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MU volunteers reach trauma victims worldwide

Friday, May 16, 2008 | 2:00 p.m. CDT; updated 10:54 a.m. CDT, Tuesday, July 22, 2008
Cheryl Strickland, Tricia Marshall-Ferguson and Tanisha Hubbard experiment with art therapy at a therapy training session in New Orleans on March 7. The training was led by mental health professionals at MU's International Center for Psychosocial Trauma.

NEW ORLEANS — Joanne Stampley, 55, appears to be asleep, but the occasional lift of the corners of her lips into a smile show she’s very much awake. She sits upright, shoulders relaxed, hands resting on her thighs. Her breathing is deep and focused. Her gold hoop earrings bob back and forth with each breath. Her eyelids flutter slightly, then slowly open. A grin flashes across her face.

“I went to my grandma,” she says. “It sounds funny, but I flew on a butterfly to my grandmother’s house. The last time I saw her, I was 15.”

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Gary Carbo nods as Stampley describes her imaginary encounter. Stampley didn’t move an inch but was able to travel in her thoughts using mental imagery — a technique used to ease the minds of victims of stress and trauma.

Stampley and Carbo are first responders with the New Orleans Fire Department. On this March day, they are learning how to counsel trauma victims of Hurricane Katrina at a three-day workshop held in New Orleans. Their teachers and coaches: a crew of doctors and professors from the International Center for Psychosocial Trauma at MU.

The MU team develops and introduces creative ways to talk and work with children and families suffering from post-traumatic stress disorder. New Orleans is the center’s most recent focus — MU teams have made six trips to the area since Katrina hit the Gulf Coast in August 2005 — but the program has reached thousands of people worldwide, focusing on children.

“Children are the most vulnerable,” founder Arshad Husain says. “They are the message of a community and nation of tomorrow.”

Husain, a child psychiatry professor at MU, started the center in 1994 after witnessing psychological effects of war in Bosnia. Since then, he or other volunteers have made 26 trips to Bosnia and have trained more than 2,000 teachers and 200 mental health professionals. They have established family counseling centers in Sarajevo, Bosnia, and Gjakova, Kosovo. They founded a hospital in Karachi, Pakistan, where they trained mothers to teach first grade. Every summer, mental health professionals from war-torn countries — Rwanda, Kenya, Jordan, Iraq, Sudan — trek to Columbia, complete training and return to their countries to train others. The center’s work has extended to Russia, India, Albania, Gaza City, West Bank, Chechnya, Afghanistan, Pakistan, Sri Lanka, Houston, Baton Rouge and — most recently — New Orleans.

Three days of help

Bars light up Bourbon Street. Habitat for Humanity has built more than 95 homes in New Orleans since Katrina. The population is estimated at 274,000 — about 60 percent of the pre-Katrina population. Waterlines are hard to scrub away from buildings; emotional scars take even longer to heal. Three years after Katrina, people still need help.

More than 100 people — firefighters, doctors, nurses, first responders, school counselors and administrators, crisis counselors and licensed therapists — took time from their own stresses to attend the MU psychosocial trauma training March 6 through 8, committed to finding new paths to restoring their communities. It is the largest Katrina relief workshop yet for the MU trainers.

The door to the Audubon Room in the Loyola University student center opens often. Latecomers trickle in. Doctors step out to take calls. Teachers and counselors leave early to try to keep up with their work. Three days is a lot of time to lose. The MU trauma trainers understand the disruptions; they, too, have left behind private practices and personal lives.

Team members from around the world have brought mixed talents and backgrounds. The New Orleans team was no exception: Wayne Anderson, a retired MU psychology professor; Cathy Grigg, a psychologist from Springfield; Iyad Khreis, associate medical director of Royal Oaks Hospital in Windsor; and Judith Milner, a psychiatrist from Everett, Wash. Potential team members must have a specialty to offer and must give a sample presentation to an advisory board of 20 physicians and mental health specialists from MU and around the country to make the team.

Anderson’s specialty is guided imagery — teaching people to relax and create a mental picture of a safe, secure place and to use positive self-talk to deal with the stress and trauma of various problems, such as sexual abuse, violence and troubled marriages. Training participants practice the technique on one another, just as Carbo, the New Orleans fire captain, has done with his colleague Stampley. Carbo read a script describing scenery character elements and turning points, which allowed Stampley to fill in the blanks while maintaining a relaxed state. The basic script can be tweaked depending on the participant. One variation asks children to envision themselves as adults.

“It’s a way of planting in their minds that they have a future,” Anderson says. “It’s a good future, and it’s going to turn out well.”

Guided imagery has been a vital component of the center’s missions.

“Everywhere we’ve gone, the safe place and inner guide techniques work,” Anderson says. “It seems to be the human capacity to imagine.”

Grigg asks participants to use their imagination for her specialty, art therapy. Participants split into groups of six or more and gather around long folding tables littered with white paper and crayons. She has them each draw a gingerbread man, hollow and faceless. Smiles emerge and chuckles escape — coloring is for kids. Grigg challenges them: Choose four different emotions and a color to represent each one. Then color the gingerbread men with the colors that correspond to the emotions they feel at that moment.

The drawn figures grow angry red arms, loving purple faces and joyful blue bellies. For one woman, orange frustration takes the shape of a heart in the middle of her gingerbread man. Her marriage has suffered several storms since Katrina. She doesn’t share her pain with many people but says she feels comfortable explaining it on paper. Those who laughed earlier have been converted.

“The thing we’re doing is so kids can tell their story and someone is there to listen to it,” Grigg says. “If it’s therapeutic and it’s play, it’s play therapy.”

Among her therapeutic tools: crayons, sand trays, costumes and puppets. Grigg says in New Orleans, props must be portable to go where the counselor goes — schools, shelters and Federal Emergency Management Agency trailers.

The team sticks together

When a long day of training is over, the MU team piles into a rented Dodge Caravan. Destination: dinner. Khreis sits behind the wheel. Husain copilots. The trainers recap their day.

“I thought it went well,” Milner says. The team agrees, and Milner starts to say something when Khreis interrupts from the driver’s seat.

“Sorry, guys.”

He had run a red light. The passengers excuse his misjudgment. No harm done.

Seconds later, red and blue lights swirl behind the minivan. Caught. The officer issues a ticket, no questions asked. Teammates jump in to comfort Khreis, but he assures them he will be OK. They all nod — good use of “positive self talk.” In a car of psychologists, anger is absent and forgiveness is freely given.

They continue toward dinner, and Milner tells a joke. “What did the agnostic insomniac dyslexic do?”

No one knows.

“He stayed up all night asking, ‘Is there a dog? Is there a dog?’”

Laughter. The ticket is forgotten. Dinner awaits.

At the restaurant, the teamwork continues. Grigg thanks Milner for help with her presentation. Milner asks Husain for a french fry; he offers the rest of his fish. Grigg clears Anderson’s place while he talks with a social worker about the state of the city.

Husain picks up the check; training trips are expensive. Primary funding for the center comes from the International Medical & Educational Trust — a nonprofit organization Husain started — grants and assistance from nongovernmental organizations. But at least half the time, team members pay their own way in addition to donating their time and expertise. Airfare overseas can cost more than $1,300 per person. Sometimes they stay in homes and eat with the locals.

On longer trips, the trainers have time to travel, visit art museums and even tour some of the schools and homes their training reaches. On shorter trips, they only have time for what can be done inside the conference room.

Making connections

Back at Loyola, participants break into small circles to share “hero stories” from Katrina.

“Group leaders are models; group leaders are heroes,” Milner says.

New Orleans crisis counselor Lauren Farrell, 39, volunteers first. She and her two cats decided not to evacuate immediately. She sat in her living room and watched the water level rise and rise and rise. If she had been in the back of the house, she wouldn’t have seen Bruce wading through her street.

She called out to him, and he came to her porch. Bruce needed help. He and eight people had climbed to the top floor of a house. They were siphoning off gas from cars in the street to power a generator. One of his friends swallowed some gas and had stomach pain. Farrell offered what she had: half a bottle of Pepto-Bismol. Bruce thanked her and left.

The next day, Farrell heard more people walking in the water. Looking outside, she saw Bruce and three friends carrying big black trash bags on their backs.

“They looked like four black Santa Clauses, coming my way,” she says.

Indeed, their sacks were full of gifts: three gallons of water, four cans of juice, eight cans of Vienna sausages and a bag of chips.

“I didn’t expect Bruce to do anything,” Farrell says. “Not only did they do that, but every single day they came to check on me. They were my heroes.”

They waited together for the water to go down. Farrell remembers drinking a bottle of hot chardonnay and playing dominoes on her living room floor with the guys.

“I still have the piece of paper with the scores,” she says.

She insisted on meeting Bruce’s mama and taking her out. She and Bruce still call each other on their birthdays.

When her story is finished, people clap, some thanking God and offering blessings. Some cry. Hero stories connect school counselors with firefighters, nurses with social workers. Stories also connect these helpers with their teachers.

“There are a lot of broken hearts in the city and a lot of mending that’s going on,” social worker Heidi Leffler says. “And the toll it takes, you can’t physically see unless you spend time with the people.”

Leffler is a workshop returnee.

“A lot of training comes in and out, but this has been the best that I’ve seen,” she says. “They’re just such wonderful people. I don’t even know what to say to give them the credit and gratitude I feel.”

Moving forward

On the last morning of the training, the group is small enough to sit in a circle. The topic: death and dying. Anderson shares the story of a village in Bosnia where the women could not find closure after their husbands’ deaths until their mass-buried bodies were identified.

“Once we learn the truth, we can go on with life,” Anderson says.

Anderson’s own parents died when he was a teenager, a fact he says connects him with the children these teachers and therapists work with. There are many ways to cope with loss, he says. What’s important is to find a way that works.

Hands fly up. Stories of loss could fill another three days.

The training ends with a session called “ABCs of Psychological First Aid” on care given in the immediate aftermath of a disaster. Volunteers came to New Orleans and Houston with good intentions, but what’s most important, Husain said, is that victims feel empowered as quickly as possible.

“I have to take responsibility as a therapist and licensed counselor, by trial and error, to help get our children back to where they were,” family therapist Tricia Marshall-Ferguson says.

“Um-hmms” and amens come from every corner of the room. Husain agrees.

“You are the experts,” he says. “You are in the trenches. You are the ones who need to build on and develop your own approaches.”

The team lays the foundation; the participants build on it. Team members and participants exchange e-mail addresses. Each participant joins the global web of humanitarian aid spun by Husain and his team members. As trips abroad become more difficult to plan and dangerous to make, training people to train others becomes more important.

“This program has great implications for progress overseas,” Husain said. “Overseas, this is the only way.”


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