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

 
 
 
 
 
REDUCING TRANSGENERATIONAL TRANSMISSION OF ETHNIC CONFLICT:
A MODEL FOR THE REPUBLIC OF GEORGIA 
 
FINAL REPORT
 
October 1999
 
 
 
 
Prepared by
 
Vamık D. Volkan
 
 
 
 
Reporting Period:
 
September 1, 1998 - August 31, 1999
USA Institute of Peace Ref: USIP-107-98-S
 
 
 
Project Participants:
 
Vamık D. Volkan, M.D., Project Co-director
 
Yuri Urbanovich, Ph.D., Project Co-director
 
J. Anderson Thomson, M.D.
 
Gregory Saathoff, M.D.
 
Joy Boissevain
 
 
 
 
 
 
Center for the Study of Mind and Human Interaction (CSMHI)
University of Virginia, Charlottesville, VA  22908
 
 
 
 
 
 
 
 
 
Overview:
 
This is the Final Report of the Project (USIP-107-98S) Reducing Transgenerational Transmission of Ethnic Conflict:
A Model Program in the Republic of Georgia. In this project the University of Virginia's Center for the Study of Mind and Human Interaction (CSMHI) evaluated and enhanced the work of the Tbilisi-based Foundation for the Development of Human Resources (FDHR) with internally displaced or otherwise traumatized individuals, especially children, in Georgia and South Ossetia.
 
FDHR was founded in 1995 under the directorship of Professor Nodar Sarjveladze. Its core members are primarily psychologists and psychiatrists, and their activities have been funded for the past four years by the Norwegian Refugee Council (NRC.)
 
One of the NRC-funded programs is a collaboration between Georgian members of FDHR and South Ossetian psychologists and teachers from the Tskhinvali Youth Palace in South Ossetia. It is one of the few grass-roots efforts to promote meaningful interaction between Georgians and South Ossetians since the end of their 1990-92 war. The objectives of this Georgian-South Ossetian initiative are to reduce the psychological effects of ethnic conflict in 90 South Ossetian children and to build a working relationship between the Georgian and South Ossetian "caretakers."
 
CSMHI became involved because we perceived that indigenous mental health professionals, who have themselves been traumatized or exposed to exaggerated ethnic sentiments, need to work through their own emotions and reactions to the trauma in order to become more effective at treating others and at lessening societal ethnic tensions. This process of empowering the caretakers by helping them bring into the open their own unspoken conflicts and fears requires the facilitation of a neutral third party (CSMHI.)
 
During the grant period, September 1998-August 1999, CSMHI began developing a methodology of experiential training for indigenous caretakers that aimed to help them deal with their own experiences of ethnic trauma, and teach the combination of clinical and political understanding necessary to address the effects of trauma in others. In particular, our enhancement of the FDHR-Youth Palace program aimed to lessen the likelihood of children being carriers of ethnic hatred and perpetuating the trauma in the future.
 
By choosing the FDHR-Youth Palace program as the focus of our efforts, we were also able to strengthen the "folk diplomacy" initiated by these Georgians and South Ossetians. At the outset, deep mistrust and hesitations kept Georgian-South Ossetian interaction at a polite, superficial level. Through CSMHI's psychopolitical workshops, participants became more aware of the psychological obstacles between them and a foundation was laid for greater empathy and trust that could lead to a broader Georgian-South Ossetian dialogue process.
 
In addition to assisting with the FDHR-Youth Palace project, CSMHI conducted experiential and intellectual teaching activities with members of FDHR. During the three visits to Georgia in the grant period, we made numerous presentations on psychopolitical topics including childhood trauma, loss and mourning, transgenerational transmission of trauma, individual and ethnic identities, and the development of enemy images. Appendix 1 provides information on CSMHI personnel, our partners at FDHR and the Tskhinvali Youth Palace, as well as a list of contacts made in Georgia and South Ossetia. Appendix 2, is a bibliography of references used in this project. This report will describe the components of the model we are developing for assisting mental health professionals in traumatized societies. It is our hope that this approach can be applied to other regions torn by ethnic conflict and war.
 
 
 
 
 
 
 
 
 
BACKGROUND INFORMATION:
 
The Republic of Georgia, with a population of 5.3 million, located in the Caucasus region, is a society traumatized by bitter civil wars and ethnic conflicts. Repercussions from four recent events in particular still haunt the society. The first event was the massacre of 21 peaceful protestors by Soviet soldiers in Tbilisi on April 9, 1989. These protestors had gathered for a rally to express their wish for independence. The killings were perceived by the population as a tragic loss and had deep emotional impact.
 
On March 9, 1990, Georgia declared its sovereignty and one year later on April 9, 1991, adopted a declaration of independence under President Zviad Gamsakhurdia. The date April 9 was then transformed into a symbol of victory. On one level, this day of humiliation was transformed into a day of victory, but the wounds that Soviets (Russians) had inflicted on Georgians the previous year had not healed and became a source of nationalist solidarity.
 
Soon after the Republic of Georgia regained its independence, a conflict erupted from 1990 to 92 between Georgians and South Ossetians, during which the latter took steps towards their own independence. Approximately 40,000 Georgians who lived in South Ossetia were driven from their homes and remain to this day internally displaced persons (IDPs) in Georgia. About 100,000 Ossetians residing in various parts of Georgia also fled, mainly to North Ossetia. There has been little subsequent violence between Georgians and South Ossetians, but no political solution has emerged. The South Ossetia issue remains an additional unhealed wound among the Georgians.
 
As if ethnic strife were not enough, a bloody conflict erupted among Georgians themselves in December 1991 and January 1992. An opposition movement against President Gamsakhurdia rose up and eventually expelled him from Georgia. Eventually Eduard Shevardnadze became President. There has been no public investigation or truth commission regarding this civil war. People are still divided according to their sentiments toward Gamsakhurdia. The influence of this civil war remains yet another open wound, and people are quickly labeled on this issue.
 
Then came a war with the breakaway republic of Abkhazia, when Abkhazia declared its own independence. This war was particularly vicious. It caused a huge exodus of Georgians (300,000) who had lived in Abkhazia for generations and resulted in a generalized sense of humiliation and defeat among Georgians because they so outnumbered the Abkhazians, yet were quickly defeated and driven out. The Georgian IDPs from Abkhazia formed a "Government in exile", and since the end of the major war, skirmishes have erupted on and off, especially in the Gali region (see map p.2). Thus the Georgian refugees' hopes of victory and return are repeatedly raised and dashed, and thus these people are retraumatized over and over again.
 
In 1993, still another civil war erupted in western Georgia between the Zviadist party (followers of Gamsakhurdia) and those loyal to Eduard Shevardnadze. Divisions and tensions between Zviadists and others remain to this day and continue to affect the current political climate.
 
CSMHI's involvement with Georgia dates back to 1991, but has intensified during the past three years. 
 
Activities Prior to the USIP Grant Period (1991-1998):
In 1991, CSMHI received a visit from Georgia's then Foreign Minister, Giorgi Khoshtaria, who was concerned about impending conflict in his country. He had heard of our Center, and came to ask for our help. While we had no funds to take action right away, we left communications open.
 
When Eduard Shevardnadze became President of Georgia, our contacts continued and intensified. Tedo Japaridze, who had accompanied Khoshtaria to Charlottesville in 1991, was appointed Georgian Ambassador to Washington. We have kept in touch, and he has met with us in Charlottesville three times over the past few years.
 
In June 1995, Yuri Urbanovich (CSMHI's Georgian-born International Scholar) traveled to Georgia with Joyce Neu (Associate Director of The Carter Center's Conflict Resolution Program) for preliminary assessment of the situation and to consult with NGO leaders, scholars and government officials. Dr. Urbanovich speaks Georgian as well as Russian. In addition to interviewing Georgian refugees, Dr. Neu and Dr. Urbanovich attended meetings in Sukhumi (Abkhazia) and met with a variety of individuals at the Foundation for the Development of Human Resources (FDHR.)
 
In October 1995, once more with collaboration and funding from The Carter Center, CSMHI convened in Charlottesville twelve representatives from American NGOs for a "Strategy Session on Conflict Resolution in Georgia." The session's aim was to discuss existing initiatives to avoid duplicating effort in the future, and to further understand the realities in Georgia and the challenges facing those trying to help.
 
Building on Dr. Urbanovich's initial contacts in June 1995, we continued communicating with colleagues at FDHR and began to plan a joint project.
 
In April 1997, Yuri Urbanovich returned to Georgia for further assessment and project exploration. He met with members of FDHR and with a variety of scholars and government officials.
 
In December 1997, CSMHI faculty members were invited to be featured presenters at a Policy Forum at the International Research and Exchanges Board (IREX) in Washington, DC., on ethnic conflict in Georgia. Manana Gabashvili of FDHR also presented at the forum, and we consulted with her and with others about the situation in Georgia.
 
Georgian Ambassador Tedo Japaridze visited Charlottesville in January 1998, and was briefed on our plans for a joint project with FDHR. He expressed his approval and support of our efforts.
 
In May 1998, supported in part by a travel grant from IREX, Dr. Vamık D. Volkan (CSMHI Director), Dr. J. Anderson Thomson (CSMHI Assistant Director) and Dr. Urbanovich traveled to Georgia and engaged in a variety of activities to immerse themselves in, learn about, and assess the psychopolitical climate and societal realities in Georgia.
 
The CSMHI team conducted in-depth interviews with a wide range of people including IDPs, psychologists, teachers, government officials, university professors, students, writers, historians, and NGO representatives. We visited refugee hotels outside Tbilisi and in Gori and traveled to Tskhinvali, South Ossetia to meet with psychologists, teachers and children at a youth center there. The team visited homes and government offices, gave lectures at Tbilisi State University, and participated in the Noe Jordania International Conference on Georgia and the Caucasus, which had gathered scholars from around the world in Tbilisi to commemorate the 80th Anniversary of Georgia's First Period of Independence.
 
During this visit, CSMHI formalized its partnership with FDHR and held several intense meetings with its core group. FDHR has had over two-years' experience in psychosocial rehabilitation of IDPs and refugees, and undertakes both emergency and long-term intervention. Their work has been funded for the past several years by the Norwegian Refugee Council (NRC) in Tbilisi. In addition to working with Georgian IDPs near Tbilisi and in the Zugdidi region, FDHR has initiated a joint program with South Ossetian counterparts who do psychosocial rehabilitation with children and youth in South Ossetia. This collaboration is focused primarily on helping children recover from the trauma and preventing them from becoming carriers of ethnic enmity.
 
As noted in the box above, CSMHI faculty member Yuri Urbanovich traveled twice to Georgia prior to this project for observation, assessment, and networking, and the rest of the team kept up with events in other ways. CSMHI's meetings with high-level Georgian diplomats in Washington, DC. revealed significant denial of the impact of the traumas on their society. Since negotiations concerning oil pipelines through the Caucasus were underway at the time, officials' desire to promote Georgia as a suitable route for pipelines may have been the impetus for minimizing the effects of trauma there.
 
When the CSMHI team first traveled to Georgia in May 1998 (with funding from IREX), the signs of shared trauma were very visible. There remain 300,000 Georgian IDPs housed in various locations around Georgia. In and around Tbilisi, many of the IDPs have lived for the past seven years in former Soviet high-rise hotels which are now in relative ruins and filled to capacity, with laundry hanging over the balconies. Many of the IDPs were proud professionals in their former home areas: teachers, doctors, scholars, etc. Today, they are unemployed and live in poor conditions with little hope of returning to their former life. There are also other overt signs of societal deterioration. Beggars on the street, unthinkable in Soviet times, are now common. The suicide rate has also increased. In one city it has increased ten-fold.
 
Practically speaking, Tbilisi's infrastructure lies in complete disrepair. Roads are marked with potholes, buildings are decaying, and because of fuel shortages, electricity is cut off during the night for hours at a time. During the hot summer months, air conditioning is non-existent and window screens are absent. Heat is often scarce in the winter. Still, Georgians spoke of some improvement and of feeling safe once again in the city. The Government is credited with disarming bands of thugs that roamed the city during recent civil unrest.
 
The box below outlines trips and activities during the grant period that will be described in greater detail within the context this report. Further information on CSMHI team members and our partners at FDHR, as well as a list of contacts made in Georgia can be found in Appendix 1.
 
Activities during the USIP Grant Period (1998-1999):
 
October 30-November 5, 1998:
This first trip under the USIP grant allowed a two-person team (Volkan and Urbanovich) to build on the findings from the May 1998 assessment trip. During; this trip they were briefed: extensively by FDHR members on their various programs and tentatively identified areas of collaboration. As in May 1998, the team visited Tbilisi Sea, a refugee complex outside Tbilisi, and traveled with FDHR to Tskhinvali to meet with South Ossetian counterparts there. While at Tbilisi Sea the team met for a second time with members of the Balanchivadze family whom they had met the previous May. The team conducted a series of workshops with FDHR members, including a joint meeting with the South Ossetians.
 
March 12-19, 1999:
This second trip under the grant was made by a four-person team (Volkan, Urbanovich, Thomson, Saathoff.) They held additional workshops with FDHR and visited Tbilisi Sea where they again interviewed the Balanchivadze family. When they traveled to Tskhinvali (South Ossetia), they again held joint sessions with FDHR and South Ossetian psychologists and teachers. In addition, CSMHI had meetings with several South Ossetian Government officials to inform them of our activities and to seek their support and cooperation. Back in Tbilisi, CSMHI met with the Georgian Minister of Public Health, with a representative of the UN Office for the Coordination of Humanitarian affairs, and with the director of the UNHCR mobile team in Georgia. The team also gave a lecture on trauma, prejudice, and children at Tbilisi State University.
 
August 5-13, 1999:
The final trip to Georgia during the grant period was made by a three-person team (Volkan, Urbanovich, Thomson) in August 1999. Dr. Saathoff had been scheduled to go as well, but had to cancel at the last minute due to unexpected clinical obligations. The team made presentations at a conference in Tbilisi organized by FDHR entitled Society and Psychological Support and later presented a day of seminars on psychological topicsto the FDHR group alone. During the visit, CSMHI held several meetings with the FDHR group and interviewed the Balanchivadze family at Tbilisi Sea.
 
During this trip a crucial juncture in the Georgian-South Ossetian collaboration was also reached. Instead of traveling with the Georgians to meet in Tskhinvali, CSMHI invited members of the South Ossetian group to come to Tbilisi. With permission from South Ossetian officials, a group of South Ossetian teachers traveled to Tbilisi for the first time, to meet with FDHR and CSMHI. The CSMHI team also met with USAID staff to discuss CSMHI's ideas for continued involvement in Georgia. We were also approached by officials from the Georgian Ministry of Refugees and Accommodation who requested our assistance in designing a program to repatriate exiled Meskhetians back to Georgia.
 
Role of Mental Health Workers in Societal Rehabilitation:
Societies can be traumatized by a variety of causes. We speak of traumatized societies when external events occur that injure or affect a large part of the population directly, and the rest of the population indirectly. Individual and collective defense mechanisms are called upon to respond to the trauma, but if the trauma is too massive and its effects cannot be coped with emotionally, the end result is maladaptive adjustment, often on a large scale. When responses to a massive societal injury cannot be worked through, their influences tend to spill over to subsequent generations. Without being aware of it, children and grandchildren may be given "tasks" to deal with the effects of the trauma that their parents faced. Such tasks may include mourning losses, reversing helplessness, or taking revenge.
 
Among the causes of societal trauma, we can distinguish natural disasters (such as hurricanes and tornadoes), manmade disasters (such as the nuclear accident at Chernobyl), and finally ethnic or national conflicts, such as occurred in Georgia in the early 1990s. The sources of the trauma influence greatly how a society recovers from it and what kinds of measures may be helpful in the process of societal rehabilitation.
 
In this section, we will focus primarily on traumas caused by ethnic conflict. Such traumas lead to a sense of shared humiliation in addition to difficulties in mourning and feelings of helplessness. If conditions permit, the next generation may wish to take revenge on those whose relatives caused the original trauma. This transgenerationai transmission of trauma caused by ethnic conflict creates an atmosphere vulnerable to being enflamed into violence by certain types of political leaders. Therefore, it is this perpetuation of trauma that this project aims to prevent or mitigate in Georgia.
 
By way of context for our project activities with mental health professionals in Georgia, we will first describe four areas that we have identified where mental health workers can make significant contributions to a society that has been traumatized by conflict or other trauma. (See Appendix 3,  by Vamık D. Volkan's speech at an April 1998, UN. Conference.)
 
1- During the acute phase of a trauma, during and soon after the fighting, for example, crisis intervention is needed to help new refugees and others in the midst of the trauma. Normally such teams include those providing humanitarian aid in the form of security, shelter, food, water, and emergency medical treatment.
 
Researchers who have studied massive disasters tell us that, initially, 12-15% of the survivors of such trauma will show grossly inappropriate behavior, anxiety, and other obvious psychiatric signs and symptoms. Another 75% will be dazed, stunned, bewildered or will show signs of the so-called "Disaster Syndrome." This syndrome is characterized by an absence of emotions, peculiar indifference toward events, inhibitions, and an inability to make decisions (Ratnavale, 1983). Most of these people will reject psychological help while still in the crisis stage. This is because they have an emotional need to deny the tragedy and are subject to shame and guilt even if they are not aware of such feelings. When mental health workers can join such crisis intervention teams at this early stage, some acute mental disorders and the development of Post Traumatic Stress Disorder (PTSD) can be mitigated.
 
2- After the guns are silent, the killing has ceased, and large portions of the population have been displaced, many people, especially those who are directly affected, will develop Post Traumatic Stress Disorder (PTSD). With PTSD, internalized versions of the trauma remain in the victims' minds. They relive the trauma in nightmares, dreams, and daydreams. They may develop amnesia or become hypervigilant. When adults are anxious, even little children who do not understand what has happened suffer from anxiety.
 
It is often difficult to be specific about the proportion of people suffering from PTSD after the acute phase of the trauma is over because it has a variety of expressions, some of them hidden from observers. Expressions may also vary from culture to culture. When the trauma is massive, some degree of PTSD is inevitable. In Georgia, every internally displaced person (IDP) that the CSMHI team interviewed exhibited some degree of PTSD symptoms. Mental health professionals routinely assist international and indigenous organizations in dealing with such disorders.
 
3- After a massive ethnic trauma or war, societal changes occur. (Saathoff, 1995, 1996; Howell, 1993, 1995; Volkan, 1979, 1997, 1999c.) Some changes will be overt, such as increased criminality, prostitution, poverty, and the general breakdown of previously functioning institutions and economies. In South Ossetia, for example, we learned that since the war there has been a marked increase in drug use, sexual promiscuity, and prostitution among teenagers, phenomena which are bewildering to the adults and increase their sense of helplessness and rage.
 
There may also be hidden societal processes at work for which the diagnostic skills of mental health professionals can be very useful. For example, in Georgia since the conflicts, a split has developed within the society, with the settled Georgians devaluing those who have moved to their region as IDPs. There is little contact, social or otherwise, between these two groups. Even the schools are segregated with schedules in split shifts, so that Georgian IDP children attend at different times from non-IDP children.
 
Understanding such societal processes is important because mental health professionals can help develop programs to respond to the possible negative effects of such changes. For example, they can illustrate that integration of IDP and local children in schools may prevent perpetuation of the split between local Georgians and IDPs in general. Most importantly, they can deal with the resistance to this integration, which is a denial on the part of both IDPs and local Georgians. If IDPs promote integration, they are accepting their status as IDPs and the idea that they may never return to Abkhazia. If the local Georgians make a move for integration, they are admitting defeat in Abkhazia. The fact is that for nearly eight years the schools have been "segregated" and a generation of students is graduating. Because of the emotional denial involved, CSMHI found that this issue could only be raised by an outside party. If school integration can be achieved, it will be a major step toward healing the split between local Georgians and Georgian IDPs.
 
4- Mental health professionals are also in a good position to address and help mitigate the transgenerational transmission of trauma. When the effects of ethnic conflict are transmitted from one generation to the next, one can see the intersection of psychological and political dynamics. Subsequent generations become the reservoirs of the survivors' traumatic experiences. It is as if, unconsciously or consciously, new generations are given the task of reversing their parents' humiliation and helplessness, of mourning their losses, and even, if the environment is suitable, of acting on their parents' entitlement for revenge. These children who become carriers of ethnic hatred may have profound social and political impact when they become adults. If this source of their motivations and attitudes is not understood, neither will their seemingly irrational and dangerous beliefs and behaviors be understood. When such persons reach positions of political power or influence, their impact on the society is magnified.
 
Teaching indigenous caretakers about the concept of transgenerational transmission of trauma is crucial. The effects of massive trauma will continue for decades to come, long after outsiders like CSMHI have left. The indigenous caretakers should be taught now so they and their colleagues can recognize manifestations later when they become more apparent. One way to train them to recognize transgenerational transmission of trauma is to have them observe and participate in actual therapeutic interviews of several generations of a traumatized family, conducted by CSMHI. This participant/observer experience helps bring the concept to life, and shows how to identify traumatic effects as they exist in different generations. The ensuing discussion also begins a process for mitigating the spread to future generations.
 
 
FDHR'S PROGRAMS AND INITIATIVES:
 
CSMHI's USIP-funded project was carried out in collaboration with the Foundation for the Development of Human Resources (FDHR) in Tbilisi, Georgia and its director, Professor Nodar Sarjveladze. FDHR programs to assist and support IDPs and other traumatized persons are supported by the Norwegian Refugee Council. The goal of CSMHI's grant from the US. Institute of Peace was to enrich and enhance FDHR's programs.
 
During a trip in May 1998 sponsored by the International Research and Exchanges Board (IREX), CSMHI completed the initial diagnostic or assessment phase of this project. On this trip, CSMHI observed and was briefed on many of FDHR's initiatives. We determined that our partners were involved in each of the four areas described above, though they were at times unaware of some of these dimensions to their work. During the USIP grant period, CSMHI has been able to help the FDHR team articulate needs and focus more deliberately on areas where they had instinctively already begun work. The box below describes FDHR's programs as they respond to the four categories of intervention by mental health professionals outlined above.
 
 
FDHR'S PROGRAM AREAS: 
 
Crisis intervention:
Although the major Georgian-Abkhazian conflict has subsided, hostilities at the border flare up periodically. FDHR is involved in the resulting crisis situations trying to mitigate some of the immediate consequences of this continuing violence. During CSMHI's May 1998 trip, for example, a four-day war occurred in the Gali region (see map p.2). Some Georgian IDPs who had recently been allowed to return to Abkhazia were now being attacked once again and forced out of the region for a second time. These re-displaced Georgians were stranded in Zugdidi as refugees, and FDHR members traveled there to help with crisis intervention.
 
PTSD:
During other CSMHI visits, FDHR members were often dealing with PTSD patients, especially in the Tbilisi Sea area. This complex of dilapidated Soviet resort hotels currently houses 3,000 IDPs and is situated just outside the capital Tbilisi, overlooking a man-made lake. The physical beauty of this location is in stark contrast to the ruined state of the buildings and the hopelessness of their inhabitants. FDHR also frequently traveled to Gori, Stalin's birthplace, a city just south of the breakaway republic of South Ossetia, which has old hotels and apartments full of Georgian IDPs driven from their homes not many miles away in South Ossetia.
 
Societal changes:
FDHR members recognized some of the societal changes affecting the Georgian IDPs in Tbilisi Sea and elsewhere. These IDPs had lost the entire societal infrastructure with which they were familiar, and FDHR members became social guides for them as they tackled legal and social issues. The IDPs of Tbilisi Sea were a society where death at an early age had become routine. FDHR noted how this Tbilisi Sea society had become physically more vulnerable from their trauma. The whole community of 3,000 attended the frequent funerals, and FDHR wondered how to develop strategies to deal with these illnesses and the collective mourning that accompanied them.
 
Transgenerational transmission of trauma:
FDHR members were only dimly aware of the concept of transgenerational transmission of trauma, though their efforts instinctively aimed at preventing it. One of the side effects of trauma in children is withdrawal and difficulty in bonding with other people. In their programs with Georgians at Tbilisi Sea, FDHR members encouraged the children to play together and build relationships with each other. Although FDHR was successful in helping the Georgian children at Tbilisi Sea with their bonding process, CSMHI observed that they had more difficulty in encouraging children to speak of their hidden fears and to bring up anxieties passed on to them by their parents. Just before their collaboration with CSMHI began, FDHR had also begun working with South Ossetian colleagues to help traumatized South Ossetian children in Tskhinvali, the capital of South Ossetia. There, they noticed that the children were spokespersons of their parents' anxieties and feelings for enemy.
 
 
CSMHI'S ROLE:
 
 
Assisting traumatized mental health workers:
As shown above, CSMHI observed FDHR to be involved to some degree in all four areas where mental health workers are needed in a traumatized society. We believed that through the USIP grant we could enhance their work by increasing their awareness of the issues involved, and by conducting further clinical/psychopolitical training with them. But there was an additional major issue to be addressed which was one of the underlying premises of our proposal: The Georgian caregivers were themselves traumatized, and this affected their work.
 
Although only one of the eight FDHR core group members had been directly involved in the fighting, ethnic conflict affects all members of an ethnic group to some degree. When ethnic conflict flares up, it triggers greater cohesion of the group identity and greater investment in that identity by members of the group. Thus the group identity becomes prominent and can overshadow an individual's personal identity. Even individuals who fire no guns themselves keenly feel their group's victories and failures and respond in unison. (Volkan 1999a, 1999b).
 
When FDHR began working with IDPs, and especially with the traumatized children in South Ossetia, their own reactions to the trauma were reactivated more intensely. These Georgians felt isolated and were seen as traitors to their own group, because their friends and neighbors continued to see Georgian IDPs as reminders of the humiliation in Abkhazia, and the South Ossetians as enemies.
 
FDHR psychologists and teachers had received professional training from the outside since the conflicts, but no one had inquired about their own emotional challenges to their work. In fact, when CSMHI first invited them to talk about these challenges, FDHR members were surprised and relieved to begin unburdening themselves of the hidden aspects of their own trauma and isolation. More details on this process can be found below in the description of Workshops 1 and 2 (pp.15-24). As will be discussed later, all of the South Ossetian psychologists and teachers had been directly traumatized, since major fighting had occurred in Tskhinvali where they lived.
 
 
AREAS OF COLLABORATION:
 
After our initial evaluation of FDHR's effectiveness and of the overall psychopolitical situation in Georgia, CSMHI turned to the question of where to focus our efforts so as to be most helpful and effective given the limitations of time and funding. Determining an appropriate focus would have been impossible without the initial diagnostic period. From our first trip in May 1998, it became clear that the Abkhazia region was still too volatile to be practical (or feasible economically) for our kind of intervention.
 
We turned instead to the Georgian-South Ossetian relationship and to strengthening the effectiveness of FDHR and other caretakers through academic and experiential training. Our intervention under this grant focused on the following three areas:
 
A- Enhancing the joint FDHR-South Ossetian project already funded by NRC to help reduce transgenerational transmission of ethnic conflict to South Ossetian children (the main project.)
 
B- Beginning to develop a methodology for teaching mental health workers how to deal with traumatized society issues pertaining to crisis intervention, PTSD, societal changes, and transgenerational transmission of trauma (experiential teaching); Disseminating IDP-related psychological and psychopolitical information to as wide an audience as possible through lectures, seminars, meetings with decision-makers, and total immersion in the community (academic teaching.)
 
C- Preparing an atmosphere for a grass-roots level Georgian-South Ossetian psychopolitical dialogue.
 
 
All of these tasks depended on the success of the first, and therefore supporting the joint FDHR-Youth Palace program for South Ossetian youth became our principal focus. Since this program was already funded by the Norwegian Refugee Council, our involvement was an opportunity to enhance a project larger than our own funding alone could have supported. Because it crossed interethnic lines, the program faced many obstacles, but these were precisely the challenges CSMHI felt were crucial to long term progress. On the positive side, we could see that, because the program's objective was to help traumatized children, Georgians and South Ossetians were willing to come together despite all the obstacles for the sake of saving the children.
 
 
A- Joint Georgian-South Ossetian Program in Tskhinvali:
This youth program had its roots in a request from FDHR's principal sponsor, the Norwegian Refugee Council (NRC), who wanted to promote meaningful communication between Georgian and South Ossetian mental health workers. Accordingly, FDHR initiated contact with counterpart caretakers in South Ossetia. In 1996, they organized a week-long youth camp near the neutral city of Batumi for 16 Georgian and South Ossetian children accompanied by counselors from both groups. This was a first step to collaborative efforts between the Georgian and South Ossetian psychologists and teachers and an example of "folk diplomacy" to combat negative societal consequences of the Georgian-South Ossetian conflict.
 
Further Georgian-South Ossetian collaboration was slow to develop, but in 1998, with the support of NRC, FDHR began a program to be conducted jointly with South Ossetian counterparts at the Tskhinvali Youth Palace (South Ossetia). Under this program, 60 (and later 90) traumatized South Ossetian children between the ages of nine and fifteen meet regularly with South Ossetian teachers and psychologists at the Youth Palace. The South Ossetian caretakers have had training in teaching but not in child development or fields that would help them understand the clinical aspects of traumatized children's needs. Therefore, every month or so, two Georgians from FDHR come to the Youth Palace to meet and provide training for their South Ossetian counterparts. During these joint sessions, FDHR members conduct therapeutic activities with the South Ossetian children, and the South Ossetian teachers and psychologists observe. What is unusual about the whole process is that the "enemy" (Georgians) are teaching the victims (South Ossetians) and their children how to treat the effects of the "enemy's" assaults.
 
CSMHI traveled to Tskhinvali in May 1998, November 1998 and March 1999 to observe FDHR members and the South Ossetians with the South Ossetian children, and to hold workshops with the psychologists and teachers from both groups. To understand the challenges of this program, it is helpful to have an idea of what going to Tskhinvali is like today.
 
Although we encountered no problems as we made the three hour trip from Tbilisi to Tskhinvali by car with our Georgian partners, USAID staff were later surprised to hear we had ventured into South Ossetia because of the fear of kidnapping and other lawlessness there. Since no political solution to the Georgian-South Ossetian conflict has yet been reached, the border is marked by a police checkpoint where "customs duties" are collected from those transporting commercial cargo through South Ossetian territory. One passes by hundreds of trucks parked by the roadside to be checked. Vehicles registered in South Ossetia can be distinguished by their license plates, which differ from the Georgians' and others.
 
As one enters the town of Tskhinvali, it looks worse off than Tbilisi, and the effects of the fighting and siege are evident everywhere. Buildings are dilapidated and riddled with bullet holes; roads are filled with potholes. There appears to be no functioning industry. In the colder months, inhabitants burn any available fuel as heating systems are inoperative or intermittent at best. The salary for a professor or senior level teacher here is much less than the $10-15 per month one might earn in Tbilisi. In the winter, everyone wears overcoats indoors, even in schools or government offices.
 
UNHCR has a presence in one building, but there are few other signs of contact with the outside world. People here use Russian rubles, despite the fact that they are not part of the Russian Federation. Their vision of joining with North Ossetia to become one great Ossetia did not materialize, and South Ossetians are separated from North Ossetia not only politically, but also geographically, by a high range of mountains. But, the physical surroundings do not tell the whole story. In this isolated and downtrodden place, there are proud, beautiful people with high levels of education, who have studied Ernest Hemingway and Edgar Allan Poe, and who remember better times. Without knowing these contrasts and paradoxes, one cannot understand South Ossetia.
 
The Youth Palace in Tskhinvali is headed by Venera Basishvili, a woman in her 60s with three university degrees, who intuitively sensed after the war that many traumatized South Ossetian children needed psychological help. Having been the teacher of many of the current parents in town, Venera represented authority and benevolence and was successful in attracting students to her programs at the Youth Palace. Parenthetically, this institution has nothing to do with a palace, (see photo). The name comes from Soviet times when children would gather there for creative activities. The structure itself is a dilapidated two-story building with simple classrooms, desks and chairs that are falling apart, no heat, and bathrooms that are so filthy as to be unusable. The metal bust of a South Ossetian hero greets visitors as they enter the building. The only decorations on the walls are pictures clipped from newspapers.
 
Some of the children in the program were from relatively well established and successful families and attend a highly regarded day school. They were traumatized over many months during the siege of Tskhinvali and would talk openly about the ethnic conflict, parroting their parents' feelings against the Georgians. The names the children called the Georgians were so bad that when CSMHI asked the South Ossetian psychologists and teachers for examples, they would not repeat the epithets, indicating they were too awful even for them to utter.
 
Other children in the program attended a nearby boarding school and were mostly the children of displaced South Ossetian villagers. Interestingly, according to Ms. Basishvili, their open verbal hatred was not as severe as that of the day students from the other school, perhaps because the boarders lived at the school and were separated from their parents.
 
Another fact added to the omnipresent legacy of the recent conflict for schoolchildren. During the fighting, South Ossetians who were killed could not be buried in the usual cemeteries because these were then under Georgian control. Instead they were buried in the schoolyard of one of the Tskhinvali secondary schools. Education and youth were thus physically and symbolically linked with unresolved "hot" ethnic sentiments.
 
 
SERIES OF CLINICAL / PSYCHOPOLITICAL WORKSHOPS:
 
As CSMHI began its involvement with the joint FDHR-Youth Palace program, we hoped to lessen the emotional obstacles confronting the Georgian and South Ossetian caretakers as these former enemies sought to work together. To do so, we conducted what we call "clinical/psychopolitical workshops." with FDHR members as a group and also with FDHR and South Ossetians together.
 
Each workshop typically lasted three to four hours, and CSMHI conducted several of them on each of the visits to Georgia. In format, the workshops were simple. The participants were seated around a table with the CSMHI facilitators. The lead facilitator did not introduce specific topics, but indicated from the beginning that the purpose was to discuss FDHR's work with IDPs, other traumatized persons, and with the South Ossetians. The Georgians were invited to say whatever came to their minds and to begin a dialogue with each other about their work together. The CSMHI leader indicated that he would intervene whenever he had observations to share.
 
CSMHI facilitators include highly trained clinicians with years of experience in conducting small psychotherapy groups. They also have many years of experience conducting small group psychopolitical dialogues (i.e. between Arabs and Israelis, or Russians and Estonians) and have dealt with other traumatized societies (in Kuwait, Albania, Northern Cyprus, Croatia.) (See Volkan, 1997, 1998) Our methods combine clinical and political insights and encourage participants' concerns and hidden fears to be articulated and acknowledged. The assumption is that once a concern has been verbalized in the group, it becomes a shared concern and loses its power to be an obstacle to their work. Instead, the participants can work through these concerns together in a more realistic and less rigid way. This can happen in workshops with only one ethnic group present, as well as in gatherings of two opposing parties, when sufficient trust has developed.
 
For this report, we have chosen to describe four clinical/psychopoiitical workshops held on consecutive days in November 1998. Three are with the Georgians from FDHR and one with both FDHR and South Ossetian Youth Palace teachers and psychologists. These workshops are part of our developing methodology for helping indigenous caretakers work through their own ethnic tensions and responses to the trauma. For confidentiality purposes, we have changed the names of the participants in these accounts.
 
 
 
FIRST WORKSHOP:
 
 
October 31, 1998
Tbilisi, Georgia
 
 
  

Georgians:

Ilia (psychologist), Bekari (psychologist), Tina (psychologist), Eteri (psychiatrist), Nana (psychologist), Tamriko (psychologist), Shota (psychiatrist), and Sopiko (psychologist). Sopiko also acted as the interpreter. (All names are pseudonyms.)
 

CSMHI:

Vamık D. Volkan and Yuri Urbanovich
 
Tina began the meeting by describing a gathering that the Foundation for the Development of Human Resources (FDHR) had organized two years ago in Kobuleti, a resort on the Black Sea near Batumi. It was a weeklong meeting with eight Georgian and eight South Ossetian boys, aged 12 to 16. The Georgians were EDPs from South Ossetia and the South Ossetians were IDPs from Georgia. Tina, Ilia, and Tamriko were present, as well as a group of teachers from South Ossetia, led by a man named Phillip.
 
Tina first spoke about how impressed she had been with the South Ossetian children. They appeared mature, verbal, and tolerant, while the Georgian children were passive and did not seem as articulate as the South Ossetians. Tina found herself liking the South Ossetian children and wishing that the Georgians could be more like them. It was obvious to her that the Georgian children sensed her empathy for the South Ossetians and were irritated with her for it. Indeed, during a break, Tina urged the Georgian boys to be more assertive. Tamriko added that she had also been impressed with the South Ossetian boys. They were real gentlemen; they helped carry luggage and were attentive to adults. The Kobuleti workshop was conducted in Russian, and the South Ossetianchildren spoke Russian better than the Georgian children did.
 
After listening to Tina's and Tamriko's accounts, the CSMHI facilitator asked the group if they had any thoughts about Tina's and Tamriko's praise for the "enemy" group's children. (He used the word "enemy" deliberately since he felt that it was difficult for them to refer to the South Ossetians with whom they were working as the enemy. By bringing this word out in the open, he hoped to evoke their unexpressed feelings.)
 
First, the FDHR group gave "intellectual" responses using psychological terms such as "compensation" or "denial" to describe Tina's and Tamriko's behavior. They also explained that the upbringing of Georgian children generally does not encourage them to express themselves in public. Only gradually, these intellectual explanations gave way to stories with more revealing emotions.
 
Going back to the Kobuleti meeting, Tamriko recalled that there had been an argument between the Georgian and South Ossetian children as to the type of music they wished play. There was one tape of rap music whose title roughly translates as "informer" or "spy." The South Ossetians wanted to listen to this tape, while the Georgians were against it. The children apparently took stubborn positions as to whether or not to listen to this music. Since they could not resolve their conflict, in the long run the adults resolved it for them by asking the kids to role-play. Georgians pretended to be South Ossetians and vice versa, and they all listened to the tape.
 
We cannot say whether this particular music title held psychological significance for the children. What was clear however, was that Tamriko knew what it meant, and that it was she who had brought the name of this tape to our attention. Sopiko then suggested that the tape was about the behavior of people like Linda Tripp, i.e. traitors. Now the core group's discussion turned to how FDHR members sometimes feel like traitors because of the work they do. Their collaboration with the South Ossetians and their efforts to work with South Ossetian children indeed were perceived by many people they know in Tbilisi as unacceptable and even as the work of traitors. Sopiko suggested that the reason why the Georgian children did not wish to listen to the tape was that they did not want to be reminded of their "treason."
 
Bekari noted that while Tina was speaking, her neck had become red. He implied that Tina's choosing to bring up the Kobuleti meeting, which had taken place two years ago, as the first topic of discussion with CSMHI might indicate certain hidden emotions. Tina thought that the Georgian children were passive because they represented the losing side in the Georgian-South Ossetian conflict. (When the conflict ended, it was generally believed that the Georgians had been defeated since the South Ossetians were able to declare themselves independent.) Tina was reminded of this defeat by the contrast between the Georgian children's passive behavior and the South Ossetians' assertive behavior. In turn, the CSMHI facilitator suggested that because of this she had identified with the "aggressor", the South Ossetians. Tina was also aware that the Georgians could be considered the initiators of the bloody conflict, and she may have therefore felt guilty about the tragedy that ensued.
 
Tina told us that another teacher named Tsaroh (a Georgian IDP from South Ossetia whom the CSMHI team had met in May 1998 in Gori) had also been present at Kobuleti. Tsaroh had criticized the FDHR group for having no idea how much the Georgian IDP children had suffered and been traumatized. Tsaroh was upset that Tina and Tamriko were so impressed by the South Ossetian children and found the Georgians lacking. Tsaroh told the FDHR group how the father of one of the Georgian boys at the Kobuleti meeting had been taken hostage when the boy was seven years old. Afterwards, he would sit by a window everyday waiting for his father. The father eventually returned, but the child had already been severely traumatized.
 
Tamriko then began to speak more openly of feeling like a traitor. Even a family friend in whose house the CSMHI group was staying on this trip, has said that he would break off relations with Tamriko if she continues to make negative remarks about the role of Georgians in the South Ossetian conflict.
 
Now, CSMHI had heard the FDHR group criticized from two sources. Their neighbors saw them as traitors and "enemy lover", and Georgian IDPs (like Tsaroh) criticized them for not understanding the suffering of Georgians who had been directly traumatized. Everywhere the FDHR group turned, they were being attacked. Now they feared that CSMHI would also criticize them for their shortcomings, so they opened the meeting by saying how "nice" they were to their former enemies (South Ossetians.) Underneath all this was the guilt they experienced for their aggression towards the South Ossetians. CSMHI empathized with their dilemma. FDHR members genuinely wanted to be helpful to IDPs and those on both sides who had been hurt by the conflict. At the same time and in spite of themselves, they were members of the Georgian ethnic group and carriers of enmity for the other side.
 
Slowly, the real story came out, beginning when Ilia described how he had first become involved with the South Ossetians and how their relationship had developed. In spite of himself, Ilia sensed a certain competition with them. Gradually, the South Ossetian group leader, Phillip, came to symbolize the enemy as a whole (South Ossetians) for the FDHR group. Ilia's story is as follows:
 
He had just begun working with the Norwegian Refugee Council (NRC) and the Council wanted him to look into the possibility of joint programs with the South Ossetians. So in 1994, Ilia and a driver traveled to Tskhinvali, the capital of South Ossetia. At that time, certain Georgian and South Ossetian authorities were meeting every Thursday in Tskhinvali under the auspices of a Russian general, the commander of the Russian peace keeping forces. Ilia carried a letter and written proposal for Ludvig Chibirov, the South Ossetian leader. Ilia wanted to give these papers to the Russian general so that he, in turn, could give them to Chibirov. The idea was, with Chibirov's permission, to initiate a joint project of rehabilitation between the Georgian FDHR group and a group of psychologists and teachers from South Ossetia.
 
When Ilia appeared at the Georgian-South Ossetian gathering, he noted that the officials were preoccupied with issues pertaining to transportation, roadblocks, and bribery. The Russian general had a hangover and Tskhinvali looked like a cemetery. Hia managed to give the letter and the proposal to the Russian general, who promised to take it to Chibirov (but apparently, he never did.)
 
The point Ilia wanted to get across to us about this experience was his sense of loneliness in the business of reconciliation between Georgians and South Ossetians. Nevertheless, he believed that a joint project was a good idea, and deep down he had felt proud of himself for taking risks and going to Tskhinvali. He had felt like a "hero" who alone had entered the fortress of the "enemy."
 
For a long time after Ilia's first foray into South Ossetia, nothing happened. It was 1996, when Ilia was at last able to get in touch with some South Ossetian psychologists and teachers through NRC, and a joint project was begun. But Ilia continued to be aware of his internal ambivalence about the work. He remembered feeling ambivalent when the group was traveling to Kobuleti. The meeting there between Georgian and South Ossetian children and their adult "caretakers" from both sides would be the crowning event of this joint project. During the trip, Ilia sat next to an athletic and handsome South Ossetian boy. When they arrived in Batumi, on the way to Kobuleti, this young man became very excited, as did the other South Ossetian boys. They had never seen the sea before and were also impressed with the citrus orchards. Ilia found himself talking to the athletic teenager. "Now, you see what a wonderful country our Georgia is!" He felt a sense of competition with the South Ossetian youth and wanted to put him down.
 
Ilia's recollection of his "competition" with the teenager reminded him of his irritation with Phillip, the adult leader of the South Ossetian group in Kobuleti. Ilia did not like Phillip because he talked too much during the meeting instead of allowing the kids to talk. Phillip had described how the Georgians who lived in South Ossetia had become "bad guys" once the conflict started and how they had helped Georgians outside of South Ossetia fight against and kill South Ossetians. Ilia felt that Phillip had come to the Kobuleti meeting to fight. Not tolerating his long speeches any longer, Hia had asked the South Ossetians to cut his remarks short and allow the children to speak. Sulking, Phillip had stormed out of the meeting room and smoked a cigarette to calm down. When he returned, he was silent.
 
At this point the CSMHI facilitator realized that no one in the room was acknowledging that Phillip was now dead. The facilitator recalled that at the time of CSMHI's first team visit to Georgia in May 1998, Phillip had just been killed in a car accident in South Ossetia. Indeed, with Phillip's death, Ilia had been unsure who would be FDHR's contact person in South Ossetia, and indeed, whether the South Ossetian group that had worked under Phillip's leadership still existed or was functional. It became very clear that the FDHR group's involuntary ethnic aggression against South Ossetians was intertwined with their dislike of Phillip, who symbolized for them the "bad" South Ossetian who wanted to continue fighting. The CSMHI facilitator sensed that they were feeling guilty because their sense of retaliation had become connected with Phillip's death.
 
The CSMHI facilitator offered this interpretation to the FDHR group, and, sensing that they had developed sufficient trust in him, felt he could verbalize for them what they were afraid to say—that Ilia's aggression had killed Phillip! Immediately the group understood that the facilitator meant only that Ilia might unconsciously have wished Phillip dead, but the remark had a striking effect on them. They burst into laughter. It was like a release of their aggression against Phillip and by extension against South Ossetians in general. They were also expressing guilt feelings through a reversal of affect. The laughter continued for a while. Ilia went on in the same vein, suggesting that perhaps he had done the remaining South Ossetian teachers and psychologists a favor by "killing" Phillip, since the rest of the South Ossetian group did not like him either and he was interfering with their work. The laughter increased. After Phillip's death, the joint project with the South Ossetians had in fact evolved positively, though it is possible that the collaboration would have improved in any case as time passed and as the political situation between Georgia and South Ossetia became more conducive for joint work.
 
To close this first workshop with the FDHR core group, the CSMHI facilitator interpreted and summarized some of what had been said. What he said could be expressed as follows:
 
            "We can let Ilia remain powerful so that he can "kill" people by being angry at them, or we can remind him that being angry or having bad thoughts does not kill people (more laughter). I do not yet know your individual motivations for becoming members of this FDHR core group and for doing this noble job, but it is clear that you want peaceful solutions to ethnic conflict. Nevertheless, in the society you live in, you also feel like traitors. Indeed, you are accused of doing a job that is contrary to the sentiments of many individuals in your own ethnic group. The sense of ambivalence you feel about South Ossetians and about your work with them is to be expected, even normal. Perhaps you have unconsciously linked Phillip's death with your aggression toward him— after all, he was "fighting" against you. His death may induce guilt feelings in some of you, but today you have developed some antidotes for these guilt feelings. You discharged these troublesome feelings with laughter. In addition, becoming more aware of the complexity and range of the emotions you feel can reassure you and make you better equipped to carry on with your tasks. Today, we heard you speak of feeling like traitors, of ambivalence for the enemy, of guilt over aggressive thoughts; but you also expressed a sense of pride and assertiveness. The facilitators from South Ossetia with whom you work probably have some of the same emotions  and struggles.  Recognizing your internal  resistances toward working with the "enemy" may lead to more a more genuine and effective approach to your work."
 
As the meeting broke up, many members of the FDHR group spontaneously said that they agreed with the facilitator's closing remarks and that this first workshop had induced in them a sense of relief.
 
Insights from Workshop 1:
 
1- FDHR members' fear of being perceived by their compatriots as traitors and enemy lovers.
 
2- Fear of alienation.
 
3- Need to deny their own group's aggression (that they had "killed" the South Ossetian group leader.)
 
4- Need to compete with the enemy and prevail (narcissism of group identity.)
 
 
  
SECOND WORKSHOP:
 
 

November 1, 1998

 Tbilisi, Georgia
 
 

Georgians:

Ilia (psychologist), Bekari (psychologist), Tina (psychologist), Eteri (Psychiatrist), Nana (psychologist), Tamriko (psychologist), Shota (psychiatrist), Sopiko (psychologist), Tariel (public relations specialist/writer). Sopiko (also acted as the interpreter. )
 

CSMHI:

Vamık D. Volkan and Yuri Urbanovich
 
While the first workshop had focused on bringing into consciousness those feelings and conflicts pertaining to working with an enemy group, the second workshop, held the following day, illustrated the work group's sense of helplessness in the face of the human tragedy that they must deal with daily. Hundreds of thousands of internally displaced persons (IDPs) in Georgia continue to suffer both materially and psychologically. Furthermore, in the public at large aggression has turned inward. Within the FDHR core group this has created splits among the members.
 
The second workshop with CSMHI began with a statement from Tamriko that the FDHR core group's aim and strategies were unclear. She demanded more structure for their work. Eteri felt that Tamriko's position was extreme, that their work could not be structured with definite parameters, and that they needed to discharge their accumulated emotions now and then, as well as adjust to changing external circumstances. Tamriko, however, continued to insist on her demands and express her desire that the core group change its style. This provoked an exchange between Tamriko and Ilia. Ilia wanted to defend the group by insisting that the FDHR indeed had an aim and structure, but that because of the work they do, they needed to remain flexible in responding to various situations.
 
The CSMHI facilitator noted that the core group's mood was depressive; it was as if they were stuck in an internal struggle mirrored by the argument between Ilia and Tamriko. He pointed out that, in the workshop the day before, the FDHR core group had focused on emotions resulting from outside forces—such as their being seen as traitors by friends and neighbors and their ambivalence toward South Ossetians. He wondered if the arguments and disagreements expressed in today's workshop reflected the group's emotions coming from internal struggles. Ilia and Tamriko's argument about the group's aims, strategies and style sounded as if it came from a feeling of helplessness within the core group. Helplessness would be a natural reaction to the human tragedies they faced daily when they worked with IDPs, and the difficulties in working with South Ossetians could easily add to it. The CSMHI facilitator asked the FDHR group if they sometimes felt as if their efforts were like drops in the sea. He suggested that they should not try to get away from the mood of depression, but rather be patient and see what images came to their minds.
 
Eteri told about a five-year-old IDP child from the kindergarten at Tbilisi Sea (a former resort outside of Tbilisi, which currently houses 3,000 Georgian IDPs who fled Abkhazia). The child's father had died from an illness. When Eteri heard about the man's death, she had decided to go to the wake and pay her respects. When she arrived, she found the child crying. She entered a room where the body was lying surrounded by flowers. What shocked Eteri, and what has remained in her mind vividly since that time, was the fact that the dead man's shoes had holes in them. The IDP family did not have enough money to provide the dead with appropriate shoes. Eteri went on to say that the boy is still in the kindergarten and every time she sees this child, the image of the dead man with torn shoes comes to her mind and she is filled with pain.
 
Ilia began speaking of an old couple whose two sons were killed during the Georgian-Abkhazian conflicts. When Ilia met the old couple they were living in Kutaisi, in Western Georgia, as IDPs. The couple was taking care of their five grandchildren, ranging from four to twelve years old. Pictures of their dead sons' adorned the wall of the place where they lived. In spite of their tragedy, the old couple seemed at peace. They were busy being a good host and hostess to Ilia and did not express any hostility toward Abkhazians. Ilia was surprised at this and experienced a feeling of despair. He had expected to see the old couple in despair, but when he failed to observe this in them, he felt the despair within himself.
 
The CSMHI facilitator pointed out to the group that Ilia had just given an example of how a caretaker absorbs a traumatized person's "bad" feelings, while the traumatized person appears on the surface to be all right. The shadow of helplessness thus falls on the caretakers.
 
Returning to his story about the old couple, Ilia told the group that the wife had hidden in her basement in Abkhazia for a year, refusing to escape because she wanted to find out where her sons, who had died in the initial phase of fighting, were buried. One of her sons used to write poetry. When Ilia visited the couple, the dead poet's daughter recited one of her father's poems. This was a moving experience for Ilia, and he felt again the sense of despair within himself. The old woman's name was Jajuna, which means "joyful," and Ilia thought how ironic it was that despite the severe blow dealt her by the conflict, she still maintained her joyfulness, at least on the surface.
 

The way that Ilia came to know this old couple is a story in itself. The NRC representative in Tbilisi had wanted to go to Kutaisi and asked Ilia to make arrangements so that an associate of FDHR who lived in Kutaisi would meet him. Ilia tried to get in touch with his contact person by telephone, but the telephones were not working, so he decided to go to Kutaisi himself and prepare the people there for the NRC representative's upcoming visit. Ilia, Tina, and Avtandil (a teacher who works for the FDHR core group) board a train and headed for Kutaisi. It was wintertime and the train was overheated and quite uncomfortable. When they arrived in Kutaisi very early in the morning and descended from the heated train, they were met by a bitter cold wind and icy streets. Tina recalled how Ilia lost his balance and slid on the ice like a duck.

 
Her description of Ilia's "helplessness" on the ice was reminiscent of the general helplessness felt by the FDHR members at this workshop. Just as Ilia was helpless against the ice and winter weather, the core group was helpless against the massive human tragedy of the IDPs. Tina's description of Ilia trying to walk on the ice provoked laughter among the group members. Once more humor and laughter were used to discharge a "bad" emotion and to change the core group's mood. After their treacherous walk on the ice, Ilia, Tina, and Avtandil found a "breakfast" place where hashish was being served. (More laughter.) Then Ilia, Tina, and Avtandil were taken to the old couple's house to wait for their contact person.
 
This story of how Ilia, Tina, and Avtandil met the old couple and their grandchildren was also indicative of the level of sacrifice FDHR members made in their efforts to bring some comfort to the IDPs. What did they gain in return, we wondered? Shota gave an answer.
 
He told the group how helpless and depressed he had been during the first year that he worked with the IDPs. He was struck by their material losses and yearned to compensate for them, but of course lacked the resources to do so. At one point, the FDHR core group had a discussion on this issue and decided that their work could not include giving material assistance to the IDPs. This made Shota feel better by limiting his sense of responsibility, but what became even more important to him was the realization that he was being enriched by this work. The IDPs were in a sense his "teachers." Seeing people who had lost so much retain their human dignity and call on inner strength to adapt to their circumstances was inspiring. It was teaching Shota how to be a better person and was a true reward for his efforts.
 
Soon more examples of the FDHR members' powerlessness came out in the discussion, but now the tone of despair was no longer present. They were dealing with this topic on a more intellectual level, as if they wanted to assimilate the experience.
 
We heard stories from Bekari, Tamriko, and Tariel. Bekari spoke of his helplessness when IDPs in Zugdidi told him that they did not want his kind of help. They said that for two years they had been struggling to rebuild their ruined houses, and now Bekari and his friends were interfering with their work. Tamriko described how her feeling of hopelessness came to the surface when she met an IDP woman who had lost seven members of her family.
 
Tariel had taken part in the fighting against the Abkhazians and had a more direct experience of the Georgian-Abkhazian conflict. Later in Zugdidi he met the leader of a group of IDPs who were meeting with the FDHR members. This man was paralyzed and had compensated for his inability to get around easily by becoming the group's leader and in a sense making his universe come to him. The paralyzed man spoke of wanting to return soon to his home in Abkhazia. Tariel knew that this would not be possible and felt acutely the helplessness of this paralyzed IDP.
 
The FDHR core group members gradually began to realize something that they already knew but hadn't previously been truly aware of—that they were periodically the carriers, at least temporarily, of the feelings of helplessness of the people with whom they were working. They now knew that when this phenomenon was not recognized, it could lead to struggles and splits within the core group.
 
Ilia compared the FDHR members' work with that of other organizations who deal with IDPs. He described a group of physicians who meet with IDP representatives on a fixed schedule, give lectures, and then distribute certificates to attendees as if these pieces of paper could certify that the lectures had ameliorated the IDPs' state. By contrast, the FDHR members immerse themselves when working with IDP children and adults. They treat the IDPs as people like themselves.
 
Sopiko added that despite their efforts to immerse themselves in the lives of IDPs and to deal with them as people, the FDHR members' frequent sense of hopelessness and despair sometimes interfered with their work. To counteract this, she had found the experience of accompanying the CSMHI facilitators as they conducted in-depth interviews with IDPs at Tbilisi Sea extremely helpful. Through the interviews, one in particular, the interviewee became a distinct person, not just a face. Sopiko was deeply affected by this experience, and it has helped her empathize with and treat the IDPs as fellow human beings to an even greater degree. (See section below on Experiential Teaching for more details of these interviews.)
 
 
Insights from Workshop 2:
 
1- FDHR's sense of helplessness in face of the enormity of their task-fear that their efforts will be like drops in the sea.
 
2- Refugees' depression is contagious, absorbed by FDHR.
 
3- Isolation of this kind of work it is overwhelming.  
 
 
 
THIRD WORKSHOP:
 
 
November 3, 1998
Tskhinvali, South Ossetia
 
 
 
SESSION WIIH SOUTH OSSETIAN CHILDREN
AND
JOINT WORKSHOP WITH GEORGIANS AND SOUTH OSSETIANS
 
 
On November 3, 1998, four Georgians from FDHR and two CSMHI faculty traveled to Tskhinvali. First, the FDHR mental health professionals held a session with South Ossetian children (as planned under their collaborative program), while the South Ossetians and CSMHI observed. Afterwards, CSMHI held a workshop with the Georgian and South Ossetian caregivers. Both sections are described here. While two of the Georgians had participated in previous sessions with the South Ossetian children, for the other two it was the first visit to South Ossetia since the hostilities. This FDHR session with the South Ossetian children was the third in a scheduled series of six to take place between September 1998 and April 1999.
 
Session with South Ossetian Children:
When we arrived at the Youth Palace, 25 South Ossetian children, ages 9-12, were gathered in a room, sitting in three concentric circles. Two members of  FDHR led the session while the other two Georgians, the two CSMHI faculty, and  five South Ossetian teachers and psychologists observed the process. The language used was Russian so that the South Ossetian children and their Georgian group leaders could understand each other.
 
The first instructor began the meeting by introducing herself and explaining that she and her colleagues had come to the Palace to talk to the children. Noting that she knew some of them already, she said to them, "Don't be shy. Let's introduce ourselves."
 
She then threw a soft yellow ball about the size of a tennis ball toward the group of children. Whoever caught the ball was to introduce himself or herself and name something he or she liked. Then this child would throw the ball to another who would do the same. The children spoke of  liking soccer, music, wrestling, folk dancing and so on. After everyone had had a chance to speak, the instructor introduced a new twist to the game. After catching the ball, each child was to name one "rule" of social behavior in the group. Children identified rules such as smiling in friendship, accepting others' appearance, listening more and speaking less, and being polite.
 
The interactions became more interesting when the children were asked to make up a story as a group and then to draw pictures. Through these activities, the instructors were creating a canvas onto which the children could project aspects of their internal world. Once out in the open, such projections could then be discussed.
 
The story that the children created involved someone sailing in a boat to an island where he searches for food. At one point, he sees an Iranian boat and wants to fight the people on board. While there were no references to South Ossetians or Georgians, the CSMHI observers sensed that the children were indirectly expressing feelings about the conflict that had traumatized them. The first picture one of the children drew depicted an island with two trees on it. On the highest point of the island, a stick figure stood shouting, "Help! Help!" There was no explanation as to why the figure was calling for help.
 
Whenever reference to aggression surfaced, however, most of the children would say something like "Even though it is difficult to make friends after a war, we want peace!" Thus, any expressions of aggression were quickly suppressed. Surprisingly, the instructors made no effort to help the children speak about their aggressive feelings.
 
The drawings that followed also reflected the children's preoccupation with water, though there were no more figures shouting for help. People in the other drawings were in sailboats traveling to leisure resorts, and the discussion of such vacation spots provoked joy and laughter.
 
CSMHI  Workshop with Georgians and South Ossetians:
After observing the session with the South Ossetian children, CSMHI held a workshop with the Georgian and South Ossetian caregivers. Because this workshop followed a clinical session, part of it was didactic and focused on enhancing clinical knowledge and methods for helping the children. At the same time, since this was our first joint workshop with both Georgians and South Ossetians, we sought an opportunity to bring to the surface some of their hesitations and concerns about working with each other.
 
We noted that in the session we had just observed, the stories and drawings had effectively brought to the surface the children's hidden concerns about the legacy of the trauma. Emotions such as helplessness, anger, and anxiety were revealed in their responses, but they were not explored. Our perception was that if the sessions proceeded in this fashion, the children would continue to act friendly and happy while their unresolved anger and reactions to the trauma raged beneath the surface. Without help to acknowledge and tame their anger and helplessness, these children would become carriers of ethnic enmity, and sustainable peaceful co-existence between the former enemies would remain out of reach.
 
We hoped that if we could help the Georgian and South Ossetian caretakers to better understand each other's feelings and perceptions, ultimately, they in turn would be able to help the children deal with the Georgian-South Ossetian relationship. By bringing their own feelings and fears out into the open, the caretakers would be better equipped to help the children reveal their previously hidden, "dangerous" feelings.
 
Our perception of the instructors' own traumatization was confirmed when, during the workshop discussion, one of the Georgian instructors admitted that she was afraid to touch on painful topics such as aggression and helplessness. We asked the South Ossetian psychologists if the children behaved the same way and produced similar stories when the Georgian instructors were not present. They replied that with or without the Georgians present, the children created similar stories, and the South Ossetian instructors too tended to focus on "friendly" scenarios. When we inquired as to what happened to the children's aggressive feelings, one psychologist responded "It is too much for the teachers to talk about painful things, so we do not let the children talk about them either."
 
Because of these sensitivities and the fact that this was our first joint workshop, CSMHI decided not to plunge directly into discussion of ethnic issues, but rather to focus instead on the clinical issues raised by the children's drawings and stories.
 
In the first drawing of an island with a figure calling for help, the island might represent South Ossetia, and the stick figure a traumatized child. South Ossetia is indeed geographically isolated, and South Ossetians generally have little opportunity to travel. The stick figure calling for help seemed to be a child's direct expression of helplessness, but there was almost no discussion of this picture during the session, and instant denial of such negative emotions took over.
 
All the professionals present understood that many of the children's drawings depicting boat trips to fun, peaceful places reflected their desire to escape from painful situations. Since some of the adult caretakers were traumatized themselves, however, they too wished to avoid stirring up painful feelings.
 
The children's preoccupation with water during this session caught the attention of one of the CSMHI clinicians. South Ossetia has no lakes or seas, yet most of the children's drawings showed water. It was as if water were present everywhere in the room. The clinician asked the caretakers to consider whether the children were trying to send the adults another message. Based on his clinical experience and knowledge of traumatized children, he suggested that the water in the drawings might reflect the symptom of bed-wetting. It has been clinically observed that traumatized children often suffer from this and through dreaming about water they indirectly express their internal dilemma. CSMHI asked the caretakers whether this were a problem with the South Ossetian children.
 
One of the South Ossetians confirmed that indeed bedwetting was quite common, but rarely spoken of openly because it was humiliating. Many of the mothers had told her that their children dreamt frequently of water and had problems with bed-wetting. Now one could see that perhaps the children's drawings said something about their reaction to the trauma, how it resulted in bed-wetting, but that this was shameful and could not be expressed directly.
 
Confirmation of this symptom opened a discussion of how to address bed-wetting with the children without humiliating them further. While no immediate solution was found, identifying it as a concern initiated a collaborative discussion among the Georgian and South Ossetian caretakers as to how to tackle it. This sensitivity around the issue of bedwetting illustrates the overlap between the clinical and the psychopolitical. It was evidence that emotionally based symptoms arising from the ethnic trauma are more difficult to face because of the residual trauma and ethnic tensions present in the caregivers themselves. Another example of the caregivers' personal stories affecting their work was revealed in a private conversation that arose between a young South Ossetian psychologist and one of  the CSMHI team, while the general discussion continued around them.
 
Here is her story:
 
                     When Tskhinvali was under attack by the Georgians, this young psychologist was still in her teens. Her father had died before the war, and she was living with her mother and her sister. An international organization arrived in Tskhinvali offering to take 40 South Ossetian children and youth away from the war zone and out of harm's way for the duration of the conflict. Representatives of this organization asked the psychologist's mother to choose one of her daughters to be part of the group of 40 and taken to safety. The mother chose the psychologist, and she was taken to another location to live for about four months while her mother and sister remained in Tskhinvali. She was aware of the similarity between her story and William Styron's novel Sophie's Choice. In her case, she was the chosen one.
 
                  While she was away, she had no idea what was happening to her mother and sister. When she was brought back to Tskhinvali, she found them alive and unharmed. But while she was in exile, she had developed severe guilt feelings for having been the one who was chosen to be taken to safety. Even after seeing her mother and sister alive, she could not get rid of the guilt. She had internalized these feelings to the degree that she considered herself a "bad" person. She could not talk about her condition with her family members or friends. She said that she also could not allow the children at the Youth Palace to talk about their traumas and memories of the horrible times. Since she was the "chosen one," and spared such trauma, hearing others talk about it would rekindle her guilt feelings and make her feel horrible.
 
 
Note: CSMHI was able to help this South Ossetian psychologist therapeutically. Within a year, she blossomed as a professional and even got married.
 
 
During the Tskhinvali workshop, CSMHI noted an "inequality" or disparity between the Georgian and South Ossetian team members. While the Georgians from FDHR had not experienced the war directly, most of the South Ossetians had been in Tskhinvali and lived through bloody fighting and shelling. The facilitator asked them to consider how this difference in their experience of the trauma might affect their interactions as they got to know each other. This led one South Ossetian to comment that, although the South Ossetian caretakers had their government's blessing to collaborate with FDHR, many of their neighbors and friends in Tskhinvali were against the project. The ethnic aggression suppressed among children was far more open among adults, and the caretakers were viewed as "black sheep" or traitors. However, parents knew their children suffered from bed-wetting, depression, nightmares, and inhibitions, and they needed help. As long as the parents understood that this collaboration with the Georgians of FDHR was in the service of helping their children, it appeared that the project would survive.
 
It was clear that the relationship between these Georgian and South Ossetian caretakers was delicate and that sensitivity would be crucial to maintaining it, yet all of them seemed dedicated to working at it for the sake of the children. After the meeting, at a social reception prepared by the South Ossetians, traditional toasts were made to friendship and peace. The CSMHI observers sensed that both Georgians and South Ossetians were careful in choosing their words so that no one would get hurt.
 
 
Insights from Workshop 3:
 
1- Surface collaboration and friendliness between former enemies may hide minefields of hidden emotions.
 
2- Competition in historical grievances is inevitable. South Ossetians wanted to let CSMHI and the Georgians know that they were more traumatized than the Georgians. There is an inherent inequality between the two groups. South Ossetians had lived through combat and a siege, while the Georgians were more insulated from it.
 
3- Having others verify one's grief gives self-esteem to the injured party, who can then become more flexible.
 

4- The facilitators' empathic listening to both sides creates a model of empathy for the two groups to follow vis-a-vis each other.


5- A psychologist's own hidden guilt feelings (for having been luckier than others in the ethnic group) inhibit effectiveness in helping others.

 
 
 
FOURTH WORKSHOP:
 

November 4, 1998

Tbilisi, Georgia
   
 
The next day in Tbilisi, the CSMHI facilitators met with eight Georgian FDHR members, including three who had been to Tskhinvali the day before. CSMHI began by asking one of Georgians to describe what it had been like for her to go to South Ossetia for the first time since the war. She recounted that she had been very anxious before the trip, and that her prejudices had surfaced. She had said to herself, "I am a good Georgian and therefore the South Ossetians will treat me badly." But she had reassured herself by focusing on her identity as a professional, remembering that children are children anywhere. When asked to describe her worst fantasy concerning the trip, she admitted that she had been afraid she might fail in demonstrating the methodology, that she might be embarrassed in front of the South Ossetians. She had also been concerned that her Russian was not good enough, and that this too could cause embarrassment.
 
Another of those who had attended the previous day's workshop in Tskhinvali recalled an incident that occurred during the social hour after the session. She and the others were sitting around a table when a rather tall man had entered the room. Her immediate reaction was fear that the newcomer was an Ossetian who had come to take her hostage. She recounted, "I thought I had never seen him before and did not know who he was. Then someone asked him to sit down with us, and I realized that he was the driver of the car I had ridden in from Tbilisi." Her level of anxiety over being in "enemy" territory had blurred her normal powers of observation and was evidence of the Georgians' involuntary psychological resistance and the painful emotions evoked by helping the South Ossetians.
 
FDHR members took turns going to Tskhinvali for the joint meetings, so some had been once or twice, others not at all. Now, each member of the group who had been to South Ossetia began to describe his or her feelings regarding the visits. One woman thought that the South Ossetians might reject her offer of help. Although she anticipated such an attitude, she was met with friendliness each time she went. She noted how tired she felt during the visits, and added "Just imagine—we go to the enemy, bring them money for the project and ask them about their feelings. When I put myself in their shoes, I realize how impossible it must be for them to speak. We should reconsider how we approach them."
 
A discussion then began as to what style of approach to use, and the CSMHI facilitators sensed that this focus on the mechanics of the meetings with the South Ossetians was taking the Georgians away from exploring further their own anxieties. CSMHI brought the talk back to that topic.
 
One of the FDHR members feared that visiting South Ossetia would be very depressing. Georgian-South Ossetian relationships had historically been very good, and to see them now reduced to ruins was sad and distressing. Another went one step further and said she felt shame when she visited South Ossetia. She felt Georgians should take more responsibility for their role in the conflict, and added, "Why do civilized people fight like this? I can't find justification for the way the Georgians fought the South Ossetians. While I have no guilt concerning the Georgian-Abkhazian conflict, I do feel guilty for having fought with the South Ossetians."
 
There was also real fear of the South Ossetians. One psychologist described how when she had seen a group of young men in Tskhinvali, her first thought was "Are they killers?" One of the men recounted that at one point during the session with the children, he had left the room to smoke a cigarette. He now explained that his main reason for leaving the room was not his addiction to tobacco. Through the window he had seen some men hanging around one of the cars in which the group had traveled to Tskhinvali. He knew that the men had noticed its Georgian license plate, and he had left the room to make sure they did not damage or tamper with the car. Whether this was a realistic possibility or not, it reflects the heightened sense of danger and anxiety that sometimes interferes with the primary tasks of these caretakers.
 
 
Insights from Workshop 4:
 
1- FDHR has open and hidden anxiety over visiting enemy territory.
 
2- Need to assess the real danger that may come from the enemy, but differentiate it from the fantasized danger. Otherwise, the fantasized fear overburdens the realistic fear, distorts communication, and becomes an obstacle to constructive collaboration.
 
3- Georgians have guilt over inflicting damage on the South Ossetians. The desire to deny this guilt gets in the way of collaboration. Need to differentiate realistic guilt with denied guilt.
 
4- Watch out for the accordion phenomenon. The accordion phenomenon is a concept (see Volkan, 1998.) to describe a common pattern that occurs when enemy groups get together. At some point in their discussions, they may appear to come close together and be friendly as they deny oppression and guilt feelings over the conflict. Usually, this is a defensive mechanism and does not last because it blurs the identities of the two groups and thereby raises anxiety, which may quickly give way to exaggerated distancing.
 
The Georgians felt this togetherness at the end of Workshop 3 during the social gathering in Tskhinvali. The next day, during Workshop 4, it was important that they look at the situation more realistically and be able to more carefully assess their anxiety over being in enemy territory.
 
 
Further Work on Georgian-South Ossetian Project:
On the two subsequent trips to Georgia in March and August 1999, CSMHI held workshops similar to those described above. Rather than reporting them in detail, we will give some highlights below.
 

March 1999 Trip and Visit to Tskhinvali:

On this visit, the South Ossetians felt freer to describe their sense of isolation from their compatriots in working with Georgian FDHR members. This time we heard more openly about South Ossetian children's bedwetting, teenagers' increased criminality and prostitution, and their parents' desperation over these developments. Because the Georgian-South Ossetian project offered some antidote to parents' helplessness and the pathology of the youth, parents allowed their children to participate, despite their apprehension over Georgian involvement in the project. The perception was that participants in the Youth Palace programs were spared from developing anti-social behavior, therefore more parents wanted their children to participate. Nevertheless, the ambivalence over working with Georgians persisted, as did the view that the South Ossetian teachers and psychologists were in some sense "traitors."
 
CSMHI's strategy was to find ways to increase the public credibility and acceptance of this program and the South Ossetian instructors' participation in it. We sought ways to obtain open support from public authority figures in South Ossetia. Accordingly, we arranged to meet with the following individuals:
 
- Kosta Dzugaev, Speaker of the South Ossetian Parliament.
 
- Fatima Poukhayeva, Counselor to the President of South Ossetia.
 
- Murat Jioev, Minister of Foreign Affairs of South Ossetia.
 
- Accompanied by Georgians from FDHR and South Ossetians from the Youth Palace, we thoroughly briefed all of these people on the joint Georgian-South Ossetian youth program, and all expressed their public support for it. Because of this support and the increasingly positive reputation of the programs, more parents allowed their children to participate, and between March and August 1999 the enrollment grew from 60 to 90 children.
 
 

August 1999 Meeting in Tbilisi:

This time we decided to experiment with the format of the workshop with Georgians and South Ossetians together. Instead of meeting in Tskhinvali, we invited the South Ossetian psychologists and teachers to come to FDHR's offices in Tbilisi to meet with us. This meant that we did not observe the youth programs on the last trip under the grant, but we felt that what would be gained from bringing the South Ossetians to Tbilisi would outweigh an additional opportunity to observe the children.

 
We were hoping that six or eight South Ossetians would come to Tbilisi, but in the end only three were able to do so. As we observed these three communicating with the Georgians under our facilitation, discussing where the dialogue evolution stood at the end of the grant period, the South Ossetians were polite, but reserved and anxious. One of them is the niece of the South Ossetian President, Ludvig Chibirov. The Georgians had not been aware of this fact and it came as a surprise to them. It had been difficult for this young woman to come to Tbilisi without telling her uncle, as she feared his emotional reaction. The South Ossetians were very genuine in expressing their gratitude to the Georgians for their assistance in treating the Ossetian children. They noted that although they had their own university, the kind of approach demonstrated by the Georgians had not been part of their training. They also repeated that they had the blessing of the South Ossetian Government, from the president on down, for having a relationship with the Georgians. This last assertion was ironic, given the president's niece's obvious and considerable anxiety about coming to Tbilisi.
 
Whenever the CSMHI team had traveled with the Georgians to South Ossetia on previous visits, their hosts had given them a dinner. This practice was guilt inducing since it was clearly a great sacrifice for the South Ossetians to put on such feasts in the midst of ruins and hardship. When the South Ossetians came to Tbilisi during the hot days of August 1999, they were taken to a restaurant. The Georgians had chosen a relatively fancy one (by Georgian standards) with an unusual amenity, air-conditioning. Since air conditioning is rare in Tbilisi, and probably completely unavailable in South Ossetia today, we wondered whether the South Ossetians felt comfortable with this contrast. The next day when we discussed this with the Georgians at a debriefing, it was clear that the Georgians were aware of the disparity. Nevertheless, they may have unconsciously chosen a fancy restaurant to demonstrate some feeling of superiority, though they had not consciously meant to do any harm.
 
As will be noted in the section on Evaluation and Impact below, our participation has made a positive impact on this Georgian-South Ossetian program, but the relationship between these two groups is very fragile and vulnerable. It could greatly benefit from continued facilitation from a neutral outside party such as CSMHI, and in fact, is in danger of backsliding without continued support.
 
 
B- Teaching and Training by CSMHI:
 

The Need:

One of CSMHI's aims in this project was to teach Georgian and South Ossetian mental health workers tools to deal with IDPs and other traumatized individuals' psychological scars. There are, as we stated earlier, 300,000 IDPs in Georgia alone who have continued to live under miserable conditions for the past seven or eight years. Thousands of other inhabitants are also traumatized. For example, South Ossetians who live in Tskhinvali and are not IDPs were directly traumatized (as were many Abkhazians, though we are not focusing on them in this report.)
 
Georgian and South Ossetian resources to deal with the ruined psychological infrastructure were as limited as their resources for dealing with the physical infrastructure. There are no mental health workers properly trained in South Ossetia to address their own society's psychological wounds. Georgian psychologists are generally better trained, but the number who have decided to devote themselves to the psychological plight of Georgian IDPs is very small. This number includes eight core FDHR psychologists and psychiatrists, a dozen or so other FDHR friends, and some university psychology professors.
 
FDHR core members have intervened with hundreds of traumatized people in a collective way. For example, when new Georgian refugees fled to Zugdidi from Abkhazia, FDHR members went there and spoke with refugees in school buildings trying to be helpful. In many ways, FDHR has far greater experience than CSMHI in dealing directly with IDPs. When FDHR core group members briefed us about their meetings, we were impressed with their dedication and knowledge.
 
They knew how to diagnose traumatized persons' symptoms, cognitive disturbances and their "paralysis" in interpersonal relationships. But we also noted that FDHR mental health workers had certain blind spots due to two factors:
 
1- They themselves were, either directly or indirectly, traumatized.
 
2- They had been trained under the Soviet system of psychology that did not emphasize understanding the "internal worlds" of clients. Often directly treating a surface symptom does not lead to lasting change. One needs to understand the person's "internal" motivations.
 
CSMHI is developing a training methodology that includes two types of teaching for mental health workers:
 
Experiential and Intellectual:
The workshops described earlier were examples of experiential teaching. By learning more about their own (previously hidden) internal worlds, Georgian and South Ossetian mental health workers will be better able to appreciate the South Ossetian children's hidden fears and emotions.
 

CSMHI also experimented with another form of experiential teaching regarding IDP issues. We chose one Georgian IDP family and conducted a series of interviews with them (each several hours long) each time we went to Georgia. By observing as CSMHI faculty conducted these interviews, and by discussing in detail the kinds of data collected, FDHR mental health workers expanded their observational abilities and techniques for dealing with IDPs. Although the number of psychiatrists and psychologists trained in this manner was very limited, we hope that they will be able to pass their newly gained insights on to their colleagues. The section below will describe this experiment in experiential teaching.

 
The second type of teaching was addressed to larger audiences. FDHR core members joined us in disseminating IDP-related psychological and psychopolitical information to as wide an audience as possible through lectures, seminars, and other activities. These are described in detail below under intellectual teaching.
 
1-   Experiential Teaching:
 
1.a- Work at Okros Satsmisi (The Golden Fleece.)
 
2.b- The Balanchivadze Family.
 
 
1.a- Work at Okros Satsmisi :
Georgians from Abkhazia displaced since 1992, the Balanchivadze family (not their real name) lives in a hotel called Okros Satsmisi (The Golden Fleece) which is one of three former resort hotels at Tbilisi Sea. Once a popular recreation area for Tbilisians, Tbilisi Sea is a man-made reservoir about half an hour north of Tbilisi. Today, 3,000 Georgian IDPs are crammed into its now dilapidated hotels, and the infrastructure lies in complete disrepair.
 
Prior to CSMHI's involvement, FDHR had done some work with IDP children at Tbilisi Sea and had met the Balanchivadze family. Because of their prominence and willingness to be involved in political activities, this family has become a sort of spokesperson for the 3,000 IDPs of Tbilisi Sea. As proof of this, we noted that there is only one telephone available for all the residents of Tbilisi Sea, and it is located in the Balanchivadzes' apartment (a former hotel room). Thus the family's apartment has become a kind of headquarters.
 
Life at Tbilisi Sea includes some communal activities, the most prominent of which appear to be funerals. Although there are no official statistics, it struck us that relatively young people (in their 40s, for example) die unexpectedly with great frequency here. Intuition says that despair and depression kill these IDPs. In fact, on two out of the four visits that CSMHI made to Tbilisi Sea, a funeral was taking place. These are collective affairs and attended by the whole community of 3,000 persons.
 
The other communal activity that we observed was the gathering of wives and mothers at the Balanchivadzes' apartment when husbands and sons go off to war. Skirmishes still occur between Georgians and Abkhazians at the border (near Gali and Zugdidi, see map, p.2.) When this happens, some men from Tbilisi Sea volunteer to go and fight, usually for several days at a time. Their wives and mothers huddle by the phone at the Balanchivadzes' apartment, anxious for news from the outside world.
 
Recently, the Shevardnadze government began discouraging participation of  Tbilisi Sea "volunteers" in these skirmishes, and this in turn has evoked negative feelings toward the President on the part of IDPs at Tbilisi Sea. They see this as the Georgian government not allowing them the opportunity to fight and regain Abkhazia.
 
CSMHI decided to interview Balanchivadze family members, with their permission, and to observe closely how they are adapting to their forced exile. FDHR members were participant observers during these interviews, which took place in May 1998, November 1998, March 1999, and August 1999.
 
2.b- The Balanchivadze Family (all names are pseudonyms):
 
Bekari: Male, age 46. In Abkhazia, he was a well-known soccer star and police officer. Since fleeing Abkhazia, he has acted as a "paramilitary" officer, at times leading other IDPs to the Gali region to fight the Abkhazians.
 
Lia: Female, mid-forties, Bekari's wife. In Abkhazia, she was a teacher.
 
Merabi: Bekari and Lia's oldest son, now 22.
 
Gogi: The second son, age 19.
 
Nana: The youngest, a daughter, age 17.
 
Lia's parents: In their 70s. They live in the "apartment" above Bekari's and Lia's. In Abkhazia, Lia's father Tengiz was a well-known writer and journalist who had written six novels. He had been involved in protesting the Abkhazians' treatment of Georgians and in promoting nationalistic feelings among Georgians there. Now he writes poems about IDPs' psychological wounds and their consequences, and about the political situation in this part of the world.
 
Sopiko: Merabi's wife of seven months, also an IDP.
 
Charlie: The family dog. (died in 1999.)
 
 
 
The flight of the Balanchivadze family from Abkhazia in 1992, was very traumatic (for the sake of brevity here, we will not go into the details). After they became refugees, Lia witnessed, on Russian television, their beloved family house in Abkhazia being burned to the ground. She also saw the family dog, Charlie, wandering around the ruins. Deeply affected, the children found a stray dog at Tbilisi Sea, took him "home" to their apartment, and named him Charlie. The new Charlie therefore became an important emotional "link" to their previous lives.
 
Bekari's and Lia's "apartment" of hotel rooms on the fifth floor of Okros Satsmisi consisted of one "living room" with a table and a couple of old chairs, partitioned by a hanging curtain. Behind the curtain, in a cubicle without a window, was the bed where Bekari and Lia slept. The living room also opened onto a balcony that was cluttered with old furniture and salvaged items. A kitchen adjoined this living room, and through the kitchen one could enter another apartment where the two sons slept. The daughter, Nana, slept in an upstairs apartment with Lia's parents.
 
We have called our conversations with the Balanchivadze family "therapeutic interviews," as they aimed to help the family members therapeutically. While we believe that our interviews were helpful to the Balanchivadzes, for the purpose of this report we will focus on their teaching function, rather than their therapeutic effect.
 
The Balanchivadze interviews provided occasions for demonstrating and experientially teaching FDHR members about the four areas in which mental health workers can contribute to societal rehabilitation after trauma, (see pp. 7-9.)
 
We have organized this section on experiential teaching around those four kinds of assistance:
 
1- Crisis Intervention.
 
2- PTSD.
 
3- Societal Changes.
 
4- Transgenerational Transmission of Trauma.
 
 
 

1- Crisis Intervention:

On our first visit to Tbilisi Sea in May 1998, Bekari and his men were dressed in their paramilitary uniforms and were getting ready to drive to the Gali region where renewed fighting had broken out. Indeed, soon after we interviewed Bekari, the men got into paramilitary vehicles, which were parked outside the hotel, and left. We later learned that one of them was killed in the fighting and the rest returned about a week later.
 
We interviewed Lia that day as her husband was getting ready to go to war, then a second time two days later when Bekari was still away, and finally a third time after Bekari had returned. As the "leader" of the anxious Tbilisi Sea women whose husbands and sons had gone to fight, Lia needed to remain calm. She was a role model for the other wives with whom she often gathered during that time, around the telephone. Her only openly-expressed anxiety centered around her oldest son Merabi's desire to join his father in war. She was so worried that she said that if Merabi went to fight, she would go too. In the end, Merabi stayed at Tbilisi Sea.
 
During our interview, we also learned about other ways that Lia handled her anxiety. For example, she dreamt that someone else's husband had died and the widow was in grief. She was displacing her own expected predicament onto others. In spite of her outward calm, this woman was constantly preoccupied with losses and anxiety.
 
CSMHI's interviews with Lia showed the FDHR members that even though someone in a crisis situation appears nonchalant and effective, her internal world is very busy and she should be perceived with empathy. One should not be fooled that everything is under control, and by interviewing carefully, one can see how a person is bubbling with anxieties and defenses against these anxieties.
 

Paradoxically, when Bekari returned unhurt, both he and Lia were in some ways retraumatized. When Bekari was active in the fighting, he, and by extension Lia also, was able to suppress his helpless IDP self. His helplessness was transformed into assertiveness. When Bekari returned from the fighting, yet Abkhazia was still under the Abkhazians (i.e. no progress had been made), he and Lia were once more filled with helplessness, shame and humiliation. To cover up these feelings, they were also full of rage against the Georgian Government that had, in their eyes, stopped them from retaking Abkhazia. (There was, of course, no realistic chance of winning a decisive victory with this small skirmish.)

 
 
Insights from the interviews: Crisis Intervention:
 
a- Even when a traumatized person appears nonchalant and calm during a crisis period, his or her internal world is filled with anxieties, mostly regarding possible further losses. Being aware of these hidden anxieties can help the mental health worker encourage the traumatized person to put the anxieties into words, thereby bringing some relief.
 
b- The opportunity to be assertive and active can temporarily relieve helplessness.
 
c- When assertiveness does not get results, re-traumatization occurs.
 
d- Mental health workers need to pay special attention to the feelings of humiliation and shame during crises (especially when re-traumatization may be taking place.)
 
e- Mental health workers must develop empathy for the re-traumatized persons' need to express their rage against a target (in this case President Shevardnadze and his government), even if this rage appears irrational or unjustified. At the same time, mental health workers should also assess any psychopolitical ramifications of such reactions. (In this case, the sentiments against the Shevardnadze regime died away within a few months and appear to have had no long-term consequences.)
 
 
2- Post Traumatic Stress Disorder (PTSD):
 
2.a- FDHR members were already experts in diagnosing the symptoms of  PTSD in individuals years after the trauma. We pointed out how the image of the trauma threatens self-esteem and illustrated the kinds of mental defenses that traumatized individuals utilize to deal with this threat to self-esteem. If these defenses are "sublimated" (good adaptation), they should be supported.
 
2.b- Tengiz, Lia's father, exhibited an example of a "good" adaptation. After becoming an IDP, Tengiz began writing poetry almost daily about his internal world, which he perceives as being imprisoned. Below is one of his poems entitled Children Beggars. He told us how he suffers and feels humiliated when he sees IDP children begging for food or money in the streets of Tbilisi.
 
 
Children Beggars
 

When I see your hand begging My dignity suffers.

I cannot give you my soul (suli.)

Since it is impossible to give one's soul to someone.

But, I have nothing left except my soul.

I am pressing against prison bars
If you need my life, I can give it to you.
 
 
Even though the content of the poem is very sad, the act of writing it is Tengiz's way of turning his passivity into assertion, discharging his humiliation, and finding an acceptable defense against his loss of self-esteem. Furthermore, his poems provided a link to his former life in Abkhazia where he thrived in an intellectual atmosphere. Tengiz's poetry writing is an example of sublimation, of developing adaptations that address losses from the trauma and turn them into new ways of living and moving forward. Writing poetry helped him keep continuity with his former life.
 
When the CSMHI team showed interest in Tengiz's poems (which he kept lovingly in stacks of neat folders), his mood changed abruptly, his self-esteem returned, and his dignity increased. After we discussed this interview with FDHR, they began developing plans to arrange for Tengiz to read his poems on national television. In addition to the benefit to Tengiz himself, this event could also have much wider psychopolitical ramifications and lessen the split between native Tbilisians and the IDP Georgians in their midst.
 
 
Insights from the interviews: PTSD:
 
a- More examples of turning passivity to assertiveness.
 
b- The need to find ways of supporting IDPs' sublimations of theirtraumatic experience.
 
 

3-  Societal Changes:

Our interviews with the Balanchivadze family also revealed clues to broader psychological processes that may be affecting whole sections of society, and that are sometimes difficult to unravel and detect. An example of such a society-wide issue came out of a seemingly insignificant detail in Lia's story.
 
When Lia was escaping from their home in Abkhazia, she deliberately left her internal passport behind. During Soviet times, everyone had an internal passport, which indicated one's ethnic identity. What concerned Lia the most—in case of trouble or capture by Abkhazians—was that her passport identified her as the daughter of Tengiz Chachava. Because of his notoriety, the Abkhazians were in fact actively searching for Tengiz Chachava at the time of Lia's escape. At one point, they apparently captured at gunpoint an old Georgian man whom they mistook as Chachava. (He was released when they realized their mistake.)
 

Lia's married surname of Balanchivadze was listed on her passport, but she said that everyone knew Bekari Balanchivadze's wife was Chachava's daughter. To Lia, leaving her passport behind symbolically came to mean leaving her identity behind. As a refugee, she felt she had no identity, and this induced in her a sense of shame. "When I go to a bank, they ask for my identity. I tell them my name and they don't believe me," she said. Indeed, if she had an "identity," she would be eligible for financial help from the IDP assistance funds. In order to prove who she is and to get a temporary identification card, Lia would have to go to court, but so far, she has refused to do so. First of all, she would have to pay a court fee, but, more importantly, she was ashamed that people no longer recognized her, that in the bureaucrats' eyes she was nobody now. It seemed that internal psychological processes prohibited her from going to court. Economic gains were secondary to her wish to avoid exposing herself to bureaucrats who thought she was nobody.

 
Upon hearing her internal passport story, the CSMHI interviewer said, "We believe you are Lia from Abkhazia. We will write your story—with your permission—and we will verify who you are." Hearing this, she responded with laughter and pleasure. We also agreed with her that it was emotionally humiliating to have to establish a new identity. "Very humiliating," Lia said, now at ease.
 
We learned that there were many others lacking internal passports and therefore legal identities. This aspect of our interview with Lia brought attention to a psychological difficulty among the refugees that probably would not have been identified through a simple "question and answer" type of data collection. Subsequently, through friends at the Foundation of Human Resources in Tbilisi, we initiated a process to assure that Tbilisi authorities would provide identity cards for those refugees who had lost their original ones. We emphasized that it should be done in a respectful manner so as not to induce humiliation among the recipients. We also suggested that the new identification cards should denote the refugee's original place of birth or residence.
 
By the time of our next visit in November 1998, Lia had acquired her new identity card. Once she had verbalized her humiliation, and we had discussed how acquiring a new internal passport did not negate her original identity or her continuity as a person, she was able to go and get one.
 
 
Insights from the interviews: Societal Changes:
 
a- An individual's psychological problems may interfere with resolving social or legal issues. To hold onto one's threatened identity is sometimes more important than economic gain.
 
b- It is important to identify, or diagnose, maladaptations to new environments that may stem from hidden internal needs. If such maladaptations can be articulated, they may also be changed.
 
c- When IDPs' self-esteem and Identity are verified, they are more prone to turn their state of helplessness into assertion.
 
 
4- Transgenerational Transmission of Trauma:
 

4.a- As noted earlier, this concept involves members of one generation, who have undergone trauma, passing on attitudes and tasks to members of subsequent generations, with the result that new generations perpetuate in one form or another the conflicts and trauma that befell their parents. Among refugees, when mothers or other caretakers are under stress and regressed, transgenerationai transmission of tasks can be observed, even when interactions take place only between adults and no direct communication from parent to child articulates the "task."

 
4.b- In the case of the Balanchivadze family, it was Lia who unconsciously transmitted her trauma to her daughter Nana. From our interview with Lia, we learned that every night, she went to bed worrying about how to feed her three growing children the next day. She never spoke to Nana about her worries, but the daughter sensed her mother's anxiety. She also unconsciously took on the task of responding to and alleviating her mother's pain. Nana refused to exercise, became somewhat obese, and kept a frozen smile on her face. When we interviewed both of them, we learned that the daughter, through her bodily symptoms, was trying to save her mother by sending her a message: "Mother, don't worry about finding food for your children. See, I am already overfed and happy!"
 
4.c- When the CSMHI team returned for the next visit, several months after the interview that revealed this dynamic, we found that Nana had lost weight, and no longer wore a frozen smile, but seemed more relaxed and "herself."
 
 
Insights from the interviews: Transgenerational Transmission of Trauma:
 
a- When traumatized individuals are regressed, they may send messages down generational lines, without verbalizing them, or being conscious of them.
 
b- Younger generations may be given "tasks" to perform by their parents and grandparents that respond to the older generation's emotional needs. Again, articulating and bringing such dynamics to the surface lessens the harmful influence they may have on the people involved.
 
 
2- Intellectual Teaching:
 
2.a- During the project period, CSMHI also engaged in dissemination of practical information on trauma, interethnic relations, post traumatic stress disorder and other topics to clinicians, teachers, politicians, political scientists, historians, reaching as many people as possible. We scheduled our trips to Georgia to coincide with major political and academic conferences. We were in Georgia during the 80th Anniversary of the founding of the Georgian Republic under its first president Noe Jordania. President Jordania's surviving son, Redjeb, had organized a conference in Tbilisi in May 1998. While preparing for this big event, Mr. Jordania came to Charlottesville to consult with CSMHI faculty about the conference program, and invited CSMHI faculty to give two lectures there. In the process, we became acquainted with government officials who participated in the conference.
 

2.b- Also in May 1998 and again in March 1999, we gave lectures at Tbilisi State University and developed a relationship with academicians and deans there. Topics included post-traumatic societies, the psychodynamics of prejudice, and childhood trauma. After the event, CSMHI's ideas on ethnic conflict were written up in Georgian newspapers.

 
2.c- As our USIP grant came to an end, FDHR prepared a significant event to coincide with CSMHI's last visit with them and the South Ossetians. The event was a two-day conference entitled Society and Psychological Support, and included presentations by three CSMHI members and FDHR core members as a culmination of our year's work together. Topics presented were Transgenerational Transmission of Trauma, Individual Traumas and Adaptations, and the Psychodynamics of Post-Soviet Phenomena. Appendix 4, is a list of presenters and topics from this conference. This meeting was hosted by the Ombudsman of the Republic of Georgia. The Ombudsman opened the conference and CSMHI later met with him and briefed him on our project.
 
2.d- The last set of lectures given by CSMHI at the request of FDHR took place on the last day of our August 1999 visit. In a sense, this full-day seminar by J. Anderson Thomson, served to review clinical and psychopolitical aspects of all their activities to establish a firmer conceptualization of their work. Topics ranged from re-evaluation of PTSD symptoms in adults and children, PTSD treatment, mental health workers' emotional reaction to PTSD patients, and theories of aggression and violence, including large-group violence.
 
 
3- Laying a Foundation for Psychopolitical Dialogues:
 

Introduction and Definition:

In CSMHI's terminology, psychopolitical. dialogues are a series of intensive workshops (like those conducted with FDHR and Youth Palace participants under this grant) in which members of two opposing groups are convened under the facilitation of an interdisciplinary CSMHI team. This team is composed mainly from three fields: psychoanalysis/psychiatry, diplomacy/political science, and history.
 
During the workshops, CSMHI facilitators bring into the open previously unrecognized thoughts and feelings and help the participants work through them. The goal is to prevent these disturbing thoughts and feelings from remaining in the shadows and interfering with a realistic evaluation of and relationship with the "enemy." In this sense, the workshops are therapeutic, but not at the level of personal problems. Since they deal with conflicts pertaining to participants' large group identity, images of the enemy group, and historical grievances, they are also psychopolitical.
 

This series of meetings or psychopolitical dialogue becomes a "process" where historical grievances are aired; perceptions, fears, and attitudes are articulated; and previously hidden psychological obstacles to reconciliation or change are brought to the surface. Their aim is not to erase the images of past historical events and differences in identity and culture, but rather to detoxify the relationship so that differences do not lead to renewed violence. When two groups are in conflict, the enemy is obviously real, but it is also fantasized. If participants can differentiate their fantasized dangers from the current issues, then negotiations and steps toward peace can become more realistic.

 
To be effective on a long-term basis, the series of workshops calls for the same 30 to 40 participants to meet two to three times per year for 3-4 days each time. During the workshops, there are plenary sessions, but most of the work is done in small groups led by members of CSMHI's interdisciplinary team. CSMHI has conducted workshops among participants at the senior decision-making level (legislators, ambassadors, government officials) as well as at the grass-roots level in small communities. In each case, the participants become spokespersons for their ethnic or national groups, and in each case, we seek to spread the insights gained to the broader population through concrete programs that promote coexistence. Members of CSMHI have carried out such psychopolitical workshops between Arabs and Israelis, Turks and Greeks, Estonians and Russians, and Croatians, Serbians, and Bosniaks. Descriptions of such workshops can be found in the following bibliographical references: (Apprey 1996, 1997, Volkan, 1988, 1997, 1998, 1999a, 1999b, Volkan and Harris 1992a, 1992b). For theoretical background and technique of this type of workshop, (see Appendix 5.)
 
If psychopolitical dialogues are to succeed and have any impact on a society, the outside facilitators must earn the trust of the participants from both parties. In the course of this USIP-funded initiative in Georgia, we have achieved just that. We have established credibility and trust with both Georgians and South Ossetians, not only in the actual project work, but also by immersing ourselves in the place and living with the people.
 
On each trip to Georgia, rather than opting for the glamorous isolation of hotels, the CSMHI team chose to stay in apartments in the same building as our partner Professor Nodar Sarjveladze. We experienced with our hosts the physical challenges of every day life in Tbilisi, including intermittent electricity, scanty heating systems in the winter, and total absence of air conditioning during one of Georgia's hottest summers ever. We traveled three times to South Ossetia across its eerie non-border, although we learned later that even USAID staff had not ventured to do so. We visited refugee camps, were welcomed into Georgian homes, and were shown the birthplace of Stalin. We survived severe food poisoning and other ailments, but it was clear that our Georgian partners were truly moved by the fact that we chose to live, travel, and work with them.
 

We have gained the trust of our South Ossetian partners as well. In fact, the South Ossetians have asked the CSMHI team to visit South Ossetia more often, and bring with theminformation and organizational suggestions to reduce criminality and prostitution among their teenagers. South Ossetia was a cohesive society even during Soviet times. They are now deeply saddened and wounded by the destructive behavior of their sons and daughters that they cannot deal with. They do not view CSMHI as outsiders who come to preach at them, but rather colleagues who care for them. They do not have much experience with American or other Western outsiders.

 
Having earned the trust of our Georgian and South Ossetian partners, and having completed an in-depth assessment of the psychopolitical climate in Georgian-South Ossetian relations, we have laid a firm foundation for a series of grass-roots level psychopolitical dialogues. If appropriate funding becomes available, we hope to build on this foundation.
 
 
Evaluation and Impact: 
 
We will evaluate and describe the impact of this project according to the three areas of our activities:
 
A- Georgian-South Ossetian Youth Programs in Tskhinvali.
 
B- Teaching / Training by CSMHI.
 
C- Laying a Foundation for Psychopolitical Dialogues.
 
 
 
A- Georgian-South Ossetian Youth Programs in Tskhinvali:
 

Improvement in the Children:

During the course of our consultation, we saw marked improvement in the South Ossetian children being treated at the Youth Palace. One way to evaluate such progress is through the children's drawings, an often-used measure of viewing a child's internal world, especially in young children who do not have the developmental capacity to verbalize their emotional states, and who instinctively protect themselves from the pain of openly expressing anxieties. The initial drawings that we saw when the project started included images such as those described in Workshop 3. One drawing showed an island with a single stick figure on it shouting for help. Others were of lonely figures with hair sticking out as if frightened. Over time, the drawings changed to depict less anxiety and more socialization. Instead of solitary individuals, recent drawings were of groups of figures interacting, reflecting the children becoming more social beings.
 
In a memorable session where the Georgians were present, the children were elated and telling stories of "eating up" their South Ossetian teachers. (Eating symbolizes taking something in, which stands for active identification.) Georgian psychologists were able to point out to the South Ossetians that these images reflected the children's identification with their teachers, taking them in, and did not represent something angry. It was clear that the South Ossetian teachers had become crucial role models for the children.
 
Another measurement of the success of the program was that while criminality, alcoholism, and prostitution were rampant in Tskhinvali, the children who attended the Youth Palace program did not exhibit such behavior patterns.
 

Growing Reputation of the Program:

The South Ossetian caretakers had also learned from FDHR and from CSMHI some techniques for increasing the self-esteem of these traumatized children. The number of children enrolled in the program grew from 60 in fall 1998 to 90 by August 1999, reflecting the program's growing positive reputation and parents' recognition of their children's needs.

 

Increased Role in Society by South Ossetian Caretakers:

The South Ossetian caretakers' ability to deal with children has improved since the Georgians began coming to work with them. They have also increased their involvement in social rehabilitation activities outside the Youth Palace. In one instance, we were told of a second grader who was the second oldest of seven children in a traumatized family. His parents had become alcoholic, and he was frequently beaten by his father. When the South Ossetian psychologists went to the family's home to protect the child, the family would not admit them. Since he was unsupervised, however, he was able come regularly to the meetings at the Youth Palace. Gradually, the instructors were able to change the child's attitude towards himself, making him feel worthwhile despite his parents' neglect.
 

Progress in Caretaker to Caretaker Relationship:

Regarding the relationship between the Georgian psychologists and teachers at FDHR and their South Ossetian counterparts, we have also seen progress. Although neither the Georgians nor the South Ossetians are yet prepared to reveal their own wounds and reactions to the trauma to each other, they have become more aware of the obstacles to their full collaboration. Given the history of the Georgian-South Ossetian relationship and the violent enmity of seven years ago, it is natural that emotional resistances still remain.
 

Official Support of Georgian-South Ossetian Collaboration:

Despite its challenges, the relationship between the Georgians of FDHR and the South Ossetians of the Youth Palace is now completely out in the open. As mentioned earlier in this report, CSMHI met with South Ossetian government officials and received their approval in March 1999. We also met twice, in November 1998 and March 1999, with the Georgian Minister of Public Health Avtandil Jorbenadze and have his enthusiastic and official support as well. (See letter from Georgian Minister, Appendix 6.)
 

Approval and Continued Funding by Norwegian Refugee Council:

We met again in August 1999 with a representative of the Norwegian Refugee Council and learned that they have given the FDHR-Youth Palace program a very positive evaluation. They will continue to fund it during 1999-2000 and have committed $100,000 to FDHR's programs.

 
 
B- Teaching / Training:
 
Balanchivadze Interviews:
 
Experiential Teaching and Therapeutic Success:
The series of interviews that CSMHI conducted with the Balanchivadze family at Tbilisi Sea illustrated all four kinds of intervention that mental health professionals can make in traumatized societies. These observations and experiences, coupled with what happened during the workshops facilitated by CSMHI, were perceived by the FDHR psychologists and psychiatrists as the most important aspects of CSMHI's consultation with them. (See Appendix 7 for FDHR's feedback on the project.) They form the basis for CSMHI's developing experiential training methodology. These techniques differed dramatically from other teaching and training they had received in their formal education, as well as from consultations from other outside organizations that they received since the conflicts.
 
In these "therapeutic interviews" with the Balanchivadze family, CSMHI demonstrated the merger of clinical skills and psychopolitical insights that are essential to helping a society traumatized by ethnic conflict. FDHR members were exposed to new methods for understanding and supporting the psychological needs of traumatized persons. Unlike in the aftermath of a natural disaster, the problem is not just physical and economic devastation, it is compounded with political and ethnic strife. Likewise, one needs both theory and practice, and both clinical and psychopolitical. Because they live in the midst of the ongoing tensions, the Georgians already have instincts regarding the psychopolitical, but in many cases they lack the clinical skills to know how to draw things out, to ask the questions that will bring out how the clinical and psychopolitical intersect.
 
From a therapeutic point of view, we learned that attention from the outside, as infrequently as every three months, can make a difference in the lives of IDPs. Through our own observation, verified by interim visits by FDHR members, we have seen increasing adaptiveness in the Balanchivadze family. We learned how positive transferences to the outsiders (meaning the outsider is seen as someone who will love and care for them) helped them to bloom in the midst of privation. Nana has lost weight and no longer bears physically her mother's worries.
 

When CSMHI first met the Balanchivadze family in May 1998, the husband was going off to fight the Abkhazians. The family spoke of possible victory and hoped to return home within six months. The May 1998 skirmish did not lead to victory, and on a later visit, the family had adjusted a little and were looking at a five-year horizon for going home. By the end of the project, the family had accepted their refugee status, at least for now, and were thinking in terms of 10 more years as refugees. As evidence of this acceptance of their situation, they began to renovate the dilapidated hotel rooms in which they had already been living for over seven years.

 

Intellectual Teaching:

In the course of this project, CSMHI identified gaps in the training and knowledge of FDHR and attempted to fill them through various means. On each trip to Georgia, we gave lectures and seminars to FDHR members alone, to university and professional audiences, and to broader conferences that included Georgians and representatives from abroad. In each case, the feedback from attendees was extremely positive and always included requests for additional presentations.
 
One of the best indications that our training was useful came in August 1999, in the presentations that FDHR members gave at the conference on Society and Psychological Support. (See Appendix 4) The content and emphasis of their presentations included many of the topics and insights covered by CSMHI. Here was clear evidence that FDHR members had assimilated many of these ideas and were now passing them on to a wider audience.
 
 
C- Foundation for Psychopolitical Dialogues:
 

Increased Trust Between Georgian and South Ossetian Caretakers:

CSMHI has observed that trust has increased between the Georgian psychologists and psychiatrists at FDHR and their South Ossetian counterparts. While they had already begun a joint project before CSMHI's involvement, their interaction shows signs of becoming more direct. During our workshops with FDHR members alone, these Georgians began to examine out loud their anxieties and feelings vis-a-vis their work with the South Ossetians. As they saw in themselves and in their own unspoken reactions echoes of the historical grievances and legacies of the war, they could begin to imagine what the collaboration must feel like for their South Ossetian counterparts.
 
Although we did not have the opportunity to meet with the South Ossetians alone during this project, we have seen signs of increased trust on their side as well. At CSMH's instigation, some of the South Ossetians came to Tbilisi in August 1999 for the first time as a group to meet with FDHR and CSMHI. Previously, all meetings had taken place in South Ossetia or a neutral location, and this marked a big step in the level of trust and risk-taking within the group, as well as in empathic understanding of each other's fears.
 
 

CSMHI's Credibility Among Georgian and South Ossetian Authorities:

In addition to developing trust among the Georgian and South Ossetian mental health professionals, CSMHI has also become known by Georgian and South Ossetian government officials. In Tskhinvali, the team met with and briefed Kosta Dzugaev, Speaker of the South Ossetian Parliament; Fatima Poukhayeva, Counselor to the President of South Ossetia; and Murat Jioev, Minister of Foreign Affairs of South Ossetia. In Tbilisi, the team met twice with Dr. Avtandil Jorbenadze, the Georgian Minister of Health, and received his enthusiastic support for our approach and efforts (See his letter of support in Appendix 6.)

 
Another sign that CSMHI's expertise and understanding is respected in Tbilisi came in August 1999 when Devid Japaridze, Chief Advisor on Repatriation, in the Georgian Ministry of Refugees and Accommodation approached CSMHI for guidance and assistance in their plans to repatriate some of the 300,000 Meskhetians who were deported by Stalin. Today, many of these Meskhetians and their descendants live in the Northern Caucasus (Russian Federation) and Azerbaijan, and OSCE has given Georgia 12 years to bring back to Georgia those who wish to return. With its thorny ethnic, legal, and social aspects, this process will be no small task, but CSMHI is exploring with the Ministry possible approaches to the issue.
 
 
 
Conclusion:
 
The situation is ripe but fragile:
While violence in the Georgian-Abkhazian conflict continues to flare up periodically and resolution continues to be elusive, the Georgian-South Ossetian relationship appears more stable. There has been no fighting since the conflict itself ended, and official and unofficial contacts between Georgians and South Ossetians are increasing slowly. For the South Ossetians, union with North Ossetia and assistance from the Russian Federation did not materialize, so this landlocked territory is left with the option of negotiating an arrangement with the Georgians. From the Georgian perspective, the conflict with the South Ossetians is not tinged with the same humiliation and shameful defeat that characterizes their fight with the Abkhazians. In fact, in some quarters there is unspoken guilt for the damages done to South Ossetians and an unspoken belief that the Georgians provoked the conflict. Thus for a variety of reasons, the Georgian-South Ossetian relationship appears amenable to rapprochement, if one can overcome the obstacles caused by the recent enmity and violence.
 
Mistrust, hesitation, enmity, and grief are present on both sides, and CSMHI has seen how fragile and vulnerable efforts to collaborate can be. We believe that a neutral third party can promote face-saving ways for Georgians and South Ossetians to begin to overcome these obstacles and normalize their relationship. While other Georgian-South Ossetian contacts and dialogues exist, none appear to be dealing with the psychological obstacles involved. CSMHI has the clinical/psychopolitical skills and experience to address and reduce the painful resistances to a deeper and more sustained working relationship. The collaborative work already begun with Georgians from FDHR and their South Ossetian counterparts can serve as a foundation and an entry point to opening up a broader dialogue between Georgians and South Ossetians. CSMHI is exploring ways to build on the results of this project so that the progress made can be solidified and lead to greater stability and peaceful coexistence among Georgians and South Ossetians.
 
 
 
-----------------------------------------
 
 
 
APPENDIX 1:
 
PROJECT PERSONNEL AND CONTACTS:
  
 
 
CENTER FOR THE STUDY OF MIND AND HUMAN INTERACTION (CSMHI):
 
PROJECT CO-DIRECTOR: 
Vamık D. Volkan, M.D., L.F.A.P.A., F.A.C. Psa., is a professor of psychiatry and psychoanalyst at the University of Virginia. He is the director and founder of the University's Center for the Study of Mind and Human Interaction (CSMHI), an interdisciplinary center that brings together psychoanalysts, psychiatrists, psychologists, former diplomats, historians, and political scientists to study large-group psychology, especially as it relates to national and ethnic conflicts. He is also a training and supervising analyst at the Washington Psychoanalytic Institute, Washington, DC.
 
Dr. Volkan was a founding member of the International Society of Political Psychology (ISPP) and served as president. Since 1990, Dr. Volkan has been a member of The Carter Center's International Negotiation Network (INN.) In 1996, he served as chairman of a Select Advisory Commission to the FBI's Critical Incident Response Group, a committee formed to give advice on the role of behavioral scientists in responding to critical incidents such as Waco and Ruby Ridge.
 
Dr. Volkan's interest in the psychological causes and consequences of large-group conflict was prompted by a statement in a 1977 speech by former Egyptian President Anwar el-Sadat to the Israeli Knesset. In his address, Sadat suggested that 70 percent of the problem between Arabs and Israelis was psychological. As a member and subsequent chair of the American Psychiatric Association's Committee on Psychiatry and Foreign Affairs, Dr. Volkan participated in a series of dialogues that brought together influential Israelis, Egyptians, and Palestinians from the West Bank and Gaza between 1980 and 1986. In 1988, Dr. Volkan founded CSMHI to build on insights and experiences gained during these dialogues.
 
Dr. Volkan has done psychopolitical work in the USSR, Romania, Slovakia, Hungary, Cyprus, Tunisia, Turkey, Albania, Croatia and Kuwait. He led CSMHI's five-year project in Estonia. He was project director of CSMHI's 1998-99 USIP-funded project the Republic of Georgia.
 
In addition to the three previous grants from USIP, he has received grants from the W. Alton Jones Foundation, the Pew Charitable Trusts, the William and Flora Hewlett Foundation, the Massey Foundation, the Winston Foundation, the International Research and Exchange Board (IREX), and USA Information Service.
 
In 1994 he received the Nevitt Sanford award from the International Society of Political Psychology (ISPP) for his contributions to the field of political psychology. In 1995, he received the Max Hayman award from the American Orthopsychiatric Association for outstanding contributions to the knowledge and understanding of the Holocaust and genocide. In 1996, the American Anthropological Association's Society of Psychological Anthropology awarded him the L. Bryce Boyer prize for his work in post-Ceaucescu Romania. In 1997, Dr. Volkan gave the Anna Freud Lecture at the Vienna Psychoanalytic Association. In 1998, he received the Margaret Mahler literature award for his clinical writing. He returned to Vienna to give the 1999 Annual Sigmund Freud Lecture on his work in Arab-Israeli dialogues. In 2000, he will serve as an Inaugural Fellow at the Yitzhak Rabin Center for Israel Studies in Tel Aviv.
 
He has written over 150 articles and book chapters on clinical and psychopolitical topics and has authored, co-authored or edited over thirty books. His work has been translated into Finnish, German, Italian, Japanese, Romanian, Russian, Spanish, Swedish and Turkish. His clinical research relevant to the project in the Republic of Georgia includes a multi-year investigation of the topics of grief, mourning, trauma, and depression.
 
Dr. Volkan has served on the editorial boards of a dozen professional journals, including 10 years' service on the board of Political Psychology. In 1989, he founded and became editor-in-chief of CSMH's quarterly journal, Mind and Human Interaction.
 
PROJECT CO-DIRECTOR:
Yuri Urbanovich, Ph.D., was born in Tbilisi, Georgia to Armenian and Lithuanian parents. He speaks Georgian and Russian as well as English. He has been the International Scholar at CSMHI since 1992 and was formerly Associate Professor and Director of the Special Projects Task Force on Negotiations at the Diplomatic Academy of the Russian Ministry of Foreign Affairs. He participated in the Soviet delegation at the Geneva Conference on Disarmament (1986-87.) While at CSMHI, he has been central to our Baltic project and the USA-Soviet meetings that preceded it. He has also been a key member of CSMHI's 1998-99 USIP-funded project in the Republic of Georgia.
 
CSMHI TEAM MEMBERS:
J. Anderson Thomson, Jr. M.D., is Assistant Director of CSMHI and Clinical Associate Professor of Psychiatric Medicine at the University of Virginia. He is also a staff psychiatrist at the University of Virginia Student Health Services. His clinical work includes general psychiatry, psychoanalytic psychotherapy, psychopharmacology, and forensic psychiatry. Dr. Thomson is an expert in personality profile examination of leaders and specialist in Post-Traumatic Stress Disorder, post-traumatic societies, and the psychology of prejudice and racism. He has developed training seminars on post traumatic stress disorder and how it applies to societies.
 
He participated in CSMHI's Baltic and Kuwait projects. The Baltic project included psychopolitical dialogues between Estonians and Russians and community building programs in Estonia. In Kuwait, Dr. Thomson was a member of team interviewing adults and children in order to assess the society's response to the Iraqi invasion. He is also a team member in CSMHI's 1998-99 USIP-funded project in the Republic of Georgia. With Max Harris and Vamık D. Volkan, he co-authored The Psychology of Western European Neo-Racism. With Boissevain and Aukofer, he wrote a psychological profile of Lee Harvey Oswald.
 

Gregory B. Saathoff, M.D., is a member of the CSMHI faculty and Associate Professor of Clinical Psychiatry, University of Virginia and serves as Conflict Resolution Specialist for the FBI's Critical Incident Response Group. In 1995, he served as psychiatric consultant to King Faisal Specialists Hospital, Riyadh, Saudi Arabia. He is a consultant to the Virginia Department of Corrections and the Virginia State Police. He participated in CSMHI's Baltic and Kuwait projects. The Baltic project included psychopolitical dialogues between Estonians and Russians and community building programs in Estonia. In Kuwait, Dr. Saathoff was a member of team interviewing adults and children in order to assess the society's response to the Iraqi invasion. He has participated in our CSMHI's 1998-99 USIP-funded project in the Republic of Georgia.

 
STAFF:
Joy Boissevain, CSMHI's Program Director, is responsible for overseeing CSMHI's grant writing and reporting process, as well as general and financial administration of the Center. She has participated as a team member on CSMHI's Estonia project and coordinates the team work on all projects. Her previous experience includes administration of USAID-funded participant training programs and teaching secondary school French.
 
Kathryn Sparks, Assistant to Program Director, has been working with the CSMHI team for nearly two years. She has considerable administrative experience from time spent working in New York, most notably at Citibank. She serves as CSMHI's event organizer and web site manager and helps in a variety of capacities with the running of the office in Charlottesville. She is also a dancer, choreographer, and dance teacher.
 
FOUNDATION FOR THE DEVELOPMENT OF HUMAN RESOURCES (FDHR) GEORGIAN PARTNERS:
1- Nodar Sarjveladze, Psychologist, Director, Foundation for the Development of Human Resources (FDHR).
 
2- Amiran Dolidze, Dramatist, Assistant Director, FDHR.
 
3- Zourab Beberashvili, Psychologist.
 
4- Jana Djavakhishvili, Psychologist.
 
5- Manana Gabashvili, Psychologist.
 
6- Nato Sarjveladze, Psychologist.
 
7- David Charkviani, Psychologist.
 
8- Nino Makhashvili, Child Psychiatrist-Psychotherapist.
 
9- Rezo Jorbenadze, Social Psychologist.
 
10- Marina Baliashvili, Social Psychologist.
 
11- Shermadin Sharia, Psychologist.
 
12- Mamuka Erkomaishvili, Teacher.
 
13- Lela Tsiskarishvili, Translator.
 
 
OTHER GEORGIAN CONTACTS:
14- Avtandil Jorbenadze, Georgian Minister of Public Health.
 
15- Gela Charkviani, first (or special) assistant to President Shevardnadze.
 
16- Givi Shugarov, member of Georgian Parliament, Chairman of the Parliamentary Group in Charge of Cooperation with the USA Congress.
 
17- Dali Pardjanadze, Dean of the faculty of psychology, Tbilisi University.
 
18- Valeriy Chokashivili, Professor of Georgian history.
 
19- Manana Rogovskaya, Psychologist working with refugee children.
 
20- Rousiko Mshvidobadze, Psychologist researching mass media.
 
21- Dali Berekashvili, Psychologist who compared regular orphans with refugee children.
 
22- Archil D. Soulakaouri, well known abstract realist painter who painted the civil war in which he participated and was wounded.
 
23- Nina Kipshidze, Georgian art historian.
 
24- Redjeb Jordania, the son of the first president of Georgia, Director, the Georgia project, The Harriman Institute of Columbia University.
 
25- Nicole Jordania, Humanitarian Specialist, Office of Humanitarian Response and Social Transition, USAID/Caucasus.
 
26- Alexander Rondeli, Professor of history, Tbilisi University.
 
27- George Khutsishvili, International Center for Conflict and Negotiation, Tbilisi.
 
28- Kent Brown, former USA Ambassador to Georgia.
 
29- Rıfat Atun, Physician from the British Government charged to initiate public health policies and their management in Georgia.
 
30- Julia Kharashvili, United Nations volunteers - National Community Facilitator.
 
31- Elizabeth Zaldastani Napier, President, Georgian Association, USA.
 
32- Genrikh Mouradian, Head of Administration ("Gamgebeli" in Georgian) of Akhalkalaki region, Republic of Georgia.
 
33- Zourab Shalamberidze, President, Cargo Transportation Co.
 
34- Gia Tarkhan-Mouravi, UNDP, Georgia.
 
35- Nana Sumbadze, lecturer in Social Psychology, Tbilisi State University.
 
36- Kent Larson, Chief, Office of Humanitarian Response/Social Transition, USAID/Caucasus.
 
37- David Japaridze, Senior Advisor to the Georgian Minister of Refugees and Accommodation.
 
38- John Andrew, Head of UNHCR Mobile Team, Georgia.
 

39- Hans Dieset, Resident Representative, Norwegian Refugee Council.

 
 
SOUTH OSSETIAN PARTNERS:
1- Venera Basishvili, Director, Palace of Child Creativity.
 
2- Rusiko Gobozova, South Ossetia, Palace of Child Creativity, Cultural activities organizer.
 
3- Ariana Jioyeva, South Ossetia, Palace of Child Creativity, Head, Director of cultural activities.
 
4- Madina Gazzayeva, Professor of developmental psychology, South Ossetia State University.
 
5- Aliona Siukayeva, Developmental Psychologist.
 
6- Irene Bekoeva, English Teacher at the Palace of Child Creativity.
 
 
OTHER SOUTH OSSETIAN CONTACTS:
7- Kosta Dzugayev, Chairman of the South Ossetian Parliament.
 
8- Murat Dzhioyev, South Ossetian Minister of Foreign Affairs.
 
9- Fatima Poukhayeva, Counselor to the President of South Ossetia.
 
 
-----------------------------------------
 
 
APPENDIX 2: 
 
BIBLIOGRAPHY:
 
 
1- Apprey, M. (1993.) The African-American Experience: Forced Immigration and Transgenerational Trauma. Mind and Human Interaction, 4:70-75.
 
2- Apprey, M. (1996.) Heuristic Steps for Negotiating Ethno-national Conflicts: Vignettes from Estonia. New Literary History: Journal of Theory and Interpretation, 27:199-212.
 
3- Apprey, M. (1997.) Alterity as Process in the Resolution of Ethnonational Conflicts: The Case of Estonia. Journal for the Psychoanalysis of Culture and Society.
 
4- Howell, W.N. (1993.) Tragedy, Trauma and Triumph: Reclaiming Integrity and Initiative from Victimization. Mind and Human Interaction,  4:111-119.
 
5- Howell, W.N. (1995.) "The Evil That Men Do...": Societal Effects of the Iraqi Occupation of Kuwait. Mind and Human Interaction, 6:150-169.
A Report on the Psychopolitical Diagnosis by CSMHI Involving Over 150 in-depth Interviews of Kuwaitis from A Wide cross-section of Society.
 
6- Ratnavale, D. (1983.) Mental Health Needs of Refugees and Other Victims of Disaster. Journal of Social Psychiatry, 3:39-46.
 
7- Rogers, R. (1991.) A Global Call For "Common Security" For All Children. Mind and Human Interaction, 3:108-111.
 
8- Saathoff, G. (1995.) In the Hall of Mirrors: One Kuwaiti's Captive Memories, Mind and Human Interaction, 6:170-178.
 
9- Saathoff, G. (1996.) Kuwait's Children: Identity In the Shadow of the Storm. Mind and Human Interaction, 7:181-191.
An article on the effects of the Iraqi occupation on Kuwaiti children.
 
10- Thomson, J.A. (1993.) Latvian Vignettes. Mind and Human Interaction, 4:191-197.
 
11- Thomson, J.A., Harris, M., Volkan V.D., and Edwards, B. (1995.) The Psychology of Western European Neo-racism, International Journal on Group Rights, 3:1-30.
 
12- Urbanovich, Y.V. (1997.) Georgia On My Mind. Silk Road, 1:18-25. A Report On Dr. Urbanovich's June 1995 and April 1997 Trips to Georgia.
 
13- Volkan, V.D. (1979.) Cyprus¾War and Adaptation: A Psychoanalytic History of Two Ethnic Groups in Conflict. Charlottesville, Virginia: University Press of Virginia. (Second Edition: 1980.)
 
14- Volkan, V.D. (1988.) The Need to Have Enemies and Allies: From Clinical Practice to International Relationships. Northvale, NJ: Jason Aronson.
 
15- Volkan, V.D., Julius, D.A., and Montville, J.V. (Eds.) (1990.) The Psychodynamics of International Relationships, Vol. I: Concepts and Theories.
Lexington, MA: Lexington Books.
 
16- Volkan, V.D., Julius, D.A., and Montville, J.V. (Eds.) (1991.) The Psychodynamics of International Relationships, Vol.11: Unofficial Diplomacy at Work.
Lexington, MA: Lexington Books.
 
17- Volkan, V.D., and Harris, M. (1992a.) Negotiating A Peaceful Separation: A Psychopolitical Analysis of Current Relationships Between Russia and the Baltic Republics.
Mind and Human Interaction, 4:20-39. A report on CSMHI's International Psychopolitical Dialogues in the Baltics.
 
18- Volkan, V.D., and Harris, M. (1992b.) Vaccinating the Political Process: A Second Psychopolitical Analysis of Relationships Between Russia and the Baltic States.
Mind and Human Interaction, 4:169-190. A report on CSMHI's International Psychopolitical Dialogues in the Baltics.
 
19- Volkan, V.D., and Harris, M. (1995.) The Psychodynamics of Ethnic Terrorism, International Journal on Group Rights, 3:145-159.
 
20- Volkan, V.D., and Itzkowitz, N. (1994.) Turks and Greeks: Neighbors in Conflict. Cambridgeshire, England. Eothen Press.
 
21- Volkan, V.D. (1997.) Bloodlines: From Ethnic Pride to Ethnic Terrorism. New York: Farrar, Straus and Giroux. Chapter 13.
Is A Comprehensive View of CSMHI's Multi-year Projects in Estonia.
 
22- Volkan, V.D. (1998.) The Tree Model: Psychopolitical Dialogues and Promotion of Coexistence. In Handbook for Interethnic Coexistence.
New York, NY: The Abraham Fund.
 
23- Volkan, V.D. (1999a.) Psychoanalysis and Diplomacy Part I: Individual and Large-group Identity. Journal of Applied Psychoanalytic Studies, 1:29-55.
 
24- Volkan, V.D. (1999b.) Psychoanalysis and Diplomacy Part II: Large-group Rituals. Journal of Applied Psychoanalytic Studies, 1:223-247.
 
25- Volkan, V.D. (1999c.) Das Versagen der Diplomatic-Zur Psychoanalyse Nationaler, Ethnischer und Religioser Konflikte.
(The Failure of Diplomacy: The Psychoanalysis of National, Ethnic, and Religious Conflicts). Giessen: Psychosozial-Verlag.
 
26- On Immigrants and Refugees: Children (1999.) A Special Issue of CSMHI's Journal, Mind and Human Interaction, 10, NO:1.
 
 
Featured the Following Articles:
 
Akhtar, S.                                  Age at Migration: An Introductory Overview.
 
Narayan, M., and Srinath, S.       Immigration and Autism in India.
 
Bonovitz, J., and Ergas, R.          The Affective Experience of the Child Immigrant: Issues of Loss and Mourning.
 
Van Essen, J.                            The Capacity to Live Alone: Unaccompanied Refugee.
 
 
Minors in the Netherlands:
 
Etezady, M.H.                           Review and Commentary: Child Immigrants and Refugees.
 
Ratnavale, D.                            Preparing for Peace and Healing the Psyche in Sri Lanka.
 
 
 -----------------------------------------
 
 
 
APPENDIX 3:
 
 
PRESENTED AT THE EIGHTH  INTERNATIONAL CONFERENCE ON HEALTH AND ENVIRONMENT:
 
        "GLOBAL PARTNERS FOR GLOBAL SOLUTIONS" 
 
 
Speech by
Vamık D. Volkan  
     
 
 United Nations, New York
April 23, 1999
 
 
 
 
POST-TRAUMATIC STATES:
BEYOND INDIVIDUAL PTSD IN SOCIETIES RAVAGED BY ETHNIC CONFLICT
 
 
 
Ladies and Gentlemen;
I am deeply honored to speak at the United Nations. I would like to thank Dr. Christine Durbak for inviting me again to come to the Eighth International Conference on Health and Environment: "Global Partners for Global Solutions" here at the UN. Along with many others, I appreciate your efforts in dealing with critical issues in health and the environment around the globe.
 

Today, I would like to focus on psychological health issues pertaining to ethnic conflicts and wars.
 

All of you are familiar with societies traumatized by war and ethnic, racial or religious conflict. And you are well aware of the individual suffering these tragedies inflict. Today, I would like to provide you with a new lens through which the aftermath of these devastating events can be viewed.
 

Though we are all familiar with the psychological state of the individual Post-Traumatic Stress Disorder (PTSD), we must also look closely at three other groups affected by PTSD, the first of which is composed of indigenous caretakers who themselves may be traumatized by or caught up in ethnic hatred. How do we help them?
 

Next we will look at the large group, or society, and at some of the signs and symptoms of societal processes which follow in the wake of these calamities. How do we diagnose post-traumatic states of societies and develop policies to combat them? And, finally, we will look at future generations and how the legacy of trauma and hatred is passed on at both the individual and societal levels. How do we identify and intervene in these transgenerational transmissions of trauma?
 
Natural or Accidental Traumas:
Before speaking of societies traumatized by ethnic, national, or religious conflicts, I wish to discuss the societal traumatization that can be caused by natural or accidental manmade disasters. A tropical storm, such as the one that devastated the Dominican Republic in 1998, or an earthquake such as the one that ruined Armenia in Columbia in 1999, are natural disasters. When a natural disaster takes place, there is shock. The level of outside assistance offered in a particular crisis depends on many conditions. Chaos and physical hunger can occur. Furthermore, the survivors need to mourn their losses as they clean up their environment. For months, or even years, their minds may be preoccupied with images of death and destruction. They may exhibit what is known in psychiatry as "survivor's guilt," condemning themselves for having lived while others perished. A shared anxiety also many linger on because the people lose their trust in "mother nature."
 
As far back as 1954, Rangell studied the importance of our physical surroundings, and he described a phenomenon called "attachment to the ground" (p.314) as a psychic prerequisite for the maintenance of the social state of poise. Massive environmental disasters caused individuals or the society to lose their poise. In the long run, the survivors of natural disasters usually come to find comfort in ascribing an inner meaning to what has happened, declaring that it is the will of God, for example. Massive trauma can also be brought about accidentally by humans. An example of this is the Buffalo Creek tragedy of 1972, a disaster that occurred when a slag dam collapsed in the West Virginia mountains and inundated many coal camps, and sixteen towns, with millions of gallons of black water and sludge in a seventeen-mile-long valley, killing 127 people.
 
Though a relatively small segment of the state of West Virginia was affected, I mention this tragedy because it was the first manmade disaster that was studied extensively by psychiatrists, psychologists, sociologists, and legal professionals (Lifton and Olson, 1976; Erikson, 1976; Rangell, 1976). When the survivors were examined thirty months after this event, their images of death and destruction were still vivid. Many of them also exhibited survivor guilt. Legal settlements in this tragedy played a crucial role in restoring normality to the Buffalo Creek Society.
 
When a society is put on the right track after a disaster, there may occur what Williams and Parks (1975.) refer to as a process of "biological regeneration" (p.304). For example in the Welsh village of Aberfan, for the five years following the engulfment there of 116 children and 28 adults by an avalanche of coal slurry, there was an increase in the birthrate.
 
The impact of some accidental manmade disasters is much wider. Consider the nuclear accident at Chernobyl. The anxiety of individuals and societies about contamination lasted many years, and for good reason. Thousands in Belarus, for example, considered themselves contaminated with radiation and did not wish to have children because they feared they would have birth defects. Thus, the existing norms for finding a mate, marrying and planning for a family were affected. Those who had children remained anxious that something "bad" would evolve in their offsprings' health. Here, instead of an adaptive "biological regeneration," society reacted negatively.
 
Traumas Caused by Others:
Even though they may cause massive environmental destruction, societal grief, anxiety and change, natural or accidental disasters should be differentiated from those where massive trauma is due to ethnic or other large-group conflicts. When nature shows its fury and people suffer, people ultimately accept the event as part of their fate. In manmade accidental disasters, survivors may blame a small number of individuals or governmental organizations for carelessness. Even when this happens, there are no "others" who had deliberately sought to hurt people. When a massive trauma is due to ethnic, national or religious conflicts and wars, the situation becomes complicated because of the presence of enemies who deliberately inflicted pain and suffering on the victims.
 
Ethnic or other large-group hostilities initiate a number of shared psychological processes. First of all, when a large group's conflict with a neighboring large group becomes inflamed, the bonding between members belonging to the same large group increases. There is a shift in members' investments into their large-group identity, which, under stressful conditions, may become more important than the individual identity. This movement leads to further differentiation between one's large group and its enemy group. The relationships between people in each group are now governed by rituals of large-group psychology (Volkan, 1988, 1997, 1999.)
 
 
In wars or warlike situations, such rituals are performed according to two obligatory principles:
 
1- Maintaining one's large-group identity separate from the identity of the enemy,
 
2- keeping a psychological border between the two large groups at any cost.
 
 
When two ethnic groups are in a "hot" conflict, they wish to erase any sameness between them; thus, these two principles become operational. When large groups are not the "same," they can project more effectively their unwanted aspects on the enemy, thereby dehumanizing that enemy.
 
Anything that disturbs these two principles brings massive anxiety, and large groups may feel entitled to do anything to protect these principles. The hostile interactions are perpetuated. When one large group victimizes another one, those who are traumatized do not turn to "Fate" or "God" to understand and assimilate the effects of the tragedy. Instead, they may increase their sense of rage and revenge.
 
Feelings of rage and revenge oscillate with helplessness, humiliation, and victimization. Such internal turmoil prohibits the evolution of certain psychological processes that the victims need to go through in order to assimilate and accept their tragedy. Among these psychological processes is the work of mourning (Freud, 1917.) Humans are obliged to mourn their losses and changes in life. Mourning allows us to accept that a loss or a change has occurred. Without mourning we are trapped in the struggle to accept the tragedy and to adjust to life after it. If that struggle is not won, we cannot move on with our lives. We metaphorically remain hiding in the basement after the tornado has passed over and fair weather has returned. An individual, or a society, traumatized deliberately by others has a tendency to remain in the basement. The sense of shame, humiliation, and helplessness may become internalized, which consequently complicates the survivors' guilt.
 
The psychology of individuals and societies traumatized due to ethnic or other large-group conflicts and hostilities should be considered a unique category, quite distinct from those devastated by natural or accidental manmade disasters. What is most interesting is that the study of this psychology is relatively new and that often we still deny its horrible effects.
 
The survivors of the World War II German concentration camps provided psychiatrists, psychoanalysts and other mental health workers with a hitherto unprecedented opportunity to study individual and mass reactions to overwhelming stress brought about by the politically motivated cruelty of man. Persecution in its other forms—for instance, the hunting down of people in hiding, emotional and intellectual erosion, and the mass expulsion from a home—could also be studied in psychoanalytic terms. It is interesting that when the Jews were rescued from the concentration camps, no one, through an astonishing oversight, (Friedman, 1949) took into consideration the psychological plight of these victims. The naive notion that releasing the prisoners from their confinement would end their suffering seemed to prevail.
 
Writing in 1949, Friedman noted how incredible it seemed in retrospect that when plans were first made for the rehabilitation of the Jewish survivors of the Holocaust in Europe, no one considered how likely it was for them to have psychiatric difficulties. Instead, everyone concentrated on the alleviation of their physical suffering. However, when the first survivors of the camps reached the United States, psychiatric help was provided for them, and an understanding of their situation in psychoanalytic terms began.
 
The Vietnam War again brought to mental health workers' attention the fact that many individuals, even those who are active participants and not prisoners, can be psychologically trexperiences. Present-day tasks and activities are experienced through the prism of the mental images of past trauma, which are not assimilated and worked through. These individuals' preoccupations with such images are accompanied by either paralysis of initiative and/or hyperarousal. They also distance themselves from others, wish for revenge, feel depressed and have suicidal thoughts, or feel inappropriately elated. They suffer from shame, guilt, and helplessness. Over time, their symptoms may subside or change function, but new versions of their symptoms continue to disrupt their lives.aumatized. In clinical terms, such individuals suffer from Post-Traumatic Stress Disorder, a relatively new category in the classification of mental disorders. PTSD exhibits symptoms that are now well known by those who are charged with helping such sufferers. These victims continue to experience their present-day interactions with others and their environment by way of the mental images of the traumatic.
 
Today, when a society is traumatized by mass cruelty to humankind, the victims' mental health is routinely considered by international and indigenous authorities. Nevertheless, a closer look suggests that a tendency to deny the mental health problems still exists. There is an extensive and rich literature covering PTSD after ethnic or other large-group conflicts. I am sure that many of you in the audience have a great deal of information about PTSD and efforts to treat it. As I stated earlier, I wish to provide an additional lens for viewing other aspects of traumatized societies.
 
1- How do we equip local mental health workers with the proper tools for serving the directly traumatized population?
When a massive, bloody ethnic conflict erupts, indigenous mental health workers, such as those caretakers who were in Sarajevo during the months-long bombing of this city by the Bosnian Serbs, may be directly traumatized.
 
One Bosnian psychiatrist, who was assigned to deal with the PTSD population after the arrival of peace, continued to have a symptom that had started three years earlier during the siege of Sarajevo. Before going to sleep or upon awakening, she would check her legs to see if they were still attached to her body. When I examined the meaning of the symptom with her, we found out that it was connected to an incident during the siege.
 
Adults who are drastically traumatized may deposit their traumatized self-images into the developing identities of their children. A Holocaust victim who appears well adjusted may be behaving in this way because he has deposited different aspects of his traumatized self-images into his children's selves (Brenner, 1998). His children now are responding to the horror of the Holocaust, "freeing" the older victim from his burden.
 
After a shared massive trauma, affected individuals' traumatized self-images are linked with the same trauma. When hundreds, thousands, or millions of individuals deposit their traumatized images into their children after a massive shared trauma, this process affects the large-group identity. While each child has his or her individualized personality, they all share similar links to the "memory" (the mental representation) of the trauma and similar unconscious tasks to deal with this "memory." Therefore, under such a situation, an unseen network among hundreds, thousands or millions of people is created. Usually, the shared task is to keep the "memory" of the parents' trauma alive and to mourn their losses, revere their humiliation, or take revenge. If the next generation cannot effectively deal with their shared tasks—and this is usually the case—they will pass such "tasks" to the third generation, and so on.
 
According to external situations, shared tasks may change function from generation to generation (Apprey, 1987, 1993; Volkan, 1987, 1992, 1997, 1999.) For example, in one generation the shared task is to grieve the ancestors' loss and feel their victimization. In the following generation the shared task may be to express a sense of revenge. But, keeping alive the mental representation of the ancestor's trauma remains the primary task. Since it is shared, the new generation's burden also supports the large-group identity. I call such "memories" (mental representations) the large group's "chosen trauma." In open or dormant fashion, a chosen trauma continues to exist within the generations throughout years or centuries.
 
When there is a new ethnic, national, or religious crisis in the large group, leaders intuitively re-kindle memories of past chosen traumas as Slobodan Milosevic and his entourage did before the Serbs' recent war with Bosnian Muslims. They reactivated the memory of the Battle of Kosovo, which had taken place 600 years ago when the Serbs and Ottoman Muslims fought. The "memory" of this battle had been the Serbs' "chosen trauma." The six-hundred-year-old remains of Prince Lazar, who was the Serbian leader during the Battle of Kosovo, and who was captured and killed, were put in a coffin. This coffin traveled from Serbian village to Serbian village for a year-long journey, and at each stop a kind of funeral ceremony took place. The Serbian people reacted as if Lazar had been killed just yesterday. Such a response created a "time collapse." Feelings, perceptions, and anxieties about the past event were condensed into feelings, perceptions, and anxieties pertaining to current events. Since Lazar was killed by Ottoman Muslims, present-day Bosnian Muslims—seen as an extension of the Ottomans—were killed and raped. In effect, an atmosphere was created in which the Serbian people could consider revenge a Serbian entitlement.
 
Time does not permit me to detail this "reenactmenf of Serbia's "chosen trauma" (Volkan, 1997, 1999.) I simply wanted briefly to introduce you to certain possibilities concerning the "fate" of a chosen trauma. There are, as far as I know, no established NGO methods for dealing with the transgenerational transmission of shared trauma. I am familiar with the work that is being carried out in regard to aspects of this phenomenon in Georgia and South Ossetia. But, the prevention of malignant developments due to transgenerational transmissions, for practical purposes, remains unexplored. Governmental and non-governmental organization' should note this phenomenon and help develop effective measures for dealing with it.
 
 
 
Summary:
My aim today was to provide you with a new means of seeing the social aftermath of ethnic, national and/or religious conflicts. While ministering to individuals who suffer acutely from PTSD remains our primary task, it is important for NGOs to be aware that PTSD hinders the restoration of individual as well as societal processes. Indigenous caretakers of victims, such as mental health workers, are themselves victims and need outside intellectual, consultative and supervisory assistance, but, more importantly, they need help to work through their own emotional complications. Programs need to be developed in this regard. The effects of this disorder also permeate, distress and linger with society at large. Some diagnostic techniques are now available to NGOs. The resulting psychodynamic data should prove valuable. Lastly, I have noted that shared trauma crosses generational boundaries. As I have said, dealing with this notion by NGOs is, by and large, unexplored territory that needs further study.
 
Our knowledge of the legacy of ethnic wars is expanding with the effort of many disciplines. NGOs can transform this new knowledge into more effective efforts in restoring the peace, securing stable societies, and derailing the passage of ethnic hatreds to new generations.
 
 
 
 
REFERENCES:
 
1- Apprey, M. (1987.) The Unraveling of Incest in a Transgenerational Context, Part 1- "I hate light blacks: They are sneaky": A Pregnant Adolescent's Protest at Father's Anonymity.
In From Metaphor to Meaning, Vol.2: Papers in Psychoanalytic Anthropology, (Eds.), H.F. Stein, and M. Apprey, pp.55-91.Charlottesville, VA: University Press of Virginia.
 
2- Apprey, M. (1993.) The African-American Experience: Forced Immigration and Transgenerational Trauma. Mind and Human Interaction, 4:70-75.
 
3- Brenner, I. (1998.) On Returning to the Fire. Paper Delivered at the "Psychotherapeutischer Arbeitskreis fur Betroffene des Holocaust" Conference, Düsseldorf, Germany.
 
4- Cain, A.C., and Cain, B.S. (1964.) On Replacing A Child. Journal of the American Academy of  Child Psychiatry, 3:443-456.
 
5- Erikson, K.T. (1976.) Loss of Communality at Buffalo Creek. American Journal of Psychiatry, 133:302-325.
 
6- Freud, A. (1936.) The Ego and the Mechanisms of Defense. In The Writings of Anna Freud, Vol.2. New York: International University Press, 1966.
 
7- Freud, A., and Burlingham, D. (1942.) War and Children. New York: International Universities Press.
 
8- Freud, S. (1917.) Mourning and Melancholia. Standard Edition, 14:237-258.
 
9- Friedman, P. (1949.) Some Aspects of Concentration Camp Psychology. American Journal of Psychiatry, 105:601-605.
 
10- Howell, W.N. (1993.) Tragedy, Trauma and Triumph: Reclaiming Integrity and Initiative from Victimization. Mind and Human Interaction, 4:111-119.
 
11- Howell, W.N. (1995.) "The Evil That Men Do...": Societal Effects of the Iraqi Occupation of Kuwait. Mind and Human Interaction, 6:150-169.
 
12- Howell, W.N. (1996.) Personal Communication.
 
13- Kestenberg, J., and Brenner, I. (1996.) The Last Witness: The Child Survivor of the Holocaust. Washington, DC.: American Psychiatric Press.
 
14- Kestenberg, J., and Kahn, C. (Eds.) (1998.) Children Surviving Presecution: An International Study of Trauma and Healing. Westport, CT: Praeger.
 
15- Lifton, R.J., and Olson, E. (1976.) The Human Meaning of  Total Disaster: The Buffalo Creek Experience. Psychiatry, 39:1-18.
 
16- Mahler, M.S. (1968.) On Human Symbiosis and the Vicissitudes of Individuation. New York: International Universities Press.
 
17- Poznanski, E.O. (1972.) The "Replacement Child": A Saga of Unresolved Parental Grief. Behavioral Pediatrics, 81:1190-1193.
 
18- Rangell, L. (1954.) The Psychology of Poise—With A Special Elaboration on the Psychic Significance of the Snout or Perioral Region.
 International Journal of Psycho-Analysis, 35:313-333.
 
19- Rangell, L. (1976.) Discussion of the Buffalo Creek Disaster: The Course of Psychic Trauma. American Journal of Psychiatry, 133:313-316.
 
20- Saathoff, G. (1995.) In the Hall of Mirrors: One Kuwaiti's Captive Memories. Mind and Human Interaction, 6:170-178.
 
21- Saathoff, G.B. (1996.) Kuwait's Children: Identity in the Shadow of the Storm. Mind and Human Interaction, 7:181-91.
 
22- Volkan, V.D. (1979.) Cyprus¾ War and Adaptation: A Psychoanalytic History of Two Ethnic Groups in Conflict. Charlottesville, Virginia: University Press of Virginia.
(Foreword by John E. Mack) (Second Edition:1980.) Hardcover,192 pages.
 
23- Volkan, V.D. (1982.) "A Young Woman's Inability to Say No to Needy People and Her Identification with the Frustrator in the Analytic Situation,"
in Technical Factors in the Treatment of the Severely Disturbed Patient, (Eds.), Peter L. Giovacchini, and L. Bryce Boyer, pp.439-465, New York: Jason Aronson.
 
24- Volkan, V.D. (1988.) The Need to Have Enemies and Allies: From Clinical Practice to International Relationships. Northvale, NJ: Jason Aronson.
 
25- Volkan, V.D. (1987.) Six Steps in the Treatment of Borderline Personality Organization. Northvale, NJ: Jason Aronson.
 
26- Volkan, V.D. (1997.) Bloodlines: From Ethnic Pride to Ethnic Terrorism. New York: Farrar, Straus and Giroux.
 
27- Volkan, V.D. (1998.) The Tree Model: Psychopolitical Dialogues and Promotion of Coexistence. In Handbook for Interethnic Coexistence, pp.343-349, New York,
NY: The Abraham Fund.
 
28- Volkan, V.D. (1999.) Das Versagen der Diplomatie: Zur Psychoanalyse Nationaler, Etnischer und Religibser Konflikte. Giessen, Germany: Psycho-sozial Verlag.
 
29- Volkan, V.D., and Masri, A.  (1989.) The Development of Female Transsexualism. American Journal of Psychotherapy, 43:92-107.
 
30- Williams, R.M., and Parkes, CM. (1975.) Psychosocial Effects of Disaster: Birth Rate in Aberfan. British Medical Journal, 2:303-304.
 
 
 
-----------------------------------------
 
 
 
APPENDIX 4:
 
 

EXCERPTS FROM CONFERENCE PROCEEDINGS SOCIETY AND PSYCHOLOGICAL SUPPORT:

 
A CONFERENCE SPONSORED BY THE NORWEGIAN REFUGEE COUNCIL
AND
FOUNDATION FOR THE DEVELOPMENT OF HUMAN RESOURCES
 
 
 
Tbilisi, Georgia
August 9-10, 1999
 
 
 
 
 
 
-----------------------------------------
 
 
APPENDIX 5:
 
 
  
 INFORMATION ON SMALL GROUP “WORKSHOP”: THEORY AND TECHNIQUE
 
 
     FROM BLOODLINES: ETHNIC PRIDE TO ETHNIC TERRORISM
 
 
 
By
 
Vamık D. Volkan M.D.
 
                                                                           
 
Volkan, V.D. (1997). Bloodlines: From Ethnic Pride to Ethnic Terrorism. New York: Farrar, Straus and Giroux, pp.256-258.
 
 
 
My understanding of small-group dynamics has roots in a teaching method called "the fieldwork method." which I developed in the late 1960s, and early 1970s at the Department of Psychiatry in the University of Virginia's School of Medicine (see Volkan and Hawkins. "Field-work Case in Teaching Clinical Psychiatry," "Fieldwork Method of Teaching," and "Learning Group.") The teaching format consisted of a small group of about eight psychiatric residents who met regularly with me (the teacher/leader) and occasionally with my con­sultants for over 225 hours per year. The small groups observed (behind a one­way mirror) all the sessions of a patient's treatment conducted by one of the residents. This fieldwork involved simultaneous discussion with the leader, which helped the residents gain knowledge on the spot. The group's learning was a process and went through expected phases. I repeated this program for five consecutive classes of residents.
 
The experience of guiding the psychodynamics of these non-patient resi­dent groups was essential to coordinating the dialogue groups in Estonia two decades later. As leader, I had developed techniques to deal with anxiety, made interpretations when residents became reservoirs of patients' projections, helped to combine intellectual understanding with emotional experience, dealt with resistances to learning, encouraged curiosity, and acted as a role model. In dealing with these learning groups, the aim was not to provide therapy for the participants, but to help them open new channels of conceptualizing what they were observing.
 
Other information about small-group dynamics comes from studies of pa­tients in group therapy. Our team members, especially those in the psycholog­ical fields, have also benefited from the pioneering works of psychoanalysts such as Foulkes and Anthony, Group Psychotherapy; Bion. Experiences in Groups: and Abse, Clinical Notes on Group Analytic Psychotherapy.
 
Bion's studies, for example, of small working groups indicate that groups operate on a mature level whenever their members devote themselves to the performance of a specific task—they are then properly called a work group. However, when a small group cannot function in a mature way and regression occurs, it is prone to behave according to specific unconscious fantasies. The group members may, for example, increase their suspicions ot others and per­ceive the leader as an omnipotent savior. Without a task that has been agreed on either tacitly or directly, a work group cannot be established, and the small group is no more than a collection of individuals. The leader of a work group must maintain effective contact with the real world for without it he or she will contribute to the youp members' fantasies.
 
While Bion's small-group dynamics are useful for therapy groups of eight to twelve people who meet to improve themselves with the help of a group leader our Estonia meetings had a different purpose. They aimed to improve the members' understanding of their large-group conflicts. Unlike the learning or therapy groups, the Estonian dialogue groups were influenced by multiple leaders, which changed their psychodynamics. Each dialogue group contained opposing subsections (Estonians, Russians, and Russians living in Estonia), each with its own proclaimed or implicit leader. In addition, each small group was led by American facilitators. Group members also felt the influence of political leaders who were not present at the meetings.
 
Because the principal focus was on the psychology of large-group inter­action as reenacted during the dialogues, small-group dynamics pertaining to the participants as individuals were only taken into consideration when they got in the way. To create a work group during the dialogues required attention to the way in which members wore their ethnic garments and the kinds of projections they made onto others' garments. When participants spoke about themselves, facilitators helped show how these personal stories reflected the history of the groups and helped illuminate the emotional investment in events and mental representations. When group history is thus taken to a personal level, it can be more intimately shared, which in turn helps loosen die rigidified positions of large groups.
 
In Estonia as elsewhere, when facilitators are involved in ongoing psycho-political dialogues with opposing groups, they become targets of group mem­bers' projections. When this happens, facilitators who are also mental health professionals have an advantage because they are accustomed to receiving and dealing with their patients' projections (transference.) Countertransference— irrational expectations on the part of the facilitators—may also surface. Rub­bing elbows with politically important individuals, for example, may give the facilitators a sense of undeserved omnipotence. We are cognizant of this phe­nomenon and after decades of work in the field are less likely to succumb to countertransference responses.
 
 
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APPENDIX 6:
 
 
LETTER OF SUPPORT:
FROM AVDANDIL JORBENADZE, GEORGIAN MINISTER OF HEALTH
  
  
Tbilisi, Georgia 
30. 03, 1999
 
 
 
 
 
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APPENDIX 7:
 
  
EVALUATION STATEMENTS:
FROM GEORGIAN PARTNER AT THE FOUNDATION FOR THE DEVELOPMENT OF HUMAN RESOURCES 
 
 
 
Evaluation by the Foundation from the Development of Human Resources:
During 1998-1999 the CSMHI group visited Georgia four times and was collaborating with Georgian NGO Foundation for the Development of Human Resources. The group contributed to the ongoing projects of FDHR on psycho-social rehabilitation of IDPs and building the bridges of reconciliation between the Georgian and Ossetian people.
 

It should be noted that joint work with the Ossetian partners was already taking place, (with financial support from Norwegian Refugee Council) but the relationship with CSMHI gave a new sparkle to these activities. The already existing project was oriented on working with traumatized children and for these purposes involved sharing of experience between Georgian and Ossetian colleagues. As a result of collaboration with the Center, new aspects of the relationship were outlined. In particular these included the idea of expanding the project and including in it professionals from different fields.
 

Apart from this, it appeared that for establishing more frank and open relations, the participation of an objective catalyst is very important. Members of the Center were very successful at this. As a result of joint meetings they conducted (Georgian-Ossetian), many important aspects, that are an important pre-condition for long-term relations, were realized. Professional support from the members of the Center in conflict resolution activities (on folk diplomacy level) was very important in terms of usefulness of our collaboration. Lectures and seminars where members of CSMHI shared with us their great knowledge and experience gained as a result of working in different parts of the world were very enriching as well.
 

We had an opportunity to attend interviews conducted by the CSMHI group with IDPs. This gave us an important experience and helped us acquire techniques of conducting an interview. After interviews we participated in group analysis of interesting cases. This enriched our professional experience.
 

It is also important to elaborate on the mechanisms of disseminating experience that each party will gain as a result of joint work. In this sense, the peculiarities of relationship with one's social environment that still has a stereotypic perception of the opposing party are especially important. These topics were emphasized during our joint meetings with CSMHI.
 

Georgian and Ossetian partners think that this program should continue, because this was only the beginning of building the bridges, and they need more efforts for enhancement. Therefore the process of "emptying" from pain, mourning the loss, and thus coping with trauma should continue. For increasing efficiency of the project, the involvement of professionals from different fields is also significant.
 

It is important that catalysts of these processes are professionals from CSMHI Center, who have a great experience in this field and are familiar with the region. If the project will not continue there is a danger of losing the effects which were reached as a result of this very subtle and significant work.

 
 
Foundation for the Development of Human Resources, Tbilisi, Georgia.
 
 
 
 
Reflections on Cooperation with the Centre for the Study of Mind and Human Interaction in Tbilisi (Georgia) 1998-1999:
It gives me a pleasure to share my experience of co-operation with Dr. Vamık D. Volkan, Dr. J. Anderson Thomson and Dr.Yuri Urbanovich of CSMHI at IDPs Collective Centre in Tbilisi.
 
I had the privilege to interpret Dr. Volkan's psychotherapeutic interviews with an IDP family. It would not be an exaggeration if I say that these interviews were a very good school for me. (At the same time I should confess that I have been professionally lucky first in my studies and then in my work from the very beginning of my entering in the profession: I had the advantage of belonging both to the famous Uznadze School of Georgian Psychology of Set and to the outstanding Luria Moscow School of Neuropsychology.)
 
However, the art of putting questions and framing the answers that I witnessed with Dr. Volkan was more than impressive. The in-depth information that the therapist gained from these conversations seemed to me even much richer than long-term attempts to grasp all the nuances of IDPs' suffering.
 
The therapeutic impact on the interviewee's personality should be specially emphasized. During the past couple of months we have observed many changes in the family, changes both in the outer and inner reality: apartment being rebuilt and enlarged, the newly married couple (son and daughter in law) and sparkles in the eyes and success in football competition... The list could be continued.
 
The co-operation of American and Georgian psychologists is certainly a very significant issue. It contributes to our professionalism but what is more important it makes the process of healing of our clients more fast, more sustainable and more effective.
 
And lastly, no-one can question the role of psychotherapy in IDPs' healing. But there is one more issue that is no less important: due to their trauma, the IDPs in Georgia present a group that could be easily manipulated by some destruction-oriented politicians. That's why this kind of psychotherapy is not only a medical issue, it is a political issue also it helps to strengthen the fragile Georgian democracy and defend it from Nationalistic intolerance or Communist revenge.
 
 
Manana Gabashvili, Ph.D.,
Research Scholar in Uznadze Institute of Psychology; formerly part of the Foundation for the Development of Human Resources,
now, Coordinator of the Projects on Psycho-Social Rehabilitation of IDPs Norwegian Refugee Council.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Copyright © Vamık D. Volkan and Özler Aykan 2007.
 
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Last modified on: Apr 20, 2016