CASE HISTORY 14
Name: Shobha
Sex: Female
Occupation: Clerical Officer
Complaints and duration:
Retention/Difficulty in passing urine, sometimes for more than 24 hours, on and off.
Severe lower abdominal pain
Depression
Past History:
Had been given some drugs or psychotropic substance by classmates at university.
Hallucinations.
Divorce within one year of marriage.
Depression.
Treatment History
Consulted various doctors and psychiatrists.
Prognosis
The patient was in danger of getting renal infection because of repeated catheterization to relieve urinary retention. Her depression was likely to get worse. She would have ended up a wreck or committed suicide.
DISCUSSION
Urinary retention
When the urinary bladder cannot be completely emptied, or at all, despite an urge to urinate, it is termed urinary retention. Urinary retention can be an acute, short-term condition or a chronic, long-term condition. It requires medical attention for relief, treatment and detection of the underlying cause. Sometimes hospitalization may be needed. Failure to treat the condition can lead to infections or damage to the urinary tract and kidneys.
Acute urinary retention is a medical emergency. It is painful and the patient is unable to urinate despite a full bladder. Chronic urinary retention, whilst not immediately life threatening, can lead to renal impairment and puts the patient at risk of acute-on-chronic retention.
The cause of urinary retention in women is unknown in about a third of cases but approximately half are due to Fowler’s syndrome, typically seen in women in their 20s-30s and thought to be due to failure of the urethral sphincter to relax appropriately.
Urinary retention studies have shown that retention of urine in the female results from various medical, surgical and gynecological causes, but is often thought to be due to psychological disturbances. Intermittent catheterization is the best management. A multidisciplinary approach between the urologist, the psychiatrist and the neurologist usually provides the best management. Ultimately, retention leads to renal impairment.
Effects of yoga and meditation
Shobha could not pass urine, sometimes for days on end. She was having severe pain. She used to be afraid to drink water for fear of provoking the symptoms. She had been told urinary retention could damage her kidneys if allowed to persist. She had tried different types of treatment from generalists, physicians and psychiatrists, without much success.
“Last year, shortly after Lord Rama’s birthday festival, I suffered from kidney trouble. I was in great pain.”*
Her neighbour used to attend our ashram regularly. Once when the condition was very severe and patient was in serious pain, not having been able to pass urine for the past 36 hours, they went to the psychiatrist. The latter told them that western medicine could not cure her permanently. Better look for some alternative method, some sadhu or pundit or swami (religious person). Her neighbour brought her to the ashram after this.
“My neighbour who was attending Siddha Meditation sessions at the Ashram, volunteered to take me…the following day”*
They did not mention any specific problem when they came. They only told she was having severe pain. She was made to lie down and do some deep yogic breathing. She was told to relax.
“That day, Yoginiji placed her hand on my forehead. She made me take a few deep, yogic breathings and mentally repeat the Om mantra. To my surprise, within seconds, my pain disappeared. I felt relief and normal once more.”*
Suddenly she emptied her bladder. Everything around her became soaked in urine. She had to be given a bath and a set of clothes. The whole room and the foams had to be washed. Later she was given initiation and she meditated for one hour.
“Yoginiji understood my plight, and to boost my spirit granted me initiation on the spot”*
Afterwards, she told about her past history. Some 5 years back she had gone to India for higher studies. There she got some fits of hallucinations after having been given some drugs by classmates. She tried to follow some treatment but her condition worsened. She had to stop her studies and return to Mauritius.
She managed to get a job as clerical officer. Sometime later, she got married but had to divorce within a year because of incompatibility. She then went into depression. She was ashamed about her divorce and did not want anyone to know about it. She used to present herself by her maiden name. She was in constant tension and in depression. Then followed the chronic urinary problems.
From the very day she was initiated she never had the urinary problem again. She continued with meditation regularly. Her depression and her general condition improved.
“Yoginiji…came as a blessing from God: at a time when I was going through a most delicate and dire phase of my life. My spirit was at a low ebb. It could have left me a complete wreck.”*
Yoginiji advised her to try and take up her studies and complete her graduation. The university was contacted but they could not take her back because of more than two years break in her studies.
Yoginiji then advised to join the University of Mauritius for a course. She secured a seat for Library studies. She was able to cope well with her work and studies. She gradually recovered her self-confidence.
“I have regained a lot in self-confidence and my zest for life. I now realize the marvelous transformation that has taken place in my life. I feel a lot stronger to face life with all its horrid problems.”*
She was encouraged to continue her studies. She graduated and secured a senior job. Later she would become senior librarian in government service.
Conclusion
The patient had been suffering from chronic depression because of her problems. She could not complete her studies in India. Soon after her return she got involved with an unreliable young man of doubtful character. In spite of being warned by friends and relatives, she got married. She lived almost one year of hell and divorced. This shock further increased her frustration. She was reluctant to go out. She would to use her maiden name, not to allow anyone to know about her scandalous marriage.
All this pent up tension led to her urinary retention problems. When she was brought to the ashram, she was extremely down and in intense suffering. She was listless, almost lifeless. She had to be carried and helped to lie down on the foam. She could not sit. She was made to repeat the Aum mantra mentally and do deep yogic breathing.
The inflow of prana was thus increased through the whole system. This relieved her of her pent up tension. The blockage of the urethra and the disruption of the nerves that connect the urinary tract with the brain and the nervous system was also set right. Her bladder emptied spontaneously.
Afterwards, her initiation and meditation further consolidated the beneficial effects she had obtained from that first session of yogic breathing and mantra repetition. But this would not be enough. She had to build up a reserve of prana through regular meditation. She was made to come daily for meditation. She would meditate for 1-2 hours. After just 1-2 weeks, she was transformed. She became care free, happy go lucky.
“I am now a more disciplined person, confident and carefree. I realise that life is worth living though temporary as it may be. By ‘living’ I really mean ‘being’ not existing.”*
Yoginiji made her realise she has to develop a more positive attitude and break away with the past. Meditation will help in the process. Meditation involved shaktipat, deep conscious yogic breathing and repetition of mantra. The shaktipat would spontaneously put her to a superconscious level, cut off from the world of fear. The discipline involved in meditation helped. She had to come and sit daily for 1-2 hours after work. She had to meditate at home daily.
“It was unbelievable. A mere touch from Yoginiji and I drifted into a spontaneous superconscious state.”*
“When I sat for meditation…I experienced such an ecstatic state…There was no fear…”*
She became very much at ease, with a higher sense of self-esteem. She became more conscious of her looks. She began taking pain in her dress, following the latest fashion. Yoginiji encouraged her to resume studies. She became very excited that she could resume her studies and become somebody. She did score high marks and secured a high post. Some time back she was promoted and secured a senior post in civil service. She was transformed. From wretchedness to fulfillment! She is now serene and contented.
“In this modern world where stress has become a way of life, one needs to feel serene and in harmony with one’s inner self.”*
“The world would become a real paradise and progress in any field of life would be rewarding.”*
Despite all treatment she had been following, there was the danger of recurrent infection, kidney problems and complications. On the mental level, her chronic depression would have aggravated. She would have ended up a cripple for life, perhaps in mental hospital. Even her doctors had given up on her. Alone, she could never have come out of her dilemma.
Left to herself she would have drifted into a life of chronic disease and severe depression. All the treatment she had been following did not cure her of her condition. Something was lacking. This would be provided by meditation which managed to do what no therapy had been able to do: it helped in reestablishing the disturbed homeostasis in her system.
(*Excerpts from Shobha’s article, Annual Magazine 1, 1990, page 42-43)