‘I think we’re all together here, on the ward’ - A Personal Reflection on Sarah Pinto’s Daughters of Parvati: Women and Madness in Contemporary India
By Maite Ramos
In mid-October of last year, I read a monograph by Sarah Pinto Daughters of Parvati: Women and Madness in Contemporary India, which grapples with themes of agency, gender, medicine, and madness in the female psychiatric wards of North India. The author focuses on two wards in particular. Firstly, Moksha, which is a rural institution that often treated women from lower socioeconomic backgrounds and frequently suffered from lack of funding and oversight. The other is the female wing of the Nehru Government Hospital, which serviced an enormous number of urban women around New Delhi. While different in many ways, both units frequently relied on diagnoses of female hysteria or related disorders like spirit possession to explain the complex and disturbing symptoms women presented with. Pinto teases out threads of kinship and love and their relationship to North Indian psychiatric patients struggling to find their way through the ups and downs of their lives. As a middle class American, I was taken aback at how deeply my own teenage experiences of psychiatric care in the U.S. parallelled Pinto’s stories.
When I was 14 years old, I was institutionalized for the first time. I was suffering deeply, and the language typically used to describe my experience - of sadness, isolation, fear, and self-consciousness, - did not accurately describe the somatic pain that radiated through my body and life. I struggled then with feelings of the madness that is being a teenage girl; of being in a body that I did not understand, of being expected to behave in a way I felt I could not achieve. I was also reconciling with the truth of systemic childhood abuse, which plunged me head-first into a crisis of the meaning of care. This challenged normative ideas about kinship, and questioned the separability of the care I had received from the abuse I survived. I was falling deeply into the harmful coping mechanisms common amongst teenage girls, such as Anorexia and self-harm. I felt a pernicious panic that I was losing control, but also a savage relief in becoming unmanageable and disfigured. I listened to music full of rage and pain at such a high volume my ears hurt, I restricted my body until it became almost fully under my control, I exploded my pain out into my circle of similarly suffering friends, and I started to know my new sexual body as something uncanny and distressing.
As I began to visibly deteriorate, the choice was made to put me in a psychiatric ward. I was admitted in mid-November after muddily describing what I was going through to my dad, in what I thought to some degree was a deathbed confession. First, I was taken to the emergency room. I waited with my dad in the sterile waiting room. I felt relief, anger, and fear. After a day in a hospital bed, hooked up to an uncomfortably cool IV, witnessing my body probed and recorded by others, we were told that I would be transferred to a state-run inpatient girl's ward. My phonewas taken, I said goodbye to my dad, and was loaded into the back of the cop car in paper scrubs adorned with handcuffs and shackles. The dehumanization of this moment set the tone for the rest of my experience with the American psychiatric institution
The first night at the girl’s ward was desolate. The next 11 days are blurry in my mind, filled with endless gaps of nothingness and acute moments of agony. I was kept in scrubs for three days while my clothes went through rigorous sanitizing and inspection. I only met with a psychiatrist once, in a cold room with two chairs and nothing else. The other patients and I had meals three times a day, medication handouts twice a day, and “group meeting” for an hour a day. Other than that, we were pooled together in the common room with activities one might find in a Kindergarten. What I remember most was the other woebegone teenage girls; us sitting in tight circles coloring in children's coloring book pages with magic markers; us swapping stories and mementos; us trading socks for extra blankets or smuggling our phone numbers to each other or using the knotted bundles as the only token of love and hope we were still allowed. I remember walking in silent lines to the cafeteria, I remember the fantasies we had of romance and rescue. I remember the heartbreak of a daily phone call hour, when most of us cried and asked to go home. I remember one girl, about my age, named Kelsey, who called her estranged mother to speak to her toddler who had been put under her mother’s care by CPS (Child Protective Services). Kelsey had already been to this ward three times before.
This experience defined the next decade of my life, both privately and publicly. I was institutionalized three more times after that, the last was for 11 months during my sophomore year of high school. However, I don’t think the consequential admissions left as vivid of a stamp on my life as the first psychiatric ward. It shaped how I viewed myself as a subject, the kind of agency I had, the kinds of places I was allowed, and what would happen to me if I was deemed truly mad. I learnt how much power there is in the love and connection that happens in solidarity with other women who are deemed broken. I thought, perhaps naively, that this was some bond I shared with only the people who sat in those circles with me.
While many of our contextual realities may have differed from the patients of Moksha or Nehru on the surface, in that dark, carpeted community space we too were struggling with control, abandonment, care, love, and kinship. We were desperately seeking a place where we fit at the fraying edge of relationships and institutions, where we fit within our own bodies that we had been told are sick. We, too, negotiated truth and agency with the medical system, our families, and each other. We knew that the reason we were there was largely because there was no other place to put us; many of us were already involved with other institutions like CPS or the carceral system. In this way my psych ward mirrored Moksha, which upheld the normative gender and kinship structures for those women who were failing to fit within their bounds. However, we had the added nuance of being legally unable to make decisions for ourselves due to our age. Our agency was mitigated by the fact that we were children who were not to be trusted with the assumption of truth or legal rights to determine the kind of care we wanted or needed. The American conception of hyper-independence also bleeds through my experience of care, whereas the residents in Moksha and Nehru were often steeped in a deep sense of community and kinship which perforated the boundary of medicalization – for better or for worse.
The most consequential difference between us and Moksha was that our situation was explicitly temporary. Most of us were only there for the minimum hold period for psychiatric cases, during which you were deemed a threat to yourself or others (for minors, this was 10 days). Some filtered in and out of the ward, adding sporadic time to their cumulative weeks in psych wards. This element of never-ending transition added something frenetic to all of our negotiations, that seemingly many residents of Moksha gave up after a time and languished into acceptance or lethargy. We often fretted about the stress at home and returning to it, while simultaneously aching for the freedom of being in the real world again.
An odd but significant detail is that we could not see outside - all the windows were frosted. This elevated isolation and imposition of control was unfamiliar and hostile. It exacerbated the symptoms which had brought us here in the first place. However, many of us with non-psychotic symptoms became ‘manipulative’, a word that I have a deep repulsion and hurt feelings towards. To my ear, it is a biased word, laden with assumptions about morality, and often steeped in sexual connotations when used towards women. Perhaps this stems from Freudian understandings of hysteria and the later disarticulation of Freudian women’s motives and illnesses. What I wish to say in my defense to accusations of manipulation is as follows. : In my experience, when all that you can use to communicate is your symptoms, because your agency is negated by your illness, as Pinto describes in both Moksha and Nehru, you will try to find a way - consciously or subconsciously - to achieve your goals by "using” your symptoms.
Needless to say, it unsettles me to read this notion of manipulation in accounts of mental illness. One one hand because the word itself is riddled with shame and stigma, but on the other because it feels uncomfortably like pathologizing a natural human trait we all regularly participate in throughout our lives. It certainly has its merits as a defined symptom in particular diagnoses, such as Narcissism or Sociopathy, but in the context of Moksha and my own psychiatric experience I find it places the sufferer within an impossible task of both behaving ‘normally,’ while also submitting themselves wholly to the agency and naming of other people. Other people determine your level of sanity - often ensnaring you in the confines of diagnostic criteria - but when you are not playing by the rules of insanity the way you ought to, you are given the double stigma of manipulating your own illness in order to achieve something most likely impossible in a clinical psychiatric setting: freedom and agency. The language of mental illness is a never ending losing hand as a patient; everything you are depends on how you can appear to others - and as a student of critical feminist theory I am obligated to note that this is mostly professional men - regardless of whether or not you are actively in control of your appearance of sanity or insanity.
Despite this, I cannot fully dismiss the necessity of control as care. Care as an imposition of normative behavior and values; care as removal from the ‘real world’ that was bleeding us dry. Many of us could not even define the kind of care we wanted or knew what kind of care was healthy. However, we could describe abandonment and what it felt like to be dumped. We struggled, like the women of Moksha, with the blurring of care and abandonment and how it felt to be controlled and also left to the judgment of people who did not feel any attachment to us. It was both dehumanizing and a relief to become a chart instead of a person, which I would argue occupies a large space in abandonment. To some degree, abandonment in my context was a release of the things that both constrain and punish you, and make you a person. Even now, I doubt I could create a comprehensive system of care for myself encompassing everything that is good and healing for me in my worst moments when breaking from sane behavior. I challenge anyone to do the same. So, I struggle to invest full-heartedly in any ‘empirical’ or ‘objective’ way to create care for all based on a universal diagnosis. Care is messy and ugly. The duty of those providing it is to remain sensitive to the complexity and personal attachment of care.
My experiences as a mentally ill person have been full of contradictions. On one hand I feel profoundly connected to other people who went through similar experiences. Thosewho listen to the same music, and those who have the same scars. n the other hand, I feel deeply lonely. That is the nature of being ill in many ways: you may be sharing the same illness, the same hospital room, but you are not sharing the same body. No person knows what it is like to inhabit another person's body, mind, and soul (much to the dissatisfaction of many an ethnographer), but you can sit together and hold hands. I cannot tell you what it means to me that the women Sarah Pinto writes about are like me, or perhaps just that we were like versions of each other, because I don’t know. It feels oddly wrong to view them in the way Pinto views them, largely because I am both her and I am those women. Likewise, it feels uncomfortable to interject my own experiences in the nuances of Pinto’s ethnography and project myself on strangers, and it feels equally strange to take the subjective side of the clinicians and caregivers when my experiences are so ontologically akin to those of the women of Moksha.
Ultimately, what I am left with upon finishing Pinto’s monograph is educational value colored with my own dissolution and questions about what it means to be ill as both a subject and an agent of academia. What does it mean to be a part of a whole that is so pockmarked by pain and abuse across time and space? What does it mean to connect both abstractly and emotionally without any tangible connection? What does it mean to feel that you might truly hear and see someone on a level that supersedes the differences of culture, knowing you will never be contextually the same? What do my feelings mean in the historical perspective of colonialism, anthropology, and psychiatry? These are the questions that float in the margins of my book and now in the addendums to my own memories. What Pinto finds in me as a reader is an unwitting, silent participant in her ethnography; someone who was both there and never there at all.