"You've to Be a Detective to Be Able to Understand What Is Going on With the Patient" - Dr. Rahul Khemani

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1. Tell us more about your background and journey.

I'm a consultant psychiatrist in Mumbai, and I've lived my life here. I think I always wanted to become a doctor so that I could take care of others. While I was doing my graduation, I realized I like listening to stories that people tell. The feedback I got was that I was a patient listener. 

I think the seeds were sowed then, and I seriously started considering finding my way through psychiatry. Also, there are no easy answers when it comes to mental illness. You've to be a detective to be able to understand what is going on with the patient and why it is happening. 

The mystery of it is definitely what has pulled me and kept me going.

2. What are some common misconceptions about psychiatric medications in society?

To begin with, a lot of people think of psychiatric medications as sleeping pills. But that is simply not true. No properly trained psychiatrist today will give sleeping pills! The medicines might have a component that can affect your sleep, but it does so much more than just that. 

Another common misconception is that these medicines are addictive. Again, the medicines are prescribed for a specific amount of time, and you don't get used to it. Some people fear that they'll have to take medicines for life once they start. 

That might be the case in some cases or disorders, but it is not a rule for everyone. And even if you're asked to take medicines for a lifetime, we need to consider it like other physical illnesses such as diabetes which also requires lifetime medication. 

The point is, make sure that you ask your doctor if you have any doubts regarding the medicines. Don't assume things on your own or by Googling them.

3. How can people practice mindfulness?

Mindfulness is simply paying conscious attention to what you are doing in the present. It is a way to bring back your monkey mind to the task at hand. The way I advise it to my patients is to focus on their breathing while they are involved in any task. 

Start counting while you inhale, hold your breath, and exhale. Do it at regular intervals. Do it when you wash utensils when you are walking when you are listening to music. 

And especially do it when you experience negative emotions such as when your loved one doesn't pick up your call, or when you're stuck in traffic, or you feel angry. Keep some time aside every morning and night to sit at one place and practice mindfulness. Being consistent is the key!

4. How can one manage stress?

Recognize, Label, Challenge, Reject (RLCR) is perhaps the most useful technique to combat stress. Recognize the cognitive errors when you are worrying. This makes takes some time, but when you feel stressing out ask yourself if you are getting caught in unhealthy thought patterns. 

Mentally label the negative emotion (or cognitive distortion). This simple act can reduce rumination. Once you label your negative emotions, thoughts, and distortions, challenge them. 

Ask yourself if this is an opinion or a fact. Are you making a catastrophic prediction based on inadequate information? Is this type of thinking going to help you or harm you? 

Reject those negative thoughts. We have around 60,000 to 80,000 thoughts in a day, and it's fair to assume not all of them are healthy. So after challenging negative thoughts, you need to reject them.

5. Is work-life balance a myth or reality according to you?

Ideally, I would like to believe in work-life balance, but that's a distant dream for me. The thing is it is not sustainable, you can have that perfect balance at a certain point in time, but more or less the scales are going to be tipped on either side. It is also a lot about priorities. 

For someone who loves what they are doing work-wise, will be engaged in it for long enough to ignore their personal life. On the other hand, if someone has just had a baby, the rewards of giving more attention to personal life are more than staying back at your cubicle. 

What I do strongly recommend is that we try to achieve that balance though- that trying part and succeeding at times gives us a breather, a pause from the hectic work or personal life we are leading. That is more important than maintaining that work-life balance.

6. Can you give some advice to people who want to practice this profession?

Be patient - the rewards exist, but it is not easy to come by. And perseverance. It is not the easiest job, but it is the most rewarding job. And if you are convinced you to want to work in the field of mental health, then the satisfaction from being able to help people is what helps you sleep at night. 

The last two cents are that I urge those planning to enter the profession to work on themselves, start the process of finding your identity, your anxieties, your neurotic tics, your patterns.

- Dr. Rahul Khemani

- Interviewed By: Soumya Jain

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