For those interested in pictures (from the Rwanda Embassy in DC) and formal information about what the AACC, Dr. Diane Langberg, and others including myself are planning on doing in Rwanda, click the following: MOU AACC alert.
Tag Archives: trauma
Standing with Rwanda
Filed under "phil monroe", christian counseling, christian psychology, Diane Langberg, Rwanda
Rwandan meetings
Spending today at the Rwandan Embassy in DC. Discussing best ways to memorialize without further traumatizing the population. Yesterday we spent a good portion of the day at the National Holocaust Museum. Believe it or not, it was a wonderful experience. I intend to blog about it in the coming days. But for now, back to our meetings.
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Filed under Uncategorized
Rwanda meetings
This coming week I have the pleasure of meeting up with several folks interested in the next step in our Rwanda efforts. We will be meeting with Rwandan church and gov’t officials to discuss possible training efforts before next Memorial period. Along with meetings in the DC area, we will tour, together, the Holocaust museum. I understand this will include a behind the scenes interaction with curators, holocaust survivors and others. Cool!
Hopefully, we will come out of these meetings with a clear plan for our next, yet-to-be scheduled trip. I don’t know if I’m alone in this experience, but meetings seems to drag on when I would rather start doing something. I know, at one level, how important listening is. But brainstorming and planning are way more fun! I hope we’ll get to that!
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Filed under christian psychology, Historical events, Rwanda
Fear and trust hand in hand?
This week I’ll be speaking to a group of counselors about complex PTSD. One of the hallmarks of C-PTSD is the combination of chronic relational fear AND chronic shame/guilt over having said fear. It manifests itself as, “I’m afraid of you but I know it’s my fault for being afraid.” (NOTE: the reverse is not necessarily true: that those who have chronic fears, trust problems, and self-condemnation have PTSD or C-PTSD.) My focus at that training will be on this question: How do you lead someone (in therapy) in the repetitive work of “Do not give in to fear”?
On Sunday, Tim Lane of CCEF preached a sermon about fear and disappointment. In that sermon he mentioned our propensity to “flail ourselves”–assuming that we must be doing something wrong–if we experience fear. Instead of focusing on the experience, we ought to examine our responses to fear. Do we shut down? Do we believe that we are alone and isolated? Do we turn inward and act only in self-interest?
He gave us this quote from CS Lewis (Screwtape Letters): “The act of cowardice is all that matters, the emotion of fear is, in itself, no sin.”
Here’s my question: Is it possible to be afraid and to trust nonetheless without much reduction in the level of fear? Don’t we assume that if we act in a trusting way that our fears should abate? Especially in light of trusting God? Is it possible to trust God fully and yet fear? What might such fear and trust together look like? If we could do both at the same time, would it reduce inappropriate self-condemnation?
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Sebarenzi on reconciliation
Am just finishing up Joseph Sebarenzi’s God Sleeps in Rwanda: A Journey of Transformation (Atria Books, 2009). Joseph, A Tutsi, tells his story from childhood experiences of Hutu-Tutsi violence and state-sponsored discrimination to the 1994 massacre (he was out of the country then) and meteoric rise to power where he became the speaker of the parliament and then was pushed out by the Rwandan dictator.
I’m not sure if his story is accurate (about how Kagame tried to have him killed, but I found his views on reconciliation (and the lack thereof thus far) very helpful:
Ever since the genocide, I have asked myself how the nation could heal. How could we live together again in peace? …
Reconciliation brings enemies together to confront the painful and ugly past, and to collectively devise a bright future. It brings together communities in conflict to tell the truth about all past human rights violations and to create a society where they can live in peace with one another….
Reconciliation is in many ways the hardest option, because it requires effort, humility, and patience–whereas revenge is quick and easy. Reconciliation is complicated. it cannot be reduced to retributive justice…nor to forgiveness…. Reconciliation…includes several components: acknowledgment, apology, restorative justice, empathy, reparation, and forgiveness–and several accompanying measures, namely democracy coupled with consensus, peace education, and international assistance. pp 214-215
The author goes on to describe what he means by each of these components (and some of the weaknesses in Rwanda). He subscribes to a rather Christian view of this process. It is not merely Hutu groveling to Tutsi but both listening to each other.
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Filed under Christianity, conflicts, Forgiveness, News and politics, Repentance, Rwanda
Just don’t blow it
Having spoken last week on the topics of trauma and pastoral sexual abuse (and the resulting conversations with attendees at both sessions), I keep thinking this thought: Just don’t blow it.
Let me explain. Both sessions are filled with examples of Christian leaders abusing vulnerable people. It is common that attendees want to come up and chat with me about something similar that has happened to them or a loved one. During my trauma session, an individual commented to the whole group about a recent serious (and very public) allegation about a camp counselor and a decade of abuse to young boys. What would I tell these boys who were (allegedly) abused by someone they should have trusted?
Even when the problem is not abuse but moral failings, I note the massive, rippling fallout (fear, anger, anxiety, crushing heartbreak) in those in the know.
After the second session I got to go have a wonderful dinner with my wife. During it I was having double consciousness. I was with her and enjoying her company but having intruding thoughts about my own capacity to fail her, my kids, my parents, my colleagues, my students, etc. These vignettes I heard of “blowing it” can’t be all stupid of course. They too must have known how much destruction their choices would bring. I cannot rest on the fact that since I’m in the know, it won’t happen to me. Why? Because we are all prone to forget.
So, I spoke to myself, Just don’t blow it Phil. Remember that glowing face of your wife in the dinner light.
I’ll need a bit more than that I suppose…regular reminders and lots of prayer! It is easy to be ensnared and deceived by desires for comfort, glory, etc.
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Filed under Abuse, adultery, christian counseling, Christianity, self-deception
Disorders of Extreme Stress Not Otherwise Specified (DESNOS)
I recently scanned a book, Healing Trauma(published by Norton in 2003), and ran across a new name (for me) for the problem of complex PTSD–Disorders of Extreme Stress NOS or DESNOS. Because many christian counselors are only marginally aware of the research on complex PTSD I’ve decided to give a brief summary here.
The following symptom presentation may be found in those with prolonged and severe personal abuse (and often starting at an early age):
- alterations in the regulation of affective impulses, including difficulty with modulation of anger and being self-destructive,
- alterations in attention and consciousness, leading to amnesias and dissociative and depersonalization episodes,
- alterations in self perception, such as a chronic sense of guilt and responsibility, and chronically feeling ashamed,
- alterations in relationships with others, such as not being able to trust and not being able to feel intimate with people,
- somatizating the problem: feeling symptoms on a somatic level when medical explanations can’t be found, and
- alterations in systems of meaning (loss of meaning or distorted beliefs)
Some folks include a 7th characteristic: (alterations of perceptions of perpetrator(s).
Check out the this paper(44 pages long) written on the assessment and treatment of DESNOS. Though written for psychiatrists, I found the language easy to understand. The authors do a nice job of helping counselors differentiate between Borderline Personality Disorder and DESNOS. While they recognize significant overlap between the two constellation of symptoms, DESNOS folks tend to experience less relational push/pull (less manipulative behavior) and more push behaviors coupled with more intense sadness and grief.
Counseling work falls (per this paper) into 3 categories: stabilization, trauma processing, and re-integration into their world.
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Rwanda Day 8 (and 9)
Our final day in Rwanda! We fly out at 7:45 pm. This was a day packed right up to the last minute to get to the airport. Just like the Bishop to make sure we use every second! We had lunch with the Commission to prevent Genocide and the rector of KHI to present the beginnings of our proposal to them. We proposed a 3 pronged response to the needs we observed:
1. Information dispersal: (a) 1 page informational statements to educate adults and children about the symptoms of trauma, simple things to do if one witnesses another having a trauma reaction (grounding), and ways to remember the genocide without creating more trauma. This would be sponsored by the Commission; (b) basic workshops for psychiatric nurses, doctors, HIV workers, and pastors), (c) helping community care givers, and (d) developing better ways to run the memorial 100 days using their own new theme of Hope.
2. Support the sending of key Rwandans to the US to complete MA/PhD in Counseling so they can return as teachers
3. Developing a Masters degree counseling programfor KHI to run that is Christian based (at least a track of it would be.
Our proposal was met with enthusiasm!
We thought we were going to end the day with a bit of shopping. I got a bit of coffee and a few trinkets. However, on our way to the airport, we detoured to see the Minister of Education. He had been unavailable earlier in the week and now wanted to meet us before we left. Though we should have been at the airport, we flew across the city to meet with him for 15 minutes. As an MD, he was able to give us some good guidance.
Got to the airport and through security (much laxer than the US). A large number came to see us off. Sadly, the Bishop was not allowed to get on the plane. Something wrong with his visa (he got back to the States where his family is staying til December two days later). Our plane left one hour late and very full of children (expats on the way to holiday in Europe). Going up the stairs to the plane I got what I hope not to be my last sniff of the cooking fires. After the doors closed the attendants went through the cabin spraying something to kill mosquitoes (repeated after our brief stop at Entebbe, Uganda). They said it wasn’t dangerous to us but I wonder just the same.
After a full day in Rwanda, we travelled to Belgium (10 hours), had a lay over of several hours (where I purchased some Belgian chocolate), and then another 8 hours to Newark. Sadly, I cannot sleep on planes so I enjoyed several “Bourne” movies. Our team was not able to sit together on the flight to the US and this was sad. As we got off the very full flight, we lost track of Leah. We went in the wrong customs line and she must have gotten through before us.
So, we end our trip with much to process, little time to do it, and no time to do it together. I have grown fond of my new acquaintances in Rwanda and teammates Leah and Josh. But, now it is time to sleep as 40 plus hours of being awake is taking its toll!
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Rwanda Day 7
Started the day as usual with some quiet meditative reading on the porch overlooking the lake and the distant sound of many children getting water on the other side (yelling Muzungu (white person) to get my attention). Diane read us this quote from John Fawcett’s “Christ’s Precious” (published by W. Milner in 1839, p. 82)
I am but a stranger in this world, wherever I may be situated, or however I may happen to be distinguished. And such, it is my privilege that I am so. [However] when I look not upon myself as a stranger and a pilgrim, when I am captivated with anything in this place of my exile, I forget myself, and act far beneath my character, as a candidate for an immortal crown.
Fitting. It is easy in the US to forget our “exile” status. We focus, instead, on our own status. But here in Africa, there is little to do but remember how fragile life is and how we must depend on God for our daily existence.
Today we met with Justin Remera, a psychiatric nurse at Gahini hospital. The hospital was built in 1920s. He is the head of mental health. He sees some 30 patients per day and has a caseload of 500 with PTSD. He sees lots of “epilepsy” and has documented some 350 new cases in the past 2 years. But they have normal EEGs, thus it is trauma related not brain injury. Justin told us that there is an openness to therapy here because they see the benefits.
Problems noted by him? no medications other than Haldol. Infrastructure needs. His office is the size of a small closet and he has had violent patients and no escape (his desk and chair are away from the door). Also, next to his office are rooms where patients were screaming (while we were there). Seems they may have been doing some minor surgery without anesthetic. He also mentioned problems with demobilizing military and their own trauma as well as his own burnout.
Next we went to Kigali and met with the the permanent secretary of Defense. One of the persons there talked about having 520 peer counselors in the military to deal with the problem of HIV. Nothing dealing with PTSD. They have NO chaplains in their military.
Next, we visited the National Council of Protestant Churches of Rwanda. Specioise told us that 52% of the country are protestant. They have a program to deal with gender based violence, to educate the the church about laws designed to protect women. Their booklet combines Rwandan laws and biblical passages.
For our final meeting, we visited with Jean Baptiste at World Vision. He is new to WV in Rwanda but not new to WV (previously in Mali). He is a tall man with much presence. He spoke very openly and honestly about the issues of NGOs in the country and the problem of lukewarm Christians. He suggested they were much more problematic than rank atheists or Muslims. He gave us some advice as how to work with both churches and government officials. Josephine, a woman Diane had worked in Rwanda on previous trips, was there and spoke of the continued need to train and care for Rwandan caregivers.
Our day ended in Gahini with a farewell dinner. Members of the church and community (the local mayor) attended a dinner at the Seeds of Peace retreat houses. The dinner was outside under a canopy. During dinner we watched the local youth perform traditional dances with drums, singing and costumes. The young women danced with wooden milk bottles on their heads. We learned their trick. A heavy stone in the bottom of the bottle helps it stay on their head. Ouch! The night ended with gifts from our hosts to us and a few words of thanks from us.
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Rwanda Day 5b
[Sorry for the delay. Recovery and vacation time to Maine took precedence to posting more Rwanda entries.]
In my last entry I spoke of our exposure to prisoners at a local prison–all innocent in their own eyes, or at least deserving of being forgiven and released. All had been convicted by either a federal court or a Gacaca (local) court of genocidal activities.
In the afternoon we invited victims and perpetrators to our retreat house to interview them about their experiences. Jared, a diocese employee, our driver, and wise man brought two victims and one perpetrator to us (in the same car!). We sat under a tree and drank Fantas together, first with the victims and later with the perpetrator. Here’s what we learned:
Victims. We spoke with a woman and two men. The following quotes are through a translator.
The woman told us she was hidden by a Hutu (this is one of the few times we heard this!). She lost her husband and some children in the genocide.
I saw it with my own eyes. People killed people who knew each other. Some of the criminals now live in the community. We share life. Their homes are close. Some of the criminal’s children are seen by me. Their father killed my family. I have forgiven him because he confessed. It is a formula…confess, be forgiven, and live together. But do I forget? No. I see him (the killer) hang back and hesitate to ask for help. Rwanda is a country of sharing but he hesitates to ask. I have to be the one who makes more efforts to connect than he does.
Older man.
I thank God I am alive. It is a miracle. I didn’t expect to survive. There was no place to hide because no friend was left. So, I hid in churches, bushes, and rushes. It was terrible to see. I lost 170 people in my extended family. Remembering is the problem not economical. I knew those doing the killing. I survived by some miracle by moving around and going to another town where they didn’t know if I was a Hutu or a Tutsi….Afterwards, we had to live with those who committed the crimes and now we are trying to cover. Among those who killed, some confessed. They blame the government’s teaching and mobilization. But now they thank God we have a government that wants unity. So, we have to forgive to live together.
Younger man.
I was 11 when the genocide started. Some teachers came to our class and told us, “Tutsi, stand up.” They counted the number of each. I was in the thicket when the killers came. Some Hutus covered me up. When it was over my father was dead. My brother was killed and my sister too in Kigali. Our family was nine. Now we are three. In 2005 I finished school. I have been a judge in the Gacaca courts. It is good that I survived but now I am head of my family and I have to support my mother and my two married sisters (their husbands have to support their own families of origin). But I have no job. I hope to go to university some day.
What is it like to live in the same village with those known to have killed family members?
We are taught to forgive by government but then we see the criminals with their family. So it hurts. His family can achieve what we cannot because they have their whole family. I can’t provide for my family because I am a widow. I could if my husband was still here.
They can hurt you with their words even now. During the three months of memorial they can say things that shows they are proud of what they did.
Does it help to talk about it?
Yes and no. You have to be selective who you talk to. Some one might be happy or proud that I am hurting. I don’t tell it in public because it might be used by someone without good intentions.
How are you feeling about your country?
Today we should build Rwanda together by using Gacac courts to build trust. We try not to be aggressive. Unfortunately, some confess only to get absolution.
Finally, we interviewed a man who is a confessed killer. He is admitted to kill our female victim’s husband. (Remember they came in the same car from the same village. We thought was hard by the woman didn’t think anything of it! EVEN MORE AMAZING, we learned that this man also killed Jared, our translator’s father. Jared didn’t bat an eye when this was revealed to us!).
Since 1967 we learned who is Hutu and Tutsi in school. In 1990 the RPF (rebel Tutsis from Uganda who later became the government) it became worse. People said Tutsis were snakes and taught us this division. “Cut bushes” meant to cut Tutsis with a machete. For me, the genocide started 6 April 1994. When the president was killed I thought Tutsis killed him. They asked us to take revenge and killed the Tutsis. We started the same day. I killed different people. I remember each and every one. It lasted one week. Only a few survived. The RPF stopped us. I was exiled in Tanzania. We came back in 1996. I was arrested and imprisoned. In prison, they mobilized us to ask for forgiveness. I learned that I could be forgiven by God if I confessed. In prison, there were two parties–those who confessed and those who wouldn’t because they wanted to finish the job. Those who sincerely confessed had charges dropped. I was given only 9 years. But in prison, some (we learned later that some meant his own father) some tried to stop me and said the government was tricking us. Now, I’ve been here for 6 years with no problems.
What did you hear in prison?
Some confessed in order to get free. Some wanted to kill me for telling the truth. But I don’t care, I just want to tell the whole truth.
What helped you tell the truth?
The church taught me that you must confess the whole truth to the victim so you can be forgiven by God. Also, once you do this, you have to tell it many times to get it off your heart and to realize what you have done. Yet, it is difficult to come back and live with people whose relatives you killed.
What is the hardest thing for you to deal with?
I’m responsible for their pain. I have flashbacks. I hear them (the victims) crying in my memory.
Musings on Faith and Psychology 