RANGOON — A group of former political prisoners in Burma are undergoing training to offer mental health counseling to others who were imprisoned under the military regime.
Over the weekend, 14 students in Rangoon wrapped up a 12-day course about a method of counseling that was developed in the United States for use in countries around the world where communities have experienced high levels of trauma but lack resources for treatment.
Thousands of people in Burma were imprisoned for political reasons under the former regime. Since a nominally civilian government came to power nearly three years ago, a majority have been released, but many face challenges reintegrating back into their communities. They say the government has offered no help and that mental health services are not widely available.
“We passed terrible events and very hard times in prison, and after we were released many of us experienced depression,” says Kyaw Soe Win, a former political prisoner who now works as the chief clinical supervisor at the Assistance Association for Political Prisoners (AAPP), an advocacy group that is leading the counseling project with support from US universities and funding from the US Agency for International Development (USAID).
On one of the last few days of the course in Rangoon, Kyaw Soe Win stood before the 14 students in an upstairs room at the local YMCA, reading out different scenarios that counselors might encounter while meeting with clients who are dealing with trauma.
In one hypothetical scenario, a man explains a memory from the past, about the day he and his wife were attacked by a group of soldiers. He says three of the soldiers captured, injured and restrained him, forcing him to watch as his wife was raped. Now he says he can never again trust another man.
“What is the problem, what’s his behavior, and what do the doctors need to do?” Laura Merchant, a social worker and therapist from the University of Washington in Seattle, asks the students as they determine how a counselor should respond.
The students are learning a sort of checklist to move from some of the earliest stages of counseling—including introducing clients to the therapy approach—to more advanced stages, where they shift negative thinking habits to more positive thoughts. “They follow step by step how to do it,” Merchant tells The Irrawaddy, adding that counselors receive supervision from the US-based trainers.
The evidence-based psychotherapy approach, known as the Common Elements Treatment Approach (CETA), was developed by researchers from Johns Hopkins University in Maryland and the University of Washington, who say the therapy is easy to learn and implement by people who do not necessarily have formal schooling in social work. It has been used to help trauma victims in Iraq, Colombia and the Democratic Republic of the Congo, countries which, like Burma, lack clinics, funding and human resources for mental health services.
Last year, Johns Hopkins provided the first round of training in Burma to members of the AAPP, who are now leading their own trainings to the new batch of students.
After completing their coursework, counselors focus on a couple of pilot cases first, with heavy supervision, before taking on more clients. Since last year, nine counselors have met with a total of 84 clients in Rangoon and Mandalay. Over the border in northwest Thailand, where many Burmese refugees live, a team of five counselors is also offering services. The AAPP has an office in Rangoon but is based in Thailand.
The 14 new students in Rangoon are all former political prisoners or family members of former political prisoners. They represent not only the AAPP, but also the Former Political Prisoners Society, the Ex-Political Prisoners Network of Upper Burma, and opposition parties including the National League for Democracy (NLD) and the Democratic Party for a New Society.
Among them is Hnin Pan Ein, a 48-year-old writer based in Rangoon. “When I was 7 months old, my father was arrested. I saw my father for the first time when I was 7 years old,” she says, recalling how her husband was also imprisoned for political reasons six years after their marriage. “In my whole life, the people of Myanmar have experienced a lot of stress because of the pressure of the government. … The people like me, who have similar life experiences and have also suffered trauma, I would like to help them.”
The counseling is free and open to former political prisoners and their family members.
“The biggest challenge for us is that the word ‘counseling’ is not familiar with our society in Myanmar,” says Saw Thet Tun, AAPP’s deputy chief clinical supervisor. “Many people misunderstand counseling—they think it’s for HIV patients or for crazy people.”
He adds, “Most former political prisoners have a strong mind, they fought against the military regime, so we think we don’t need counseling.”
Saw Thet Tun said he joined the training because he was frustrated by a lack of assistance from the state.
“The lives of former political prisoners are neglected by the government,” he says. “We spent so long in prison—for me it was 19 years—but after prison they neglected to rehabilitate us.”
The government does not have social welfare programs specifically for former political prisoners, says Aung Tun Khaing, deputy director general of the social welfare department at the Ministry of Social Welfare, Relief and Resettlement.
He says the ministry provides medical assistance to women criminals who are diagnosed with HIV behind bars, but not for political prisoners.
After political prisoners are released, he says, they can seek services like any other Burmese citizen.
“Our policy is that if any Myanmar citizen has social problems and social needs, they can contact our department and we can provide some social assistance,” he tells The Irrawaddy, saying the government can, for example, help provide microcredit or job training for families that lack enough income.
In the absence of any dedicated government help for the country’s former political prisoners, AAPP hopes to expand its counseling services in the future, but for now its mandate is limited.
“We can’t give counseling to ordinary people because they are not former political prisoners or family members,” Saw Thet Tun says. “But really these are our citizens, too. Lots of people have been in areas with civil wars, or in [Cyclone] Nargis-affected areas, or areas with religious conflicts. There are a lot of people who have experienced trauma.”