अनोळखी

आम्ही आठवड्याच्या शेवटी अशा सत्रांची आखणी करतो ज्यामधे रुग्ण मित्र काहीतरी नव्याने व्यक्त करतील, अशाच एका सत्रातील ही कविता जी एका रुग्ण मित्राने लिहिली आहे

मला व्यसनमुक्ति केंद्रामधे आधार देणारे माझे समुपदेशक कसे होते त्याची ही कविता


पाठमोरा एकटा खिडकीशी बसुन मी
मुसमुसन बोलत होतो  ……।
शब्द नव्हे तर यातना म्हणा
डोळ्यातून टपकत होत्या,

उमगली जणू मजला
स्वतःची सद्यस्थिती,
अवघडलो  , बावरलो मी
 तुटला  आतून  परी

असंख्य चूका अन असंख्य शाप
समोर केवळ  भकास सकाळ,
व्यसनात बुडलेले, कललेले प्राण
जगण्यालाही ना उरला त्राण

कोणी अचानक पाठीवरी देवून थाप
बोलला स्वतःची कहाणी कित्येक तास
भोगुन, जगून माझेच हाल
मदतीचा का देवू पाहतो हात?
म्हणे मला ………

  मित्र वा बंधू समज
शांत ऐकणारा सोबती समज
मरगळ सारी बोलून टाक
चैतन्याला देउनि हाक

म्हणे तो मी ही होतो व्यसनी,
दोघे मिळून तोडू व्यसनाची साखळी
असलो जरी अनोळखी

दोघे मिळून तोडू व्यसनाची साखळी
असलो जरी अनोळखी
असलो जरी अनोळखी

अनामिक मद्यपी

Interviewing Relapsed patient

Treating a relapsed patient takes lots of efforts. They have fixed view towards treatment, Counsellors & therapy structure. Many of them carry a belief that they know the program & that is not helping them.  They feel that relapse is a outcome of treatment failure. Almost all the de-addiction rehabilitation centres introduced 12 step program & relapse patients they feel there is nothing new I am learning in repeated admissions. Here are some important things therapist can keep in mind before interviewing relapse patients.

1.       Understanding his perception towards treatment: Mostly the structure, timetable & sometimes therapeutic program may have similarities with the previous treatment experience for the client, so allowing him to talk about the past good & bad experiences with the treatment centre or self help group is very important. Though sometimes it sounds irrational but gives the clear idea about his beliefs.     

2.       Allow catharsis: Patients has their own analysis of relapse, what triggered them or why they refused help etc, one need to understand that because that is the reality for the patient. Immediate confrontation with the patient may push him to the shell; He will not feel comfortable to talk anything after that. Giving them a chance of catharsis strength the rapport with him.

3.       Making a partnership: Motivating a client to participate in individual & group therapies is very important. It gives them a message that they are responsible for their recovery. Sometimes they feel that doctors will take care of my disease, I need not do anything about it. After detoxification therapist should clearly mention patient’s role & therapist’s role in his recovery. Making a partnership will motivate them to cooperate with treatment.

4.       Tailor-made Program:  Each client has unique & has different issues, one has to address the client’s needs. Same assignments & treatment may not be effective with everyone. 

Why In-patient Treatment for addicts?

Nobody likes the confinement, we all love freedom. Addicts compare jails with in- patient treatment. However family also sometimes feels that outpatient treatment will be a better option but it eventually gets fail. An addict is pre-occupied with the thought of using substance it is difficult for him to participate in individual counselling sessions with this mind set, There are high chances of addict to use substances as a result of uncontrollable cravings. He may feel ashamed or guilty to go to therapist after drinking or using substance. An addict always gives first preference to his substance so adherence to outpatient treatment becomes challenging.  There are few rational for suggesting a in-house treatment for an addict; the reasons are as below:

1.     No access to substance: In a natural environment addict has open access to substances or alcohol. In-patient treatment automatically turns in to compulsive abstinence as rehabilitation caters doesn’t allow the patients to use any chemicals once they are admitted.  
  

2.     Structured routine: after detoxification, patients are supposed to follow the structured timetable in the rehab. It includes fixed timings for food, exercise, sleep etc. An active addict doesn’t have a structured day in natural environment. He sleeps whenever he wants or he don’t mind skipping food for days together which may worsen his health condition. 

  

3.     Peer help: In the rehabilitation units he gets the peer group like him who is also fighting with the addiction, the peer educators works as role model & he can get motivated.   

4.     Less deviation: patient is able to avoid the unnecessary deviations like meeting the using friends or responding somebody on phone or mails by being in the in-house treatment.

5.     Focus on self: Less deviation, good positive peer support, in puts by therapists allow the patients to focus on themselves and change their thoughts, attitudes towards substances. They will be able to put conscious efforts for bringing the desirable changes. 
  

6.     Under observation: While taking the in-patient treatments there counsellors, therapists, doctors are supposed to give a feedback, that means the patient will be under observation & he will get the right suggestions during the treatment. It saves lot of time & patient gets good directions to mould his behaviour.

7.     Helps to introspect: The suggestions, psycho education, peer feedback, etc helps the individual to introspect his behaviour & learn from the past mistakes.

8.     Managing cravings & triggers without substance: During the treatment patients learn that they can overcome the craving & stress & negative emotions without the substance; they learn the new coping mechanisms & become confident.  
    


     Sheetal Bidkar

चांगल्या व्यसनमुक्ती केंद्राचे काही निकष

मागच्या कही वर्षात महाराष्ट्रात नव्हे तर पूर्ण भारतातच जणु व्यसनमुक्ती केंद्रांचा सुळसुळाट झाला। मी पुण्यात मुक्तांगण नावाच्या एका प्रशिक्षण केंद्रात काम करात होेते आणि सुदैवाने मला पाच राज्यामधील व्यसनमुक्ती केंद्रांची पहाणी करण्याची संधि मिळाली। महाराष्ट्र, गोवा, मध्यप्रदेश , गुजरात आणि छत्तीसगढ़ या राज्यमधील जवळपास ९२ केंद्रांशी माझा संपर्क होता।

त्यानंतर मी २०११ पासून आंध्र प्रदेशमधे काम करीत आहे, सर्व अनुभव एकत्रित करता मला अस वाटत की चांगल्या व्यसनमुक्ती केंद्राचे काही निकष आपण ठरवले पाहिजेत, त्यामधे खालील मुद्यांचा समावेश असावा।


१. व्यसनमुक्ती केंद्रामधे शारिरिक आणि मानसिक आरोग्याची काळजी घेणारे लोक असावेत जसे फिजिशियन, साइकोलोजिस्ट, साइकेट्रिस्ट, कौंसिलर, असावेत

२. व्यसनापासून दूर राहणारे (रेकवरिंग अलकोहॉलिक्स ) लोकच अनेकदा केंद्र चालवत असल्याचे आढळते, पण प्रत्यक्षात त्याचा खास फायदा होत नाही। पिअर एज्युकेटर म्हणुन त्यांची भूमिका नक्कीच महत्वपूर्ण आहे पण उपचारामधे आणखीही घटक असणे योग्य ठरेल

३. कुटुंबीयांसाठीही मानसोपचार होणे आवश्यक आहे.

४. स्व मदत गटाची ओळख व्यसनमुक्ती केंद्राद्वारे होणे गरजेचे आहे.

५. अनेकदा व्यसनमुक्ती केंद्रांमधे मानसिक आजारांच्या रुग्णांचाही समावेश असतो, अशा केंद्रामधे व्यसनमुक्ती साठी लागणारे उपचार वेगळे असल्याची खात्री करावी

६. व्यसनमुक्ति केंद्रांमधे शारीरिक मारहाण तसेच अपमानास्पद वागणूक असू नये.

७. व्यसनमुक्ति केंद्रांमधे पालकांना भेटीची परवानगी असावी।

८. उपचारानंतरही रुग्णानी काय  करावे काय करू नये याच्या सुचना स्पष्ट असाव्यात।

९. उपचारादरम्यान रुग्णमित्राना मोकळेपणाने त्यांचे विचार आणि भावना व्यक्त करण्याची मुभा असावी।

१०. नोकरी, व्यवसाय याबाबतच्या देखील सूचना असाव्यात।

तुमच्या शंका जरूर विचारा 
email: sheetal.bidkar@gmail.com


शीतल बिड़कर 

दुधारी आजार

व्यसनामुळे जे मानसिक आजार होतात, त्याची ही कहाणी


नको नको ते मनात येते
अगतिक मजला करुनि जाते,

भयंकराची भीति आणिक शंकेची गति
अपसूक वाढत रहते अस्वस्थतेची स्तिथि ,

जाणीव जणू मरुनि पडते
कधी जणू मन निपचित होते,

कधी अनावर क्रोध माझा
माझ्या वारी स्वारी करी,

बेभान उद्रेक मज
लाजवी अनेक समयी,

खरे तर मी असा नव्हतो
बुरा परी मी राक्षस नव्हतो,

आता कळेना माझे मला,
वेडा म्हणू की व्यसनी स्वतःला …..
वेडा म्हणू की व्यसनी स्वतःला .......

झेप

व्यसनापासून दूर राहू लागलेल्या मित्रांच्या या भावना। व्यसनमुक्तीच्या सुरुवतीच्या काळात कोणी सहज विश्वास ठेवत नाही, आधार देत नाही तरीही व्यसनपासून दूर राहत स्वतःशी लढणाऱ्या धाडसी मनाच्या  फ़ीनिक्स रूग्ण मित्रांच्या वेदनांची ही कविता।

सर्वांमधे असतो परी  हरपतो मी भान,
उराशी येतात नकळत भूतकाळाचे पाश 

नव्याने शोधतो आहे जीवनाचे नवे रंग
परी आप्त दुःखविल्याची बाळगतो खंत

रोज नव्याने बजावितो मी मजला
पुन्हा नको तो एकच प्याला

दशक अवघे विरुन गेले
मरण यातना देवून गेले

परी आता उठेन म्हणतो
उरले जे ही जपेन म्हणतो

पुन्हा एकदा झेपावितो उंच
व्यसनमुक्तीचा घेऊनी मंत्र। ..
व्यसनमुक्तीचा घेऊनी मंत्र। ..


शीतल बिड़कर

LIFE DOES NOT REWIND

LIFE DOES NOT REWIND

In one of the interviews, an anchor happens to ask me, the most memorable cases I handled in my practice.  Four different cases were coming into my mind again & again.

A widow 32 yrs old came to my clinic as she was abusing prescription drugs from last 6 months. She lost her 20 months old child & husband in a fire accident & she became depressed after this traumatic incidence. She was in U.S.A for 7 yrs after her marriage. Her husband was a chronic alcoholic. Immediately after her marriage she recognized the fact. Under the influence, he uses to be very abusive, aggressive.  Whenever she complained about his behaviour her family & in-laws use to ask her, ‘Who doesn’t drink in U.S.A?, it’s ok, get adjusted , etc’ She lost the hope of getting help from relatives  as her husband was ill-treating everyone. Many times he has put their life in risk, i.e. driving a four-wheeler with almost 140km/hr under intoxicated phase, not attending the child even when he needs medical attention, being the furious & threatening wife for money to drink etc .

The fire accident happened because her husband was intoxicated & was smoking in the bathroom. He was insisting that he help play with his son in a bath tub, she was refusing but he was very irritable & was not listening to wife. He ordered her to prepare some food for him. As he was drunk he was unable to handle a child, the child was excited & was running here & there in the bathroom, pulling things down & started playing with it, he was trying to do something with the geyser & fire cached. By seeing  father into a fire the child just went & catch him. The child died on the spot & 98% burned husband was in ICU for 2 hours & he also died.

She came back to India at her parent’s place & she was blaming herself for the accident, she was cursing herself for not being farm to protect the child.

But.................Life doesn’t rewind.

Case 2:

A very young 19 yrs old boy was socially drinking with his friends. He was very intelligent, goal oriented boy & was willing to join navy after his 12^th. One day he went to an overnight party. Somebody had introduced injective drug. He decided to taste it just once; he used the drug for the first time. After almost 4 moths he was frequently suffering from the fever, cold, he lost weight. Doctors asked him to test HIV. He was infected with HIV. He was then never being able to go to navy or similar services as he was not physically fit. All his dreams were shattered, he was repenting on his decision to taste the drug but it was too late.

Life doesn’t rewind.

Case 3:

40-year-old recovering alcoholic was hunting for small scale jobs from 6-8 months. On the everyday basis, he was struggling to gel with the outside completion. Almost after 18 yrs of alcoholism he was trying to understand the world consciously. The facts were terrifying that market needs multi-skilled people & even peons are graduates.

He was learning computer, willing to continue distance education but soon he learns that his physical health is not supporting him thus he has to do things slowly but steadily. He remembered those years when he was young but was wasting all his time, energy & money in using alcohol & tobacco. He remembers his well-wishers who use to warn him & suggested rather requested him to be productive. 

But life doesn’t rewind.

Case 4:

An artist was hooked to ganja & was thinking that ganja improves his creativity. He was a very good painter. Under influence one day he met with an accident, he was seriously injured his right hand has was completely damaged. Doctor has to take the decision to cut his hand from elbow to save his life. He was bed ridden & was not able to sit for almost 2 years. Money, popularity, advanced science, Modern facilities, supportive parents none of this were able to bring back his skilful hand.

his art, skills, creativity became past for him.

Then he realizes that .......... Life does not rewind.

All the four cases express the curial reality of ill effects addiction. isn't it?

Sheetal Bidkar

तुमच्या सह आम्ही

ही कविता व्यसनी व्यक्तीच्या कुटुंबीयांचे मन जाणणारी आहे

अपुरा प्रयत्न आमुचा आधार बनण्याचा
मनी भाव आमच्या आजाराशी लढण्याचा
थकालो आता पुरते तुमच्या संगे
म्हणे व्यसनाचे शिकारी
तुमच्या सह आम्ही


रगडाली आम्ही प्रयत्नपूर्वक मती
आशा ठेवोनी मनी
एक न एक दिनी
जाणीव होईल तुम्हासही
अन झालो  दरिद्रतेचे वाटेकरी
तुमच्या सह आम्ही


फुके गेले नवस आणि पुराण
विरुन गेला  भगवंतावरचा विश्वास
सखे सोबती म्हणती
बनोनी नास्तिक
भोगितो भोग नशिबीचे
तुमच्या सह आम्ही


भय, निराशा, शरम आणि चिंता
रोज भोवती घालती पिंगा
आपसूक आचरली लबाडी
बनालो पापाचे भागीदारी
तुमच्या सह आम्ही


पुरे झाले हाल आता
लढू व्यसनाशी पुन्हा पुन्हा
हार येवूदे अनेकदा
पण बळ मिळेल निश्चयाला
तलवार घ्या हाती
पुन्हा वार सोसु ………
तुमच्या सह आम्ही


शीतल बीडकर