A Long Way to Go
The next day, before we leave, we spend time at the Foyer des Orphelins d’Haiti, an orphanage not far from the airport. The cramped gray-walled quarters, beds without mattresses, and, especially, the kids’ desperate need for attention and touch and anything else we might give, bring us all to tears or to that state in which we knew if we would but let them, they would come. There are 70 kids who live in the orphanage and 100 more who go to school there each day. Already, the principal tells us, 60% of the older kids who have participated in our groups, are calmer, more focused. We will, over the next few months, have 10-week-long small groups for all 170, and do whatever we can to help the orphanage’s caring, committed, and overwhelmed staff provide enough food and guidance so that these kids will have the best possible chance at life.
Now…and Then
In Port-au-Prince the next day, Kathleen and Catherine have the opportunity to see the small groups—with kids, teenagers, and adults—in action, to hear which technique has been most helpful to each person, to feel the closeness that develops over the weeks of regular meetings.
On to Jacmel
Jacmel, a seaside town famous for its crafts, is a three hour drive south across the mountains. At the side of the road are chickens, donkeys and the occasional stray dog, behind them banks of vegetables in stalls; overhead, blue, purple, pink, and orange flowers, and, beyond, ranks of mountains marching off toward the horizon.
Visiting Notre Dame de la Guadeloupe
Before we leave for the countryside we visit classrooms at Notre Dame de la Guadeloupe where our Haitian team is currently leading workshops. After workshops, which take place in classrooms, have been offered to all 700 students, we’ll begin 10-week-long small mind-body groups for all the kids, and the teachers and administrators as well.
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Letters The New York Times Chose Not to Print: Occasional Postings
Like many people I know, I’ve long been in continual dialogue with The New York Times, my breakfast companion for over 60 years. Often I’ve nodded my head with appreciation when The Times reporters have brought back news from far away or previously ignored places, or its columnists have set out a position with which I agreed or one I was groping toward. Sometimes I’ve been stumped, particularly by the arcana of financial reporting. And on occasion—coverage of the run-up to the war in Iraq comes to mind—I’ve found myself shouting at the folded paper, even shaking my fist.
I’ve written for The Times occasionally, over more than 40 years, mostly for The Book Review but also for the Science section. The Times has also written about me and my work, mostly quite favorably. And I’ve also written letters. A couple have been published, and a number of them have been rejected. Or is “ignored” the better word?
Perhaps it’s vanity or the infirmity that comes with age—or maybe it’s just experience and conviction—that makes me feel I have something to say that others should attend to. In any case, I decided that I’m going to share with you what doesn’t appear in The Times to let opinions and words that may have seemed peripheral, tendentious, or perhaps too challenging to The Times staff, find a more welcoming home.
What I’m going to do is publish the letter I wrote here with a link to the original article and another to the letters The Times did choose to publish. I hope you’ll find this experiment interesting and that it will also inspire you to let your own voices be heard. In any case, please let me know what you think.
This first posting, below, concerns a column by Nicholas Kristof “A Veteran’s Death, The Nation’s Shame,” which I admired, which appeared on April 15th, together with the letters that were in the paper today, April 20th.
Preventing Military Suicide with Self-Care
James S. Gordon, M.D.
In his poignant piece on escalating post-deployment military suicides (NYT, April 15), Nicholas Kristof writes that “we refurbish tanks after time in combat, but don’t much help men and women exorcise the demons of war.”
There are in fact programs that do address these demons successfully and in ways that are stigma free and widely acceptable to the military and their families. Unfortunately they are not yet widely available.
These programs are based on the understanding that persistent stress and trauma may come to all who are in combat; and that practical self-care skills like meditation, guided imagery and movement can provide prospective on and address the agitation and aggression, the overwhelming memories, isolation, despair, and suicidal feelings—the symptoms of post traumatic stress disorder (PTSD)—that may come in its wake.
At The Center for Mind-Body Medicine we have used this approach to reduce symptoms of war-related PTSD by 80%-in Kosovo and Gaza. The 300 US military and VA clinicians whom we have trained and the active duty, veterans, and family members with whom they work, appreciate the stress-reducing, mood enhancing practicality of our “mind-body” program. They embrace the opportunity to express themselves without fear of censure, or career foreclosure, in small groups whose support is reminiscent of combat units.
We are currently undertaking a Department of Defense funded randomized controlled trial of this method with war-traumatized US vets. Others are doing similar studies with similar approaches. Our preliminary results are promising, but research is slow and the time for many vets, like Ryan and Michael, is short. The Defense Department and the VA need to move ahead swiftly to offer this program and others to the hundreds of thousands who can make good, perhaps life-saving use of them.
“A Veteran’s Death, The Nation’s Shame”
“Letters to the Editor, April 20th, 2012″
James S. Gordon MD, a psychiatrist, is the author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression and the Founder, Director of the Center for Mind-Body Medicine in Washington, DC, and Dean of the College of Mind-Body Medicine with Saybrook University.
Day Five: Images of Our Time Together
So much happens to all of us in the Jacmel training as we go deeper, become more aware, take chances, and connect over five days.
Our faculty faces fears of not performing well, of not sleeping at night, and of missing what is muffled in translation. We take the chance of feeling our uncertainty of daily supervision and are gratified that our colleagues have at least as much compassion for us as we feel for those we are helping.
The interns are stars, setting examples of emotional risk taking and taking care of business: filling in where the translator is a bit off, pointing out what faculty may have missed, and making sure, as if they have invited all of us into their own homes, that we are well cared for in lines at lunch, during the lectures, and at the beginning and end of each day.
I see the participants grow more receptive each day, feel them more engaged with every exercise we do. Men and women who have never heard of, let alone participated in, psychotherapy are exquisitely sensitive to each others’ complex feelings and thoughts, and us. Often without words, old and young, farmers as well as physicians, create a climate of acceptance in which everyone–and I really do mean everyone–seems to feel safe.
The suspicion and rancor among religious groups–Catholics, Protestants, Vodoun Healers—is palpable in the early days. Though the saying has it that Haiti is 80% Christian and 100% Vodoun, some of the Christians seem quite fearful. “Who are these Vodoun people?” They ask with uneasily politeness. By the last day, after having sat in the same small groups, most of them seem at ease. “We are just people” says Clement, who heads the Jacmel Vodoun Healers Association. “I feel like these people are my family,” and the nuns in their habits and scripture-quoting-Protestants nod their heads.
Nature is so important. In drawing after drawing on the final day, the restoration of hope is symbolized by new trees, green and blue where there was, on the first day, only brown.
If it is possible, community is even more important. The final day’s drawings of the goal each participant would hope to reach are crowded with family, friends, and neighbors. When the groups come to the front of the grande salle to receive their certificates of completion, they sing songs to their leader and intern, and to themselves, and they call themselves “family”.
Already on the first evening many of the participants are sharing what they’ve learned with children, spouses, and parents. On the fifth and last day, they are, without being asked, pledging to take “CMBM,” this work, to their schools, churches, clinics, and to everyone in their communities. Linda has to slow them down a bit. “Sharing with your friends and family is good, but you need to practice much more. You are just learning. When we have the Advanced Training in November we will teach you how to lead groups.”
James S. Gordon MD, a psychiatrist, is the author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression and the Founder, Director of the Center for Mind-Body Medicine in Washington, DC, and Dean of the College of Mind-Body Medicine with Saybrook University.
Amazing Graces: Days Two, Three and Four
The Missing Twin: Part Two
For two years whenever the teacher closes her eyes to sleep or rest she sees “only all darkness.” After a while of doing Soft Belly, it changes. By the second day she is “seeing colors” and pronounces herself “very satisfied.” That first night she returned home and, just as we had done in the training, she shook and danced with her surviving son. The next night, after we had used imagery, she tells him to “close your eyes and say what you see.” “A house and a sailboat,” he tells her. She is amazed. This is exactly what she had drawn in the picture of how she would be without her biggest problem. On the third day she tells her group, “My smile is back.” She brings her son to a party and we kid around and dance a bit. Her smile lights up the restaurant.
Then, on the fourth day, when I give my talk on Trauma and Transformation she finds herself, like so many others, remembering and crying. “I am afraid the crying will never stop,” she confides. That she will never again locate the smile which has so remarkably reappeared. Toni tells her that smiles and sorrows can live alongside one another in the same person, that she felt that way when she did our training after Katrina destroyed so much in her own state. She and I and our whole team have seen it in Kosovo, Israel, and Gaza, and indeed everywhere we’ve gone.
When people are frozen in shock and grief all the emotions are deadened. As our work unfolds, they recover what they have lost. Years ago, I remember teenage Kosovan girls in a refugee camp in Macedonia. When they shook and danced the tears they had held back finally came, tears for the loss of fathers and brothers dead, imprisoned, or fighting. Only after they cried could they laugh with the ordinary joy of girls.
On the fourth night, the teacher returns. She is going to partage, to share, everything she is learning with her husband.
James S. Gordon MD, a psychiatrist, is the author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression and the Founder, Director of the Center for Mind-Body Medicine in Washington, DC, and Dean of the College of Mind-Body Medicine with Saybrook University.
Amazing Graces: Days Two, Three, and Four
The Missing Twin: Part One
The loss of life here in Jacmel is far less than in Port-au-Prince but the burden is still heavy. There are of course the ordinary deaths that come with age, and the losses of younger people cut down by accident, sudden illness, or murder. And in the background for everyone in this coastal city, and all the surrounding communities, as well as in Port-au-Prince, is the tide of losses that came with the January 2010 earthquake. The deaths of children seem the hardest to bear.
Toni, a clinical social worker from Baton Rouge, tells me about a woman in her group–a school teacher. Her six-year-old twin sons were buried under the rubble with their father. He struggled to carry both out, but one fell under a collapsing ceiling. The father suffered a serious head injury as he carried the first boy to safety. Still, he returned to dig frantically for the fallen twin, but to no avail. By the time he reached him, his second son was no longer moving or breathing. Two years later the family is still frozen in grief. The surviving twin is furious. “Why are you alive?” he shouts, when family tension rises, at his father. “And why is my brother not? He should be alive, and you dead.” Toni and I both suspect that the boy feels guilty that he could as easily be angry at himself.
After her son died, his mother “lost my smile. When I smile now,” she goes on, “it feels”–and here she grimaces, all teeth–“like this.”
James S. Gordon MD, a psychiatrist, is the author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression and the Founder, Director of the Center for Mind-Body Medicine in Washington, DC, and Dean of the College of Mind-Body Medicine with Saybrook University.
Who Will Lead Haiti's Mental Health Recovery?
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.
From left: 4th row: Lee-Ann Gallarano, Spencer Aimable; 3rd row: Caroline D. Coicou, Lynda Richtsmeier Cyr; 2nd row:Junie Delmont Fortuné, Linda Delmont Métayer, Amy Shinal, Anne-Kary Perrault, René Domersant; 1st row: Fornia Cenezir, Clairetida Cassamajor, Jim Gordon, Jesse Harding, Marie Ange Octena
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.”
