Earthquake: Helping Haitians Emotionally Heal

As international faculty from the Center for Mind-Body Medicine (CMBM) initiate a multi-phase program of training Haitians in psychological healing techniques, they confront a population still in shock from the devastating earthquake, reeling from a cholera epidemic and dodging armed mobs in demonstrations.

           James S. Gordon, MD, a Georgetown Medical School professor of clinical psychiatry and CMBM founder/director, said the default position for most Haitians is a state of shock.

  “There is a kind of self-protectiveness, a kind of shutdown, with which any clinician is familiar,” he said. 

          On his fourth trip to Haiti since the Jan. 12 earthquake left some 300,000 Haitians dead and more than a million still homeless, Gordon told Psychiatric Times that the slight reduction in the tent camps populations signals little positive change. The support—food, water, health care—that the camp residents had in the several months following the earthquake “is no longer there to the same degree or reliability, and there is more bitterness, more frustration, more despair,” he reported.

          Last December, the day before beginning CMBM’s initial 5-day training of Haitian clinicians and other care providers, Gordon and a few team members walked from their hotel to a sprawling tent-and-tarp camp of 50,000 to 60,000 people in the Champs de Mars plaza of Port-au-Prince.

        “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,” Gordon wrote in his blog.  “Mothers tell us that so many of the children are ?hyper’ since the earthquake…When I ask about emotional problems everyone—men, women, teenagers—says they are angry.”

         To dissipate the anger, some tent camp residents told the team they pray.  One man said he drinks “medicine” (home brew), and a mother sadly confessed that she beats her children.

        “Everyone agrees that psychological issues are of paramount importance,” Gordon told PT, “and everyone also agrees that the country is woefully ill-equipped to deal with them.” 

CMBM’s role, he explained, is to create “a functioning basic program of primary mental health care that will be implemented in a variety of different places and a variety of different ways by people, the majority of whom are not mental health professionals, because there are not enough in the country to do the job.”

         The nonprofit Center for Mind-Body Medicine, based in Washington, D.C., is partnering with the Haitian Ministry of Health, schools of medicine and nursing and several nongovernmental organizations as well as local churches, hospitals and schools to provide trainings.  The train-the trainers’ model addresses the trauma caregivers have experienced and their ongoing stress, as well as the major psychosocial needs of the Haitian population. 

         CMBM’s model, Gordon said, has been validated in several scientific studies, and Gordon’s book, Unstuck: Your Guide to the Seven-Stage Journey Out of Depression (Penguin Press, 2008), describes the model in detail and the scientific studies supporting it

“Our methods are simple, self-care techniques: relaxation, meditation, guided imagery, biofeedback, yoga, self-expression in words, drawings and movement, and sharing one’s pain and hopes with others in a supportive, small group setting,” said Gordon.  “And the groups are… totally nonstigmatizing …You don’t have to say you have a problem to come into the group.” 

Training the trainers

Moved by Haiti’s plight, a long-time CMBM board member gave the organization one year’s funding (about $1 million) to establish a program to fully train the first group of 120 Haitians—key personnel from the country’s Ministry of Health, a few psychiatrists, psychologists, physicians, nurses, midwives, some social workers, priests, nuns, educators, and voodoo healers; to provide supervision for them for a year; to hire a small Haitian staff; and to develop a Haitian leadership team of 20 selected from the group that attended the initial and advanced trainings.

          Eventually, Gordon said the organization hopes to train 1,500 to 2,000 Haitian clinicians, clergy and peer counselors in the CMBM model who will, in turn, use what they have learned to help some 100,000 children and adults in the country each year.  To accomplish this goal, Gordon said, CMBM needs ongoing donations. 

         The first 5-day training in the science and experience of CMBM’s model began in December and involved individuals from the Port-au-Prince area, Gordon said. 

         But even getting to the training was an arduous and dangerous process, according to Gordon.  Some of the participants were kept away by the demands of cholera care, as the disease spread to 130,000.  Midway in the training, participants had to make their way through large, often armed mobs, angry over the election. 

         Once at the training, participants described their ongoing stress and almost unimaginable loss. 

        “There are not many people in my profession,” an anesthesiologist shared, “and after the earthquake, we did amputations all the time. It was painful.  I lost my spontaneity.  I think we all have.”

        Many participants described how the CMBM’s techniques have enabled them to sleep peacefully for the first time since the earthquake and how they have already begun sharing the mind-body techniques with others. 

.