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Dealing, or Not Dealing
Published November 11, 2008 @ 12:36AM PST
[Drinking in Nairobi]
We all cope in our own ways. During the most stressful times in Afghanistan, I'd smoke hash in the evenings to help me sleep. Mostly, though, through Afghanistan and Africa, I prefered to drink. Not alcoholism - or if so, a highly functional sort of alcoholism.
(One sign of maturity - getting drunk on red wine instead of beer. The glories of living in Nairobi.)
In Iraq, I barely drank, though that was mostly a function of living on a dry base. It was also the only time in my life I actually found myself using the gym.
And then, after three years working overseas, I came back to the States. An apartment in Los Angeles, consulting and writing, a more settled life.
As I've written before, I missed those worst-times the most, a friend's kidnapping in Kabul, or just driving down the road in Mosul.
Those feelings of fear and adrenaline, and a sheer, almost fierce joy. Everything heightened, everything that much closer to the surface.
A feeling of being completely alive, of being present in each moment.
Late at night I'd find myself walking around the block, almost shaking, sometimes shaking.
In Iraq, someone told me the best way to deal with fear was just to ride it through, to accept it and continue to function.
I thought that, no matter what else, I could always function.
[View from inside a Humvee in Iraq]
And then one night in Los Angeles, months after I returned, I thought I heard a gunshot. A sound that made me think of other gunshots, of all those moments spent waiting - and then it all suddenly came together, this jumble of memories, all that fear and sometimes panic and sometimes terror.
Moments later, I was curled on the floor of my bathroom, sobbing, unable to stop.
It's been hard to come back, much harder than I imagined. And the best thing I've done over the last ten months is see a therapist - to accept that sometimes I can't just ride it through.
Others have seen, experienced different things - some far, far worse. And some people cope better than others, or at least better than me.
But I think that what we do marks us all.
Comments
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Author
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Michael Bear Kleinman
- Los Angeles, CA
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Michael is an aid worker, lawyer, and consultant with experience working in Afghanistan, across east and central Africa, and Iraq.
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MBK -- That's a very powerful post. Thank you for sharing.
Posted by Brooks Keene on 11/11/2008 @ 03:33AM PST
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I am really glad you wrote this. I think some counselling should be mandatory for people coming back from dangerous posts. Pretending not to be marked doesnt make it go away.
Posted by Alanna Shaikh on 11/11/2008 @ 06:49AM PST
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Your post eloquently highlights something many of us don’t recognize or necessarily question – at what point are we too stressed, and is it time to get out. Not necessarily because you can’t do it anymore, but in doing the job…witnessing the horrible things that human beings do to other human beings - especially armed men to civilians, being caught up in one too many firefight or living with the daily possibility that you could be targeted because you are a humanitarian worker…something of yourself can get lost, you can become cynical, jaded and increasingly immune to the suffering of others. Providing assistance becomes a technical problem – people become numbers, objects to be pushed through a humanitarian ‘assembly line’ rather than thinking, feeling human beings with rights, expectations, and specific, individual needs and desires.
Everyone's breaking point is different and we each cope with the stresses of the job in different ways (some positive, some not). All humanitarian workers need to think about what is their breaking point, before they go to the field…and what are the signs that they have passed it - drinking too much, sleeping with the nearest warm body, or taking increasingly riskier chances with their own lives and those of their colleagues? Every interview I have been in has included questions about handling stress (but, honestly, no one ever answers...'I drink heavily' or something similar...if they seriously want the job!). But beyond the interview questions, it is not something one usually thinks (or is advised) about when getting into ‘the business’, even when going into places like Darfur, the DRC, Zimbabwe or Afghanistan. Given that it is hard to recruit for the places mentioned above, which means a substantive portion of staff are relatively inexperienced, perhaps counseling (before being sent to the field) should be mandatory for all newly recruited humanitarian staff, as well as those ‘old hands’, who are going into extremely stressful humanitarian situations. It won't make the job or the situations less stressful, but could help to ensure that humanitarians are able to cope with the stresses in a positive manner, and improve the quality of the assistance they provide.
Posted by Leslye Rost van Tonningen on 11/13/2008 @ 11:53AM PST
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A colleague of mine in Helper's Fire (a consortium of humanitarian staff wellness consultants & psychotherapists) forwarded this blog to me. I really appreciate what I discern to be Michael’s sense of ethics and purpose in posting this. What I say now comes from being a physician practicing in preventive behavioral medicine and psychotherapy in the area of humanitarian aid.
My two cents to this thread would be to say that in addition to post-mission psychotherapy/counseling, I have seen that pre-mission training and organizational interventions fill gaps that cannot be filled effectively by therapy. I’d like to hear from others reading this blog about whether they agree or disagree.
Organizational change might involve policy-based, managerial and structural interventions that mitigate rather than exacerbate trauma. For instance, we can do teambuilding in such a way as to acknowledge, rather than stigmatize, the shared occupational hazards of this work.
Training aid workers before their deployment might involve two basic messages:
1) A scientifically-informed language on how occupation and work environments may pose psychologically traumatic hazards 2) Self-care techniques to prevent traumatization or mitigate traumatization from becoming entrenched. Self-monitoring tools that allow a person to assess how he/she is doing, thus learning to triage in a ways that suggests what mix of self-care, peer support and/or professional care is appropriate.
Posted by Siddharth Ashvin Shah on 11/19/2008 @ 01:27PM PST
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