Dr Arshad Hussain, professor of Psychiatry, Institute of Mental Health & Neurosciences (IMHANS), Srinagar, has been observing the mental health of the general population in the Valley in a situation of conflict from the early 1990s, when he was just a medical student. “In the old days, there were many stories of distress. I remember, for instance, a young man who would climb a particular tree every morning and sit on it all day. He did this for 20 years before psychiatrists could rehabilitate him.”

It is thanks to the efforts of people like Dr Hussain and civil society organisations that took upon themselves the task of addressing the forgotten issue of psychiatric stress that Kashmir today has both medical expertise and rising awareness. Today mental health is a well-recognised condition and J&K has about 40 trained psychiatrists, unlike three decades ago when people had to depend on family elders, local pirs and visits to shrines and dargahs to cope with their mental agony.

Speaking to Dr Hussain provided us with an insight into how large a toll the current violence is taking on the mental health of the population, a trend that was perceptible in the outpatient department of IMHANS, which gets around 150 patients, coming in from all parts of the Valley, every day.

According to his estimation, at least 11 per cent of the population suffer from mental health morbidity currently.

Dr Hussain pointed out that trauma is the result of an abnormal event in the natural cycle of life; there were two aspects to recovering from such trauma: gaining a feeling of internal security and a feeling of external security. Both these are difficult to achieve in situations of constant violence. Typically, people will somehow manage. Belief systems evolved, fathers grew more pious, neighbours extended a hand of support, but the families of those left permanently disabled will never be able to escape the perpetual cycle of struggling to cope. According to Dr Hussain, while death brings intense grief and suffering, there was also closure. But here, as in cases of disappearances, the trauma was unending. In all cases of such loss, there were also secondary traumas within the family like financial breakdowns because of the loss of an earning member or a job. Unemployment is a major trigger factor for mental health disorders in the Valley, with unemployed persons having twice the possibility of going into clinical depression than their employed counterparts. Also, the poorer the person was, the higher the trauma of the adverse events they experienced.

In the immediate aftermath of the [Burhan] Wani assassination, there was a widespread feeling of insecurity among the general population, according to Dr Hussain, something that was last perceived in the early 1990s when there was the midnight knock syndrome, with patients getting panic attacks at night as they kept imagining people coming in search of them.

This time, however, there was a significant change. Because the use of force was much more widespread and had permeated every section of society, there was more anger and less fear. “You now have a generation that is desensitised to fear,” observed Dr Hussain.

What also come out clearly in the data is that women were twice as likely to suffer mental health morbidity than men. Among the cases that came to Dr Hussain’s attention over the years was a woman who was so affected by her son’s death that she banged her head in despair and fractured her skull. Another shattered mother would visit shrines and keep repeating the words, “Get my son”. This morbidity may be noticed by the rest of the family, but most often it is just accepted as a normal physical change. One of Dr Hussain’s patients began losing her eyesight after she learnt of her son’s death. Family members thought it was related to age. Yet, as Dr Hussain pointed out, trauma did have physiological impacts as well. This was clearly the case with Mehmood’s mother as well, when she mentioned that she had lost hearing in one ear from the moment she heard of her son’s injury.

Interestingly, women not only bear the burden of reversals within the family, they contribute towards stemming what Dr Hussain pointed out as “social drift”, when a family member becomes socially dysfunctional. They were also the ones who observed changes in family members and invariably took the lead in bringing affected people to hospital, either as mothers, sisters or wives. As he put it, “Women we find constitute the largest group of survivors. They demonstrate a higher resilience in terms of coping. They are the ones who tend to see the brighter side of things, telling victims ‘at least you are alive!’.”

But hope, “that thing with feathers/That perches in the soul” as the poet Emily Dickinson wrote so long ago – is difficult to hold on to in the Kashmir Valley today. The ordeals and uncertainties marking life formed a constant thread in the conversations we had with Kashmiris across age-groups and backgrounds. What was most conspicuous in these conversations was the death of hope – hope that the violence will abate, hope that life would become more secure, hope that a modicum of justice would be delivered, hope that the Indian state was serious about addressing the Kashmir issue.

As Professor of International Law, Sheikh Shaukat Hussain, observed, “We have been engaged in so many exercises for dialogue. Over the years we have been telling and re-telling our accounts to anyone who will listen, knowing full well that nothing will emanate from these conversations. There is a sort of hopelessness we feel when we search for any remedy within your system.”

The irony of the Government of India claiming Kashmir as part of its country, yet treating it in ways markedly different, is not lost on Kashmiris. “They want Kashmir, the land; not Kashmiris, the people”, was an observation we heard again and again.

It startled us to hear young Amir, still nursing a wound caused by a pellet gun in July, whisper, “After they cause such wounds, no one from the government even bothers to come and ask about our condition. They hate us, they want to remove us from the face of the earth.”

The questions put to us had no answers. How was it that if suo moto action could be taken by the courts in the case of the Bhagalpur blindings in Bihar, no one bothers when hundreds of people suffer blindings from the use of pellet guns in the Valley? Why is it that pellet guns are not used to quell protests when Jats go on a rampage, as they did in March 2016, or in the instance of angry mobs burning buses in Karnataka in September 2016? What is the reason that the Supreme Court of India took cognisance of the excessive use of force by the state in Manipur, but refused to rule against the use of pellet guns in Kashmir unless it can be guaranteed that stone pelting would end?

Like the threads woven into the exquisite shawls the Valley produces, questions arise, twine and intertwine, creating a narrative of their own – a narrative of a fissured earth.

Excerpted with permission from Blood, Censored: When Kashmiris Become the ‘Enemy’, Dinesh Mohan, Harsh Mander, Navsharan Singh, Pamela Philipose and Tapan Bose, Yoda Press.