"Support for the helpers"

Therapy offers and trainings for psycho-social helpers in SEKA-House, Croatia
Author: Gabriele Müller, 45 years old, dipl. pedagogue and psychodrama therapist, professional experiences: a.o. work with women and children, victims / survivors of domestic violence, psychological support, supervision and trainings with psycho-social helpers during war in Croatia and Bosnia-Hercegovina, co-founder and psychological-pedagogic leader of project SEKA on the Adriatic island of Brac, Southern Croatia

A View back:

It was in autumn 1994 when I visited Bosnia-Hercegovina for the first time in war. The psychological team of the Women's Therapy Centre Medica Zenica had asked me to offer a training in the method of Psychodrama to them and to colleagues of two further women's therapy centres. During this training and in a number of talks with workers of Medica I noticed the alarming constitution of the local psycho-social helpers.
In this time all of them were living more than two years under war conditions. They had survived a twelve months lasting blockade of Central Bosnia which meant lack of food, electricity and water and the permanent threatening of death. Most of them had also experienced traumatic events in their private lives. And all of them were confronted with the severe traumas of their clients in their every day work. Most of them were working more than 12 hours per day, working Saturday and Sunday. So it was no wonder that all of them were in a severe state of "Burn out".

These helpers felt a big need for getting more information about consequences of severe trauma and how to deal with it as well as more education in further therapeutic methods. The few psychologists remaining in the war area had in pre-war-time usually worked as psychologists in state enterprises. They were now - without the necessary skills - confronted with a huge number of severely violated and traumatised patients. It was amazing how they dealt with this difficult situation but it was obvious that they urgently needed support.
Due to the war situation also a big number of activists with other professions (social- workers, sociologists, teachers, nurses but also lawyers, architects, economists, students...) had to overtake the role of psycho-social helpers as there was a big lack of psychologists in this situation.
Neither the psychologists nor the other helpers had ever experienced personal therapy or any kind of supervision. Up to this moment only some of the therapists had participated in some trainings concerning several therapeutic methods. These trainings were offered by international humanitarian organisations. But, they felt it "like a drop on a hot stone".
"What we most need is long-term education in trauma therapy and in adequate therapeutic methods!" several of the colleagues told me.

My impression in this situation was that indeed there was a big necessity for further education but still more for therapeutic and supervisional support for the helpers themselves: for support and space for their feelings, their experiences, their needs and problems in their difficult every day work and in their really hard private lives.
After two further trainings with a group of therapists and a group of other psycho-social helpers in spring 1995 I suggested the teams of the Medica Centre to come to Zenica for a period of three months and to work with them for their own relief. As they had experienced already our common work the accepted my offer.

In the period from September to December 1995 and May and June 1996 I worked with about 40 workers (from 60) of the Women's Therapy Centre Medica Zenica and Visoko.
I offered group and individual work as well as (if wished) case and team supervision, mediation (between several teams) and crisis intervention. To the psychological team I also offered some further trainings in Psychodrama.
This five-months-work with helpers in Bosnia-Hercegovina let grow the idea of a special project from which should benefit traumatised women and children as well as the workers and activists of psycho-social projects in the area of Former Yugoslavia.
In July 1997 together with my friend and colleague Mirjana Bilan and friends and colleagues in Hamburg as well as in Croatia and Bosnia-Hercegovina I could finally realise this project, a Centre for Recreation, Therapeutic Aid and Education for Women and Children on the Adriatic island of Brac, Croatia. We called this project SEKA, from 'SEminarna KucA' = House for seminars, but also from 'seka' = 'dear sister' in Serbo-Croatian. A short portrait about the project you find below.
In the following I want to describe our experiences with therapeutic and educational offers for psycho-social helpers in SEKA House. And I want to point out, why these offers still today are necessary.

Help for helpers in SEKA-House

When we began with the fund-raising work for project SEKA we found that it was not easy to find donors supporting the offers for traumatised women and children in SEKA House as the public interest in Bosnia-Hercegovina and even more in Croatia was going down.
But almost impossible was it to find donors who were ready to give money for the offers for the helpers. Again and again I explained why it was necessary to be not only concentrated on the "victims", the traumatised women and children, that it was imperative to support also those who in a big number of psycho-social projects work with the victims of violence. If we don't care for the mental health of the workers and activists they will "burn out", get ill, leave the projects and the projects will brake down or will have serious conflicts as a consequence of the burn out of the workers and the lack of supervision.
However finally The Staples Trust, England, and the European Commission were ready to support therapeutic group and individual work with workers and activists as well as trainings for therapists working with traumatised women and children.
In the period from January 1998 to April 1999 SEKA could offer to 29 women in 3 groups for each of them 58 resp. 76 hours group therapy. In the same period we provided for 51 women between 8 and 43 hours individual therapy. The therapy groups were led by experienced local therapists, the individual work was done by local therapists, by one colleague from England (bodytherapist) and by myself.
In the period from January 1998 to December 1999 altogether 54 local therapists participated in altogether 13 therapeutic trainings each lasting for 6 days.

Therapeutic group work

In the therapy groups we included women from almost all population and religion groups of the area: Serbian-orthodox, Croatian-catholic and Bosnian-Muslim women, as well as women, who didn't want to define themselves in these categories. There were also some returnees who had fled to foreign countries and after their return were confronted with the resentments of those who had survived the war in BiH. Mixing the groups is one basic principle in the work of SEKA (see below).

For all the women of these groups it was the first time to come out of the (former) war areas, and it was the first offer of therapy / releasement for them since the war had begun. All of them were active in their groups / projects, always caring about others, helping others, supporting more severe traumatised women and children. A long time they did not feel that also they themselves had a right to get support, that also they needed help to overcome their traumas. All of them had survived really traumatic events (as siege, severe shelling and fear of death, loss of near relatives / friends and / or loss of their homes, extreme hunger period, flight, expelling and imprisonment in detention camps, separation of family members and total insecurity what happened to them, witnessing of extreme violence and cruelties, ...)

When the women arrived, all of them were in a very bad state. For some of them it was not easy to travel through Croatia as they had survived extreme attacks and cruelties from the Bosnian-Croatians and in the beginning they were full of fear in spite of their wish to come to SEKA House.
All of the women were deeply exhausted / burned out. And most of them were also full of bitterness, suspiciousness and resignation. But they had come knowing that they needed urgently help and with the longing to escape - for a short time - the ruins of their everyday surroundings.

Arriving in SEKA-House for almost all of them - as they told us - meant a "wonderful shock".
This was not only caused by the loveliness of the house and the surroundings especially the sea, but even more by the atmosphere and our welcome. Many of the women could not believe that something like this could happen to them again: That we - women they had never seen before and mainly Croats (this was especially important for Muslim and Serbian women) - did everything for them that they should feel well and enjoy their stay.
The warm atmosphere in SEKA House, the openness and empathy of the SEKA-team were a very good basis for the women to open themselves for a therapeutic process.

The mixture of the groups included the possibility of severe conflicts as well as the chance of finding a way of real communication and building up mutual understanding.
The six local therapists leading the groups (having also different ethnic backgrounds) are very experienced in the work with traumatised women as well as in conflict resolution. Using methods of debriefing, Psychodrama, body-exercises, relaxation, energising exercises, trauma-work, painting, guided fantasies, sculptures and conflict-resolution they succeeded in leading the groups through an intensive therapeutic process.

After a first process of acquaintance, building the group (developing basic rules that women from all sides feel safe and well in the group) and expressing their expectations, the women worked on their strengths and their resources. This led over to the "active remembrance" of traumatic events, expression of the feelings connected with the traumatic experiences, then to the process of mourning and integration of the traumatic experiences.
The basic process naturally varied in the different groups, dependent from the resources of the women, the depth of the traumatic experiences, the constitution of the group, further important topics etc.

One group had to work long and intensive on the traumatic experiences of some women. An other group set more weight on the mutual understanding between the women from different population and religion groups. In the third group the present experiences of the women took a bigger space: situation as refugee / as returnee, very hard living conditions, lack of perspective for themselves and especially for their children, problems in their marriage, health problems, oppression as belonging to minority, first short return to home place, impossibility to stay there...

After three meetings (2 times three days, 1 time 6 days) two of the groups could finish their work. The feed-backs showed that the women had profited very much from the intensive group work, they felt released, they had got newenergy. The therapy process had helped them to understand their own reactions on the trauma better, to find a new understanding for themselves and also for the experiences of the other members of the groups. Most of them could integrate the traumatic experiences much more. For some of them it was clear that they need further therapeutic help, as their vulnerability was very high or the survived trauma very severe. Some of these women we offered further individual therapy work or tried to find possibilities of therapeutic support in their surroundings.
In the process of the third group it was obvious that the women needed to continue with their groupwork. We could offer them a fourth meeting (18 hours) to conclude the group-work.
(Naturally for the participants of all groups it would be helpful if we could offer them some further meetings. Up to now we could not realise this due to the lack of finances and the big number of further helpers who are waiting to join a therapy group.)

The members of all three groups built through the therapeutic process intensive relationships between each other. They support each other further on personally as well as politically. Some of them already organised meetings resp. mutual visits of their groups / projects.
One of the participants expressed it like this: "The groups in SEKA-House I feel like a seed, from which grows a women's friendship network all over Bosnia-Hercegovina and Croatia." We see this as a concrete step on the way to peace and reconciliation in this area.

In November 1999 we started with a forth therapy group (11 participants) with which we will continue in 2000 as we have already a lot of requests for this kind of therapeutic support and releasement. If we can secure the finances for these offers we plan to start still two further therapy groups for workers / activists in 2000.

Trainings for therapists in SEKA-House

for example "Psychodrama" and "Body-Psychotherapy":
The trainings in "Theory and Praxis of Psychodrama in the therapeutic work with traumatised women" were lead by myself. The trainer of the seminars in "Body-Psychotherapy" was the German Therapist Gisela Endel. Gisela Endel is experienced in the work with traumatised women. She also offered supervision and trainings to psycho-social helpers in Bosnia-Hercegovina during the war.

The six-days educational seminars always included about three days of self-experience with the method of Psychodrama resp. Body-Psychotherapy, as most of the therapists had never experienced therapy themselves - this was not included in the study / education for psychologists in the old socialistic system (see above).
For most of the women it was the first time, that they had space to work at their own traumatic events and their own feelings which they had pressed down for a long time.
So the processes in the self-experience phases in the educational seminars were often similar to therapy groups. We as trainers always had to find the balance between the big need for therapy and on the other hand the reality to lead an educational / professional seminar and so not to open too deep processes.
It was not easy to lead these seminars, but in the same time it was very touching and a special intensive experience.

Besides the big need for self-experience the members of the groups in there role of professionals were (and are) highly motivated to be educated in these special methods.
They were very glad about the offer to join a continuous education so that they were really able to learn the method and to use it in their everyday therapy work. (Most educations that they had passed through during war-time were lasting only one weekend or one week. After this they naturally were not able to use the methods in their work).
Another fact is, that the now existing possibilities of qualification for psychologists and medical Psychotherapists at the University of Sarajevo are only concentrated on traditional methods. They do neither include selfexperience / therapeutic experiences of the therapists themselves nor non-traditional methods as f.e. Body-Psychotherapy or Psychodrama, which are - as we experienced - especially appropriate in the therapy work with traumatised clients.

For the year 2000 we plan to continue with the trainings in Psychodrama. After concluding the educational part we want to go on with supervisional seminars to support the therapists in using Psychodrama in their own work. In 2001 we would like to start another training group for Psychodrama.
The training-group "Body-Psychotherapy" we finished after the 4th training week.
The members of the group use this method already in their therapeutic work. If we can find the finances we would like to offer also to them further supervisional seminars.
Educational seminar: "Body-Psychotherapy with traumatised children"
For therapists working with children still today exist scarcely possibilities of further education in the area of Former Yugoslavia.
As response to a big number of requests from therapists working with traumatised children we began in March 1999 with trainings in "Body-Psychotherapy with traumatised children".
Trainer of these seminars is the German Body-Psychotherapist Veronika Stober, who is specially experienced in the work with traumatised children.

The main subject of the first training was self-experience, getting into contact with the own "inner child" as a basis for the therapeutic work with the children.
The participants of the seminar were fascinated by this method and especially by the way of learning through self-experience, to experience themselves as children.
"I discovered totally unknown aspects of myself", said one of the participants after the first training. And another colleague realised: "The best way to learn this method is really to experience it myself, to feel like a child."
We plan to continue with these trainings in the year 2000. We hope to be able to secure the necessary finances.

Why are these kind of (free) offers for helpers still necessary?
Sometimes colleagues in Germany or other Westeuropean countries are surprised that five years after the end of the war in BiH and Croatia we still offer therapeutic work and trainings to psycho-social helpers and that we still finance these offers completely. "We have to pay ourselves for therapy, professional trainings and further education," one colleague told me. "Why should I then give donations for such seminars in SEKA-House?"

We only can reply, that, if f.e. therapists should have to pay for trainings in SEKA-House, in spite of the big interest, not one single woman would have been able to participate.
We hope that the economic situation in the countries of Former Yugoslavia will change. But this will take still a long time.
Up to now even psychologists or physicians, who are the best paid professionals, have very low salaries. The prices however for every day goods are in Bosnia-Hercegovina about the same as in Germany, in Croatia they are as double high as in Germany and most colleagues have not only to feed their own family but usually also a number of further old, ill or otherwise needy relatives.
Helpers with other professions or activists have still lower wages, if they have wages at all. Sometimes the projects, in which they work, have no money, or are in present difficulties so that they can't pay wages. We usually ask workers and activists, who want to participate at trainings or therapy groups in SEKA-House, to overtake the travel costs. Most of them do. But sometimes we found out that they had to borrow the 50,- or 70,- DM for the bus ticket. For some of them it is the amount from which they feed their family during one week.
So in special cases we also overtake the travel costs.

I think I need not to mention that almost none of the local organisations and groups have any funds to finance supervision or further education for their workers. For almost all of the helpers who participated in therapy groups in SEKA-House it was the first possibility to get psychological support themselves. Therapy, supervision or further education - for professionals in Westeuropean Countries and in the USA a matter of course especially if they are working with traumatised clients - seem for the helpers in the Balkan region still to be luxury. We in SEKA-House think it must be a "Human right" for the helpers!
Therefore we will go on providing this kind of support for those who themselves support thousands of victims of war and violence. And we hope that further on organisations as well as private donors will help us with this task.

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