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, email@example.com
Thanks for this post Bharati. I have had an interesting experience here in Cambodia. A number of my Cambodian colleagues have said that they do not want to learn or read about conflicts from other countries, as it is too painful to know that other countries have gone through or are going through similar experiences. They are however happy to talk about the conflict in Cambodia with each other. Is this something you have experienced too?
This is such a good point, and quite a complex phenomenon.
There have been times when individuals I have worked with have expressed apprehension about hearing of the experiences of trauma of those outside their intimate circles often saying something like “it is just too much.” A traditional Western, trauma -informed clinical framework offers one way of understanding this– some people who have been through trauma can have a particular sensitivity to hearing of people’s traumas, as those stories can “ re trigger” their own pain. This potential for re –triggering impels me to be very cautious about whether and when I bring up stories with those I work with.
Yet, when these individuals have an opportunity to share within more intimate circles that do not include professionals or empathic witnesses (and only encompass members who have first hand knowledge of a specific tragedy)- they often do share, without much apprehension. I wonder whether these types of intimate exchanges offer a type of mutuality that is particularly and powerfully healing. Sharing and disclosing with those who have been through what one has been through can offer a the very healing encounter of what neurobiologists refer to as “ limbic resonance” or the experience of “ feeling felt.”
Beautiful post, Bharati! I appreciated all of it and especially the last part… “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.” I think there’s much potential for women to heal in groups, circles or red tents that are committed to the healing process and allow everything to be present, the ‘good’ as well as the ‘bad’.
Thank you for your kind words- Like you, I believe there is an incredible amount of healing potential in groups.Often healing is viewed as something that is done by ” an expert,” who imposes some therapeutic intervention onto a patient. However, when people are viewed as experts in their own lives, they often find their way back to communities, collectives, circles and traditions that facilitate deep and wonderful growth.
While I do have appreciation for my formal clinical training, there is so much to be learned from circles of women.
Beautifully and sensitively put, ditto! So glad to hear there are professionals like yourself out there who appreciate the benefits of both therapy, individual-led healing and community involvement 🙂
As one who has worked internationally as a journalist and now in the Dev sector..I find it would be useful if more of us were better informed about trauma and its effects/affects. After all, we work in environments where so many of our colleagues, clients and beneficiaries suffer post-trauma affects and to “build capacity” ( to use a term I don’t love) we need to k or how to support post-trauma growth. Bharati lends great expertise to this!
Thank you so much Bharati for sharing this fascinating piece! I am deeply touched by the women you have encountered throughout your work. I loved your explanation of traumatic growth: “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.” Your work is amazing and I am truly grateful to know that you are so passionate about it.
Thank you for your kind comments! I appreciate them.
Beautiful post, Bharati. It reminded me of the power of story telling and how stories help us connect with others – even those who seem different – at least at first. You also make important points about resilience and not pathologising people. Thank you.
Thanks Bharati for your post. Stepping back and asking someone what is important to them, rather than telling them, is a pretty important part of offering support for healing following trauma. Not to do so is to stand with the agency of the trauma rather than with the agency of the woman.
I think this needs to be taught to more and more people working in so-called, Development. I was on a project in Liberia and a colleague thought it would be “neat” to share his copy of the documentary “Pray the Devil Back to Hell,” about the women-led peace movement in Liberia. And he wondered why none of the women, (only men) showed up to see the film he decided to show. One woman peeked in and then left. I really was concerned about re-traumatizing the staff! and there was no opportunity to process it, lead a discussion with a professional such as yourself, Bharati. I am really struck by the lack of awareness and knowledge of HOW to work with staff and colleagues who have suffered such trauma in post-war/conflict countries.
Thanks Karen. I think trauma clinicians walk a fine line as we work, believing that people ARE absolutley resilient and robust does not negate the importance of using caution and skill when working with people who have trauma in their histories.
I also think that trauma speaks in many tongues. If re-triggered by a current stimulus that reminds one of a past trauma, those I consult with do not necessarily say ” I think i have been triggered.” They will however, experience sudden outbursts of anxiety, agitation, anger, interpersonal conflict, or periods of sluggish despair. Trauma speaks crytptically at times, so we have to be willing /able to listen and support appropriately.
The experiences that you describe here as far as sharing in small groups are also true of our Women Veterans. They are cautious but eager to share there stories of combat experience or military sexual trauma but will do so more easily in intimate peer lead, peer support groups with other women veterans. Their is a lot they don’t have to say – things that are understood – in a peer support group among women veterans. They can go on and share what works and share the hope when they share together, knowing that they are all in different places on the journey. It brings hope to see someone who has moved forward and is offering their story of hope.
Absolutely, Sharon. I heard a wonderful interview about a teacher who understands that his best teaching occurs when he ” gets out of the way,” and allows his students to learn from each other. It reminded me of some of my experiences in facilitating groups. The best groups seem to be those that allow for genuine, resonant sharing among members who have been down similar roads.