The Center for Mind-Body Medicine

Visiting Leogane Haiti – Mind-Body Skills at Cardinal Leger Hospital

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: Earthquake Epicenter to become Center of Healing

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 . . .

Haiti's New President Michel Martelly, and New Hope

May 14, 2011 in Port-au-Prince felt like January 20, 2009 in Washington DC: a new president producing unexpected smiles, and tears, too– and in devastated Haiti, a sense of new life.

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.

Jim &  Linda Metayer, meeting Wyclef Jean

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.

Meeting Martelly: A New President for Haiti is Inaugurated

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.

Mind-Body Medicine is “How to Heal Psychological Trauma”

Dear Friends,

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:

THE GUARDIAN: How to Heal Psychological Trauma: From Haiti to Gaza, psychiatrist James Gordon counsels survivors of disasters around the world

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.

Haiti Snapshot: A Guest Blog by Mark Silverberg, volunteer photographer

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.


Jim

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.


by Mark Silverberg for CMBM

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.


by Mark Silverberg for CMBM

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.


by Mark Silverberg for CMBM

In Haiti, Faces of Change: Mercedes' Transformation

Yesterday I told you about James (from the National Police), Ty Rose (an anesthesiologist and teacher), and Marilyn (a pediatrician).  (Here is the link, if you missed it.) Now, here is Mercedes’ story.

We go around the circle to “check in” about our emotions and what’s happening right now, this moment. It is Mercedes’ time to ‘partager,’ or share. “Most of you,” she begins, “have seen how I was last time,” and I remember – and imagine that all the others remember as well – how at the very first training, in December, she sat erect in clothes that hung like armor, her face as immobile and solemn as the great statues on Easter Island, speaking occasionally and telegraphically about the death of her husband and her daughters, and her own despair.

Mercedes now opens her hands and, amazingly, grins. “I have found calm,” she begins, “doing the deep breathing and the shaking and dancing every day,” (she is emphasizing now). “And I have found much more as well.”

by Mark Silverberg for CMBM

“On the anniversary, January 12th, my daughter and I and our whole community were in Church. And everyone was so sad, but tense also and unable to express the sadness. And I let myself cry. And then my daughter was able to cry too. And in my crying I found strength. And I asked myself ‘what have I learned in the Mind-Body program and how can I use it to help everyone in this Church?’ And I began to sing a song – I have never done this before. And my voice grew stronger, and I asked everyone to lift their arms and glorify God. And they all began to sing and lift their arms, and cry. And I sang three songs and then we opened our eyes and we were all calm.”

She concludes, “you know I work as a teacher. But my students no longer call me teacher,” she says, wagging her finger and pausing with what I cannot help but think is a mischievous grin. “now,” she goes on, “they call me ‘mommy’.”

Thank you for reading my accounts of CMBM’s trainings in Haiti, and these stories from our trainees. I hope you are finding the people as amazing and their stories as touching as I do.

Now that the first 120 Haitian professionals have completed our Initial and Advanced Trainings in Mind-Body Medicine, they will begin to offer Mind-Body Skills Groups to their family, friends, community, and at their institutions, and I will be sharing more of their stories here as they teach and share with others, and learn and grow themselves.

Jim

In Haiti: Faces of Change

Two months after gunfire and bonfires in the streets interrupted our first Haiti Professional Training Program our participants are back – with stories of how they have used what  they learned from us and what they have taught to others.

Their faces are eloquent with change as we sit together in the circle of our small group. Marilyn the pediatrician, looking almost as young as her twenty something daughter, is laughing as she greets us. James, the head of psychology for the National Police, has put on ten much needed pounds. And Ty Rose the anesthesiologist looks as content as she says she is.

“I am teaching the nurses to give anesthesia.” Ti Rose begins, after we have done our opening “soft belly” meditation. “And of course there is never enough equipment and much that we have doesn’t work. But I am somehow easier in my mind. I breathe deeply and do my best and teach my students to do the same, and it is going very well indeed.”


“Police work,” James says, “is an at risk job.We lost many colleagues in the earthquake and many more of us are still living in the streets. There is great stress. But I am doing the CMBM techniques and teaching them. And I am these last two months usually calm – and even calmer now after breathing together.”

photo by Mark Silverberg for CMBM

The next morning the riskiness of his profession will be brought home once again. “I woke to learn that two of my colleagues were killed, but the soft belly I did at home and here, and this morning’s yoga helped so much. You know how here in Haiti we put coffee in a sock and drip the water through and afterwards the coffee is just lying there – very even, but also full of energy. That I believe is how I am.”
Marilyn has begun to move through the melancholia that engulfed her in the year after the earthquake, beyond the deaths of her brother in the quake and her husband in the political violence that has followed it. “I remember my loss and I cry, but then I use the guided imagery and the deep breathing and dance like I did when I was a teenager and I watch my mood change, and the insomnia has gone. And I am sharing  what I am learning with my patients and in my church.”

by Mark Silverberg for CMBM

The next day she will discover in her genogram – her family tree – another source of strength: “My father’s brother disappeared in the Duvalier regime and my auntie raised six children on her own. Many in my family have faced difficult situations” - she laughs now – “and I am finding strength from them as I look at this genogram, and from God too – I think he is all over this genogram – and the love he still has for me.”

And Mercedes, who has metamorphosed from impassive to expressive, cannot wait to “partager,” to share what has happened to her.

Continued–to read about Mercedes’ transformation, click here

"Hope, Healing in Haiti" profile in NBC Washington

Dear Friends,

I’m delighted–NBC Washington online just posted a wonderful profile of our work in Haiti.  Read about our program and the many people it is helping here.

Hope, Healing in Haiti: How Locals Are Rebuilding A Nation

In Haiti: Signs of Healing

I’m not quite sure when or even how it happened but Haiti is starting to feel like home. Not in the sense that I have my family with me, or know where to do grocery shopping, or can lay my hands on the books I love most.

It’s something else, an ease with people, a sense of words and actions contributing to something really good – right now and for the future — a welcome, even an embrace that keeps expanding.  It swells from the team around me, and from the 120 people — doctors, psychologists, nurses, midwives, teachers, priests and nuns and voudoun healers — who come to our training with great fidelity and teach the techniques they are learning from us to friends, family, and patients as soon as it is humanly possible. In order to keep the training inside me always, I have to share it with others,” one young teacher announced this morning.

In the days after Yehlie’s first communion we complete the training we began in December. My ‘small group’ of participants, gathered together again, begins as always with a few minutes of soft belly meditation – slow deep breathing, in through the nose, out through the mouth, with the belly soft and relaxed — quieting our nervous systems, our minds and bodies. And then we “check in”, tell each other what has happened since we last saw each other and share what we are feeling “right now.” Already it is becoming a commonplace for us, a way to regularly connect with those around us, outside as well as within the training. “Check in,” laughs one priest, “is almost now a second religion.”

photo by Mark Silverberg for CMBM

There are still major problems and issues – almost half of our group is still not living in their homes, and there is abiding sadness for those who have died, but there is more energy for understanding and meeting current challenges.

We discuss the short term memory loss that bedevils several people and makes them apprehensive, even in their thirties or forties, about Alzheimer’s disease. I say it is highly unlikely, that trauma has long been known to obscure memory. And one of the other doctors in the group assures us that her memory – devastated amidst the loss of her brother and her husband — has begun slowly to return: “Sharing my emotions, accepting help from others, permitting my own tears – it as if the memory flows back with them.”

This doctor’s face is no longer constricted in pain as on our last visit, but open, changeable, easy with laughter as well as tears. Many of the faces I see are equally changed. James, who is head of psychology for the National Police, scrupulously kind, but painfully thin and equally serious in December, is ten pounds heavier, relaxed, expansive. And the woman I think of as “the Teacher,” as immobile and expressionless as mahogany in devastated grief at the loss of husband and home two months ago, is now a river of feeling and words.

One participant says, “The earthquake brought us so much pain, but also we are seeing it brings good things to the people who survive. Psychology [i.e. traditional therapy] was useless to me and my community – no one could go because it meant you were crazy. Now with CMBM approach I am helping myself and others too.”

Says another, “On January 12th, the anniversary, when everyone in my church was so tense, I taught them the breathing. And as I relaxed I let myself cry, and found my strength, and then we cried together, my children and my friends. And then I sang a song – I have never led a song any time – and I asked everyone to sing with me and praise god. And we did, three songs, and then we all felt more calm.”

It is so encouraging to see the positive changes in our trainees, and to hear that our participants are taking the techniques back to their homes, churches, workplaces. Giving the people of Haiti practical tools for their own emotional healing, and empowering them to teach these tools to everyone they meet, will, we hope, help the Haitian people heal themselves.

Photo by Mark Silverberg for CMBM

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