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The
consequences of truth: Post-traumatic stress in new South Africa
(continued) Part 5 of 7 |
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A Specific Mandate The Truth and Reconciliation Commission had several specific duties. The provision of counseling services was not among them. "The Act (that created the TRC) is filled with simplistic assumptions," says Brandon Hamber, coordinator for the project on truth and reconciliation at the Center for the Study of Violence and Reconciliation, "like if we get the truth and we go this route and people speak out they'll feel better. And it just wasn't really that simple." Hamber, 28, is a clinical psychologist and has written extensively about the emotional aspects of the TRC for survivors of violence. He readjusts his long legs and strokes his chin before he speaks. "One of the problems with the process is that I think in the beginning we basically spoke the language in which the country had a psyche, and that a country is the same as an individual...in that the truth about the country will help heal in the same way we might say that dealing with your own personal truth in therapy might heal you," he says. "The real bottom line is it's very unlikely that your individual healing process, no matter how useful the testimony is to you, is going to correspond with the national process." He agrees with the popular tenet of psychology that says repressed pain is likely to later cause adverse emotional and possibly physical consequences, but thinks the process of confronting the past is very important. He believes there are two ways of examining the commission and the part it has played in reshaping the country. "On one level we can criticize the commission and say well, we opened up this trauma and there weren't adequate services and it's very problematic," he says. "A more positive way would be to say the trauma was there in the first place, it's going to come up at some point in time. We have zip, no services anyway, and perhaps by opening it up at least we've started the process. At least we've forced people to think they need to set up mental health services." The mental health profession in South Africa is colored by deep hues of racism. During the apartheid years, people who were detained by the state went untreated or mistreated for psychological illness. In some cases, psychologists and psychiatrists assisted security police in developing torture methods and psychological warfare. Traditional psychoanalytic thought equated blacks with a rampaging id that threatened to spin out of control without the whites, the superego of South Africa. Prime Minister Dr. Hendrik Verwoerd, a psychologist obsessed with the psychiatric eugenic theories developed in Nazi Germany, intensified the system of apartheid. In the 1960s he encouraged scientific societies like the South African Psychological Association to split along racial lines. The resulting segregated organization, the Psychological Institute of South Africa was an active proponent of apartheid until its dissolution in the early 1980s. Indeed, the horrible acts committed under apartheid were, except in rare cases, never part of the country's psychological agenda. Many, though not all, of the psychologists and counselors today are very young and without much experience. Many of the older generation, an all white group that has spent its professional life ignoring or harming blacks and treating only whites, have settled into lucrative private practices. South Africa is dealing with conditions which are less than perfect. "Mental health is still a second cousin to other types of health, and it still seems curative, it's not seen as a preventative strategy," Hamber says. In the Northern Province, where there are five million people, there is only one psychologist. People have had to do it themselves. "Forced with your back against the wall you might say it's better than nothing." If treatment for traumatized individuals is different in South Africa, so is the nature of their condition. Hlengiwe Mkhize, formerly the national director of mental health and substance abuse, and now chair of the TRC's reparations committee, says the diagnosis of PTSD is not an easy one to make. Speaking at the TRC's Mental Health Workshop held in Cape Town in November 1997, she said, "We have had quite a number of people coming before us who had made statements but who had expressed difficult emotions like anger, depression, suffering, complicated grief and all those difficult emotions which go with the past... we are not too keen to diagnose those people because we know those are people who are people who were functioning at a high level, they were leaders." Thulani Grenville-Grey, one of the few people left at the TRC's pared down headquarters in Cape Town, was in charge of the mental health needs of both the commission's staff and testifiers during the human rights hearings. He is defensive about the commission's performance and the criticism that the commission didn't provide enough support for the victims. Rolling from side to side in his office chair and curtly excusing himself for the cigarette he is smoking in his office (“It is supposed to be lunch, you know”), he explains that the TRC was constrained by the Act which created it. It is a familiar argument. Given its resources, he says, the commission did all it could. The people who complain about the treatment of victims, he argues, are the ones who need to be acting. “My experience of mental health workers is a passive one,” he says. “They watch. They're not proactive.” Things like trauma centers and counseling won't just materialize, he says. The mental health community needs to organize itself and lobby the government. “I think they should get on board. It's got to be a loud voice.” |
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