CMBM Training, Days 2-3, continued
During the training, we do a drawings exercise, a sequence of three pages: one of “one’s self,” “one’s biggest problem” and “the solution to the problem”- and they are as always a revelation. They display what is inside each person and the images of one participant so often are a mirror for those of others.
The biggest problem of one physician here is shown as a clot of black guilt and fear and shame, of inhibited action and feeling buried under a mountain. She is straining for faith, toward a distant Jesus, and to do what must be done. But she feels unable to move or believe. In the third drawing all the conflicted colors of the mountain are striped in an arc du ciel, a rainbow. “ I was buried,” she says, “and now in this drawing I can see myself free, imagine myself again with my God.” (To learn more about our drawing exercises, read this post, “CMBM’s Drawing Exercise Resonates in Haiti,” when we introduced it in June.)
“I have in my drawings,” says Linda, the psychologist who coordinates our Haiti program, “dropped the mask of sunny happiness that I felt I had to put on. I have allowed myself to feel the loss of my father last week. And dancing and crying,” she adds, pointing to her third drawing, “I have found the authentic happiness inside myself.”
Checking in emotionally on the second day, my group members find their own choked-off voices- amazing how many cough and clear their throats and say they have forgotten how to say how they feel. They speak and are heard, listened, and they recognize that they are actually here with others who care and not alone. A nun and teacher who at first had felt so lonely as the only religious (woman) in the group realizes that she is not alone at all, “My images of pain and sadness are so similar to those of others. Showing you my drawings, telling you about them, I feel you are my sisters, and my brothers too.”
After the first day our participants are already using what they have learned. Several speak of “traffic meditation,” pulling over to the curb amidst Port-au-Prince’s daily madness, soft belly breathing (click here for a short guided meditation) until they are “calme” and “douce,” peaceful, soft and amazingly unhurried. A psychologist at odds with her teenage son reports asking him to breathe deeply with her and dissolving the tension that had led to fights, “…every night since the earthquake.” Several say that deep breathing and shaking and dancing had allowed them to sleep peacefully for the first time ever since January 12th.
Here is a short video of Linda Metayer, our Haiti Clinical/Program Director, describing what she feels Haitian trainees are gaining here:
(video by Mark Silverberg for CMBM)
The Training Begins– Day Two & Three
Tears are everywhere. Like high water behind a dam, you can see them swelling, pressing for release in the stiff bodies and taut faces of men and women who gather for the first day of our training.
We’ve selected 120 clinicians, educators and religious leaders. About that many crowd the registration desk and fill the chairs in our lecture hall. But they aren’t exactly the 120 that we invited.
This is the beginning of our Haiti training, but before I tell you about these new colleagues of ours and about what we are learning together, I have to jump to Wednesday morning—Day Four– and to the hours last night, after the election results were in. Demonstrators filled the streets outside our hotel in front of the Champs De Mars, angry thousands protesting results which certified President Preval’s son-in-law in-waiting, Jude Celestin, as a participant in a run-off election. Last night our team heard the pop of gunshots as a counterpoint to the rhythm of music from the hotel band. This morning, smoke from fires fills the air as demonstrators march toward, and, we are told, destroy Celestin’s headquarters.
Everyone we meet believes Mrs. Mirlande Manigat was indeed the legitimate top vote getter, and they are convinced that another candidate, Michel “Sweet Mickey” Martelly, the pop singer, had more votes than Celestin and if he didn’t, someone else certainly did.
The election results seem to the Haitians only the most recent insult, the latest dismissal of their sovereignty, indeed of their humanity- -once again the big man appoints his successor. All the frustration of all of their months since the earthquake and all the years before, all the pain we’ve seen in the tent dwellers on the Champ de Mars and in the faces of the men and women we are training is erupting- moving this afternoon uphill towards Celestin’s headquarters, and the homes of the rich and powerful.
On this day of anger and danger, only half a dozen of our participants have made their way through large, angry, often armed mobs and small fires. The rest however, have been on the phone, “Tomorrow?” “Don’t do too much today; we don’t want to miss anything.” “Can your international team stay another day?”
Back to the Beginning-Training, Day 2
On Day Two some of our invited participants were kept away by the urgent demands of cholera care, and by fears of the demonstrations that had not yet occurred. But others arrived from the Ministry of Health, the universities, the schools and churches to take their place. By the second day these eager volunteers and the original invitees were joined by the latecomers and by some who have somehow heard stories about unexpected relaxation and education, welcome, and safety. At lunch we feed 145.
The small groups which are central to this adventure in self discovery and self-care- so supportive and inviting for men and women who have held back personal feeling in favor of continual service to others- have swollen in size.
12 or 14 men and women sit in circles meditating, breathing in through their nose and out through their mouth, allowing their bellies to relax, expand, become soft. After they open their eyes they share who they are, what they do, and why they took five days from over burdened schedules to be with us. They speak in turn about the first morning’s large group lectures and “experiential exercises.”
“After the shaking and dancing,” an anesthesiologist begins, “I felt freer. There are not many people in my profession and after the earthquake we did amputations all the time. It was painful. I lost my spontaneity. I think we all have. It was good to dance.” (Read more about the shaking and dancing we used in Haitian schools here)
As we go around the circle the possibility of sitting peacefully, of relaxing at the end of the day, rises on horizons dimmed by almost unimaginable loss, “I have tried,” another physician says, “to bury myself in work so that I do not think of all of those who have died and are buried in the ground.”
“Or are still buried under piles of concrete,” another adds with grim precision.
To be continued tomorrow–check back to learn about how CMBM’s healing drawing exercises and what the participants appreciate about the training.
CMBM Training in Port-au-Prince
Our team has been gathering for the last two days, long flights and sometimes long delays as well.
Jamil Atti is in from Gaza, Afrim Blyta and Jusuf Ulaj from Kosovo, and Naftali Halberstadt from Jerusalem- psychiatrists and psychologists who have lived through war and terrorism themselves, leaders of our program in their country, friends and brothers. From the US, Amy Shinal (our Clinical Director) Lynda Richtsmeier Cyr, Kathy Farah, Lora Matz and Jerrol Kimmel, physicians and psychotherapists–long time friends of 10 to 15 years, talented, adventurous, deeply committed to this international work.
Linda Metayer is our Haitian Program Coordinator, a psychologist with a degree in public health, as brave and courteous as she is smart and competent. Lee-Ann Gallarano, who organizes all of our work with trauma around the world, was working with Linda before we arrived with Jesse Harding, our newest staff member, who several years before worked with Lee-Ann when they were Peace Corps Volunteers in Mali. Tod and “B”, gifted documentarians, are filming us, and Mark, who has volunteered his time, is taking most of the still photos you’ll see on this blog.
We spend this first day “checking-in”, hugging, laughing, sometimes crying, as we tell the stories of our first meetings, recalling the power of soft belly breathing to help us relax in the middle of fire fights, of Afrim informing us in Gaza City that the 3AM earth shaking noises were in fact sonic booms. And everyone is speaking of the realization, growing over the years that, “You are my people,” “This is the work I want to do,” “I am at home.”
In the early evening Linda, Amy, Jesse and I walk with our camera crews into the sprawling tent camp across from our hotel- 10,000 people in the Champs de Mars. We had been told that “from the outside things look better.” There were fewer tents, less crowding. Up close the opposite turns out to be true- some people have indeed left, clearing out in terror of cholera, but everyone doubts they have found places much better. Meanwhile, moving from one clump of canvas, plywood, plastic and corrugated metal– one collection of shelters to another — we hear similar disturbing, dispirited stories: there is actually less food and water than there was four months ago and far more violence. Women, and muscular men as well, tell us that if and when they are able to sleep, it is with one eye open, alert to robbers who are often armed, and to rapists. The jobs cleaning rubble that once helped sustain these encampments have moved on, though no one knows exactly where.
Though some people are shy and wary, virtually everyone is gracious and within a few moments, eager to talk to us. Mothers tell us that so many of the children are “hyper” since the earthquake. We see them shuffling from foot to foot, eyes shifting with their bodies. The mothers say they have lost weight. When I ask about emotional problems everyone- men, women, teenagers- says they are angry. “What do you do?” I say. “I pray to God,” several say. “I take this medicine,” says a man raising a small bottle of homebrew. A woman says, troubled, but resigned, “I beat my children.” Several others nod.
As we move from one section of the camp to the other, two teenagers run past and jostle Linda. A moment later we see that her necklace is gone. She is a bit shaken, but philosophical, “They do it to eat,” she says. Other camps are likely to be somewhat better, but some are not and there are 10,000 people here. Walking back to our hotel I feel the weight of life here in Haiti, people stretched and pushed beyond breaking. I think of how much our work is needed, and I feel frustration along with everyone else. “Where is the organization?” I ask rhetorically, “The benefits of all the money the international community has committed?”
Exciting news–I’ll be speaking on NPR’s Talk of the Nation today, Thursday Oct. 28, about the best ways to rebuild Haiti, sustainably and permanently, in the wake of the earthquake and continuing hardships the Haitian people face.
I’ll talk about what has worked for CMBM in the past when creating sustainable programs of mental health care in post-war and post-disaster areas like Gaza, Kosovo, and New Orleans, and what we have planned for Haiti. (Our first Professional Training Program in Port-au-Prince is scheduled for early December.)
If you’d like to listen to the show live, check your local NPR listings here (If you’re in the DC area, it’s on WAMU 88.5, 2-4pm EST, and the segment will probably air between 3-3:45pm EST).
If you can’t catch it live, check back at the Talk of the Nation website, and it should be available for listening or download later today. I hope you can tune in.
A big thank you to all the donors who are making this program possible (and there’s still time to donate), and all my best to all of you.
Already at 9am, the air is hot and heavy in the workshop tent. Fifty or sixty people are present, most of them quite young, taking notes, wonderfully attentive and responsive. They are a bit shy at first, but as we all introduce ourselves, they offer stories of trembling bodies, panicked hearts, of sights beyond endurance—watching family members crushed under falling concrete.
We teach them slow breathing to quiet the mind and body and relieve stress. They participate with eagerness and enthusiasm. Afterwards they clamor eager to “partager,” to share: “A feeling of calm for the first time since January 12th;” “a letting go in the shoulders;” “this is the first time also,” one adds, “that we’ve had an opportunity to learn about our own psychology, to share our feelings, to look at what stress causes in the body and to feel relief from it.”
After a mid-morning break, 30 or 40 more people join. “We have spread the word,” one of the young men says with a grin. After we do drawings (of “yourself,” “your greatest problem,” and “the solution to that problem”), the HRC staff and volunteers share them in animated groups of three. “There is hope here,” say several, of their third drawings.
They are filled with sunlight after darkness of the second drawing; with music—drums and guitar—and dance and movement, after “the biggest problem” of buried and walled off emotions, broken bodies and silence: “It gives me direction,” says one young woman, and others agree. Several stand to show their drawings to the whole group; many more want to.
Then we push back the chairs and stand together, shaking our bodies and releasing tension. When the music changes, the young people sing together, clapping their hands. Afterwards, no one seems to want to leave. Little groups form around each of our faculty and staff.
Twenty-five or thirty of the Red Cross volunteers and staff write notes of appreciation. Most are translated from Creole and French by our interpreters, and a couple are in English. Here, in English, are a few:
“Today I have found the means to comfort myself when I have a problem, to change my way of thinking and looking at things in other people and in myself.” Jeanty
“I feel so good. If everywhere they could have someone learn these exercises and teach them in their neighborhood, everything would be okay for everybody, and accept life as it is. Thank you so much to teach us. May God bless you and protect you.” Myrka
Many of the young people say spontaneously that the experience, has, in the words of one, “taught me how to face the dangers that present themselves to me instead of flying from them.” Another adds, “I’m very happy with the information that I learned today. Now I know how to confront my fears. I would like to be a part of another one of your workshops. Thanks a lot. I’ll never forget you. We needed it.”
“I’m Elder,” writes a third, “I’d like to say I’m very happy and I say to you a big thanks to you for that. You’ve made me a messenger to a lot of people in the world. Thank you so much for your encouragement and the hope of living you bring to me. I love you very much.”
Many, many of the HRC volunteers and staff tell us how much they appreciated the copies of the exercises that we gave them, as well as the workshop, and that they plan to share what they have learned with others. But still, “we want to learn more.” A number invite us to come to visit with them, to bring “workshops of healing” to family members and friends in schools, tent camps, and churches in Port-Au-Prince and beyond.
These idealistic, committed, bright young people (some Red Cross staff, most volunteering), are such an important resource for Haiti’s future. They have a tremendous appetite for learning about themselves and the world, and for helping others. I would very much like to do a full professional training for them.
We move during the rest of our week in Haiti from one group of health professionals and community leaders to another. It is a slow progress through the traffic jams in Port-Au-Prince’s rubble-narrowed streets, and sometimes even slower over the gorged-out, flooded dirt roads that take us to Bishop Pierre Andre Dumas’ diocese in Anse-a-Veau, three hours outside the city.
We use a variety of techniques in our workshops, including explanation of the fight-or-flight and stress responses, meditations, guided imagery, and shaking and dancing. We also 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, sketching solutions to problems that seemed insoluble.
In Haiti, we guide our groups through three drawings. The first picture is of “yourself,” the second, “you and your greatest problem,” and the third calls for “the solution to that problem.” (We modify the exercise when we use it with children: read my post about using the drawing exercise with Haitian children in the General Hospital.) Afterwards, participants share their drawings in groups of two or three, telling what they see in what they’ve created and how it makes them feel. Then they have the opportunity to share with the entire group.
As you will see, the results are often touching, and almost always surprising.
Here are a few examples and snapshots of the workshops in which they are created:
For L’Institut Haïtien pour la Doctrine Sociale Chrétienne (Haitian Institute for the Christian Social Doctrine)
Such wonderful, accomplished people: 100 of them—physicians, architects, lawyers, police officials, business men and women. All, in this time of crisis, are renewing their commitment to the welfare of those who have suffered even more than they have. They tell us about the terrible sadness—their own, and others—and about unaccustomed irritation that surfaces at home and at work, as if, somehow, angry will could restore what has been lost.
An obstetrician/gynecologist, tall, broad-shouldered, powerful and handsome in a bright, tailored shirt, has come “for rest and peace—I have not slept since January 12th.” He says he works “always” to forget the loss of his house, the deaths in his family—his sister, nieces, nephews—as well as to care for his patients. In his second drawing (a picture of his biggest problem), he is inside a tunnel, tiny as an ant, lost, unable to touch the equally tiny figures outside. In the third (a picture of his problem’s solution), the figures are larger, recognizably human. They are dancing together and he is laughing, “for the first time since the quake.”
For Anse-a-Veau diocese—nuns, priest, lay brothers
Out in the countryside a couple days later, we are meeting with priests, nuns, and lay brothers in Bishop Dumas’ diocese. It’s like rural Africa out here: lush, green and very still, faded pastel cottages with tiny yards in which seeds, sown or thrown, produce a few vegetables and fruits. We begin and end our visit with Bishop Dumas’ blessing and simple ceremonial meals: tiny, boned, tender white fish, rice, beans, greens, fresh lemonade and thick coffee.
The religious, in straight-backed chairs, are as still and elegant as the statues in the porticos of Chartres. They are so attentive, so sweet tempered amidst the flood of suffering, homeless, city people that the earthquake has forced back to the countryside. One priest draws a scene of despair—“The Cross of Death—Good Friday without Easter Sunday,”—and then, in his third picture, much to his amazement, produces a sun that covers the page with radiant yellow. “It’s the sun of freedom. Together we can overcome.”
They dance, too—nuns, brothers, and priests together—as freely and as happily as children. Before we finish in mid-afternoon, another, older priest calls the Bishop from the next diocese. It turns out he would like us to come there.
More soon about another workshop, this time with the Haitian Red Cross staff and volunteers . . .
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 of dead bodies, the horror of loss and the ambush of fearful anticipation. Knowing—feeling—that they can breathe deeply and relax, they will have a small but important sense of control in world where so much—whether or not they can concentrate or sleep, where they live and how they will make a living—is, or feels, beyond their power to affect.
You can experience a relaxing guided Soft Belly meditation here, at The Center for Mind-Body Medicine’s website.
2. Later we do some shaking and dancing so they can let go of fixed patterns of physical tension and mental preoccupation; can feel their bodies moving freely; can raise their energy, lift their mood, and lower their anxiety. They clap and laugh and shout and afterwards, flop happily onto their hard seats.
3. We also explain the value of sharing here in the classroom, at home, or with a friend, the pain they feel and the fears and concerns that arise.
Many of the kids would like us to do more, to tell them where they can go to practice the techniques and talk to others. For now, I say, “you have each other and your families. We are giving you these techniques, written in French. Practice them at home and we will come back to your school. Soon we will be training many people, including some of your teachers, to do this with you.”
The story of how CMBM’s model helped Andre, a Haitian boy, overcome feelings of grief and guilt, coming soon . . .
The school is the College Canado Haitien, one of the best in Port-Au-Prince, we are told, before the earthquake and afterwards, too. The students, a few weeks after the school has reopened, are sharp in well-pressed maroon and khaki uniforms—the girls’ hair pulled through berets, the boys sideburns neatly trimmed, tout propre, I think.
Instead of the pre-earthquake concrete buildings, there are open sided wood and metal sheds. Sounds flow from one classroom to another, overlapping in a kind of reverberating clamor. Toward the end of one of our classes, when time of dancing is kept by nimble palms on desktops, the whole campus rocks.
Our equipe, our “team,” –the French is beginning to emerge from deep layers of my unconscious—includes six of us: Lee-Ann juggling logistics as before, with Cassidy, my assistant back home, here to help her and me; Amy, the social worker who is our clinical director, will come tomorrow. Today, Lynda and Kathy, psychologist and family physician, are with me. They are CMBM senior faculty who are adventurous enough to come and to commit to coming again and again. They and Amy will teach our Haitian colleagues and provide consulting and supervision as we build our program.
Today we have been invited by Frere Jacques Anthony Germeil, the principal, to College Canado Haitien. We will have an hour in each of four classrooms with eleventh and twelfth graders who have been told they will learn “lessons in dealing with stress.”
I lead the first class and the third, forty twelfth graders in each, sitting shoulder to shoulder at their desks. Lynda and Kathy, experienced with kids, but new to Haiti and to the trauma and loss that overwhelms the population, will lead the second and fourth classes.
We begin our classes lightly—a little goofily—“How do you breathe?”, I ask to general puzzlement, and then talk about babies doing it easily—naturally—their bellies rising and falling, while adults, and even high school students, cramped in chairs and on benches, barely move their chests. Laurent, my interpreter, and I act out the roles of cats in full fight or flight mode—hissing and growling at each other, and then stepping back to breathe easily. Lynda has her all-boys class—a surprise—consider Kobe Bryant, cool and relaxed, imagining his shots, inspiring the boys to imagine theirs swishing the net.
When we turn the topic to relaxation’s antipode, stress, the bravado of a few—“I’m fine, we’re all fine,” claims one boy; “it was simply a natural disaster” intones another—contends with the more complex memories of their classmates.
Soon, in each and every class, there is a rush of sharing of what happened on January 12th, of how surprise and relief yielded to horror. “I thought the shaking would be eternal. Then, it stopped, and I thought, ‘that’s not so bad, I am ok,’ and I laughed, then I saw my sister covered in dust like a ghost, and I was afraid. And then, underneath my neighbor’s house, there were twisted bodies.”
And the stories come—many, we learn, shared for the first time—and the classmates’ losses pile up: a mother gone, an older brother, “my best friend,” “almost my whole family,” We hear of bodies discovered under rubble and strewn on sidewalk, of dogs chewing on corpses.
When we ask if there are questions, a small forest of hands rises: “How do you go to sleep when these memories keep coming in nightmares?” “How can you breathe deeply to relax when the air is so bad?” “How do you deal with family members who now are arguing all the time?” “What do you do with your belief that another earthquake is coming, or as some say, ‘a tsunami’?”
More about the techniques we use to address these questions coming soon . . . .