Community. Healing. Hopefulness. Tens of thousands of Palestinians in the Gaza Strip are using the CMBM model to repair the damaging effects of trauma and stress. They have created a community of healing and support that touches lives and builds a sense of hopefulness for the future.
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.”
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.
I have wonderful news to share with you today, an amazing article on our work in Gaza from this morning’s New York Times. It gives such an accurate feeling for the touching , powerful, and effective work The Center for Mind-Body Medicine is doing in Gaza and for the spirit of healing, community and hope that I believe pervades everything that we do.
Please read this testament—so amazing to have it so well and feelingly presented in The New York Times—to the possibility of transformational change
We’re delighted that this Gaza program, which is nurtured and sustained by so many dedicated and generous people (health and mental health professionals, teachers, community and religious leaders, and our funder, the Atlantic Philanthropies) is being so positively recognized. I hope you’ll take the time to read this beautifully crafted piece and share it with friends.
I also wanted to share a few stories I’ve been saving for you from a visit to our program there in August, (the second visit within three weeks). We were moved on both visits by the ways our Gaza team is helping children and other folks—every kind of person—to relax in the midst of poverty, danger and chaos. And it was so touching and such fun to be with our dedicated, passionate, raucous, talented and tender Gaza team (you hear some of their voices in The Times article) and with Jamil, who leads them.
During our time in Gaza, we visited with some of our recent trainees –there are about 130 new ones this year. Throughout his training with us, one counselor—I’ll call him Abed—was so skeptical, so cantankerous: no question was too obscure to ask, no objection too small to raise. A couple of weeks ago, we watched him sit on the floor—sweet and solicitous and playful –with the most troubled five year old boys from the kindergarten with which he was consulting. The boys—cute, squirmy, solemn and giggly—showed us how to do “soft belly breathing” and told us how they have brought relaxation into their families — “and guided imagery too.” And, an excited five-year-old added, “I taught my brothers and sisters and my parents about the genogram.”
We saw two groups for women with breast and lung cancer. Cancer, we were told, is regarded in Gaza as a disgrace as well as a disease, a kind of plague which provokes shunning. “No one wants to know you,” we were told, “except in this group.” “I felt worthless…dead already,” said another woman. “The mind-body group relaxed me and brought me back to life.” Another woman, stout and older, proudly showed us “chaotic breathing”—flapping her arms up and down, breathing deep and fast. “I do it every day. It makes me feel so strong,” she said with a grin.
Then there was a group for kids with Down Syndrome, the boys lying on mats, imagining safe places “at a beach,” “in the garden,” or “at a sister’s beautiful wedding.” We now have 160 mind-body groups in Gaza. They meet for ten weeks and then 150 to 160 more begin. The film of all this and more will be ready soon, and we will share it with you as soon as it is. (I’ll be sure to post a link here.)
We’re growing—in many ways.
More soon. In the meantime, lots of love to all of you.
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
By Ilene R. Prusher Staff writer / December 28, 2009
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.)
“We have been on a journey,” says the psychologist who is leading the final session of Mohammed’s group. She sits comfortably cross-legged on the floor, in her long coat and headscarf, next to the young man who is her partner on this last day. “We have come to know each other in a way that is not usual here in Gaza,” she goes on. “men and women speaking together from their hearts, all of us finding new friends.”
This is our last group and, as we check-in, and while my translator summons up her English, I find myself pondering old mysteries and contemplating new wonders. The dress of the woman’s co-leader: He is wearing a sport jacket and slacks, neatly pressed, and a tie, secured with a Windsor knot, a professional code of dress that many of the men favor. How much effort, I wonder, does it take to maintain such self-respect amid Gaza’s crushing, demoralizing constraints? And how does he do it with the dearth of dry cleaning facilities and the scarcity of solvents? I am impressed once again by the intelligence, dignity and, yes, elegance of a woman who, except for a tiny slit for her eyes is completely covered. Her assessment of herself this last day is so open, unsparing, witty – “I want to thank all of you,” she begins, “I realize now I have been too rigid, and often wrong, in my judgments; and I have been unnecessarily covering my feelings, not just my body.” I too realize once again – what a grace of these groups – that I have much to learn about my own preconceptions and judgments.
In this session we do drawings similar to the ones we do on the first day of the first training, pictures that often show us how much – sometimes how stunningly, satisfyingly much – we have changed since that opening group. The wires of a cage that contained an irritable, frustrated physician have turned into steps on a ladder which will bring him to a place of peace, among trees in his yard and within himself; a psychologist’s family members scattered across the landscape by misunderstanding in day one’s picture are now gathered in a comforting circle in which they are, like members of the mind-body group she is addressing, “sharing their feelings.”
Our leader has brought us candies wrapped in red foil, to celebrate our time together, and to mark its end. “I Love You” is written across them in silver. Another woman has brought us all pens “to remember this group when you write.” A third has baked a cheesecake, its top speckled with many colored candied glitter, with a single candle. “This is,” she announces, “to celebrate our journey and also,” she adds, “the Prophet Mohammed’s hijra,” his journey from Mecca to Medina in 622, “whose anniversary falls on this day.”
It was in Medina, I remember, that Mohammed created the umma, the spiritual community that is the model for Islamic society. It provides Muslims with the opportunity to gratefully practice the prayers and manifest the precepts and the code of conduct that Mohammed brought to them.
As our leader carefully divides the cake in squares I hear, as clearly as if he were once again standing in front of me, the closing comment of a young psychologist in our previous training nine months before. A tough, pale, earnest, bearded young man, he had spoken with some formality: “I did not know what to expect when I came; these techniques, it seemed to me, were foreign to Gaza. But as I have been here these days I have been so impressed. You and your faculty are so knowledgeable and such good teachers, and I have learned so much about myself as well as psychology. But even more important” – I can hear again his voice lowering, more intimate now – “you have all been so kind to me and all the participants, have made us feel so much at ease. I believe,” – I knew he was getting ready to conclude, but never could have imagined what he would say – “that this is what it must have been like in the time of the Prophet Mohammed.”
Our leader hands us plates, and we eat our cake and savor each other’s company. There is general sadness at “concluding this blessed vacation with ourselves,” as one woman observes, to general agreement. But there are also commitments to “meditate daily” and “shake and dance with my children when we are feeling overwhelmed, or stressed.” Everyone expects to “start mind-body groups for patients on the first of the year.” There are promises all around to be in touch in the months ahead – in the supervision groups that Mohammed and the rest of our faculty will be leading every week throughout Gaza, and less formally too. Phone numbers are exchanged and a paper passed around for email addresses.
And then our leader in her long coat and head scarf reaches over and turns on the CD player and stands and claps, and sways a little, while her young colleague in the sports coat, his collar open and tie now loosened, rises and steps to his right toward Mohammed and the other men, and begins the steps that will take them and me too, our arms on each others’ shoulders, in a small happy circle, around our room.
December 20, 2009
If Gaza is saturated with tradition, and blessed with generous impulses, it is galvanized by politics. Until several years ago, when we developed a high level of skill and firmness in directing our trainees back to their own present feelings, simple declarative statements often threatened to veer off into impassioned political narratives. The Palestinian faculty we have trained now recognizes the hazards, and has become adept at forestalling rhetoric, foreclosing budding arguments, redirecting attention inward, and calling for immediate feelings as well as the historical conditions that may have provoked them. Inevitably, however, politics and the devastating consequences of political decisions are not far from the minds and speech and feelings of Gaza’s men, women and children.
In the small groups we see and hear that the consequences of history are inscribed in our participants’ pain and fears. Remember the hurt that the young psychologists whom I described in the previous blog carry from childhoods shadowed by loss and deprivation and squeezed by self-righteous brutality. And anxiety about present safety and future survival is absolutely, understandably universal: Gaza is closed off from the rest of the world, vulnerable to unpredictable attack from Israelis who control its borders and airspace and to violent schisms and reprisals within. Inevitably there are symptoms: One stocky young male psychologist from a distinguished family of Gazan warriors admits, embarrassed but eager for help, to “panic attacks” when his toddler daughter develops a cold or returns late from a babysitting relative; several other mental health professionals speak of waking abruptly, hearts racing at innocent sounds that evoke body-memories of Israeli shells landing or Fatah and Hamas fighting under their windows.
Six months ago, Gaza, though deeply wounded, seemed far more hopeful. Crumbled buildings – large public and small private ones – punctuated the streets of Gaza City and Rafah; blasted orchards and fields torn by shells tolled a loss of innocence as well as income; memories of the 1400 who died in the fighting in December and January filled the eyes of families we visited and appeared, often briefly, modestly, but with head-shaking sadness, in conversation. Still, there was a sense that things might, even that they likely would, finally change for the better.
One of Hamas’ top officials, Deputy Foreign Minister Ahmed Yousef, spoke of the renewed faith in American idealism that Barack Obama’s election and his speech in Cairo had inspired in him and others; of his hope for reconciliation between Fatah and Hamas; and of a future in which a regional partnership “of the world’s three great monotheistic religions” would bring peace, tourism and industry to Gaza and the West Bank as well as Israel. “Soon, inshallah, (god willing)” our Gaza faculty estimated, “we will be able to go with you to Israel, the West Bank, maybe even America.”
The current “situation” – the word is an all-purpose one that Israelis as well as Palestinians regularly use – seems by contrast dispiriting, even desperate, to the Gazans I meet outside of as well as in our training. Now Ahmed Yousef reminds me that “we have not fired on Israel for a year,” and asks, sadly, rhetorically, “and what has been our reward?” Young people wonder whether a world that will not open Gaza’s borders to trade that is necessary for rebuilding or to the free passage that will overcome their punishing isolation, understands or cares about or even notices their plight. Several speak, with resignation but chilling firmness, of the inevitability, in the absence of progress, of resuming “resistance”:
I do not feel that the vast majority of Gazans whom I meet – and I have worked closely with several hundred and met many hundreds more over the last seven years – want to return to fighting; it is that they do not know what else to do, how else to lift the crushing weight of the occupation, to signal, amid what appears to them colossal indifference, if not hostility, that they are “human,” and deserve the basic rights that the rest of us assume. “Don’t the Israelis understand we are just like them” one young woman, a well educated “political independent” asks me. “I have parents and children I love. I want to help my people. Yes, I hate what the Israeli government has done to us, but I do not hate Israelis.”
There are to be sure fanatics in Gaza, people chained to an unchanging allegiance to past wounds, committed to a holy war that will wipe Israel from the landscape. They are, however, very few among the very many I have met. Hamas has been a resistance movement and has committed terrorist acts, as, I would add, have other movements in this region. However, many of its leaders and many of the young who have been drawn to it now aspire, in spite of their current distress, frustration, and discouragement, to becoming partners in leading a state, productive members of a tolerant regional and world community. A burly young man, a high ranking government functionary who speaks with resignation about the possibility of resuming resistance, sounds a few moments later exactly like an American graduate student. He is particularly glad to talk with me, he says, because he wants my advice on framing a topic for the PhD thesis he hopes to write.
The day before our training ends, I speak, at Ahmed Yousef’s invitation, at The House of Wisdom, an independent Swiss funded Gaza City “think tank” that he helped found. “Everyone has to speak English here,” he tells me. “We want to be part of the world community.” Thirty earnest young intellectuals – political scientists, environmentalists, government officials – gather on short notice: Some are affiliated with Hamas, others with Fatah; many are unaffiliated with any political party.
I sit at the intersection of long polished seminar tables – it could be Georgetown or Harvard- and talk about the work we are doing in Gaza, the research that demonstrates its efficacy in reducing stress, improving mood, and enhancing hope for the future. I discuss the resilience of the people and the community that supports them; the central role of self-care and mutual help in all health and mental health care; the necessity of knowing and caring for and changing oneself as a prelude to helping others do the same; the dangers of fixed ideological positions that force people to deny or suppress their true and changing needs; and the importance of meaning and purpose in sustaining all of us. There are nods of heads and some smiles. The questions and comments are thoughtful, balancing appreciation for and curiosity about our work – “Yes, I and others in politics could use that,” remarks one man – with reminders of the challenges to safety and survival as well as sanity that continue to confront all Gazans.
As the seminar draws to a close, the House of Wisdom executive director Mahmoud El Madhour, a wavy haired, urbane PhD engineer and MBA who has studied Greek philosophy in Greece, and is a proud independent, thanks me. He ends the afternoon with a few words of reflection: “Without communication,” he begins in easy but urgent English, “we have nothing.” He pauses for a moment. “We stand here in Gaza, with no other place to go. This is my resistance. Gaza is a lovely place. And I want you to know I do not mind sharing it.”
Gaza City, December 16, 2009
As the days pass, our participants discover and discuss new possibilities of psychophysiological self-regulation – breathing deeply to relax in spite of the anxious anticipation of leading a group for the first time, or to find a calm place from which to encounter memories of family members “martyred” by violence. They find in the creative imagination of guided imagery unexpected ease: “When I go to my imaginary ‘safe place’ I discover it is my home – I would not have believed it because we are close to the border and have often been shelled – and I thank God for my family and for seeing the green of the trees every day.”
Sitting in the circles of our small groups we move more deeply into each others’ minds and hearts. Experiences and feelings that are rarely if ever publicly revealed in tradition-saturated Gaza are shared; long suppressed emotions and conflicts emerge.
We hear about the ways that the frustrations of men, deprived in the Nakba – the “catastrophic” loss of homes and villages of 1948 – of their patrimony, unable to maintain their self-respect without jobs or freedom, have manifested in the self-righteous abuse of women and children. Her late arrival after difficulty navigating the streets during a Hamas demonstration reminds one young psychologist – gentle, always smiling, pale in her long black coat – of her father’s fury at an elder brother when one evening years ago he came home late: The old man burned the boy’s arm with a stick glowing with red heat, and turned the instrument on his wife when she pleaded for mercy. The girl watched. A university professor cries with shock and pain for her young colleague, and recalls her own father’s contrasting kindness. Then it is the turn of a large young man, a gentle giant I think, who is also a psychologist. “I have not spoken of this before,” he begins. When he and his brother were six and five, their father forced them, out of, the psychologist now believes, some warped idea of discipline and manliness, to walk 10 kilometers to school each morning before dawn; the young man remembers, his face softening in hurt, his hands opening in incomprehension, how furious his father became when one day, attacked by dogs, the boys ran home. The participant who is leading the group today suggests we stand and hold hands. He asks us, so wisely I think, to “Feel the support of the group,” The pale young woman, quietly tearful, nods with relief and release; the young man thanks us – “Shukran” – and tells us he has vowed always to understand and be kind to his own children.
The ways of Gaza are ancient, sometimes painfully problematic, but also rich and in many ways still sustaining. The closeness to families that can under pressure constrict can also hold up people who should by all ordinary reckoning have collapsed. Mothers, fathers and especially grandparents appear in another imagery exercise – the summoning of a “wise” or “inner guide” with a frequency I have seen nowhere in the Western world. “My grandmother was strong and kind” one young woman announces, emphasizing the conjunction. “she was always there for me.” Another says his long dead, imagined grandfather counseled him not to throw stones at Israeli tanks; “It is a waste, he says to me. True courage will be in caring for your children and your wife.” When a young psychologist – unusually lithe and natty, a “dead ringer” I am told for a Turkish movie star – tells me I remind him of his grandfather. I’m at first taken aback, ready to protest – “I’m much too young,” I think. When I look again and see the sweetness of his face, the tears in his eyes, I am aware of the foolishness of my reaction, and accept the honor he is giving me.
Each day the nature that remains free from overcrowding, the destruction of artillery shells and fear of Israeli patrols appears, vital and hopeful, in mental imagery, check-ins and reminiscences. In the drawings participants make of “how I want to be” and “how I will achieve it,” there are palm trees with ladders- steps to a more hopeful future- leading upward; small patches of green issue gracious invitations; many colored flowers represent “all the brightness of experience;” birds of free thought and feeling fly at the top of pages; the sun warms tired heads and softens hunched, burdened shoulders. Often the sea that borders Gaza appears, deep and ever present, calming troubled minds.
Here’s another video update of our 2009 Gaza Advanced Training Program (ATP)! You’ll see another technique we use, chaotic breathing, a form of very “active meditation” illustrated at minute :37. You’ll also see the introduction to the “fishbowl,” in which we demonstrate to the trainees the small group model, at 1:24. (Small mind-body skills groups meet privately, so this demonstration during training is the best way we’ve found to show the health and mental health professionals attending how to lead their own groups.)
Here’s the video I promised from Day 3 of the training. I think it gives you a good feel for what life in Gaza and our training is all about.
You’ll see the training participants practicing the “shaking and dancing” technique at minute :50–and then check out all the smiles.