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Reconciliation in : thirty years after the terror of the regime

Estelle Bockers, MA*, ** Nadine Stammel, MA*, *** & Christine Knaevelsrud, PhD*, **

Abstract order (PTSD), depression, and feelings of During the Khmer Rouge regime one quarter of anger and revenge are highly prevalent in the Cambodian population was killed as a result postconflict societies such as Cambodia.1 of malnutrition, overwork and mass killings. Al- In villages throughout the country, victims though the regime ended 30 years ago, its legacy and perpetrators of the atrocities committed continues to affect Cambodians. Mental health during the Khmer Rouge regime from 1975 problems as well as feelings of anger and revenge to 1979 live side by side. How can social resulting from traumatic events experienced dur- ing the Khmer Rouge regime are still common in reintegration be fostered under such condi- Cambodia. These conditions continue to impede tions? social coexistence and the peace-building process Desire for revenge is a common psycho- in society. logical response to violent events causing Thirty years after the Khmer Rouge regime harm and loss.2 Feelings of anger and the this article gives an overview on the status of the desire for revenge can have the important country’s current reconciliation process and rec- adaptive function of helping people to cope ommends potential future steps. with their anxiety.3 However, these feelings can also have a negative impact on mental Key Words: trauma, reconciliation, Cambodia, war, health and interpersonal relationships, thus Khmer Rouge regime promoting cycles of violence among indi- viduals and between groups.4 Introduction The purpose of this article is to analyze The psychological aftermath of civil wars the current status of Cambodia’s reconcili- and violent political conflicts can pose im- ation process, 30 years after the end of the T

mense challenges for social coexistence in ORTURE Khmer Rouge regime. We first define the the population. Posttraumatic Stress Dis- term “reconciliation” and outline psycho- Volume 21, Number 2, 2011 logical, sociological, and educational meas- ures that may contribute to it. After briefly summarizing the history of the Khmer Rouge era, we then evaluate approaches that *) Treatment Center for Victims, Germany, es- [email protected] have been implemented to promote recon- **) Department of Clinical Psychology and Psychother- ciliation in Cambodia to date and make rec- apy, Freie Universität Berlin, Germany ommendations for the future. ***) Department of Clinical Psychology and Psycho- therapy, University of Bielefeld, Germany 72

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Reconciliation intrapersonal process, reconciliation is Reconciliation and the related concept of understood as an interpersonal process. forgiveness were originally religious notions. The definition of reconciliation that In the wake of the civil wars and human has become widely accepted in literature right violations that have recently taken and that is used in this article has five key place in countries such as South Africa, components: a) a reduction of feelings of Rwanda, former Yugoslavia, and Cambodia, anger and revenge, b) the ability to take the interest in reconciliation as a political, jurid- opponent’s perspective, c) reduced personal ical, and psychological construct is growing. avoidance of the opponent, d) openness to From a psychological perspective, the positive relationships with the opponent, and process of healing traumas and bringing clos- e) renunciation of violence.12 ure to the relationship between victims and Several approaches and methods to perpetrators is essential for reconciliation.5 promote reconciliation are expounded in lit- A psychological change has to be effected in erature.13 In the following, we introduce and the former opponents’ beliefs, attitudes, and discuss the most widespread, appropriate, motivations, namely “a transition to beliefs and target-oriented approaches. and attitudes that support peaceful relations between former enemies”.6 Approaches and methods Most definitions describe reconciliation to promote reconciliation as a reciprocal and gradual process. Crocker7 Retributive justice defined three consecutive stages of the rec- The notions of merit and desert are central onciliation process: “simple co-existence”, to retributive justice. This approach focuses developing to “democratic reciprocity,” on individual accountability and punish- and finally a third stage in which the social ment of perpetrators; it can contribute to bonds between former victims and perpetra- reconciliation in various ways. First, the fact tors are reconstructed.7 Pham, Weinstein that perpetrators sentenced to imprisonment and Longman defined reconciliation as a after a criminal trial can no longer commit process aiming at community, interdepend- increases the sense of security in ence, social justice, and nonviolence.8 The society, which is an important condition for ultimate goal of reconciliation appears to be reconciliation.14 Second, retributive justice that people learn to live peacefully together.9 responds to people’s “profound sense of This can be achieved only within a relatively moral equilibrium” and satisfies their need stable social and political order that is robust for perpetrators to pay for the harm they enough to provide physical security for both have done, thus helping to rebuild an indi- former victims and perpetrators.10 vidual sense of justice.15 Reciprocity is a crucial aspect in the process of reconciliation, which cannot Restorative justice take place without the perpetrators’ cooper- Restorative justice emphasizes the interests ation.11 This is in contrast to the similar of the victims and is less concerned with construct of forgiveness, which is under imposing punishments on the offender. It in- the victims’ control. The establishment of cludes non-criminal measures such as truth

Volume 21, Number 2, 2011 Volume relationships between the victim and the and reconciliation commissions, which are perpetrator is therefore necessary for rec- tasked with revealing all wrongdoings and

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war or dictatorship. The aim is to establish Educational measures the truth, to encourage the perpetrator to The way a state educates its young people accept responsibility and express remorse, about its own history reflects how the gov- and to stress reconciliation without the in- ernment and its institutions appraise and tention of prosecuting or sentencing the per- reappraise their history. According to Cole, petrators. This approach has been popularly the reform of history education can be un- implemented in South Africa, for example. derstood as a sign of changed identity on the part of the state.18 The fact that a new Reparations regime does not deny past atrocities demon- Reparations to individuals or communities strates that the state is not an accomplice to who have suffered injustice include monetary past crimes and that atrocities are unlikely to compensation for material damage or physical be repeated.19 injury. Reparations may also be made in the Educating the next generation about his- form of resources for economic development tory can also contribute to reconciliation by (e.g. building schools or supplying water serving as an instrument of remembrance. wells) or community service by the wrong- The younger generation’s recognition of doer. Although reparations cannot compen- victims’ suffering through this form of com- sate all of the victim’s losses, they show that memoration may help the victims to recon- the wrongdoer feels remorse, which can pro- cile. mote forgiveness and reconciliation and help to restore victims’ sense of justice.16 Therapeutic measures Many people in postconflict settings suffer Sites and practices of remembrance mental trauma as a result of their experi- Museums and memorials document and ences.1 In Cambodia, many are still strongly acknowledge the crimes and human rights affected by the aftermath of the .20 violations of former regimes. Typical exam- As Staub has described, reconciliation, for- ples are memorials and mu- giveness, and healing mutually support each seums built in Germany and other countries other and an advance in each aspect can to remind current and future generations of facilitate advances in the others.21 Therapies the crimes committed during the Nazi re- aimed at healing traumas in individuals or gime. Days of remembrance serve a similar groups include traditional, medical, and purpose. Etcheson14 suggests that, if these public health approaches, as well as coun- days are properly designed, “they can bring seling, self-help groups, and (trauma-fo- cused) psychotherapy.

a nation together as one in remembering T shared trauma and loss.”14 Forgiveness and Table 1 (next page) summarizes the ap- ORTURE forgetting are often perceived to be simi- proaches to promote reconciliation outlined Volume 21, Number 2, 2011 lar concepts, and resistance to forgetting above. past atrocities may lower the readiness to forgive.17 Therefore, it seems important to A brief history of offer alternative ways of remembering past the Khmer Rouge regime atro cities. Both symbolic measures and days At the end of the 1960s, Cambodia was torn of remembrance can contribute to reconcili- by civil war. Bombings by U.S. planes dur- ation by marking, acknowledging, and hon- ing the Vietnam war in the late 1960s and ouring the victims’ suffering. early 1970s also had a hugely detrimental 74

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Table 1. Approaches to promote reconciliation in postconflict societies. Primary Level of Intended impact Examples target group intervention Retributive Perpetrators Individual Instilling a sense of justice and Punishing perpetrators Justice security Restorative Victims and Individual and Establishing the truth; encour- Truth commissions Justice perpetrators community aging perpetrators to assume responsibility Reparations Victims Individual and Instilling a sense of justice; Monetary or economic community demonstrating that the compensation for vic- wrongdoers feel remorse tims’ losses by govern- ment or wrongdoers Sites and Victims, Individual and Remembering human rights Museums, memorials, practices of perpetrators, community violations; recognizing and days of remembrance remembrance future honoring the victims’ suf- generations fering; establishing sites for grieving; educating younger generations Educational Future gen- Community Showing the government’s History textbooks, measures erations and changed appraisal of the past; teaching students others not recognition of the victim’s about the past involved in suffering by future generations the conflict and others not involved in the conflict Therapeutic Victims Individual and Healing, psychological Counseling, self-help measures community wellbeing groups, psychotherapy

impact on the country.22 In the late 1960s tion.23 The following years were characterized , the leader of the Cambodian Com- by mass killings, forced labor, forced mar- munist movement, also known as the Khmer riages, rapes, deportations, separations from Rouge gained more followers. In 1970, head family members, torture, and starvation. The of state Prince Sihanouk was deposed by Khmer Rouge closed schools, government the pro-U.S. general Lon Nol. Appalled by offices, courts, and embassies. All foreign- the suffering caused by the U.S. bombings, ers were expelled, religious practice was thousands of Cambodians refused to sup- outlawed, the use of foreign languages was port the American-backed government and banned, and foreign medical and healthcare followed their revered prince in joining the assistance was refused. Currency and the Khmer Rouge. postal system were abolished; newspapers However, when the Khmer Rouge entered as well as television and radio stations were on April 17, 1975, Cambodian shut down.24 In their attempt to establish an society was transformed radically. The entire egalitarian and agrarian society, the Khmer urban population was evacuated; all inhabit- Rouge presided over the organized killing of ants of Phnom Penh and other cities were professionals and educated persons, especially Volume 21, Number 2, 2011 Volume forced to move to rural areas, with anyone doctors, teachers, and former government 25 ORTURE who remained being threatened with execu- officials. Simply wearing glasses or being T 75

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able to speak a foreign language was reason Sonis et al. are similar to those found in enough to be killed. other postwar societies: 17.1% of Kosovar Estimates indicate the loss of at least 1.7 Albanians suffered PTSD after the war.28 million lives, one quarter of the Cambodian 11.8% of a sample of Guatemalan refugees population, during the Khmer Rouge regime living in Mexico 20 years after civil conflict as a result of malnutrition, overwork, dis- were found to have PTSD.29 ease, and execution without trial.26 The prevalence of PTSD also seems The Khmer Rouge regime ended on to be related to individual perceptions of January 7th, 1979, with the invasion of Viet- justice. In a recent study on PTSD and dis- namese forces, but low-intensity warfare ability in Cambodia, Sonis et al. found that continued throughout the 1980s. After a ser- Cambodians with low levels of perceived jus- ies of complex negotiations, the Paris Peace tice were significantly more likely to present Accord was signed by all factions (including with PTSD.27 the Khmer Rouge) in 1991, and the United In addition to eliciting PTSD, violence Nations Transitional Authority in Cambodia and traumatic experiences can also cause (UNTAC) was established. However, the other mental health problems. Anxiety dis- Khmer Rouge, who backed out of the peace orders and depressive disorders are common process and refused to participate in elec- in war survivors.30 General social function- tions, continued their guerilla warfare until ing can also be impaired as a result of the the movement finally collapsed in 1998. traumatic events experienced.28 Man-made traumatic experiences often The impact of the atrocities committed have devastating effects on survivors’ basic during the Khmer Rouge regime psychological needs for trust, esteem, iden- on Cambodia today tity, feelings of effectiveness and control, Although the Khmer Rouge regime ended and positive connections to others.4 A typ- 30 years ago, its legacy continues to affect ical epiphenomenon of posttraumatic stress the Cambodian population. Every Cambo- symptoms is that the victims’ central beliefs, dian alive during the regime experienced on such as the belief that the world is safe and average 10 traumatic events, such as starva- people are basically good, are called into tion, lack of shelter, being close to death, question. Victims of extreme traumatic stress forced labor, torture, or witnessing the death feel vulnerable and often perceive the world or killing of family members or friends.2 as a dangerous place.31 This may be one of In 2001, de Jong et al.1 found a higher the main psychological causes of political in-

prevalence rate of PTSD in Cambodia stability in postconflict societies. People who T (28.4%) than has been reported in other see the world and other people as threaten- ORTURE postconflict countries.1 However, a recent ing and dangerous may overreact violently Volume 21, Number 2, 2011 study by Sonis et al. reported a PTSD rate to defend themselves in situations where ranging from 7.9% in the younger genera- violence is not provoked or warranted.32 tion of Cambodians to 14.2% in the older Staub and colleagues4 have argued that this group.27 The difference in the PTSD preva- self-protective violence is especially likely if lence rates might be due to different sample victims and perpetrators lived side by side recruiting methods and measure instruments under a chronic sense of injustice.4 or maybe also to a change of the PTSD As noted above, harm and distress can prevalence over time. The rates found by also give rise to anger and a desire for re- 76

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venge. These feelings are common in post- The people of Cambodia were suffering conflict societies.33 For example, Pham et amidst a general climate of starvation and al. found that most Cambodians who lived dislocation during 1979, physically and under the Khmer Rouge regime feel hatred emotionally exhausted after the four brutal toward those responsible for the atroci- years of Khmer Rouge rule. At that time, ties (84%).34 More than two thirds wished many Cambodians were wandering the land to see those responsible hurt or miserable in search of their missing relatives, while (72%), and almost 40% would seek revenge dodging the on-going combat between Viet- if they could. These findings are in line with namese forces and the rump of Pol Pot’s results of Lopes Cadozo et al., who found army. One might well wonder how deep strong feelings of hatred (88%) and revenge an impression the in absentia conviction of (43%) in survivors of the war in Kosovo.28 Pol Pot and actually made on the Although the emergence of these feelings is Cambodian people at large under these cir- understandable, and although it is impor- cumstances, and indeed how many of them tant to acknowledge and commemorate the even knew about it at all.37 deaths and suffering, such feelings may also have negative consequences. In 1996, Cambodia’s Prime Minister Hun Inability to reconcile or forgive and feel- Sen offered amnesties to several high-rank- ings of hatred and revenge are associated with ing Khmer Rouge leaders, including Ieng poorer psychological functioning and may Sary, who was one of the main architects of impede positive interpersonal relationships the Cambodian .38 The prospect and social coexistence.27 These conditions can that there might be no future chance to seriously impair the peace-building process prosecute or sentence those responsible for in society. In fact, they are a breeding ground the genocide must have been unbearable for for violence among individuals and between many victims. groups as well as for .4 Now, 30 years after the genocide in Cambodia, and following lengthy negoti- Evaluation of approaches and methods ations between the government of Cambodia implemented to promote reconciliation and the , a new court called in Cambodia the Extraordinary Chambers in the Courts Retributive justice of Cambodia (ECCC) has been established. Immediately after the end of the Khmer It started its work in July 2006 and became Rouge regime in 1979, a People’s Revolu- fully operational in June 2007.39 The ECCC tionary Tribunal (PRT) was established to is known as a hybrid court because it applies prosecute the genocide and crimes commit- Cambodian and and em- ted. Two symbolic personalities of Demo- ploys a mix of Cambodian and international cratic Kampuchea, Prime Minister Pol Pot judges. The decision was made to limit and Deputy Prime Minister and Minister prosecutions to five of the senior leaders of of Foreign Affairs Ieng Sary, were accused , namely those who and found guilty of the of genocide.14 gave orders and those primarily responsible However, neither of them appeared in court for the most serious crimes committed. The 35 Volume 21, Number 2, 2011 Volume or were punished for their crimes. The ECCC is the first war crimes tribunal in tribunal was later denounced as a “show which the role of victims is not restricted to

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T trial”. As Etcheson noted: that of a witness. All individuals who have 77

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suffered physical, psychological, or material Rouge regime and to promote national rec- harm as a result of a crime investigated by onciliation.27 As Staub has argued, justice is the court have the opportunity to participate an important need for survivors of violence, as complainants or civil parties.39 The first and finally seeing the former Khmer Rouge trial began on 17 February, 2009. leaders sentenced may reflect the official The ECCC has been met with both acknowledgment of the harm and suffering hope and criticism in Cambodia. There is caused to the victims.43 controversy over the decision to hold just five individuals responsible for the entire Restorative justice genocide. Furthermore, there is concern Although former victims are able to par- that it took almost 10 years from the start ticipate as complainants and civil parties in of negotiations until the court started work- the ECCC, the tribunal’s role seems to be ing: the defendants are now elderly and may predominantly retributive. Given the large well die before being sentenced. The lack of numbers of victims and perpetrators in publicity surrounding the tribunal has also Cambodia, it is impossible for all of them been criticized. According to Pham et al., to participate in the tribunal. Consequently, 39% of Cambodians have no knowledge of it may be important to promote reconcili- the ECCC, and 46% have only little know- ation by emphasizing restorative ways of ledge.34 Yet people are more likely to have justice. To date, however, attempts to estab- positive attitudes toward the tribunal if they lish a public truth commission in Cambo- feel informed about its work and involved dia have been opposed by members of the in the process.8 Initiatives such as increased current government who were previously outreach activities in the villages and greater Khmer Rouge officials themselves. In 1979, media coverage might increase public aware- the Cambodian government established a ness of the tribunal. Research Committee on Pol Pot’s Geno- There is general mistrust of judicial and cidal Regime. Information about killings, government officials in Cambodia. With mass graves, and crimes committed by the a Corruption Perceptions Index (CPI) of Khmer Rouge was collected from victims 1.8, Cambodia is one of the most corrupt and perpetrators.14 Unfortunately, with the countries in the world.40 The Cambodian exception of a single report published on the judiciary is widely considered to be corrupt, commission’s findings in 1983, no informa- dependent, and untrustworthy.41 For this tion about the commission’s work was made reason, some people in Cambodia “would available to the general public. As Etcheson

prefer that no trial be conducted at all rather pointed out, “truth commissions cannot T than having the country undergo a substand- work well if their findings are not widely ORTURE ard judicial process”.42 However, more than publicized to the people.”14 The Research Volume 21, Number 2, 2011 50% of Cambodians who lived under the Committee thus contributed little to recon- Khmer Rouge regime want those responsible ciliation in Cambodia. to be put on trial. Additionally, one third In the absence of a public truth commis- of Cambodians identify punishment of the sion, the Documentation Center of Cambo- Khmer Rouge’s top leaders as an important dia (DC-Cam) is an independent research precondition for their forgiveness.34 A major- institute that collects, archives, and publishes ity of Cambodians expect the ECCC to have data on the Khmer Rouge regime and pro- a positive impact on victims of the Khmer vides objective information about the geno- 78

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cide to the public. Its two main objectives against the Khmer Rouge, their allies and are to preserve the history of the Khmer their foreign backers.46 In 1990 the stated Rouge regime and to compile evidence of aim of the Day of Hatred was to “make the Khmer Rouge’s crimes, both being foun- people realize the current crimes commit- dations for reconciliation. ted by the Pol Pot clique, and be dedicated to the prevention of the return of the re- Reparations gime”.47 Until today, each May 20 the According to the United Nations list of least crimes of the regime are remembered in developed countries, Cambodia is one of public meetings and ceremonies at village the poorest countries in the world.44 Dur- cemeteries and the Tuol Sleng Genocide ing the Khmer Rouge regime, Cambodia’s Museum. The ceremonies all include wreath public property (e.g., social and technical laying, songs, prayers and other religious of- infrastructure) was destroyed and individual ferings to the dead, and speeches by official property was seized. Many people were representatives.48 Some of the activities in- forced to leave their houses and had to give volved in the Day of Hatred seem therapeu- away their livestock and other resources. To- tic, with victims recounting and re-enacting day, many Cambodians still live in poverty. their personal experiences of Khmer Rouge The many negative effects of poverty include crimes. Traumatic memories are invoked in the experience of injustice, which increases a protected environment, in the same way the potential for anger and violence.45 Ac- as trauma confrontation in cognitive behav- cording to Staub, Rwandans perceived eco- ioural therapy. Learning to express one’s nomic support to be a means of restoring emotions, especially anger, can be a useful justice that would help to promote reconcili- therapeutic tool for dealing with chronic ation after genocide and mass killing.21 pain and depression.49 In a Buddhist-coined Of course, money cannot replace loved society it is less esteemed to display anger. ones lost in the conflict, but material com- The Day of Commemoration provides a pensation of material losses may give victims culturally accepted space for Cambodians a sense of justice. To date, the Cambodian to express their anger and pain at the crimes government has planned no monetary com- of the Khmer Rouge regime and can thus pensation for victims of the Khmer Rouge contribute to healing and coming to terms regime, and the prospects of reparations be- with the past. In 2001 the Day of Hatred has ing made are small. been renamed the Day of Commemoration, which might characterize another important Sites and practices of remembrance scope of the day – to not forget about the In 1984, Cambodia’s government declared past. May 20 a National Day of Hatred to com- There are memorials commemorating memorate the crimes and the victims of the the Khmer Rouge genocide throughout Khmer Rouge regime and to give people an Cambodia. The Memorial on opportunity to vent their anger. It seems that The , where the Khmer Rouge the skope of the day of hate has changed executed an estimated 17,000 people, is over time. The Day of Hatred was initiated probably the best known. Mass graves in

Volume 21, Number 2, 2011 Volume while the Khmer Rouge was still active. this area contain a known 8,895 bodies, but Originally in 1984 the objective of the day many mass graves remain unopened. Today, ORTURE

T was to mobilize international public opinion Choeung Ek is marked by a glass-sided 79

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Buddhist stupa filled with over 5,000 human cation as a right, the access to educational skulls. Choeung Ek and other memorials services, especially for remote populations, is serve as symbolic sites where Cambodians deficient. A report by the Ministry of Educa- can grieve and commemorate the deceased tion, Youth, and Sport in 2000 indicated that and so reconcile with their own losses.14 in Cambodia 45.1% of women and 24.8% Cambodia has two museums document- of men are illiterate.51 However even for ing the terrors of the Khmer Rouge regime. young people with a better access to educa- The best known is the Tuol Sleng Genocide tion, being informed about what happened Museum, which was built in the former in the past is not common. Cambodia’s Security Prison 21 (S-21). An estimated history between 1975 and 1979 is rarely 17,000 to 20,000 people were imprisoned, covered in the country’s schools. Only 6% interrogated, and tortured in S-21 dur- of randomly sampled young Cambodians ing the Khmer Rouge era. There are only learned about the Khmer Rouge in school; 12 known survivors. Today, the Tuol Sleng 85% stated that they wanted to know more buildings are preserved as they were left in about the regime.34 The first textbook about 1979. It is possible to visit the prison cells the genocide, developed by the government and see photographs of former inmates as in collaboration with the Documentation well as paintings by the artist , Center of Cambodia (DC-Cam), was is- who was held there. The Tuol Sleng Geno- sued in 2009. This development might be cide Museum serves as an important site interpreted as the first sign of a greater of remembrance, preventing past cruelties willingness to teach Cambodian school chil- from being forgotten. The individual stories dren about the genocide. Heightened public and photographs presented in the museum awareness of the Khmer Rouge atrocities give the younger generation an opportu- may also promote dialog between the gen- nity to recognize and honor the suffering erations and help Cambodians to come to of the Khmer Rouge victims. Additionally, terms with the past. museums like Tuol Sleng serve to educate In addition, the Youth for Justice and young Cambodians about the horrors of the Reconciliation Project run by Youth for Khmer Rouge years. Peace (YFP) organizes workshops on the history of the Khmer Rouge era and the psy- Educational measures chological and cultural factors behind col- Most young Cambodians know little about lective violence. It initiates dialogs between the Khmer Rouge regime. According to villagers with the aim of facilitating open

Pham et al., more than 80% of those who discussions between the younger generation T were not alive during the regime describe and older Cambodians who experienced the ORTURE their knowledge of the period as poor or regime. Volume 21, Number 2, 2011 very poor.34 With two thirds of the Cambo- dian population aged 29 years or younger, Therapeutic measures the number of people with limited know- The approximately 30 years of civil war de- ledge of the Khmer Rouge regime is high. stroyed Cambodia’s public health infrastruc- Scholars attribute the limited awareness of ture.52 During the Khmer Rouge regime, the the younger generation to a lack of public two psychiatrists practicing in the country education.50 Although the Cambodian con- were killed and the only mental health hos- stitution guarantees a nine year basic edu- pital was shut down.53 With no conventional 80

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psychiatric or psychological care, people had Staub et al. developed and evaluated a to rely on traditional healing. Cambodia’s psycho-educational group intervention for mental health system is still significantly use in the context of genocide and war, with underdeveloped, particularly in view of the the aim of promoting healing, reconcilia- high prevalence of trauma and PTSD in the tion, and prevention of violence in Rwanda.4 country.54 Several studies have found that After the intervention, participants showed poorer mental health is related to unforgiving reduced trauma symptoms and a more posi- attitudes and a lack of willingness to recon- tive orientation toward members of the other cile.55 This seems to apply to postconflict set- group. Similar approaches may help to pro- tings across cultures. Pham et al.8 found that mote reconciliation in Cambodia. Rwandans who met the PTSD symptom cri- teria “were less likely to support the Rwandan Additional factors challenging national trials, to believe in community and the reconciliation process in Cambodia to demonstrate interdependence with other How soon a postconflict country is able to ethnic groups.8” Likewise, Lopes Cardozo et reconcile and reconstruct depends on vari- al. argued that mental health problems related ous factors, including the nature of the con- to the war in Kosovo needed to be addressed flict, the present-day situation of the society, in order to re-establish a stable environment and the manner in which the society deals in the territory.28 with its past. As noted above, poverty and Despite the availability of effective ap- corruption in present-day Cambodia may proaches for treating postwar mental health fuel a sense of injustice and mistrust in the problems, there have been few attempts current government, thus hindering recon- to implement treatment for Khmer Rouge ciliation. A society’s ability to deal with the victims in Cambodia or to evaluate the wounds of the past may be characteristic, efficacy of such treatment.56 In one Cam- having evolved from its unique historical bodian study by Leang, Andeth, Seang, & and cultural development. Cambodia was Chhim, participants showed reduced PTSD occupied and oppressed by its neighbour symptoms after receiving a form of cognitive countries at various times over the past behavioural psychotherapy.57 In addition, centuries. Nearly all artists and intellectu- their attitudes toward former perpetrators als in the country were killed during the became more positive and forgiving, and the Khmer Rouge years; critical thinking and tendency to take revenge decreased. asserting one’s rights were life-threatening The provision of treatment for Cambo- undertakings.59 To date, none of the perpe- dians with mental health problems is still trators of the Khmer Rouge genocide have very limited. Currently, there are only 32 been sentenced. Leuprecht has described psychiatrists working in the country.58 One the Cambodian situation as a “persistence well-known organization where people with of impunity.”60 After the UNTAC era, hun- mental illness can seek help is the Tran- dreds of nongovernmental organizations scultural Psychosocial Organisation (TPO). came to Cambodia trying to provide aid, It offers psycho-social education, self-help but also creating a culture of dependency.61 groups, counseling, and psychiatric treat- Against this historical background, it seems

Volume 21, Number 2, 2011 Volume ment. To our knowledge, trauma-focused plausible that Cambodian society lacks the psychotherapy is not currently available in self efficacy-beliefs and intellectual resources ORTURE

T Cambodia. needed to restore justice with the aim of 81

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coming to terms with the past. Cultural to have major benefits for social co-existence issues also influence how individuals in a Cambodia.4 society cope with adverse feelings such as anger. In Buddhism, displaying anger and References expressing private thoughts and inner feel- 1. De Jong JTVM, Komproe IH, Van Ommeren ings openly means loss of face. It is thus M et al. Lifetime events and Posttraumatic Stress Disorder in 4 postconflict settings. JAMA 61 desirable to avoid anger. Yet, not being 2001;286:555-62. able to express anger can delay the grieving 2. Field N, Chhim S. Desire for revenge and at- process. Murrell (p. 148) points out that the titudes toward the among Cambodians. J Loss Trauma 2008;13:352-72. decades-long Cambodian reluctance to hold 3. Lane RC. The revenge motive: a developmental a war crimes trial may be related to the “fear perspective on the life cycle and the treatment of unleashing so many memories with the process. Psychoanalytical Review 1995:82(1):41- result that many of its peoples would lose 64. 61 4. Staub E, Pearlman LA, Gubin A et al. Heal- face.” ing, reconciliation, forgiving and the prevention of violence after genocide or mass killing: An Conclusion intervention and its experimental evaluation in The process of reconciliation in postconflict Rwanda. J Soc Clin Psychol 2005;24:297-334. 5. Galtung J. After violence, reconstruction, recon- countries such as Cambodia requires action ciliation and resolution: coping with visible and on several levels. An important challenge invisible effects of war and violence. In: Abu- on the political level is to combat poverty Nimer M, ed. Reconciliation, justice and coexist- and corruption, which can fuel a sense of ence: theory and practice. New York: Lexington Books, 2004:3. injustice and mistrust in society, potentially 6. Bar-Tal D. Conflict through conflict resolution to giving rise to violence. On the legal level, reconciliation: Psychological analysis. Polit Psy- the establishment of the ECCC represents a chol 2000;21:351-65. first step in paying public tribute to the vic- 7. Crocker DA. Forgiveness, accountability and reconciliation. Perspectives on Ethics and Inter- tims of the Khmer Rouge regime. To instill national Affairs 2000;2(7):13-4. a sense of justice to the Cambodian people 8. Pham PN, Weinstein HM, Longman T. Trauma and to foster reconciliation, the tribunal’s and PTSD symptoms in Rwanda. JAMA 2004;292:602-12. work must be fair, transparent, and access- 9. Lederach JP. Building peace: sustainable recon- ible to the public. Community-building on ciliation in divided societies. Washington, DC: an individual basis is equally important for Institute of Peace Press, 1997. social healing and reconciliation in society. 10. Rasmussen JL. Negotiating a revolution: toward integrating relationship building and reconcili- It is thus vital to further promote history ation into official peace negotiations. In: Abu-

teaching in schools. Rituals, ceremonies, and Nimer M, ed. Reconciliation, justice and coexist- T memorials help individuals to deal with the ence: theory and practice. New York: Lexington ORTURE losses of the genocide and should be culti- Books, 2001:101-27. 11. Stoop D, Masteller J. Forgiving our parents, Volume 21, Number 2, 2011 vated. Finally, concerted efforts should be forgiving ourselves. Healing adult children of made to increase the provision of therapeutic dysfunctional families. Ventura, California: Regal approaches focusing on trauma reprocess- Books, 1991. ing and the activation of future-orientated 12. Stammel N, Knaevelsrud C, Boettche M et al. Reconciliation and mental health in traumatized resources. The integration of interventions victims of human right violations. Presentation such as the one developed by Staub et al. to at the International Congress of Psychology, July target both healing and reconciliation in reg- 2008, Berlin, Germany (unpublished). ular health care provision can be expected 13. Crocker DA. Reckoning with past wrongs: a nor- 82

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