Healing a Violent World: Healing Invisible Wounds

America's Domestic Violence to Our Soldiers Returning Home from Iraq and Afghanistan

The story in the New York Times on January 13, 2008 (entitled: "Across America, Deadly Echoes of Foreign Battles"; click here to access the article) saddened me.  These stories reflect as much upon our social relationship to our veterans as to the psychology underlying the violent actions of combat veterans.  Domestic violence results in violent acts by perpetrators of violence.  Of course, this is not always true since some individuals have the capacity for hurting others regardless of their environmental context.  In the case of the soldiers in the New York Times story, none had had a previous criminal or psychiatric history prior to their current actions.

"Domestic" in the Oxford English dictionary refers not only to "one's place of residence or family affairs" but also to "one's country or nation". Certainly both elements of the term are applicable to our country's returning soldiers.  Now let us investigate the basic question, "How can the transformation of young men and women (as well as some adolescents) into trained killing machines be reversed once they return to a normal society not at war?"

Soldiers are trained to kill and are legally allowed to break standard conventional norms in order to resist an "enemy" of this country.  The taking away of someone else's life which in many religious circles is considered precious, unique and sacred, is at minimum an instrumental act to achieve a socially condoned outcome. Yet the killing and death of an enemy as well as the enemy's killing of a fellow comrade in arms has to be one of the most disturbing of all human activities.  Literally, within the brains of many soldiers these legally sanctioned violent activities are stored as memories that cannot be forgotten.  While few soldiers returning home commit violent crimes, in all of the stories presented in the New York Times article you are able to see a glimpse of a soldier's shattered life world ( i.e.. all of his/her life experiences to date).

These soldiers can be seen to be tumbling down from a relatively normal pre-war life to a new post-war experience of emotional distress and ruin.  In my clinical work over the past 30 years, I have witnessed many victims and perpetrators of extreme violence living in a life of despair that is full of nightmares and traumatic memories.  I have treated family members who cannot seem to be able to comfort their soldiers with their love and support.

It is an ancient and well-known story that society rejects their wounded warriors.  Sophocles in his great play Philoctetes more than 2000 years ago described the plight of the Greek hero, Philoctetes.  Philoctetes, who is mortally wounded by a vengeful act of the goddess Hera, is abandoned by the Greeks on their way to Troy with a snake wound of unbearable and extraordinary pain.  He is left to suffer alone on the island of Lemnos with a wound so sever he howls in agony and a stench so foul it permeates the clean air of the island where he is a prisoner.  This play provides a classic metaphor of society's treatment of its wounded warriors.

It is my belief that American society (like many societies) cannot accept its guilt over the soldiers' injury.  At the same time, society is ashamed of the soldiers' weakness, especially if they exhibit emotional problems from the war.  But most importantly, citizens are afraid that the soldiers' rage and deadly killing skills will be turned against them.

The soldiers in the New York Times' article fulfill our worst fantasies of the "crazy" homicidal combat veteran.  These combat soldiers broke free somehow of their socially prescribed roles to "suck it up", put the war behind them and/or passively accept a psychiatric diagnosis of PTSD and enter into a lifetime of treatment at the Veteran's Administration hospitals or even worse suffer a homeless existence of begging for handouts in our cities and towns.

Yet maybe there is a middle ground for our warriors who have returned home. Philoctetes was healed not only by the gods but by the love of his great friend Achilles' son Neoptolemus.  The systematic elimination of empathy in a soldier contributes to a soldier becoming an effective "killing machine" in the war.  Similarly, the military must reverse this process by re-kindling the capacity for empathy in those returning home.  The re-entry of soldiers into their families and communities must be given immediate attention and responsibly resourced.  The havoc being perpetrated on soldiers' families is not an unpleasant side-show but a direct cost of war that must also be ameliorated.

It would be great if any soldiers or their family members, the American Legion, or other veterans could contribute to this discussion.  I would be delighted to post anyone's comments and/or relevant links on this blog.

THE WAR ON TERRORISM IS A WAR ON DOMESTIC VIOLENCE

I would like to thank Angela and Megan for their thoughtful comments.  Certainly the empathic failure demonstrated by all acts of domestic violence have enormous social and political consequences. It is hard to imagine sensitivity to a neighbor or community member if one is unable to respond empathically to our own family members. I remember the recent case of a female drug addict who allowed many men to have sex with her 12 year old daughter to obtain money.  There are so many things wrong with this situation one does not even know where to begin. The fear, anxiety, and degradation of the young person when imagined is almost too much to bear. This type of humiliation leads to anger/revenge and/or hopelessness and despair, with sometimes both states existing concurrently in the same person.  As Angela suggests this is our most common form of terrorism that we must do battle against.

Any suggestions on how to prevent all forms of interpersonal terrorism ?

Thank you
Richard

THE PUBLIC HEALTH CAMPAIGN TO INCREASE FAMILY EMPATHY IN THE BATTLE AGAINST VIOLENCE

I would like to thank everyone for their comments over the past two weeks. Forming a new anti-violence structure of government is certainly an interesting idea I had never considered. In Italy recently, people were so sick of the corruption in their government, an email was sent prompting millions of people to congregate, protesting that they had had enough. So many citizens today feel this way about the violent world we live in and the increasing violence in daily life. Many other comments on the blog centered round the age old question of whether we need to fix the violence in ourselves first before we take aim at stopping the violence of perpetrators. Since I am not a great philosopher I cannot give an answer to this question. Clearly human beings are very aggressive and can hurt others given the right social cues (e.g. Milgram experiment). But in my work and dialog with citizens around the world in post-conflict societies it has come to my attention that in many violent situations there is a breakdown in empathy especially in the home. I would like to share a story that still disturbs me after hearing it 2 years ago in Peru. A clinician told me of the big problem of domestic violence fueled by political violence in Peru. The WHO study found Peru to have one of the highest country rates of domestic violence. This clinician said that she had helped a patient from a small Andes village that was repeatedly beaten by her spouse. She was able to work with the husband and wife to reduce this situation. The clinician felt very good about her success. The patient then went on a little trip to see her family in another village. I do not know where her husband was when the following events unfolded. She came home and found her teenage son hanging from a tree outside the kitchen window. Her brother—the boy's uncle—had killed the boy over a minor land dispute with this family. The uncle was arrested for three days and then was released by the major, who was a friend of the uncle. That was the end of his prosecution. The woman came back to therapy and the clinician was told she would be harmed if she tried to interfere in this case. The clinician was devastated.  And so she shared with me this story. I was also overwhelmed by such a cruel act by the boy's uncle. This is a story of a total breakdown in empathy. You can imagine that if you have family violence with little to be empathic to your immediate family members, how can you have any regard at all for your neighbors or for people who are different from yourself. The battle against violence must work first to increase empathic relationships in the home.

Looking forward to your comments on this aspect of the declaration.  Also, I will eliminate as suggested the term "poor" as in "poor women".
 

War: a Mental State - Interview on ABCNews

Featured on the July 29, 2007 ABC World News segment about Iraqi refugees. Here I discuss the mental and social ramifications of Iraqi citizens' life in a war zone.

CLICK ON THE IMAGE AT RIGHT TO VIEW
(The video is hosted on ABCNews.com and includes advertisements before and after the interview segment)

Boston Globe Health and Science Article Today

An article/essay I wrote, "Trauma Care," is featured in The Boston Globe, Health and Science section today.

Pictured at right is the article, including a featured image of Svang Tor, Harvard Program in Refugee Trauma staff member, and former refugee. She holds her identification photo from her time in a Cambodian refugee camp.

From the article:

Trauma victims can transcend the most horrific events imaginable and go on to lead rich and meaningful lives. Ultimately, traumatized people heal themselves -- and what's more, their experience can teach the rest of us how to deal with the tragedies of everyday life.

You can find the article (for the next couple of days) here:
http://www.boston.com/news/globe/health_science/articles/2007/07/02/trauma_care/

Declaration: A New Perspective on Healing a Violent World

I recently drafted this "manifesto" on healing a violent world. I invite visitors to this blog to comment on it, suggest additions/revisions, and share your own ideas about what such a declaration should include.

In one year, I will summarize comments and improvements to the declaration and re-post a final version based on your feedback.  There is a comment link at the bottom of this entry. Please share your thoughts here.

- Richard Mollica

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A New Perspective on Healing a Violent World

Seeing reality clearly, we observe that the world is awash in a sea of physical and mental suffering due to human cruelty. While at times this vision seems too much to bear, we do not give up our dream for a more loving and peaceful humanity. Seeing reality clearly means that in this new age of global communication the pain and suffering as well as the joys of each and every human person can be heard by every other human being without censorship or the control by political and social forces that in the past and present rationalize and falsify the extent of man’s cruelty to man. This new and original power of seeing gives us a technology of observing and changing the world comparable to that discovered by the Italian Renaissance discovery of perspective by Brunelleschi, Alberti and Piero della Francesca who moved us from the flat 2 dimensional images of the ancient and medieval world.

Seeing reality clearly, we can no longer accept a world with more than 40 nations in civil conflict and over 1 billion (i.e. 1/6 of our world citizens), harmed by mass violence. Torture is still widely accepted and is at epidemic proportions. Domestic violence, child abuse and culturally-sanctioned violence toward women, children and persons of different gender and racial orientations is a plague on our planet. The trafficking and sexploitation of women and small children including infants and pre-school-aged kids are becoming thriving multi-billion dollar industries. The commercial exploitation of youth and child labor and the economic oppression of the poor remains a financial pillar of many societies. The planet itself which gave birth to all life forms is selfishly destroyed.

Unafraid, we declare that uncontrolled human aggression and greed is a cancer upon our world body that must be cured. As medical practitioners we affirm that modern medicine not only has the right, but the moral obligation to address human cruelty and violence as the leading cause of illness and death. The shocking loud silence in our medical schools, health, and public health institutions and among our healing community is so loud it is deafening.

Unafraid, we affirm as healers of every type— community elders, religious and spiritual healers, traditional healers and shamans, holistic medical practitioners, medical and mental health practitioners, counselors, teachers, artists and all the human-oriented professions— that we can make a difference and reduce the pain of suffering from human cruelty.   

1. The goal of healing has always been primarily the relief of human suffering. The healer must embrace with ardour this primary principle and subordinate the now dominant ambitions of speed and the obsession with the power of machines and molecules.
2. We declare that the patient is a beautiful living organism that freely acts and loves in a family and a community and is not an isolated body part or a disembodied mind. The healer must have a relationship to the man, woman or child and their social and cultural context. Otherwise, human cruelty will continue to freely operate as a pathogen.
3. The healer will understand that humiliation is the major instrument of human violence that is systematically applied to others to annihilate the individual, their family and society. We must relinquish the myth that most violence is a random action perpetrated on an unsuspecting victim. Humiliation creates hopelessness, despair, anger, and revenge (often existing together) in the violated person. Humiliation must be acknowledged and its victim released from its tight grip.
4. Science has revealed that at the moment violence strikes, the biological, psychological, social and spiritual power of self-healing is activated. Today many healers and social agents set up barriers that dampen the self-healing response. The pathway to recovery is filled with the roadblocks of human design and creation. Modern day healers will do better to imitate their ancient Greek and Roman counterparts who followed the medical practice called "Vis Medicatrix Naturae," that is, "the path of natural healing." These early physicians intimately knew the life course of an illness and gave hope to the patient through their knowledge and support of the self-healing process.
5. We glorify the survivor of violence because of their heroic struggle to survive human violence, cruelty and degradation. We strongly combat anyone who barbarically blames the victims, or considers them guilty of criminal acts and subjects them to shame, social ostracism and even death--especially those poor women who have been sexually violated.
6. We glorify the healers who, at great sacrifice to themselves materially and emotionally, engage in the case of traumatized persons worldwide. Through their compassionate and courageous work they willingly suffer the pain of their patients as they engage in their therapeutic efforts. These healers in some situations risk their lives to help others, and in all cases accept upon themselves the victims’ pain as their pain. In many communities of the world, these are the unheralded giants of the medical community. They need and appreciate our support and we joyfully give it to them.
7. The trauma stories of the survivor and their healers need to be collected and archived for all to read without censorship. Since the beginning of our humanity, these stories present an evolving history of survival and healing, teaching all of us how to cope with the tragic events of everyday life. The failure to collect and archive these stories denies us the opportunity to prevent a future generation of violence.
8. Only through imagination can healing occur. Healing is the imagination to heal. The survivor and the therapist create within themselves the image of a whole and complete human being who has shed the pain and suffering of the illness state caused by human cruelty. We will sing of wellness, resiliency and a life full of love and friendship. We will sing of a world no longer tainted by human degradation and violent aggression.
9. Except in beauty there is no healing. Beauty is the salve and ointment that creates our healing space and healing relationships. Beauty is the pre-eminent healing medium that allows all physical, social-cultural, and spiritual forces to flow like the river Nile bringing all of the life- giving elements to the people of Ancient Egypt. But many humans want to destroy beauty because of envy and jealousy of its purity and innocence. Modern medicine wants to have with beauty a master-slave relationship. Realizing this, we will fight against all institutions and practices that are vulgar, ugly, sterile and demoralizing. On this point, science reveals that beauty is healing’s greatest ally.
10. At the start-up of this new century we are clear that the empathic circles formed by human beings need to be greatly expanded to include more of us. Everywhere we turn we find that the family which is supposed to be a zone of love and affection is filled with violence and child abuse. How can we consider all others as our brethren if we routinely harm our own family members? Worst of all, in most places, societies condone this behavior as normal. Family violence is not normal and is not acceptable. This failure at non-violent intimate relationships does not bode well for us holding back our aggression towards strangers outside our kinship groups. The fight against cruel degrading human behavior must begin with positive changes in the home!
11. We will call a social myth the popular belief that acts of social justice and social healing from violence can occur without concern for personal healing. The desire for justice is embedded within the hearts and minds of all victims of violence and this reality must be openly acknowledged and supported by society.

On our journey to the new ideal city, we will find at its end not the perfect environment of Piero della Francesca devoid of people, but one filled with human life. All of us can now see the dirty little secrets and ambitions of violent perpetrators who are actually few in number but use their money and power to harm the majority. We affirm that the world’s magnificence can be fully realized, sustained and protected from our human impulse to hurt and destroy all that is beautiful. 

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BBC Interview with Richard Mollica on Darfur Trauma

LISTEN TO THIS STORY

The World's Jessie Graham reports on a program here in the United States that helps immigrants from several African countries cope with their memories of war back home. We hear how some American therapists are trying to overcome the immigrants' reluctance to talk about their traumatic experiences.

Torture Today - Interview on Los Angeles KPFK Radio

Sonali Kohutkar and Ian Masters interview Richard Mollica on the topic of torture and current events:

Interview with Sonali Kohutkar (interview starts at 26:23)

Interview with Ian Masters (interview starts at 43:34)

The Innocence Project Exoneree Presentation

I promised to post the slides for the March 24 presentation/workshop/discussion with exonerees from wrongful convictions at the Innocence Project Conference at Harvard Law School. It was an honor to speak with you all and to hear your experiences.

Here is the presentation: Download innocence_project.ppt

Humiliating the Wounded Warrior - Walter Reed Op-Ed in Baltimore Sun

Op-Ed, The Baltimore Sun, Sunday, March 25, 2007
by Richard F. Mollica

No amount of money is going to fix the tragedy unfolding under public scrutiny at Walter Reed Army Medical Center and the Department of Veterans Affairs...Sadly, the ill treatment of injured soldiers is a tale with a long history. The public neglect of Vietnam veterans, for example, is well-known.

It is the genius of the ancient Greek playwright Sophocles that he described our current situation more than 2,000 years ago. In his play Philoctetes, he addresses the condition of every wounded hero: How can traumatized soldiers be made whole again, after terrible events place them in painful and unpredictable circumstances, and our society either ignores or abandons them?  More>

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