Saturday, April 11, 2015

Self-Healing in a Traumatizing Society

A boy is born in hard time Mississippi,
Surrounded by four walls that ain't so pretty
His parents give him love and affection
To keep him strong, moving in the right direction,
Living just enough, just enough for the city...

– “Living for the City,” Stevie Wonder 

In the building where I work, there is a very nice lunch room, in which there are a number of magazines for people to read at lunch or on breaks. In the late spring of last year, someone left a magazine containing an article about the treatment of trauma and mental illness in the developing world. (When I first started working there, most of the magazines tended to be on the geeky side, although someone later started bringing in clothing fashion magazines and copies of Better Homes and Gardens.)

I read the mental health article with some interest. It described the prevalence of psychological trauma caused by organized violence such as war, as well as the trauma caused by sexual exploitation. (It may have also mentioned human trafficking, but I can't remember.) It also described how health-oriented NGO's were becoming involved in the training of primary health care workers in poorer countries in order to equip them to heal psychological trauma caused by organized violence. The focus of the training is the use of relationships of support and communities of support to help survivors heal. Medications are not the primary mode of the treatments studied, largely because the medications are expensive and therefore mostly unaffordable. However, the relational methods boast a high rate of success in helping survivors manage and heal from trauma. (One of the sidebars to this article described the decline of “talk” therapies and the rising use of medication in the treatment of mental illness in the West, especially in the United States.)

At the time I read the article, I didn't realize how appropriate its information would be for dealing with the events of the last several months. Both the article and the magazine which carried it were thrown away at some point, to be replaced by a clothing fashion magazine. Over the last few months I have tried without success to find an online version of that article. If anyone who reads this blog knows of the magazine, the article, or the authors of the article, please feel free to send me a comment.

In my research, however, I have found a wealth of other material on the subject of managing and healing the trauma caused by organized violence. Almost all of the material was written by researchers and health care workers dealing with traumatized populations in the developing world. But even the most cursory look at events in the U.S. over the last several months reveals that there are plenty of people being traumatized right here by the wealthy, the powerful and the privileged in this country and by their minions. Think of the many unarmed Black men and women who have recently been shot to death by white police in this country – think also of the bereaved families of these victims – and you will have some idea of the trauma being caused by organized violence against the powerless here in the United States. Think especially of the shooting of Tamir Rice, a 12 year old boy in Cleveland, Ohio, last year. Or think of the shooting of John Crawford in a Wal-Mart in Beavercreek, Ohio, as he was buying a toy for his children. One media source reveals that police in the United States killed more people last month than any other nation killed in 2014. That includes China, a country four times as populous as the U.S., a country which, according to Western media, is supposed to be both godless and evil, yet whose police killed far fewer of their own citizens in 2014 than American police did this last March. (See also this and this and this.)

Consider also that the purveyors of trauma have for a long time been expanding their efforts beyond groups traditionally considered to be scapegoats in this country. For instance, there's Governor Sam Brownback (R-Kansas), who recently signed into law a bill that will allow anyone in Kansas to carry a concealed weapon without a background check and without training. This is yet another victory for American gun manufacturers and purveyors of the American myth of rugged individualism and the license to kill in the defense of white American “liberty.” Kansas is the sixth state to enact such a law. I am sure more states will follow. Now all the Constitutional “sovereign citizens” who worship the Second Amendment can traumatize each other, as I'm sure they will, after reading a recent study which links gun ownership to uncontrollable anger. (There are also many studies which irrefutably link gun ownership with domestic violence.)  In many other ways, the wealthy of our country – and the politicians they own, especially the Republicans – are trying to give us all a case of PTSD, as one blogger recently noted.

If you're poor, nonwhite, or both, and you live in the United States of America, it is therefore quite likely that you will have to deal with the trauma caused by organized violence at some time within the next few years. It therefore also necessary to learn how to recognize the effects of trauma, and how to manage and recover from trauma. I have written before about the narcissistic motivations of those who are causing the trauma. (Yes, yes, racism and oppression are expressions of narcissism.) What is the goal of those who abuse their fellow human beings, and how does that message affect the targets of abuse?

The goal of the abuser is to magnify his own grandiosity by invalidating and destroying his target. The height of success for an abuser is therefore to get his victim to internalize the abuser's message – for the victim to come to believe that he or she is worthless, that he or she is worthy of the treatment perpetrated by the abuser, that the treatment received is the victim's fault, to get the victim to endlessly ask, “What did I do to bring this on myself?” Indeed, one of the things that makes the abuse so traumatizing is its unpredictability, and the resulting powerlessness of the victim in avoiding the abuse or managing encounters with the abuser. This is why self-rejection and self-harming behaviors are the pervasive effects of the trauma caused by organized violence. The self-harming behaviors then serve to reinforce the message implanted in the victim that the victim is worthless and deserving of the abuse inflicted by the abuser. (See this, this, and this for a discussion of self-rejection in victims of gender violence. See this for a discussion of self-rejection as one of the outcomes of colonialism, and this for a discussion of self-rejection in victims of racism.)

What then is the key to managing and healing from the trauma inflicted by organized violence? This question has been explored by a number of mental health professionals, among whom is Dr. Richard Mollica, author of Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World. In a presentation given in 2011, Dr. Mollica described the importance of the trauma story in the healing of trauma victims, as well as the creation of a safe space for trauma victims to share their trauma stories. In his words, “Dialogue and empathetic listening between survivor and therapist maximizes the benefits of emotional disclosure.” He also described how to facilitate and encourage the natural process of self-healing of emotional wounds inflicted by severe violence. In that same presentation Beth Filson, a certified peer specialist, described the benefit of relationships of support which can arise within a community of survivors, and the need to foster those relationships. One of the keys to activating the self-healing response in trauma survivors is survivor involvement in projects or teams performing altruistic service for others who are also disadvantaged or who have suffered trauma.

A good example of a healing community of survivors engaged in altruistic service is Trinity United Church of Christ in Chicago, Illinois. This is the church which was pastored by the good Reverend Jeremiah Wright for a number of years. This church has a strong Biblical commitment to social justice and the healing of those who have been broken by the injustice of the United States of America. In their statement of the Black Value System, they address many of the same elements of self-healing discussed by Dr. Richard Mollica. The statements in the Black Value system also address the legacy of self-harm produced in the Black community because of the oppressions of a dominant, exploitative society that is hostile to anyone who is different from its members.

We need to form many such communities of healing. The communities need not be large or highly visible, yet they should be deep, rich and full of mutual support. We will need to learn all the healing techniques at our disposal as the United States becomes an increasingly traumatizing place to live. One of the chief goals of our healing must be the recovery of our human ability to observe, orient, decide and act wisely in the midst of a hostile space.  And we cannot wait for someone else to do this recovery for us. We are the ones we have been waiting for, as a writer said a while back. The tools are at our disposal. Let's get to work.

For more information, please read:

“Bringing Order Out of Chaos: A Culturally Competent Approach to Managing the Problems of Refugees and Victims of Organized Violence,” Eisenbruch, et al., 2004

“The ISTSS/RAND Guidelines on Mental Health Training of Primary Healthcare Providers for Trauma-Exposed Populations in Conflict-Affected Countries,” Eisenman, et al., 2005

“War Exposure, Daily Stressors, and Mental Health in Conflict and Post-Conflict Settings: Bridging the Divide Between Trauma-Focused and Psychosocial Frameworks,” Miller and Rasmussen, 2010

“The Impact of War and Atrocity on Civilian Populations: Basic Principles for NGO Interventions and a Critique of Psychosocial Trauma Projects,” Summerfield, 1996

"Invisible Wounds: A Practitioners' Dialogue on Improving Development Outcomes Through Psychosocial Support," World Bank, 2014

No comments: