We are seeing an exponential rise in the nature and extent of mental health issues in young adults and children which poses a serious problem that needs timely intervention !
Nanki Oberoi, our next pathbreaker, is Chartered Clinical Psychologist & Treatment Specialist who works with children, adolescents, young adults and their families, addressing a range of clinical concerns such as anxiety, depression and trauma.
Nanki talks to Shyam Krishnamurthy from The Interview Portal about her personal experiences that strongly influenced her career in Developmental Psychology and Psychotherapy.
For students, remember that being a therapist not only requires a very strong and long term commitment to your work but also takes an emotional toll as compared to other jobs.
Nanki, can you share your background with our young readers?
Born and brought up in New Delhi, India, we were a family of five- my parents, an elder brother, me and my twin brother. My father served in the Indian army, retiring as a Lt. Colonel soon after our birth, subsequently moving into becoming a consultant for golf course architecture and designing. His education as a civil engineer and his experience as an avid golfer over the years in the army took him into the offbeat and innovative work of landscaping golf courses. My mother, qualified as a Counselling Psychologist, began her clinical career at what was then known as The Modi hospital. However, my twin brother, who had hearing impairment due to the side-effects of certain medications, became the most significant push that mobilized my mother into school-based work as a psychologist.
Growing up, I attended DPS RK Puram, which is a school known for its heavy focus on academics. While performing well in school academically was fortunately never a challenge, I didn’t particularly enjoy it, and was far more interested in socialising as I found stable friends who were more interesting. In retrospect, I realised that studying was reinforced at home due to the fact that it was the one thing I was good at and invariably made my parents happy. My social life was a lot more important to me during my school years and I was blessed to have a stable set of friends through middle and high school. Growing up amidst parents with such offbeat career choices along with disability in the family became implicit influences in my decision to pursue psychology, which was a decision taken as early as Grade 7. I didn’t necessarily know much about it then, but simply associated it with work in the area of disability which was automatically a cause close to me because of my brother. At the time, I neither knew the term mental health, nor associated myself with terminologies like anxiety and depression.
What did you do for graduation/post graduation?
I did my major in psychology from Lady Shri Ram College, university of Delhi (BA honors in Psychology). I then went on to complete my post graduation, also in psychology at the Faculty of Arts (North Campus), University of Delhi. I then gathered some experience across clinical and school settings to understand the specific area of clinical work that interested me. I went on to complete a second post graduation – MSc. Psychoanalytic Developmental Psychology at The Anna Freud National centre for children and families and University College London (UCL), UK. This was a hugely transformational and life-changing experience – both personally and professionally. What I learnt during my time at AFC continues to influence the therapist I try to be everyday.
What were some of the drivers that influenced me to pursue such an offbeat, unconventional in Psychotherapy?
I believe the biggest influencers in my life most definitely are both my parents. With their own courageous choices, especially in a societal era that didn’t easily make space for the offbeat, they modeled courage and freewill in a way that fuels passion. While my father has designed/redesigned a number of golf courses across the country, specially the ones belonging to the armed services (Army, Navy, Airforce), my mum took up the cause of working with children with special needs in a way that had not been conceived before. She was awarded the National Award for Education (2007), the first School Counsellor ever to be awarded and recognised for her contribution to education in a category where most co-awardees were administrative leaders like Principals of schools. It hugely helped to have her in the field, as it automatically gave me access to what was then a closely knit fraternity of professionals at the time, who were kind enough to indulge me with conversations as early as graduation, and agreed for me to learn under their wing. These opportunities, which came in the form of internships during my first post-graduation, were essentially opportunities to gather information on the kind of work I liked and the kind I did not like. Each conversation served to further me along my path in ways that only compounded over time.
The turning point in this professional journey would definitely be my role as a School Counsellor at Shiv Nadar School, Noida, which at the time of my joining was a fairly young school still in its own stage of infancy. My time here came with a very different mix of challenges, both specific to my role as a mental health professional as well as as a professional working in education, exposing me to the larger systemic challenges. As the middle and senior school counsellor, I faced some of my most challenging clinical moments here, opening my mind to the domain of psychotherapy. This pursuit was serendipitously mirrored with being awarded the Chevening scholarship, which allowed me to go on to train further and pursue a pre-clinical training at The Anna Freud Centre, UK.
How did you plan the steps to get into the career you wanted? Or how did you make a transition to a new career? Tell us about your career path
The honest and short answer is that I didn’t plan anything. I just went with it, and in fact continue to. An even more transparent answer is that my professional journey is very deeply and intricately linked to my personal journey.
A number of personal challenges punctuated and interrupted my professional endeavours right from the get go – starting in high school. So planning was never a choice available to my mind.
In retrospect, I do understand that most of my work related decisions have been offbeat and not conventional, and thus not easy. My first role began as a Developmental Psychologist with Children First India, where I was focused on therapeutic work with children who have developmental challenges such as Autism Spectrum Disorder and ADHD, along with some psycho-educational assessment work. The choice to take up this job role coincided with simultaneously being waitlisted on the MPhil program of IHBAS (Institute of Human Behaviour and Allied Sciences), which at the time was a 2 year course that, upon completion, provides you with a practicing license from the Rehabilitation council of India . However, the feedback regarding the learning outcomes of this course had been mostly mixed. Personal context along with an intuitive pull towards the learning offered at “Children First” made me decide on the job, which I believe provided me with a kind of learning that lent me the confidence to step into clinical work altogether. Simultaneously, I co-founded a non-profit organisation with the vision for awareness and advocacy around mental health of children, young people and their families. My experience here allowed me to involve myself in designing workshops and conferences for professionals based on the needs and gaps that emerged within mental health in India as per research.
I then proceeded with moving into school counselling, joining The Shiv Nadar Schools, which was still young and upcoming at the time . It was here that I found my true interest in psychotherapy by working specifically on the social and emotional well-being of children, young people and their families. It was during this time that I also began to use my practice as a psychologist within a school setting to inform my research practices, subsequently resulting in a few publications across both Indian and International Journals. Practicing within a school setting exposed me to some deep rooted systemic issues within organisations, the larger culture and society as a whole which unknowingly are perpetuating the very rise in the mental health crises observed in young people.
When I joined The Shiv Nadar Schools in January 2016, the school was as young as 4-5 years old, with the first batch of students just about entering grade 9/10. I was recruited as the school counsellor for the already existing middle school and the senior school that was to be was an interesting mix of freedom and responsibility. On the one hand, being the first counsellor for the middle and senior classes gave me a lot of creative freedom to understand the nuances of child and adolescent mental health within an organisational framework such as school. But on the other hand, the challenges posed by the lack of mental health literacy- which I believe is not limited to a school, made the role extremely difficult at multiple levels. As I became increasingly acquainted with the individual stories of students, it became increasingly evident that between heavy time tables, long school hours, and ever-increasing academic pressures, children and young people are struggling to survive in a system which is apparently designed to make them thrive. Adolescence is a very rich time in an individual’s life and if we are to understand it within the Indian context, the nuances are complex. Some common mental health concerns that I worked with during my time here included adolescent depression, self-harm, concerns regarding sexuality, anxiety and anxiety disorders and family trauma. Working within a school system allowed me to develop a very vivid understanding of the systemic factors that in fact perpetuate mental health problems, and also the limitations which can hinder getting better. The learning through this continues to inform my clinical work with young people and their families today.
Evoking my academic aspirations, I felt the need for further education and training, feeling largely ill-equipped to deal with the kind of concerns that I was dealing with as a school counsellor. I was awarded the Chevening scholarship for the year 2018-19 after a rigorous application process, allowing me to pursue my second masters, an MSc in Psychoanalytic Developmental Psychology at University College London and The Anna Freud National Center for children and families, UK.
MSc PDP is a course focused on an orientation of understanding mental health that was developed by pioneers like Anna Freud and Donald Winnicott amongst others-famous child psychoanalysts/paediatricians of their time. The course focuses on an understanding of the development of the mind right from in-utero and birth unto the age of 25, which is the biological age upto which the brain is developing. The course, which is also a pre-clinical training for a further clinical doctorate, focused in equal parts on theory as it did on the practical development of clinical skills such as observation. The role of Research Psychologist at the Tavistock was part of the dissertation I was allotted, a project called I-Thrive undertaken by the trust in collaboration with the AFC to expand on the practice of Shared decision-making in treatment with children and young people. The role was limited entirely to the project for research purposes such as data collection which was mostly qualitative. It exposed me to clinician discussions and challenges faced when making treatment decisions for CYP in mental health and an understanding of how SDM is an important tool to prevent dropping out of treatment, thus improving treatment outcomes. I subsequently submitted my course dissertation on the same.
To say the learning here was transformational and changed the way I approach the concept of mental health and well being would be an understatement. Upon my return to India, I ventured into private practice as a psychotherapist for children, adolescents, young adults and their families. As part of continued professional development, I went on to pursue two years of supervised training in the form of two course modules and weekly supervision in Systemic Therapy (Couple and Family Therapy) under the aegis of Yun Pang Psychotherapy in India from 2020 to 2022. The learning from this training has deeply enriched my therapeutic work with children and young people, as understanding them in their context as minors becomes imperative . In January 2024, I completed a training called the Story Stem Assessment Profile (SSAP), which is a play based tool for both assessment and intervention with children aged 4 to 9 years.
I continue to practice as a Chartered Clinical Psychologist for children and young people, registered with the British Psychological Society (BPS) in Delhi-NCR, India. I work both in-person as well as online, making my practice hybrid. My previous education and training as a developmental psychologist enables me to work across the entire age span. However, based on my experience and subsequent qualifications, my preference is to work with children, adolescents, young adults (upto 30 years) and their families, thus identifying myself professionally as a Child and Adolescent Psychologist. Clinically, I am integrative in my approach to treatment, definitely person-centered, which means that I work with the premise that every client is different and thus might need an adaptation on part of the therapist to approach treatment based on their unique needs and context.
How did you get your first break?
The clinic I got my first role at was where I had completed a summer internship which was in fact a mandatory module during my masters program as part of coursework.
What were some of the challenges you faced? How did you address them?
Challenge 1: Personal medical family challenges which caused necessary interruptions and gaps between work assignments
Challenge 2: The emotional toll the job has cannot be dismissed and causes a higher degree of burnout at a much more rapid rate as compared to other jobs.
Challenge 3: Systemic issues which perpetuate stigma, and thus resistance around seeking mental health support which influence attitudes and beliefs around not just the act of seeking help, how we speak about it, how much we are willing to pay for it is also a reflection of how undervalued and in fact misunderstood the service of therapy is. This is in fact an ongoing struggle, and often shows up in clinical work with families in various shapes and forms.
There is a lack of an updated/revised regulatory body to monitor the practice of psychotherapists in India, which has made the profession polluted with an excessive surge in malpractice and ‘bad therapy’ in the name of therapy. This specially emerged during the pandemic as a lot of people suddenly decided to become ‘therapists’ when they witnessed large scale vulnerability in people. Specifically, online platforms emerged in numerous numbers promising to offer therapy at lowered prices, essentially compromising on the quality of care these services had to offer. All kinds of unqualified individuals claim to call themselves psychotherapists, and cashing in on people’s illiteracy around mental health and therapy. This is a serious and rising problem in India currently, posing a large-scale threat to the long-term well being of people.
Where do you work now?
I work in private practice as a psychologist for children, adolescents, young adults and their families. As a clinician, I work with a range of clinical concerns presenting as anxiety, depression, and trauma across the above-mentioned age span, mostly up to the age of 35 years.
What problems do you solve?
I work primarily as a treatment specialist and not as a diagnostician as my clinical experience has reinforced the belief that at the root of every diagnosis is an experience which needs to be understood and integrated by the patient. I combine my training in psychoanalytic developmental thinking along with the systemic way of thinking to understand the nature and cause of clinical suffering. As a clinician, this helps me to consider both the intra-psychic as well as the inter-psychic influences to a patient’s mental health and well-being. The goal of therapy, is always to facilitate in the patient a psychic journey which brings them to a place of empowerment and agency whereby they are able to subjectively experience not just relief from their suffering but a maturation of the mind in a way that they are able to manage distress in a healthy way going forward. Through the process of therapy, they hopefully arrive at an independence in their mind that sustains even in relationships of co-dependence.
What’s a typical day like?
A typical day is usually filled with sessions for patients. The structure and frame of the treatment approach is as important to the effectiveness of intervention as the contents of conversation, which means I see the same patient at the same time weekly. Continuity and consistency to the process is key. Long lasting change cannot become visible instantly and often compounds over time, which is also why therapy takes time and commitment – both on the part of the patient and the therapist.
There are multiple challenges being a psychotherapist in India which reinforce the stigma of seeking support for one’s mental health. The greatest, however, is the lack of regulation to professional practice which has made mental healthcare predisposed to compromised quality therapy/therapists. This is an extremely dangerous situation because any and every one is currently claiming to be a psychotherapist.
How does your work benefit society?
Very honestly speaking, I have never thought about this dimension of my work. What I have often thought and felt since I became a practitioner is the limited reach of clinical intervention to only the families that one works with. The educational and training workshops that I have previously organized emerged from the very desire to reach a larger set of people.
Tell us an example of a specific memorable work you did that is very close to you!
The work I did through my foundation, The Bitty Oberoi foundation which engaged me in organising, designing and curating conferences and workshops on mental health would be the most memorable work I have engaged in. Of course, clinical work with patients and families is always meaningful in a different way.
Your advice to students based on your experience?
In my mind, to be a psychotherapist means to commit yourself to a life where you commit to the practice of constantly working on yourself – seeing the good, the bad, the ugly within you. The reason I say that is that the patients you work with are coming in with emotionally charged stories which you bear witness to, and as you engage with them, they are going to evoke something in you and your internal world. There is nothing shielding you from the power of these stories. It is for this reason that most competitive clinical programs globally mandate candidates to pursue their own psychotherapy as part of training, in order to be a psychotherapist. It is important because it trains your mind to separate your story from that of your patients’ when their experience mirrors yours. It is essential to experience the vulnerability of being a patient, the courage it takes to share your story, and most importantly to heal your own emotional wounds. If you don’t heal your wounds, you are always going to run the risk of transferring your own wounds on to your patients. I believe one’s own psychotherapy and supervision to be the pillars of ethical practice in order for a therapist to be able to equip himself/herself with the skills require to be a clinician – to be able to have it in you to be beside your patients as they process their stories in way that fosters healing.
Future Plans?
I continue to engage in ongoing clinical training to learn newer modalities of tools and treatment to become a better clinician. I also offer supervision to school counsellors and therapists with 0 to 2 years of clinical experience. I am scheduled to launch an educational program along with a trusted colleague which is envisioned as a preventive measure towards mental wellness. Alongside this, there are additional skill-based workshops I offer for different categories of people – counsellors, parents/families and educators as well as organisations with a vision to create literacy around mental health and therapy, which to my mind is a necessary precursor to any destigmatisation.