Ahmad Al-Taj is a physiotherapist at CVT Jordan.

When a person has survived torture, he carries memories with him. Simple things can become overwhelming when they bring back horrible memories; for example the sound of an airplane or loud voices can bring a survivor back into that place of fear. With physiotherapy, we help clients recognize that they are safe now, enhance the body/mind connection, and help them to gain some skills and techniques to deal with their physical challenges. Much of my work is helping clients to have regular daily activities or exercise, something as simple as breathing in the right way – this helps them heal.

Before I joined CVT, I worked in a number of hospitals and clinics, including working in Saudi Arabia for several years. I worked on different kinds of cases, doing physiotherapy for post-operative, orthopedic and neurological conditions, working with inpatient, outpatient, children and adult cases.

I had first heard about CVT in a workshop at school; it was something new for us to learn about survivors of torture or war violence and what they are suffering from, things like triggers, flash backs, panic attacks or dissociation. This needs highly specialized skills, as these individuals will respond differently to physiotherapy practices such as touching their bodies, and questions must be chosen very carefully, down to the specific words, during the treatment. For us as students, this was not completely understood at that time because we did not have that experience yet. And I realized that even more when I started working at CVT.

My role at CVT as a physiotherapist requires conducting physiotherapy assessments, group and individual therapy sessions for both adults and children, doing follow-up sessions for the clients, and documenting all the clinical activities that I have conducted.

During our intervention, we help our clients understand how emotions affect our bodies and we normalize that, which helps in decreasing their anxiety and stress about their physical condition. We focus primarily on the four main emotions: anger, sadness, fear and happiness, and how these emotions elicit certain physical reactions – with our clients, these reactions might be more intense than for other people. For example, hearing noises like shouting might bring back traumatic memories that the person has experienced in the past and cause increased heart and breathing rates. Over time with our clients, this condition might become chronic and lead to changes in breathing patterns, causing muscle tightness and tension that get worse over time.

Breathing is a key technique that we teach our clients to help them regulate their bodies and feel comfortable and stable. There are different kinds of breathing techniques that we can teach for different purposes.

I remember a client who had severe pain in his back, neck, shoulders and lower extremities. He had experienced a very hard trauma story. During the sessions, I noticed that his physical abilities were improving very positively, yet he was still having a high pain level. It was clear for me that the client had a shallow breathing pattern and that he didn’t use his diaphragm as he should, so we agreed to focus on practicing diaphragmatic breathing and to progress this slowly.

After a couple weeks, the client noticed a very big improvement in his pain levels, and he was very grateful for that. He shared this experience with other clients in the group, telling them how helpful and useful it was to pay attention to your breath and use the correct breathing pattern. He told them this will help you to gain control over your body and make some improvement.

At the last session of this group therapy, when we asked this client for his feedback on our therapy he said: “Everything was great, but for me the most effective thing was the breathing exercises which decreased a lot of my pain and helped me a lot to calm myself down when facing challenges.”

This was just one example of how breathing problems can affect physical pain levels even without having any physical damage or injury.

I am very proud and really appreciate our pure humanitarian work with these kinds of survivors, because I realized that these people need help more than anyone due to the terrible circumstances they have faced, in addition to the current challenges in their new life.

Funding for CVT’s work in Jordan is provided by the United States Government and the United Nations Voluntary Fund for Victims of Torture.