A Pattern of Neurosis in India

When I was asked some time ago to contribute to this Journal a “short case study which shows the influence of individual, familial, and cultural factors in the development of emotional disorders,” the great problem consisted in choosing a case from among my Indian patients in which the barriers of language had not been all too powerfully forbidding and in which, on the other hand, the influences of the West had not been too likely to overlay and disturb an original Indian pattern of life. I had to exclude all those patients I saw in regular psychotherapy over the first two or three years, since at the beginning of my psychiatric activity in the north of Indian, my rudimentary knowledge of Hindustani equipped me to deal only with people who were accustomed to express themselves in English. These, of course, are those who have also been most exposed to the cultural influences of the West. Although by now I can, if need be, communicate even with a simple villager in his own language without an interpreter, this usually is possible in only one or two interviews, as the patients often come from places hundreds of miles away and are neither psychologically nor economically prepared for a long course of treatment in the city. All they usually want is some “magic” cure for their ailments, and, within the short time available, our simple attempts to reveal some of the underlying emotional factors seldom can penetrate the thick, hard crust of customary beliefs, prejudices, and attitudes.

Recently, however, time and good luck played into my hands. A patient came to our clinic without a previous appointment who seemed to fulfill all the requirements for a case-study of this kind. He was a farmer from a village at the foot of the Himalayas, about 200 miles from Lucknow. He had been sent by the doctors of a Government hospital, where he had tried in vain to get help for his obviously neurotic symptoms. We found him sitting on the floor of our waiting-room, a tall, bony figure, dre