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  • Richard F. Mollica, MD, is the author of "Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World." A Harvard Medical School professor of psychiatry and director of the Harvard Program in Refugee Trauma, Dr. Mollica holds an MAR from Yale Divinity School and is a Fulbright New Century Scholar. He is the recipient of many honors and awards, including the American Psychiatric Association's Human Rights Award.

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June 28, 2007

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

_________________________________

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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Thank you for writing this declaration with its emphasis on creating peace. I am nourished by reading your declaration and the many insightful comments. I would like to suggest some clarifications to really bring out the power of this piece.

* Signers. Who is the "we" in the declaration? Is it limited to healers in the West?
* Audience. Who will be reading the declaration? Also just healers in the West, or do you hope to communicate to others who are less familiar with these ideals or with Western history (as described in the intro, point #4, #9, etc.)?
* Point 2 should acknowledge that some "patients" (I hope another word is chosen) are not in families/communities. Some who have chosen to heal themselves (perhaps with a healer's help) are going it alone, without family, without community (other than the healer, perhaps).
* Points 5 and 6 should acknowledge the transitory nature of the survivor and healer roles...we can switch between these roles and more. The survivor can become a perpetrator, a rescuer, and so forth....
* Point 7 - suggest adding "without Western interpretation/framing" - applicable to trauma stories not from the West!
* Point 9 - are "modern medicine" and "science" really opposing each other here? I tend to want to put them in the same camp.... Also, how can healers and those choosing to heal incorporate beauty into their approach? I'd like to be able to visualize this point!
* Point 10 raises many questions in my mind. How big are the "empathic circles" today (that need "to be expanded")? Stating that the family "is supposed to be" a certain way implies a value judgment that conflicts with reality for many and that could get in the way of your main message. Same with the statement that "family violence is not normal" - the term "normal" implies "common" in addition to "what should be," so the statement confuses me. The statement "holding back aggression" presupposes that we have aggression. Is that true for everyone? How do healers address the problems discussed in this point? And are these problems assumed to be present in the healers' families as well?
* I hope you consider addressing the comments of Ifalade TaShia Asanti regarding the wounds of the wounded being made visible through their acts of violence. We must move away from black-and-white victim/perpetrator thinking and acknowledge our equal capacities for both experiences (in addition to the rescuer part of this triad).
* Please incorporate Suzanne LeLaurin's comments regarding the necessity for public stands against violence. (I would like to see this point expanded.) Also, Suzanne's comment about the term "victim" reminded me that this label implies qualities in the person that go beyond the event and that persist in framing the person in others' minds, while "survivor" is strictly related to the event, not the nature of the person who went through it.
* Denise Heringer highlights the equal capacities we all have for kindness and evil. Anyone who we would hold up or condemn is really more than that "good" or "bad" label - they are complex human beings. This complexity must be acknowledged.
* I was illuminated by Sherry Tyger Goodell's comments about humiliation involving fear of others knowing or judging and about how experience of community violence affects individual beliefs about violence.
* Ben Porter does a great job summarizing the work espoused by your declaration as individuals "taking control of your response to violence." Wow. That's the bottom line, isn't it?
* All of the comments have enlightened me by introducing new ways to think about violence and peace. I am very appreciative!

I have many more (detailed) suggestions that I completed on my own as an exercise to articulate my response to your declaration. My edits may be helpful to you in honing your declaration. Please feel free to contact me for a copy of my edits.

Thanks again,
In peace,
Pamela

It is obvious that what has been tried in the past has not worked. There is no negotiations with Mother Earth. There are many debates in high places between patriarchs and matriarchs, competing theories, paradigms, pedogogies, capitalist vs marxist, yet genocides still happen, invasions occur, species like polar bears, gorillas, ocean fish stocks, are becoming extinct or endangered. Yes, the time for talking about new possibilities is upon us, we cannot afford to remain silent and bound by the lies our fathers have told us. Only thru liberation and self-actualization can the needed truth be found, reserected, and used as the vehicle needed to transport a participatory citizenship, fuled by peace and love. We need (soul)diers willing to wage peace on every avaiable space found on this tired and wounded planet. We must stand against paperarchy and let our truth be heard, this venue is but one attempt to do so. After all rainforests, gorillas, and polar bears, and our other cousins are worth it, for we will not be far behind.

I have ready the doctor's blog as well as some of the other comments in response. I am delighted by the potential here of creating a space for voices to be heard. I would like to add, if I am so obliged, that the wounds of the wounded are made visible through their acts of violence and in turn create painful links in the chain of victimhood and victimization. Thus, offering a space like this for the healing of wounded souls, and making it uncensored but checked for extremism and misdirected rage, can be a healing channel for the masses. And with the hope of a new governmental structure we can perhaps create a world where authentic healing is possible and prevent the recurrence of trauma which keeps the existing wounds from ever healing. I am very much interested in supporting this effort in whatever way I can. Perhaps a conference??

Ifalade Ta'Shia Asanti, Ifa Priestess, Ancestral Healing Mother, Award-winning Journalist and Writer

Greetings to everyone,

I am just back from Italy and reading through the wonderful comments and will be reflecting and posting this week.

Thank you,
Richard

I'm just commenting on the post before,about the article that came out in the Boston Globe and especially the line :"...that most trauma victims can transcend the most horrific events imaginable and go on to lead rich and meaningful lives". I remember something along these lines came up in conversation in Milano, at the Art and Survival study day.
Being from Bosnia, I am very much convinced of the truth in the previouis statement.
It is incredible to see people that had lived thru the siege of Sarajevo, even fought on the front lines, now having normal lives.
We talk of war a lot in Sarajevo. Even time is also divided by the "time before the war" and "after the war", people rarely speak of the gruesome things that happened. When people talk of the war, it is usually re-telling of funny stories and situations. These stories are in fact hair raising, yet delivered like one was telling a joke. I guess you can say that this is self-healing thru humor. Humor is empathic...
And we all laugh and move on...
I really appreciate what you are doing.
It was a great plesure to meet you in Milano, too bad we didn't have time to talk more!

Thank you for initiating a blog on how to heal from violence and trauma. I appreciate your declaration that beauty heals and that access to beauty could and should be provided to all who suffer from violence.

I would like to see your declaration lead to more emphasis on prevention, particularly the public health methods that would have society pay attention to curbing violent behaviors before they begin. That in itself I find beautiful.

This is a wonderful declaration to which I completely subscribe. More needs to be done at every level in the educational systems throughout the world to highlight one of Gandhi's truths: violence breeds violence. More, much more needs to be done to teach our youth that peaceful resolution of conflict is the only path worth pursuing.

Thanks for this artical Mollica, being a practicing counseling psychologist, i am daily disheartened by the domestic violence that family members are exposed to, and little do those parpetrators realize of the effects that this emotional, social, psychological, physical and sexual violations have in the future of the victims. Its time that we woke up and saved the family, because with the current trends the family unit will completely be destroyed, and each will be againt each other, and only heavens know what will becaome of the society

I completely support your initiative to bring this important issue out in the open and stimulate discussion to learn from each other.
As physicians/healers, we are not immune to the malignancy of violence in our own personal lives; whether it be in the past, present or the future. Just like we can be stricken with cancers, strokes, heart attacks etc and jokingly are considered the "worst patient's" for not seeking timely help , I would like emphasis placed on this issue. As healers it is very hard to seek and accept help because of un-realistic expectations of others turning to us and depending on us for providing care. I wonder if the 'deafening silence" from academics that you talk about is related to this issue? Working with trauma survivors may trigger flashbacks and memories of one's own trauma and lead to avoidance of such work and emotional numbing.
I have a few specific comments on the following points;
# 4 Humiliation. I couldn't agree with you more about this. I would add however , that this is perhaps the most common reason for silence on the part of the survivors. The fear of being rediculed, blamed, made to feel guilty of having induced the violence in some way would be even more humiliating than the actual violent act itself. Survivors need to be freed of its grip.

#5 It should suffice to say 'women who have been violated" instead of calling them "poor" which points towards pity; and thus un-necessary. Also keeping the work "sexually" violated out will also keep the message simple and free of un-necessary sensationalism.

#7 Survivors need to be able to feel safe and validated before they can share their stories. Providing a safe environment thus becomes a pre-requisite.

#10 This is the most important area to be emphasized as I believe this to be the root cause of all violence. I feel through education at every level and mass media the importance of a nurturing, loving, caring home needs to be emphasized.

In addition, I would like to point out the effects of substance abuse on the fabric of familial values .
The role of faith and spirituality towards prevention of violence and healing survivors shouls not be discounted either.

I would like to thank you for taking on this role,
Regards,
Batool Kazim,MD

Hello, I really am nourished by the ideas presented here and am excited to learn more.

Please visit exposeugandasgenocide.blogspot.com and participate in our Write CHOGM! campaign, be a Global Witness.

Thank you.

Thank you for your initiative on global violence. I study trauma and its effects on refugee children. I graduated with my masters in social Work and particularly with interest in trauma.I have been a refugee myself throughout my life to this day and have witnessed a lot. Unfortunately I came to practically see violence that occurs in a non-refugee situation and the results are even more catastrophic. There is too much violence because people are being brainwashed to believe that freedom is not free. If freedom is believed to be a result of violece then we can not heal a violent world because violence follws those who are vulnerable. We can not wait a judgment day however, but truthfully proclaim the effects of violence on vitims. Victims must stand up and peacefully recognize the fact that the solution against a violent world is not violence itself. Victims of violece must speak up. Those who perpetrate violece never live it.

Godfrey Elizai

Greetings to all,

Dr. Mollica, you have made another great contribution to those of us committed to healing. Your declaration illustrates the importance of advocacy and public presence as part of the healing process. As someone involved in direct service to survivors of mass violence, I have for many years recognized that individual service to survivors must be coupled with public stands against such violence for individual healing to occur.

Several others have posted a few suggestions on word changes. Let me offer three more. (1) While I understand the use of the term “patient” is common, I would prefer one that transcends the nature of the professional relationship to the healer. As you and other posters have so eloquently pointed out, healers come in the form of spiritual leaders, family, friends, counselors and many others, not just doctors. (2) For similar reasons, I would change “therapist” to “healer” in point 8. (3) And finally, I struggle with the term “victim” – I prefer “survivor”. Let us acknowledge the strength within each survivor, even as they may struggle with their pain.

Thank you for beginning this dialogue. I look forward to participation in the expansion of our community of practice to heal this violent world.

Suzanne LeLaurin

For me, as a mother, partner, friend, and frontline social worker the problems I see around me are not so much violence. I believe violence to be a natural human response to certain emotions just like love or joy. It's what triggers our emotions that is problematic. Much of the world's woe, in my humble opinion, stems from greed. Decrease want and we will decrease greed. Perhaps taking less and giving more will help?

I do not think that pointing the finger and denouncing those who perpetrate violence is helpful as it is my personal belief all humans have equal capacity for it. We all have equal capacity for kindness as well so I would never revere those who demonstrate it.

I will work towards personally taking less and giving more and hopefully in doing so I will decrease some of the world's sadness by a fraction. Approximately 135 llb fraction! ;)

Good luck and best wishes.

Well, as long as there is injustice in the world, there will be aggression and violence as well.
Personally, I think that every person also has an inherent aggression and violence,which can be good if used in a constructive manner.So, violence and aggression are personal as well as social phenomena.
In some societies in the world (e.g. Canada), the word war is almost forgotten, while in the other ones (Middle East) or Balkans, the war is almost a state of mind.
Personally, I am not too optimistic that greediness and violence can ever be really extinguished, but nevertheless.....we shold keep on trying.If we provide opportunities to people to develop their positive strengths and express their aggression in a constructive way, we have made.....a step forward to a more peaceful world

Greetings,

Thank you so much for your work and dedication to addressing and healing violence. I believe that this is one of the most important issues facing humanity.

In addressing the impact of violence on the individual, I think that it's also important to acknowledge how humiliation is related to fear. On point #3, the discourse on humiliation might also include fear of others knowing or judging the experience of surviving violence.

I have also considered the assertion of point #10, and I wonder about how to incorporate the experience of community violence in that statement. As a worker who has served adult and adolescent survivors of violence, I recognize how community violence impacts individuals' responses to and beliefs about violence. I believe my role as a worker should include working with communities to build trust and comradeship.

Let us continue this dialogue in the hope that truth through non-violence is realized.

Sincerely,
sherry tyger goodell

I'm heartened to read this manifesto, as an emergency physician, I've recently taken care of a woman in a domestic violence situation who decided to return home to her abusive husband and a child who had been abused by her parent who is the most functional person in the family. It can feel overwhelming and heartbreaking to realize how little my medical training can assist my patients when their own community is so broken. I loved hearing the manifesto if only to remember that I and my patients are not alone and there is hope and love in this world that may heal them if we can only keep working together.

I also have a comment, in point #5, I dislike the phrase "poor women" because it undercuts the earlier tone of strength. I would prefer if you would change it to women or just to "those who have been sexually violated" (since children are often sexually violated and are often blamed for it).
Best wishes from Brooklyn

First of all, the work was enlightened. Our community of practice needs someone like you to lead them and stimulate the deep philosophical questions about suffering and healing. The work was also pristine-a chapter could be written on every item.

Here are a few comments:

* Being in Northern Uganda, especially during this important peace process, I have clearly seen the interconnection between forgiveness and healing. Because justice is so abstract (especially retributive justice-ICC),
and no mechanism of justice or compensation can be made for damage done and an internal release of the perpetration must be enacted. Your point #10 says, "The fight against cruel degrading human behavior must begin with positive changes in the home". This begins to get at the point of taking control of your response to violence, but may warrant more. I am profoundly impressed by those who have released the stronghold of aggression and revenge by choosing to forgive. This is ultimately how we stop the cycle of violence.
* Will some people struggle with your use of the word "man" instead of "humankind"?
* Point #5, last line says, "poor women". I understand your point well, but the phrasing may imply pity or sympathy that some victims of sexual assault may not appreciate.
* Point #9, should the text read "flow like the river Nile" instead of "Follow like the river Nile"?

On a different note: I remember having lunch together one day in Italy. You said something like, "You must have a deep love for "the people" [for you the Indochinese] if you're going to spend 20 years trying to help them". When you said that I doubted my deep unfailing love for Ugandans (and I still do to an extent). Here is a very simple story that made my heart grow.

Yesterday, in a very remote IDP camp, I told a group of parents a story about a woman who went through a terribly traumatic event. Her husband and all six children were killed by rebel forces (in Congo). This women stayed inside without speaking to anyone for weeks. The community around her was encouraged to support her by "being close to her". Every day for weeks a group of women went to her hut and simply sang gospel songs and prayed. After a week of doing this they became tired and felt like giving up. They were encouraged to continue singing... and they did. After another week of standing outside her hut, the woman came to her door with tears streaming down her face. She embraced her friends and they began singing together.

The point of my story however, is that when I told this story to the the group of parents here, they were captivated till the end of the story when they all began cheering and clapping for the success and power of the woman and the community to over-come.

I imagined telling the same story to a group of Westerns and not getting quite the same overwhelming response. Yesterday I was taken aback at the immense compassion Ugandans have. It was beautiful.


Grace and Peace,
Ben Porter

Delighted to discover your site and hear of your vision - in our School of Natural Medicine here in Boulder, Colorado we are devoted to supporting all our students in their depth Self-Healing so they may emerge as radiant authentic guides and teachers in living kind service to humanity...Enjoy www.independentlyhealthy.typepad.com

Keep up your good work. May God bless you. Best wishes and best of luck from Malaysia.

Hello.

Greetings and respect to you.

This document is a good start towards a goal that is vast and complex. Your focus is narrow, but I believe that is okay considering the intense specificity of the problem you have in view.

Being involved in the work that you are, I hope you understand that you too are a survivor of trauma. It is traumatizing to keep looking at what you see day in and day out, and it necessarily creates an arousal response that is highly focused and pointed. My guess is that this arousal response is fairly constant, and doesn't give you too much peace. This will color your work and limit your effectiveness over the entire scope of the problem. THAT'S OKAY! The "enemy" that you've chosen is indeed an enemy and deserves to be targeted. If you want to see this document take a bigger bite out of the entire problem, however, you might want to get some input from others who aren't in the exact same field.

As a point of interest, I too have experienced some things which, while not as horrific and intense as what you're dealing with, left me with a damaged psyche and impaired functioning. In particular, the statement in #10 seems so obvious and simple, but many wouldn't believe the resistance I have encountered to even acknowledging it. It really depends on what people have done to cope with their own trauma.

By the time many survivors are adults, they have repressed the sensitive and empathic parts of themselves as a means of reducing their own symptoms and distress. However, these same parts are required to love and function in family relationships. So, they act out without remorse or regret the same violence or neglect that was enacted upon them and the cycle continues. Just mentioning family violence is enough to cause many people to completely dissociate and change the subject or, when pressed, draw their anger out so that they begin to attack you with minimizing or even humiliation. Sensitive people would be incredulous at this. But I'm finding that so many people have coped in this way, that they tend to group together and reinforce one another. This creates an atmosphere where just speaking the truth is a desperate and heroic act - requiring intense emotional arousal to even accomplish.

Thank you for your work. I am glad you are there and I hope that survivors find out about you and feel safer knowing that you're there working on their behalf.

~Whitewave

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