw a modernisation in the outlook towards abnormal behaviour with mental illness - specific acts being passed along with the introduction of psychotropic drugs and the construction of new asylums. The outbreak of the World Wars as well as an influence by Indian philanthropists lead to the academisation of psychiatric studies in India.  (Nizamie et. al., 2010)

Post-independence, India is widely credited as one of the first post-colonial countries to have a dedicated approach towards mental health. Modern psychiatry is widely recognised in India, however, it still faces challenges from the backwards practises of witch-hunting, demonology and considering abnormal behaviour taboo. The general populace only knows the difference between “insane” and “sane” instead of knowing the various basic forms of abnormal behaviour. (Ghosh et. al., 2021)


What Next?

The digital revolution and subsequent changes brought about greater awareness and a more empathetic approach towards mental health by youngsters. Social Media platforms have inbuilt algorithms to predict and help alleviate abnormal behaviour among their users. Recent reforms such as the Mental Health Act (2017) aim to regulate and streamline the treatment of abnormal behaviours and integration of patients into society as smoothly as possible. There is, however, a lot to be done. Stigma related to mental health is still prevalent in a large chunk of the population and critics have often viewed previous attempts to tackle the same as failures (Srivastava et. al., 2016). From a personal standpoint, now might be the perfect time to bring out more youth-driven and focused strategies promoting a societal shift and structured care network for people who might have mental health issues aggravated by the pandemic and subsequent lockdowns. Perhaps the author and the readers would be some of the people responsible for bringing about this shift

References

Capasso, L. (2002). Principi di storia della patologia umana: corso di storia della medicina per gli studenti della Facoltà di medicina e chirurgia e della Facoltà di scienze infermieristiche. SEU. https://en.wikipedia.org/wiki/History_of_mental_disorders#cite_note-5

Hooley, J. M., Nock, M. K., Butcher, J. N., & Mineka, S. (2017). Abnormal Psychology, Global Edition (17th ed.). Pearson Education Limited.

Mishra, A., Mathai, T., & Ram, D. (2018). History of psychiatry: An Indian perspective. Industrial psychiatry journal, 27(1), 21–26. https://doi.org/10.4103/ipj.ipj_69_16

Nizamie, S. H., & Goyal, N. (2010). History of psychiatry in India. Indian journal of psychiatry, 52(Suppl 1), S7–S12. https://doi.org/10.4103/0019-5545.69195  

Ghosh, Simantini, & Hemendra, Arihant. (2021) Class notes 

Srivastava, K., Chatterjee, K., & Bhat, P. S. (2016). Mental health awareness: The Indian scenario. Industrial psychiatry journal, 25(2), 131–134.https://doi.org/10.4103/ipj.ipj_45_17

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