Nupur Dhingra Paiva: Children have complex inner worlds

Do you know an inscrutable, inarticulate man who is helpless around children?

Psychotherapist and debutant author Nupur Dhingra Paiva explains how he got to be that person in her book, Love And Rage: The Inner Worlds Of Children. She tells you about children with unspoken emotions and fears—how ordinary and yet explosive these can be. Paiva practised psychotherapy in the UK, before she moved to Delhi. In the Capital, she found a new loneliness, not because of the city’s sheer size or coldness, and she tells you why in this interview. She also explains why children aren’t the ‘weeds’ many parents consider them to be.

Books on psychotherapy—and other fields of medical science—published in India are seldom anchored in engaging narratives. There have been some exceptions recently, such as Shyam Bhat’s How To Heal Your Broken Heart. Paiva’s book uses the fact of her being a child psychotherapist as the basis for an engaging socio-personal narrative.

Her writing is unpretentious, the book is without jargons, and filled with uncomfortable insights, even into the most unremarkable of childhoods.

Edited excerpts from the interview:

You’ve been a practising child psychotherapist for several years. Was it difficult to distill your experience and knowledge in a 235-page book?

It wasn’t. I tend to be succinct in my writing (though perhaps not when I speak!), where the aim is to put difficult, complex things on paper in a way that is accessible and jargon-free, but also impactful.

Writing the book was a process for which I had to dig very deep so that it was meaningful. I could not write from the surface—those drafts were either bland or blank.

You write that you felt lonely in your profession when you moved to Delhi from the UK and started your practice. Can you elaborate?

The work we do as mental health professionals is very misunderstood. Having been taken over by the medical model, mental health gets confused with madness (more severe forms of mental ill-health; difficulties with reality-testing and everyday functioning) and the public perception of the importance of emotions, of the intangible, out-of-sight parts of our lives is, frankly, incomplete, inadequate or non-existent. In fact, we are illiterate, completely unschooled in this area. And yet it is central to our relationships, to material success in school and in the world of work.

We are more likely to seek help for a wart or acne (external, visible blemish, though not always painful) than for emotional distress, which is always painful. In case of the latter, we start back-peddling, working hard in the opposite direction to deny that anything hurts at all.

Children’s emotional lives are even more misunderstood or unseen. We are still more ready to accept that adults can be depressed or anxious, manic, psychotic or bipolar (words that are available for us to use, without really understanding what they mean) but we are extremely reluctant to imagine that children can have complex internal lives. That there is more to them than basic needs and bad behaviour; that there is stuff that needs something other than instructions or food. Whether it is teachers, doctors or parents, many adults fall into the trap of looking at things only on the ‘outside’ – the grades, the weight, the absence of illness, the compliance to instructions.

Our children are much more than that. They have complex inner worlds.

Being surrounded by a social context of this kind made my early years of working in Delhi very lonely, until I found like-minded professionals. Now we band together, it is a very small group and we are only too aware of the work we have to carry out in building awareness. We are all doing our own little/larger bit to make people more self-aware.

Love & Rage: The Inner Worlds Of Children— By Nupur Dhingra Paiva, Yoda Press, 235 pages, Rs450.

Parents, especially in India, as your book suggests, view approaching a counsellor for their children as a failure of parenting. Some parents might consider it over-parenting and let a child go through everything like they did when they were children.

We don’t want to recognize emotional distress as being worthy of attention. Not every emotional event needs to be attended to by a counsellor or professional, but every emotional event does need attention. Usually, the parent is the best person to do it, provided they are available or able to see it. Parents have their own baggage as well. So ‘the way they did when they were children’ is not necessarily a good yardstick. Ironically, it is the only yardstick we have and the kind of parents we become to our children depends almost entirely on the parents we had (plus some education and reading).

I am not of the view that ‘Bacche to apne aap hi pal jaate hain’. They aren’t weeds. Even plants don’t grow without proper care in our cities today.

Children need to be slowly tutored, mentored or guided (choose your word) to regulate their own emotions and handle their relationships. They cannot do this on their own. There are options other than the extremes of being over-protective or neglectful.

As the mother of a six-year-old daughter, I found your book insightful and, at the same time, aware that perhaps all children, including mine, will benefit from counselling. Should all parents consider it?

Yes, parents would benefit from keeping their minds open to the idea, especially if they feel there is something distressing their child repeatedly or chronically or there is some behaviour that is unusual, erratic, destructive. Whether it is a young child whose experience we don’t connect with or a teenager whose anger seems out of proportion, a trained counsellor can help to bridge the gap between parent and child as well.

You write about “psychotherapeutic imperialism"— the psychotherapist considering herself knowledgeable and capable of rescuing others, although she has her own shortcomings. That is one of the concerns expressed by those who believe counselling is not a solution to life, or rather, psychotherapy can’t save you from everything and make you perfect. Your thoughts?

Psychotherapy never claimed to make anyone perfect or happy. There is a difficulty here itself – our assumption that there is anything that is perfect when it comes to being human. Parents or children. There isn’t. The process of psychotherapy only claims to make you self-aware. Self-observant. Many things in our lives actually need to be mourned, accepted that they happened and cannot be changed. So psychotherapy is not a solution to life at all. It can’t take anything away. It is helping you to adapt to the life you received (as parents or personality) or make changes (if you want to).

Can a child get dependent on therapy?

This is like asking ‘Can a child get dependent on their mothers?’

The short answer is, ‘Yes, they are and can be dependent on their mothers’.

But just like the aim of mothering is to hand-hold a child through the different stages (a 3-month-old needs very different things from their mother than a 10-year-old or a 16-year-old. The mother is the same. The child is the same. Or are they?). When therapy works well, it has a built-in component of learning to notice /acknowledge one’s dependence and the desire for dependence and move ahead from it. Learning to say goodbye to people we like/love/depend on is part of life and good therapy helps you to learn that too.

In one of the fascinating chapters in the book, ‘In The Beginning’, you write that experiences during infancy become our “neuronal wiring" and shapes us in significant ways. Can effects of traumatic or unpleasant experiences of this stage be reduced or done away with in the years leading up to adulthood?

There is a lot of research now on the lasting effects of our earliest experiences – including in-utero experiences. These become hardwired into us and impossible to explain in words since they were happening before words came to us. Before that part of the brain (the pre-frontal cortex) was created. In such situations, psychotherapy is almost too little too late.

Effects of early traumatic experiences can be addressed depending on the age at which these traumas took place and whether they were sustained, longterm traumas or an isolated on-off event. They are rarely done away with.

Working with trauma is a very specialized field in psychotherapy and not something just anyone can handle.

You write about the experience of being an adopted child briefly. What is the one advice you’d give to adoptive parents?

Prepare to be tested. You will have to prove that you are going to stay the distance, no matter what—which is something biological children take for granted. So there will be times of difficult/very difficult behaviour.

Isn’t being maternal the most stressful experience? As you write in the book, sometimes being ordinary, with failings, isn’t enough.

When it comes to the maternal role, it needs to be accepted that it is extremely difficult. In psychoanalytic theory, we have a concept of “good enough" mothering, “good enough" fathering. We don’t look for “perfect", we look for “real", and the real is always mixed. There is always conflict, always love and anger together. Both in the mother and the child, that is what makes it all so stressful.

How often should a child play and what kind of play uniformly benefits a child?

Everyday ideally and a variety of play. Children let us know their preferences. Some like more boisterous physical play, others prefer quiet imaginary play, some like reading or drawing – the kind without instruction praise, feedback or reward, but just for themselves. Just for itself, for the joy it brings, not the outcome. Mostly, all children need all of this.

Let’s face it, we can’t avoid screen time for our children today. When does it become harmful?

Children do need to watch some television or use digital devices to know how to use them. Since this is inevitable, it is best to teach them how to regulate themselves as well. Just they way we teach them to cross the road or use the stove.

Smartphones, tablets, computers and the internet encourage “endless scrolling" and it is a kind of a drug. It becomes addictive because in that process you can forget about your real life. It takes away the anxieties of what you have to actually deal with and instead you can binge watch Netflix or a YouTube channel or your Twitter or FaceBook feed.

So if we can watch ourselves to see what effect it has on us, we can use that experience to help our children regulate the timing and quantity of screen time.

Is it being used to distract a child when they cry? Or when they don’t want to eat? It is being used as a nanny so the parents can have some quiet time? The occasional use of all of this -- we all do it. The question is, is it becoming a pattern? Is the child or the parent dependent on this device to manage some other interaction?

You emphasize, in what you describe as the most difficult chapter to write, the importance of a father’s involvement in the life of a boy, especially in a society which is bringing up boys who are violent towards women. Do you believe this applies across the world or is more relevant to India?

Because my client group is in India and the stories I have to tell, which make it all real are also local, I want to say that this applies to us. However, these ideas of mine are by no means original and there is ample material I have referred to from all over the world. So it is not just a struggle we face. It applies to all societies where gender roles are very disparate and where men go out to work and do not see their children for most of the week/year.

Is therapy the only solution to learning difficulties in children? How can parents accept learning difficulties and with them give their children a fulfilling life?

If a learning difficulty can be accepted as real by the parents that is half the battle won. Psychotherapy is usually needed for this part – the emotional part of it. Once accepted, learning difficulties are actually best handled by specific tutors who are trained to work with children whose ways of grasping the world are different from what we are used to. Occupational therapy, Arts-Based Therapy, ABA, for autistic spectrum disorders – these are some of the often used therapies for learning difficulties.