25 Mar 2011

Children, War, and The Forgotten Ground of Healing

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This essay deals with ways to focus on the strengths and gifts of communities, and especially children, in war and other adversity. It comes out of the many years that I worked in the field of child health and rights.

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Abstract: The paper examines ideas about the impact of suffering on childhood, and places trauma healing in perspective with the importance of grief and loss for psychological growth. Resilience theory provides a basis for focusing on the strengths of people in adversity, but tends not to recognize the importance of the child’s relationship to nature for the restoration of psychological health. Children from war-affected contexts bear the double burden of rupture of their web of human relationships and their relationship to their home place. The reconnection to nature and the earth should be given equal importance along side the conventional focus of psychology on the restoration of healthy intrapsychic and interpersonal relationships.

key words: nature, resilience, mental health, trauma, armed conflict

Chorus of elders:
Zeus, whose will has marked for man
The sole way where wisdom lies;
Ordered one eternal plan:
Man must suffer to be wise.
— Aeschylus, Agamemnon

In his play about a king’s return from the Trojan Wars the Greek poet Aeschylus planted, at the roots of Western culture, the hard truth that we become fully human through suffering. But this lament of old men, that ‘man must suffer to be wise’ is misleading. It puts too much weight on adult experience. We know that the suffering of children influences character formation long before the woman or man struggles with adult problems. The word ‘character’ comes from the Latin root meaning to be etched or inscribed upon—to be marked by life, an image of wounding.

Yet it is also a mistake to read this as a one-sided, tragic point of view. Jung, Freud and many other storytellers have added to Aeschylus’ insight, affirming that grief can stretch the soul, articulating our emotional range and realizing our full potential of feeling. The darker the shadow, the brighter the light. Though many are not transformed by suffering and some may find it intolerable, out of suffering can come the breadth of soul to encompass all that life has offer.

What I fear in saying this here is that it could be used as an argument to rationalize the fact that children all over the world, in more than forty countries, are exposed to the horrors of war and the unfathomable suffering that it can bring. War is hell, but necessary, just as the poor will be with us always, say the voices of realpolitik. That’s life, it’s the school of hard knocks, we accept that millions of kids will go through this and for many, it builds character.

What does an adult know about children, about childhood? There is an old saying that if you have made it to the age of twelve, you have been through enough life experience to write volumes of poetry. Radiant joy, passionate attachment, inconsolable loss, black terror—these are normal childhood emotions that most children feel. By the time we reach the ripe old age of twenty, however, the hormonal fires of adolescence, information overload and the burden of the years have dulled our memory of the full experiential range of childhood. We put aside childish things with a mixture of condescension and nostalgia. The modern western mythology about childhood takes over. It is a web of contradictory fictions which includes sentimental notions of powerless innocence—the kind of thinking that insists all child labour is abusive—as well as pop fantasies of limitless freedom without responsibility—the world of Bart Simpson. Most of us can’t remember the intensity of childhood experience with the awe and respect that it deserves. We grow ‘up’, and therefore arrive above, childhood. Indeed, psychology teaches us that the achievement of maturity is the growth out of infantile states and mental illness is correlated with regression to earlier stages of mental life.

But we do know that it is profoundly important to commit resources to the special needs of girls and boys affected by armed conflict, not only because we have compassion for human suffering, but also because “the child is father to the man.” The brutalized child you comfort may one day be a mediator, and the one you fail to reach today may be the vengeful warrior of tomorrow. Why focus on children? The international movement to protect children from armed conflict is based on the recognition of the potential developmental damage of acute psychosocial distress on children. Children lack the emotional defenses of adults. They may bear effects of traumatic experience, such as distortions in moral learning, for the rest of their lives, acting out in anti-social ways and perpetuating the cycles of violence when they grow up. The focus on helping children is naturally future-oriented and regenerative, so it allows post-conflict communities oppressed by bad memories to begin to move forward positively, contributing to the slow, painful process of reconciliation. War trauma specialist John Van Eenwyck describes how a child-centered approach can generate a powerful ripple effect in a community:

Any time we work with children, the children themselves are transformed by what we do with them. They carry that back to their environment, and their parents see what they do… the ripple effect carries into everywhere the child goes. The child becomes essentially an island of calm and growth in a sea of turmoil. And like oil on troubled waters, the child can actually transform the environment that they’re going back into.

Recall the phrase ‘healing the hurt child’. Is an external healer needed? Getting hurt, feeling hurt is a normal part of childhood, and it is normal to heal our hurts by internal processes. We self-heal, ideally with comfort from family or friends. If the adversity is not overwhelming, the hurts of childhood open up, stretch and flex our self-healing capacities. The problem is that when children experience severe abuse or neglect, when they are injured physically or mentally by violence, the adversity may be overwhelming—traumatic. But even after acute traumatic stress, many children, as many as eight out of ten, can recover over time without professional help. In some children it is remarkable to note that resilience can actually increase due to the experience of war and displacement, giving credence to Nietzche’s claim that what doesn’t kill us makes us stronger.

What is resilience? It is the ability of a person to bounce back from the blows of adversity. It is your ability to protect the integrity of your personality and to be mentally healthy.

What do we mean by healing? It is an easy word to say. We mean a combination of providing experiences that can enhance resiliency and a therapeutic process that can lead to a reduction of pathology. At the same time, we recognize that it is the social situation of war that is sick, not the child. We don’t need to justify our efforts by counting cases of Post Traumatic Stress Disorder (PTSD). We recognize that in the madness of armed conflict, people are bound to manifest symptoms of PTSD. The pathology that disturbs the child is outside the child, so the child needs to be resilient to live in this disturbed context.

Maybe healing is not what is required, if this means a return to innocence. We must be careful that in our efforts to help, we do not stifle the healthy process of grief. Some aboriginal people say that white Western culture is lukewarm, so white people are only cooked on the outside, they are not fully human. We mistakenly assume that we are born human, but that isn’t true. How do you get cooked on the inside? You have to swallow hot stones. There is no easy way to do that, but you have to do it to become a human being. Grief, it has been said, is a good teacher.

So it is useful to question ‘hurt’ as only a negative thing, and to question what we mean by healing if it means avoidance of being cooked on the inside. Expressed in another way, “we are like iron, and must be heated before we can be wrought upon.”

On the other hand, it is important to understand that severe traumatic experience can override all of a person’s resilience and lead to long-term disability. What doesn’t kill you does not necessarily make you stronger. Even the strongest personality can be broken. The experience of terror may steal something from you that is extremely difficult to recover. But even in cases of acute traumatic experiences, recovery is possible.

The idea of resilience allows us to focus on nurturing children and to respect their natural responses to adversity. There is now a widespread recognition of the importance of restoring the playfulness and resilience of children through activities including drama, storytelling, puppetry, and local arts and crafts. The importance of cultural and non-formal activities such as songs, storytelling, traditional dance, community theatre and memorial festivals to heal the psychological wounds of war have also been explicitly highlighted.

So we create the conditions for children to do things that help them come home to themselves. This is of the essence of good practice in work with refugee children, internally displaced and also children whose home place, whose world, has endured the stress, threat and abuse of armed conflict. For these children, nothing can ever be as it was before. For these children, home is indeed where the heart is, and the task at hand is to help them see that home, a source of safety and comfort, is inside themselves, to see how beautiful they are. Our idea of rehabilitation comes from the Latin rehabilare, to come home to oneself. It is the reinhabitation of the soul.

But the common Western idea that Self is just the individual, that my troubles and pain are mine alone and no one else can share or understand, is too limited. If this is held exclusively to be true, it cuts the individual off from the relationships that make the Self whole, and without which a person is doomed to be less than fully human, and to suffer without achieving the wisdom that Aeschylus said was the potential outcome of suffering. We need to humble ourselves and accept the transpersonal dimensions of suffering. Your individual loss opens you up to grief. The wound is the point of entry, but once opened up the individual is given the gift of access to the suffering of others and of the earth, to ever-widening circles of empathy. If, as adults, we understand this in our hearts, we are better equipped to accompany children in acute distress.

In all of our western helping professions—medicine, psychology, social work, and education—we learn that people help, guide, instruct, accompany or provide therapy to other people. The literature on resilience describes a range of protective factors or assets that children may have in themselves or in their lives, and when we go through the list we are likely to do some quick comparisons. Yes, I had talents valued by society and self, and effective school, and community resources, and loving parents; street kids don’t usually have socioeconomic advantages, but they often have self-efficacy, and appealingness, and war-affected kids may pull through fine if they have faith and connections to competent and caring adults, and these are all things that should be restored in order to regenerate resilience. Among the strategies for promoting resilience, there is often an important reference to non-human protective factors, access to playgrounds, sports and recreation. This has led some people to ask, “What about the relationship with nature, with the non-human world, plants and animals and sunshine, wind and rain? Do we derive strength, comfort, pleasure and identity from these things?”

The therapeutic value of a relationship with nature—with the outdoors, the elements and other living things—is at best marginalized, at worst dismissed. Humans look after each other, and if nature and other species are noticed at all it is only as a space for recreation, such as a playground, or as pleasant context for the real business of the therapeutic relationship between or among humans. Yet common sense tells us that self-healing occurs through a spectrum of activities and processes outside of the therapist-client relationship. Conversations with a caring professional can supplement, reinforce, mediate, or moderate the effect of the life experience that is ongoing when there is no therapeutic conversation with another person, or a group, going on. In adversity, there may be a whole range of daily toxic experience undermining the therapeutic process. Thus, the recognition of the potential therapeutic importance of our relationship with the natural, non-human world has a practical purpose as well. It takes the unreasonable projection of expectations off the interpersonal therapeutic relationships and shares the burden of human suffering with one who has infinite patience, infinite love, infinite generosity —Mother Nature.

Kerry Maynard Moody, a therapist from Lawrence, Kansas who works outdoors with children from violent homes, speaks of the joy of helping a child to allow herself to be touched by butterflies, bluebirds, spring flowers, and sunshine. The child needs permission to take the time to do it, and someone safe and kind to accompany her, and then she discovers that she can do it for herself, it’s just a few blocks from home, and it’s free. She can have a look at what is growing, pick a bouquet of flowers and give it to someone, or if there is no one else around she can give it to herself. Neither the abused girl nor her family are aware that they are disconnected from the natural world, blind to something so essential to psychological health. Moody suggests that in this situation the therapist has a responsibility to work in nature with the child.

Indeed, for most urban people, and that is now more than half the people on earth, the connection with nature is a rumour and a nice idea, but they don’t have it. Both in the West and in the developing world, the powerful combination of human-centered cosmologies and social ideas, the adversarial relations of settled agrarian peoples to uncultivated nature, and the forces of techno-dependent urban civilization have conspired to give us confidence that we don’t need to be close to nature, and that we are better off without it. Because after all that is for savages and pagans. One more bite of etymology: originally the pagans, pagani, meant “those who live on uncultivated land”, although it also came to refer to those who held beliefs other than our own. Today, these pagans are the small clusters of aboriginal peoples who still grasp tight the old ways, whose integrity and humanity is inextricably linked with nature.

All children start out, as we have said, having an ecological sense of continuity with nature. What if we didn’t put aside childish things as the price of maturity? Some tribal peoples who have remained on intimate terms with the natural world actually do, even today, raise their children in a way that we might learn from. Coming through a fully human childhood and appropriate initiation, the adolescent “will not put his delight in the sky and the earth behind him as a childish and irrelevant thing. He will graduate not out of the world but into its significance. So, with the end of childhood, he begins a life-long study, a reciprocity with the natural world in which its depths are as endless as his own creative thought.”

The garden, the outdoors, is a ground of healing because it invites the child or the adult caregiver, however schooled and disciplined, to relax and be receptive. It makes it possible that the person who has endured toxic experiences might be able to let go of some of that, be open to take in sustenance through all the senses, and feel safe. It is also the ground, or basis, in which play is most possible. Physical play, and imaginative play can lead to integration of stressful memories, which is what is meant by self-healing.

Why should the work to integrate acutely stressful experience be based in nature? Is nature just a nice setting for our work with children?

War teaches children so much. Its sound and fury rings painfully in their ears, drowning out the gentle, patient, and beautiful messages of nature. Traumatic stress deafens people to the reassuring voices of nature, so that they no longer notice the songs of the life force in the cycle of the seasons. Death is a natural process, and so is violence, but these are always part of a cycle of life, growth and generation. In a harsh climate, the reassurance that this wisdom brings is more subtle, but no less sweet for that subtlety. Children can gain great comfort and renew their confidence in life from observing how nature heals itself, bearing witness to the dauntless efforts of creatures to rebuild their nests after a storm, learning how interdependent all living things are with the nutrients from the elements, and how even fire sometimes plays an essential part in nature, helping grasslands to renew their health and complexity.

It is now well understood that if people don’t form this reciprocal relationship with the non-human world outdoors when they are children, it is much less likely that they will value this relationship and seek to renew it in adult life as a way of looking after their mental and spiritual well-being. Given the chance, children can experience the play of the imagination in the mind suffused by wonder—see the universe in a grain of sand, heaven in a wild flower—and carry that affinity forward as a way to be kind to themselves and others, by sitting under a tree, or walking in a park, by finding some open ground or just an open window, to bask in the sun.

Perhaps we should ask, what would be missing if the therapeutic process remains in a clinic, or if an art and play program is simply classroom based? Surely, it is enough to bring nature in through the use of natural materials, with a few photographs of pretty outdoor scenes, with fresh or dried flowers to decorate the space. The answer is that anything we can do to bring nature into a counseling space, into a classroom, or into a child’s built environment, including home, is a good thing. In a harsh climate in winter, we have no choice. And any efforts to decorate with natural images or objects adds charm, interest, and points of stimulation for children. But things will really start to get interesting if there are living things in the project— soil, water, sunlight, growing plants, creatures in the soil, wild or domestic animals or birds. Not just decorative elements in the room, but living things that invite children to communicate, to care for, to have a relationship. In offering children opportunities to communicate with other living things, to look closely at natural processes of seeding and growth, we provide them with a chance to rediscover, or discover for the first time, the basic patterns and dynamics of life, including their own life.

In relationship with animals, the child can experiment safely with kindness and trust, even if there is no opportunity to practice these skills and have these feelings at home or school. We can expect children who have experienced cruelty to be capable of it themselves, and indeed cruelty among children is common and normal even if they have no war experience. There can be plenty of cruelty in a normal home or school. This should not surprise us. Harsh treatment and indifference to the suffering of animals may be normal in the local culture. In many cultures, fear of the wild or the bush as a hostile and dangerous place may be taught from birth. But this respect born of fear, too, is a relationship that we can work with. The role of older mentors is very important, to model kindness, caring and respect for the safety of other living things. With patience, we can help children to experience nature beyond the obvious and common affinity for flowers and trees and sunshine, or the taste for pictures of flowers and trees and sunshine.

A nature-based project gives children the possibility to experience their own intimacy, fascination and comfort with non-human nature, to have a feeling for the whole cycle of the lives of particular plants and animals, and to be strengthened by that deepened relationship with nature’s ever-renewing processes, nature’s flow, and nature’s beauty. With time and patience, we can help children to recognize these qualities within themselves too. Nature teaches us that we, too, have the capacity to renew ourselves, to endure and flow and swim through the storms of life, to reach for the sun and the rain, to
grow stronger and more hearty over time, to be open and joyful and beautiful.

The challenge that is addressed in a nature-based project is to help children experience this closeness and symbiosis with both cultivated and wild nature, with the vitality of the elements and the abundance and fecundity of the non-human world. Caregivers create a garden with the children to help them discover for the first time, or renew, their active relationship with the natural world, so that they can derive comfort, strength and well-being from it. Such a garden offers children opportunities to discover how natural places, particular trees or creatures, can be their friends. The garden speaks to the children, and in their visits to this place over time they begin to hear its language of kindness, gentleness, creativity. For many adults, ‘nature’ is a useful idea, but the child can’t have a relationship with an idea. For a child, nature is not an abstraction, she is a person, Mother Nature, embodied in places and objects, temperature and texture, colour and sound, breath and movement, fragrance and taste. Nature is the experience of direct contact with dirt, rain, bugs, sunlight, dark of night, critters and slug slime and swimming undersea with the fishes, getting buried in leaves and moss, sitting up in a jackpine smelling the pine gum with an steady west wind showing you what parts of your flesh are facing west…The child comes to know and communicate with particular places and particular living things or communities of living things. A therapeutic garden is a particular place with its special spirit and its voice, and in this sense the garden is a person. She speaks to us with as much kindness and wisdom as we might find in a very good human therapeutic relationship.

I came to this understanding through a combination of lifelong personal experience in the outdoors, and through many years of research and action to produce educational tools for people who work with children in adversity. This work has offered me the privilege of learning from many people engaged in this vital work around the world. While most people concerned with the welfare of children acknowledge the positive values of outdoor play and work activities, there is, as I have said, a tendency to see nature as a backdrop for the real work.

When I began to focus on developing a program for children affected by armed conflict, before I came to work with Médecins Sans Frontières, I was inspired by the innovative work of artists with children in the Spiral Garden, a summer day program that integrates children with physical disabilities and other children from the community at the Bloorview MacMillan Rehabilitation Centre in Toronto, Canada since 1984. The Butterfly Garden, a project for war-affected children in Batticaloa in Sri Lanka’s eastern province, was established in 1995 by one of the founders of the Spiral Garden.

Subsequently I cast a wide net among child-serving agencies around the world to look for locally run, site-based long-term programs offering creative learning and play for children grounded in the local physical and social ecology, including the local flora, fauna, culture, stories, art, aesthetics, and spiritual traditions. The ones that exist have much to teach us about good practice. For example, the network of Rediscovery projects focus on cultural regeneration, usually based in aboriginal communities, grounded in aboriginal land-based practices. The All Species Project based in New Mexico promotes care for the earth by children through play and the arts in many countries affected by organized violence such as India, Ecuador, and Chile. While these programs combine art and play activities with emphasis on the healing power of nature, the Spiral Garden is more artist-driven, with greater emphasis on creative processes and the poetic imagination—free play in image making and seeing the world. Although they don’t know one another, the founders of these programs draw inspiration from common sources including the socially engaged ceremonial theatre traditions of Welfare State International and Bread and Puppet Theatre , as well as the writings of change agents such as ecologist Edith Cobb, theologian Thomas Berry, psychologist James Hillman, art therapist Shaun McNiff, and trauma specialist Judith Herman.

This research provided the basis for the development of a framework for mental health projects with children at Médecins Sans Frontières—Canada (MSF), called the More Than Bandages program. We have been given space within MSF—Canada to research and develop these ideas for possible pilot testing. MSF focuses on populations in danger, and includes mental health in its medical relief mandate in some contexts. One of the main challenges of this initiative is to find appropriate places to integrate a nature, play and art based psychosocial project for children with the very concrete, patient-treatment orientation of MSF field missions. What MSF knows best is the ‘medical act’, the life-saving gesture, the timely application of technical skill and resources. Yet in today’s wars we know that many of the wounds are in the mind, they arise from the systematic destruction of culture and security of the home place, and many of the clinical cases are psychosomatic not just on the Macedonian border of Kosovo, where it was around 90 per cent, but in the many low intensity conflicts of the world too, such as Chiapas and Chechnya and East Timor, where the state now understands that to destroy a people, you must suffocate their culture. The inclusion of culture and nature in medical relief may not be a luxury; perhaps it is a responsibility that we are now just beginning to recognize.

We have not yet conducted any pilot projects of this nature with MSF. Our research on good practice suggests that an effective project to assist children in acute psychosocial distress will create a safe place for them and provide the context of care, playfulness and imaginative possibility that allows them to recover and flourish. The aim would be for caregivers to work openly and spontaneously with the earth, with images and with each other. Armed conflict destroys the social ‘space’ where we feel safe to be together with others. We know that in places affected by armed conflict, it is essential to help people carve out new spaces where they can regenerate kindness and beauty for both the children and their war-torn communities.

How can visual and performing artists, storytellers, musicians, clowns, gardeners and other gifted creative people stimulate “mental health” of individuals and groups in emergency situations? How can they help war-torn communities and displaced people to remember who they are, and where they have come from? How can they draw from the wellsprings of stories, images, songs, and folk wisdom to help them rebuild community?

Commonly, humanitarian agencies send in mental health professionals from outside, or identify local professionals to work with. There is a near-universal bias among institutions to value only the knowledge and skill that has come from formal training validated by professional status as a pedagogue or counsellor. Unfortunately these people are rare in war-affected communities, due to death or flight to a safer place. Thus, it is important to work with and train people of goodwill, perhaps without much formal schooling, who live in context. These caregivers live among the stresses and pain of war, among children. Like the children, they may have experienced terror, insecurity, material scarcity, lack of love, lack of comfort, disconnection from their traditions, lack of opportunities to relax and have fun, lack of social and emotional support. They may be cut off from nature; the earth, and their home place, rivers and trees may be very damaged due to armed conflict.

In the aftermath of war, the watersheds of the earth also need regeneration. The earth is resilient, and she has to be. The military is at war with nature, even when there is no ‘collateral damage’ to people or property. As much as thirty per cent of all global environmental degradation can be attributed to military activities. Our own healing can come in the act of regenerating local ecosystems, repairing the damage that people have wrought on the land. This can be profoundly therapeutic for children, a mutual therapy between the person—the child—and the land.

Play is at the heart of this method. But we are not talking about a simple day-care centre with toys and games, nor is it a traditional “play therapy” program with its emphasis on diagnosis and treatment. Out of play with materials, words or movement, the children in the project make images that are not analyzed or judged. Out of the images planted in the soil of the garden, stories emerge and grow. The idea is that, with the help of the garden staff, the children can turn these stories into theatre, perhaps with music, dance, costumes or masks. In this process, they can reconnect with the beauty in themselves, the kindness in others, and the self-healing power of nature.

Maybe there is no tradition in the local culture for playing with children in nature as a job, as a vocation. In fact, it is not a very common thing for people to do for a living anywhere in the world (it is especially rare among men). But child’s play is a deeply rewarding thing to do with one’s life, and those who discover these rewards are lucky. It is the joy at the heart of creation. The Chinese sage Mencius said, “A wise person keeps the childhood habit of mind.”

* * * * *

In a moment of doubt, a friend who does theatre projects with refugee children encouraged me recently. He said, “Healing gardens for children! This is very, very important to write about, you must do it. We need it. There should be many of them, everywhere.”

After some years of research and development, against a range of practical and philosophical opposition, I still feel that my friend Philippe is right. But I also feel acutely aware that we now need to leave behind the potent abstractions of trauma healing, peace, and expressive arts and humbly enter particular places to work with children, with love and humility. Wendell Berry, a wise old man on a farm in Kentucky (where my own father came from) reminds us that only love “can bring intelligence out of the institutions and organizations, where it aggrandizes itself, into the presence of the work that must be done.”

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