On our first night in Port-au-Prince, while Lee Ann and I are going over the next day’s schedule, Father Fredy appears at our table on the Plaza Hotel’s terrace.
Fredy is whippet-thin and angled slightly forward, a living emblem of his eagerness to share what he has been learning and doing even before the CMBM training begins on Tuesday. “The children who have lost their homes and parents are the ones I work with most. I have them breathe deeply to relax and then draw their biggest problem and imagine its solution – a new home, people who care for them. And then we sing together, and I ask them to imagine that place they have created.”
He has also worked with parents who, displaced and frantic since the earthquake, have been abusing their children – having them do dialogues with their “problem” (the abuse), and the unending frustration that seems to compel them to it. For the first time they are able to talk about what shames them, to gain a little perspective.
“They thank me,” Father Fredy says, a huge smile opening his face.
“On the anniversary of the earthquake,” he goes on, “I used an image of a river. I told our whole congregation to imagine they were on its banks, that the river was helping to take away the memories and the sorrow. They were so happy. ‘It’s just like we are there’, they said.”
Father Fredy is still fresh but Lee Ann and I are getting tired. We do a ”dialogue with a symptom” and he realizes something that is just below the surface of his consciousness. “I know I should be tired too. I want to help, but it is too much – seven days a week, long, long hours. I am awake when I should be asleep and then I fall asleep during the day when I should be awake. My Inner Guide says I have to change that,” he says, laughing.
“You have planted a seed,” he tells us, before we all go off to bed. “Other ways, like medication and just talking, weren’t working or were too difficult, or even if good, like prayer, were not enough. But this seed is now becoming a tree and it is bearing fruit.”
We are in Port-au-Prince this week doing an Advanced Training in Mind-Body Medicine with 120 Haitian health, mental health and education professionals and caregivers.Please look for more posts in the days to come. More info on our Global Trauma Relief program in Haiti can be found here.
We do a drawing exercise that has been enormously helpful to children and adults in war, post-war, and post-disaster situations, in Kosovo, Gaza, Israel, and New Orleans, and with US military. For a while, everyone—bent over paper, crayons in hand—becomes young, earnest, playful, surprised. The drawings allow people to tap into their intuition and imagination without effort. As a series of pictures unfolds, they find themselves creating images they’d never imagined . . . .
At the end of the third class, a quiet, solemn boy asks if he can speak with me. “What,” he had wondered during class, “about memories of the lost person that come back again and again?”
Andre says that he has great difficulty falling asleep, and when he finally does, nightmares always come. “I feel so helpless. I cannot talk to anyone.” He grabs his throat with every other sentence. When I mention the gesture, he tells me that his “words are stuck in my throat. And I am afraid to cry. It is not manly.”
We keep our sessions as simple and clear as we can: an introduction to fight-or-flight, stress, and trauma, answers to their questions, and three lessons. Here they are:
1. Slow deep breathing with the belly soft. This, we explain, is the antidote to the flight or flight and stress response that the earthquake has inscribed in the kids’ minds and bodies. Soft belly will quiet their physiology, slow their racing thoughts, give them a little perspective on the flashbacks . . . .
In his article on the possible evolutionary purpose of sadness, Jonah Lehrer, a talented writer and knowledgeable scientists confuses an adaptive mechanism –the capacity for greater focus that the rumination of depression may afford – with a therapeutic one. Even more important, he does not address the causes of depression and, in accordance with his emphasis on enhanced problem solving, limits his discussion of therapeutic efforts to cognitive change.
Work with many hundreds of depressed people in my psychiatric practice and tens of thousands more in war, post-war and disaster situations around the world gives me a very different perspective and leads me to different conclusions. So many of us are depressed because we are living at variance with both our genetic programming and our need for meaning and purpose. We are affected so dramatically by losses of relationships, jobs, etc. because we are not sustained by the adequate social support that is a hallmark of traditional societies. We are subject to an unprecedented level of stress and overstimulation in our environment, to toxic food, and sedentary ways of living that are anathema to our evolutionary development and detrimental to our mood. Many of us lack a sense of purpose in our lives, a connection to something greater than ourselves that gives human life meaning, and can give us hope in difficult times.
The symptoms of depression – both the rumination on what went wrong and why that Lehrer focuses on, and the lethargy, hopelessness, decreased interest in sex and food that go along with it – are best understood and responded to not as an evolutionary advantage but as a wake-up call. They let us know that it is time to address the conditions that are creating the imbalances in our lives; to use food and exercise, meditation and imagination to improve our biology and enlarge our perspective, and to reach out to others—therapists, clergy, family and friends—who can help us. The true purpose and challenge of our depression is to wake us up to what is wrong in the way we live, to point us toward ways to become more fully human.
In Haiti three days of "memorializing the dead," of prayer and fasting have begun.
We drive downtown, past blocks where some houses are still erect and others down, victims we are told of neglected building codes, and others where everything is flattened like discarded, half-eaten sandwiches; fragments of concrete and stone and dust are everywhere. S.O.S. signs are chalked on walls. We pass open air congregations, gathered like human lakes in front and on the sides of tent encampments, several hundred people here, a few thousand there, listening to sermons in Creole, raising their voices in song . . . .
Shortly after we arrived yesterday afternoon, Star and I crossed the street and walked down the ragged line of incongruously bright new tents that front the road. An open space gives us entry, and we wander through the maze of living and cooking spaces, . . .
There is a weight to the air; we begin to feel it at the border where we enter from the Dominical Republic. We can smell it, too, in the swirl of dust that forces some to wear masks, in the acrid edge of burned and burning building materials. It grows heavier as we bump around flanks of rubble on the outskirts of Port-au-Prince. In the city, it roughens our voices and presses tears from our eyes.
The Christian Science Monitor featured an article on our Healing the Wounds of War program in the Middle East! Ilene Prusher interviewed some of our Gaza trainees, and myself, to write this thoughtful piece. She also notes that it is the one-year anniversary of the Israel siege on Gaza, “Operation Cast Lead,” which devastated the people and landscape of Gaza, and from which they are still struggling to recover a year later.
Here is an excerpt of the article, but I hope you check out the original, with some pictures and related stories on Gaza and the Middle East, here.
Gaza war anniversary: How one group helps victims overcome trauma
Rawya Hamam was watching her son deteriorate. Hisham wouldn’t sleep, clung to her incessantly, and said he wanted to go back into her belly so he’d be safe. “Grandma is lucky she died so she doesn’t have to live here now,” the boy told his mother.
It’s not a normal statement to expect from a five-year-old child, but neither were these normal times. A year ago, at the outbreak of war between the militant Palestinian group Hamas and Israel, anything resembling a normal life disappeared into a violent maelstrom that wreaked unprecedented destruction on the Gaza Strip. More than 1,400 Gazans were killed, according to a Palestinian count, in a campaign the Israeli army named “Operation Cast Lead,” with the aim of getting Hamas to stop the daily launch of occasionally fatal rockets onto Israeli communities. Thirteen Israelis were killed in the three-week war. . . . keep reading
We’re so thankful for the recognition of our work in Gaza, alleviating psychological pain and suffering, and all of the work we do, both in the Middle East and here in the US teaching health and mental health professionals to learning to handle their stress and incorporate mind-body techniques into their practice through our Mind-Body Medicine Training as well as our Healing Our Troops program. These warm, caring professionals we train use their skill and wisdom to help families recovering from disaster, like those who survived Hurricane Katrina, as well as working with troops returning from Iraq and Afghanistan and their families.
(If you kept reading my post, don’t forget to check out the rest of the original CSM article with pictures and related stories on Gaza and the Middle East, here.)
My piece, "Some Simple Steps for the Stressed-Out: Psychiatrist Offers Simple Steps for Coping with Uncertainty," on dealing with stress from the economic downturn, appeared on the front page of the Washington Post Health Section today!
Large numbers of people across the country are trying to quiet their apprehension with drugs or drink, or have turned to antidepressants, anti-anxiety medications and sleeping pills. But after decades working not only in Washington but also with war-traumatized populations overseas, I've found there are simple strategies for helping people cope that are easy to learn, practice at home and, in these stressful times, free.