CREATING PATHS TO HEALING
Laurie Anne Pearlman, Ph.D.
Trauma, Research, Education, and Training Institute, Inc.
South Windsor, Connecticut, USA
Ervin Staub, Ph.D.
The University of Massachusetts at Amherst
Amherst, Massachusetts, USA
Copyright 2002 by Trauma, Research, Education and Training Institute, Inc.
People have all kinds of painful problems and symptoms as a result of traumatic stress. These may take the form of physical illnesses, depression, profound grief, anxiety, flashbacks, or numbing. Many people have relationship problems like aggressive behavior, an inability to trust others, and avoidance of other people. And many people experience deeply personal problems like terror, low self-esteem, and a deep sense of spiritual disconnection. These problems may seem unrelated to each other. Because each person's experiences and pain are unique, each person's path to healing may be different from the others'. But there are common elements in the healing process that most people will share.
People must heal if they are to get on with their lives. That means being able to do things like earn a living, raise children, and relate to friends, family, and community. Healing is essential to basic life satisfaction and fulfillment. It means restoring a sense of connection with God or one's spirituality more generally.
Healing is also essential to prevent future violence. Without true healing, our wounds can lead us to harm others, even if we don't mean to do so. One group may seek to blame others for their pain, to make others understand, to make others suffer as they have suffered, to create justice, or to restore their sense of themselves. These needs can lead to aggression when wounds are not healed.
Finally, the children of victims and perpetrators are affected by violence, even if they weren't born when it took place. Parents can't help carrying their unhealed injuries into the next generation. Because trauma disrupts basic psychological needs, unhealed parents will naturally find ways to meet their needs that can affect their children negatively. This happens even when parents are trying to protect their children from the pain they experienced.
What is the Context for Healing?
The context for healing is the post-traumatic social environment. We must continuously be aware of the meanings of traumatic stress in the culture as well as ways of healing that are natural in the culture. We must also be aware of the social and physical needs people have in the aftermath of war, genocide, or mass violence. Those needs in turn have psychological and cultural meanings. To lose one's home, for example, has profound psychological as well as physical implications. Living with the fear that trauma creates also profoundly affects peoples thinking and behavior.
As counselors, therapists, clergy and mental health workers, our expertise is in helping people deal with the psychological and spiritual consequences of traumatic loss. We must work, in partnership with others who can help address the very real and significant social and physical needs (such as housing, food, and medical attention) that go hand in hand with psychological trauma after war and mass violence. We can help people understand the connection between their social and psychological problems, the psychological implications of their social and physical needs, and the various approaches to working with all of these problems.
What is Required for Healing?
The essential ingredients for healing are respect, information, connection, and hope. These four elements are interwoven, each relating closely to the others.
Acknowledgment is one part of the respect that is necessary for healing from traumatic loss. Traumatized people need to acknowledge what happened: what was done to them, what they did, what they have lost. Losses can include loved ones, a sense of security, an understanding of who you are and your place in the world, your connection with God. Mourning these losses and acknowledging that they occurred and that things will never be the same again is part of respecting one's traumatic experience. Mourning also means acknowledging that one's life may never be the same again and expressing one's sorrow and anger about that. Acknowledgment means feeling and expressing feelings, including grief, rage, and despair.
Acknowledging the tremendous losses that the Rwandese people have suffered will open up a lot of pain. In order to bear such pain, victims need to forgive themselves. That means understanding and accepting your choices about what you did and did not do during the genocide, to help others, to harm others, to protect yourself and your loved ones, to bear the unbearable, to survive physically and emotionally. It can help to try to understand and talk with someone you trust about the personal, interpersonal, social, and political circumstances that shaped your choices. It's also important to acknowledge that there may not have been choices or that the only options available were all terrible or tragic. Many people find prayer, meditation, writing, drawing, storytelling, or dance helpful with the process of acknowledging.
Trauma survivors can also benefit from acknowledgment from others with status or authority. The world owes Rwanda an apology and explanations for not helping to stop the genocide. The world has yet to acknowledge the terrible turmoil and great need in which the genocide has left the country. Such acknowledgment from the community of nations, from journalists, from relief agencies, from international clergy, and others could promote healing. Financial assistance from the international community is a meaningful acknowledgement.
Trauma survivors can benefit from acknowledgment of the injuries, losses, and needs from important people whom they love, who understand, and/or who are concerned about them. That could include friends, people in positions of authority, or professional helpers such as social workers and clergy.
Justice is another aspect of respect. Healing is promoted by the feeling that justice, as defined by the individual, community, and society, has been or will be done. That may mean that perpetrators are held accountable for their actions through formal channels such as the gacaca or tribunal. It may mean faith that God will see that justice is done. It may mean a belief in the natural order of things, in which we reap what we sow.
Healing is also promoted when perpetrators atone or make amends for their actions. This includes admitting that their actions were wrong, ensuring that they will never do such things again, and attempting to make reparations to their victims. It means showing through their actions that perpetrators are aware they have caused horrible injuries and that they wish to try to do things differently, to "make it up" to the victims. Of course nothing can ever compensate for the losses caused by genocide. But the spirit of atonement is to show one's remorse through positive actions on behalf of the other.
Forgiving perpetrators may be a shocking notion in the context of genocide. Yet it is one process that has helped some people move toward healing. Forgiving means offering a gift that is not deserved, but is offered nonetheless. It means giving up resentment and hatred and taking a stance of openness. No one can suggest to survivors of horrendous actions such as genocide that they forgive. However, some survivors try to forgive in order to be able to reclaim their own lives and move into the future without the burden that hatred places on peoples’ hearts and spirits. While forgiving is a choice, it is one that people often can make only after some healing has taken place. It requires courage, determination, and patience. Thus forgiving both arises from and contributes to healing.
Healing requires that people know as much as possible about what happened. Both those who have been injured and those who have done harm may have a strong desire to deny, to pretend it wasn't so bad. But without knowing what happened, including genocide, mass killings, and other violence such as rape, other assaults, thefts and so forth, healing cannot take place. It is not possible to grieve losses of which we are unaware. The gacaca process is intended in part to provide such information.
Information helps people understand how such a thing could have happened. That includes information about how genocide comes about in general and the events and feelings leading up to the genocide in Rwanda.
People also need information about traumatic stress. They need to understand how their changed thoughts, feelings, and behaviors relate to their traumatic experiences. They need to understand that their responses, no matter how uncomfortable and problematic, are normal. People also need information about healing. Just knowing that there is a path toward healing can help, and knowing what some of the steps are along the way is also helpful. It is possible to create a life that includes what happened but isn't defined by it. That information can give people a sense of control over their future and hope that things can be different some day, for themselves, for their children, and for their country. Healing does not mean forgetting.
Healing requires connection with oneself. That means feeling one's own feelings, knowing one's pain, and being aware of one's thoughts. It can be frightening to feel rage or grief or terror. Yet being cut off from those feelings, if they are there, makes healing impossible. Connecting with feelings means connecting or reconnecting with one's body. Two useful questions are, "Where in my body do I feel my rage (or grief or fear)?" and "What emotion might that pain in my body be representing?" People often find that their physical pain lessens as they are able to put their emotions into words.
Connection with oneself is a step toward connection with others. As we let ourselves know our feelings, we can begin to talk with others about them. Having someone bear witness to our experience is an important part of the healing process. Others can help us bear our pain and understand our responses. It can be too frightening to remember alone. The presence of another person who listens without judging can neutralize our experience, making it less shocking and frightening.
People telling each other the stories of what happened can support connection. These may be Stories of events and their consequences, stories of what people said, did, and felt, stories that link the past to the present.
Traumatic experiences assault our spirituality. Afterwards, people may feel that life is not meaningful. Traumatized people often feel hopeless about the future. Those who have endured horrible things like the genocide must find meaning in their suffering. This includes both trying to understand the terrible things that happened and creating a life that feels worth living.
Developing or rebuilding a spiritual life is essential to healing. That process may include a different relationship with God, a new or renewed commitment to community or to humanity, or a commitment to helping others. Renewed spirituality can also include trying to transcend the realities of what happened, trough processes like forgiving or developing a vision, shared with all Rwandese people, of a better life for the next generation. People may gather to create ceremonies that include a vision for the future. Such a vision might be to raise children whose lives are not dominated by violence and trauma. It might lead to shared projects, which in turn can provide meaning and hope. The vision for the future may include acknowledging traumatic experiences, but not being defined by them. That means acknowledging what happened but not thinking of oneself primarily as a victim or a perpetrator. It means living life as a farmer, a teacher, a sister, a parent... someone who experienced the horrors of genocide and is now trying to make a life again.
Recovery from traumatic stress is a challenging process. Healing is complex and requires support, determination, and patience. It is difficult and cannot happen quickly. It takes a long time and requires support from other people who are trying to do the same thing. There will be setbacks along the way. Yet there is hope for a different kind of future when people have the courage to face their problems and work together to heal.