“We don’t need empathy to solve social and political clashes. We need a new constitution,” Candansayar told Today’s Zaman in an exclusive interview.
Candansayar, the chairman of the Individual and Social Mental Health Association (BTSR) and a columnist with the Birgün daily, explained the dominant mental situation of Turkish society as it passes through rapid social change and said the most frequently detected psychological problems due to this rapid change are depression, anxiety and post-traumatic stress disorder.
The psychiatrist actively works in the field of prevention of violence against women and thinks that as modernity increases, so does violence against women. He says hospitals and the health system in general should be centers of the fight against this violence instead of police stations, as is the case now.
Mental health and the Constitution
 Professor Selçuk Candansayar, chairman of the Individual and Social Mental Health Association and a columnist with the Birgün daily, is a psychiatrist working to prevent violence against women. Candansayar thinks that as modernity increases, so does violence against women, and speaking on social changes in Turkey, says ‘being an individual has nothing to do with being selfish, as is often misunderstood in Turkey’ |
“In order to protect our mental health, we need a new constitution -- one that defines the rights, freedoms and responsibilities of the citizens of this country. The existing Constitution harms our mental health. In any case, the Constitution’s aim was to do just that. The Sept. 12 [1980] coup harmed many things, but mostly our souls,” he says.
According to him, asking for empathy between rival political groups is not useful but is also proof of the bankruptcy of the state mechanisms, including the Constitution, which is supposed to regulate the political realm.
“Turkey does not need empathy but a new constitution. Empathy is possible between two people, but not necessary between two rival political groups. Why should they have empathy for each other? You can neither solve social problems through empathy nor can you expect mental health workers to solve these problems. Such an attitude does not befit a democracy. Democracy does not mean rival groups having feelings of empathy for each other. Instead, it involves parties continuing their fight within a state of law and by following the rules of democracy. I think empathy has often been misused,” he underlines.
When asked about the psychological dimension of the democratization process launched by the government to solve Turkey’s Kurdish question, Candansayar says it all depends on the aim of the process.
“If it is only to reshape the Middle East and pursue new energy routes and reassessments of power, this is one thing; but, if it really aims to introduce more democratization, then psychiatry has a lot to do with this, though we should keep in mind that social clashes cannot be solved by psychiatrists,” he says.
Candansayar adds that the Kurdistan Workers’ Party (PKK) will come down from the mountains and that it had always thought it was not given the right to exist, while those who lived under the threat of PKK violence always thought they would be exterminated by the PKK. Both groups have been told to live together now, and it is not easy to do that.
“If such a situation exists, blame should be put on those who governed this country during the last 25 years as well as on the PKK. If you used to tell people they are a threat to each others’ existence but in one day you change your discourse, it is not easy for the people to adjust themselves. If the decision-makers are sincere about democratization, if they really mean it, they have to consult psychiatrists. Even very small and simple arrangements can be helpful to prevent social clashes. This is why the health dimension of the process should be strengthened and the number of mental health sector workers should be increased. Furthermore, training programs for various segments of society have to immediately be implemented,” he explains.
Candansayar is of the view that for the last 25 years, the people have only been hearing from opinion and decision-makers who say the only way to solve the problems is through violence.
“One side is saying it will continue its armed struggle until it enters into a power-sharing agreement, while the other side talks about exterminating every single person in the first group. It is no surprise, then, that a society which listens to this discourse so frequently resorts to violence as a way to solve problems. What is tragic is engaging in violence and simultaneously and frequently using words of empathy. This is hypocrisy.”
‘Transition period brings many mental problems’
According to Candansayar, the mental health of Turkish society is very much affected by the period of transition through which it is passing. He underlines that the process is overseeing a change from a collectivist personality to an individualistic personality.
“In collective communities, members only see themselves as extensions of the community. Being an individual means drawing a border between one’s self and the external world. In order to protect this border, one must develop an ethic based on responsibilities. But for collective personalities, the main source of ethics is outside each individual member and can be religion or tradition. This does not mean that individualistic personalities do not pay attention to these sources, however. Furthermore, being an individual has nothing to do with being selfish, as is often misunderstood in Turkey.”
Candansayar underlines that the human soul, comprising multiple layers, faces many difficulties during this transition period from being collective to individualistic.
“The transition is not always consistent and can result in identity and gender crises as well as lifestyle problems. By lifestyle problems, I mean the kind of job a person has, the kind of marriage they have and the kind of behavior patterns they exhibit when it comes to other people and the opposite sex. These details play a crucial role. In rural societies, people often get married to someone from nearby. This pattern can indeed be replicated in major cities because we’ve often seen large parts of or entire villages moving to the same neighborhood of a city and constructing a shantytown. In due time they move out of these dwellings, but when they do so, life begins to change. For example, fights between brides and their mothers-in-law are less frequent because their houses are separate or they’ve moved away from one another. All these transformations took place in Turkey very quickly. People moved to the cities between 1960 and 1980 -- meaning within 20 years they moved from the village to live in the city.”
He also says it is impossible for people to adapt to this transformation and that this is why it is possible to witness a young university-educated couple fight over the bride’s dowry.
Candansayar underlines that this transformation captures the human soul and if coping strategies are not developed, depression settles in.
“We’ve recently witnessed many cases of depression. Another problem we see is post-traumatic stress disorder because this social change is in fact a trauma. A third common problem is anxiety because the future is extremely uncertain,” he says.
When it comes to coping mechanisms for these problems, he says protective and preventive services have not been developed and cites the fight against drug addiction as an example.
“If you don’t want youngsters to use drugs, first let them assemble freely and ensure their contribution to civil society. Open youth centers in every neighborhood in which the youth can do sports, study and learn a hobby. This will serve as a preventive measure. If the aim is to prevent them from using drugs, it is not important if they are learning chess or studying the Quran in these centers,” Candansayar says.
In his view, municipalities have to enlist the assistance of psychological experts to find out where to construct parks and youth centers.
“But in Turkey this is not happening, and while therapy services are improving, preventative services are not given any attention at all,” he stresses.
Candansayar points out that during the transition period, disadvantaged groups such as children, the elderly, the disabled and women became even more vulnerable. As an example, he cites an increase in violence against women.
According to him, a firm policy is needed in the fight against violence towards women. As a starting step, the understanding that violence against women will not be tolerated should be instilled in the public.
Second, Candansayar says violence against women should not be seen as a matter to be addressed by security forces but one with which the health system should be concerned.
“Those who oppress women usually only let them go to a hospital or to a doctor. If these women turn to a police station, this usually results in negative consequences for the women. If healthcare providers are trained in this matter, this will be of immense help to the women. A system has to be established in which healthcare professionals can detect women who are victims of violence. The next step should be for hospitals to put in touch women who turn to them with security forces and other social service institutions, such as shelters, to help them. We have in the past implemented such a program at Gazi University’s medical emergency department and trained personnel on how to talk with a woman who claims she fell down the stairs, for example. Within one year we were able to help around 360 women who were victims of violence.”
Turkish psychiatrists successful
Candansayar underlines that one of the basic problems Turkish psychiatrists face is a lack of laws regulating their field of work.
He says the only authority able to restrict personal freedoms apart from the justice system is a psychiatrist, but no law as of yet regulates this authority.
“Psychiatrists can make the decision to limit someone’s freedom as a requirement of medical ethics, but this nonetheless is illegal to do. The lack of regulations also opens this field to abuse. Health is a human right and must therefore be regulated by law,” he says.
According to Candansayar, the second problem that results from a lack of laws regulating mental health institutions and professionals leads to an ambiguity in authority of professions connected to the field of psychology: psychiatrists, psychologists, psychological counselors and psychiatric nurses.
“Every profession considers itself a psychiatrist, but this leads to harming the patient. Many physical problems start as psychiatric problems, so if a person providing services is not a medical doctor, he or she might not notice physical problems.”
Candansayar underlines that the Psychiatric Association of Turkey, which counts 99 percent of all Turkish psychiatrists as members, frequently issues statements and gives ideas on what to do vis-à-vis specific problems. The association says it is ready to do its best if asked for help, but notes that decision-makers pay no attention to it.
“Despite all these problems, three international scientific magazines on psychiatry originate from Turkey. Some Turkish psychiatrists even have to see 80 patients a day, but they do not give up on research and writing articles which are read and respected internationally. Considering these conditions, we can say that they are very successful.”
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