SUMMARY. This article presents a woman-centered approach to healing that is necessitated by trauma inflicted by armed conflict. The authors present a historical context within which they depict many of the daily consequences that citizens experienced. A training program was developed during a trip to Bosnia in which sixteen women, among whomwere social workers, psychologists, physicians, teachers and one Islamic theologian, participated. This program was comprised of five training modules: introduction to basic concepts and issues, the social psychology of war, the counseling process and techniques, social work in a wartime environment, and termination. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com]
KEYWORDS. Woman-centered training, trauma counseHng, training program, feminist training, psychoeducation
THE HISTORY OF THE PROJECT
When the war in Bosnia began, we were living in Vienna, Austria. Thus, it was very much a conflict in our neighborhood and, as such, awoke many of the old feelings of fear and anxiety that we had experienced as children, either as a three-year-old forced to flee with her parents through large parts of rural Germany, or as a young girl immersed in the tension of the immediate post-war era, when many thought another conflict was imminent. Dulled by time, these fears were roused once again in 1956, when the Hungarian Crisis burst upon our consciousness.
From the beginning, events in Bosnia filled us with rage. The power politics of the governments involved, their actions designed to sabotage any hope of a negotiated settlement, together with the empty rhetoric of the European "community" more generally left us feeling helpless, yet determined to contribute in some small way to the cause of peace. It was at this time that feminist groups from various countries began to make contact with local women's organizations, providing support and assistance that went mostly unnoticed by a mainstream media narrowly focused upon government-sponsored aid programs. Moreover, it was also in this context that we embarked upon our first intervention in the region, offering training courses in Zagreb and Split (Croatia) in an environment that might be characterized as one of collective shock and emotional desensitization (Scheffler and Mi.ichele, 1996). Without wishing to downplay the difficulties and challenges we faced, this was preferable to the sense of powerlessness we had previously felt in Austria.
Planning for the project was undertaken in 1994/95, and the work itself was carried out over a three-year period, from 1995 to 1997. Our objective was to provide woman-centered training in therapy and soda-therapeutic counseling, with a total of 16 women taking part, among them social workers, psychologists, physicians, teachers and one Islamic theologian from Bosnia. All were involved in the activities of NGOs working in the region.
As one might imagine, our work in Bosnia and Croatia was motivated and underpinned by our own political commitments and consciousness. In short, itis our position that the attacks carried out against women during the conflict were part of a deliberate strategy that is retlective of the gendered nature of the societies in which we live. Through our intervention, we sought to contribute to the healing of those who had suffered violence, while helping to build capacity among women of the warring region.
ORGANIZATION AND FINANCING
Project financing was derived from the following sources: German People's Aid (coordinated by Karin Schiiler); Norwegian People's Aid (coordinated by Liv Bremer); Caritas Leverkusen (coordinated by Friedel Herweg); personal donations by women psychotherapists at the Fritz Perls Institute, Dusseldorf, Germany; and Women's Association of Split (responsible for project logistics in Split). Translation services were provided by Lejla Derzic. Our co-trainer in two courses was Angela Reinhardt. Planning, management and implementation were conducted by Dr. Sabine Scheffler and Dr. Agnes Miichele.
PROJECT DESIGN
If our initiative was to be successful, we deemed it vital that we make a preliminary trip to the region; not only would this allow us to gain some insight into the day-to-day challenges faced by the women themselves, but we would also be in a better position to tailor our training program to the needs and requirements of participants. Setting out in August 1995 (during the time of the Krajina offensive), we visited several women's projects being implemented in Tuzla and Zenica (Bosnia). On the one hand, our trip was useful in forcing us to question our assumptions and become more realistic in our goals and objectives. On the other, it served to strengthen our resolve to carry out the training program in Croatia, and not in Bosnia as some participants had originally wanted. In our opinion, a relaxed environment is critical for meaningful learning to take place, and the atmosphere in Bosnia was anything but relaxed at that time. Finally, on a more mundane level, our journey to the region gave us an opportunity to discuss the aims of the project with our local partners and to assess local working conditions. It should be noted that this aspect of the trip was of particular symbolic importance to our partners, who took it to be indicative of the non-hierarchical nature of the project.
Assumptions
Throughout the planning and implementation stages of the project, we were guided by the premise that, for healing to occur, women's suffering must be understood within the broader politico-historical contexts of nationalism and patriarchy. That is to say, women who are victims of war cannot be expected to regain their dignity and self-esteem unless the processes and events that led to their victimization have been acknowledged and exposed for what they are (Laub and Weine, 1994; Graessner, Gurris, and Pross, 1996).
Injustice Against Women During the Injustice of War
At a personal, social and historical level, war means something different for women and men. Thus, while dominant discourses (including those of the mainstream media and the state) are focused narrowly upon the "organization of war" and issues of concern to men (e.g., battles lost and won; number of personnel injured, missing or dead), the violence experienced by women is targeted and total, and is used as a way of sapping the morale and weakening the resolve of men. Objectified and subjected to torture, humiliation and violence, the destruction of women's dignity undermines and destroys the social bonds and values of the culture in which they live. However, in spite of these attacks, women struggle continuously for their dignity and freedom, both in the face of wartime atrocities and the daily humiliation and violence of life under a patriarchal social order. Indeed, in this regard one might argue that the public response to violence is equally as important as the psychological resources available to an individual who is setting out on the path to recovery. Recognition of the truth must precede the victim's recovery, as Judith Herman (1994) has so aptly noted.
Of course, the wartime victimization of Bosnian women is an atrocity that has been largely ignored by the international community and mainstream media, which is reflective of the taboo nature of the topic itself. For example, it was only in the early 1990s that German feminists were able to initiate a public discussion of the atrocities committed against women during the Second World War (Sander and Johr, 1992). In a similar fashion, Austrian women had a very difficult time indeed convincing the Minister for Women's Affairs in that country to accept rape in war as a basis for political asylum. While by no means wishing to suggest that either Austria or Germany has gone far enough in addressing the issue of violence against women in war, they are sadly two of the more "progressive" cases. In many other countries, there is absolutely no interest in the issue, which serves as a shameful testimony to the willingness of societies to accept male violence and its pernicious effects upon women's lives.
Aware of this situation before we had even embarked upon the project, we arrived in Bosnia expecting to be confronted with women whose socialization into a patriarchal, conservative culture would leave them feeling ashamed of their victimization, as well as causing them to suppress its effects. However, as we began the training courses, we were reminded of the fact that talking leads to recovery, and that joint responsibility in combination with the women's own coping strategies would provide the basis for them to overcome their suffering. Significantly, these findings are confirmed by scholars examining healing processes in the context of women's shelters (Bruckner, 1997; Walker, 1979).
A Woman-Centered Approach to Healing
That violence toward women is grounded in patriarchal relations of power is well-established, and is equally the case for Bosnia as it is for Austria or the United States. However, it was our hope in intervening in the manner that we did to contribute to a process of change whereby Bosnian women were able to make gains similar to those achieved by women in other countries. Of course, there is a long tradition of solidarity among women in the face of domination and violence, and we have shown our power to overcome the latter in order to begin life anew. Drawing upon the legacy of women's projects the world over, one might identify the following premises upon which to ground our anti-violence work. In particular, there is a need to: acknowledge injustice and injuries; find a language to describe the act; become responsible and bear witness; reestablish individual and collective selfesteem; promote self-confidence; and achieve balance between dependence and independence.
Needless to say, these aims require facilitators to establish active contact among all members of the group. Our strategy in this regard involved taking the skills and competencies of participants seriously, and using them as the starting point. for a two-way learning process. On the one hand, this demanded that we focus continuously upon the group and group events. On the other, we had to resist the temptation to take charge, since it was critical that members find their own solutions to the issues they were facing. Our role was to offer support, stimulation and knowledge in a manner that would be helpful in developing self-confidence and confidence in others.
The Concept
Aims
Focused on the development of professional skills in social-therapeutic work with female war victims and refugees, the training course was designed especially for the women who would take part, among whom numbered physicians, psychiatric nurses, teachers, social workers and psychologists. Moreover, we identified three areas in need of priority intervention: Enhancement of theoretical knowledge; Counseling methodologies; The work context.
At a theoretical level, the course dealt with such issues as the psychodynamics of trauma, diagnosis of post-traumatic stress disorder, sociodynamics of war, models of crisis intervention and trauma counseling. We also dealt with a number of general concepts, including: Contact and relationships; Defense and resistance mechanisms; Transference and counter-transference; Group settings; Counseling techniques and media (creative media and dreams, role-playing, body techniques and exercise-centered work). Of course, in dealing with all of these issues we also emphasized the importance of focusing, identifying one's strengths and weaknesses, taking care of oneself, and strategies to avoid bumout.
Structure
The meetings we held with prospective participants during our preliminary field visit were useful in familiarizing us with one another, as well as helping all concerned finalize their decision as to whether or not they would become involved. From our perspective, it was important that the group be heterogeneous, since we wanted to bring together a wide range of experiences, while at the same time fostering networking opportunities.
The course itself lasted two years, and was divided into six modules, consisting of 40 units (each unit was 45 minutes in length) spread over the course of five week-days. The modules may be summarized as follows: Introduction to basic concepts and issues related to work with war and trauma victims; Establishing group strengths and weaknesses; Social psychology of war and violence; Deconstructing gender roles and relations; Counseling techniques and the counseling process; Social work during and after a war; Completion of counseling processes; Discussion of the case studies; Conclusion.
At the end of the two-year period, all participants were expected to document a counseling experience, as well as describing their application of methodologies we had discussed in the training. Finally, it should be noted that we are currently in the process of planning a seventh module, scheduled for September 1998, when we will have returned to the region in order to take part in the day-to-day counseling work of project participants.
Principles of Evaluation
Seeking to engage with our own assumptions in planning and carrying out the project, we distilled a number of key questions from the training material, our progress reports and evaluation exercises. These may be summarized as follows:
However, while these objectives informed our interventions in the training courses, it should be noted that we placed particular emphasis upon group work (e.g., dream work, role-playing and sculpture work), as we were concerned that we might exhaust ourselves if too much time was spent in individual sessions, and all the more so because participants were dealing with the legacy of their own war-time experiences.
Challenge# 1: The Way from Dependence to Independence
Before the training courses began, we assumed that those taking part would be cooperative, appreciative and motivated to learn as much as possible within the existing time constraints. However, once the project was underway, we were forced to revise our expectations somewhat. Although the participants were prepared to accept our leadership, even in the face of difficult or provocative topic areas, it became clear to us that they were anxious, and would become silent and introverted whenever we pushed them too far. This response, together with the chatting, loud laughter and somewhat frantic attitude during leisure-time activities suggested to us that we should reduce the intensity of the sessions and provide more release mechanisms.
Challenge# 2: Acknowledging the Needs of Those Traumatized by War
When we made our first trip to Bosnia in 1995, we were immediately struck by the looks of exhaustion on the faces of our colleagues, and by their willingness to accept whatever we offered with the words, "It would probably be useful." We interpreted their wariness as indicative of the traumatic experiences they had undergone, experiences that made them fearful that the training course would lead to nothing but the repetition of their wartime humiliation.
Faced with the exhaustion of the individuals with whom we had come to meet, along with that of the country itself, we felt an enormous pressure to give something of ourselves, to present a token of our solidarity. However, we soon realized that solidarity, professional support or money was not what was required here. Instead, what our partners needed above all was recognition of the humiliation and injustice they have suffered, and so to bring an end to their sense of shame and isolation. Needless to say, this presented us with a significant challenge, since on the one hand, we hoped to validate and acknowledge their grief and, on the other, we wanted to ensure that they learn to act by themselves and overcome their sense of humiliation. Thus, we sought to provide constant support and positive reinforcement, so that the women began once again to appreciate themselves and to develop the selfconfidence necessary to make use of their skills and talents. However, by no means do we wish to downplay the difficulty we experienced in negotiating this knife edge between over-identification and the need for distance; all too often we were left feeling overwhelmed and tempted to give up.
Challenge# 3: The Ambivalence Inherent in a Solidaristic Relationship
From the moment that we first set foot in the Former Yugoslavia, we were faced with a discernible gap, between us-foreigners, prosperous, our lives in no direct danger-and those with whom we were working, women grounded in a mixed socialist-Islamic culture heavily oriented toward family. Needless to say, we often asked ourselves "What are we doing here?" as we nursed our self-doubts. "Are we good enough? Do we have something useful to offer? Are we imposing our Western feminist values upon participants (which we were communicating unconsciously to them in any case)?" As for our partners, they confronted us with their attitudes towards children and men, testing the limits of our tolerance, although soon warming up enough to share with us their cordiality, directness and charm. It should also be noted in this regard that the gap appears to have reproduced itself among the participants themselves, as they went about their work with female refugees who had come down from mountain villages in the Bosnian hinterland.
We strongly believe that our relationship with the participants was a special one, characterized by a deeply hidden intensity of emotions on both sides. From our perspective, we interacted with the women in a way that was reflective of our own sense of sympathy and solidarity, our fury at the horror and injustice of the war, and the ambivalence of participants who were forced to make do in a highly precarious, dangerous environment. This ambivalence was evident in the conflicting messages they sent us; at one moment they would be serious, highly productive and creative, and the next this would be replaced by avoidance, regression and a tensed silliness.
Thus, as facilitators, we could only give of ourselves, our sympathy, solidarity and knowledge, while acknowledging that these were merely a symbol of our belief in the injustice of the war. In other words, we were forced to accept the fact that participants' behavior in the course was only tangentially related to our own motives, desires and expectations. Of course, relinquishing control in this way was difficult and often painful, and at times we would seek to regain our sense of power by pushing through difficult topics.
The issues touched upon above encapsulate our experiences during the course of the training project, and, paradoxically enough, they help to explain its success as well. That is to say, not only was the latter due to the particular manner in which we approached the participants and the issues addressed, but it also depended crucially upon the women themselves, who engaged in their own interpretations of the material, which provided the basis in tum for its incorporation into their personal and professional lives.
Evaluation Strategies
External Standards
This would include the trip made by the project coordinator to assess its impact. She carried out interviews with participants concerning changes in their work lives. Also relevant in this regard is a women's shelter being planned for the Tuzla region by some of the women involved in the training course.
Internal Standards
Falling in this category would be the participants' assessment of the project; the case studies, which were presented and discussed at the end of the course; and, finally, our own evaluation reports. It is our position that the evaluation reports provide an especially powerful lens through which to assess the relative success or failure of the project. In short, they retlect the complexities inherent in communicating, in a theater of war, topics related to trauma and crisis, but they also lay bare our own engagement with the women and the topics covered, summarized as follows in the form of two key questions:
How does the language of the reports mirror and retlect our attitudes and prejudices towards the participants?
How do we describe and reflect upon our experiences?
The reports also include references to our fantasies, our prejudices, our likes and dislikes. In the pages that follow, we analyze this material, in its entirety, in order to shed some light upon that which is usually unconscious, in the background, the gestalt. In so doing, we hope to show that our facilitation of the training courses was informed throughout by our positioning within a complex web of social relations and structures (Benjamin, 1990; Nadig, 1992).
The Evaluation Questions
As the preceding discussion suggests, our evaluation strategy is part operational, part discursive. In this regard, we would argue that the context of the project, i.e., the fact that it was undertaken in a post-war environment, the war-time experiences of the women themselves, along with the professional demands placed upon them in terms of the lack of preparation for the type of psycho-social problems generated by the war, together served to create what one might call a special learning situation. How so? Consider the following points: The energy and tension engendered by the crisis were given concrete manifestation in the training seminars through the actions and reactions of participants. The relationship between participants and facilitators was characterized, on both sides, by ambivalence and resistance. On the one hand, we were the conveyors of skills and knowledge, and they the receivers. On the other, we were women outside of our own cultural milieu, interacting with individuals who were on their home turf, albeit one shattered by the effects of war. In this way, the evaluation reports offered a means of working through the implications of being immersed in a special learning environment by giving us the opportunity to reflect upon the events, the participants, and the ways in which we dealt with the process.
EVALUATION PROCEDURE
Group-Centered Interventions
We scrutinized the evaluation reports in search of examples of interventions that were related, at an operational level, to the project objectives. Having identified relevant cases, we then assessed participants' responses to our interventions, and registered their effects. We discuss our findings in detail in the paragraphs that follow.
The Adjectives
We extracted all the adjectives contained within the reports and divided them into categories. In doing so, it was our contention that an activity as complex as "working with traumatized women" engenders reactions at the psychological, somatic and social levels, thereby int1uencing behavior, perception, sensation, cognition and affect. It was also our belief that these coping mechanisms would be changed, emphasized, corrected and extended as we pursued the training objectives over the course of the project.
Adjective Categories
In total, we identified 968 adjectives in the six reports, not including those used in the assessment circle undertaken in the final training module. Although we discuss each of the adjective categories below, the reader should bear in mind the fact that equivalent words do not always exist in English and German. However, we have endeavored to ensure that our translation is as faithful to the original as possible.
Category 1: Modifiers
Adjectives which intensify, increase, underline or make more extreme.
Examples: very professional, very slow, tiny deviations, only German women, little courage, lots of fear, very silly
Category 2: Value Statements
Words that judge, value or rate.
Examples: good answer, wrong, bad, morally, nice, professional, lazy, good attitude
Category 3: Body Sensations
Adjectives which describean individual's condition at a sensuous body level. Examples:wrinkled-up nose, ill,wounded, shitty, strong
Category 4: Activity
Descriptors of initiative, vitality, vigor (or their opposites).
Examples: exhausted, explosive, powerful, quick, slow, tough, vivid, politically active, sexual
Category 5: Relational Statements
Words that imply or describe a relationship.
Examples: keen, empathic, polite, social, open, erotic, present, reserved, competitive, lonely, affected, appreciative, together
Category 6: Emotions
Examples: anxious, guilty, happy, furious, pissed off, desperate, sad, funny, proud
Category 7: Cognitive or Technical Terms
Adjectives related to cognition (i.e., perception or thought).
Examples: pensive, resigned, perplexed, disappointed, vague, impressed, clever, traumatic, depressed, hysterical
Category 8: State of Being
Any word that implies an assessment of one's state and that cannot be categorized under Emotions, Cognitive or Technical Terms or Body Sensations.
Examples: apprehensive, pleasant, satisfied, finished, comfortable, strange, diffuse, cheerful, quiet
Principles of Evaluation and Group-Centered Work
As we have already made clear, our interventions in the training course were group-centered. That is to say, we placed particular emphasis upon group development, seeing it as a way of building self-confidence among participants. The following example illustrates the precise means by which we accomplished this.
During the second morning of the first module, we asked participants to describe their moods and dreams. Having spent the first day in small groups, punctuated by a number of mini-lectures, this was our first real opportunity to perceive and appreciate the women and their feelings. After the session, one of the group members approached us and asked if she could introduce a rule, namely that participants should avoid speaking, discussing or interpreting when another woman is making a statement. We took this as a reaction to the experience of having to deal with such a diverse group, as well as an attempt to provoke us into setting group norms and rules of behavior.
In our evaluation report, we described the group's mood as "immediately tensed" after the participant voiced her request. We responded to her by noting that there are as many opinions and perspectives on a given problem as there are women in the group, and thus that it behooves each member to decide for herself what feedback is helpful and what is not. Following this intervention, a conversation ensued regarding the distinction between what might possibly be manipulative and what it means to be a mutual intluence. The discussion became increasingly confused until there was no longer any scope for understanding. It was at this point that we decided to end the session: it was time.
In the seminars, participants continually expressed their disappointment with the fact that we were not more forthcoming with advice and opinions, and that all of our attention was directed towards their knowledge, their views and their possibilities. Even when we were engaged in dream work, the focus was always on the group's feelings, fantasies and associations. Thus, we were pleased when, during the course of the final module, several participants came forward to express their surprise at how far they had come in perceiving and appreciating their fellow group members, and how much they had learned from them. These comments were especially gratifying in light of the self-doubt, counter-transference and mood changes we had recorded in the evaluation reports, all of which we took to be indicative of our fear that we would be unable to meet the needs of participants. Of course, to a large extent we were merely reflecting the emotions of the group, who were constantly expressing their desire to "consume" our authority.
This meant, in effect, that we were often faced with participants who perceived our knowledge as more important or significant than that of the other group members, a problem that was especially marked during the supervisory elements of the course. Moreover, this in tum was exacerbated by the fact that we were not always successful in stimulating the women in their activities and reflections. We often reminded ourselves in the evaluation reports not to use the group like a stage (in the manner of gestalt therapy), but rather to focus upon developing a group-centered position. In the end we were somewhat successful in this regard, as attested to by the fact that the women were becoming increasingly active in their statements, in their personal presence, and in setting themselves apart from one another. We will relate another example in order to illustrate the d