The session was opened by Dr. Basit Koshul who introduced the TCI initiative as a response to a particular problem. The problem is that the contemporary university has become a collection of silos. No doubt there are many experts who are excellent in their respective fields, but they exist and operate in silos across which there is no communication. These experts do not have the language and the skills to speak about their subject outside of their areas of expertise, neither do they feel the need for it. Each of these silos considers itself to be a self-sufficient whole. A sociologist, for example, feels no need to communicate with a physicist, a physicist feels no need to communicate with a psychologist and so on. This is a problem. The TCI initiative recognizes this as a problem and is itself not an attempt to solve it but to bring the problem under discussion. After briefly introducing Dr. Ali Madeeh Hashmi and Dr. Tahira Haider, he opened the floor.

Dr. Ali began by describing that the job of a psychiatrist is unique in that the patient has to want to change themself. How many psychiatrists does it take to change a light bulb? Only one. But the bulb has to want to change itself. He then introduced the etymology of the word Psychiatry / Psychology in which the ‘psych’ has historically stood for ‘soul’. Today the concept of soul has become controversial and brings up many skeptical questions.

Dr. Ali then mentioned that mental health is health of the mind, but what is mind? Is the mind simply the function of the brain? An exchange of neural signals? Where do the beautiful verses of poetry localize themselves in the brain? Which neurons get fired at the sight of an artistic masterpiece? What is ‘mind’? We still haven’t figured out. We are only beginning to map the function of the brain down to its neural synapses. Will we be able to map them down to their essence? Can we develop machines that can be called a human? The question goes back to Descartes. How are the mind and body related? How can mental events cause physical events? How can physical events cause mental events? Is the mind a computer program? Could a machine think?

Among other things, Dr. Ali also mentioned the Maslow’s hierarchy or the framework of humanistic psychology according to which there are a number of steps, starting from physiological needs, which must be covered before humans can reach the stage of self-actualization. In another instance, Csikszentmihalyi’s flow theory puts the level of skill and challenge on the two axes of the graph and argues for striking a balance between them to avoid both boredom and anxiety as the individual moves through the flow zone.

The crisis in mental health has been brewing for a long time, and it took some horrible events on college campus in the past years to force people to acknowledge that there is a problem. However, Dr. Ali mentioned that the problem also explained that the challenges in the domain of mental health extended to the practitioners symptoms for mental health or mental illness are not as hard and fast as that for the human bones, but they nevertheless appear according to certain rules, they can be rated, measured, and quantified. He then mentioned that even doctors may disagree with the diagnoses of mental diseases. Mental health professionals love over-medicalizing mental illnesses. While the intention was noble when it started out, namely for the purpose of categorization and communication among psychologists, the terminologies have since exploded. Today, mental health professionals are in many ways over-medicalizing the normal human experience. He mentioned that he was very distressed by the particular pharmacalization of normal human experiences in the US towards which we are also headed. He recalled an instance of a school shooting in the early 1998 in the US in which two students killed around a dozen students while on prescribed medications. Pharmacological interventions do help, he said, just as in older times kicking the TV could fix the broken picture, but they are not long-term solutions. Interventions are important, but one also needs to look at the larger picture.

When Dr. Tahira Haider took the stage, she began by introducing the work which the counselling and psychological services department has been engaged in. She also gave a brief overview of the factors which may give rise to mental illnesses. Traumatic experiences in childhood, for example, make it harder for children to come to terms with newer worldviews. Genetic predispositions may also make them more susceptible. However, these factors in themselves are not a guarantee that a particular mental illness will manifest itself in the future.

Dr. Tahira highlighted that mental health includes emotional health, spiritual health, and also a healthy social functioning. It is an interplay of all these factors and every individual is on the continuum. Some might be on the extreme end, some may be in the middle and manifest particular traits and some on the healthy end. How do pathologies come about? Here the inner world of the person becomes very important. Particularly, the notion of ‘self’ becomes important. The individual may not perceive themselves as worthy and lovable, they may think that there is some deficit, and may adopt certain coping mechanisms such as perfectionism which will eventually lead to a burn out. The concept of the self is therefore very important in understanding mental health. The goal of psychologists is to help individuals function at the optimum level. Therapy itself is a type of exercise for self-awareness and self-reflection. It asks questions such as, what are we about? What makes us tick? Who are we? What do we believe? If we do not know what our demons are, how will we deal with them? Are we simply going to pop a pill to escape our demons? True, it may sometimes help temporarily, but it does not address the problem in the long term.

Individuals have urges and desires, and they also have what may be called a seat of wisdom. It is also important to recognize that all humans have values. These values are not right or wrong, and everyone has a different set of them. They are our life’s compass and while trials and tribulations are natural, a life lived in accordance with these values will be more stable and endurable than the pursuit of transient emotions such as ‘happiness’. An individual living their life in accordance with values is less likely to fall. Self-reflection is also important in this context to understand these values it is the job of therapists to engage people in a lot of self-reflection.

Before the floor was opened for Q&A, Dr. Basit highlighted that there was an important set of questions that needed to be asked in the context of this session. What is mind? What is body? What is ‘psyche’ and is it different from the mind and the body? He then mentioned the work of Viktor Frankl, his experiences in the concentration camp, and his quote ‘text books lie’. Following what Dr. Tahira had mentioned at the end, he reminded the audience of Nietzsche’s quote which Frankl had also mentioned, ‘given a why, man can endure almost any how’. In the presence of a why, the how becomes bearable no matter how difficult. Yet despite Frankl’s remarkable emphasis on this particular topic, he was almost missing from the textbooks on psychology and psychiatry. During his time in Vienna Frankl had been in charge of a mental health program where a huge spike in suicide attempts had been recorded. Through his intervention, the number of cases were practically brought down to zero. What did this intervention look like? What do we have to learn from him? What was his program about? Sadly, these questions were not only unanswered, they went unasked.

When the floor was opened for questions, one audience member asked whether there was any relation between distress and the gut? Dr. Ali acknowledged the question and mentioned that it is very common for stress, in all its forms, to localize itself in the gut and cause all kinds of problems. In fact, much of psychiatric medication was prescribed by non-psychiatrists to address bowel and gut related issues.

Another questioner asked the utility of psychiatric pills and whether, if taken, the patient would still be willing to work on their issues in the longer term. Dr. Tahira mentioned that pills are given when therapy has stopped working and it is therefore an extreme measure. Its purpose is only to give relief long enough to get the patient to therapy. It is therefore important that psychologists and psychiatrists work together to ensure proper long-term therapy. Only in a few cases of chemical imbalances the client may need medication for life. Here Dr. Ali was of the view that while milder symptoms may well be treated by psychology, psychiatric intervention is needed for more severe symptoms. Popping a pill always seems easier than facing your demons and a visit to the psychiatrist takes less time and labor than intensive sessions with a therapist. However, medication will only give relief for short periods of time whereas psychotherapy gives you treatment for long periods of time. Don’t take medications for the stress of mid-terms, he advised the students with some humor.

Another audience member asked how safe it was to get a self-diagnosis through online search engines. Here Dr. Tahira informed the audience that diagnoses given by medical professionals are quite comprehensive and offer a far more detailed analysis than a search engine can. Dr. Ali cautioned against the plethora of misinformation available on the internet around mental health. Dr. Basit advised the audience that a search engine is not capable of knowing the individual on a personal and medical level which the medical practitioner has been trained to do. Search engines are driven by profits and corporate interests and are never advised to be used as an alternative to professional help.

One member of the audience referred to Dr. Ali’s earlier quote from William James regarding the multiplicity of selves. They asked whether it is possible for a particular mental disorder to be confined to one of the many ‘selves’ of the individual. Here Dr. Tahira commented that mental illnesses tend to manifest themselves across all ‘selves’ which an individual may have in relation to different people and in different roles. However, there are certainly versions which are feigned or put up as ‘masks’ and in such versions the apparent absence of symptoms is not unusual. Dr. Ali commented that as individuals move further in life, the many different versions of selves tend to consolidate.

The event ended with a note of thanks for the speakers.