Vamık D. Volkan, M.D., DLFAPA, FACPsa.

 
 
 
 
INTERNATIONAL INDEPENDENT RESEARCH AND EXCHANGE BOARD (IREX) PROJECT
 
FINAL REPORT  
 
 
July 2002
 
  
 
 
 
 
 
IREX BLACK AND CASPIAN SEA COLLABORATIVE RESEARCH PROGRAM:
GENDER ISSUES AND FAMILY VIOLENCE:
PUBLIC AWARENESS AND SERVICES TO VICTIMS
 
 
 
 
 
   
Prepared by
Vamık D. Volkan 
  
 
 
In collaboration with:
 
Nino Makhashvili, M.D. (Georgia) 
 
Nodar Sarjveladze, Ph.D. (Georgia)
 
Işıl Vahip, M.D. (Turkey) 
 
Madinna Gazzaeva (South Ossetia)
 
Özge Doğanavşargil M.D. (Turkey) 
 
 
 
Center for the Study of Mind and Human Interaction (CSMHI)
University of Virginia, Charlottesville, VA  22908
 
 
 
 
 
 
  
 

A- Background information concerning the project:
 
Goals of the project:
This project aimed to draw profiles of victims and perpetrators of family violence in Turkey, Georgia, South Ossetia (with references to similar situations in Armenia and Abkhazia) by the collaborative research of participants from the above mentioned locations and experts from the Center for the Study of Mind and Human Interaction, at the University of  Virginia, Charlottesville, Virginia, USA.
 
This project also focused on the  cultural barriers to examining family violence, especially violence directed towards women and children in the above locations.
 
Finally, the project’s longer-term goal was to encourage further collaborative research in the Black Sea and Caspian Sea regions and to aid in the development of multi-disciplinary task forces and/or organizations to bring the victims’ painful experiences and cultural dilemmas to public awareness and to generally increase open public discussions of family violence-related issues. 
 
 
Meetings:
Thanks to the additional support for lodging and travel provided by Ege University, Izmir, Bilgi University, Istanbul and the UN. authorities stationed in Abkhazia, we were able to hold three rather than two meetings as originally planned. 
 
The first meeting took place from November 11th to November 16th, 2001 in Izmir, Turkey. Representatives from the USA, Turkey, Georgia and South Ossetia were participants.
 
The second meeting took place from March 10th to March 14th, 2002 in Tbilisi, Georgia. Representatives from the USA, Turkey, Georgia, South Ossetia, Armenia and Abkhazia were participants. 
 
The third meeting took place from June 15th to June 19th, 2002. Representatives from the USA, Turkey, Georgia and South Ossetia were participants. 
 
 
Core collaborators:
 
 
From Georgia: 
 
Nino Makhashvili, Psychiatrist, Georgian Center for the Rehabilitation of  Torture Victims (GCRT) and Saphari (Women’s Shelter) (F).
 
Nodar Sarjveladze, Psychologist, Foundation for the Development of Human Resources (FDHR), Georgia (M).
 
Jana Javakhishvili, Psychologist, FDHR, Georgia (F).
 
Zurab Beberashvili, Psychiatrist, GCRT and Saphari (M).
 
Lela Tsiskarishvili, Medical Student, GCRT and Saphari (did not attend the first meeting) (F).
 
Rezo Jorbenadze, Psychologist, Tbilisi State University, Georgia (attended only the second meeting) (M).
 
 
From South Ossetia:  
 
Madinna Gazzaeva, Psychologist, South Ossetia State University (F).
 
Irina Yanovskaya, Journalist for Human Rights (F). (attended only second meeting).
 
Fatima Turmanova, TV – IR (F) (attended only second meeting).
 
Gana Yanovskaia, Journalist for Human Rights (F). (attended only second meeting).
 
 
From Armenia:     
 
Dina Manukian, Psychologist, Millennium Association for Education and Research, Armenia (F). (attended only the second meeting).
 
Tsatourian Irina, Lawyer, Millennium Association for Education and Research (F). (attended only the second meeting).
 
 
From Abkhazia:
 
Logua Khatuna, Abkhazia, a NGO leader, Sukhumi (attended only second meeting). (F).
 
 
From Turkey:        ,
      
Işıl Vahip, Psychiatrist, Ege University, Izmir (F).
 
Zehra Çalışkan, Social Worker, Ege University, Izmir (F).
 
Özge Doğanavşargil, Psychiatrist, Ege University, Izmir (F).
 
Çağdaş Eker, Psychiatrist, Ege University, Izmir (M).
 
 
From USA:    
 
Vamık D. Volkan, Psychiatrist, University of Virginia, Center for the Study of Mind and Human Interaction (CSMHI).
 
Ali Gallagher, Lawyer and Psychoanalyst. (attended the preparatory meeting in Tbilisi).
 
Kerry Leavitt, Social Worker, CSMHI. (attended only second meeting).
 
Lisa Aronson, Lawyer, Social Worker and Psychologist, CSMHI. (attended only the third meeting).
 
 
From Sweden:          
   
Birgitta Johansson, Psychiatrist, CSMHI and World Health Organization (WHO). (attended only the first meeting).
 
 
Other participants:
 
Besides the core collaborators, others also participated in at least one of the meetings and assisted the core collaborators with their work on the project between the meetings. 
 
Attendees at the Izmir Meeting:
 
Leyla Baysan, Nurse, Ege University. (F).
Tirhan Baykal, Psychologist, Ege University. (M).
Seval Sekin, Director, Women’s Studies Center, Ege University. (F).
Müge Kocadere, Psychologist, Ege University. (F).
 
Attendees at the Tbilisi Meeting:
 
The Georgian Ombudsman.
The Georgian Commissioner of Mental Health.
Leaders or Representatives of Eight Georgian Non-governmental Organizations (NGO) Dealing with Societal Issues:
Rusiko Bochorishvili, Social Worker, GCRT and Saphari (M).
Nino Kiladze, General Practitioner, GCRT and Saphari (F).
Maha Kortua, Nurse, GCRT and Saphari (F).
 
Also attending:
 
The Dean of Psychological Studies, Tbilisi University, and her colleagues and students.
 
Attendees at the Istanbul Meeting:
 
Işın Sayın, Psychiatrist (F).
Tolgay Özsoy, Psychiatrist (M).
Banu Büyükalp, Psychiatrist (F).
Mine Özgürlü, Psychiatrist (F).
Pınar Demiraslan, Psychiatrist (F).
Ayla Yazıcı, Psychiatrist (F).
Özdem Terbas, Psychiatrist (M).
Özlem Tuncay, Psychiatrist (F).
 
 
The above participants all belong to the Vamık D. Volkan Study Group of Psychoanalytic Psychotherapy in Istanbul, and each one of them presented a case history of family abuse which they had been studying in-depth on average one to two years.
 
 
 
B- Research on threats to extended family structure and violence:
 
Background on a qualitative approach to research:
Even they are geographical neighbors, there has been not much (if any) communication between Turkish mental health workers and social scientists and their counterparts living in Caucasus largely on account of the vast differences in their two previous political systems. Furthermore, the two groups’ education in the social sciences, psychology and their clinical foci have traditionally been quite different. Turkish professionals have adhered more closely to current Western teachings and systems while the Georgian, South Ossetian, Abkhazian and Armenian practitioners have adhered to systems based upon largely upon the models promulgated under the rule of the former Soviet Union.
 
Accordingly, the first priority of the initial meeting in Izmir was to help facilitate individuals from these different locations in getting to know one another and to better understand each other’s cultural perspective, especially vis-à-vis the social roles that women and children occupy in their respective mythologies, histories and present day societies.
 
During this first meeting, it also became clear we could benefit from taking a more qualitative approach to the research. We generally agreed that taking a more quantitative approach would be more difficult for the following reasons:
 
 
1- Psychological tests and measurements for mental health have not been fully standardized in Georgia or South Ossetia.
 
 
2- Little previous quantitative research on family violence has been done in these locations, so there is little foundation for further research.
 
 
3- In South Ossetia, there was a single psychologist, Madinna Gazzaea, not trained in statistical research.
 
 
4- Cultural resistance to our research topic was manifest in all locations. If the research depended upon quantitatively measurable responses to a standardized set of questions, cultural factors would likely have biased the results.
 
 
 
Accordingly, we took the approach of “qualitative research” (Bryman, 1994; Kvale, 1996; Miles, 1994; Rubin, 1995; Seidman, 1998), and utilized qualitative interviewing techniques and analysis of case studies in our research.
 
Qualitative research, unlike quantitative research, depends on less structured instruments-of-measure and is much more subjective since its methodology does not easily lend itself to the implementation of precise experimental controls. However, this lack of controls, if you will, yields more open-ended questions and provides far more descriptive detail on behavior. So, we came to the conclusion that investigating gender issues and family violence using qualitative research methods would give us the greater latitude we needed to pursue this culturally sensitive topic.
 
 
Our method:
 
The literature (see references above) describes at least one of the following methods as being utilized in qualitative research:
 
1- Detailed, open-ended interviews with subjects.
 
2- Direct observations of behavior.
 
3- Analysis of written documents.
 
 
 
We decided to rely upon “open-ended interviews” and case studies in conjunction with “formulation,” an approach taken from psychoanalysis or psychodynamic psychology which yields detailed interpretations of clinical findings according to an established knowledge of how the human mind develops and how human beings respond to trauma, both physical and psychological (e.g. beatings, rape, domination, oppression.) So, formulation is a kind of “formal theorizing.”
 
Our qualitative research depended particularly on core participants’ (and other consultants’) open-ended interviews and case studies. Put another way, Turks, Georgians, South Ossetians, (and at one meeting Armenians and one Abkhazian) would report cases of victims as well as perpetrators of family violence. Then, we would arrive at formulations for each case, collect data on individual and shared findings and reach conclusions via consensus.
 
It should be noted, the success of qualitative research relies heavily upon the training and level of expertise of the person who is conducting the in-depth interviews or treating the subjects. To further facilitate this qualitative research, CSMHI provided the meeting participants with specific topics to be asked of each subject. CSMHI also focused on teaching the methodology of interviewing and of deriving formulations. CSMHI’s teaching took the form of conducting interviews and presenting formulations of previously studied cases. (See: Volkan, 1997; Volkan and Hawkins, 1971, 1972 for a detailed examination of how a “formulation” is derived and how it can be taught).
 
Turkish and Georgian core participants belonged to organizations where facilities existed for subjects to come to be interviewed in a therapeutic environment; South Ossetians participants did not benefit from having similar organizations in their location. So, they were assisted in the development of a team of interviewers, under the direction of Madinna Gazzaeva, to develop techniques and methods for a suitable therapeutic environment in which to carry out their work.
 
 
Collecting information:
 
The “standardized” information collected from each subject would include the following:
 
1- Identification of the subject:
 
a-     Gender
b-     Age
c-     Place of birth
d-     Level of education
e-     Occupation
f-      Social class
 
 
2- Presenting problems, signs and symptoms of the victims (or perpetrators.)
 
 
3- The history of most recent family abuse and traumas:
 
a-      Physical abuse, beatings
b-      Sexual abuse
c-      Restriction of autonomy
d-      Others
 
 
4- The history of similar abuse and trauma throughout the subjects’ life.
 
 
5- Childhood family structure:
 
a-      Parents
b-      Grandparents
c-      Siblings
d-      Other relatives
 
 
6- The accounts given by the abuser of his victimizing behaviors.
 
 
7- History of the subject’s family, especially its customs and traditions.
 
 
8- Threats to the family structure:
 
a-      Deaths
b-      Disease and famine
c-      Forced or voluntary migrations
d-      Ethnic conflicts and wars
e-      Changes in the political system
f-       Influnces of “globalization” and confusion in identities.
 
 
9- The subjects’ personal history during the “developmental” years (ages 0-13), that period of time when one’s core personality develops and crystallizes. Factors such as being a planned and wanted child vs. being an unplanned and unwanted child are given strong weight along with the following trauma in each developmental year:
 
a-      Loss of a parent or other adult relative
b-      Birth or death of a sibling
c-      Mother's illness
d-      Subject's physical illnesses and accidents
e-      Abandonment
f-       Beatings
g-      Sexual abuse
h-      Incest
i-       Divorce
j-       Migrations
k-      Poverty
l-       Others
 
 
10- Childhood symptoms including the following:
 
a-      Bed wetting
b-      Recurrent dreams and nightmares
c-      Phobias
d-      Anorexia
e-      Separation anxieties
f-       Others
 
 
11- Observable manifestations of childhood trauma in adult behavior (e.g. a person who was beaten and humiliated as a child reproducing similar behaviors in the adult years as a parent.)
 
 
12- Subject’s relations with his/her own children.
 
 
13- Support structures within the family for victims of violence.
 
 
14- Support structures within the family for perpetrators of violence.
 
 
15- Societal complicity or intervention in family violence.
 
 
 
Number of cases:
 
The total number of cases studied was 49. 
From Turkey: 18 cases (including 7 cases from Vamık D. Volkan Study Group of Psychoanalytic Psychotherapy.)
From Georgia: 16 cases.
From South Ossetia: 15 cases.
 
 
During the Tbilisi meeting, we also examined one case from Abkhazia and two cases, with video presentation, from Armenia. At each meeting, cases were presented to all core collaborators and consultants in attendance. Particular cases were then selected for in-depth discussions and further teaching and illustration of interview techniques, formulation and data collection. Of  the 49 cases, most of the victims were either women or female children. In two cases, men were the victims and in another two cases, boys were the victims. There were also two cases relating to perpetrators rather than victims: in one case, a female victim herself become a perpetrator and a role reversal took place where she would regularly administer beatings to her husband.
 
 
Analysis of data:
 
Each case is then analyzed from three perspectives:
 
1- Personal (individualized) reasons for being involved as either a victim or perpetrator of family violence. Examples: developing a masochistic personality organization and then illogically seeking abuse due to the perception that to be loved is to be abused; developing a sadistic personality organization due to the perception that if you hurt others you will avoid humiliation.
 
2- Cultural and societal influences which give de facto support to family violence.
 
3- What each case can tell the investigator about the educational/social/political strategies which should be developed to combat the family violence in each location.
 
 
 
Present researchers postulated that family violence occurs in every society around the globe, including American, Swedish as well as Turkish, Georgian and South Ossetian societies. Combining both CSMHI’s experts’ in-depth clinical experiences with individuals with a history of family abuse, both victims and perpetrators, and well as a review of the psychiatric literature, yields a fairly complete picture of the etiology of family violence and the psychology of victimization. Antecedents associated with family violence and abuse include: not having an early nurturing environment, experiencing early childhood traumas and humiliations (Kramer and Akhtar, 1991; Levine, 1990; Rothstein, 1984; Shengold, 1989) and developing character traits in which aggressive and sexual acts are experienced as temporarily enhancing the subject’s self-esteem. (Kernberg, 1984; Volkan and Ast, 1994).
 
So, researchers assume that cases from Turkey, Georgia and South Ossetia, as well as Abhkazia and Armenia, are no different in the individualized qualitative factors for behavioral outcomes than cases from the USA or Sweden. What took on particular importance to our research was the focus upon location-specific cultural and societal factors which either increased or reduced the likelihood of family violence; these same factors were then compared for Turkey, Georgia and South Ossetia.
 
 
Focus of the qualitative research:
 
Extended family:
The most prominent finding related to societal factors as precursors to family violence, especially the influence exerted by threats, including ethnic wars, migrations from rural areas to urban areas and poverty, to the existing extended family structure in all locations studied. While there are significant differences in language, religion and family myths among Turkish, Georgian and South Ossetian societies, they all share the common influence of extended family structure. Each extended family includes a number of related persons all housed in the same dwelling or home. This structure is especially strong in the rural areas, but also continues in modified ways after rural-urban migrations occur and within indigenous urban families. (Özbek and Volkan, 1976).
 
In an extended family, one family name (the bride receives the groom’s family name) identifies a number of different individuals, all of whom are supposed to have recognizable family characteristics –behavioral as well as physical– in common. Some families have a reputation for generosity, for example, and others for greed. And members are expected to refrain from asserting individual deviance from the family style. They share one another’s emotional, social and economic problems, presenting a united front to the world. But, there is always the potential for intra-family violence. Uncertainly concerning the boundaries dividing one member from another tends to engender aggression. If the extended family structure is functioning well and every member knows his or her role, then aggression is either channeled or suppressed. However, if the extended family structure is threatened - then violence may erupt. 
 
Sometimes, members unconsciously “pick” a specific individual to be the family scapegoat. He or she becomes like a lightening rod, receiving and absorbing the frustrations and anger of other members, thus enabling the survival of the extended family. When the family structure is dysfunctional, other members may not only physically or sexually abuse the unfortunate victim, but may also intrude directly into the victim’s day-to-day life, usurping their autonomy. For example, in one case from Georgia, when a couple gave birth to a child, the mother-in-law would frequently enter the couples’ bedroom where the baby also slept – without either knocking at the door or otherwise announcing herself - thus violating the privacy and personal space shared by her son and daughter-in-law. 
 
Variations in cultural and social customs within the locations studied include, for example, in South Ossetia (also in Abkhazia) a bride will not directly speak to her father-in-law. Rather, she speaks to her child and might say “We need bread.” The father-in-law then hearing this goes out and brings back bread to the family. Only after the bride has a male child, does she earn the “right” to address her father-in-law directly. Another example, in Abkhazia, if an animal is beforehand sacrificed, the bride and father-in-law are allowed to break this taboo for a short while. 
 
However, there is no parallel custom for sacrificing animals in Turkish, Georgian or South Ossetian extended families. Significantly, in all of these societies - a new bride’s giving birth to a male child firmly establishes her place in the extended family structure of her husband’s family. In Turkey, where the Islam religion dominates, if a wife does not bear a male child - the husband often takes a second “wife,” which is an illegal but accepted practice in the rural areas based upon the old Muslim custom of taking up to four wives. In the remote southeast and eastern regions of  Turkey, about ten percent of women are in polygamous marriages, even though as noted this practice is illegal (From: Women’s Rights in Turkey, International Herald Tribune, June 20, 2002, p.10). In Georgia or South Ossetia, the custom would be that the husband would divorce his wife and marry again with the hope that the second wife would give birth to a male child.  In all societies studied, the mother-in-law as well as sister(s)-in-law compete with the new bride thus dividing the groom’s family loyalties from the onset. Although on the surface, the extended Turkish, Georgian and South Ossetian families are male-dominated, a closer examination will reveal that the mother of the male head-of-the-family is actually the one who determines the emotional climate. An old Turkish expression states, for example, that: “Heaven and Hell lie at the feet of the mother”  (Özbek and Volkan, 1976).
 
This is not to say that extended, or modified extended family structure is the direct cause of family violence. In fact, when it is not threatened, this structure acts as a social support system, creating a sense of belonging for all family members by defining their specific social roles within the extended family. However, as the following summary shows, extended family structures based upon strong cultural traditions have the potential to give rise to family violence when they are threatened.
 
 
Case samples:
The following brief case vignettes are presented here only to illustrate the kind of subjects examined by the collaborators. The focus is on a description of the threats to the extended family structure. We neither provide a detailed account of personal or individualized reasons for involvement in family violence nor give a detailed formulation concerning the cases:
 
1- This case illustrates how the Georgian-South Ossetian war (1991-1992) threatened the existing structure of a family in Tskinvali:
Salina is a Russian woman married to a South Ossentian who before the war was relatively rich in South Ossetian terms. They have two children. According to family tradition, a wife lives with the husband’s extended family. After the war, therefore, when Salina’s husband left for Moscow to find work, she had to go live with her husband’s family. Because she had no money, she opened a stand and began selling things to make money. But, according to tradition, a woman who works with the public is a “loose” woman, and Salina was perceived as such, despite the fact that in reality she had been loyal to her husband. Her husband’s family contacted the husband in Moscow, where he had a lover, with details of his “loose” wife. Eventually, they made the wife leave the house, but kept her children. Salina then went to live in the suburbs, but she would occasionally return to Tskhinvali to gaze at her children from afar. Later on, when the husband returned from Moscow and they tried living together again, he beat her severely leaving her little recourse other than acceptance of her mistreatment. She eventually contacted Dr. Gazzaeva, but since this is South Ossetia, there are no laws relating to family violence and her only resource became an overworked psychologist, who could provide her with neither money, a job, nor legal advise. (Reported by South Ossetians. Salina still is a client of the South Ossetian team.)
 
2- This next case also illustrates the influence of ethnic conflict upon the stability of the extended family structure:
Here too, unemployment and poverty were direct by-products of ethnic conflict. Ia, age 25, is a married woman with one male child. Ia became an internally displaced person (IDP) on account of ethnic conflict. That was 10 years ago. After losing everything their home and social surroundings, and experiencing terror and profound helplessness, the family moved to a IDP community near Tbilisi and tried to reestablish their extended family structure.
 
However, every member of the family had suffered past trauma, e.g. Ia’s husband became an alcoholic. Prior to her family’s forced migration, Ia recounted that her husband had been the opposite of her strict father: “very tolerant and appreciative of my femininity and sexuality.” After they became IDPs, Ia again became pregnant and had a daughter who is now 7 years old. As IDPs, they lived in a small three-room flat which provided housing not only for Ia, her husband and their two children, ages 13 (son) and 7 (daughter), but also for her mother-in-law. And since the mother-in-law considered herself to be the head of the family, she began demanding that Ia become more obedient to her husband. The mother-in-law also behaved as if she possessed her son and treated Ia as an intruder into their relationship. The mother-in-law’s complaints to her son about her daughter-in-law eventually resulted in the husband subjecting his wife to beatings, something which had not occurred previously. (Reported by Georgians).
 
3- The following case illustrates sexual abuse by a young “uncle” within the Turkish extended family:
It also illustrates the transgenerational transmission of abusive behavior. Raziye, now age 26, lived in an extended family in a southern Turkish town. Besides her parents and younger brother, her paternal grandparents and a step-uncle (father’s step-brother) also lived with her in the same household. The paternal grandmother frequently competed with Raziye’s mother making her so unhappy that she could not emotionally nurture her own daughter. Raziye was “picked” by other members of the extended family to be the target of everyone’s frustrations and anger, i.e. the scapegoat.
 
As long as family members abused her, they kept their frustrations and anger under control amongst themselves. Raziye was sexually abused starting at age 5 by her “uncle.” She felt very ashamed.  But the dynamics of the family would not allow her to speak openly about this to anyone. In fact, other family members maintained a “wall of silence” around Raziye. As the family scapegoat and primary target of frustrations within the family, both her mother and grandmother began complaining daily about Raziye’s behavior, starting in early childhood. She received frequent beatings by her father. And if the father tried to beat Raziye’s brother, the grandmother would intervene to prevent the beating of a male child.  
 
At age of 17, Raziye eloped with a man who became her husband. He took her with him to a big city where he became a lawyer. In this city, Raziye now lives with her husband and her 6 year old daughter; an extended family structure no longer exists.
 
But the previous trauma she had experienced within the extended family made its mark. Raziye came to seek help because she now experiences her daughter as a competitor and feels that her husband likes her daughter more than her, a reflection of her childhood experiences, where her brother was more liked than was she. This conflict with her own child, similar in form to her own mother competing with her mother-in-law, manifested itself in the physical abuse of her six year old daughter by Raziye. Her own violent behavior frightened her and this is why she decided to seek treatment. (Reported by the Turkish group).
 
 
 
Summary of research findings:
 
The qualitative data obtained from the 49 cases in our study found the following central factors were related to the question of the role played by extended family structure as a precursor to family violence:
 
1- Traditional extended family structure, by itself, does not cause family violence or dysfunction.
 
2- In a stable society, the extended family provides protection, support and rituals that keep individual anxiety in check and serves as a source of continuous identity.
 
3- When a society is destabilized by wars, ethnic tensions, social upheaval, urbanization, poverty, displacement of populations, or changes in the gender balance of the workforce (e.g. women obtaining a higher education or working outside of the home), aspects of the family structure which once strengthened the individual and group may suddenly become harmful or destructive. 
 
4- Family violence or dysfunction can emerge under the pressures of societal breakdown or be caused by pathological forces within the family itself; often these two causes are intertwined.
 
 
Our research illustrates that the following extended family conditions evolve as factors for family abuse, when the society is destabilized and/or when pathological forces within the family emerge:
 
1- The over-protection of the younger generation by the older generation increases when society is destabilized. In this situation, the older generation forcefully asserts its control over how the younger generation gets to live out its dreams and ideals. And as expected, when the younger generation fails to meet these expectations, the older generation may react with disproportionate anger and commit violence upon the younger generation.
 
2- In the extended family system, the mother-in-law typically holds a revered position of power. However, when the extended family is under stress, she may attempt to consolidate and further assert her power by controlling her son’s own immediate family: starting with his choice of bride and progressing to eventual mistreatment or physical abuse of her daughter-in-law. The mother-in-law may also openly compete against her daughter-in-law by creating new family alliances against this “new” woman whom she perceives as a threat to her dominance. In many cases, the mother-in-law is joined by her unmarried daughters, living within the extended family, in expressing direct violence against the daughter-in-law. This in turn can adversely affect the daughter-in-law’s mental health, interfering with her ability to parent and engendering child neglect or abuse on her part.
 
3- Transgenerational replication of patterns of family violence: when the abused wife herself becomes a mother-in-law, she may recreate the trauma she experienced at the hands of the mother-in-law by visiting violence against her own daughter-in-law and by directly or indirectly supporting her son’s violence against his bride.
 
4- According to the cultural norms at the locations in our study, if a wife does not produce a male child for her husband, her status within the extended family may be degraded and her husband may take additional “wives” or lovers in order to produce a male heir. This greatly diminishes the bonds of marriage with the first wife, creating a profound sense of helplessness and loss of hope on her part, affecting even her fundamental ability to parent and function within a family setting.
 
5- The ordinary balance between sexual repression and simulation in the family, as dictated by cultural norms such as having women cover the exposed parts of their bodies in the presence of men, may become destabilized when the family structure is under stress and lead to sexually proscribed behaviors or even extreme sexual violence.
 
6- The gender-based roles of power within the traditional extended family structure may become quite exaggerated under pressure. Under these conditions, the centrally powerful husband and mother-in-law’s interest in the wife may be overshadowed and usurped by the collective power of the male side of the extended family.
 
7- Often, if a husband goes to war or relocates in order to find employment, the wife is then forced to seek employment outside the home in order to survive economically. However, by doing so she breaks a fundamental custom of the extended family: “a mother’s place is in the home.” To make matters worse, when her husband eventually returns to the family, his mother may try and convince him the wife has become “loose” in his absence, because she was “away” from the home and her family while working; this is often considered sufficient justification for a husband to beat his wife.
 
8- When the traditions in an extended family are threatened, the presence of many young adult “uncles” and “aunts” exposes both female and male children to the possibility of sexual harassment and abuse.
 
 
  
Conclusions:
The collaborators in this study wanted to review the existing literature to see if our findings would add to an understanding of family violence in Turkey and Caucasia. In Turkey, research papers on family violence appeared scientific journals and were readily available. However, we could not find a similar body of research in Georgia and other Caucasian locations.
 
We examined ten Turkish research papers written within the past decade: (Yalın, Kerimoğlu, 1992; Yüksel, 1993; Canat, 1994; Çelikol, 1994; Yalın, Kerimoğlu and Erman, 1995; Avcı, 1995; Yalın, Avcı, Kerimoğlu and Aslan, 1995; Yıldırım, 1996; and Boratav, 2002). These papers provide statistical data on persons in distress who sought help from the various clinics. The data refer mostly to responses by the patients to medical background questionnaires administered at the time of their initial visits. Some of these papers include data from over one-thousand subjects.
 
The interpretation of data and findings in these papers focused largely on the symptomatology of the victims of violence, with limited attention also being paid to the perpetrators of violence. Their clinical symptoms were usually compared with the symptoms of victims and perpetrators recorded in the Western (e.g. USA) literature. Brief summaries of selected case studies were also reviewed. No clear picture emerged of the role played by individual members of the extended family. None of these papers drew the conclusion that threats to the structure of the extended family might be a major cause of family violence in Turkey and Caucasia. By contrast, the qualitative research and analyses in this report focus upon these broader questions, hopefully opening up new avenues of research into the causes of family violence.
 
At the meetings, Georgians, South Ossetians, Armenians and an Abkhazian agreed the collapse of the Soviet empire, and the ethnic wars and severe economic disruptions which followed, were instrumental in changing the roles of men and women within the modified extended family structures in their locations. In Turkey too, there has been an “ethnic war” (between Turkish Government and the PKK) and drastic changes in economic conditions. One example would be the voluntary and forced migrations of significant populations in all of these locations. In Georgia alone, there are over 300,000 Internally Displaced Persons-IDPs. Those who remained in their villages tried to maintain the traditional family structure, but severe poverty in these areas eventually forced women into the workforce, thus weaking the structure of the traditional extended family and transforming the socials roles of both women and men in these societies.
 
Furthermore, the effects of “globalization” upon cultures and societies worldwide have made it impossible to return to the family traditions of the past. It would seem then, that we must now pursue the ambitious goal of developing institutions which will foment a deeper understanding of the social effects produced by various threats to the structure of the extended family if we are to be successful in reducing the problem of family violence.
 
There is also a need to take more immediate steps to empower the victims of family violence, while the institutional adjustments to new social conditions take place. One example, of a creative approach to the dealing with the problems of the victims of family violence:
 
In a village near Izmir, where societal changes are palpable, it was commonly known that many women were being beaten and abused. However, when asked by an “outside” victims advocate to discuss their dilemmas and conditions – they withdrew and avoided further contact with this person since it was considered shameful to speak openly of these matters to strangers.
 
So, the outsider then decided to open up a kind of handicraft school in the village. This gave the abused women in the village a pretext to come to the “school” and get to know the helper and share their experiences. Slowly, the women of the village began to share their accounts of violent victimization. At the same time, the outsider educated the women as to their legal rights under the law.
 
After word of this unique approach was circulated at the first meeting in Izmir, a similar approach was successfully implemented in Tskinvali, South Ossetia.
 
 
 
Note: Prior to the start of our research, the first women’s shelter (known as “Saphari”) had opened in Tbilisi. Our teaching the techniques of interview and data collection in conjunction with the contributions of collaborators seeking “creative approaches” to the problem of family violence had improved Saphari’s effectiveness. Participants from both Saphari and FDHR have already prepared a handbook dealing with trauma and psych-osocial assistance (Sarjveladze, et al, 2002).
 
 
This research makes it clear that more public education in Georgia, South Ossetia, Armenia, Abkhazia and Turkey about the structure of extended and modified extended families and the threats to them is required. There is also a need for education within certain professions: health care providers, lawmakers, police and teachers. Furthermore, there is a need to include the topic of family violence in civil society and democracy-building activities. New laws dealing with family violence and proper application of existing laws should also be given emphasis.
 
 
 
C- Dissemination of information and initiation of public discussion of family violence:
 
Denial of family violence and trial project:
In all locations, including Abkhazia and Armenia, there was public denial and a lack of acknowledgement of the existence of family violence. And while in Turkey, many laws exist to protect the legal rights of women and children, they are not effectively enforced. One significant research finding presented to all collaborators at the Izmir meeting by Leyla Baysan was that most of the one-hundred and 52 police officers working in a district of Izmir did not know how to “diagnose” or evaluate an abused child, though the policemen could see visible signs of physical abuse such as bruises on the child’s body.
 
One approach taken was to run a trial project in Izmir to see if the Turkish collaborators could effectively educate 500 police officers on recognizing the signs of family violence. Collaborators worked with Ege University’s Women’s Studies Center and also a group of lawyers associated with the Center. The teaching sessions were not effective when lectures were given by lawyers in large sections to 500 police officers. The police officers did not seem to want to invest in either listening or learning. So, the collaborators came up with the idea of dividing the police into small groups; here they conducted more intimate sessions with them under the leadership or co-leadership of the Turkish collaborators. While this approach was generally accepted, resistance still persists to teaching in small groups. The Izmir collaborators are also attempting to improve their overall teaching techniques.
 
The public perceptions of police in Georgia and South Ossetia are different from those in Turkey. In the former Soviet republics, the common image of police treatment is one of “you are guilty until proven innocent.” And because they wear a uniform, they must be inextricably bound to all other Government authorities. Therefore, they can never be trusted but must always be avoided. And traditionally, people have not relied upon the police to intervene in “domestic disturbances” or family matters. In fact, there are no present laws in these locations dealing specifically with family violence.
 
 
Breaking the taboo in Georgia:
 
Our initiation of a discussion on family violence in Georgia took a somewhat different tact. CSMHI took a two-pronged approach:
First, CSMHI gave public talks about family violence and sexual abuse at the Tbilisi University to large audiences. At the conclusion of the first lecture of approximately 300 people, comprised mostly of university professors from different departments and their graduate students, many senior faculty stood up immediately and loudly declared that there was no such thing as “family violence” in Georgia. They wanted to emphasize to everyone that Georgia was a different from other countries: the possibility of family violence was simply unthinkable. However, graduate students and some of the younger faculty in the audience eventually joined in the discussion and declared that family violence in Georgia was not only a possibility, but it might well be prevalent in their society. As the heated discussions continued, we took some satisfaction from the fact that we were able to break down a taboo against discussing such topics in a public place. In all, there were five lectures given at Tbilisi University by CSMHI experts to either large audiences or small groups of professors, graduate students and undergraduate students within the department of psychology.
 
Second, we arranged a smaller meeting in the Georgian’s Ombudsman’s conference room where the Ombudsman, the Commissioner of Mental Health and leaders or representatives of ten NGOs dealing with civil issues were present. President Eduard Shevardnadze had given an order on February 25th, 2000 for an “Action Plan on Combating Violence Against Women,” so Georgian authorities were obliged to listen to us.
 
The CSMHI’s two-pronged approach opened the way for many NGOs and university organizations, and even the media, to began a frank discussion about family violence in Georgia; we had broken the taboo. 
 
Other activities in Georgia:
Saphari’s involvement with the IREX Project brought the women’s shelter to notable public attention. Saphari’s reports of victim statistics and brochures also help to make the issue of family violence real. 
 
Since the IREX Project began, Saphari experts have appeared on television (Channel 1 and Channel Rustavi-2) to discuss issues concerning family violence. They also participated in five radio shows and published six newspaper articles on the same subject. Their other activities included: participation in four conferences on family violence, with one of these conferences being an international meeting with participants from Georgia, Armenia, and Ajerbajan, including representatives from the Georgia State Chancellery and the Georgian Ministry of Health, Labor and Social Affairs.
 
This group also prepared a “Handbook on Human Rights” for students of middle schools; this book promotes a culture of non-violence.
 
Saphari also conducted teaching seminars for 39 schoolteachers from Tbilisi (March-April, 2002) and 43 school teachers from Akhmeta and Pankisi, Georgia (May-June 2002).
 
Meanwhile, experts from FDHR gave one lecture on domestic violence for the staff of the Georgian National Institute on Addiction and three lectures to seventy-five medical students at the Tbilisi State Medical University and three lectures to ninety students at Tbilisi’s State University of psychology department - on the same topic. FDHR experts also participated in one radio show (Channel of Orthodox Christians.) 
 
Other activities in Turkey:
In Turkey, while there are many organizations actively engaged in open discussions of family violence at conferences and media events, there is still a good deal of resistance to discussing this issue in many places.
 
Representatives of 33 organizations met in Izmir on March 2, 2002, “Woman’s Day,” for a major conference which deservedly received media attention. CSMHI’s long-time friend and international associate Halina Kobecktaike, the Lithuanian Ambassador to Turkey, was a keynote speaker at the meeting. Also, our Izmir collaborators took an active part in the gathering of other relevant information which was presented to the conference by Dr. Işıl Vahip. This meeting received media attention (both television and newspaper coverage.)
 
In February 2002, Zehra Çalışkan spoke to an audience of nurses from the Ege University Hospital and in April, 2002, Dr. Işıl Vahip gave a lecture at the Turkish Psychiatric Association meeting on domestic violence. These two individuals with other Turkish collaborators also arranged a panel discussion at the Ege University in May, 2002 to expose other physicians and caretakers to this topic. Two papers by Dr. Işıl Vahip have been accepted for publication:
 
An NGO in South Ossetia:
An NGO was founded in Tskinvali, South Ossetia to deal with abused women. And while it kept in contact with collaborators at the other locations, support from the collaborators in Georgia and Turkey was especially crucial to its success. This organization was completely overwhelmed by requests coming mostly through anonymous telephone calls for information and assistance.
 
Swedish consultation:
A consultant from Sweden, Dr. Birgitta Johansson, an international associate of CSMHI and a consultant to the World Health Organization (WHO) informed collaborators from Turkey, Georgia and South Ossetia that Sweden had a serious problem with family violence and domestic abuse 22 years ago, and described how they dealt with the problem through legal channels and with the help of the media. Her presentation emphasized that there is no quick solution to these problems; the first step is to begin a social dialogue on the subject. Because the Swedish solution involved collaboration by the victims with police, it could not be easily generalized for use in Caucasia or even Turkey until such time as the democratization of these locations becomes further crystallized. 
 
New and continuing research:
All collaborators from Turkey, Georgia and South Ossetia expressed their desire to continue on with the qualitative research previously conducted and summarized in this report. They also devised a new qualitative research topic, expanding upon the findings of the initial research. It utilizes cultural proverbs reflecting society’s implicit “support” for family violence in its methods. Examples of such proverbs are:
 
 
“If you love your wife, you beat her” (Georgian, South Ossetian and Russian).
 
 
“A rose blooms at the place on the child’s body where his or her mother strikes the child” (Turkish).
 
 
“The person who cannot be tamed by words deserves a beating” (Turkish).
 
 
 
Turks and Georgians assembled a list of representative proverbs and began asking their subjects - teachers, university students, polices officers and journalists in each location – to answer certain standardized questions such as: “When was the last time you heard proverb, and what was the occasion of its use?”
 
Some data have already been collected. And when more become available, hopefully a clearer understanding will emerge of the ways in which culturally embedded family violence finds its expression within the structure of the extended family. 
 
Note: This study is on-going and will continue after the present IREX Project expires.
 
 
Further education for main collaborators:
In consulting with International Psychoanalytic Association, we were able to secure an invitation from them to Turkish, Georgian and South Ossetian collaborators to attend their newly opened Eastern European school: The Han Groen-Prakken Psychoanalytic Institute for Eastern Europe, teaching techniques of clinical interviewing and the psychodynamic approach to understanding of human problems. The first teaching session is schedule to take place in August, 2002 in Bulgaria; IPA has agreed to cover the lodging and meal expenses. 
 
Future considerations:
The biggest success of the year long IREX Project was to establish a remarkable working alliance and friendship among Turkish, Georgian, South Ossetian, as well as Armenian and Abkhazian collaborators; a diverse group of intellectuals from many different disciplines ranging from mental health to law. We hope this new alliance and network will become the nucleus of an intellectual and practical collaboration among neighbors in this part of the world. 
 
 
What is needed:
 
1- Systematic teaching program on family violence for certain professions in each society, such as heath care providers, lawmakers, police and teachers.
 
2- Inclusion of family violence related issues in civil society and democracy building activities such as the creation of new NGOs.
 
3- Emphasis upon legislating new laws against family violence and enforcement of existing laws.
 
4- Utilization of the media to disseminate information concerning family violence and help promote the above objectives.
 
 
 
 
 
 
   
 
 
REFERENCES:
 
 
1- Avcı, A. (1995.) Ailede Cinsel Sömürü (Intrafamilial Sexual Abuse). Çocuk ve Gençlik Ruh Sağlığı Dergisi, 2:147-151.
 
2- Bozatav, H. (2002.) Unpublished Research (Personal Communication.)
 
3- Bryman, A., and Burgess, R.G. (1994.) Analyzing Qualitative Data. London: Routledge. 
 
4- Canat, S. (1994.) Ergenlerde Aile İçi Cincel Taciz (Sexual Abuse of Adolescents in the Family.) Çocuk ve Gençlik Ruh Saglığı Dergisi, 1:18-22.
 
5- Çelikkol, A. (1994). İki Kızkardeşe Yönelik Üç Kuşaklık İnsest Olgusu (Incest Directed Against Two Sisters by Three Generations). Düşünen Adam, 7:47-49.
 
6- Kernberg, O. (1984.) Severe Personality Disorders: Psychotherapeutic Strategies. New Haven, CT: Yale University Press.
 
7- Kramer, S., and Akhtar, S. (Eds.) (1991.) The Trauma of Transgression. Northvale, N.J.: Jason Aronson.
 
8- Kvale, S. (1996.) Interviews: An Introduction to Qualitative Research Interviewing. København: Reit­zels Forlag.
 
9- Levine, H. (Ed.) (1990.) Adult Analysis and Childhood Sexual Abuse. Hillside, N.J.: Analytic Press.
 
10- Miles, M.B., and Huberman, A.M. (1994.) Qualitative Data Analysis. Newbury Park, CA: Sage.
 
11- Özbek, A., and Volkan, V.D. (1976.) Psychiatric Problems within the Satellite-Extended Families of Turkey. American Journal of Psychotherapy, 30:576-582.
 
12- Rothstein, A. (Ed.) (1984.) The Reconstruction of Trauma: Its Significance in Clinical Work. Madison, CT: International Universities Press.
 
13- Rubin, H.J., and Rubin, I.S. (1995.) Qualitative Interviewing: The Art of Hearing Data. Thousand Oaks, CA: Sage.
 
14- Sarjveladze, N.; Beberashvili, Z.; Javakhishvili, D.; Makhashvili, N., and Sarjveladze, N.; Kharashvili, J. (2001.) Trauma and Psychosocial Assistance.
Tbilisi, Georgia: TUTU Publishers.
 
15- Seidman, I. (1998.) Interviewing as Qualitative Research: A Guide For Researchers in Education and the Social Sciences. New York, NY: Teachers College Press. 
 
16- Shengold, L. (1989.) Soul Murder. New Haven, CT: Yale University Press.
 
17- Volkan, V.D. (1997.) A Methodology of Integrating Information in a Psychoanalytic Biography. Mind and Human Interaction, Vol.8:82-100.
 
18- Volkan, V.D., and Hawkins, D.R. (1971.) A "Fieldwork" Method of  Teaching and Learning Clinical Psychiatry. Comprehensive Psychiatry, 12:103-115.
 
19- Volkan, V.D., and Hawkins, D.R. (1972.) The "Learning-group". The American Journal of Psychiatry, 128:1121-1127.
 
20- Volkan, V.D., and Ast G. (1994.) Skektrum des Narziβmus. Göttingen: Vandenhoeck and Ruprecht.
 
21- Yalın, A.; Avcı, A.; Kerimoğlu, E., and Aslan, H. (1995.) Çocuklarda Fiziksel Örselenmenin Ankara ve Adana İllerinde Görülme Sıklığının Taranması
(Screening the Incidence of Psychical Abuse of Children in Ankara and Adana). 3P  Dergisi, 3:39-43.
 
22- Yalın, A., and Kerimoğlu, E. (1992.) Survey of Battered Children in Two Elementary Schools. Journal of Ankara Medical School, 14:334-343.
 
23- Yalın, A.; Kerimoğlu, E.; Erman, H. (1995.) Okul Öncesi Çocuklarda Cinsel İstismari Önleme Programı (A Program to Prevent Sexual Abuse Against Pre-schoolers). 
Çocuk ve Gençlik Ruh Sağlığı Dergisi, 2: 19-27.
 
24- Yıldırım, İ. (1996.) Eşi Dayak Atan Evli Bireylerin Özellikleri (The Characteristics of Married People Beating Their Spouses). 3P Dergisi, 4:108-115.
 
25- Yüksel, Ş. (1993.) Ensestin Tanımı ve Değerlendirmesi (Diagnosing and Evaluating Incest). Nöropsikiyatri Arşivi, 30:352-357.
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
    
 
 
 
 
 
 
 
 
 
         
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                                             
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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