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Expert Voices

Therapy + Ritual: Healing Through Testimony

Published March 22, 2017

Craig Higson-Smith, MA, CVT director of research

How does civil society recover after years of torture, executions and war atrocities? Where does a community begin its healing? How does community healing intersect with individual healing?

One approach is Testimony Therapy (TT), which was developed specifically in response to gross human rights violations. The practice arose in 1970s Chile as a treatment for victims of political oppression, torture and imprisonment. Participants in the therapy relay testimonies of their traumatic experience in order to diminish their post-traumatic stress levels. What makes Testimony Therapy so interesting is that it reaches beyond the private therapeutic relationship and into the community as survivors offer their stories of victimization in more public spaces.

Dr. Jennifer Esala, CVT research associate,  and Sopheap Taing, researcher at the Transcultural Psychosocial Organization (TPO), Cambodia, have just published their analysis of the efficacy of TT in an article entitled “Testimony Therapy with Ritual: A Pilot Randomized Controlled Trial (RCT).” Published in the February 2017 edition of the Journal of Traumatic Stress, Jennifer and Sopheap assessed TT’s effectiveness amongst 88 survivors of the Khmer Rouge regime – a political party known for the genocide of the Cambodian people from 1975 to 1979.

“The ritual process includes a particular form of rhythmic chanting by the monks: ‘the chant of death,’” says Sopheap. “This chanting follows the rhythm of the breath and is held by many Cambodians to have a powerful, calming effect on the audience. The pansukula chant is one of the many means by which the Cambodian clergy ritually enable the laity to transfer merit to their dead relatives, thus assisting their progress through the cycle of death and rebirth. In Cambodia, it is recognized that healthy grieving involves maintaining a good relationship with the dead and perhaps assisting the dead towards rebirth. ”

The therapeutic study was also made more meaningful to participants with the addition of ritual. Testimonies were paired with Buddhist rituals that had been prohibited by the Khmer Rouge. The inclusion of Buddhist rituals was an attempt to modify the approach in line with cultural and contextual realities. Their effort garnered Jennifer and Sopheap news coverage in The Phnom Penh Post.

“The research has affirmed my anecdotal belief that this intervention has meaningful and positive implications for clients,” says Jennifer. “I was particularly happy to find that such a brief intervention (five days) shows significant reductions in key mental health symptoms. This study makes me all the more eager to extend this research and isolate the impact of the individual counselling, cultural ceremony and truth telling components of the intervention. My hope is that this pilot research will motivate more research in TT in different contexts.”

This is a good example of CVT reaching beyond direct service provision to build the capacity of partners around the world to use and test new intervention strategies. The implementation of an experimental trial in a therapeutic setting is already a very challenging endeavor. To support and run a study in a partnership that spans 13 time zones is very ambitious indeed. And yet they have done it, and managed to get it published in arguably the most scientifically demanding journal in our field. Further studies will need to be conducted to discover if TT’s effect is long-term, but what one can extrapolate from their study is that Testimony Therapy is effective in the short-term treatment of PTSD with Cambodian torture survivors.  I’ve followed the development of this study from concept to final publication. It’s been a long and challenging journey. Jennifer and Sopheap should be very proud!

Read the abstract here.

Click through to learn more about TPO Cambodia.

Partners in Trauma Healing is made possible through the financial support of the United States Agency for International Development and the American peoples’ support.

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