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

Vamık D. Volkan
Measuring and Fostering the Progress of Societies: Second OECD World Forum on Statistics, Knowledge and Policy, Istanbul, 27-30 June, 2007.



                                                  “We may insist as much as we like that the human intellect is weak in comparison with  human instincts, and be right in doing so. But nevertheless there is something peculiar about this weakness. The voice of the intellect is a soft one, but it does not rest until it has gained a hearing. Ultimately, after endlessly repeated rebuffs, it succeeds. This is one of the few points in which one may be optimistic about the future of mankind.”
                                                                                                                                                                         Sigmund FREUD.

Since I am a physician and a psychoanalyst, I consider the well-being of a society from a medical point of view. Long ago, the constitution of the World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not necessarily the absence of disease or infirmity” (World Health Organization, 1946.) It is interesting that this statement includes a reference to social well-being which directly refers to the main theme of this Second OECD World Forum. This statement describes an idealistic and perhaps unattainable view of health and raises many questions. With the theme of this conference in mind, I ask the following:
1- What is social well-being?
2- How do we measure or foster it?
Finding answers to these questions is very difficult. The first reason it is difficult to assess and measure the “health” of a society is because of the very long list of factors that can cause social disturbances in the first place. A list of factors that disturb the well-being of a society would include: bad economics, unfair trade, mismanagement of human rights, criminal activities, lack of education, destructive religious or political ideologies, natural calamities, endemic diseases, pollutions, man-made accidental disasters, assassinations of political leaders, dictatorships, the collapse of political or ideological “empires,” terrorism, wars and war–like conditions.

Another reason for our difficulty in defining and assessing the well-being of a society is that very often no single professional discipline can fully understand and evaluate factors that cause social problems. An interdisciplinary approach then becomes required to investigate the causes of the problems and subsequent social progress. Building up interdisciplinary teams takes time and often cannot be achieved, mainly because of competition between disciplines. Accordingly, some key aspects of what causes disturbances, and potential progress that grows from knowledge and understanding, may remain illusive.

During the last few decades, “globalization” has become the buzzword in political as well as academic circles that personifies a wish for prosperity and well-being of societies by standardizing economic and political elements and by bringing democratic freedom everywhere in the world. The tragedy of September 11, 2001, and the Western World’s­­­—especially the United States’—response to it, the wars in Iraq and Afghanistan, and war-like conditions in Africa and elsewhere, in my mind, at the present time make an idealized version of globalization an illusion. In the twenty-first century once more we are witnessing the amazing ability of the human mind to create incredible technological achievements, while the aggressive aspect of human nature remains the same. Furthermore, globalization that includes prejudice, racism and an indifference to national differences (Liu and Mills, 2006; Morton, 2005; Kinnvall C. 2004; Ratliff, 2004), never brings about the well-being of the affected societies.

At the beginning of this presentation I referred to Freud’s statement where he encouraged us to continue to use the human intellect to better life, in spite of the strength of human instincts and the role they play in creating massive disasters. This OECD World Form is a platform to utilize the human intellect and look at factors that disturb the well-being of societies at the first place. I am sure that some of the items I listed before will be discussed at this meeting in depth. Each item on this list, even if it is closely related to some of the others, requires specific consideration in order to turn its negative impact on societies into positive societal processes. Some of them will benefit more from input formulated by economists, others by educators, still others by those from the legal profession, and so on.

Global transformations: “Soft” and “hard” factors:
It is generally thought that global transformations take place along three major dimensions: economic, political, and social. Such transformations not only affect the adult populations, but also children and youth, the future generations (Kaufman, Rizzini, Wilson and Bush, 2002). When there are crises in these transformations, we usually look to a number of “hard” and macro-level factors to explain the causes of social problems. For example, in an economic crisis what comes to our minds first are visible factors such as austere budget cuts, high interest rates, and strict monetarist policies.  Bolitho, Carr and their colleagues (2003), remind us that there are softer and micro-level processes hidden behind the “hard” and macro-level considerations, and they include psychology among them. They state that “soft” micro-level factors have been increasingly recognized by economists since the days of Adam Smith (1723-1790). The Bolitho-Carr school of thought focuses on the importance of communicating human perceptions and motivations, both within and between community and organizational groups affected by economic crisis. Such communications will improve efforts to combat downward spirals into poverty. In spite of the optimism implied in Bolitho, Carr and their colleagues’ paper, too often macro-level factors of a society’s problems overshadow the micro-level factors, and the later are overlooked. This happens despite the reality that often micro-level factors must be taken into consideration if there is to be a reversal in conditions within the society. By analogy, this is like a big machine that requires tiny screws to be in their proper places for it to function well, or even function at all.

In this very brief presentation, my illustration of the intertwining of macro-level and “soft” psychological issues as they support or disturb a society’s well-being, is necessarily limited. First, I will expand on the idea of using psychology in diagnosing and suggesting solutions for an economic collapse by including the effects of a past and shared massive societal trauma on a society which made communication itself between subgroups very difficult. Second, I will focus on societal trauma at the hand of “Others/Enemies” in a more general way, and describe some hidden shared psychological processes that take place in the affected societies that disturb the well-being of people for decades and even centuries to come. Recognizing these processes and then dealing with them can make the work on visible macro-level factors, such as economic and political changes, more effective. The type of psychology I refer to in this presentation is the psychoanalytically informed large-group psychology.

Post-Enver Hoxha Albania: A meeting place of economic and psychological issues:
From 1944 until his death in 1985, Albania was ruled by dictator Enver Hoxha. A few years after his death, communist rule in Eastern Europe collapsed and the effects of this were felt deeply in Albania. Albania’s first free elections since the 1920s took place in 1989, and by 1996, a large number of Albanians thought that they were rolling in new wealth. In that year 85,000 Mercedes cars were registered in Albania. But this wealth was imaginary. Twenty pyramid schemes, which grew into murky empires, were the foundation of this imaginary wealth, and in March 1997, pyramid operators one by one began tumbling down, swallowing an estimated $1.2 billion in savings. This amount was about half of Albania’s gross domestic product. This economic disaster touched “everything from Liberian shipping companies and German salami plants, to New York bank accounts” (Frank, 1988). The pyramid schemes were so embedded in Albanian society that their collapse initiated a national uprising in which 1,500 people were killed, and outside military intervention was necessary to bring order to the situation.

Auditors from Pricewaterhouse Coopers and Deloitte and Touche, as well as other experts in economics from the World Bank, Italy, Greece and Turkey, arrived in Albania to scrutinize “hard” macro-level factors in an effort to unravel the pyramid finances. Their success was very limited. It was said that some powerful and influential Albanians, who were themselves connected with the missing money, stonewalled and interfered with the investigation. The failure of the pyramid system ushered in new social disorganization.

In the second half of 1997, the Atlanta-Georgia based Carter Center in the United States, under the leadership of former President Jimmy Carter, wanted to help the social disorganization in Albania mainly through focusing on macro-level economic factors. It proposed to assist Albania in the development of a National Development Strategy (NDS) through a broad “participation” process. The Carter Center was following the World Bank’s definition of the term participation:“Participation is a process through which stakeholders influence and share control over development initiatives and the decisions and resources which affect them” (The World Bank Participation Sourcebook, 1996, p.xi.)
The World Bank was outlining methods for stakeholders’ consultation and various outreach techniques to garner public input.  A few years earlier, the Carter Center’s National Development Strategy in Guyana, had been a success story. Thus, it expected similar success in Albania when a former diplomat Tom Forbord, who had worked on the Guyana project, went to Albania as the Carter Center’s representative.

Armed with well-prepared plans, Forbord was to identify influential Albanians, choose participants for meetings to design economic strategies, and, once these strategies developed, get feedback from the Albanian government and opposition, help to revise and improve plans, pass them along to authorities, and influence the economic recovery in Albania. But Forbord immediately noticed that something was seriously wrong. Even with the prestige of a former US. President behind him and access to Albanian government and opposition officials at the highest levels, it was difficult for the diplomat to gather a group of influential Albanians willing to participate in serious discussions on economy or the future of the country’s social disorganization.

In 1998, The Carter Center sent a small group to Albania to learn what went wrong: Joyce Neu, then the assistant director of the Carter Center’s Conflict Resolution Program and a linguist; Norman Itzkowitz, a historian from Princeton University who is one of the leading authorities on Ottoman history and who is also trained as a psychoanalyst; and myself, then a member of the Carter Center’s International Negotiation Center (INN). Previously the three of us had worked extensively in other troubled spots of the world with other colleagues from various disciplines to understand and deal with psycho-political and psycho-social issues (Volkan, 1988, 1997, 1999; Volkan and Itzkowitz, 1994). We learned that the enduring psychological effect of societal trauma, which happened decades ago, on the Albanian society was a major factor in the Albanians’ difficulty in utilizing the Carter Center’s offer to develop a strategy for economic recovery and the well-being of the society. The so-called “soft” psychological issues were like little screws that needed to be placed in their proper places before the Albanian big machine worked. Our findings were primarily based on many psychoanalytically informed interviews we conducted with Albanians from different backgrounds.

Enver Hoxha had transformed Albania from a semi-feudal remnant of the Ottoman Empire into an industrialized economy. But improvement in economy does not always make for the well-being of a society, just as being a millionaire does not guarantee the physical and mental heath of an individual. As a psychoanalyst I have treated poor individuals as well as very wealthy individuals with depression or other psychological disturbances. In truth, Enver Hoxha’s society was a “sick” society. 

Albania has a relatively homogenous population in spite of religious divisions and two major subgroups: the Gegs and the Tosks. But during Enver Hoxha’s long reign, the country was divided into those who were followers of the leader and those who had a “black spot” on their family. If someone was perceived to be against Enver Hoxha and his brand of communism, even if they complained about not finding freshly baked bread in the bakery or were caught playing backgammon, this person could face a “black spot,” or a likely prison term. There appeared a rigorous division of goodness and badness, loyalty and disloyalty. “Bad” people would often face torture or exile to a certain areas in the country. A person could try to remain “good," but a relative who became “bad” could ruin the entire family. For example, young people who had someone with a “black spot” in their family would not be able to obtain a university education. Officials were sent to elementary schools regularly to interview children about whether their parents spoke against Enver Hoxha in the privacy of their homes. When democracy came to Albania the psychological effects of the decades-long societal split did not disappear.  If someone had a son in a high school, this person would wonder if the headmaster was the son of a person who had tortured his or her grandfather.

Psychologically speaking, a healthy society is one where the citizens trust one another while interacting among themselves under culturally accepted guidelines and democratic legal rules. Using psychoanalyst Erikson’s (1985), term,“basic trust” among citizens disappears when a society is not healthy. Basic trust is a concept that describes how children learn to feel comfortable putting their own safety in a caretaker’s hands; by developing basic trust, children discover, in turn, how to trust themselves. In a healthy society, adults also depend on trusting themselves and others to remain functioning citizens.

In 1998, Albanian society continued to suffer from a severe societal split, even though it was hidden. This was the reason why it was difficult to put a group of influential Albanians in a room, expect them to trust one another, discuss societal problems, and come up with mutual understanding for developing economic strategies. The severe societal split between good and bad families was also reflected in severe splits in other large-group processes. For example, the Albanian main opposition party and the ruling party were so far apart, that the opposition’s elected members would not even attend the regular meetings of the Albanian Parliament.

We were lucky to find an Albanian organization, a kind of “think tank,” that was co-chaired by two intellectuals—one came from a family who had been loyal to Enver Hoxha, and the other one came from a family with a “black spot.” Both of them were aware of the severe psychological division in their country, and they had formed their organization to study and do something about this situation. We began making plans to bring a group of influential Albanians, including those knowledgeable in economics, to this “think tank” and first help them remove the effects of the social splitting and develop “basic trust.”  Then we would support them in their efforts to make an economic recovery plan for Albania. We also met with the leader of the opposition Sali Berisha who was a former prime minister. Interestingly we found him receptive to our ideas; he himself was aware that the severe social division that remained psychologically from the days of Enver Hoxha was paralyzing Albania. In fact, after he and his people talked with us, Berisha ordered his party deputies to resume attending parliament. This was short-lived without more input from us.

We could not put our plans to start a psychologically informed economic recovery process in action in Albania due to events that took place in the former Yugoslavia. Ethnic Albanians in Kosovo began to suffer Serbian attacks; the NATO bombing of Serbia followed. In the summer of 1999, some 450,000 Kosovar Albanians sought shelter in Albania. When these refugees flooded Albania’s disused factories, sports stadium, and city parks, it looked like the chaos would reach its peak. This tragedy however, in a peculiar and unexpected way, had a significant impact on both the economy and psychology of Albania.

When I revisited Albania at the end of  2000, I learned that taking in the refugees during the upheaval in Kosovo had improved the economy (officially, by eight percent) as various officials from foreign countries, journalists and others poured in from abroad, stimulating the Albanian private and governmental security industries. Interestingly enough, I observed that having an external enemy in the Serbs began to heal splits within Albania and appeared to remove the malignant large-group psychology that interfered with work on macro-level social, economic and political issues.

I briefly described my study of post Enver Hoxha Albania to illustrate that there are many causes for a society’s well-being or its entry into a paralyzing chaos. Some of these causes are visible, while others require psychological assessments in order to be noticeable and definable. My emphasis is on the effect shared societal trauma has on a society’s well-being after the trauma ends. In Albania a group of people inflicted trauma on another group of people of their own kind due to a political ideology and the personality organization of a political leader. Elsewhere, shared societal traumas occur due to other causes. In South Africa racism was the factor responsible for Apartheid.

What does South Africa teach us ten years after the Truth and Reconciliation Commission proceedings?:
In November 2006, I had the honor of giving the keynote speech at the University of  Cape Town as part of a meeting reflecting upon ten years of South Africa’s Truth and Reconciliation Commission and celebrating Archbishop Desmond Tutu’s life of peaceful justice (Volkan, 2006a). It is clear in my mind that the Truth and Reconciliation activities played a significant role in preventing bloodshed South Africa. There might have been unimaginable tragedies in this country without the character of new leadership and the work of the Truth and Reconciliation Commission. Nevertheless, ten years later and “basic trust” has not been achieved.  Driving through Cape Town or many other cities in South Africa, one sees fences, barbed wire, or signs on walls in residential neighborhoods that declare,“Protected by Armed Response.” Eagle and Watts (2002), make reference to 1996 data in South Africa describing most disturbing statistics: An average of  52 murders a day, a rape committed on average every 30 minutes, a car stolen every 9 minutes and an armed robbery committed every 11 minutes. Ten years after the Truth and Reconciliation work, in 2006, a report informed us that during the previous year in South Africa 1,200 children were murdered, 1,500 children were the victims of attempted murder, 24,000 children were assaulted and 2,200 children were raped (Cape Times editorial, “Suffer the Children,” November 22, 2006, p.10).

Psychologically speaking, many blacks in South Africa have turned the frustration and rage they experienced under Apartheid onto themselves (Volkan, 2006a). In November 2006, I had an opportunity to make some observations in the Cape Town Township of Langa, which is separated from a very plush golf course by a super highway. What made the greatest impression on me was not the unbelievably bad physical conditions and unemployment rate in this place, but the many black students I saw singing and dancing in a classroom at the township’s school, which is also surrounded by a fence. While watching them I remembered that one of their male teachers had been murdered only a week before, and the news had terrified the kids. I also knew that every other girl and one boy out of five, who were so beautifully and gracefully singing and dancing in front of me as if they had no worries, were rape victims. For an outsider like me it was impossible to reconcile their traumatized selves with the personalities they were outwardly exhibiting. I had to think that they were showing an adaptation to constant trauma, the understanding of which was beyond my emotional comprehension.

What South Africa’s situation shows us—a full ten years after the Truth and Reconciliation Commission Proceedings—is how the effects of a societal trauma persist after it is over, above and beyond real-world issues pertaining to economy and politics.  My belief is that any macro-level strategy to deal with South Africa’s present economic and political problems may face resistance, unless it first takes into account the shared psychological processes that exist in the society, and unless further meaningful communications between the white and black communities take place. The sense of humiliation much of the population still feels must be removed.

The psychological impact of past events:
When a large group of persons, such as blacks in South Africa during Apartheid, are oppressed by “Others,” the victimized group experiences a shared sense of shame, humiliation, and even dehumanization. They cannot be assertive, since the expression of direct rage toward the oppressing group threatens their livelihoods and even their lives. Their “helpless anger” interferes with their mourning over losses that touch every aspect of their lives, ranging from their dignity, to their property, relatives or friends (Volkan, 2006b). Shared unfinished psychological tasks are passed from generation to generation. The existence and the effects of such transgenerational transmissions are clearly demonstrated in psychoanalytical studies of the descendants of Holocaust survivors (For a review of such studies see: Volkan, Ast, and Greer, 2001).

Societal traumas at the hand of “Others,” obviously can also be inflicted during armed struggles. Their effects are different from those of massive traumas due to natural causes, mainly because they, like oppressive or racist regimes, induce shared shame, humiliation, helplessness, and dehumanization and make societal mourning complicated, or even impossible. We can recall the well-known American novelist William Faulkner’s lines: “The past is never dead, it’s not even past” (Requiem for a Nun, Act I, Scene III.) As I write this paper in the spring of 2007, Argentine courts are once again confronting the horrors of a brutal Cold War regime under Augusto Pinochet that executed thousands of dissenters. The three-decades-old wounds will be reopened. When Slobodan Milosevic was alive and in power he, with the help of some Serbian academicians and the Serbian Orthodox Church, re-enflamed the “memories” of the Battle of Kosovo that took place in 1389. Elsewhere I describe the details of their work and how it rekindled shared emotions in Serbia that were connected with a 600-year-old wound, and the part this activity played in creating an atmosphere for most brutal actions against Bosniaks and Kosovar Albanians (Volkan,1997).

At the present time it is difficult to imagine peace in Iraq. But, let us imagine it. First macro-level issues involving politics, economy, legal issues and environment need to be taken care of. This is natural. Once more I will use a medical analogy. If someone comes to the emergency room with a bleeding stomach, the first thing to do is to stop the bleeding. But the heath of this individual will not be looked after properly until the hidden cause of the stomach bleeding is found and repaired. Similarly, for the well-being of Iraq, after the hoped-for peace arrives, it will be necessary to heal the psychological scars in order to create a firm foundation for the macro-level changes. At present, generally speaking, we do not yet have established guidelines for studying these types of psychological factors in previously traumatized societies that would instruct us in implementing such tasks as necessary. However, programs for fostering the progress in societies should be aware of shared psychological processes that potentially exist in them.


Concluding remarks:
In this presentation I tried to illustrate how macro-level economic, political, legal, and environmental factors are intertwined with rather hidden shared psychological processes in traumatized societies, even long after the trauma is over. These are the societies in need of improving their well-being. I emphasized the role of interdisciplinary teamwork in order to assess what such societies require to foster progress and opportunities for material prosperity, but also to create an atmosphere where the citizens can maintain their “basic trust” in relating to one another and their governments.

Shapiro and Carr (2006), state that the attempt to understand society is a daunting prospect, and that it may be “a defense against the experience of despair about the world, a grandiose effort to manage the unmanageable” (p.256). I join them, however, in their suggestion that to make some efforts nonetheless is essential for societies’ psychological well-being and even survival. My colleagues and I have developed a method called the “Tree Model” (Volkan, 2006b), that is designed to support co-existence between enemy groups. In this presentation I will not be able to give details about this method except to say that with some modification, its principles can also be used, to one degree or another, in scenarios such as those I have discussed today:  between those who were victimizers and those who were victimized and their descendants.







1- Bolitho, F.H., Carr, S.C., Chuawanlee, W., Chaijukul, Y., et al. (2003.) Poverty and Economic Crises. In Poverty and Psychology: From Global Perspective to Local Practice. (Eds.), S.C. Carr, and T.S. Sloan, pp.205-225. New York: Kluwer Academic/Plenum Publishers.

2- Eagle, G., and Watts, J. (2002.) Psychodynamic Contributions to Formulations of the Impact and Treatment of Traumatic Stress Incidents. Part 1.
Psycho-Analytic Psychotherapy in South Africa, 10:1-24.

3-  Erikson, E.H. (1985.) Childhood and Society. New York: W.W. Norton.

4- Frank, R. (1988.) Jungle Accounting: Auditors in Albania Pick Through Rubble of Pyramid Schemes. The Wall Street Journal, August, 6, pp.1,7.
5- Kaufman, N.H., Rizzini, I., Wilson, K., and Bush, M. (2002.) The Impact of Global Economic, Political, and Social Transformation On the Lives of Children: A Framework For Analysis. In Globalization and Children: Exploring Potentials for Enhancing Opportunities in the Lives of Children and Youth. (Eds.), N.H. Kaufman, and I. Rizzini,
pp.3-18. New York: Kluwer Academic/Plenum Publishers.

6- Kinnvall, C. (2004.) Globalization and Religious Nationalism: Self, Identity, and the Search for Ontological Security. Political Psychology, 25:741-767.

7- Liu, J.H., and Mills, D. (2006.) Modern Racism and Neo-liberal Globalization: The Discourses of Plausible Deniability and Their Multiple Functions.
Journal of Community and Applied Social Psychology, 16:83-99.

8- Morton, T.L. (2005.) Prejudice In An Era of Economic Globalization and International Interdependence.(Ed.), J.L. Chin. In The Psychology of Prejudice and Discrimination: Disability, Religion, Physique, and Other Traits, Vol.4.pp.135-160. Westport, CT: Praeger.

9- Ratliff, J.M. (2004.) The Persistence of National Differences In A Globalizing World: The Japanese Struggle for Competitiveness In Advanced Information Technologies. Journal of Socio-Economics, 33:71-88.

10- Shapiro, E., and Carr, W. (2006.) “Those People Were Some Kind of Solution”: Can Society In Any Sense Be Understood? Organizational and Social Dynamics,

11- The World Bank Participation Sourcebook (1996.) Washington, DC.: IBRD/The World Bank.

12- Volkan, V.D. (1988.) The Need to Have Enemies and Allies: From Clinical Practice to International Relationships. Northvale, NJ: Jason Aronson.

13- Volkan, V.D. (1997.) Bloodlines: From Ethnic Pride to Ethnic Terrorism. New York: Farrar, Straus and Giroux. (Bluts-Grenzen:  Die Historischen Wurzeln und Die Psychologischen Mechanismen Ethnischer Konflikte und Ihre Bedeutung bei Friedensverhandlungen. Tr. Klaus Kochmann. Zurich: Scherz Verlag, 1999). (Kan Bağı Etnik Gururdan Etnik Teröre. Istanbul: Bağlam Yayınevi, 1999).

14- Volkan, V.D. (1999.) Das Versagen der Diplomatie: Zur Psychoanalyse Nationaler, Ethnischer und Religiöser Konflikte. (The Failure of Diplomacy: The Psychoanalysis of National, Ethnic and Religious Conflicts). Giessen: Psychosozial-Verlag. 

15- Volkan, V.D. (2004.) Blind Trust: Large Groups and Their Leaders in Times of Crises and Terror. Charlottesville, VA: Pitchstone Publishing. (Blindes Vertrauen: Grossgruppen und ihre Führer in Kriesezeiten. Giessen: Psychosozial-Verlag, 2005.), (Körü Körüne İnanç. Istanbul: Okuyanus, 2005.)

16- Volkan, V.D. (2006a.) The Next Chapter: Consequences of Societal Trauma.

17- Volkan, V.D. (2006b.) Killing in the Name of Identity: Stories of Bloody Conflicts. Charlottesville, VA: Pitchstone Publishing. (Kimlik Adına Katillik. Tr. Banu Büyükkal. Istanbul: Alfa Yayınevi, 2007).

18- Volkan, V.D., Ast, G., and Greer, W.F. (2001.) Third Reich in the Unconscious: Transgenerational Transmission and Its Consequences. NY: Brunner-Routledge.

19- Volkan, V.D., and Itzkowitz, N. (1994.) Turks and Greeks: Neighbors in Conflict. Cambridgeshire, England: Eothen Press. (Türkler ve Yunanlılar, tr. Banu Büyükkal. Istanbul: Bağlam Yayınevi, 1999).

20- World Health Organization (1946.) Constitution of the World Health Organization. Chronicle of the World Health Organization, 1:29-43.

Copyright © Vamık D. Volkan and Özler Aykan 2007.
All rights reserved.
Policies & Info / Accessibility / Sitemap / RSS / JSON
 Webmaster: Oa Publishing Co. 
Editor: Ö–zler AYKAN
Last modified on: Apr 20, 2016