Mental health issues are increasingly coming to the fore as the world faces increasing uncertainty about the future. However, an increasing number of mental health practitioners understand that drugs or psychotherapy are not sufficient – or even desirable – to treat people and societies dealing with traumatic events, whether they be wars or the effects of climate change. ANGI YODER-MAINA, an American who has made Kenya her home, is one such practitioner. Her Nairobi-based organisation, Green String Network, advocates for a more holistic approach that looks at how societies can heal from collective trauma. She believes that because Kenya has never really reconciled with its brutal colonial past, it remains a trauma-organised society, and is in need of trauma-informed healing. She spoke to RASNA WARAH about how this approach can help individuals and communities, not just in Kenya but in other countries that have experienced trauma, to overcome adversity.
Q.Mental health issues have gained prominence since the COVID-19 pandemic. Studies have shown that levels of depression and suicide rates have increased around the globe, including in Kenya. In a world facing recession, climate change and now a war in Ukraine, there is a lot of fear about what the future holds. How can we mentally deal with issues that are out of our control and which threaten to derail and traumatise present and future generations?
In 2020, as the pandemic broke out, everyone was living in the shadow of collective trauma. Uncertainty, stress, and fear were high, even for those who didn’t get sick. People lost jobs, and livelihoods. Kids stopped going to school. Life shifted and changed for much of the globe. The threat of losing financial stability, health, or a loved one stalked all of us – and for many of us is still happening. All these feelings are normal and not a sign of our pending mental ill health.
Mainstream biomedical perspectives of mental health are currently and historically rooted in a deficit-based perspective. The deficit models create a cycle of negative experiences, and behaviours, and possibly even further lead to the deficits themselves. Within this cycle, once the deficit and needs of the community are identified, specific prescribed interventions are created to address a particular problem (i.e. a new mental health hospital with a Western, psychiatric focus). Because the problems that we all experience tend to be complex, most current mental health interventions do not holistically address our very real pain.
The need for holistic well-being support is growing every day in poor communities all over Kenya. When people cannot afford therapy, or if they live in places where there is limited access, they need other solutions that work that are culturally grounded and accessible.
Q.Your organisation engages the world’s problems through healing-centred peacebuilding. You say you fill the gap between peacebuilding, mental health and development. What exactly do you mean by that?
The reality is there are not enough trained mental health experts, counsellors, or social workers in poor, violence-prone communities to help young people (and the rest of us) deal with the high levels of distress they face in their daily lives. So, instead of giving up, we must expand what is possible to deal with realistically. All of this adds up to the process of collective social healing. It is the missing piece that allows us to build the foundations for well-functioning and cohesive institutions, communities, and countries. Healing – for individuals, but also collectively – is what makes peace work.
Green String Network (GSN) designs and supports community-based network partners to implement community care and relational well-being programmes all over East Africa, including in Kenya, South Sudan, Somalia, and Ethiopia. We have also developed a similar programme for the Kenyan police. We use a healing-centred approach that assists communities in crisis and specialises in the most fragile areas.
Additionally, we conduct critical research on trauma, adversity, violence, and inequity, and how these things are deeply connected. There are limited mental health professionals in the communities we work in, and so we have developed deeply transformative and healing community care systems.
Q.Much of your work is in conflict-ridden countries like Somalia and South Sudan. Can you explain some of the work you do there.
As peacebuilders we have found that without engaging in social healing, it is nearly impossible to support local communities and leaders as they seek to stabilise and build peace in their own communities. Globally, mental health issues, including substance abuse, impact about 10 per cent of the general population but in conflict-affected countries, such as South Sudan and Somalia, it is estimated that much higher portions of the population suffer from some form of emotional and mental distress.
In conflict-affected communities, we find that “invisible wounds” often keep people from engaging in recovery, reconciliation and governance initiatives and programmes. In such contexts, people are visibly exhausted and emotionally fired. At the community level, residents express frustration that engagement in such activities will not help their daily lives, and they do not wish to attend another “useless” meeting or give more information for another assessment. Or leaders intentionally sabotage agreements.
Q.You once told me that all Kenyans are traumatised in one way or another and need healing. What did you mean by that? How can Kenyans confront their traumas and heal?
I am not sure traumatised is the right word, as traumatised is defined and pathologised to mean that people are disordered and mentally ill. That is not what I meant; what I meant is, given the fact that Kenya has never really healed from its colonial history, a post-colonial Kenya is a trauma-organised society. We lack opportunities that support social and collective healing. The fragmentation of the social fabric created by violence, inequity, injustice, and pain means we do not have safe spaces that allow us to build supportive and caring communities. This is something you and I have talked a lot about Rasna, which I know you also often feel is missing here in Kenya.
A trauma-informed society will tell people that it is not what is wrong with them but rather it is what happened to them, their parents, their grandparents. The trainer and author Lisa Cherry once noted on Twitter that “[t]he person one becomes to survive is invariably the person who presents for help. Finding ways to support people to find their core, to visualise a different person than the ‘surviving’ self is a large part of healing.” Well, it is the same with the collective.
When society is trauma-organised, all our systems are broken and traumatising. When systems are traumatised, the collective becomes personal because it impacts how we are treated by an uncaring or dysfunctional government and how we receive (or don’t receive) social services like education, security, and healthcare. Everyone is impacted, yet we all feel alone and isolated and have to respond to social issues alone as individuals.
This is one reason why we moved away from just a trauma-informed approach to a healing-centred approach because, as noted by Dr. Shaun Ginwright, “A healing-centered approach to addressing trauma requires a different question moving beyond ‘what happened to you’ to ‘what’s right with you’, and views those exposed to trauma as agents in the creation of their own well-being rather than victims of traumatic events.” I believe that a collective social movement is what can help Kenyans become the agents of their own lives and help us move beyond being stuck.
Q.Tell me a little about the work you have done in Kenyan prisons.
In 2019, we worked with prison wardens and always dreamed of also working with young people in the prison system to prepare them to reintegrate into society rather than rejoin a life of crime and violence when they leave prison. For the last few months, our partner organisation, Samba Sport Youth Agenda, is using our curriculum in the local Kwale prison, working with young men who are between 18 and 24 years-old by engaging them in the Kumekucha Question Programme (KQ). KQ is a 12-week peer support programme that engages a restorative circle process. The young men are mostly in prison because of gender-based violence convictions. While we have not finished that work, we really believe that this small (and inexpensive) intervention will have an impact on the participants, their families and on society. The warden has already said that he has noticed a difference in the prisoners’ outlook on life and what they hope to accomplish once they are released.
Q.You are a big fan of the Canadian doctor Gabor Maté, who makes a strong link between childhood trauma and adulthood addictions and disease. Do you believe that most mental health problems are the result of some kind of childhood trauma?
Yes, I am.
In the words of Dr. Maté, “Let’s all drop the pretense that we are either normal, or abnormal. We are all in the same support group: ordinary people who must deal with the struggles that come with being human.” The concept of adverse childhood experiences or ACEs is first about adults and not about children. This is because many of our adult issues (such as our addictions, depression, and even physical sicknesses) originate from the adverse feelings we had as children. From these adverse feelings, we developed coping mechanisms that initially were there to protect us from hurting and pain when we were younger. But these feelings and coping mechanisms are very hard to let go when they no longer protect us. Thus Dr. Maté also writes, “The question is not ‘why the addiction’ but ‘why the pain’.” Most of our addictions are there to numb us and let us feel good for a short time – because no one actually wants to live in pain, but most of the addiction actually brings more suffering.
My last quote from Dr. Maté is, “[a]ll of Western medicine is built on getting rid of pain, which is not the same as healing. Healing is actually the capacity to hold pain.” So, when adults do the work of healing, kids (and other adults) in their lives benefit most.