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Mental Health & Mental Illness
Children & Adolescents
Haitian Mental Health
2nd Annual Conference on Haitian Mental Health
The 2nd Annual Conference on Haitian Mental Health was held on May 3-4, 2013 at the Massachusetts School of Professional Psychology in Newton, MA.
Keynote and Invited Speakers included Dr. Guerda Nicolas, Professor Marjory Clermont-Mathieu, Professor Ronald Jean Jacques, Dr. Patrick Bellegarde-Smith and Dr. Jean B. Tropnas. The conference was attended by clinicians, researchers, educators, public health officials, community leaders, and students from Haiti, Canada, Miami, New York, California and elsewhere.
Proceedings of the 2nd Annual Conference
Abstracts & PowerPoint Presentations
Keynote & Invited Addresses
Children and Adolescent Resilience after the Earthquake in Haiti
Marjory Clermont-Mathieu, Ph.D., Clinical Psychologist & Professor, Faculty of Human Sciences, State University of Haiti; & Ronald Jean Jacques, DESS, DEA, President, Haitian Association of Psychology
According to Anaut (2003), resilience is best understood as the art of adapting to adverse situations (biological and socio-psychological) and the ability to develop capacity in connection with internal (intrapsychic) and external (social) resources. More precisely, we envision resilience as “the ability of a person or group to thrive, to continue to plan for the future in spite of destabilizing events, difficult living conditions, and sometimes severe trauma” (Manciaux, Vanistendael, and Cyrulnik, 2001). In theoretical articulations of resilience, several approaches are recommended as a basis for building resilience. The ecological model of resilience based on the work of Bronfenbrenner (1996) advocates for the interactions between individuals and environment in building resilience (Toussignant, 1998). The psychodynamic approach posits that it is the psychological trauma and the threat of psychic disorganization that are at the origin of the entry into resilience. The assumption at the crossroads of several current states of development is that resilience is formed on the basis of a tripod consisting of three areas: the feeling of having a secure base, internal self-esteem, and a sense of self-efficacy. The process of building resilience is a result of a multifactorial complex mesh between individual abilities and skills (intrapsychic, cognitive, behavioral) and resources from the social environment and community. Basically, resilience can be born, grow and develop in “relation to others.”
During this panel, Drs. Clermont-Mathieu and Jean Jacques presented the findings from a joint research project (between ANR-UEH-Ulyon-Editec-UParis 13 and the State University of Haiti) entitled, “Resilience and Creative Process in Child and Adolescent Haitian Victims of Natural Disasters” in which resilience is analyzed both as a trait and as a process. Their presentation highlighted the different layers of the environment that serve as “guardians” of potential resilience; namely, factors that shore up and provide the necessary supports that children and adolescents use to cope with life’s adversities. The panelists discussed the research study that they conducted, and an assessment tool that was developed and used on a sample of 1,475 children and adolescents aged 6 to 20 years who lived in camps following the January 12, 2010 earthquake in Haiti. Qualitative analyses of in-depth individual interviews and focus group data were presented to provide explanatory factors of the mechanisms and dynamics created by study participants to cope and move forward. Dr. Clermont-Mathieu described the different phases of the development of the tool and its usefulness as a support element for understanding the process of resilience among displaced youths. Dr. Jean Jacques then presented the main results of the study. The panelists’ approach to understanding resilience in the Haitian context is that of a process, which gives it a dynamic and evolving characteristic, registered in the temporality and thus not fixed. In this study, it is assumed that resilience may develop at different stages of the life of an individual and is thus subject to fluctuations. As such the presenters focused on children and adolescents’ ability to transform potentially traumatic events and their mental resources to continue to grow in a balanced way.
Disaster Response, Recovery, and Resilience in Haitians: Contributing Factors
Jean B. Tropnas, MD, Clinical Assistant Professor of Psychiatry, State University of New York, Downstate Medical Center
Traumatic disasters tend to bring overwhelming human, material, and environmental losses as well as serious devastation of the very resources that could have helped the stricken individuals and communities to cope, leaving them in desperate need of outside help. It has been suggested by researchers and practitioners in the field of trauma and disaster recovery that major steps to generate effective and sustainable interventions that would help in post-disaster extreme stress can be achieved by promoting 1) a sense of safety, 2) calming, 3) a sense of self and community efficacy, 4) connectedness, and 5) hope (Stevan E. Hobfoll, et al., 2007). Dr. Tropnas argued that Haitians appear to have incorporated these five healing principles into their daily lives, thanks to the following three cultural factors: a) throughout their history, they have been repeatedly exposed to multiple natural and man-made disasters that almost leave them with an innate level of self-reliance and problem-solving capacity; b) Haitians’ religious beliefs have always been for them a source of strength, hope and faith, and have given them a sense of community; and c) seeking relatives, friends, and neighbors to create a social support system has allowed Haitians to experience a sense of belonging, safety, an empathic connection to their community, and an increased ability to adapt. As a result of the aforementioned factors, Haitians have developed a certain level of resilience. Resilience encompasses different aspects of stress resistance. It can be modified and improved with therapeutic interventions, leading to better functioning and adaptation to life circumstances.
Does One Size Fit All? The Applicability of the Term “Resilience” to Haitians
Guerda Nicolas, Ph.D., Chair, Department of Educational & Psychological Studies, School of Education, University of Miami
According to the dictionary, the term resiliency is defined as “the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress” or “an ability to recover from or adjust easily to misfortune or change”. In fact, within the field of mental health, the latter definition is most widely used when referring to individuals who have overcome some significant negative change or life event. These definitions make several assumptions. First, they imply that the misfortune or change is a new experience for the individual. Such an assumption leads to the question of what must it mean for Black individuals who, due to experiences with slavery and colonization, have been enduring misfortunes for a lifetime? By definition, one could argue that all Black people are resilient and thus the idea of applying the term to certain ethnic groups (i.e., Haitians) and not to others is misguided. Second, these definitions imply that the individual has recovered from the misfortune or change. Although it is unclear what the word “recover” means or how it is manifested among different groups, the underlying assumption is that recovery has indeed taken place. Accepting the second assumption negates the first because, to the extent that Black people have not adjusted or recovered from their misfortunes or negative experiences with slavery and colonization, the label resiliency cannot be applicable to them. Lastly, the definitions also use the word “ability,” which often means “natural aptitude” or “acquired proficiency”—all of which supposes that the individual must have access to some skills that can be used subsequent to the “misfortune” or “change”. Although the term resilience, resilient, or resiliency, is commonly used within the field of mental health, an opportunity to unpack its origin, its meaning, and its applicability across different cultural groups is rare. Through the forum provided by the Haitian Mental Health Network’s 2nd Annual Conference, there is an opportunity to begin such an exploration for at least one ethnic group—namely, Haitians. This presentation focused on the use of the term and its application to Haitians in the U.S. and in Haiti. The link between resiliency, coping, and thriving was also explored.
Resilience is More than Skin-Deep, Cultural Foundations are Lasting: “Enstitisyon Se Fè, Vodou Se Banbou” (The Role of Vodou in Understanding Haitian Resilience)
Patrick Bellegarde-Smith, Ph.D., Professor Emeritus of Africology, University of Wisconsin-Milwaukee
The first rule to a better existence is to recognize what ails us. The second is to want to take action, to make amends, and remedy the situation. These rules apply whether we are speaking of an individual or of a collective. Vodou informs us that an illness has both physical and spiritual anchors and consequences, and social ramifications, yet that there is no malady without its remedy. All, en vase clos, as it were, with an emphasis of the unicity of the cosmos, that we are all viscerally connected in nature. In the realm of the mind, there are mental predispositions and “issues” that derive from societal conditions over which we, as individuals, would seem to have little control. Societal pathologies evolve out of constructs elaborated over centuries, yet affect each one of us today. We must heed the lessons that are rooted in our history as a collectivity. Haitian society has been deeply affected by events outside its control, which were present at its “cradle,” at its birth. One recalls that a ritual steeped in religious meaning, was at the base of our struggle for freedom in Bwa Kayiman. That the resistance to the American Occupation was oftentimes led by oungan and manbo (Vodou priests and priestesses), imbued by a sense of purpose, conscious of a centuries-old tradition tethered to an ancestral discourse that is spiritual, though there exists no clear demarcation between our temporal existence and our spiritual lives as they flow naturally into one another. We memorialized the prayer of Boukman Dutty and Cecile Fatiman who distinguished between our God and “theirs,” assigning blame where it ought to go.
In this Invited Address, Dr. Bellegarde-Smith addressed the role of Vodou, from an historical perspective, in understanding the notion of “Haitian resilience”. He discussed how Haitian culture provides us with clues for the well-being of Haitian society while informing us of the secret for its survival and stamina rooted in an ancestral vision. He drew upon his personal experiences as an oungan asogwe (the highest ranking in the priesthood in Haiti) as well as four decades of scholarly work to address the following:
Panel Presentations & Concurrent Sessions