As the anniversary of Haiti’s catastrophic January 12, 2010, earthquake approaches, physical and emotional symptoms that were ebbing or had disappeared, are rising. We hear it everywhere as we– Linda Metayer, our Haiti program director, and I–move through a day of visits and talks with staff at the General Hospital and the Ministry of Health, as well as with kids and adults in tent camps in Petionville, a suburb of Port-au-Prince that is a city of half a million.
Headaches have intensified, and sleep is ever more disturbed by sudden awakenings and half remembered nightmares. Irritability and anger sweep people away in rage at children, who are themselves agitated by neighbors who are too close and too ever-present, too troubled and helpless, too painfully mirroring their own suffering.
Everyone knows in their bodies, as well as from the calendar, that the anniversary is coming, but there is little plan for public ceremony that might make remembrance and mourning easier, and bring hope for a happier future. The program that Linda Metayer and Rene Domercant (a Ministry of Health official who attended our first training in December) have organized at the General Hospital is a happy exception.
After an introduction by Dr Jocelyn Pierre-Louis, one of the Ministry of Health’s leaders and a strong supporter of CMBM’s program, Linda, Rene and I speak. Our talks are nicely paired: Linda and I discuss the extent of psychological trauma and the practical steps people can take to heal themselves and their communities psychologically, and I teach slow, relaxing soft belly breathing and get everyone to move their body. A number of these professionals appreciate the immediate effectiveness and ease of the techniques – “I feel so calm,” says one; “So calm I went to sleep,” adds another, and everyone laughs, recognizing the tension that keeps them awake and the need for rest. “I felt tears come,” another woman adds – all the emotion that needs to be released, I suggest, and she nods.
Afterwards Rene, who is an engineer as well as a psychologist, shows slides from a manual for safe rebuilding: foundations propped and buttressed so they are no longer unbalanced and unstable, second stories supported by first floors that have sustaining walls. Each slide is paired a “Don’t” in red which can lead to collapse in a future earthquake, a “Do” in green – the safe way to sustain a dwelling and save lives. These slides will be shown everywhere in Haiti and distributed in booklets, Rene tells us.
What a pleasantly surprising symmetry and pairing: principles and building blocks for new safe houses, and for emotional and physical self-care–a hopeful beginning for the new year.
25 participants come today, making their way to the hotel around barricades and tire fires in the streets avoiding the demonstrators armed more and more now with guns as well as machetes. Just outside the hotel several men, apparently from one political party, have opened fire on others. Three are dead.
(by Naftali Halberstadt for CMBM)
The tent camp on the Champ de Mars is uneasy. People are moving away from the street, ahead of rumors of revenge for political sympathies that some feel are unacceptable. Inside the hotel, its gates locked, its security guards on alert, we feel pretty safe. We’re sitting in a large circle answering questions, sharing what we have learned and are learning. “Is it helpful?” a psychologist asks, “to talk about what makes us afraid? Shouldn’t we use images to make it go away?”
“We cannot force away our fear,” I say. “It doesn’t seem to work. The fear will return.” Heads nod in agreement.
“But isn’t it possible to relax with your fears?” a teacher asks.
“Yes,” I respond, happy at an apt pupil, “that is exactly what we teach.”
(by Mark Silverberg for CMBM)
“Well,” grinning now, he says, “Let me tell you about yesterday. I was at my school and there was shooting outside between political parties and everyone was upset and very scared. I said, ‘I’ve been in a training and I’ve learned a technique for relaxing even in such difficult situations.’ So, I taught them the safe place images. We sat for ten minutes or so, and afterwards the shooting was still going, but we were smiling and talking with each other, and even singing together.”
And so it goes for the rest of the day, stories of finding a little calm in the chaos, our participants’ eagerness to take what they are learning into their homes, classrooms and clinics.
“My bishop,” a priest tells me, “wants everyone in the parish to learn what you are teaching.” The dean of the midwifery school says she will begin tomorrow to bring our work into the delivery room, to all “sage femmes” who will attend the births of the next generation.
During the training, we do a drawings exercise, a sequence of three pages: one of “one’s self,” “one’s biggest problem” and “the solution to the problem”- and they are as always a revelation. They display what is inside each person and the images of one participant so often are a mirror for those of others.
The biggest problem of one physician here is shown as a clot of black guilt and fear and shame, of inhibited action and feeling buried under a mountain. She is straining for faith, toward a distant Jesus, and to do what must be done. But she feels unable to move or believe. In the third drawing all the conflicted colors of the mountain are striped in an arc du ciel, a rainbow. “ I was buried,” she says, “and now in this drawing I can see myself free, imagine myself again with my God.” (To learn more about our drawing exercises, read this post, “CMBM’s Drawing Exercise Resonates in Haiti,” when we introduced it in June.)
A participant shares what she learned during the drawings exercise (photo by Mark Silverberg for CMBM)
“I have in my drawings,” says Linda, the psychologist who coordinates our Haiti program, “dropped the mask of sunny happiness that I felt I had to put on. I have allowed myself to feel the loss of my father last week. And dancing and crying,” she adds, pointing to her third drawing, “I have found the authentic happiness inside myself.”
(photo by Mark Silverberg for CMBM)
Checking in emotionally on the second day, my group members find their own choked-off voices- amazing how many cough and clear their throats and say they have forgotten how to say how they feel. They speak and are heard, listened, and they recognize that they are actually here with others who care and not alone. A nun and teacher who at first had felt so lonely as the only religious (woman) in the group realizes that she is not alone at all, “My images of pain and sadness are so similar to those of others. Showing you my drawings, telling you about them, I feel you are my sisters, and my brothers too.”
After the first day our participants are already using what they have learned. Several speak of “traffic meditation,” pulling over to the curb amidst Port-au-Prince’s daily madness, soft belly breathing (click here for a short guided meditation) until they are “calme” and “douce,” peaceful, soft and amazingly unhurried. A psychologist at odds with her teenage son reports asking him to breathe deeply with her and dissolving the tension that had led to fights, “…every night since the earthquake.” Several say that deep breathing and shaking and dancing had allowed them to sleep peacefully for the first time ever since January 12th.
Here is a short video of Linda Metayer, our Haiti Clinical/Program Director, describing what she feels Haitian trainees are gaining here:
Tears are everywhere. Like high water behind a dam, you can see them swelling, pressing for release in the stiff bodies and taut faces of men and women who gather for the first day of our training.
We’ve selected 120 clinicians, educators and religious leaders. About that many crowd the registration desk and fill the chairs in our lecture hall. But they aren’t exactly the 120 that we invited.
This is the beginning of our Haiti training, but before I tell you about these new colleagues of ours and about what we are learning together, I have to jump to Wednesday morning—Day Four– and to the hours last night, after the election results were in. Demonstrators filled the streets outside our hotel in front of the Champs De Mars, angry thousands protesting results which certified President Preval’s son-in-law in-waiting, Jude Celestin, as a participant in a run-off election. Last night our team heard the pop of gunshots as a counterpoint to the rhythm of music from the hotel band. This morning, smoke from fires fills the air as demonstrators march toward, and, we are told, destroy Celestin’s headquarters.
Full streets in post-election Port-au-Prince (photo by Mark Silverberg for CMBM)
Everyone we meet believes Mrs. Mirlande Manigat was indeed the legitimate top vote getter, and they are convinced that another candidate, Michel “Sweet Mickey” Martelly, the pop singer, had more votes than Celestin and if he didn’t, someone else certainly did.
The election results seem to the Haitians only the most recent insult, the latest dismissal of their sovereignty, indeed of their humanity- -once again the big man appoints his successor. All the frustration of all of their months since the earthquake and all the years before, all the pain we’ve seen in the tent dwellers on the Champ de Mars and in the faces of the men and women we are training is erupting- moving this afternoon uphill towards Celestin’s headquarters, and the homes of the rich and powerful.
On this day of anger and danger, only half a dozen of our participants have made their way through large, angry, often armed mobs and small fires. The rest however, have been on the phone, “Tomorrow?” “Don’t do too much today; we don’t want to miss anything.” “Can your international team stay another day?”
Back to the Beginning-Training, Day 2
On Day Two some of our invited participants were kept away by the urgent demands of cholera care, and by fears of the demonstrations that had not yet occurred. But others arrived from the Ministry of Health, the universities, the schools and churches to take their place. By the second day these eager volunteers and the original invitees were joined by the latecomers and by some who have somehow heard stories about unexpected relaxation and education, welcome, and safety. At lunch we feed 145.
The small groups which are central to this adventure in self discovery and self-care- so supportive and inviting for men and women who have held back personal feeling in favor of continual service to others- have swollen in size.
Sharing difficult emotions in small group time (photo by Mark Silverberg for CMBM)
12 or 14 men and women sit in circles meditating, breathing in through their nose and out through their mouth, allowing their bellies to relax, expand, become soft. After they open their eyes they share who they are, what they do, and why they took five days from over burdened schedules to be with us. They speak in turn about the first morning’s large group lectures and “experiential exercises.”
“After the shaking and dancing,” an anesthesiologist begins, “I felt freer. There are not many people in my profession and after the earthquake we did amputations all the time. It was painful. I lost my spontaneity. I think we all have. It was good to dance.” (Read more about the shaking and dancing we used in Haitian schools here)
A Haitian trainee helps Jim demonstrate chaotic breathing, an active movement meditation (photo by Mark Silverberg for CMBM)
As we go around the circle the possibility of sitting peacefully, of relaxing at the end of the day, rises on horizons dimmed by almost unimaginable loss, “I have tried,” another physician says, “to bury myself in work so that I do not think of all of those who have died and are buried in the ground.”
“Or are still buried under piles of concrete,” another adds with grim precision.
To be continued tomorrow–check back to learn about how CMBM’s healing drawing exercises and what the participants appreciate about the training.
Our team has been gathering for the last two days, long flights and sometimes long delays as well.
Jamil Atti is in from Gaza, Afrim Blyta and Jusuf Ulaj from Kosovo, and Naftali Halberstadt from Jerusalem- psychiatrists and psychologists who have lived through war and terrorism themselves, leaders of our program in their country, friends and brothers. From the US, Amy Shinal (our Clinical Director) Lynda Richtsmeier Cyr, Kathy Farah, Lora Matz and Jerrol Kimmel, physicians and psychotherapists–long time friends of 10 to 15 years, talented, adventurous, deeply committed to this international work.
Jusuf Ulaj, MD (CMBM senior faculty from Kosovo) and Jim Gordon, MD in Port-au-Prince (photo by Mark Silverberg for CMBM)
Linda Metayer is our Haitian Program Coordinator, a psychologist with a degree in public health, as brave and courteous as she is smart and competent. Lee-Ann Gallarano, who organizes all of our work with trauma around the world, was working with Linda before we arrived with Jesse Harding, our newest staff member, who several years before worked with Lee-Ann when they were Peace Corps Volunteers in Mali. Tod and “B”, gifted documentarians, are filming us, and Mark, who has volunteered his time, is taking most of the still photos you’ll see on this blog.
Linda Metayer, MPH, psychologist: CMBM's Clinical/Program Director in Haiti (photo by Mark Silverberg for CMBM)
We spend this first day “checking-in”, hugging, laughing, sometimes crying, as we tell the stories of our first meetings, recalling the power of soft belly breathing to help us relax in the middle of fire fights, of Afrim informing us in Gaza City that the 3AM earth shaking noises were in fact sonic booms. And everyone is speaking of the realization, growing over the years that, “You are my people,” “This is the work I want to do,” “I am at home.”
In the early evening Linda, Amy, Jesse and I walk with our camera crews into the sprawling tent camp across from our hotel- 10,000 people in the Champs de Mars. We had been told that “from the outside things look better.” There were fewer tents, less crowding. Up close the opposite turns out to be true- some people have indeed left, clearing out in terror of cholera, but everyone doubts they have found places much better. Meanwhile, moving from one clump of canvas, plywood, plastic and corrugated metal– one collection of shelters to another — we hear similar disturbing, dispirited stories: there is actually less food and water than there was four months ago and far more violence. Women, and muscular men as well, tell us that if and when they are able to sleep, it is with one eye open, alert to robbers who are often armed, and to rapists. The jobs cleaning rubble that once helped sustain these encampments have moved on, though no one knows exactly where.
Though some people are shy and wary, virtually everyone is gracious and within a few moments, eager to talk to us. Mothers tell us that so many of the children are “hyper” since the earthquake. We see them shuffling from foot to foot, eyes shifting with their bodies. The mothers say they have lost weight. When I ask about emotional problems everyone- men, women, teenagers- says they are angry. “What do you do?” I say. “I pray to God,” several say. “I take this medicine,” says a man raising a small bottle of homebrew. A woman says, troubled, but resigned, “I beat my children.” Several others nod.
Linda Metayer, with Haitians living in Champs de Mars camp, Port-au-Prince (photo by Mark Silverberg for CMBM)
As we move from one section of the camp to the other, two teenagers run past and jostle Linda. A moment later we see that her necklace is gone. She is a bit shaken, but philosophical, “They do it to eat,” she says. Other camps are likely to be somewhat better, but some are not and there are 10,000 people here. Walking back to our hotel I feel the weight of life here in Haiti, people stretched and pushed beyond breaking. I think of how much our work is needed, and I feel frustration along with everyone else. “Where is the organization?” I ask rhetorically, “The benefits of all the money the international community has committed?”
Exciting news–I’ll be speaking on NPR’s Talk of the Nation today, Thursday Oct. 28, about the best ways to rebuild Haiti, sustainably and permanently, in the wake of the earthquake and continuing hardships the Haitian people face.
I’ll talk about what has worked for CMBM in the past when creating sustainable programs of mental health care in post-war and post-disaster areas like Gaza, Kosovo, and New Orleans, and what we have planned for Haiti. (Our first Professional Training Program in Port-au-Prince is scheduled for early December.)
If you’d like to listen to the show live, check your local NPR listings here (If you’re in the DC area, it’s on WAMU 88.5, 2-4pm EST, and the segment will probably air between 3-3:45pm EST).
If you can’t catch it live, check back at the Talk of the Nation website, and it should be available for listening or download later today. I hope you can tune in.
A big thank you to all the donors who are making this program possible (and there’s still time to donate), and all my best to all of you.
I’m so pleased to present to you this brand new, powerful documentary we filmed this July. I hope you’ll take a few minutes to watch it (it’s under ten minutes long) and see the beautiful, healing work our trainees are doing in this troubled place.
Thanks to everyone who has made this work, and this film, possible; especially our donors (including Atlantic Philanthropies, and private donations by donors like you), our Gaza Program Administrators, and our talented staff (including Catalina LeMaitre, who produced this video).
I have wonderful news to share with you today, an amazing article on our work in Gaza from this morning’s New York Times. It gives such an accurate feeling for the touching , powerful, and effective work The Center for Mind-Body Medicine is doing in Gaza and for the spirit of healing, community and hope that I believe pervades everything that we do.
Please read this testament—so amazing to have it so well and feelingly presented in The New York Times—to the possibility of transformational change
We’re delighted that this Gaza program, which is nurtured and sustained by so many dedicated and generous people (health and mental health professionals, teachers, community and religious leaders, and our funder, the Atlantic Philanthropies) is being so positively recognized. I hope you’ll take the time to read this beautifully crafted piece and share it with friends.
I also wanted to share a few stories I’ve been saving for you from a visit to our program there in August, (the second visit within three weeks). We were moved on both visits by the ways our Gaza team is helping children and other folks—every kind of person—to relax in the midst of poverty, danger and chaos. And it was so touching and such fun to be with our dedicated, passionate, raucous, talented and tender Gaza team (you hear some of their voices in TheTimes article) and with Jamil, who leads them.
During our time in Gaza, we visited with some of our recent trainees –there are about 130 new ones this year. Throughout his training with us, one counselor—I’ll call him Abed—was so skeptical, so cantankerous: no question was too obscure to ask, no objection too small to raise. A couple of weeks ago, we watched him sit on the floor—sweet and solicitous and playful –with the most troubled five year old boys from the kindergarten with which he was consulting. The boys—cute, squirmy, solemn and giggly—showed us how to do “soft belly breathing” and told us how they have brought relaxation into their families — “and guided imagery too.” And, an excited five-year-old added, “I taught my brothers and sisters and my parents about the genogram.”
We saw two groups for women with breast and lung cancer. Cancer, we were told, is regarded in Gaza as a disgrace as well as a disease, a kind of plague which provokes shunning. “No one wants to know you,” we were told, “except in this group.” “I felt worthless…dead already,” said another woman. “The mind-body group relaxed me and brought me back to life.” Another woman, stout and older, proudly showed us “chaotic breathing”—flapping her arms up and down, breathing deep and fast. “I do it every day. It makes me feel so strong,” she said with a grin.
Then there was a group for kids with Down Syndrome, the boys lying on mats, imagining safe places “at a beach,” “in the garden,” or “at a sister’s beautiful wedding.” We now have 160 mind-body groups in Gaza. They meet for ten weeks and then 150 to 160 more begin. The film of all this and more will be ready soon, and we will share it with you as soon as it is. (I’ll be sure to post a link here.)
We’re growing—in many ways.
More soon. In the meantime, lots of love to all of you.
I wanted to share with you an article I just published on Health News Digest. I hope you’ll find it useful going into the Labor Day weekend, and that you’ll share with friends and family who may be in need of some stress relief.
Labor Day Tips for Reducing Stress by James S. Gordon, M.D. (originally posted on Health News Digest: Original Article)
Labor Day is traditionally a time of rest before the renewed activity of fall. For tens of millions of Americans who are unemployed or underemployed it is a time of high stress, a time when anxiety caused by economic insecurity and foreclosures unsettles, agitates, and casts a shadow over the unemployed and their families.
Over the years, I have worked with thousands of people who have been made anxious and depressed by economic hardship. Here are five steps drawn from my most recent book, “Unstuck: Your Guide to the Seven-Stage Journey Out of Depression,” that people can take to address the pain and insecurity that may come with today’s economic uncertainty. All of them are free and all can be easily learned and done at home.
1. Begin a simple nondenominational meditation practice: Slow, deep breathing — in through the nose, out through the mouth, with the belly soft and relaxed and the eyes closed — is a sure antidote to the stress response that uncertainty provokes. To encourage relaxation you can say, “soft” as you breathe in and “belly” as you breathe out. Begin with five minutes, two to three times a day.
2. Move your body: Physical exercise may be the single best therapy for depression. It’s very good for anxiety as well. Find any kind of movement that suits you, jog, dance, swim, or walk, it all works. You’ll see and feel some benefits after 15-20 minutes.
3. Reach out to others: Human connection — to family, friends, co-workers in the same boat — is an antidote to the sense of aimlessness and isolation that may come from job loss or unexpected economic insecurity.
4. Find someone who will listen and help you take a realistic look at your situation: Allow a trusted friend or adviser to help you look for possible solutions for any stressful situations you may be experiencing. In addition to helping you unburden your mind, body and spirit, a trusted friend or advisor can often see solutions more clearly than you and can help you find ways to put these solutions to work.
5. Let your imagination help you find healing and new meaning and purpose: After breathing deeply and relaxing for a few minutes, imagine someplace safe and comfortable, it could be a place you know and love or one that comes to you. Make yourself at home there, notice what’s around you, breathe deeply and relax. My colleagues and I at the Center for Mind-Body Medicine have used this safe place imagery successfully with New York City fire fighters after 9/11, with U.S. troops going to or returning from Iraq and Afghanistan, and with families in New Orleans in the aftermath of Hurricane Katrina. We teach it every day in our offices and like the other four steps, we use it ourselves.
A hundred nursing students come to our hotel. More than ninety of their classmates died on January 12th in their school building. The sense of sadness and loss are palpable.
They are quiet, expectant, and perhaps a little puzzled at first. What is this “mind-body medicine” all about? And then, as I begin to talk with them about fight-or-flight and stress, they become animated—calling up the unspeakable terror of the earthquake along with the biological facts and personal experience. I explain that just as trauma can produce the symptoms of ongoing stress: difficulty concentrating, sleeplessness, anger, lethargy, flashbacks of death and destruction. The techniques we are going to teach—slow deep breathing, self-expression and self-discovery in drawings, sharing one’s pain and hopes with others, and moving one’s body—can give relief; restore a sense of calmness, provide perspective, grant them a sense of control, open the door to the possibility of a future.
By the time Amy is explaining imagery and Kathy and Lynda are encouraging them in their drawings, the young women are alive with pleasure and discovery. They share first with each other, and then with the whole group. They show us pictures bisected by the barriers between the living and the dead, whom they miss so much, and third drawings that reveal the possibility of feeling, though bereaved, whole again in nature and with family and friends.
By the time we clear away the chairs and began to shake, the girls are waving their arms and laughing. When Bob Marley’s “Three Little Birds (Every Little Thing’s Gunna Be Alright)” comes on, they sing with him, and us. Some of us are still laughing, others crying in release, with gratitude as well as grief.
Afterwards, the Dean of the Nursing School speaks for a moment. “Words,” she says, herself crying, “cannot express what you have done for us today.”
“And,” I think to myself, “what you are doing and teaching to us.”
Welcome--I hope you enjoy these stories of healing through mind-body medicine from our programs around the world. 
