Conversion disorder on the rise among women in Pakistan

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Lahore: Hysteria is rising among women in Pakistan. Known as conversion disorder, the disease occurs in patients having difficulty in expressing their desires and are at the mercy of others for their happiness. The disorder manifests itself either in the form of fits, aggression or in extreme cases paralysis. Developed countries have overcome this abnormality by discarding restrictive notions associated with woman’s freedom and sexual orientation, say medical experts.

A 24-year-old woman called Ayesha was brought to Sir Ganga Ram Hospital Lahore, having jerky movements and imbalanced limbs coordination. Her illness could not be traced to any physiological disorder, leading to the conclusion that she was manifesting her suppressed feelings through jerks. Further investigation unfolded that Ayesha’s father, an uneducated man, used to abuse her physically in her childhood. Her mother was a cold and callous woman. She would aggravate Ayesha’s helplessness by remaining indifferent to her problems. Her illiterate and financially strapped father would always remain angry with his children with the result that two of Ayesha’s siblings died in their teens of some undiscovered illness with symptoms of extreme seizures. It was only when Ayesha began experiencing jerks did her father stop abusing her physically. She experienced her first epileptic fit at the age of 10 during sleep.

High incidence of conversion disorder is reported among societies with strict social system that prevents individuals from directly expressing feelings and emotions. In developed societies ‘psychological open-mindedness’ and ease of emotional expression has reduced this disorder tremendously, writes Wen Shing Tseng, in his book, Handbook of Cultural Psychiatry, 2001.

Meerat Butt a Clinical Psychologist at the Ganga Ram Hospital, Lahore told News Lens Pakistan, “The inability to resolve conflicts is a major barrier to the elimination of conversion disorder. Women keep tolerating a problem without understanding its nature, with the result that their body starts acting up, leading to strained relations between spouses, siblings or parents.”

When we say that western societies have successfully brought down conversion disorder, we are actually referring to their ability to resolve conflicts. We lack table talk culture in our society. In a typical home, fathers and brothers want to see their daughters and sisters confined to homes or developing religious leanings.

We are more eager to fight, draw out weapons than resolve issues through dialogue,” says Meerat.

Meerat, however, cautioned that talking things out is only one side of the solution. The cure lies in conflict resolution. She says that realisation of an issue is different from finding a way out of it.

According to the World Health Organization (WHO) classification handbook ICD-10, conversion disorder was the second most common diagnosis (after depression) made among female patients admitted to Lady Reading’s Hospital Peshawar psych ward between January and November 2014. On the flip side, according to a research conducted by the Agha Khan Research Foundation, Karachi reports fewer conversion disorder incidences because of its relatively liberal outlook.

Professor Dr Altaf, Qadir Khan, head of the Psychiatry Department, General Hospital Lahore, while talking to News Lens Pakistan expressed his dismay over the negative contribution of news and entertainment channels in the lives of the people.

He says that the phenomenon of breaking news has sent many people into depression. He also condemns the way news is presented. He recalls the Army Public School massacre and its presentation on the TV. “I had innumerable patients those days with stress caused by overexposure to that incident on TV.”
Khan further adds that he knows families breaking apart due to luxurious and competitive lifestyle shown on TV. The financially constrained people, he says, are working overtime to meet the challenges posed by the demands of modern lifestyle.

“When people cannot compete, beat the challenges, or cope with the situation, they experience helplessness that leads to anxiety and conversion disorder ultimately,” says Khan

If Khan is happy that people are increasingly seeking psychiatric assistance to cure their mental illness, he is also dissatisfied with the poor facilities provided in the government hospitals. Since conversion disorder is high among uneducated and financially stretched people, there is a dire need to establish psychiatry department in all the government and teaching hospitals.

“In the psychiatry department of General Hospital, we lack proper staff, leave alone medical and other facilities which are few and far between. We do not have any associate professor, senior registrar, clinical psychologists and social workers. We have only one clinical psychologist, who at times sees thirty patients a day, which is a big number. There are no consulting rooms for individual counselling though privacy is a must for treating patients suffering from conversion disorder or other mental illnesses,” he added.

According to World Health Organization, there is only one psychiatrist for every 100,000 people in Pakistan.

Though the hospital has been established in 1959, the psychiatry department was created four years back. To Dr Khan, the absence of psychiatry department for so long in a hospital that was built for Neurosurgery, raises a question mark on the seriousness of the authorities concerned.

Dr Aneela Jabeen, a psychiatrist at the General Hospital Lahore, emphasises that due to undue cultural and social constraints, women are being increasingly abused by their male counterparts. “We encounter hundreds of girls, who had eloped form their homes and were later thrown away by their boyfriends to be further mistreated by the male members of their families. Women are being exploited in the name of religion and honour,” says Jabeen.

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