I arrived in Guatemala with a very minimal understanding of the country. All prior knowledge had been gathered through the internet and books. Upon arriving in Guatemala, I began to see how little words can convey. While I had claimed that I was entering with una “mente nueve” (a beginner’s mind) and a light backpack, I still carried with me many unconscious biases and other forms of mental baggage. The first day I arrived I purchased a ticket from the station at a price which was more than many rural Guatemalans make in a month. I paid no heed to this privilege, I had no conception of how far the U.S. dollar went here.
It was not until I sat down and watched a movie, “Cuando las Montañas Tiemblan.” This movie was about the experiences of Rigoberta Menchú, an indigenous Quiché woman who won the Nobel Peace Prize in 1992. This film was about the war between the Guatemalan Military and the indigenous Mayan population of Guatemala. It had historical footage of the violence and warfare which consumed many parts of the country from 1960 to 1996. The images spoke more than any textbook could.The indigenous women wailing as their husbands were tortured, civilians being shot on the street, villagers being kidnapped in the night, the military trapping protesters in buildings and burning them alive. Still, these words do no justice to the lives that were lost.
Ripples of the Past
I believe that echos of this conflict continues to reverberate, both psychologically and physically. The psychological pain is real and manifests in many different ways, via the gut, the mind, and behavior. While trauma varies from person to person, it is quite possible that some element of trauma exists here. Some locals have talked about “nervios,” a condition which manifests as anxiety and jumpiness.
According to anecdotal reports, there is hardly any mental health care in Guatemala. Psychiatrists generally reside in the capital behind the walls of the National Hospital for Mental Health. “Only 0.9% of the Guatemala’s health budget is dedicated to mental health, 90 percent of this is dedicated to the one mental health hospital. Moreover, there are 0.57 psychiatrists and 0.35 psychologists per 100,000 residents,” (Paiz 2012). Even if psychologists are available, it is difficult to imagine that there is access for all Guatemalans, especially those living in rural areas.
Even if the time and money existed, there is a larger issue, an overarching stigma about discussing mental illness. When people are unwilling to talk about trauma, it becomes difficult for me to imagine that it can be treated effectively. What does it even mean to treat trauma in another culture? Or to even call something trauma? I have begun to see that it is not my place to even call these experiences trauma. Western-biased perspectives regarding trauma can come into conflict with the importance of providing culturally sensitive care (Brand 2015).
I Think Therefore I Am?
Rene Descartes, the French philosopher, was quoted as saying, “I think therefore I am.” This statement was intended as proof that the human mind existed, even if the rest of the world did not. Descartes was echoing sentiment that was common in the Western world, and still is — that the ego is the perceived center of existence. Upon coming to Guatemala, I have encountered a different phase, “I am therefore I think.” I have begun to notice that whether we exist or not, the world continues. While this concept may seem futile, I believe it is a starting point for an allocentric viewpoint, that the ego is not the center of everything. To acknowledge the other, to deeply bow to the multitudes of perspectives, we can begin to accept that our perspective may never be “correct.” Delving into a culture which is so different only begins to cause this flame to flicker. Western science is so often concerned with being correct, but how is there one way to be correct when it comes to acting in a place so different?
Impulses to Act
Sometimes as citizens of the United States we can have a strong desire to fix everything. We are the best and so we have to help everyone, right? Guatemala is a clear example of the dangers of intervention, especially foreign intervention. I often notice the impulse to try and provide some hope, but nothing I can say will make it all magically go away. A part of me wonders if it “needs to.” What I call trauma is a loaded term, filled with perspectives from researchers and clinicians in the United States, not those who experienced conflict. I can simply notice my own perspective, and recall not to impose my own perceptions on any other person. To be trauma-informed in the United States is to be just that, informed about one specific culture, or even one perspective within that culture. Many cognitive techniques focus on reframing thoughts or distancing them. However, all persons cope differently. What right does anyone have to simply categorize an experience by one single Western name? What right does someone have to tell another to “reframe their way of thinking?”
What Should Be Done?
Humans can be very prone to act. One skill which I have been learning here is to simply sit and observe. For better or worse, I have to be okay with not trying to change the lives of others. I have also just begun to learn how much privilege I have as one of the wealthiest one percent of humans on the planet. One thing I do struggle with is this: when do I use my privilege to help others, and when am I being an ignorant white male, thinking I can save the world? These inner-dialogues continue; but the first step is noticing. This act of noticing can transition to mindful listening. It can be very easy to attribute everything to the “struggles of the people.” It can be very easy to think I am doing “good work.” It can be very easy to tell others of my “exotic adventures.” I have to stop myself, consistently. I have to listen and talk about the truth and be careful not to ascribe subjectivity to what is actually happening.
A smart nurse I know in the United States once said, “Mindfulness is groundlessness, the acknowledgement that we are not in control.” Moving forward, I hope to acknowledge this sense of groundlessness. Being in a new country can be one method of seeing this groundlessness face to face. I wish to accept what I cannot control and understand what I should not try to control. Moreover, it is of the utmost importance to acknowledge one’s own thoughts and stop oneself from attempting to intervene. Personally, I must hone my own virtue of prudence, to continue to poke and prod my mind about when it is morally right to act and when it is not. Moving forward, I believe the correct response is to observe without conclusion, to listen without pretending that I can come anywhere close to understanding. One question that lingers in my mind, what does the word “trauma” really mean? Is it even appropriate to use a label when encountering another culture? Can any phenomenological experience ever even be condensed into a word? Each story is different and sometimes the only thing one can do is to sit and observe.
– Dallas Ducar
Brand, J. B. (2015). Understanding trauma in Guatemala: a cross-cultural perspective (Doctoral dissertation, Rutgers University-Graduate School of Applied and Professional Psychology).
LeDoux, J. (2012). Rethinking the emotional brain. Neuron, 73(4), 653-676.
Koenen, K. C. (2007). Genetics of posttraumatic stress disorder: Review and recommendations for future studies. Journal of Traumatic Stress, 20(5), 737-750.
Paiz, A. (2012, August 01). Mental Health Care in Guatemala – Revue Magazine. Retrieved July 14, 2016, from http://www.revuemag.com/2012/08/mental-health-care-in-guatemala/
Yehuda, R., Flory, J. D., Pratchett, L. C., Buxbaum, J., Ising, M., & Holsboer, F. (2010). Putative biological mechanisms for the association between early life adversity and the subsequent development of PTSD. Psychopharmacology, 212(3), 405-417.
Disclaimer: These publications were written by each author in his/her personal capacity. The opinions expressed in these articles are the author’s own and do not reflect the view of the University of Virginia nor the University of Virginia’s Guatemala Initiative.