Women in Aid has a fantastic new guest contribution from Bharati Acharya. Bharati discusses the importance of engaging with and supporting individuals who have post traumatic stress. It highlights that connecting people with others that have similar stories can be key to their healing. After reading this post you might want to revisit a previous post by Claire Higgins which discusses her own experiences of “Making Sense of Violence”.
According to the United Nations, one out of three women on the planet will be beaten or raped some time in her life. That means over one billion women will experience some type of gender-based violence. Given these staggering numbers, it is very likely that those working in the developing world will encounter women who have endured trauma or may experience trauma themselves.
As a mental health clinician specializing in working with women, I work with clients who carry the burden of being labeled with generic terms like “chemically dependent” “addicted” and “substance abuser.” In the world of mental health, these terms are intended to guide providers toward effective clinical interventions; medical and psycho-social strategies to treat and perhaps even eradicate life-constricting symptoms associated with long-term drug and alcohol use.
Unfortunately these diagnostic terms often render invisible some of the most salient lived experiences of our clients—the experiences of violence, rape and incest that have directly and quite profoundly contributed to the their use of alcohol and drugs in the first place. Having lived through these myriad manifestations of violence and violation, many of these women turn to substances in a desperate attempt to assuage the distress of post trauma effects.
Peeling back the layers of addiction to address the core experiences of violence in these women’s lives is a new approach in the field of addiction and mental health. This “trauma informed” philosophy suggests that the comprehensive chemical/ mental health treatment can only occur in a context that acknowledges the all too common reality of violence in women’s lives.
While the trauma informed philosophy can be viewed as a positive step toward offering women a more comprehensive approach to treatment, it also presents dilemmas for clinicians who strive to address violence in women’s lives in a manner that does not “ re- traumatize” them. Thus, traversing the world of trauma therapy involves understanding that, for some individuals, deeper trauma work can actually make things worse for our clients if this work is done prematurely and without a firm emotional foundation in place. Without such a foundation, some clients can experience destabilizing emotional reactions, from unmanageable anxiety to suicidal despair.
While the standard trauma informed medical and psychosocial interventions do, to some degree, contribute to the emotional foundation necessary for deeper trauma work through “symptom management” and the development of “coping skills,” I have found there is still something sorely missing from these traditional approaches. This missing piece involves the mysterious, almost existential endeavor of restoring (or in some cases creating) with our clients the experience of the whole and empowered self that is often squelched, shattered or forgotten in the face of trauma.
This restoration of the whole and empowered self is much more than demurely telling the women we work with they will get better. Rather, this endeavor requires introducing them to vibrant examples of other women who have not only endured violence but who have also risen out of the most heinous violations to create lives that are rewarding, joy filled and connected. The vivid knowledge that this type of “post traumatic growth” is an attainable experience has been critical to the healing of so many women I have worked with.
The importance of attending to the “double story” of both pain and triumph when working with women was very clearly affirmed for me a few years ago, as I conducted a 3 day leadership workshop in Serbia, for women journalists who had lived through years of conflict in the Balkans. In an attempt to launch a discussion on leadership and post traumatic growth, I decided to hold a viewing of the film “Pray the Devil Back to Hell,” about the women-led movement in Liberia that eventually brought an end to that country’s brutal and bloody civil war. Having viewed the documentary before, I knew the potent and uplifting themes of the women’s peaceful protests were balanced by the sobering accounts of rape and other forms of violence some of these women endured during the war. Knowing that some of these accounts of violence were hauntingly similar to what the Serbian participants had gone through during the Balkan conflicts. I decided to ask my interpreter Sylvia to preview it, and to tell me honestly if it would be too much for our participants.
As the film opened with footage of people fleeing their homes, and villages as young soldiers brandished guns, human skulls, and disturbingly eerie smiles Sylvia began to gentle rock her body back and forth. She pulled out a tissue as the sounds of battle filled the room, and cried softly, whispering “Milosevic, Milosevic…Taylor was like Milosevic.”
The film continued. Sylvia remained transfixed on the screen, as the stories of Liberian women taking to the streets with songs, prayers, and dances in an attempt to persuade Charles Taylor to enter into peace talks emerged. Sylvia whispers became louder when she said, “We did that…we beat pots and pans, we made noise against him. We did that!”
Finally, at the end of the film, Sylvia sat, tearful, moved, and visibly exhausted from witnessing a traumatic journey that was clearly so close to her own.
I wondered to myself whether showing it to workshop participants would be too overwhelming. As we discussed my hesitation in showing a film that might “re-traumatize,” we created a plan to: forewarn participants about the difficult parts, remind them they can opt out of viewing, and suggest they stay for the discussion/ debriefing after in order to gain support.
As workshop participants listened intently to Sylvia’s experience of the documentary, they sat quietly. After she acknowledged both the power and the pain of the film, I asked if anyone would like to opt out of the viewing.
There was a brief silence, followed by one participant saying “Bharati, if these Liberian women lived through all of that, we can certainly hear their story.”
Experiences like these inform my work even today. Whether I am delivering trauma informed treatment in the United States, or internationally, I interweave stories of women’s triumph over trauma, worldwide, along with my standard clinical interventions. As these clients hear of Tina Turner, Somaly Mam, Oprah Winfrey, Rigoberta Menchu and others, often they listen spellbound, and at times, these stories offer them a vision of what is possible for their own lives, and — just as Sylvia recognized her own acts of resistance when watching the Liberian women — help them more richly acknowledge the often neglected aspects of their own survival.
“You know that post traumatic growth you were talking about the other day in group…. I think I have that.”- Woman at a U.S. treatment center
When working with women in either developing or developed nations, one will inevitably encounter individuals who have experienced violence. Connecting these women to the lives of others who have endured and prevailed over trauma must be an essential part of their healing process.
Bharati Acharya, M.A., LPCC, International Diplomat in Narrative Therapy is based in Minneapolis, MN. She has consulted and conducted trainings on gender-related psychosocial and women’s leadership projects. She can be contacted at, firstname.lastname@example.org