Saturday, November 7, 2009
remarkably different meanings
It was a typical training day, one like any other. For me, this meant a fine balance between didactic lessons and experiential trust building activities that facilitate self-disclosure and the feelings of the therapeutic experience rather than simply an intellectual understanding of the therapeutic experience. With time and experience I have found that my students all over the globe are much like I was when I was a green inexperienced therapist: suckers for a good case study and a deeper understanding of all the fascinating diagnosis that touch our captivating species. So the idea was to first teach a wide variety of diagnosis from depression to anxiety with PTSD and Bi-Polar mood disorder at the spectrum ends (for those of you who are curious these are all diagnosis I have seen in the numerous developed and undeveloped countries I have worked in).
As I explained each symptom constellation I stressed that the point was not to diagnosis just to diagnosis but rather to enlighten the patient, the counselor and his or her family about their experienced emotional or psychological struggles and to create a plan towards less suffering, less confusion and an experience of feeling less alone in the world. After I explained the 9 most common disorders, disorders that occur on average in 1 in 20 individuals at least once in their lifetime in a stable environment (now for a minute consider what the rates must be in environments that have been impacted by war, human rights violations, discrimination and mass violence has on psychological well being), I told them we would be would be playing a diagnosis game. I shared 8 case studies and they were to diagnosis each case base on the symptoms presented and described. The two most important features to differentiating between spectrum diagnosis (like dysthymia and major depression or acute stress disorder and post traumatic stress disorder) are frequency and duration; or, “How long and how often?”
This is where it all began. In my dramatic presentation of each diagnosis full of tears, hand wringing, lethargy, flashback and obsessive checking behavior I always ended with, “always remember we should ask for how long and how often the symptoms have been present.” Each time I said this I sensed something. It wasn’t anything that was said or even any non-verbal signs just something in the air I suppose. As I got more dramatic in my acting out of various symptom consolations came a more relaxed audience who were getting a kick out of me making a fool of myself. As they became more relaxed, the more noticeable reactions I started to get to my “now remember always ask for how long and how often the symptoms have been present.”
The module went on and they got completely enthralled by the case studies and the diagnosis game that I forgot about all the subtle confusion I was feeling and went on with my day. The next day I was enjoying a cup of 3-in-1 Nescafe while groups of trainees prepared for a pending presentation when one of the participants approached me quietly and asked if we could chat. He shared part of her personal story and then, as others started moving towards us, quickly changed the subject and said, “Gwan I have to tell you something funny about something you have been saying a lot lately.” At first I was worried that maybe I was saying or doing something that was culturally inappropriate and he was trying to be nice about breaking the news to me, but instead he said, “it’s when you say how long.”
“How long?” I replied. “Tell me more” (tell me more is my classic therapy reaction to just about anything to keep people talking in a non-directive manner).
“Well in Burmese…” he replies, “How long means without longyi.”
“Like someone who wears pants instead of the classic Burmese skirt” (that is commonly worn by both men and women albeit in a gender specific wrap style), I reply.
“No not exactly,” he says, “like when someone’s longyi has fallen off accidently.”
I start laughing which causes him to give out a sigh of relief as he must have been worried I might feel ashamed when I heard such news. I yell out “How long!” and look down at and pat my skirt to make sure it is there and we both crack up. His laugh was so fantastic that I fall into one of my silent laughing fits that lead to tears and breathless gasps (I know those of you who know me best are shaking your heads right now with deep understanding). This loss of control on my part causes everyone in the room to be briefed on the fact I had been briefed by the “how long issue” and after a collective sigh, everyone bursts out in laughter.
From there on out “How Long” was our group’s inside joke and it did wonders for the togetherness and connectivity and I didn’t mind in the least that it was at my expense. When on the final day I wrote “Mr. How Long” on this gentleman’s compliment card it was a sealed deal: we would all always remember an ever so slightly strange and potentially awkward lost in translation moment that turned into an unforgettable shared moment. Given unadulterated shared laughter is such a rare event in environments between foreigners, where language and culture and power and respect and a ton of other potentially disconnecting elements prevent such simple yet important playful events to occur, this lost in translation moment will forever remain a cherished memory for me and I will never again be able to say “how long” without a small smirk and giggle.
Saturday, October 31, 2009
these are the things I must never forget
To capture my reasoning for the final memorable item I would like to share a story.
I will call this story "bit dine thow: throw ever stand."
Bit Dine Thow is the name for a famous toy from this country; the meaning also seems to capture the resilient aspects of the civilian population here, forever being tossed around; forever managing to land on their feet.
I learned about this special toy a few days ago. It occurred during a training I was facilitating on Child Development and Experiential Education for a number of local Community Based Organizations (CBOs). After presenting on maternal health, the importance of reading to children between the ages of zero and three, mental health problems in children and the Mozart Effect, I asked the group to break into small groups and design a toy that would help foster the healthy development of all aspects of child development (i.e., physical, motor, cognitive, social-emotional and language). Interestingly, rather than design what I imagined (a high tech futuristic toy with all sorts of gadgets and interactive educational parts) each group choose a simple yet highly effective toy that have been around for ages. One group selected a jump rope and described how all 5 aspects were developed, another chose the game of musical chairs with an added trivia component to push participants in the cognitive realm. The final group chose a Bit Dine Thow.
Bit Dine Thow is one of those round weighted balls that always lands right side up. I have seen them before but I can’t quite remember where I saw them or how they were designed. I will never forget the Bit Dine Thow and just in case I ever would have this group of trainees were kind enough to gift me one as a remembrance for our time spent together. I will cherish it for its appropriateness to my training as well as for the manner in which it was presented to me.
A day to never forget:
I start the day like any other in Y: up early at my relatively swanky hotel with a cup of Nescafe instant coffee and time to work on flip charts. I enjoy getting up early in general but I appreciate it here a bit more because it is one of the rare windows of opportunity I am given to connect with friends, family and other cherished ones who are living on the other side of the globe. There is a 12 and half hour time difference between here and Colorado (10 and a half to Tennessee). After a shower and coffee and a few skype conversations I head out for my 30 minute walk to the training center. It’s a complicated walk of traffic jams, intense drivers whose cars are made for British style driving but the rules of the road match American ones, busy buses, buzzing markets, calls to prayer, musical request to give alms to the monks, church bells, curb side tea shops, load music houses, internet cafes, kids playing football, adults playing caneball, women sweeping, men hustling, women selling flowers and women and men escorting uniformed kids to school.
Upon arrival to the training center I find my very reliable very organized tag team of county coordinators and interpreters waiting for me. They are quick and they are energetic and they are passionate about learning and incorporating new skills into their already diverse portfolios. Typically we have a quick meeting of minds and then start preparing for the days training; but today was different, today I would travel. Today I would see more than my hotel and the training center. Today I would taste some freedom and meet some local kiddos. Today was a special day.
The plan is to walk another few short blocks from the training center and meet the rest of the 21 participants near the post office. They are a team of teachers, community developers and doctors. After connecting we will visit the school they built for a convent of nuns to run with at-risk/poverty stricken kids and apply the new skills they learned in the training. This team knows these kids because they volunteer their time at this school teaching English and offering medical care.
Upon arrival to the meeting spot we find 7 of the participants sitting on short stools at a curbside tea shop enjoying a breakfast of samosas and rice curry. They are all laughing and chatting and it is clear they are a close team that enjoys each other both personally as well as professionally. They welcome us warmly and I order a tea (strong not too sweet). The tea here is truly unique and there are unique ways to order it mostly based on how sweet and strong you want it. After finishing a cup of milky/sugary tea you are welcome to have as many glasses of green tea as you like and tea kettles sit in the middle of the table for the purpose of a quick endless re-fill. This endless cup of follow-up tea facilitates the opportunity for folks to linger in tea shops and pontificate on all sorts of things. I firmly believe this is one of the many reasons the interpersonal skills here are beyond reproach.
This place has a tea culture and being a tea or a coffee culture is a welcoming sign for any outsider to any country. Without a tea or coffee component to the culture it seems a bit harder to break into the local realm of socializing; it’s not impossible, but it is definitely more difficult. Sometimes I wonder if this issue alone isn’t one of the primarily reasons outsiders believe Liberia is a difficult culture to live in. Although the average Liberian is exceptionally giving with their food and will say “let’s eat” (and mean it) to any stranger that passes by when they are eating: for some, this offer of food seems like too much to give when struggling and thus the offer is denied and the opportunity to sit and share time and space with locals is denied. Without coffee or tea (which is common in places such as Afghanistan, China, Bosnia, Nigeria, much of South America and most of the Middle East), there is a void of opportunities for casual connectivity in places like Liberia that does not involve alcohol or food, which can get expensive and/or rowdy, and thus the disconnect.
But I digress, after a quick tea, supplemented with a lovely conversation about romance and dating in Burma, we jump in the back of a flatbed truck that has been set up with seats along the sides and a hard top cover. Once all 21 of us were safely inside, teaching supplies and guitar in tow, we are off. Although I am delighted to see someone had brought along a guitar, I assume it is for the school based activities and sit back to take in the scenery for the 45 minute journey. Fortunately for me, and all my travel companions, the talented musicians in the truck wouldn’t give up the opportunity to play and sing and begin singing a series of traditional and modern songs with energy and passion. After a few brief moments, 90% of the riders delightfully join in on the singing. The young woman who sits next to me thoughtfully translates the words. The songs are about not being able to live without seeing the sparkle in a girl’s eye or the inability to think without knowing the next time they will be together.
Romantic, cheesy loves songs: can it get any better than that?
Along the way we cross a bridge where we see hundreds of fishing boats hard at work. We also pass by farms, houses and storefronts all busy with people trying to make a living. Feeling the impact of the numerous pot holes and observing the many severe shades of poverty is so much more difficult to witness here in a country when, one knows, deep in the back of one’s mind, that the suffering here is not due to lack of resources or wealth, just due to an all powerful all greed driven leadership.
Upon arrival at the school house the first thing I notice is thatch roof houses that make up the living quarters, outhouse and kitchen of the school…..bustling about is about 100 pink clad junior nuns, 60-70 matching adult nuns that are either playing the role of teachers or spiritual leaders and about 90 civilian kiddos all gathered together for a day of school and learning.
The teachers did a great job with their experiential education lesson plans and following the completion of all the psycho-social activities we shared lunch and had a brief reflection session about the training and what they took from it.
Following a brief certificate ceremony I was showered with gifts and a Bit Dine Thow.
As I sit once again in my swanky hotel working on flip chats and skyping with loved ones back home I realize I’m happy and content in this very complicated place and I feel blessed to have this new orb of people in my life. In Buddhism it is said that every person you meet has played a part in a past life and we are destined to cross paths in every life to come. I like that idea very much and know that with people like this around me I will indeed land on my feet and if I ever feel thrown away or thrown down I will land on my feet forevermore.
Thursday, October 15, 2009
these are the things i know as true
I know all this, yet there is much I don’t know or have failed to learn. A hundred times over I have been trying to figure out what I love about the place I am in now and although I try, the truest reason constantly eludes me. While I seem to know exactly why I have come to cherish the continent of Africa, specifically the West African region, the reason for loving this place is less clear. Regarding Africa, if the idea of past lives turns out to be true, I know deep in my heart I once lived a life there. My gut tells me I was a large graceful woman with 10 children, with magnificent head wraps and a fabulous singing voice. I also enjoyed laughing until I cried. This last quality seems to be the only quality that remains in this reincarnated life where I am called Gwen or a variation thereof. I can no longer sing and for some reason I am now fiercely independent with a bland sense of fashion. I appreciate the brazenness of Africa superimposed on its wisdom and eternal beauty. When given the opportunity, I also love to call it home.
My love for this place is different, no less powerful, but different in many ways.
What I do know is that I love the people first and then the environment. The universal character of the people here is awe inspiring and I feel deeply pleased every time someone smiles at me or says hello. Collectively they are gentle, and sweet and smart and quick to smile. They also are deeply curious, playfully sarcastic, self-deprecating and passionate about learning. The environment is beautiful no doubt, but it pales in comparison to the everyday person you meet in the street.
I also think that in this place the suffering has indeed led to amazing moments of enlightenment. I am surrounded by survivors but no one appears to be that distressed. It makes me think of the Chinese pictogram for crisis. In it is a combination of two symbols: danger and opportunity. Although there is nothing to suggest there has been opportunity here for decades, people persevere and shine and enjoy none the less.
So as I was saying I have much to learn but I have realized that there is something interesting about the quest for wisdom. It’s not the material you find on masters level examinations that matter; the art of knowing starts not in big lessons but in small nearly unremarkable experiences of everyday life.
Saturday, July 11, 2009
The fear of not being discovered
I held onto the handlebars tightly as I glided along the heat-choked streets. Unlike my time abroad, everything about me blended in. Strangely enough I was suffering from a fear of not being discovered. For the majority of last 3 years I have stood out like a sore thumb and people were constantly attempting to know and understand me. Oddly enough, now that I was amongst my own, surrounded by people who looked just like me, I felt unknown by all.
The concrete buildings and jumble of rush hour traffic was familiar, but the streets were lined with faces that although similar to my own were strikingly foreign. I parked, locked up my bike and headed into the meeting. Even though there was no apparent reason I should be at this meeting about Denver's new bike share program because as I mentioned I had ridden my own bike there, I felt the need to go because I knew many of organizations that would be in attendance work in developing world countries and were passionate about it. These fellow explorers were my new tribe and I knew, without words, I would feel amongst my own.
After the presentation was finished the crowd broke into a challenging Q & A session. These presenters were not going to get off easy and with each successful response the crowd turned up the heat as if finding their weakness or mistake would make the evening all the more enjoyable. I had to laugh because although I can appreciate a challenge and got a kick out of the intensity in the room, the topic didn't really call for such intensity and sometimes I wonder if sheer boredom sets a president for prescribed intensity.
After the meeting a gentleman I had met and chatted with over a year ago approached me and asked me about my recent trip and our organization. He had on this fabulous set of thick rimmed glasses and clearly is passionate about his life's work and I was thankful I had come. I wanted so much to belong again. I didn't know what 3 years away would do to my internal compass. I have returned home with a strange mix of expectations and a desire to strike a true balance between my two lives, my two worlds.
Since my return I haven't written much and I can't quite figure out why. It seems my ideas rotate from being ensnared by ordinary life and ensnared by a longing for a connection with someone who lives on another continent. My writing has always been one of my first priorities, but now given I am facing so many unknowns and long for someone and something that is not here, it has lost its urgency. Writing involves imagination and for some reason imagination has been a low priority. What has mattered more is establishing myself in a place while I miss someone from another place. Exploration too, has been problematic because I seem to be playing catch up with the felt anxiety about the economy and given I was away for much of the crash I seem to be working through it at a warped speed and with each new piece of data I feel frozen in fear about the future.
With that said I feel very lucky to have the friends that I have here and with every dinner, BBQ, bike ride or phone conversation I feel myself reconnecting. One thing I always miss is sarcasm and having people see me as a dimensional being with needs and wants is refreshing. The amazing divas in my life having been asking me delightfully penetrating questions and each session spent with them feels like free therapy and I cherish them for that.
My bicycle slows to a stop and I am home. As I walk in I realize I love this little space that I call home and I am excited to get upstairs to be greeted warmly by my dear sweet Tuesday. Later that night I watched the sun set over the mountains from my balcony and could almost taste the shades of orange, yellow and red.
Tuesday, June 9, 2009
a dance of submission and resistance
I read somewhere that life in a foreign country is a dance of submission and resistance. Although I would agree wholeheartedly with this statement, what I find to by more intense is the dance of returning home. To me, the adjustment to the familiar calls for a much deeper level of submission and activates a much more intense urge of unrelenting resistance.
This is my first post in some time. Some of this is due to the nature of the situation I faced while residing in my last country as the security issues were unlike anything I have ever seen before and I experienced things I have yet to find the words to describe clearly; some of this is due to something else altogether.
Three days ago marked the 6 month anniversary of my mother’s death. What has become tricky is that I don’t know how to talk about it anymore. In the beginning anything was appropriate – tears, giggles, regrets, anger…they were all accepted as normal. I knew I was a slow processor and unlike my beautiful emoting brother I knew it would take me much longer to work through my connected emotions of this unprecedented loss; what I didn’t realize was how others would deal with my delayed reactions.
Although many people in my orbit are outstandingly well meaning and exceptionally supportive they also seem a bit shocked when I start talking about this loss in a raw/emotional way now, months later. I think they expect me to thank them for their condolences and move on. Instead I find myself talking about my feelings and becoming quite tearful; they adjust beautifully and I am thankful it is they who I turn to when I feel vulnerable and yet with every thoughtful hug and caring question I fear they are wanting me to hurry up and cope….The funny thing with loss is that there is no steps, no cycles - just longing for what is gone.
The beautiful thing about writing about my internal experience is that now that I have put my thoughts on paper I realize this last paragraph is absolutely bogus. My anxiety about how I am coping has nothing to do with how my orbit is reacting to me and has everything to do with my ideas about myself. My biggest fear has always been to “look crazy” by expressing too much emotion and as I just put my thoughts and feelings on paper I realize it was my fear of feeling, not my experience of my support system that I was describing – thank you dear sweet friends and family for being you and being unrelentingly available! I wouldn’t be getting through this without you.
But I digress………let me return to the here and now.
I’ve been home for 11 days now, and I’m not sure where I belong. I’m struggling to reconcile the reality and vista of the place I departed with the daily grind of a more or less upwardly mobile life. I find myself shifting from feeling exceptionally anxious about my financial situation and resume building successes in a fast paced achievement oriented country where occupational success means everything to willfully spacing out, trying to slow down, trying to hold onto that sense of other places I know to be true, the sense that time is simply time, not money.
Perhaps I have become a permanent expatriate – neither fish nor fowl, forever lost no matter my location. But this fluidity also means that I am like a unicorn – a magic creature that always knows there is another way. Let me end this post my accepting the unicorn in me, a magical creature that was my most favorite childhood collectible, and strive to be as unreal and magical as possible for as long as possible in a country where magic and fantasy are diagnostic rather than extraordinary …
Monday, April 20, 2009
introducing thailand and a nearby country personified...
thai is a young, handsome, slightly effeminate male frequently seen sauntering down a busy side street, cell phone and plastic bag in hand. In the bag is some sort of cooked meet on a stick covered in a slightly sweet, slightly spicy, sauce. His ring tone is set to a popular Thai pop song. On his head is a perfectly styled, perfectly hip, modern rock bandesque head of hair. His pants are slightly snug but it looks good on him because he is exceptionally thin and his shirt is simple yet slightly ironic in a witty playboy sexual innuendo kind of way.
Thai is a good kid who works hard but his job is in the tourist industry (just like the majority of his friends) and he finds it slightly infuriating. When he is feeling bold and willing to challenge his parents ingrained conservative view of work and life, he questions the point of focusing so much on a job that is meant to please others, but this thought is quickly pushed away by his hope to make his parents happy and desire to make money. He dreams of finding a good partner, girl or boy he is not quite sure, but either way he hopes they have work ethics that are similar to his own, conflicted thou they are.
The unspeakable place
This country is embodied as a couple. Personified, it is a young relaxed couple walking down the street, comfortably in love. The young man is slim and dressed in a tradition longyi and lose shirt. The young lady is beautiful in a youthful curveless sort of way with gold circles of sunscreen on her cheeks. While they clearly express this love outwardly and in public as he can frequently be seen gingerly placing his arm around her shoulder while she leans into him, no one would suggest they were publicly displaying inappropriate levels of affection. They are simply in love and can’t handle not touching each other. They are both quick to smile in a very genuine sort of way but this smile hides much pain. During the day they are exquisitely well behaved and act in ways that are deemed appropriate by their powerful ever-watchful government. Late at night they can be found attending secret rallies that speak of change, revolution and uprising, if only in whispers.
Saturday, April 11, 2009
things I didn't know or denied knowing
Second, denial can be a collective state of mind, not just a defense. In the simplest of terms denial is the rejection or denunciation of an event or state of mind. Most commonly people can be heard rejecting that they behaved in a certain way when in fact they did do the alleged action. For example someone might say, "That’s a lie I didn’t steal her wallet!" when, in reality he or she did, in fact, take it. In Thailand and Burma denial isn’t just an optional refuttal to a claim – it is a literal state of mind. It’s as if you can close your eyes and believe strong and long enough and what ever you are thinking about actually becomes a truth. In some instances there is not even a word available to describe the denied event. For example, during our recent training we covered the topic of rape. According to our participants there was no word for rape in Shan. To them, the term rape means the same thing as sex. Even though they could eventually admit it did happen and was not the same thing as sex, some of them still continued to believe that "it doesn’t really happen." If we don’t talk about it, "it" should therefore not be a word, there was no need.
Third, I am really really bad at working with an interpreter. I talk way to fast and I have very little patience for not being understood. This really sucks for the interpreter because they not only have to try and understand me talking very fast they have to translate words that don’t even exist in their native language (let me take moment and give a little shout out to anyone on this planet who has ever tried to play the role of interpreter for me – I am deeply sorry for any unfair pressure I have placed on you; you did a great job).
Seriously though, I seem completely unable to slow down and yet I can still allow myself to feel frustrated when my point does not get made. Talk about ego-centricism – look at me calling the kettle black. And, although I keep saying I need to work on this if I am going to continue working internationally, I have somehow managed to not slow down in the least and only get more frustrated when I am not understood. All I have done is become more animated in the presentation of my thoughts with the hopes that by acting everything out, I will be understood. For that reason alone, I kind of suck and really should think about only working in Anglophone environments.
