Source: Medico International
Author: Martha Cabrera
Trauma and pain afflict not only individuals.When they become widespread and ongoing, they affect entire communities and even the country as a whole. As this socially conscious psychologist explains, the implications are serious for people’s health, the resilience of the country’s social fabric, the success of development schemes, and the hope of future generations.
When we began working from the Valdivieso Center in 1997, one year before Hurricane Mitch, virtually no one was looking at the issues we wanted to deal with: the subjective, the psychological, the spiritual. We called our effort “affective and spiritual reconstruction.” Six years on, we recognize the profound ignorance with which we launched this effort and are celebrating how much we have learned.
Why have so many workshops not worked?
One of the questions we asked ourselves back then, and are still asking, is what has happened to the millions invested in training in Nicaragua and what good has it left behind, because there isn’t a community in this country that hasn’t received a workshop on something. Everybody has been “workshopped.” There have been workshops on gender, on environment, on civic participation, to name just a few. All the realities, not to mention all the vogues that international cooperation suggests and at times imposes have been topics of workshops all over the country. But with so much effort put into so many workshops and seminars, why were the results so poor? Why, despite so much training, were people not responding to the seriousness of the problems? Why weren’t they mobilizing and making demands?
After reflecting on the factors contributing to this passivity, we had come up with some ideas and intuitions on the subject. And we had already obtained a series of results that seemed interesting to us when Hurricane Mitch hit, so we were able to use our experience on how to work with the personal dimension. We initiated a process that led us to travel through a good part of Nicaragua: León, Chinandega, Nueva Segovia, Estelí, Matagalpa… We spent a lot of time in Posoltega, the area most devastated by the hurricane. It was on those tours that we realized the deeper problem and formulated our approach: Nicaragua is a multiply wounded, multiply traumatized, multiply mourning country.
How did we reach that insight? Working on the emotional recovery of the survivors of Hurricane Mitch, we found that while people wanted to talk about their immediate losses, they had an even greater need to talk about other losses that they had never voiced before. Many women in León and 2 Chinandega would come up to us and say, for example, “Look, I’m really sad about losing my house, but I want to tell you about something else that was even harder…” And we began to listen to their stories. Many women told us things they had kept bottled up, such as: “You know what hurts me most? I suffer from insomnia. And you know why? Because I lie awake worried about my husband spending the night in my daughter’s bed, touching her…”
We also found many wounds related to Nicaragua’s political history. I still recall a man we were working with from Chinandega, who relived his earlier traumatic experiences as he was rescuing cadavers buried in the mudslide caused by Hurricane Mitch on the Casita volcano in Posoltega. “There came a moment,” he told us, “when I just couldn’t go on because the smell of death brought back horrible memories from my experience in the military service.”
We heard such stories over and over again. Women talking about rape, sexual abuse, incest and other kinds of domestic violence; many, many of the men, and women too, talking about the war, the fighting, the flight into exile in Honduras. For our team members, all of whom had come from the Sandinista side, these represented “the other face of the war.”
Creating spaces to talk about pain
When we began coming up against all these realities, we decided to change our approach. We began to create spaces in which people could talk about their other painful experiences, and thus to find ourselves with what we now call the “inventory of wounds.” We worked a whole year after Mitch with those affected by the hurricane and found an enormous amount of losses, of personal and community wounds that had not been processed or even brought into the open, and had thus not been surmounted, which was the worst part. For a variety of reasons, including the quick succession of dramatic and traumatic events in Nicaragua, people had been unable to work through their experiences. When we asked people to reflect on the impact of what they had suffered and how they had dealt with it, the first thing we discovered was that they had never had enough time to process it. Cultural factors also had an influence in this lack of processing, as did the fact that people have not had the community resources to deal with such problems, and the grassroots and social organizations have always minimized or totally ignored them. We found ourselves beginning to identify and follow what would be one of the guiding threads of our work: accompanying people in processing their wounds, which always involved acknowledging, expressing and reflecting.
Once we had developed a fairly wide-ranging and very serious picture of what we began to call the “multiple wounds phenomenon,” we began discussing it with those working on development or community projects all over Nicaragua. But they didn’t seem to get it. The most they would say to us was, “So what do you want us to do, put a psychologist in the project?” We thus discovered an enormous lack of knowledge about the manifestations and consequences of this phenomenon.
Linking physical health and psychological wounds
At the same time we were inventorying all the traumas and other afflictions and getting a feel for this lack of knowledge, we began to seek tools that would help create some understanding among those working in development. One of the bridges we discovered was to inventory the population’s health conditions parallel to the inventory of psychological wounds. When we met with groups, with communities, we would ask the people to indicate the most important losses they had suffered and also tell us about the state of their personal health. That helped us find more manifestations of the multiple wounds phenomenon, which are social and political as well as personal. We observed that a series of chronic somatic illnesses—gastritis, colitis, migraines, etc.—closely connected to unprocessed traumas were among the most frequent and serious personal manifestations. We also found that the state of our population’s health in the area of psychosomatic illnesses was truly deplorable. Using their health state was a very useful way to get people to open up more, since it is a topic that does not make people feel defensive or threatened. When we began our workshops by doing the health and illness inventory, it tended to surprise people: “What’s this? I come to a workshop on development and political advocacy and the next thing I know you’re asking me about my health.” But while the approach catches them off guard, it works.
The social and political manifestations, on the other hand, are not as immediate, not as easy to access. When a person does not or cannot work through a trauma right away, its social consequences, the most frequent of which are apathy, isolation and aggressiveness, are only revealed over time. We understood that there’s a close connection between so many accumulated wounds and traumas and the behavior that can be seen today in the large number of Nicaraguans who insist they “don’t want to know any more about politics,” or “don’t want to get involved in anything.” Unprocessed traumas and other wounds and grief explain much of the current lack of mobilization.
When one has a lot of accumulated pain, one loses the capacity to communicate with others. The ability to communicate, to be flexible and tolerant is enormously reduced among people who have a number of unresolved personal traumas. The characteristics vital to a person’s ability to function adequately become affected. The loss of solidarity that we lament in today’s Nicaragua has to do with loss of trust between people. An incredible amount of money has been spent in this country on programs to build and strengthen institutional capacity, not just in state institutions but also in nongovernmental and local grassroots organizations. But the strengthening of an institution is based on mutual trust and that is one of the things that’s lost when there is an accumulation of pain and misplaced intolerance and inflexibility.
The cultural angle: gender socialization
Our work quickly led us to coincide with an anthropologist who was also doing work along similar lines in the rural world, but particularly from the cultural angle. We discovered one of the main cultural reasons why people don’t process their grief, and that was when we came up against the cultural machismo that is so deeply rooted in Nicaragua. We learned through our daily practice that the way one expresses emotions, which always has physiological repercussions, is not innate but learned, and this learning is always based on gender socialization. Men and women don’t express their emotions the same way because they’ve been taught to do it differently. If I as a woman have learned that the emotion permitted me is sadness, because there’s a feminine model that tells me that we women have to suffer, be good and put up with things, I allow myself to complain and cry. This model also allows me to express guilt, but not rage, because if a woman does that then people say “she’s really pissed off; she’s acting like a man!” The emotions men can express and the way they can express them are also taught. Men are only allowed to express anger, even violence… but never fear, guilt or sadness, and they can never cry. They pay dearly for that repression of their emotions, as do the women close to them.
Our work has obliged us to study emotions in depth. When one is sad, it’s not something that affects an ear or a foot; it runs through the whole body. Emotion is energy in motion. That’s why fury can make the entire body go rigid. The emotions resulting from being wounded, from trauma, which are rage, sadness, fear and guilt, automatically generate bodily changes. The body is wise and uses these changes to invite us to express the emotion. Emotion is a sign that we’re alive. When we feel sad about having lost something or someone, that sadness is a sign of life. When people acknowledge pain, sadness or some other profound emotion, they usually give themselves the time needed to digest it, and when they express and reflect on it, the emotion continues its normal course, eventually dissipating. But when that acknowledgement is blocked for whatever reason, the emotions—which have an impact on the immune system, the neurological system, the circulatory system, the whole body—trigger physiological changes in blood pressure, temperature, digestion, and end up making us ill. There’s always a tight relationship between the illnesses we suffer and the emotions we repress.
Together with the study of emotions and psychology, about which there is little generalized understanding in Nicaragua, the gender perspective gave us another piece that helped us put the puzzle together better. It has been documented in Nicaragua, for example, that after the war of the eighties ended, there was increase in domestic violence in households where the men had participated in the war. These men had lived through very tough situations on the battlefield without being able to process them or express any emotion about them because of the learned masculinity model. On top of that, they went from being soldiers and officers defending their country or values to being jobless and ignored by an inhumane system. The only way they found to express their pain was through violence and aggressiveness, because that’s the only way men have learned to express their emotions and shake off their traumas.
How do you empower a traumatized population?
With a clearer picture of what was happening and what we had to do, we began asking ourselves how to make the best use of all these findings to benefit people organized around development projects. A year and a half after Mitch we were invited to a meeting with the municipal mayors of the departments of Nueva Segovia, Madriz and Estelí, and one of the questions we asked was whether they knew anything about the social manifestations of phenomena such as Mitch. Most of the mayors said they did not. This reality is both serious and shocking. Virtually all development projects, from big ones like those run by the United Nations to the small community-based projects of a sister city group, always include among their objectives the now fashionable concept of “empowerment.” But how does one empower a traumatized population? We tried to get the mayors to understand the social subjects they were working with, why people very often don’t want to participate in their development schemes, why they don’t want to participate, for example, in rebuilding their own houses. It is often said that people don’t want to change, aren’t interested in the project, don’t want to develop. But it is seldom asked why people feel that way. One of the chief answers is trauma, accumulated pain. This can be very easily illustrated: when people are hit by a car on the street, they don’t just get up, brush off the gravel, go on to work and forget about it. The very least they will do is tell others about what happened, get it off their chest, tend their wounds. Well, Nicaragua hasn’t just been hit by a car; it has been run over by a long train!
When I told those mayors to write down their personal history, their “river of life,” I found the same story I had repeatedly come across all over the country: they burned my house; I had to go into exile in Honduras; they killed my brother… Development projects continue to ignore this kind of personal history, which weighs so heavily in each of us. The great majority of training sessions, of educational or empowerment programs, consist of calling a meeting of community leaders to teach them tools with which to work with the population. But who are these leaders? What do those doing the teaching know of their personal history? Ignoring the personal history of people one is trying to teach in such a battered country is evidence of an educational model that the Left has not yet shaken off. It is based on denying the person, the individual, the subjective, on conceiving of individuals as links in a transmission chain towards a more impersonal collective project that is always supposedly for the greater good.
Assuming our personal and national history
In Estelí, we had the opportunity to have input into a project called Formation of Local Development Promoters, in which we could bring various institutions together. We worked for a year and a half on the personal histories of 90 promoters from 36 organizations, providing them with a great number of tools to then help other people deal with their own histories. We also gave them tools to be able to reflect on Nicaragua’s history and culture.
This is an extremely complex challenge, because from 1990 forward, we Nicaraguans have not been able to acquire a critical distance from the history 6 we have lived through. Even the textbooks have been changed twice and they now have such an ideological slant that they don’t allow the new generations the necessary distance either. These books polarize us; they continue reproducing the same two political bands. In response to this problem, we’ve also made an effort to prepare new texts that might help us see history more critically.
We were recently in Costa Rica working with Nicaraguan migrants there, and we observed the same thing. There is so much accumulated pain in those who suffered during the revolution for siding with the Resistance, as well as among those who suffered for supporting the Sandinistas and had to emigrate earlier, during the Somoza era. In both cases, the experience and the unprocessed pain have prevented them from being able to see their history through other eyes and move beyond it.
Rethinking organizational models and changing leadership styles
All this led us to another issue: the organizational one. In Nicaragua, a great many organizations want to do “open heart surgery with a machete,” as one observer quipped. They want to “change the world,” but do nothing to change an old-fashioned model within the organization itself and thus reproduce a leadership style that blocks any real change. Daniel Ortega and Arnoldo Alemán are far from the only caudillos in this country. That political boss syndrome is reproduced in social organizations, in NGOs, in all sectors of our society. The question is not whether we have democratic organizations, but whether we can have them. We’ve discovered that it’s very difficult to build democracy when a country’s personal history still hurts.
Many efforts are being made in Nicaragua. Anywhere one goes, one finds an abundance of projects. But we have to return to the question of why so much effort is failing to bear fruit. In part, it is because activism abounds while theory is rejected. Any first world university would pay good money to come and study our country, yet we Nicaraguans have still not come up with a theory about it. When one works with organizations and offers them a pamphlet with new ideas, and a new theory, everybody grabs for a copy, sticks it in a pocket then never reads it. So we’re always returning to our reality with the same tools as always, ones that no longer work. If Paulo Freire were still alive, he would be shocked and hurt to see how popular education has become so diluted in Nicaragua. It is nothing but an endless cycle of working groups “systematizing” their discussions on drawing-paper flip charts. How can we change our reality when popular education is reduced to that and when organizations are doing the same old thing over and over without questioning why it leads nowhere?
Although the multiple wounds phenomenon cannot explain all of this, it does explain a lot and affects nearly all of Nicaragua. Most of those promoting development processes all over the country today are themselves affected by traumatic situations. Our task has been to convince those very people that they have to deal with this problem, but their typical response is: Why get caught up in all that when a self-esteem workshop would do? But it’s not enough. Experience has shown us that when we ask community leaders to talk about their life, many are taken aback at first, but afterwards they all thank us for it because it helps them understand and move forward.
Social change requires personal change
Personal change is key to organizational processes. There can be no social change without personal change, because one is forced to fight every day to achieve that change. Our proposal for accompanying organizations currently has four major areas. The first module focuses on the personal sphere, which is where crises, wounds, health, the conception of healing, life style and holistic health habits come in. A second module is historical-cultural, in which we try to understand how our personal life is marked by the country’s history and the national culture and we explain how many dysfunctional strategies our culture has and how they are expressed. The third module is the organizational one and the fourth is dedicated to development. Practice has helped us avoid seeing these four modules as separate and we constantly try to make connections among them. Depending on the organization, we give space to spirituality in the historical-cultural element, because we have found that many people in the eighties found meaning, their reason for being, in the revolution, but have not identified with any religion or spirituality since it ended and thus feel a profound emptiness. It is important for people to explore their spiritual dimension to improve their own mental and physical health, and to improve the functioning of their organizations. This is why we work a lot with rituals, using them as tools that can pull groups together.
By introducing the concept of personal healing into the organizations, we are able to reveal people’s wounds and explain to them the correct way to deal with trauma, with pain, through three simple steps: acknowledge what happened, express what happened and reflect on what happened. But while this may be the right way, it’s not easy in a society that denies the widespread nature of sexual abuse within families, the incredibly high level of incest around us. How can this be cured if society refuses to discuss it? How are we going to heal the country’s main political wounds if we have not yet reflected on them? When we go into organizations wanting to reflect on these things, they often respond, “What are you looking to do, destroy the organization?” Reflection is avoided because it involves separating the good from the bad, the correct from the incorrect. Many people from both the Sandinista band and the anti-Sandinista band still have a lot of difficulty accepting the errors committed, expressing these problems, reflecting on them. They believe that to accept, talk about and reflect on them does harm rather than heals. Our effort amounts to nothing more than providing tools so that people can begin these personal and collective healing processes.
Structuring the healing process
The healing process must have a beginning and an end. All the theories say so. We soon realized that we needed to go into this not just getting people to talk about their losses, but helping them discover that talking about them would produce a gain. We also discovered an approach to explain that traumas block the energy that circulates through one’s body and that there are ways to unblock it. It is has been studied and proven that people who suffer from the multiple wounds phenomenon have much less energy. The reason is simple: every time a person suffers and doesn’t process that suffering, the first thing that is restricted is their breathing capacity. Every time we suffer an aggression, our body reacts, shrinks into itself, tenses up. And the first effect of that 8 reaction is to reduce the amount of oxygen that the body takes in. And when the body receives less oxygen, it has less energy available. The Eastern cultures have known about this for thousands of years, which is why breathing is at the core of so many oriental techniques.
Once people have worked on the state of their health, we move on to theory and explain the process of dealing with their pain. After doing that, we invite them to go to their personal history, which they can do using the river of life method, or other methods. We put a lot of emphasis on the importance of improving interpersonal relationships to be able to work on pain. The personal module consists of three very active, very lucid workshops lasting two and a half days. What is called popular education today has lost a lot of its gaiety, its games and laughter. And games have great healing power. Healing doesn’t always have to involve tears. It’s important to provide the group with a continuous flow of tools, until people understand that they have the power to heal themselves and assume personal responsibility for doing so.
The suicide rate has shot up in Nicaragua, but while suicide is yet another manifestation of the multiple wounds phenomenon, we shouldn’t center all reflection on it. There are other daily ways of avoiding pain that are slower forms of suicide and are much more common in our country. Alcoholism, as an example, is very widespread in Nicaragua and even in the organizations, but no one has really reflected on this problem.
The importance of collective healing and assuming personal responsibility
Multiply wounded societies run the risk of becoming societies with intergenerational traumas. It is virtually a law that one treats others the way one treats oneself. Anywhere that large population groups are traumatized, the trauma is transferred to the next generation. Working with the multiple wound phenomenon means accepting that the wounds are collective as well as personal. Nicaragua’s revolution was a collective phenomenon, but any dealing with the pain represented by the loss of the revolution has been individual. And today, 12 years after the Sandinistas’ 1990 electoral defeat, we still find many people in workshops who have not gotten over that defeat. Our field work has led us to believe that we have to talk about that past, in fact our whole past history, if we want to heal ourselves.
One doesn’t need a psychologist to heal oneself. In many modern conceptions, healing is a collective challenge based on the recognition that my pain, your pain, the other person’s pain are similar. And if we are to collectively heal ourselves, we need to undergo a cultural change. Why is it that people don’t talk? Because they are subjected to the strong cultural mandate that “dirty laundry is washed at home.”
In essence, healing has to do with the process of assuming personal responsibility. It means that I assume responsibility for my life, for curing myself. And assuming that responsibility involves distancing myself from this country’s traditional leadership model and building a new one. It’s not an easy assignment. The leaders in the old Nicaraguan model are hypocritical—leftists outside of their home and fascists within. Proposing to heal oneself personally reveals this contradiction and assures us of a new leadership for the future in which there is coherence between the personal and public spheres. Our 9 leadership model has traditionally generated problems rather than resolving them as our leaders feed off political polarization and foment it. This is currently a very relevant problem: we recycle political and social leaders and they recycle ideas. Meanwhile, organizations don’t know how to confront such leadership, whether out of a lack of capacity or exhaustion.
We urge community leaders to review their lifestyle because we’ve discovered that, despite all the self-esteem workshops, people plod on without taking care of themselves. We’ve gone to communities where the heat is unbearable, yet when we ask people if they’re drinking a lot of water they say no. They don’t even take on board something as simple as this basic care for oneself. Where does development begin if it doesn’t begin within oneself? Where does leadership begin, if one doesn’t take responsibility for oneself and provide the example? Leadership of others abounds, but it’s a leadership that no longer functions. What we need is leadership that starts with the personal, leaders who lead from their own values, their own life, but that’s a lot more complicated than the do as I say, not as I do syndrome.
In one workshop in Costa Rica with a group of 25 Nicaraguan migrants, we uncovered 60 psychosomatic illnesses. Having emigrated to Costa Rica, Nicaraguans add the pain of being a migrant to the many wounds they brought with them from Nicaragua. We discovered that being Nicaraguan is painful outside of the country, particularly in Costa Rica, because it is contrasted to Costa Rican identity and Nicaraguans feel ashamed of who they are because they have a negative vision of their own history. We talked a lot about being uprooted and told them that if they want to build solid organizations as migrants, the first root they have to put down is inside themselves. If they want to build these organizations, they have to deal with reflecting on Nicaragua’s history, which could appear to be an irrelevant past but is in fact present within them. This is because pain doesn’t run on chronological time, which is only one way of measuring time. It runs on psychological time, which moves to a different beat. When a person is raped, for example, the body has a memory of that violation. When a person suffers sexual abuse at age five, that wound remains in the present even if the person is now thirty. The memory of it may be blocked for survival purposes, but it will be present in many forms: nightmares, fears, ways of relating to others, the person’s health.
It is essential to understand that all painful experiences that are not worked through are expressed not only in the person, but also in the organizations. The frequently offered advice that one should leave one’s own problems behind when one goes to work is erroneous, if only because it is impossible. People take their baggage with them everywhere they go. It is also essential not to see wounds and traumas just in their negative sense. They are a source of experience and wisdom. In fact, working through personal trauma is nothing other than transforming it into wisdom for oneself and for others.
Finding meaning helps find new energy
Populations that are multiply wounded as a product of permanent stress lose their capacity to make decisions and plan for the future due to the excess suffering they have lived through and not processed. But when people begin to talk about their history, assume it and reflect on it, a fundamental process takes place that is not achieved by traditional training programs: people find meaning 10 and significance in what they have lived through. Reconstructing the sense of our national and personal histories is a path to understanding that there is meaning in what we are and what we have lived through despite everything, and this is what allows us to go forward in life. But going forward is only possible if people can find new energy.
We begin to reconstruct both the social fabric and ourselves insofar as we allow ourselves to work through our personal history and open ourselves up to this possibility. So many projects have the stated goal of “reconstructing the social fabric,” but who reconstructs a society’s fabric? People do. So first we have to reconstruct people. This recognition should lead us to analyze the development model we are proposing in our projects. Are they really people centered projects?
The unity of mind, body and spirit
How do we create a holistic, attractive development approach that provides results? We have discovered the importance of understanding the unity of mind, body and spirit to achieve this. Unfortunately, Western tradition has created three separate professions—psychologists, physicians and religious personnel—to deal with what is really a single reality. The fact is that we are one thing: mind, body and spirit. In our proposed process for working through pain and reconstructing ourselves, we have learned to work with the body through dance, music, tai chi, meditation and relaxation exercises. And we do it in the conviction that the body has a tremendous healing capacity, its own potential to reconstruct itself. We have learned that when people talk about and assume their personal experience and begin to find sense in their life, it is easier to propose a change of habits and a healthier life, and thus people begin to shake off many bodily ills that were beating them down. Working with the body is an excellent way of helping people feel that they can change.
On the issue of development, we have embraced the “Development on a Human Scale” approach of the Chilean, Manfred Max Neef. This author has formulated a matrix of human needs that includes those related to subsistence as well as others related to affection, belonging, identity, creativity… He also establishes a distinction between satisfiers and compensators. In Nicaragua, for example, prostitution compensates for the lack of a sex life, but does not satisfy the need for it. A satisfier is fresh orange juice, and a compensator is orange colored soda pop. It’s important for organizations to reflect on what they are promoting: satisfiers or compensators. Max Neef also argues that rather than continuing to speak of poverty, we must speak of poverties, and that a chronic lack of any satisfier amounts to poverty. This approach has helped us integrate the personal, historical-cultural and organizational approaches, in the knowledge that we cannot continue separating personal and social development. To develop, Nicaragua needs to address the problems in a more comprehensive way, in which we never stop learning or understanding. International aid projects impose leadership or civic participation criteria on us, but reality is telling us that they are a failure, that we need a more comprehensive vision.
Results don’t lie. And we now have results. We began working with a few organizations, and are now working with a whole set of them, so far. We 11 firmly believe in the concept of “critical mass.” We need a minimum group of transformed people to be able to change things. A small group will be enough, as long as it is made up of people freed up and willing to do big things. That’s what we’re banking on.