The concept of Integral health takes me a step ahead. Who has come
to me for therapy? Which part of the being is the primary target of
my intervention? Not the atrophied brain which needs something like
donepezil or rivastigmine. Not the paranoid thought which may need
a low dose of quetiapine or clozapine. Not the depression that may
need a low dose of escitalopram. Not the agitation that may need a
bit of mood stabilizers. Not the parkinsonism that may need levodopa.
Not the incontinence, not the insomnia, not the vertigo, not that
bit of deafness, not that failing eyesight.
Deep inside the being is a secret essence that maintains the flow of
life, supports the élan vital. It is a veiled sovereign in a fourth
dimensional space. It is actually a beyond-ego principle. This
principle called the Psychic Being represents the atman of the
Indian tradition in its evolving form. The ego is only a dark shadow
of this true integrating principle. The ego is necessary at the
initial state to give a self-conscious identity but at a certain
stage of inner progress needs to be surpassed by the Psychic Being.
The consciousness of the Psychic Being is free from psychological
disturbances. It is not affected by any illness; its essence is not
diminished by the cognitive decline of the dementing process. It is
immune from all adversities. It gives a sense of wholeness,
integrality and unalloyed joy. The quintessence of Integral health
lies in this shift from the discord of our outer personality to the
harmony of the Psychic being.
It
is this inmost essence of the individual and not the atrophied brain
which is the altar at which our therapeutic service has to be
offered. The Psychic being carries in its consciousness the imprints
of the deepest and the most intense peak-experiences in life. This
consciousness outgrows the individual life-span and the
memory-traces of the preserved peak-experiences act as templates for
future lives. The rest of the memory-base is neither recorded by the
psychic consciousness, nor outgrows the individual life-span. It
matters nothing if an elderly subject has a cognitive decline. The
Psychic being is untouched by the outer memory loss and carries the
essence of the most intensely lived moments in future lives.
When I approach a subject of dementia or a terminally ill subject, I
am not demoralized. I know that I am not serving the outer
personality. I am not affected by the cognitive decline or the
imminent death. I acknowledge the presence of the inmost essence and
express my gratitude that it accepts my service. I consider it a
matter of grace that an elderly subject has visited my therapeutic
space. Each such visit is a moment of honour, a matter of pride. I
know that I must never make the mistake of denigrating an elderly
subject, never consider that the embodied Psychic being can be
labeled as non-productive, vegetative. For then the Divine afflatus
which lends me its healing power can withdraw its boon.
Our most important concern for the subject with dementia is to
restore the sense of self-esteem. So many times I have quoted
Milton’s ‘On his blindness’ to demented subjects. Milton overcame
the existential crisis due to his blindness by identifying with the
sentries in the palace of God. The sentry does not run like a busy
executive under the illusion of activity. He just stands still but
that is also a God-given role. Likewise, a mere cognitive loss does
not rob one’s role to serve God. God also needs people who serve in
silence.
My
wife, a clinical psychologist, used an innovative method to restore
the self-esteem of my father when he had dementia. She used to show
him the family album and helped him to recognize and relive some of
the proudest and happiest moments of his life. She used to remind
him how his sacrifices made his children build their careers. He
never needed an anti-depressant. Something more happened. He was a
geneticist but uttered something during his illness which he had
never expressed in his pre-morbid stage. He told that Sri Aurobindo
had ‘somatic mutation’. He did not remember the context in which
that term should be used. But it was a technical way to describe the
state of Sri Aurobindo when his physical body remained fresh without
decomposition for five days after his departure on 5th
December, 1950. Memory is stored in consciousness that uses the
brain for expression but is actually independent of the brain. In
conducive conditions, a supra-rational faculty like intuition can
awaken a dormant memory even in a demented subject.
One should never
lose one’s sense of optimism when dealing with demented subjects. So
many times I have seen that by losing one’s cognitive capacities,
one also loses the capacity to doubt. When such a subject prays,
there is a light that shines behind that blank stare.
