An unfamiliar mixed emotion overtook my nine year old son, Gabriel, and me as we watched the New York Giants close out the San Francisco 49ers.
For almost four hours, we’d been sitting in a San Francisco home—lone Giants fans happily slapping palms and shouting encouragement surrounded by three generations of equally fervent Niner supporters. And then, after a moment of unalloyed glee, as Giant’s holder Steve Weatherford recovered a bad snap and Lawrence Tyner nailed the winning field goal, Gabe and I fell silent.
We were, it turned out, both thinking of Kyle Williams, the Niners kick return guy who had lost the ball that opened the door to the Giants’ winning field goal, after he had earlier, inadvertently kicked away a punt. The TV camera had found him on the bench pushing his mouthpiece around with his tongue. How, Gabe and I wondered, was he going to make it through the night carrying all the burdens of his unfulfilled responsibility, and through all the nights ahead?
Perhaps it’s because Gabe earnestly loves to play ball, and I feel so intimately the pain that comes with his inevitable share of mistakes; perhaps it’s because I am a psychiatrist and older and more aware of my own blunders and their consequences, that I find myself ever more interested in the quality of the play and the feelings of the players- and less preoccupied with the identity of the winner.
I think, too, that journalists—especially the old fashioned ones who write for papers- have helped to sensitize me. Over the last few years, I’ve become aware of how much and how subtly they attend to the psychology of their subjects—players, coaches, managers, and even owners. Anticipating meeting real people- as well as the drama of the game and its results- now brings me to the sports pages with a pleasure I haven’t had since I was Gabe’s age, devouring box scores and aping batting stances.
I also cannot help but contrast this attention to what “hard news” counterparts usually offer in our papers’ front sections. I feel I know and have more fellow-feeling for the emotions and egos, the idealism, attentiveness, self-deception, and fatuousness, of Shaq, Kobe, and Dirk, of Pac Man and Kim Clijsters and Martina, than I do for Barack, Hillary, and Mitt, Bibi Netanyahu, Mahmoud Abbas, and Hamid Karzai.
The omission of this psychological, this human attention, handicaps my understanding of political players and the weighty moves they make. It also tends, I believe to make us readers less sensitive to the negative consequences- collateral damage it is sometimes called- of their actions. The presence of this sensibility in the sports pages, on the other hand, helps me to feel far more connected to the men and women who populate our playing fields and courts.
So I’m glad that the sportswriters and I can feel for and with Kyle Williams, even as I root against him, and with Billy Cundiff, who missed the Ravens’ game-tying kick, and everyone else who can’t step up or who falls down. And because I can, feel for them I can tell my son that I hope Kyle Williams will be able to accept responsibility without being devastated by self-blame; that he will, as I hope Gabe and his friends would, talk with his teammates and family and friends. And as I do so, I know that I’m at least as grateful for the opportunity to learn and share this lesson in compassion as I am for the Giants hard earned win.
James S. Gordon, a psychiatrist, is the author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression and the Founder and Director of the Center for Mind-Body Medicine in Washington, DC.
Grace is small, slight, and dark and moves almost without sound at the side of her two blond sons. But once she registers, like a negative coming alive in a tray of developer, her image stays with me, still, mournful and isolated among a crowd of a hundred adults and children who have come, curious, clamoring and needy, for Wellness Day at the Grand Isle Community Center.
Grand Isle sits at the end of a forty mile long sliver of Louisiana coast that pokes into the Gulf of Mexico. It is regularly throttled by hurricanes and, more recently, invaded by the BP oil spill of April, 2010. I’m there with a team from our sister organization the Mind-Body Center of Louisiana, physicians and psychotherapists whom the Washington DC based Center for Mind-Body Medicine has trained. Beginning just after Katrina in 2006 we’ve taught them, as we have clinicians and community leaders around the world, to teach self care – meditation and guided imagery, drawings and dance – and to lead small supportive groups in which kids and adults can learn to use these and other tools to quiet their anxiety, gain perspective on seemingly intractable problems, and feel the connection to others who are also struggling to mend their lives.
For many, particularly on Louisiana’s Gulf Coast, the oil spill was the insupportable last straw: “The hurricanes, Katrina and Gustav, scared us and took our money and some of our homes,” Judy a fit, gravel voiced 51 year old house painter who has already been in one of our eight week long mind-body groups, tells me as we take a break on the porch of the Community Center. “But this BP thing doesn’t go away. Of course, it’s in our bodies” – in an authoritative survey a year ago 48% of all Louisiana Gulf Coast residents reported “an abnormal increase of at least one health symptom”. Judy has “headaches and these rashes,” pointing to her red blotched legs, “I never had before, and my grand kids are wheezing and have sinus problems. My friend, a healthy, clean-living Christian lady younger than me has already passed from a pneumonia that never went away.
“But it’s even worse for our minds and souls.” The beach and the Gulf which were “always my solace” are now “torture” to Judy who the other day, long after residents have been told that the waters are safe, counted “forty-eight dead animals washed up, fish of all sizes and big old sea turtles, with their intestines hanging out. We know,” she concludes sadly, “it’s our mother the Earth that’s been hurt.”
Employable and feisty, equipped with skills for self-care, Judy is poised to make a new life elsewhere with her daughter and grandchildren. Grace and her family, like dozens of others whom we have met on the Gulf, and inland too, feel trapped as well as endangered. You can see it in her eyes, scampering across my face, back and forth over her six and nine year old boys, and around the room, vigilant, it seems to me, for threats. The white plastic bracelet she still chooses to keep on her wrist, emblem, she tells me, of a recent, long and scary medical work-up, reminds me of the metal ones that indicted felons under house arrest may be forced to wear on their ankles.
Except Grace and her family no longer have a house or even a rented room. Her husband Ty, who sits stolidly nearby, worked on the rigs for BP and then, like 52,000 other Gulf coast residents, on the clean-up crew He is now, he says, seeming a bit dazed, “on call,” to BP, a kind of economic and social limbo in which he has no work or pay and cannot collect unemployment.
Grace has been told that the numbness in her face, the headaches and the weakness in her limbs signal the onset of multiple sclerosis and that medicine has little to offer. When I say that many others have developed similar symptoms since the oil spill, that they, like the rashes, respiratory and digestive problems, depression, confusion, and anxiety have been noted in medical journals as toxic side-effects of the oil and the dispersants, not of MS, she seems unconvinced. The diagnosis has been made, the sentence already passed.
In the morning I teach slow deep breathing to quiet anxiety. We do shaking and dancing to release tension and raise spirits and over lunch I give a talk on foods that help the liver detoxify the chemicals from the spill and the clean-up. At the end of the day we all – children and adults – do three drawings: “ourselves as we are now,” “ how we would like to be” and “how we are going to get there.”
Chad, Grace’s six year old, jumpy and aggressive at the beginning of the day, now concentrates on crayoning himself in a new house, a little boy on his feet, holding a tiny replica of that house, symbol of his hope, in his hand. In her first drawing Grace is surrounded by all four of her children – faces without bodies, mouths turned down, big tears on her cheeks. In the second drawing all five faces are inside a house, smiling. And in the third picture, the one of how she is going to get from the situation she is in to the one she hopes for, Grace, a figure with a body now, is kneeling, praying.
I hope you’ve all been enjoying your summers. I’ve been in Israel and Gaza with our team, and more recently have been working on getting our programs ready for the fall (Professional Training Program in Mind-Body Medicine begins in just a little over a month!) as well as doing some writing.
I wanted to share with you a profile of me and of The Center for Mind-Body Medicine’s work that just appeared in the Jerusalem Post Magazine. The JP is one of Israel’s largest and most influential newspapers–in both Hebrew and English–and I am hopeful that the profile will be helpful as we raise both awareness and funding for the trauma and other programs in Israel and Gaza.
Profile from Jerusalem Post Magazine, by Lauren Gelfond Feldinger:
In that connection, we are beginning to organize a joint Israeli-Palestinian CancerGuides training in the summer of 2012. The CG program is much needed in Israel, and is of desperate importance in Gaza and the West Bank where people with cancer, particularly women, are often treated as pariahs.
Over the last year or so, we have organized the first cancer support program ever in Gaza, and now, we have ten groups running concurrently. You may remember that some of these cancer group participants are featured in our short video about Gaza, “Finding Hope in the Face of Another.”
We did a workshop for our team while we were in Haiti last week– at a church retreat center, a little, open, green place at the bottom of a hill in the middle of Petionville, bird-filled flowering trees, some fresh, if very warm air—an oasis.
More than 60 of those who completed our Advanced Training in Mind-Body Medicine came for the day—from Port-au-Prince, Petionville, Leogane, and even from further out in the countryside.
They were quiet at first, then fairly bursting with stories about the work they’d done, with children in schools; with patients in hospitals; with Catholic, Protestant, and Voudoun parishioners; with students and colleagues at universities and professional schools; and family members, friends, and neighbors.
Many people who have come to these groups are, we hear, sleeping well for the first time; chronic pains are receding; kids who’ve lost parents and homes are able to focus. The need to talk about what has happened, to share the feelings that continue to well up, is everywhere. The groups have become a place to go—to get relief, to “be at home,” to learn “something that works”.
Amy, Linda, JJ, and I all teach and answer questions–stretching mind and body; how to deal with someone who is, or may be suicidal; how to stay “present” and empathetic without being overwhelmed by needs that cannot be met.
Linda Metayer presides with grace and clarity, gives a lecture on biofeedback and autogenic training that is a model of economy. It’s a pleasure to watch her and to listen as she explains the next steps we will take together—the ongoing supervision, the site visits that we’ll make to our trainees’ groups, the workshops we’ll all be offering in the community.
We also outline our plans to develop a leadership team that will work closely with our international faculty in providing supervision and in training hundreds, perhaps thousands, more Haitians to use our work with hundreds of thousands.
The next morning, we meet with the first nine members of that leadership team: highly energetic, talented people who have deeply been moved by our approach and have begun to lead groups in hospitals, churches, school, and tent camps. Among them are a child psychiatrist, a pediatrician and neonatologist, and a medical student; several psychologists, a consultant to the Ministry of Health who is a professor as well; and an accountant who has left his practice for the more-than-full-time job of leading a tent camp and teaching mind-body medicine. I’ll tell you much more about them in future entries.
In the meantime, here’s a picture of our crew—Haitians and Americans together.
We spend the morning at the Cardinal Leger Hospital, destroyed in the earthquake and quickly rebuilt. Haiti’s lepers come here, older people without legs , or with fingers and toes amputated by the disease; brothers 8 and 12 years old whose noses have collapsed and whose faces and hands already bear the scars of the condition.
The kindly and concerned Sisters and lay nurses who are in charge have been overwhelmed by the suffering around them—staff, friends and family killed in the earthquake, as well as by the weight of sadness their patients bring. Out in the country, living with people whose illness has wasted them, meeting acute care needs, they are clearly stretched thin.
Little by little, they brighten during our workshop, appreciating the relaxation of Soft Belly, laughing with the shaking and dancing—“The first time laughing since last January 12th,” notes one sister.
Here’s a quick video we took of participants dancing at a Port-au-Prince workshop—
Sharing their drawings, One sister notes how rigid her body is in the drawing of her “biggest problem”, and how the flower that she draws in the third picture (“the solution to the problem”), bending gracefully toward the sun, is a “lesson to remember.” Before we close, JJ teaches us all to stretch in our chairs.
Afterwards, outside, the Sisters show us the bushes blooming red, yellow, white, and orange, and reach up with a net to fetch us mangos for the road. “We will use what you have taught us, ourselves,” says Sister Yolande, the Director, “and we will teach our patients too.”
Visiting Leogane the day after the inauguration, we are plunged into the canyon between the promise and its fulfillment. The city, which was the epicenter of the earthquake, is desolate, a combination of “the hour before the shootout” in the Westerns, and a scene from after the Apocalypse. There are empty lots where once there were buildings; rubbish is thrown on top of rubble; motorcycles buzz around, but their riders are solemn.
We stop to buy Haitian CD’s and talk with a 30-ish man whose face looks frozen, who is standing near the rack. “Is this your store?” I ask, of the tiny cabin.
“It is not mine,” he says, “but I built it.”
“What about your house?” I ask.
“My house was destroyed,” he replies.
“Did you lose family?” I ask.
“Yes,” he says, and slowly, deliberately, names them. “My brother, my other brother, my sister, my mother.”
Around us, other young men stand like statues. Only when the music from the CD begins does anyone move. The young man who actually owns the store shuffles his feet and smiles a little. A couple of the other guys sing along with Belo.
We know we will be coming back to Leogane and working there.
To be continued tomorrow . . .
In one of those happy coincidences—psychiatrist Carl Jung called them “synchronicities”—we found ourselves in Haiti on Inauguration Day and in the precise hotel at which the post-Inauguration reception was taking place. All of our US team—Amy Shinal, our Clinical Director; Lynda Richtsmeier-Cyr, our Senior Supervisor; Lee-Ann Gallarano, our Global Trauma Program Manager; Jesse Harding, our Program Coordinator; JJ Biasucci, our yoga instructor; and I—were amazed that we were where we found ourselves.
As the guests assembled, Linda Métayer and I approached those whom we knew or whom we believed would be interested in our work. Wyclef Jean, whose long time living outside the country had barred him from running for the presidency, was there to celebrate his fellow musician’s election. He gave us his cell phone number and assured us of his support.
Michaelle Jean, the Haitian-born, former Canadian Governor General, lit up the room with her cloud of red hair and her smile. We spent some time with her and arranged to meet again.
There were officials of the Preval government, including Prime Minister Max Bellerive, and some of the clerics who led the inauguration ceremony. Other leading figures from the Haitian diaspora were there, filled with wonder at the hope, after so many years of disappointment, that Michel Martelly’s election had brought to them. As we spoke, all of them recognized the central importance of dealing with psychological trauma to the rebuilding of the country.
President Martelly arrived with his wife and four children, each one energetic and very much an individual: the oldest boy inclined toward his cell phone; the second-oldest boy with a mohawk, gracious and at ease; the youngest boy smiling and well behaved, a beaming little girl. Here too, we are reminded of the Obama family, and of the future for which we all hope.
On the night before his inauguration, Haitian president-elect Michel Martelly came to the Hotel Karibe, where our US team and our Haitian program director Linda Metayer were staying. He sat outdoors among us as the band began to play. There were watchful bodyguards, but also a feeling of welcome, of fraternity.
The people I spoke with were happy, excited; not just the tent-camp organizers who had always been solidly behind “Sweet Micky”, the popular singer, as President Martelly was known, but also wealthy people and the intelligentsia. There had been a shift in the weeks since the election, a sense of possibility that, freed from narrow, self-serving needs—he’d already had plenty of fame, adulation, and devotion, and had made plenty of money—he might really mean what he’d said: about rebuilding the infrastructure and making, for the first time, education available to all.
It felt important to talk to him, to tell him how hopeful we were as well as what we were doing. And so, Linda and I arrived at his table. She explained in Creole—the people’s language here in Haiti—about the Center’s work and our hopes for establishing a National Program of Self-Care and Mutual Help. “Thank you,” he said to us in English, “for everything you are doing for Haiti.” He gave us names and contact information for key advisors and the next Minister of Health, embraced us with a kind of warmth and ease that is rare in politicians.
In the background, the guitarist, Belo, was joined by backup singers and other musicians—two, three, five, ten of them. The music, a kind of joyful Haitian reggae, had us smiling and dancing. I wish you all could’ve been there. The president stayed at his table for awhile, happily greeting supporters, many of whom had returned from the Haitian diaspora, enjoying his evening and everyone’s music.
On a recent trip to London, I was interviewed during Depression Awareness Week about my book Unstuck’s UK release by The Guardian newspaper. The reporter was particularly interested in CMBM’s Global Trauma Relief program and our work to bring population-wide psychological healing to places around the world that are afflicted by war and natural disaster. You can read the piece here:
I’m certainly pleased that the author recognizes CMBM’s groundbreaking efforts to teach and support hundreds of thousands of people in Kosovo, Israel, Gaza, Haiti, Southern Louisiana, as well as US military returning from Iraq and Afghanistan. It’s a shame, however, that his tone is so dismissive of integrative medicine and that he fails to recognize the fundamental importance of self-care for psychological and physical healing.
Please note that as of this writing, corrections are being made online for several factual errors, including the following:
- In Gaza, we trained 90 clinicians initially, only a few of these were “educators” (as the article states)
- CMBM now has 160 groups meeting in Gaza each week, not 48, as reported.
Beyond factual errors, though, I’m disappointed in the tone of the article. I want to emphasize that our approach to psychological trauma relief is not about “belief,” as the article repeatedly implies. It is based on hard evidence that is just as rigorous – actually more so – than most of that provided by the drug companies he seems to accept as the standard.
It is a common misconception (and prejudice) that psychological and nonpharmaceutical research is less stringent and reliable than clinical drug trials. Each of the approaches that we use, including meditation, guided imagery, biofeedback, autogenic training, yoga, self-expression in words and drawings, and movement and exercise, has a significant research base, one which demonstrates decreases in stress levels and improvement in mood. The CMBM approach combines these into a comprehensive program, and The Center for Mind-Body Medicine takes great care in scientifically researching, documenting, and publishing our findings of our approach in peer-reviewed journals. We recently published a randomized controlled trial (RCT) on our work with war traumatized children in Kosovo that shows an 80% decrease in symptoms of PTSD (read the abstract here).
This was the first RCT of any intervention with war-traumatized children, and sometime in the next few months, we will be publishing a study (in the International Journal of Stress Management) that shows similar results—80% decrease in PTSD symptoms, significant decreases in depression and hopelessness—in war-traumatized youth in Gaza. This study is particularly important because the gains that were achieved over ten weeks of once-weekly group sessions were largely maintained at seven months’ follow-up—in spite of ongoing conflict and severe economic hardship.
The point is that this approach is not alternative. It is fundamental. It makes human and scientific sense. We have an approach that works with large groups of people in developed countries as well as those ridden by disaster. It is flexible, inclusive, and culturally acceptable. And the groups in which we train caregivers can be led by anyone—teachers, and religious and community leaders, as well as health professionals; and the scientific evidence for its effectiveness continues to accumulate. And as the article states, CMBM will continue to be there to provide our program of mind-body medicine for people suffering from psychological trauma, to teach them, and help them help themselves.
Mark Silverberg is a welcome guest blogger. He is an Ohio businessman who read about our work in Gaza (in the NY Times) and got in touch. “I want to volunteer and help,” he said. “I can take pictures.” He came with us to Haiti–we saw the pictures, felt Mark’s heart, and now he is a dear part of our team. He sent us this account of his time in the tent camps.
Enjoy his story.
We hiked to three tent camps on the side of a mountain today, Thursday morning. Hot as heck. What I saw cannot be described– 13,000 people live in one camp alone. The pictures and videos only begin to tell the story. We were given a tour through the camps by the residents who are elected to help coordinate running the camps, so a school and homes were opened to us. The camp organizers kept introducing us to people and children with problems and asking us how they can help them. We suggested they apply to take the CMBM training. [Note: if this is your first time to the blog, you can read other posts about CMBM's Haiti trainings to help Haitian caregivers help these kids & families]. The visit was a very humbling experience.
An extraordinary experience on Friday morning. I went to the Champ de Mars tent camp across the street from where the CMBM training program was held at to take printed pictures to the kids and families I photographed during the CMBM training in December 2010. Laurent Sheineder helped me find all of the kids and adults in the pictures. They were very surprised to see their pictures and of course posed for many more! They told Laurent and I that of all of the people who had taken their pictures I am the only one to bring them copies. I think they must feel invisible.
Then at lunchtime the organizers of another nonprofit, Zanmi Lakay (ZM) from Oakland, CA picked me up and we went to Cite Soleil. It’s the worst slum in the poorest city in the hemisphere. And we weren’t in the BAD part of the slum. This was big time scary.
ZM organizes basic needs (food, clothing, shelter, medical care, education) for homeless children in Port au Prince. Before the earthquake they had a home and facilities for many children, but the earthquake destroyed the house so the kids are spread out in three clusters in Cite Soleil and Jacmel. The kids also receive documentary photography cameras and training in their care so they can document their lives, tell their stories and express their hopes and aspirations. There have been 5 gallery shows across the US (SF, NYC, DC, Florida) to raise awareness and funds. The kids’ pictures are sold to benefit the organization that helps care for them.
So I was able to be at the first gallery show in Port au Prince, at a cyber cafe in Cite Soleil today. Forget what you think about a cyber cafe. Small, dark, a few folding chairs – but still a space for their pictures, which were taped to the wall with packaging tape. The original location where the show was to open had too many shootings, so it had to move to this new location.
The kids got to see their pictures on the wall, to hear about the gallery shows in the US and the great reviews they got, received certificates for completion of their photography training–I donated items and foodstuffs from CMBM faculty and staff. They asked me to speak, and I told them about teaching photography to kids their age in a poor inner-city Cleveland neighborhood nearly 40 years ago. I encouraged them to continue using photography to express themselves and to clarify their dream, since their dream will keep them going through hard times. It was a gift to be present for the recognition of their struggles and accomplishments.
After leaving Haiti the memories of those two days kept echoing in my mind. I recalled that when I was leaving the school in the mountainside tent camp on Thursday, one of the kids said repeatedly, “We are waiting for you,”–meaning, “waiting for you to return.” On the following day when I brought the pictures to the kids and families in the Champ de Mars tent camp, their reaction was often puzzlement. I later realized it was because their expectation was for people to not come back, to not remember them or be touched by what they saw; to return to their normal lives, unmoved and unchanged.
I hope I’m not that person.