On violence: A creed for therapists (2000)
J. Family Psychotherapy 11(2): 1-8. An uptaded version was published (in Spanish) in Sistemas Familiares, 20(1-2): 17-23, 2004
Author: Sluzki CE< Return to Articles
“On violence: A creed for therapists.” J. Family Psychotherapy 11(2): 1-8, 2000
ON VIOLENCE: A CREED FOR THERAPISTS
Carlos E. Sluzki and Daniel Greaser
This article presents the conclusions of a group that met as part of the 1999 IFTA Congress in Akron, Ohio. The group explored the implications and responsibilities of enhancing our awareness about both societal and interpersonal violence in our daily personal and professional lives. In its report, ethical parameters in our daily praxis were proposed: Let us maintain a reflexive and militantly non-violent stance in our daily life. Let us enhance our voice toward non-oppressive, non-violent, non-sexist, non-classist, non-racist, culturally-sensitive practices in our homes, in our working environment, in the organizations of which we are a part, and in our communities. Let us sensitize ourselves to our complex personal social network and treat it as the valuable resource it is. At the same time as we address the structural and cultural roots of violence, let us understand acts of violence as multi-level, complex crisis, in order to help re-story those evens so as to empower the victims and to re-socialize the perpetrators. In sum, in the face of violence of any kind, not only we should refuse to become perpetrators, but we cannot be bystanders: it makes us, in fact, victimizers.
During the International Family Therapy Congress that took place in Akron, Ohio, in March of 1999, five groups met for two hours each day throughout the duration of the event to discuss each a different core subject. Their end product would be a summary statement that was to be read at the closing plenary and that would constitute possible sections of a more comprehensive statement of principles. This generative process, called the “Hope Process,” was spearheaded by Alan Sterling, MD, Medical Director of the Akron Child Guidance Center, the host sponsoring organizations of the event. What follows is the product of one of those groups. The group was coordinated and the report written by the signers of this paper – who should be considered responsible for its errors and limitations. The group included, at different moments, Tania Aldraghi, Ana M.Agathangelou, Pilar Hernandez, Kyle D. Killian Rose Kurdoglian, Kathleen Laundy, Carolyn Moynahan-Bradt, Maria Silvia Nogueira, Peter Rober, Michael Seltzer and Parul Shah, whose contributions are greatly appreciated.
The Task Force that produced this report was shaken by the human drama that was unfolding during those days in the Balkans, with its brutal policies of “ethnic cleansing” and the massive exodus unleashed by these and other malignant efforts at destroying the identity of an entire population. Much was discussed and proposed about our responsibility as professionals in different organizations that are – or could be – involved with helping to ameliorate the pains of the victims of those apparently never-ending ethnic hostilities. Our group discussed – and some members committed themselves to carry on the message – processes that would be maximally helpful for the masses of refugees – today, Kosovian, tomorrow, who knows – pouring into different reception centers and new relocation regions. It was underlined the need to aim at reconnecting the refugees among themselves from the moment of their reception in whichever environment, – assuring information processes that may reunite families, reunite villages, re-establish natural leaders. The process envisioned is one akin to a practice of re-tribalization. To further facilitate that process, tribunes may be created, that is, contexts to promote the telling of their stories among themselves, facilitating their reciprocal process of witnessing, and allowing us, mental health workers but also outsiders, to be witnesses and partake in their collective pain. That is a core part of the re-storying that will help the refugees recapture their identity as individuals and as collective. At the same time, let it be clear, once basic survival needs are met, in order to further the processes aimed at empowering them, we must refuse – resist the temptation of – protagonism, functioning mainly as facilitators, almost in the background.
This focus on specifics did not deter the group from exploring the broader implications and responsibilities of enhancing our awareness about violence in our daily lives. What follows is a distillation of that exploration.
During the recent rampage of “ethnic cleansing” in Yugoslavia, an estimated 20,000 Muslim Bosnian women were raped by the Serbian military in a double effort at creating terror and mass displacement and at tainting their ethnic genetic pool. An attempt at redressing that outrage and at bringing the culprits of those acts to justice in international tribunals was spearheaded by a handful of courageous women. Several of them were lawyers, all of then victims of rape themselves. That process dragged for several years and was marred by political delays and obstruction. Finally, the most vocal member of that group publicly announced that she was abandoning that redressing effort. She stated that she found herself invaded by the process, filled with indignation but immobilized by the frustration. She wanted to rescue her own life project, to go on with life, she said, rather than remaining trapped by an endless quest. It was both an act of despair and a vote for life.
Julio, an Uruguayan carpenter and union leader, jailed and tortured for two years, was granted what is know as the “right of option,” namely, he was allowed to leave his country to a political asylum offered by a host country. From jail, barefooted, he was transported to a plane, and flown to a Nordic European country. His hosts, noting his deteriorated health, placed him immediately in a hospital to allow him to begin to recover from his many wounds and both physical and possible emotional problems, a very reasonable act indeed. For Julio, the white tiles of the hospital and the intravenous tubes were not very different from the tiles of the prison and the cables of the electric rods of the torture he endured. When the first opportunity presented itself, Julio escaped from the hospital. Knowing only Spanish and dressed in hospital gowns, he did not go too far. He was re-hospitalized, in fact, in a slightly more restrictive environment, in order for him not to risk further harm, a most reasonable behavior indeed. Julio, in turn, attempted to escape several times more, which prompted further restrictions as well as psychiatric consultations, as his behavior was increasingly unruly. With the intervention of other well-meaning helpers, he was finally discharged, and transported to a suburban hostel that was devoted to political refugees. He would be finally among peers, it was reasonably argued. Only that all the other guests were Vietnamese who had been granted political asylum because of their ties to the South Vietnam forces during the war in that country. Soon after his arrival, Julio started receiving notes, slipped under his door, telling him that he, “red communist devil”, was going to be killed. He left speedily that hostel, while being accused of being ungrateful by his well-meaning hosts. He decided to manage by himself, which he did and does still with reasonable success. However, he is unable to sleep more that a couple of hours a night. When another helper tried to send him to a Center for the Treatment of Victims of Torture in still another country, in order to attempt to deal with his insomnia and night terrors, that request was rejected because PTSD is not a recognizable entity in the otherwise extremely generous health system of his host country. The moral of this story is: The road to hell is paved with good intentions.
After five years of jail without trial in her country in the southern cone of Latin America, Maria was offered asylum by a European country. Her husband had been killed by torture while in jail. Maria reunited in the airplane with her three children, of five, 8 and 11 years of age, whom she had not seen since her imprisonment. They went to that country, where they were generously provided an apartment, health care and a reasonable cradle of social and community services, including access to education. Five years later they were seen in a family consultation when the violent behavior of the oldest son, now 16, had reached intolerable proportions: he would have fits of rage in which he would insult his mother, wishing her dead, He accused his mother of having been the culprit of all their past pain. He destroyed furniture and punched holes in the wall of their apartment with his fists. Maria appeared crushed and desolated, a picture of despondency. The consultant described their predicament as a reproduction of her situation of prison, and an opportunity offered ingeniously by the son for the mother to be able to do what she hadn’t been able to do during prison, namely, acquire agency, assert herself, confront the torturers, declare that she wasn’t going to take it, She would be able to become again that lioness-mother that she had been before. and defend herself and her cubs against violence. The son was praised for helping her mother by offering all of them that opportunity. Several sessions following that line led to a dramatic change in this family, the mother having recovered her strength and dignity, and the three offspring having recovered their mother.
In the course of the first interview with Joyce, a 23 year-old woman who was consulting for relational issues, the therapist perceived her as hostile and angry with him. Reviewing in his mind what had transpired so far in that interview, he could not find a plausible explanation, and asked her why was she angry with him. After some hesitation, Joyce told him that he should not take it personally, but she mistrusted therapists. And, after some added hesitation, she explained to him that when she was a child she had been send to a child therapist because of bed-wetting. The well-meaning therapist resorted to play therapy and other vehicles to try to deal with that symptom. What he did not explore, or she did not reveal, was that Joyce had been sexually abused by her father, who would creep in her bed at night. However, bed-wetting, a blessed symptom that started during one of those frightening nights of abuse, turned off his father: he found it disgusting. So she kept on bed-wetting, sometimes on purpose, sometimes not, until the aversion process assured that her father would molest her any more. She was, indeed, angry with a therapist who tried to rob her of the best weapon she had against abuse.
Clara was born in a rural area of Colombia, plagued with political violence. Memories of her childhood include assassination of relatives, and many occasions in which her family had to run from her village and hide in the mountains to escape death squads who would come to slaughter whomever they could find in that village, suspected to be “rebel territory”. When she grew up and moved to a larger city, she became a human rights activist. After an assailant assassinated a woman friend of Clara – apparently believing that that friend was Clara herself – she escaped from her country. Isolation, somatization, depression, and multiple other manifestations of trauma plagued her life in exile in a country without special services for refugees. In despair, she decided to return to her country with a very low profile. There she consulted in a mental health service that had been created for victims of the internal war. It took her some months of therapy to regain a sense of self, and of purpose in life, while mourning without intolerable guilt the death of her friend, killed in her place.
A CREED FOR THERAPISTS
We humans are extremely complex bio-psycho-social entities. Our well being, and our suffering, is affected by, and affects, another extremely complex micro-social systems (families and personal social networks), in turn part and parcel of an extremely complex societal (socio-economic-cultural) system, in turn immersed in the exceedingly complex ecosystem that constitutes our planet.
This complexity accounts for this system’s both resiliency and fragility. In its resilience resides our hope. In its fragility, our responsibility.
Human suffering and human pain derive from injustices, oppression and other forms of violence that can be pinpointed at the societal as well as interpersonal level. These two levels are closely interrelated, and our responsibility toward one cannot be divorced from our responsibility toward the other.
Violence, unfortunately, is a significant structural component in the way we humans have organized of our society. Violence takes the form of lack of access to basic needs, education, healthcare, equal opportunity and respect, and early response to natural disasters. The powerless are caught in a vicious cycle of increased victimization and decreased hope.
Violence acquires also an active face. In our collective world, wars, genocide, forced uprooting, political disappearances, assassinations and torture, oppression of minorities, collective rapes. In the micro-systemic world of the family, family violence – especially against women and children and the elderly – sexual violence, children abuse. In addition, out there, in a gray zone, random and delinquent violence.
Our ethical responsibility is both personal and professional, and must be reflected in our daily praxis. (And even that “must” – and “musts” and “shoulds” that permeate this paper – have an oppressive, holier-than-thou, sound. But, please, reader, understand this creed as a plea for a reflexive practice, not as a prescription or imposition to others.)
To this end, we have the responsibility to live our personal and professional lives in ways that will enhance non-violent practices. We offer the following specific suggestions:
- to be vigilantly non-violent, non-oppressive in our daily personal and professional life and ready to redress any act of violence that we may generate in spite of our best intents. In that regard, we are bound to incorporate a practice of permanent self-sensitization, self-awareness and self-correction.
- to maintain that reflexive, self-critical, stance in the institutions where we work, and to enact non-violent, non-oppressive policies and procedures in those institutions that we lead
- to maintain an equally militant reflective eye in our roles as members, and leaders, of professional organizations
- to enhance the political and social involvement of our organizations toward non-oppressive, non-violent, non-sexist, non-classist, non-racist practices – we have power as professionals, our voice carries
- to acquire and maintain an active voice representing non-violent, non-oppressive practices in the many different communities of which we are simultaneously members
- to maintain ourselves culturally sensitive, actively challenging our cultural assumptions
- to keep ourselves aware of the power our own social bonds, of our own personal social networks, in order to increase our ability to be responsive to those of others – patients or otherwise – so as to move us to enhance their natural resources rather than impose on them our own assumptions and resources
- to keep ourselves aware the power of historical, cultural and geographic continuity in our lives, so as to respect that of others in our daily work
- to examine any act of violence as a multi-level crisis including its historical, cultural, economic, relational context, in order to enrich our descriptions and everybody’s options.
- as mental health socially concerned professionals, we have to be actively involved in re-storying and empowering the victimized, re-storying and resocializing the victimizer, and reinventing structures and cultural shapes that may otherwise perpetuate those roles.
The outburst of collective pain and violence currently taking place in the Balkans – and other acts of macro-violence in the world – should not deter but enhance our determination to be self-reflexive in our everyday life and practices. Paraphrasing John Donne, each act of violence, big or small, diminishes us all.
In the face of violence of any kind, not only we should refuse to become perpetrators, we cannot be bystanders: to be bystanders makes us, in fact, victimizers.
Our hope resides in the resilience of our social world and of our collective eco-system, and our responsibility in its fragility. That awareness calls us – among other daily acts – to embrace the ethical imperative to be non-violent and to act against violence. In so doing, we may begin to fulfill our responsibility as full members of the human family.