Does therapy work for Indians?

Conversations around mental health have finally entered the Indian mainstream Among the many approaches available today Cognitive Behavioural Therapy CBT is the most widely practised form of psychotherapy CBT focuses on identifying distorted thought patterns and reshaping them through rational selfexaminationBut CBT did not emerge in a cultural vacuum Developed in mid20th century Europe and North America the model is rooted in psychological traditions shaped by individualism the belief that personal autonomy selfdefinition and independence lie at the centre of emotional wellbeingIn India however the self rarely exists in isolation Identity is negotiated through family community and social obligation And so a more complex question emerges Are we just importing therapeutic models faster than we are adapting them And if therapy is not onesizefitsall what happens when the most commonly prescribed method does not fully translate to the cultural realities of Indian lifeDevyanshi Jalan prefers family counselling because itrsquos the victim that goes to therapy and not the person who causes trauma right Divya Dhanuka found the process of finding a therapist harrowingOver the course of eight years Divya Dhanuka has seen over five therapists ldquoI come from a very dysfunctional household Irsquove been actively suicidal since about the seventh graderdquo says the 21yearoldldquoWhen you tell people that yoursquore suicidal they often tell you lsquoYou should seek therapyrsquo and they think their job is done What they donrsquot understand is how harrowing the process of seeking that therapy actually isrdquo says Dhanuka ldquoThe more therapists I would go to the more I would have to share my life story the more I had to go through it again the more panic attacks I would getrdquoDhanuka is currently pursuing law from the National Law School of India University Bengaluru Her college provides counselling services for students ldquoTherapists often start by asking lsquoTell me about your familyrsquo But I wonrsquot ever tell a stranger about my family trauma This person is a complete stranger to merdquo says Dhanuka ldquoOne time I told a therapist that I have dyscalculia and she laughed at me lsquoAutism and learning disorders are so common these daysrsquo One asked me lsquoWhy donrsquot you come to the point Why are you so avoidantrsquo She got angry at me for not being able to open up It made me question my selfworth even more Am I so broken that even a professional cannot fix itrdquoIn an interview to Nikhil Kamath in 2024 actor Ranbir Kapoor said ldquoI have tried therapy before my father got sick I donrsquot think it worked for me for two reasons Firstly because I couldnrsquot express myself completely to the therapist Secondly the therapist in some way was teaching me how to manipulate liferdquoEventually Dhanuka was able to find a therapist that fits But after a while just the act of therapy got tiring ldquoTherapy is not a magic potion where suddenly your therapist says something and your life is fixed Your therapist wonrsquot give solutions to your problems They will ask lsquoWhy do you feel this wayrsquo Itrsquos an exercise to get to know your own thoughts a toandfro between two people I would understand the things he said to me three weeks laterrdquo says Dhanuka ldquoItrsquos a lot of work a lot of selfreflection and itrsquos tiringrdquoShe has taken a little break from therapy ldquoTo keep me sane I delved deeper into rock and metal music Listening to people scream in my ears makes me feel relatable to the singer It helps me get through my daysrdquo says Dhanuka ldquoIf I have to actually sit with my feelings and thoughts that wonrsquot happen unless someone guides me into it Otherwise my brain can be a horrible place to navigate on my own The process of seeking help works if the help seeks you back Maybe on some days I donrsquot need to rationalise my thoughts when Irsquom already down maybe then a therapist with just a healthy presence would help me betterrdquoCBT asks patients to lay it all bare But in India where family dynamics are deeply private and shaped by hierarchy trust is not automatically extended to strangers Moreover CBT places responsibility on the individual For someone navigating structural pressures such as academic expectations and family roles distress cannot always be reduced to faulty thinking patternsOften we treat growth as an individual responsibility You grow as a person and if those around you canrsquot grow with you you draw a boundary and move on But in India how does one draw a boundary with your parents if you live with them 21yearold Devyanshi Jalan states ldquoI prefer family counselling because most of the time itrsquos the victim that goes to therapy and not the person who caused the traumardquoldquoKota is where I experienced my first depressive episoderdquo says Jalan An academic star all her life Jalan was preparing for JEE exams at the time ldquoI grew up being a kind of counsellor to my own family mediating between their issues I had to grow up before my timerdquo Jalan says ldquoEven in Kota I couldnrsquot escape the upsanddowns in my family It all came back to me My academics suffered which made things worserdquoJalan floated the idea of seeking therapy to her parents ldquoMy father was totally against it Eventually he came aroundrdquo Jalan decided to prioritise her mental health She dropped out of her college and moved back home full time ldquoI started seeking therapy regularly I finally understood how my mind worked and why it was stuck on those issues My therapist taught me how to deal with situations when my parents say something I donrsquot agree withrdquo says JalanShe decided that to really fix the situation she needs to bring in her parents as well ldquoI wasnrsquot able to convince my father to go to therapy but if he had Irsquom sure it would have made a huge differencerdquo she says About her own relationship with her mother now Jalan says ldquoMy mother used to repeat things a thousand times over which irritated me She liked to ask around and be very involved in my life and I didnrsquot like that Because she heard it from a therapist she saw that my asks werenrsquot unreasonable She understood that I need boundaries and space Things got much better Her relationship with my father improved a lot She is now more at peace now I would sayrdquoJalan dropped out of engineering and is pursuing a degree in psychology now She also runs an Instagram page _decodewithdee about psychological tips facts myths and sharing her positive outlook on lifeThe roots of psychologyPhD candidate at the University of Virginia studying community psychology Anshita Singh explains the evolution of psychology ldquoModern psychology emerged during a time of racial hierarchy many early concepts were rooted in eugenics and the belief that white people were superior to other races Much of psychology was built on lsquoWEIRDrsquo Western Educated Industrialised Rich and Democratic populations so applying it to collectivistic societies loses nuanceAnshita SinghldquoToday psychology often asks how to keep people productive boiling individuals down to machines within capitalistic systems that extract labour while pathologising distress Instead of placing responsibility only on individuals we should think ecologically by addressing power structuresldquoA first step would be thinking about psychology in a more interdisciplinary way In my research I draw from sociological and feminist theories and community psychology Many of these ideas focus on prevention rather than cure How do we structurally support people before distress escalates into mental illnessldquoFor example in Baltimore crime rates reduced significantly because the city invested in community centres food banks and community support organisations Instead of investing only in policing or postcrime counselling This is an example of prevention instead of profiting from peoplersquos distress afterwardrdquoWhat the West doesnrsquot getCounselling psychologist Ipsita Chatterjee explains ldquoA lot of therapy focuses on identifying dysfunctional cognitions and making them functional But many times there are real systemic problems because of how society functions Especially in India which is way more collectivist than the West Itrsquos not always your thoughts that are the problem hererdquoIpsita ChatterjeeShe explains with an example ldquoMany people in Mumbai risk their lives daily in local trains We read news about deaths frequently but it has been normalised Just reaching your workplace puts your nervous system under immense stress Then pay parity may exist you have to please others and stay late without any overtime pay No matter how much you earn buying a house still feels impossible In this scenario there is no distortion in thought pattern but rather a larger issue in the systemldquoThis is where narrative therapy comes in It involves acknowledging and validating whatrsquos happening Clients learn to attune to themselves identify dominant discourses around them and find alternate narratives they can participate in Itrsquos about changing the narrativerdquoldquoCBT has made valuable contributions but it cannot be the only approachrdquo she says ldquoSomatic work helps clients notice bodily limits and regulation Expressive arts and artsbased therapy help regulate the nervous system The arts allow expression without confrontation When immersed people sometimes enter trancelike states where clarity and insight emerge I also work with child survivors of trafficking who did not want to talk In such contexts people are tired of talking Bodybased and artsbased approaches become powerful toolsrdquo Adopting Buddhist philosophies has helped her personally ldquoIf you are mindful if you practice detachment yoursquoll be regulated automaticallyrdquoHow education is changing and adaptingCounselling psychologist and educator at SNDTrsquos MMT Shah College Kruttika Dixit explains how Indian syllabi are trying to make therapy models fit better ldquoAccording to the new education policy there is increasing emphasis on Indian Knowledge Systems IKS which brings Indian philosophical traditions into education During my own training we studied multicultural counselling skills Even though counselling models such as Eganrsquos model come from Western frameworks students are trained to adapt them culturallyrdquoKruttika DixitIn India people largely seek therapy to resolve relational dynamics ldquobe it family conflicts marriage distress or parentchild obligations All of these require systemic change not just individual cognitive restructuringrdquo she says ldquoThis is why many adults who seek therapy individually donrsquot see resultsrdquoAnother difference she notes is ldquoIn Western contexts not setting boundaries may be labelled peoplepleasingrdquo she continues ldquoIn India respect and social roles complicate this For example career decisions often involve family influence One may listen respectfully to elders while also asserting personal choices by explaining how decisions affect onersquos own futurerdquo She recommends ldquoDialectical Behaviour Therapy DBT it focuses on mindfulness distress tolerance emotional regulation and interpersonal effectiveness mdash which helps in better relational dynamicsrdquo