The Center for Mind-Body Medicine

CMBM's Drawing Exercise Resonates in Haiti

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 . . .

At School in Haiti: Andre's Story

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?”

While Kathy and Lynda teach the fourth class, Laurent, Cassidy and I sit with – I’ll call him “Andre” – in the only quiet, moderately private spot we can find: our vehicle.

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.”

Andre tells us that on January 12th, he was supposed to pick up “my cousins who I love very much, at the University.” He called to them that he couldn’t. They stayed late, and died when the building collapsed.

These cousins, “my best friends,” lived with him and were more like sisters—“one light skinned, one dark,” he smiles with the memory. “I feel so guilty. I want to go back to the time and save them, but it is not possible. I have concluded,” he lowers his voice here, “I do not want to be left behind.”

I recognize the self-annihilating weight of this guilt, have seen it burden young and old in Kosovo, Israel, Gaza, have heard how it torments the nights of soldiers and marines returning from Iraq and Afghanistan.

“Would you,” I ask him, “be willing to meet your cousins in your imagination to talk with them and ask for their advice?”

“I have them always in my heart, but when I talk with them, it makes me cry.”

I tell him that he needs to cry—that releasing his emotions will open his throat, that perhaps his cousins have something to say to him that will help him with his guilt. He nods in agreement.

I ask him to close his eyes and breathe deeply with his belly soft, as we did in class. “Imagine that you are in a safe and comfortable place—a place where you feel good.” He does and I ask him to imagine that his cousins are there with him.

“Would you be willing,” I say, “to ask them for their advice?”

He nods his head.

After a while, his face softens and small tears appear at the outer edge of his eyes.

“Did they come?” I ask.

“Yes.”

“What was it like? What did they say?”

“I was so happy to see them. They told me to keep living my life and that I was not responsible for their death.”

“Write it down,” I say to him, after he has opened his eyes “and look at it every day. “Keep living your life. You are not responsible.”

I notice that he is breathing more deeply and no longer clutching at his throat.

Making our way back to the classroom, I feel how urgent it is to train hundreds of people to do this tender, powerful, necessary work.

We’ve just returned from our visit to Haiti today. I look forward to taking a look at what you’ve got to say on this and other posts from Haiti soon.

At School: A Place to Help Haitian Children

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 . . . .

Depression’s Upside: A One-Sided View

Some thoughts on Jonah Lehrer’s article from The New York Times Magazine, February 25, 2010.

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.

"Healing the Wounds of War" in Christian Science Monitor

Dear friends,

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

Jerusalem

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.)

Jim

Day 7: The Gaza Training Ends

“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.

Open Minds and Warm But Troubled Hearts in Closed Gaza (II), Day 6

December 20, 2009

Day 6

Dear friends,

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.”

Open Minds, and Warm but Troubled Hearts in Closed Gaza

Gaza City, December 16, 2009

Day 5

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.

Video from Days 4 & 5 of Gaza Training

Dear friends,

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.)

Jim

Gaza 2009 Blog, Day 1

Gaza City, December 12, 2009

Hello Friends, Many of you have asked and many more wondered, what goes on when you guys are over there in the Middle East, in Israel, and especially in Gaza, a strip of land that most of the world, including those parts of it that are closest, ignore or misunderstand, a shabby, beleaguered, always surprising territory where we have been working for more than seven years. What’s it really like? So here goes, with the first of what I hope will be communications every day or two until just before Christmas.

My room in Gaza City’s Commodore Hotel looks out on the Mediterranean, its small waves, falling coolly, brightly, and predictably this early morning. On the spit of land that points toward the open sea where Israeli Navy, vigilant for errant or desperate Palestinian boats, patrol, a dozen Hamas security men, are drilling – lining up in formation, jogging. Tomorrow our Gaza leadership team – sixteen health and mental health professionals of considerable, hard earned skill, sweet dispositions, wry humor and luminous goodwill – will gather downstairs for the faculty preparation that precedes the “Advanced Training” in Mind-Body Medicine of 150 more clinicians.

It’s our first day in Gaza after one in Israel – for me and our US team a long evening filled with meetings with Naftali Halberstadt the psychologist who directs our program there, Rhonda Adessky, the Hadassah Hospital researcher who is our clinical director, Smadar Shmuel our administrator, Danny Grossman the retired Israeli fighter pilot who supports all our healing efforts in the region, and the rest of our Israeli Board.

We’ve trained 300 clinicians, educators and community leaders in Israel – from heads of departments of psychiatry and leading academic psychologists to family physicians, police and the Zaka, the stalwart Orthodox men who gather the body parts of victims of violence for burial, and inform their families of their deaths. The mental health and health professionals use our model – of self-awareness and self-care, of mind-body skills like meditation, guided imagery and biofeedback; of self-expression in words, drawings and movement; and small group support – in hospitals, clinics and universities. The Zaka now bring our meditation techniques and our teachings of awareness and acceptance to the scenes of bombings and car accidents and into the living rooms of overwhelmed, suddenly bereaved families.

Over 120 Israeli school psychologists and school counselors have graduated from our program. They are using our model in schools everywhere, but especially with kids traumatized by shelling in and around Sderot in the South and in the North where Hezbollah’s missiles fell. A third of our Israeli trainees are Arabs, many of whom identify themselves as “Palestinians.” At our meetings in Jerusalem we discuss expanding our work in the South, developing more joint programs for Israeli Jews and Arabs (co-led by our Arab and Jewish graduates) and working with disabled military veterans. We’ll continue the planning when we return from Gaza.

Right now we’re “checking in “in my room at the Commodore, catching up on the time since we and our Palestinian colleagues began, last March, to train this committed and enthusiastic cohort of Gaza clinicians, sharing our feelings of gratitude for the opportunity to be here in Gaza, once again, in what its inhabitants call “the world’s largest open air prison.”

We are enjoying being in Gaza. You may wonder about that word “enjoy.” Actually, the feeling is much rounder and more robust, and, of course, more complex as well. Gaza is, in spite of some much needed UN sponsored cleanup of rubble from the Israeli attacks of last winter, a bleak place, terribly diminished by the severe restrictions on material coming in and exports (chiefly food and flowers) leaving, by overwhelming population density and pervasive poverty, and by the widespread – and still unrepaired – destruction of farms, fields and factories, of mosques, public buildings, and private homes. And yet Gaza is to me and to our team a place that is at least as blessed by its people as it is cursed by conflict.

As we sit in a circle each of us recalls, along with the terror of times past – days training our Palestinian colleagues in 2007 while Hamas and Fatah fought in the streets not far from our hotel, nights of Israeli planes’ building shaking, glass breaking sonic booms, the bodies of children lying in the streets – a sense of satisfaction, and, yes, love, that far outweighs it and draws us back over and over. Amy Shinal our clinical director, Afrim Blyta and Yusuf Ulaj, Kosovo psychiatrists I began to work with ten years ago during the war there, Dan Sterenchuk and Lee-Ann Gallarano, our administrative team, and I all feel it and say it each in his or her own accents: Our Gaza team feel like our family, instantly recognizable and available, and accepting and caring in a way that recalls the embrace of those bound to us by biology. We are there to teach them – about mind-body skills, and being aware of the thoughts and feelings that arise each moment, and the uses of the imagination, and about skillfully leading groups – and they inevitable teach us so much more, about generosity arising in the midst of the greatest tragedy, openheartedness to strangers, the power of community and of love for one another, the possibility of hope in the darkest of times, endurance, patience, tolerance, humor.

At lunch we eat a meal of seafood on the terrace – it is late spring warm, if breezy on this December day- of the Lighthouse restaurant with our Gaza coordinator psychologist Jamil Abdel Atti. We toast – with lemonade in dry Gaza – Chuck Feeney the Chairman of The Atlantic Philanthropies who has funded our work for five years and Don de Laski my always generous US Board member: The sufferings of Gazans, and first the promise and later the effectiveness of our work have touched them deeply. On the coast road cars and motorbikes flying green flags chug by celebrating Hamas’ birthday. We have coffee and ready ourselves for the training to come.

Jim

(Film to follow in days ahead.)

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