Café Dissensus

By Eeshita Saxena

As per APA, mental health is a state of mind characterized by emotional well-being, good behavioural adjustment, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life. Psychodermatology is a field of study that interrogates the relationship between the skin and human psychology. This paper aims to understand the mind-body connection and the manifestations of mental health, negative and positive on the outermost layer of the body, the skin, by analysing the novel Home by Manju Kapur.

Contemporary studies in dermatology have looked at the psychological reasons behind skin diseases like acne, psoriasis, eczema, itching, hives, etc. According to Gorbatenko-Roth, psychologists can help treat patients with any of the three forms of psychodermatology problems. There are three categories: first, skin conditions brought on by stressors. Second, psychological issues brought on by deformative skin conditions (reverse of first category). Third, psychological conditions like delusional parasitosis that show up as skin conditions.

Biopsychosocial Medicine, Integrative Medicine and Mind-Body Medicine are different terminologies that are investigated by doctors for research and evidence of mind-body invisible unity. Humanization of medicine programmes indicate that the current medical model excludes the ailing person and focuses singularly on signs and symptoms, transforming the disease into a separate entity of the individual affected by it. Patients are reduced to the symptoms of the malady they show and are not seen as unit whole entities. The medical gaze is focused only on the bodily organ and its diagnosis. The idea that the skin reflects the mind and emotions and simultaneously influences these domains is being studied because skin disorders can cause mental health issues like depression and anxiety as well as emotions such as fear, shame, anger, and terror. Skin disorders can also cause changes in colour, texture, and moisture of skin.

Literature is robust with representations of psychodermatological issues. Here the focus is shifted from the medicalisation of the skin condition to the socio-cultural factors that act upon the individual that causes the condition. This is in tandem with the first category proposed by Gorbatenko-Roth.

Manju Kapur’s Home is an appropriate example to do a psychodermatological reading in the Indian context. Home is an intergenerational narrative about the Banwari Lal family set in the city of Delhi. They are a traditional, business class, orthodox joint family and they are into fabric business in Karol Bagh. The sons marry and join the family business. The elder son Yashpal and his wife, Sona were unable to have children for ten years. Nisha, their first born, is born ten years after their marriage. Sona accomplishes motherhood – the role of a woman in the patriarchal Banwari Lal household. As a teenager, Nisha is the embodiment of beauty and the family assumes that marrying her off with a low dowry will be a cake walk. But certain events unfold in Nisha’s life that impede her from becoming the prototypical home maker, the role laid out for her. She is sexually abused in her paternal home by her cousin, something she does not understand nor talks about with her family. In future, Nisha is always discomforted by male presence around her. Nisha’s character can be appropriately studied through a psychodermatological reading.

Bessel Van Der Kolk’s The Body Keeps the Score talks about ways to deal with trauma. The book discusses the healing process from trauma by using case studies from the author’s real-life practice as a psychiatrist and in the process, he also bursts myths around the treatment of trauma. He talks about the neuroscience of trauma. Trauma impacts the amygdala, a region located in the limbic system of the brain which is meant to detect danger. It works on the flight or fight system. Trauma causes a disruption in its functioning and one loses a sense of ownership over their own bodies. Nisha in Home is the only girl in the third generation of the family who is discarded from the family to her maternal aunt’s home. She becomes a subject to both sexual-emotional abuse and abandonment here and this impacts not only her childhood but her adult life as well. Kolk calls repeated childhood trauma as ‘complex PTSD’ (Post traumatic stress disorder) or ‘developmental trauma disorder.’

As the story progresses, Nisha joins Durga Bai College where she has an affair with Suresh Kumar, a boy who comes from a subservient caste and her family forcefully interjects and extricates her from the situation, refusing to let them marry. She says to her mother, “Who cares about caste these days? What you really want is to sell me in the market” (Kapur, 200). Suresh and her story come to an end. She is yoked out of her aunt’s house and taken back to the Bhanwari Lal residence where she falls prey to a psychosomatic condition, eczema. The skin disease is born out of suppression of thought and emotion in this case. Psychosocial stressors and depression manifest itself via the uppermost layer of the body: the skin.

This disease has socio-cultural implications where Nisha is no longer seen as desirable in the marriage market and she also being a ‘manglik’ gets very few proposals. One of them being from a widower, Arvind. She ends up marrying him but it is a marriage of convenience and by the end of the narrative, Nisha is pushed into a docile home-bound maternal role. Due to her disease, she is viewed as an outcast within her family where her sister-in-law Pooja does not even let her touch her baby. The disease results in low self-esteem in her because it becomes the centre of her identity, nullifying everything else she stood for and represented.

Her psychological issues cause a dermatological issue that further causes alterations to her social world. She becomes doubly marginalized due to the somatisization of her emotional turmoil. Eczema literally is the result of her social stressors that she could not deal with. Eczema is also a non-verbal manifestation of her repression of emotions as discussed above. She is unable to verbalize the trauma that she has experienced at different points of time; the forced separation from Suresh and the sexual abuse she had to endure as a child, both of which had scarred her body.

This essay has been an exercise to understand skin as a marker of psychopathy and a metaphor for larger social evils by using psychodermatology to interrogate skin in literature.

Works Cited

Azambuja, Roberto Doglia. “The Need of Dermatologists, Psychiatrists and Psychologists Joint Care in Psychodermatology*.” Anais Brasileiros de Dermatologia, Sociedade Brasileira de Dermatologia, doi.org/10.1590/abd1806-4841.20175493. Accessed 8 Mar. 2024.

Clay, Rebecca A. “The Link between Skin and Psychology.” Monitor on Psychology, American Psychological Association, 11 Feb. 2015, http://www.apa.org/monitor/2015/02/cover-skin.

Germain, N., et al. “Stigma in Visible Skin Diseases – a Literature Review And …” Wiley Online Library, NG, CF, NB, MD and MT received funding for the conduction of the literature searches and writing the manuscript. KL acted as employee at LEO Pharma and was paid for the study as such. MA and RS did not receive any funding for conducting the study., 11 Jan. 2021, onlinelibrary.wiley.com/doi/full/10.1111/jdv.17110.

Kapur, Manju. Home. Faber & Faber, 2012.

Kareem, Amrin. “Home: Manju Kapur’s Treat for Those Who Love the Extraordinariness of the Ordinary.” Medium, The Window Seat, 30 May 2020, medium.com/the-window-seat/home-manju-kapurs-treat-for-those-who-love-the-extraordinariness-of-the-ordinary-9a7a44372f2a.

Kolk, Bessel Van Der. The Body Keeps the Score. I Dream Books Inc, 2015.

Bio:
Eeshita Saxena is a third-year student at Sophia College (Empowered Autonomous). She is pursuing her Bachelor’s degree in English Literature. She has been a social worker for ten years and is also a freelance language tutor. Her experience has taught her to see things from a different perspective and to incorporate them into her understanding of the world.

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Cafe Dissensus Everyday is the blog of Cafe Dissensus magazine, born in New York City and currently based in India. All materials on the site are protected under Creative Commons License.

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