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Dance/movement approaches to fostering resilience and recovery among African adolescent torture survivors*

David Alan Harris, MA, LCAT, ADTR**

Abstract boy combatants who reported continual reduc- Dance/movement therapy (DMT) interven- tion in symptoms of anxiety, depression, intrusive tions, if designed to promote cultural relevance recollection, elevated arousal, and aggression. The and community ownership, may enhance healing group´s teenage males joined actively in improvi- among African adolescent survivors of war and satory dancing and in other structured creative organised violence. The author posits a theoretical exercises. Theese former child soldiers later elected rationale for body movement-based approaches to demonstrate their wartime experiences through to psychosocial rehabilitation, and offers DMT’s public presentation of a role-play. A report on holism as evidence of transcultural applicability. this event illustrates the success of the process in Two distinct DMT initiatives with this population overcoming stigma and enabling meaningful com- are discussed in terms of theoretical assumptions, munity reintegration. Thus, whether introduced implementation, and outcomes. Both efforts af- in refuge or post-conflict, DMT approaches are forded creative means for discharging aggression shown to embody revitalizing psychosocial support and restoring interpersonal connection. The first in the aftermath of massive violence. of these programes engaged a community of South Sudanese refugee youths, resettled to the U.S., in Key words: Torture, trauma, child soldier, refugee, a series of gatherings for traditional dancing and war, Africa, reconciliation, creative arts therapy, drumming that reconstituted a central culture-of- sociodrama, dance/movement therapy origin ritual. Anecdotal evidence supports this psychosocial intervention’s emphasis on group Introduction cohesion as a vehicle with both preventive and In the year 2000, UNICEF estimated that reparative capacities. Also a series of DMT groups armed conflicts worldwide had traumatized with youths in Sierra Leone. All organized several ten million children during the decade-long years post-conflict, these interventions involved span that began in 1986.1 Given the impact applying the DMT modality within a framework of of war and organized violence on children’s Western psychotherapeutic conventions described in a series of groups with youths, all organized well-being, initiatives targeting the psycho- several years post-conflict, is presented. Programe social needs of war-affected young people evaluation revealed a drop in average symptom would logically amount to a global priority. expression among a group comprised of former Whether in developed or developing coun- tries, however, programmes that deliberately

Volume 17, Number 2, 2007 *) Rewritten version from paper presentation 1) Children and armed conflict: report of the Sec- u r e t retary-General. New York: United Nations, 2000 o r

T **) [email protected] 19 July. Report No.: A/55/163-S/2000/712. 135

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and meaningfully address psychosocial prob- Structured in three interconnected lems among children of war remain rela- parts, this paper begins with a brief ration- tively uncommon, despite the potential for ale for body movement-based interventions strengthening identifiable protective factors in torture rehabilitation. There follows an that may shield children and adolescents introduction to dance/movement therapy from severe emotional and psychological (“DMT”), particularly as defined in terms harm. of this psychotherapeutic modality’s suit- Engaging cultural resources, includ- ability for fostering recovery among young ing those associated with creative artistic African survivors. Concluding the argument expression, has been shown to enhance are descriptions of two distinct DMT ap- communities’ resilience in the face of terror proaches to working with young torture sur- and deprivation, and to cultivate children’s vivors, as inherent in a pair of interventions capacities in particular.2,3,4 Dancing is one – preventive, on the one hand, and largely such expressive activity, the collective per- reparative on the other – with African youths formance of which delivers strong potential in quite differing environments. It cannot for sublimating inter-group tensions, while be overemphasized that each of these two increasing interpersonal connection and unique DMT programmes was developed strengthening solidarity. Although rarely with a specific sociocultural context in mind: utilized as modes of psychosocial interven- A situation of resettlement in the developed tion, dance/movement programmes, if ap- North, and a situation of a post-conflict so- propriately designed to maximize cultural ciety in the global South. Any programmatic relevance, may prove an effective means of generalizability, therefore, would have to be fostering resilience after massive violence. elicited from the broader therapeutic vision This essay documents the author’s use of of the interventions, rather than from their dance as a medium of healing with war-af- specificities, which involved considerable fected African youth, both those in refuge in adaptation to social, cultural, and political the West and those living in a post-conflict realities in the two environments. situation in their war-ravaged homeland. In Chronologically first among these pro- detailing the pertinent benefits of particular grammes was an initiative that served 70 dance-based initiatives—including but not unaccompanied South Sudanese refugee limited to relaxation that flows from the minors resettled to the United States. Tradi- pleasurably contained release of aggression tional dance was this programme’s defining through body movement—the discussion be- communal activity. The second programme low focuses on methods applied for ensuring to be discussed, and the more recently T the programmes’ community ownership and completed, concerns a series of four gen- r o t cultural appropriateness. der-specific counseling groups conducted e r u Volume 17, Number 2, 2007 2, Number 17, Volume

2) Richman N. Annotation: Children in situa- 4) Boothby N. Mobilizing communities to meet tions of political violence. J Child Psychol Psyc the psychosocial needs of children in war and 1993;34:1286-302. refugee crisis. In: Apfel RJ, Simon B, eds. Mine- fields in their hearts: the mental of children 3) Miller KE, Billings DL. Playing to grow: a in war and communal violence. New Haven: Yale primary intervention with Gua- University Press, 1996:149-64. temalan refugee children. Am J Orthopsychiat 1994;64:346-56. 136

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with adolescents in a remote rural district commonly agreed that initially our bodies in Sierra Leone. All of the young partici- respond to life-threatening events through pants in these four DMT counseling groups fight or flight, or by undergoing a sort of – including the one discussed below with temporary paralysis likened to freezing.5 former child soldiers – originated from or Long after the disappearance of genuinely had returned to border communities at the acute danger, the involuntary functions epicenter of atrocity during the recent 11- controlled by the autonomic nervous system year war. may continue to operate as if the threat were These DMT projects were sponsored present. This posttraumatic phenomenon by two different humanitarian agencies, and of re-experiencing agitation and elevated involved quite contrasting sets of objec- arousal associated with memories of grave tives and therapeutic paradigms. By here threats to well-being, moreover, is observed identifying and analyzing the strengths of across cultures, regardless of vast differ- the two interventions—which succeeded ences in local understandings of the idea of in remarkably different ways—it may be trauma, and of suffering itself. possible to elucidate the underpinnings of In underscoring advances in neuroanat- DMT’s un-usual flexibility and relevance omy research that have buttressed contem- in fostering resilience and recovery among porary practice in the field the psychophysi- African youth. Indeed, comparing observa- ology of trauma, Bessel van der Kolk and his tions from this pair of programmes sheds colleagues6 have taken a lead in turning the light on what appears to be a broad capacity attention of psychotraumatology to the im- in the DMT modality for promoting heal- portance of addressing the body in trauma ing among distinct populations of African treatment. In a November 1988 presenta- youth to have survived egregious violations tion, entitled “Neurobiology, Attachment of their human rights and intrinsic dignity and Trauma,” at the annual meeting of the as persons. International Society for Traumatic Stress Studies, Van der Kolk postulated: on the body and body move- ment in torture treatment If it is true that at the core of our trauma- Even cursory analysis of the psychophysi- tized and neglected patients’ disorganization ology of trauma and posttraumatic distress is the problem that they cannot analyze what reveals that human beings both live and is going on when they re-experience the relive traumatic exposures. The original physical sensations of past trauma, but that incident and the reliving alike tend to be these sensations just produce intense emo- experienced “at the body level” through tions without being able to modulate them, such functions as heart rate, respiration, and then our therapy needs to consist of helping perspiration, often in tandem with images people stay in their bodies and to under- that may seem to overrun the mind. It is stand these bodily sensations.7

5) Rothschild B. The body remembers: the psy- Traumatic stress: the effects of overwhelming chophysiology of trauma and trauma treatment. experience on mind, body, and society. New York: Volume 17, Number 2, 2007 London: WW Norton & Co, 2000. The Guilford Press, 1996. u r e

t

o r 6) Van der Kolk BA, McFarlane AC, Weisaeth L. T 7) See note 5. p 3. 137

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Van der Kolk’s advice to clinicians to moni- ing along with her basic premise three core tor trauma sufferers’ capacity for making assumptions concerning DMT practices sense of the connection between sensation that elaborate on it: and experience serves as a guiding principle 1. Movement reflects personality. for many mental health service providers, 2. The relationship established between the and not only those with a decidedly somatic therapist and patient through movement orientation. Yet techniques for regaining such supports and enables behavioral change. corporeal understanding differ widely from 3. Significant changes occur on the move- one culture to another. ment level that can affect total function- ing.10 Dance/movement therapy and its transcultural applicability The dance/movement therapist, accord- Dance/movement therapy is particularly ingly, utilizes movement interaction as the well-equipped for overcoming cultural dif- primary – but not the only – means for ferences, while helping traumatized persons accomplishing therapeutic goals in both as- gain the skills they need both for ground- sessment and treatment. ing themselves “in their bodies,” and for For the most part, DMT has been artic- comprehending the relationship between ulated within the United States and Europe, bodily sensation and traumatic memory. nonetheless, the modality’s application may The American Dance Therapy , extend far beyond the developed North, a four-decade-old professional organiza- since its origins and development are in- tion active in the United States, has defined formed by a fusion of Western psycho- DMT as “the psycho-therapeutic use of logical precepts and dance – itself a world- movement as a process that furthers the wide form of cultural expression with its emotional, cognitive, social, and physi- beginnings in celebratory ritual. Fundamen- cal integration of the individual.”8 Thus, tal to this body-oriented mode of psycho- dance/movement therapists engage at the therapy, moreover, is the notion that health locus of the human body an extraordinary and well-being are predicated on an integral fount of meanings – physical, affective, cog- connectedness of psyche and soma. Such nitive, developmental, and even spiritual. an abiding ethos of intrinsic holism would According to one leading exponent of the appear at one with that of many cultures modality in the United States, DMT’s cen- of the developing world. Given the unusual tral premise is that “the visible movement concurrence in one treatment modality of behavior of individuals is analogous to their these three elements – foundations in West-

9 T intrapsychic dynamics.” Perhaps anticipat- ern psychotherapeutic theory and practice, r o t ing the field’s lack of consensus over such association with the global phenomenon e r u psychodynamic terminology, this same of ritual, and holistic belief in the unity of 2007 2, Number 17, Volume practitioner managed to coalesce divergent mind and body – DMT should prove ideally perspectives on the profession by identify- suited to respond to the effects of torture

8) American Dance Therapy Association, 2006. ance for Health, Physical and Recrea- www.adta.org [cited 2006 Dec 15]. tion, 1974:10.

9) Schmais C. Dance therapy in perspective. In: 10) Ibid. Focus on dance. Washington, DC: American Alli- 138

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and war among persons from holistic, col- There is, however, an emerging litera- lectivist cultures. ture that addresses DMT as torture treat- Indeed, with body movement accepted ment.13,14,15,16,17 Karen Callaghan, a therap- across many such cultures as a “basic mode ist at London’s Medical Foundation for the of communication,”11 dance/movement Care of Victims of Torture, has underscored therapists may be especially well prepared in accounts of her movement to engage survivors transculturally. Fur- with survivors an essential oneness of being thermore, the modality in its early years that is the specific target of the torturer’s – as practiced by founder Marian Chace at cruelty. “Memories live in the body,” she St. Elizabeth’s in the U.S. capital posits, “and are stimulated by one’s own – was virtually indivisible from the treatment or another’s movements.” Pointing to the regimen of numerous psychiatric casualties fundamental unity of mind and body she of the Second World War.12 Despite these locates resources at the body level – includ- diverse, transcultural origins and a history as ing “[m]uscular and visceral responses to postwar treatment, this form of therapeutic emotions and memories”18 – for repair of the intervention has, to date, been little utilized body/mind split that many survivors experi- in prevention and recovery programmes ence as an overwhelmingly dehumanizing addressing the needs of either children or consequence of the terror they have endured. adolescents affected by war and organized The dance therapist’s holistic conviction thus violence, whether in the developing or the harmonizes well with Van der Kolk’s blunt developed world. As of this writing, appar- deduction: “Brain, body, and mind are in- ently nothing has been printed on DMT extricably linked, and it is only for heuristic that specifically considers an application reasons that we can still speak of them as if with children of war. they constitute separate entities.”19

11) Pallaro P. Culture, self and body-self: dance/ ical Foundation for the Care of Victims of Torture. movement therapy with Asian Americans. Art Psy- Paper No. C36. chother 1997; 24(3):227. 16) Gray AEL. The body remembers: dance 12) Johnson DR. Marian Chace's influence on movement therapy with an adult survivor of tor- . In: Sandel SL, Chaiklin S, Lohn A, ture. Am J Dance Ther 2001; 23(1):29-43. eds. Foundations of dance/movement therapy: the life and work of Marian Chace. Columbia, MD: 17) Harris DA. Remaking the world: dance/move- The Marian Chace Memorial Fund of the Ameri- ment therapy with survivors of torture and war. can Dance Therapy Association, 1993:176-89. In: Proceedings of the thirty-eighth annual confer- ence of the American Dance Therapy Association 13) Callaghan K. Movement psychotherapy with [CD-ROM]. Denver, CO: ADTA, 2003. adult survivors of political torture and organized violence. Art Psychother 1993;20:411-21. 18) Callaghan K. Movement psychotherapy with torture survivors [master's thesis]. Philadelphia, 14) Callaghan K. In limbo: movement psychother- PA: Hahnemann University, 1991:59-60. apy with refugees and asylum seekers. In: Dokter D, ed. Arts therapists, refugees and migrants: 19) Van der Kolk BA. The body keeps the score: Reaching across borders. London: Jessica Kingsley approaches to the psychobiology of posttraumatic Publishers, 1998:25-40. stress disorder. In: Van der Kolk BA, McFarlane Volume 17, Number 2, 2007 AC, Weisaeth L, eds. Traumatic stress: the effects u r e

t 15) Callaghan K. Torture-the body in conflict: the of overwhelming experience on mind, body, and o r

T role of movement psychotherapy. London: Med- society. New York: The Guilford Press, 1996:216. 139

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Such holism is indeed core within the A search for ways of galvanizing the re- field of dance/movement therapy, and on storative strengths of the communal, as for occasion is linked with what are deemed sources of regeneration, release, and renewal timeless cosmologies and practices. While – functions Hanna identifies in dance itself some dance/movement therapists focus on – leads certain DMT practitioners and theo- the Western psychotherapeutic side of the rists beyond examination of dance ethnog- DMT healing continuum, there are others raphy to that of the rituals and traditional guided by the modality’s primary anteced- healing practices of non-Western cultures. ents in dances of communal affirmation and It would follow that applying relevant DMT defence – in “roots . . .[that] extend back methodologies, not only with individuals to ancient times in dances of celebrations from societies where an egocentric identity and crises, in dances that define individual structure prevails, as among the cultures of and group identity, and in dances of death the developed North, but with groups of and exorcism.”20 Dance therapists, accord- people from sociocentric22 cultures that ex- ingly, have referenced the scholarship of eth- ist in much of Africa23 and elsewhere in the nologist Judith Lynne Hanna, who discerns global South, has potential to yield revital- among traditional cultures a number of izing transformation in the wake of massive specific functions for dance, all possibly per- violence. tinent to healing from organized violence: Desomatizing memory through (a) the mediation of unknown and uncon- mindfulness and creative symbolization trollable forces within participants and “Trauma” may be understood as a proc- their environment, ess that encompasses an interaction of risks (b) a safe way of acting out negative or devi- associated with exposure to stressors and ant emotions and behaviors, factors that may mitigate the potential im- (c) a means for self-transformation or for en- pact of such an encounter. Overcoming the acting changes in adopted role or status, consequences of such traumatic exposures as (d) a way of releasing emotions arising from those to extreme terror and violence involves personal conflicts or pent-up frustrations what Van der Kolk refers to as a practice of and (e) the reaffirmation of an individu- “desomatizing” recollection.24 So long as the al’s inclusiveness within the communal mind deems the traumatic event unutter- group.21 able, he theorizes, the body automatically re-

20) See note 9, p. 7. Y-T, McCauley CR, Draguns JG, eds. Personal- T ity and person perception across cultures. Mah- r o t 21) Dosamantes I. Body-image: repository for cul- way, New Jersey: Lawrence Erlbaum Associates, e r u tural idealizations and denigrations of the self. Art 1999:139-62. 2007 2, Number 17, Volume Psychother 1992;19:265. 24) Van der Kolk BA. The complexity of adapta- 22) Shweder RA, Bourne EJ. Does the concept of tion to trauma: self-regulation, stimulus discrimi- the person vary cross-culturally? In: Shweder RA, nation, and characterological development. In: LeVine R, eds. Culture theory: Essays on mind, Van der Kolk BA, McFarlane AC, Weisaeth L, self and emotion. Cambridge: Cambridge Univer- eds. Traumatic stress: the effects of overwhelming sity Press, 1984:158-99. experience on mind, body, and society. New York: The Guilford Press, 1996:205. 23) Okeke BI, Draguns JG, Sheku B, Allen W. Culture, self, and personality in Africa. In: Lee 140

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sponds to the intrusive remembrances of the of shared feelings” that may enable “reaf- experience as if it were happening all over firming [their] identity or competence.”26 again. Healing means altering that feedback The creative process, improvisatory thought loop, identifying the “triggers” to such bod- and action, and symbolization more gener- ily responses and attaching words to these ally, are innately therapeutic.27,28 All are painful “somatic experiences” affords a po- basic as well to the creative arts therapy tential to loosen terror’s grip. “[T]he task of modalities, just as they are valued for their therapy,” observes Van der Kolk, “is both to role in furthering children’s healthful devel- create the capacity to be mindful of current opment. experience, and to create symbolic represen- There is a role for such pivotal creative tations of past traumatic experiences, with processes in coping with and integrating the goals of taming the associated terror and experiences of traumatic disturbance. Van of desomatizing the memories.”25 Enhanc- der Kolk indicates that individuals enact- ing mindfulness, or reunifying mind with ing posttraumatic repetition compulsions body in a way that cultivates awareness of are frequently more capable of expressing being in the present moment, the here- “internal states more articulately in physical and-now, is thus posited as an act that both movements or in pictures than in words.”29 precedes and informs symbolization, and Writing within the framework of Western in turn opens the way to recovery. These psychotherapy, he prescribes expressive arts as well are core DMT processes in trauma interventions in response: “Utilizing draw- treatment – promoting awareness of a reinte- ings or may help [these indi- grated body/mind oneness, and facilitating viduals] develop a language that is essential creative expression to represent the trau- for effective communication and for the matic suffering, its origins, and the personal symbolic transformation that can occur in or collective strengths available for recover- psychotherapy.”30 As Van der Kolk suggests, ing from its pain. the language of creative arts expression may In further situating DMT in the assess- indeed compensate for or even overcome ment, prevention, and treatment of emo- difficulties in using words to convey feelings. tional or psychological disturbances associ- This difficulty, alexithymia, is a common ated with children’s exposure to the stressors occurrence after exposure to extreme stres- of war, it may be useful to consider the sors, and one that this prominent trauma application of other expressive arts therapy researcher and others have found “mirrored modalities in such contexts. Creative activ- in actual changes in brain activity.”31 ities are broadly seen to afford children a Children of war – and adolescent torture valuable way of coping meaningfully with survivors too – may experience just such their suffering through “symbolic expression impediments to verbal expression, or may

25) Ibid. dance/movement therapy with medically involved children. Int J Arts Med 1993; 2(2):24-7. 26) See note 2, p. 1296. 29) See note 24, p. 195. 27) Maslow AH. The farther reaches of human Volume 17, Number 2, 2007 nature. New York: Penguin Books, 1976. 30) Ibid. u r e

t o r

T 28) Goodill SW, Morningstar DM. The role of 31) See note 19, p. 233. 141

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come from cultures that restrain altogether agency, and later an international NGO discursive processing of both posttraumatic in Sierra Leone, launched quite different and more commonplace disturbances. Evi- dance-based psychosocial interventions, both dence suggests that these youths may be coordinated by the author, in the service of usefully encouraged to engage in represent- resilience and torture rehabilitation among ing their feelings and thoughts through African youths. These two programmes artistic means – at least those considered articulated differing methods for achieving culturally syntonic. For young refugees, crea- similar goals considered fundamental in the tive production may be associated with the promotion of resilience and recovery after “construction of meaning and identity,”32 a exposure to extreme traumatic incidents, process that enables safer psychic passage namely: (1) desomatizing memory, between the country of origin and the site of (2) nurturing experiences of mindfulness, exile or asylum. Rädda Barnen’s approach (3) enabling meaningful experiences for to helping Southern Sudanese children the contained discharge of anxiety and ag- in the Pignudo refugee camp in Ethiopia gression, and (4) unleashing the pleasure of – members of the same group of so-called creativity, and thereby freeing participants to Lost Boys who comprise the resettled symbolize their traumatic losses and future refugee community served years later by hopes. the DIER programme discussed in this pa- The Dinka Initiative to Empower and per – thus incorporated a range of creative Restore, started in 2001, served a com- activities.33 The landmark United Nations munity of just over one hundred unaccom- study, “The Impact of Armed Conflict on panied refugee minors from the Southern Children,” (termed the Machel Study, after Sudan, all resettled in southeastern Penn- lead author Graça Machel) endorsed such sylvania. An activity programme open to an approaches explicitly, noting that children’s entire community, DIER utilized traditional ongoing need for emotional and intellec- Dinka dance as its vehicle for fostering tual stimulation may be fulfilled in part resilience. By contrast, the series of DMT through “structured group activities such groups sponsored in three towns within the as play, sports, drawing and storytelling” devastated Kailahun District of Sierra Leone (Par. 179).34 Surely, dancing and DMT ap- were short-term psychotherapeutic inter- proaches merit inclusion in any update of ventions for smaller numbers of identified the Machel Study’s otherwise partial list. clients suffering severe sequelae of torture. Combining experiential psycho-educational Comparing two distinct DMT approaches exercises that focused on the somatic impli- T for enhancing coping capacity among cations of trauma with improvisatory group r o t African adolescent survivors movement designed to enable symbolic rep- e r u Two humanitarian organizations in recent resentation of traumatic experiences, these 2007 2, Number 17, Volume years, first a U.S. refugee resettlement counseling groups incorporated local music

32) Rousseau C, Heusch N. The trip: a creative 34) Impact of armed conflict on children: report expression project for refugee and immigrant chil- of the expert of the Secretary-General, Ms. Graça dren. Am J Art Ther 2000;17(1):31. Machel. Document A/51/306 & Addenda. New York: United Nations, 1996. 33) Petrén A. The unaccompanied minors of southern Sudan. Stockholm: Rädda Barnen, 1994. 142

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and dance, while adhering to the ethical the host culture and culture of origin.36 standards and formal conventions of Western Given the multiple traumatic exposures in psychotherapy. the group’s collective history, resettlement agency staff members were alerted that these DIER: a community-based traditional young people might well prove vulnerable dance program to both clinical and sub-clinical complaints. In the years 2000 and 2001, the United Empowering this young community to meet States government resettled a population of the challenges of adapting to a previously some 3800 young Southern Sudanese – the unforeseen way of life in the host culture ne- nation’s largest ever resettlement of unac- cessitated programmatic innovations aimed companied refugee minors – in cities and at reinforcing the resilience these remark- towns across the country, many of which ably resourceful young people brought with had no pre-existing Sudanese community.35 them to their new environment. Offering an Slightly more than 100 of these young authentic experience of temporary culture- people, mostly minors but including a few of-origin immersion was deemed a produc- “majors” as well, arrived in the Philadelphia, tive, and cost-effective way of helping these Pennsylvania (PA) metropolitan area under young people face acculturation without suc- the sponsorship of Lutheran Children and cumbing to emotional or psychological dis- Family Services (LCFS) of PA. Ranging tress. By giving priority to strengthening in- in age from 13 to 25 – with most in their herent protective factors borne in the culture late teens and less than 10 percent female of origin, those developing the programme (as was the case with the entire population hoped to reduce susceptibility to the many resettled in the U.S. at that time) – all had new risk factors for posttraumatic stress in spent a minimum of five years in the Ka- the culture of refuge. kuma refugee camp in Kenya prior to their Appreciating that dance and healing are departure for a new life in a post-industrial essentially one in Dinka culture, the author society of the global North. In escaping an contacted the resettled youths in September ongoing war in the Southern Sudan, most of 2001, introduced himself as a counselor and these young refugees had endured a thou- dancer, and asked that they meet with him sand mile ordeal on foot over the course of on an ongoing basis over the subsequent a decade. They had witnessed numerous academic year to teach him their traditional killings and other acts of violence and terror, dances. With the refugees’ consent – in fact, some directed at family. At some point in their enthusiastic endorsement – LCFS their lives, extreme deprivation had brought launched the Dinka Initiative to Empower many to the brink of starvation. and Restore (or DIER, which is the Dinka Acculturating teenagers are highly word for dance) the following month, and susceptible to marginalization and need in so doing served a Sudanese refugee com- ongoing opportunities to engage with both munity that was about 98 percent of Dinka

35) Corbett S. The lost boys of Sudan. The long, countries: an overview with an emphasis on pri- long, long road to Fargo. New York Times Maga- mary prevention. In: Ahearn FLJ, Athey JL, eds. Volume 17, Number 2, 2007 zine 2001 Apr 1. Refugee children: theory, research, and services. u r e

t Baltimore, MD: The Johns Hopkins University o r

T 36) Berry JW. Refugee adaptation in settlement Press, 1991:20-38. 143

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tribal origins. Beyond agency support, For Southern Sudanese youths – singled DIER benefited as well from that of the out in the Machel study for their extraordi- Zion Mennonite Church of Souderton, the nary resilience in the face of horrific adver- Lutheran Immigration and Refugee Service, sity – a prevention strategy with emphasis and the DMT clinical internship programme on fortifying group capacity to cope with of MCP Hahnemann (now Drexel) Univer- ongoing and newly encountered stressors39 sity, which provided the author professional was an especially suitable one. Such a plan supervision as DIER’s coordinator. may have been all the more important, A substantial body of research indicates given findings of significant potential for that, while the psychosocial sequelae of ex- delayed onset of posttraumatic stress dis- posure to the stressors of war and organized order (PTSD).40 War refugee children not violence can be severe, most children survive suffering disturbance may potentially begin war and flight without seriously debilitat- to do so later. Indeed, in promoting “adjust- ing psychological disturbance.37 As a health ment mechanisms” through a programme of promotion project, DIER aimed to reach the creative arts activities, sports, and scouting, entire community of young South Sudanese, Rädda Barnen41 had utilized a parallel pre- without regard to level of function or dis- vention approach with these youth in camps ability. The goal was to provide culturally in both Ethiopia and Kenya. The Swedish relevant group activities for young refugees, NGO had initially implemented a Western- who as individuals may have presented with styled treatment programme, but abandoned diagnosable disorders, sub-clinical mental it later as inappropriate. Making a deliberate health concerns, or no discernible psycho- effort to examine the role of traditional cul- social problems whatsoever. Instead of sepa- tural expression in this group’s remarkable rating children with perceived disorders from level of resilience, Rädda Barnen encouraged the group, the continuity of which sustains the young people in the camp to engage in identity structure in the African sociocentric writing compositions about what happened environment, the cohesion of the group itself to them on their long journeys, perform- was engaged for its combined preventive and ing traditional songs and dances, recording reparative capacity. As such, the project’s favorite Sudanese folk tales, drawing places main objectives involved fostering resilience encountered on the way, and telling and dis- and healthy, adaptive development, rather cussing their dreams – a traditional cultural than diagnosing or treating mental disorder activity. While no empirical data is available in Western terms – an action that was judged to demonstrate effectiveness of these preven- likely to effect a schism, increasing chances tion efforts, anecdotal evidence confirms

38 42 T of marginalization. their value. r o t e r u Volume 17, Number 2, 2007 2, Number 17, Volume

37) Cairns E, Dawes A. Children – ethnic and 39) Ajdukovi M, Ajdukovi D. Psychological well- political violence – a commentary. Child Dev being of refugee children. Child Abuse Neglect 1996;67(1):129-39. 1993;17:847.

38) Hicks R, Lalonde RN, Pepler D. Psychosocial 40) Sack WH, Him C, Dickason D. Twelve-year considerations in the mental health of immigrant follow-up study of Khmer youths who suffered and refugee children. Can J Community Ment Hlt massive war trauma as children. J Am Acad Child 1993;12(2):71-87. and Psy 1999;38:1173-9. 144

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The DIER project, in addition, was each of two locations – the LCFS offices in designed to fulfill all three of the structural the urban West Philadelphia neighborhood factors Cowen identified as requirements for that was home to about half of the youths, an effective primary prevention programme. and the fellowship hall at a suburban church It was: (1) “group oriented”, (2) targeted – a central meeting point accessible to about to a group without significant maladjust- 40 youths who resided in small towns north ment, while risks of such problems (not an of the city. Attendance was strong and grew exclusionary criterion, according to Cowen) throughout the year. Of the 10 female Su- were certainly present, and (3) built on the danese – equally divided between the urban foundation of a “solid knowledge-base.”43 and suburban communities – spring attend- The programme also modeled transcultural ance averaged over 80 percent, male attend- sensitivity, as reflected in assertions that pro- ance in percentage terms was about half that grammes targeting the needs of war-affected number for the same time period. children from developing countries may For the most part, sessions were unpro- be successful to the extent that they forego grammed opportunities for the youths them- “conventions of Western diagnosis” and con- selves to organise dancing and drumming. centrate on matters of “social adaptation and From the outset, the author in coordinating functioning.”44 DIER determined not to assert a form, nor The preponderance of evidence in the attempt to control the use of time and space. existing literature shows that children of war Instead, the youths were presented the chal- may be usefully encouraged to represent lenge of teaching him about their dances their feelings and thoughts to symbolise their and their culture. Rather than offering the experiences of rupture and potential restor- role of passive consumer of an intervention, ation through means that are syntonic this improvisatory arrangement supported to their culture. The DIER programme the overriding goal of fostering resilience provided just such culturally specific op- through empowerment and collective action. portunities for personal expression within a This innovation indeed placed the youths collective context that helped sustain com- in the role of experts and the facilitator in munal equilibrium. DIER consisted of an the role of recipient of the group’s collective ongoing series of two-hour gatherings that wisdom. enabled participants to perform the dances On the whole, the young refugees ap- and songs they had brought as an ancestral proached their role with enthusiasm. A legacy from Africa. Some 18 sessions were dynamic sense of collective agency was slated over the course of an academic year in especially manifest in the way the group’s

41) See note 33. and refugee flight. In: Ahearn FLJ, Athey JL, eds. Refugee children: theory, research, and services. 42) Tefferi H. Building on traditional strengths: Baltimore, MD: The Johns Hopkins University the unaccompanied refugee children from South Press, 1991:207. Sudan. In: Tolfree D, ed. Restoring playfulness: different approaches to assisting children who are 44) Boothby N. Mobilizing communities to meet psychologically affected by war or displacement. the psychosocial needs of children in war and Stockholm: Rädda Barnen; 1996:158-73. refugee crisis. In: Apfel RJ, Simon B, eds. Mine- Volume 17, Number 2, 2007 fields in their hearts: the mental health of children u r e t 43) Williams CL. Toward the development of pre- in war and communal violence. New Haven: Yale o r

T ventive interventions for youth traumatized by war University Press, 1996:161. 145

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members organized music to accompany Sudanese region, women sat at the sidelines their dancing. A drum of Ugandan origin and would deliberately ignore their male and set of drumsticks, both brought in by counterparts. The women would cast their the author, were the only objects utilized gaze aside as crews of three to seven men in DIER’s core activity. These were placed engaged in group courting behavior that actually and symbolically at the center of involved vigorous gesticulating, standing the process. Drumming is a constant during very close to the woman in question, and Dinka dance, and is itself for the most part chanting poetry to her loudly – all in com- extremely forceful and vigorous—to a degree petition with other teams of male cohorts that occasionally meant replacing broken also vying for her attention and approval. drumsticks. The physical requirements of While feigning disinterest, the women in drumming were such that no one in the fact were following tradition and actively group had the stamina needed to drum on assessing the competing crews, choosing a his or her own throughout the duration of winning entry among them. Once a young a session. As a result, there was a constant woman’s selection was made, a silent nod shuttling in and out of drummers. Usually from this ostensibly reluctant judge sent the this was managed by the group in such a victorious team of young men leaping high seamless flow that the drumbeat was seldom into the air in a celebration of collective lost, and the dancing continued without prowess. Soon afterwards, the little throng break. Within this unequivocally sociocentric would form a semi-circle around the woman order, almost everyone had an opportunity – after she had walked quietly to her place to drum at some point in the course of a an appropriate distance from the drum. With gathering. the drumbeat thickening the air, everyone The programme proved successful at of both genders would jump up and down both augmenting participants’ awareness in a sustained rhythmic pattern, traveling a of the cultural strengths that had enhanced counterclockwise orbit around the drummer. their collective resilience and increasing their Indeed, this basic constellation formed and capacity to negotiate with the host culture. dissolved over and over again in the course While traditionally only males drum, in of each gathering. Big, powerfully ecstatic the central city group females began to as- bursts on the part of the young men, and sert their interest in the role of drummer. expressions of diffidence from the women, Coming well beyond the halfway point in were followed by fairly measured – though the programme, this evolution potentially still vigorously aerobic – circling by every- suggested an increasing degree of accultur- one to a constant pulse. What appeared at T ation on the part of the young women – and first to the author’s unpracticed Western eye r o t perhaps of the young men, as well, in acced- as rather constrained unison movement, in e r u ing to change. Traditionally, gender roles in fact allowed for a subtle range of individual 2007 2, Number 17, Volume the dancing are apparently strictly defined. expression within a collective whole. More- While there are important tribal distinc- over, virtuosity proved treasured, and the tions as well as variations from one region height of a leap suggested to all present the of the Southern Sudan to another, women measure of a man. generally assume a more deferential stance. At about the same time in the course of In the suburban group, whose member- the programme year that the young women ship largely emanated from one particular at the Philadelphia site began drumming, 146

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at the other location there was a parallel “psychic distress” – for the individual and incursion of gender role reversal. During the social group – through the medium of one of the formations, a small cluster of the body. The ritualized form itself provided women formed a semi-circle around one of the therapeutic container for the participants’ the especially virtuosic young male dancers. anxieties and emotions, and in much the While the women vocalized behind him in same way that in Western psychotherapy decidedly “male” chants, he danced alone, groups, the group as an entirety contains the fully and respectfully performing a woman’s tensions of its individual members. Typically role, prancing forward in the conventionally in DMT, as practiced in egocentric cultures, proscribed orbit, and with the slenderest of particularly among trauma survivors, it is the smiles on his face. function of the therapist to define “bound- As among other sub-Saharan dance aries.” Dance/movement therapists work- traditions, DIER thus apparently afforded ing with abused children in such Western a degree of playful improvisation that over- contexts appropriately introduce notions of turned temporarily the social group’s usual “personal space” and “territory” that enable hierarchies of power. Drawing from anthro- these children to begin to gain an enhanced pologist Victor Turner’s revealing analysis of sense of control over their bodies within the the “ritual order,” it could be argued that safety of a therapeutic contract.47,48 With the liminal potential for communitas as social DIER, however, the group created its own change was thus embedded in DIER’s per- container and the therapist’s role was one of formative moment.45 Extrapolating further facilitator. While manifesting to the extent of from Hanna’s contribution to the ethnology his abilities the presence of a consistently of African dance, the gender role reversals caring adult, the author worked fluidly to may be considered indicative of the dance ensure that conditions were in place for what form’s psychotherapeutic function in the one cultural anthropologist working among culture as a mechanism of collective psy- African refugees has referred to as the “re- chic management.46 The dance circle itself gaining of sociality.”49 This facilitating role, afforded an avenue for resolving potential informed as much by the writings of anthro- conflicts between the demands of the new pologists as those of Western , culture and those of tradition. was born of a conviction that healing itself Hence, in DIER, dancing and drumming is a function of the community’s capacity functioned as something of a surrogate for for social cohesion. The desired “correc- the culture as a whole, a synecdoche, a part tive emotional experience” was that of the that represented the entirety, and one which cohesiveness innate in the timelessly holistic was grounded in a ritual order that repairs culture itself.50 Revisiting the culture of ori-

45) Turner V. The ritual process: structure and who have been sexually abused. Am J Dance Ther anti-structure. Ithaca, New York: Cornell Univer- 1986;9:47-66. sity Press, 1977. 48) Goodill SW. Dance/movement therapy with 46) Hanna JL. African dance: some implications abused children. Art Psychother 1987;14:59-68. for dance therapy. Am J Dance Ther 1978;2(1):3- Volume 17, Number 2, 2007 15. 49) Englund H. Death, trauma and ritual: Mo- u r e

t zambican refugees in Malawi. Soc Sci Med o r

T 47) Weltman M. Movement therapy with children 1998;46:1176. 147

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gin through even occasional forays into tra- soldiering commonplace around the globe. ditional dancing and drumming thus opened Since the late 1990s, international NGOs the possibility for the liminal experience that involved in children’s rights advocacy have is at the core of healing and regeneration – estimated that worldwide nearly 300,000 for individuals and community alike engaged children, persons under age 18, are involved in a daunting post-war acculturative process. in military or paramilitary operations at any When addressing participants, the author given time.51 Indeed, according to the Child thus referred to himself not as a “dance/ Soldiers Research Project (CSRP), the pe- movement therapist,” but as a “dancer riod since World War II may accurately be and student counselor.” This name choice termed, “the era of the child soldier.”52 helped avert linking DIER with the shame The CSRP collected data from 24 coun- that the community associated with Western tries around the globe where children in mental health interventions. Assuming the mid-1990s, or just prior, were actively the title of “therapist” might have risked involved in conflict. Subsequent analysis invoking a stigma that would undermine contributed significantly to the 1996 United participation in an activity otherwise far Nations Machel Study, which in turn fo- from stigmatized. Rather than avoiding cused global attention on the struggle in participation, the vast majority of young Su- post-conflict societies to reintegrate demo- danese embraced the opportunity, and came bilized child soldiers into functioning com- together to engage in a revitalizing activity munities. The report generally supported that helped them transcend in the oneness the notion that interventions to address the of their bodies, minds, and spirits the vast psychological and emotional sequelae of geographic and cultural expanse between such traumatic experiences as those endured Philadelphia and the Dinka homelands of by children with past involvement in armed Southern Sudan. groups ought to be integrated into broader efforts to rebuild communities, and to at- DMT groups in Sierra Leone’s tend to the systemic problems confronting Kailahun District children. In recent decades the world has seen a vir- Among the many protracted conflicts tual rewriting of the codes of international that have plagued sub-Saharan Africa in re- and civil warfare, such that noncombatant cent decades, few have exacted a more terr- populations have experienced unprecedented ible price on children than the 11-years’ war devastation. This development, combined that erupted in Sierra Leone in March 1991. with that of the simultaneous, widespread Launching attacks initially in the outlying T proliferation of automatic weapons light Kailahun District, the Revolutionary United r o t enough for a pre-adolescent child to operate Front (RUF) targeted undefended commu- e r u handily, has made the phenomenon of child nities from the start. Systematic deprivation, 2007 2, Number 17, Volume

50) Eisenbruch M. From post-traumatic stress London: Coalition to Stop the Use of Child Sol- disorder to cultural bereavement: Diagno- diers, 2006. www.child-soldiers.org [cited 2006 sis of Southeast Asian refugees. Soc Sci Med June 15]. 1991;33:673-80. 52) Brett R, McCallin M. Children: the invisible 51) Coalition to stop the use of child soldiers. soldiers. Stockholm: Rädda Barnen, 1996. 148

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rape, slaughter, amputation, and the burning largely ignored the emotional and psycho- of entire villages were common tactics in the logical needs of participants, and also failed rebels’ broader strategy of spreading terror to ensure educational opportunity for many as a way of silencing opposition and securing demobilized children. territory. In the process, the RUF recruited In 2006, programmes designed to ad- – often forcibly – thousands of people, male dress the non-material needs of children and female, into its guerilla army. Moreo- affected by the war were few, even in those ver, as estimated near the midpoint of the parts of the country where the war left its prolonged war, perhaps half of the roughly deepest wounds. In this context, the Min- 50,000 irregular combatants, mostly with the neapolis-based Center for Victims of Torture RUF, were thought to be between eight and (CVT) – operating in devastated regions fourteen years of age.53 Sierra Leone govern- of Sierra Leone, where apparently a large ment forces, following the rebels’ lead, also percentage of present day adolescents were conscripted large numbers of minors. As recruited as children into service with rebel a result, children were directly engaged in groups – has provided psychosocial support fighting on behalf of all the various armed to child and adult survivors of war trauma factions throughout a decade-long war and torture since 2003, and trained Sierra marked by unthinkable atrocities. Leoneans to serve their communities The war was declared officially over in as paraprofessional trauma counselors. January 2002, yet children’s enforced par- Among other initiatives, in 2005 CVT began ticipation in the fighting seems not to have to sponsor therapeutic activities specifi- afforded them a proportionate share in the cally targeting former child combatants in benefits of peace. In the waning months of Koindu, one of the Kailahun District towns conflict, the United Nations helped establish worst scarred by the war’s violence. Earlier a Disarmament, Demobilisation, and Reinte- that same year, also in Koindu, CVT had gration Programme (DDR) in collaboration sponsored its initial DMT group in Sierra with international humanitarian aid and Leone – apparently the first DMT interven- development groups. The DDR demobilized tion anywhere in West Africa – for eleven 6,845 child combatants,54 and its related adolescent males. initiatives offered services to thousands of In March 2006, the CVT Kailahun former combatants of all ages, who turned District programme (which terminated in over their weapons in exchange. Unfortu- September 2006 for lack of funding) opened nately, anecdotal evidence from Kailahun three more time-limited DMT groups, one – the last district in which demobilization each in the towns of Kailahun, Buedu, and took effect55 yet probably the biggest in Koindu. The group in Kailahun town was terms of the vast need for child soldiers’ comprised of six female clients, aged 16 care – suggests that most such programmes and 17. A second, in Buedu, involved eight

53) Peters K, Richards P. Fighting with open eyes: 54) Landry G. Child soldiers and disarmament, youth combatants talking about war in Sierra demobilisation, rehabilitation and reintegration in Leone. In: Bracken PJ, Perry C, eds. Rethinking West Africa. Dakar, Senegal: Coalition to Stop Volume 17, Number 2, 2007 the trauma of war. New York: Free Association the Use of Child Soldiers. www.child-soldiers.org. u r e t Books, 1998:76-111. o r

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young Muslim male torture survivors, all for former child soldiers. Originally also aged 23 or 24. Functioning within their planned for nine sessions, this counseling community as late adolescents, and not yet intervention was ultimately extended to considered fully adults even by themselves, include a total of 16, in order to better ad- the young men in the latter group were all dress client needs. Twelve male teenagers, in the midst of completing their final year of eight of them aged 18, and the rest some- primary school, given that their educational what younger, joined three psychosocial careers had been truncated by the violence counselors (or PSCs: Training Supervisor and lingering threat in their border town. Omenga A. Kormoh, Site Administrator These two therapy groups, facilitated by the Laurence H. James, and Mustapha Abdulai) author in tandem with teams of local CVT and the author for the intervention, which trauma counselors, met for nine sessions honored such fundamental standards of each on a weekly basis. Both interventions psychotherapy as a commitment to avoiding emphasized the rebuilding of safety and physical confrontation in the group, and the trust, and the empowerment of clients to maintenance of client confidentiality. The cope with ongoing problems as well as past group’s dozen members all had been or- traumatic histories. Both in turn yielded phaned during the war, and all had a history strong results in terms of symptom amelior- of active involvement in warfare by the age ation, as well as in participants’ self-reported of 13. Their recruitment as clients and sub- improvements in functionality and overall sequent psychological assessment took place outlook. in the couple of months preceding the start Comparison of programme evaluation date for the initial phase of the intervention. data from intake and three-month assess- Prior to joining the group, each of the par- ments among the female DMT clients, for ticipants had thus engaged with a parapro- example, reveals a marked decline between fessional counselor in a number of individual the average level of both elevated arousal debriefing sessions in his own language. and avoidance symptoms, as well as those A semi-structured interview had yielded, of anxiety, and depression, as indicated by in addition, quantification of a range of such client self-reports. The average level of symptoms of anxiety, aggressive behaviors, symptoms for intrusive recollection, how- depression, posttraumatic stress, and other ever, increased from the intake assessment behavioral indicators of functional capacity to that at the one-month point, as would be – all on a Likert-type scale. As with all CVT expected given clients’ entry into a proc- clients, follow-up reassessments, surveying ess of re-examining traumatic losses. By the the same symptoms, were slated for one, T three-month point, which for most clients three, six, and twelve months after intake, r o t loosely coincided with the termination of with the aim of monitoring therapeutic e r u the DMT group, the trend had reversed it- progress. After completing client identifica- 2007 2, Number 17, Volume self, such that reported levels of nightmares, tion and symptom assessment, the three flashbacks, or other intrusive memories had counselors whom the author had trained diminished below the threshold established in DMT fundamentals, joined him in de- at intake. veloping a highly detailed group treatment Likewise, in March 2006 CVT-Koindu schedule. This plan included methods for inaugurated what appears to have been addressing 17 specific clinical objectives the world’s first DMT group specifically associated with helping reduce the former 150

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child combatants’ posttraumatic symptom extended to overt emotional expression. expression, while also encouraging the cli- Although direct in their glorification of ents to regain a sense of personal and collec- certain war-related actions – most notably tive wholeness. rape – members displayed little affect when Adapting the framework developed describing even the most horrific of acts, for the 2005 DMT group in Koindu with regardless of whether they were targets or adolescent males (which had included a perpetrators of the atrocities in question. few former boy soldiers), the facilitators Early in the process Training Supervisor introduced in the sessions a series of decid- Kormoh, in a debriefing with his colleagues, edly structured exercises and deliberately framed this blunting of affect as a likely con- improvisatory movement experiences – the sequence of participants’ violent histories. latter based on the model that DMT pioneer Throughout the 11-year conflict, it had been Marian Chace had developed with “shell- common for rebels to force their conscripts shocked” American veterans fifty years be- to laugh – and indeed, to dance and sing – fore.56 Some activities provided a container after committing such acts as killing, raping, for the physical discharge of aggression as a or mutilating civilians. Certainly, years of way of reducing anxiety, while others pro- celebrating involvement in such war crimes moted relaxation or offered skills for over- would have contributed to severe desensi- coming sleep disturbances or minimizing the tization among perpetrators, especially pre- impact of flashbacks. Participants devoted teen soldiers, just as it has among other sur- many hours over the course of several ses- vivors driven to numbness through relentless sions to a number of creative exercises, some exposure to senseless violence. Thus, from involving verbalization as well as physical the beginning of the intervention the group’s expression through gesture and action and members exhibited great difficulty even all designed to elicit symbolization as a ve- recognizing their own feelings about their hicle for the clients to integrate their trauma. experiences, and seemed distinctly unable to Overall, the facilitators aimed to foster a safe express empathy for one another. environment for rebuilding dignity and trust, With the blunting of affect a group and thereby empowering the former child norm, a pivotal struggle played out be- combatants to address two simultaneous, tween suppressing feelings associated with paradoxical needs for acceptance and traumatic experiences and revealing them accountability. – often embodied in the group in a symbolic From the outset, members demonstrated and quintessentially adolescent contest be- willingness to engage with facilitators and tween mockery and sincerity. By the end of one another in vibrant movement, usually the second session, facilitators thus identi- performed to recordings of the latest Sierra fied the need to revise treatment plans in Leonean popular music. A long history order to address members’ detachment from of surviving through taking unusual risks emotion and their broader sense of funda- perhaps reinforced this communal capacity mental dehumanization. Moreover, recog- for creativity. The openness demonstrated nizing participants’ difficulty reconnecting in movement exploration, however, rarely to their place within the community and the human family more generally, the facilitators Volume 17, Number 2, 2007

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T 56) See note 12. creating movement activities for achieving it: 151

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To stimulate reflection on personal involve- Ultimately participants demonstrated ment in the events of armed conflict in a way enhanced self-awareness, including through that promotes clients’ awareness of themselves as willingness to examine and symbolize part of humanity. through gesture their involvement in the Notwithstanding such efforts, the avoid- suffering of others. Authentic feelings of sor- ance of emotional vulnerability persisted row, along with worry, arose in connection through several of the weekly sessions. with such acknowledgements, and members Facilitators understood that for members linked these concerns verbally and nonver- of the group – many of them living on the bally to certain religious and spiritual beliefs. street in an impoverished community with- By the “closing” session in May – that is, out access to any viable means of social the one before the 12-week break – a high support – the conditions of peacetime had level of trust and dynamic interaction in the produced little improvement in meeting life’s group had thus freed expression and enabled necessities. It would be awfully difficult to these “victim-perpetrators” to identify their let themselves be vulnerable to feelings and ambivalence and confusion over the dynam- open to expressing them when struggling ics of power and powerlessness in their lives. day by day simply to stay alive. Nonetheless, While the central question of reintegration encouraged by some specifically designed into their communities remained major expressive movement activities – and per- unfinished business, in gearing toward this haps by the facilitators’ offer to reconvene preliminary termination there was significant the group for five additional sessions fol- evidence of members’ readiness to experi- lowing a dozen-week hiatus – even the more ence feeling grounded and connected to the emotionally defended members would ulti- present, to gain strength through expression mately begin speaking about their own need of authentic emotion, and to continue in- for connection with one another, including vestment in a collective process of recovery. through dance. As the sessions proceeded Before reconvening it had remained participants began interacting more in their uncertain how well Poimboi Veeyah Koindu movement together, speaking more confi- (more often by this time called “PVK” by dently to one another, sharing both leader- its participants) might function following its ship and empathy with peers, and verbalizing three-month break. To the surprise of the an appreciation of the therapeutic process as local facilitators who were stunned to find important to their lives. With the establish- adolescent clients walking long distances in ment of a sense of safety afforded by a ritu- order to attend sessions after the long hiatus, alized familiarity came increasing emotional particularly at the height of the rainy season T openness. Members chose for themselves a in August, attendance proved quite consist- r o t group name, Poimboi Veeyah Koindu, mean- ent, precisely 90.0 percent in the course of e r u ing Orphan Boys of Koindu in Kissi, their the entire two-phase therapy cycle. During 2007 2, Number 17, Volume mother tongue, and invested more and the tenth session in mid-May, the last of the more in sharing a group identity. In time, initial phase, each of the former combatants even sadness and the desire for forgiveness had taken an opportunity to position him- emerged as themes to be shared aloud. In- self in front of his peers and review aloud deed, by the ninth session, all of the dozen his personal progress, along with that of the participants had expressed feelings of re- group as a whole. Beyond speaking of the morse in both action and word. pleasure they had enjoyed together, several 152

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members openly expressed satisfaction in chose to devote an hour of each remain- the management of their own angry out- ing session – and, later, an added four-hour bursts and appreciation for the encourage- rehearsal – to devising a script and practic- ment and support that they had shared with ing its performance. Following extensive one another and secured for themselves. deliberations they endorsed the suggestion Most identified new-found capacities for of a second member who proposed includ- coping with their horrific memories and ing in the role-play scenes that would illus- handling their accumulated losses: Gaining trate three experiences shared by all in the “a cool heart” was a common refrain. Some group: (1) The slaughter of group members’ participants named as well behaviors that families, and their own forced recruitment, they had come to view as important to avoid (2) Their subsequent direct involvement in in future: stealing, selfishness, withdrawal killing and other abuses, and (3) Their desire from friends, killing. to be reintegrated back into the community. In reconvening 12 weeks later partici- Other participants articulated this hope for pants were encouraged to assume ever reconciliation in terms reflective of a nascent greater authority for the structure of session awareness of the need for healthy attach- agendas and for ensuring their capacity for ment: “We want the community to accept us meeting self-defined aims for behavioural as their children, and we will accept them as change. Collectively, they voiced a desire our mothers and fathers.” to continue in the direction established in On the September evening prior to the the group’s first phase, and proposed re- final PVK session, CVT sponsored what peating all of the activities enjoyed then. local staff publicized as a Community Cul- When questioned if there was something tural Healing Event. This included choral that PVK as a whole might need to achieve singing and a young women’s traditional before its termination the following month, dance troupe, as well as the PVK youths’ members initially were uncharacteristically 25-minute dramatization of their wartime still. A client who at the outset had seemed experiences. With hundreds of people of the one among them most often enraged, all ages filling the local hall to capacity, the especially because of the ongoing stigma he youngest among them seated just before the had claimed to face as a former fighter, then stage area, it was evident throughout that spoke up. This young man, alluding to the this special gathering might potentially both group’s shared experience in symbolizing represent and animate Koindu’s renewal members’ traumatic pasts through the enact- and revitalization. Indeed, there was an ment of sociodramas that illustrated each undeniable sense of the depth of the event’s client director’s own worst moments, urged meaning to participants and audience mem- his peers to perform a role-play before the bers alike. Tears were seen in the eyes of broader community, depicting “what we did one woman, for example, while watching in the war.” After discussing together the the early scenes of the dramatization. The advantages and disadvantages of revealing to former combatants here portrayed the agony the people of Koindu histories that had until of one boy’s coerced recruitment when that moment been guarded as secrets, con- driven to fire bullets into the corpses of his fidences only to be shared in the context of own father and sister, killed by the very rebel Volume 17, Number 2, 2007

u r e the PVK sessions, the members unanimously fighters who had forcibly inducted him into t o r

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depicted further violence committed by the that witnessing such former combatants re- boy against his will upon recruitment into nouncing their violent past had helped her the rebel army. Finally, in a post-war scene, feel safer. It became clear to CVT staff that the child returned to his village, and on his PVK members’ public admission of partici- knees asked forgiveness of the local chief pation in human rights crimes, an acknow- and others. ledgement that arose directly from the will As challenging as the story may have of the youths themselves, ultimately had pro- been to perform and to view, watching it found consequences. Not only those seeking prepared many in the audience for a genuine mercy, but the community as a whole had change of heart. Several local authorities been helped meaningfully. Healing was a – the Section Chief, Youth Chairlady and collective choice they had made together for Chairman, the Officer-in-Charge of the lo- reintegration. cal Sierra Leone Police, and a female board Clearly DMT group participants pros- member of a local community-based organi- pered from their active engagement with zation – all spoke immediately after pres- one another and their community. Benefit- entation of the role-play. Each addressed ing measurably from the course of their the young men, welcoming them back into intervention, these youths experienced an the community. One leader asked PVK’s appreciable drop in symptom expression, members to renounce violence in the future, as quantified through CVT’s systematic ap- which they willingly did on the spot. An- plication of a follow-up assessment tool for other speaker, pointing to Koindu’s future, programme evaluation. Average levels of the emphasized the role the youths might play symptoms of anxiety, depression, intrusive in local development. For their part, the recollection, elevated arousal, and aggres- war orphans themselves had deliberately in- sion – which CVT surveyed through client cluded in their script a collective wish to be self-reports at intake, 1-month, 3-month, accepted again as “your children,” and these 6-month, and 12-month intervals – all un- words reverberated in the hall, echoed back derwent continual reduction. Having begun by the newly welcoming adults. what they termed a therapeutic “journey” In debriefing the event at the final group from a baseline of extreme traumatization session the next day, the member who had and incongruent affect, the PVK member- first proposed the scene representing mem- ship had undergone a sequence of incre- bers’ welcome by village elders stated that in mental changes – experienced in stages, as preparing the role-play he had had “no idea anticipated in all effective psychotherapy how sweet” the evening would come to be interventions. The opportunity to release T for them. The teens all concurred that the aggressive drives through vigorous impro- r o t event had truly become a watershed moment visatory dancing and more contained exer- e r u in opening a brighter future for them as cises had led in time to disinhibition and 2007 2, Number 17, Volume members of the Koindu community. Moreo- the expression of otherwise suppressed rage. ver, in the days following the performance, Along with a growing sense of safety and a number of community members reported trust, encouraged within the container of appreciation for coming to understand bet- the group process, and furthered especially ter what these child soldiers themselves had by the kinesthetic empathy established in endured. Perhaps representing the feelings movement activities had emerged greater of many, one townswoman told facilitators ownership and interaction, and in turn, 154

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authentic expression of a broadening range of recently resettled Dinka refugee minors. of emotions and cognitions. Regaining a The programme’s reconstitution of a cere- capacity to feel kinship with one another had monial Sudanese dancing circle afforded its afforded a familial atmosphere to the PVK participants an opportunity to revisit their group, and expressing concern for peers led culture of origin and deliberately hold onto clients to similar expressions for their vic- its ancestral strengths while adapting to tims, and for themselves. Members came new challenges in a very foreign host cul- in time to voice the word forgiveness – and ture. Similarly the CVT-Sierra Leone DMT through it, their collective desire to make programme in the war-ravaged Kailahun amends, and to accept the gift and respon- District enabled its clients – notably a group sibility of being forgiven by the community. known as PVK comprised of former child Indeed, through the role-play about their combatants – to master skills for reducing war experiences that they elected to perform hyperarousal and managing difficult emo- before the people of Koindu, they created a tions indivisible from their background as culturally relevant vehicle for ritualizing both “victim perpetrators.” Opportunities in the truth of their experience and their need PVK for creative expression through dance for community reintegration. Appropriately, and non-dance movement facilitated clients’ they embodied their own journey through integration of extreme traumatic histories. creative movement performed as communal The embodiment of personal experiences rite. Ultimately it may be inferred from this and attitudes through active participation in emergent therapeutic process that, by foster- contained thematic exercises helped these ing conditions for a much needed synthesis teenage ex-fighters come to terms with the of acceptance and accountability, the mind- past in a way that enhanced longer term fulness and symbolic capacities inherent in prospects for survival, and provided a model DMT created a pathway for a unique pas- for reconciling to a community still torn sage toward recovery and reconciliation in apart by years of brutal war. the aftermath of torture and war. Both of these quite dissimilar groups ultimately found ways through DMT to Conclusion overcome the serious ruptures associated Dance/movement therapy interventions de- with their trauma. Eventually DIER’s par- signed to foster resilience or recovery among ticipants openly voiced the need to embrace African adolescent survivors of torture and the traditional strengths of their culture like wartime exposures may maximize the as a means to thrive during exile. PVK’s healing capacity of widely available cultural members, not physically segregated from resources. Drawing on dance’s rich po- their home culture yet suffering nonetheless tential for heightening communal solidar- a stigma that excluded them from its heart, ity, along with the sense of wholeness and developed an innovative way to reconcile well-being animated through purposeful themselves with the community to which engagement in bodily expression, DMT is they had returned after years of violence. flexible enough to be adapted for applica- Having found in dancing a culturally accept- tion in various contexts. The DIER pro- able release of long held muscular and psy- gramme in the Philadelphia area used dance chic tensions, the former soldiers reclaimed Volume 17, Number 2, 2007

u r e to reinforce traditional coping mechanisms a capacity, recovered as well by the resettled t o r

T among a particularly resilient population Dinka, for mindfulness, connecting to the 155

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reality of the present moment. By then rep- resenting war experiences through a commu- nal rite that PVK members themselves de- vised to be performed in the presence of the community and its elders, the group found a formal way to symbolize at once traumatic powerlessness and power, the losses of their past and their hopes for the future. Indeed, symbolization through bodily performance created a container for wartime terrors, members’ own and those of their audience, and literally set the stage for reconciliation, opening a new pathway for the youths to as- sume meaningful roles in their impoverished community’s renewal. Whether introduced in a post-conflict situation in the global South, or in one of refuge in the North, the DMT modality, em- bodying an integrated, holistic approach to psychosocial support and transformation in the aftermath of horrific violence, effectively mobilizes the empowering and restorative functions of dance, with collective revitaliza- tion a foreseeable result. T r o t e r u Volume 17, Number 2, 2007 2, Number 17, Volume