Tahmina's story: giving voice in a safe place
Herat, Wed 18 Dec, 2013
Tahmina* was a young woman, who was brought to the clinic, by her father and sister. When she presented to the clinic, she was lying motionless on a bed. Tahmina’s father explained his daughter had been having attacks where her body went stiff, and she seemed to be unconscious. She also complained of headaches, sadness, lack of appetite, and had engaged in self-harm. Tahmina’s father was distraught; he did not know what was wrong. He had taken her to religious leaders for special prayers, and to see several doctors, all to no avail.
I noticed although she appeared unconscious, her body and face showed signs she was internally aware. I surmised, she was experiencing a conversion reaction, where people’s psychological stress shows up in physical ways even though there is no physical reason for that. Common symptoms include things like paralysis, blindness or numbness. I encouraged her to accompany me to the counselling room.
Her family members objected, maintaining Tahmina was unconscious and couldn’t hear me. After several minutes of discussion, I left the waiting room, and Tahmina supported by her family members, entered the counselling room. I requested to speak alone with Tahmina. When her family left, she began to talk explaining she had many problems, and was particularly troubled about her family life.
First, she spoke about her mother, who had died four years prior. Every night she still dreamt about her. They had been very close, and she was still grieving. In addition, Tahmina’s father had forbidden her older sister from getting married ordering the sister to look after the younger children instead.
Moreover, Tahmina’s father had arranged a marriage for her, but Tahmina hadn’t met the man and had little information about him. Furthermore, he would be working for another year in Iran. Tahmina noted these difficulties were only a small part of her problems, and so she was overwhelmed by worry.
She said “I don’t know what to do. I am really tired of life and am most unfortunate. There is no one who understands me and now people call me crazy and keep their distance from me.”
We talked for about an hour and at the end, she said it was the first time she was able to talk to another person about her difficulties. She commented, “I feel much lighter and more relaxed.”
Tahmina’s family was invited back into the room and explained about the causes of her symptoms. Then, I offered some strategies on how to help Tahmina, and I then referred her to a doctor to prescribe some medication.
Tahmina left the clinic walking independently from her father and sister. They were noticeably less worried, and her father returned to express his thanks and surprise that counselling had been so effective.
*name has been changed for confidentiality