Afghan children running away from the scene of the recent suicide attack in Kabul. Photo: Reuters

Afghan citizens have been going through long periods of war for over the past 30 years. By now, millions have been displaced, hundreds of thousands killed or disabled, and the major infrastructures seriously damaged. Nevertheless, the war had a different shape. There was the regime and there were the rebels. The lines were pretty much clear.

But this picture has changed after the first suicide attack took place in Afghanistan. Most of these attacks are planned in crowded areas of the major cities. Kabul, for instance, looks more like a military base rather than a city. Its appearance has changed. Its dynamic has changed. Its people have changed.

Apart from the demographic shift in Kabul in the past decade, one of the major reasons that keep people on edge is suicide bombings. These attacks do not require the investment and management of a small brigade let alone an army. They don’t require a big budget. All is needed is a few number of brain-washed fanatics, some explosives, and a good plan. At the same time, however, they consume significant resources in order to be prevented.

On the other hand, a plan of this small caliber leaves a very deep impact. It leaves uncertainty. It worsens unpredictability. It shatters the trust in security and it causes an increasing sense of constant instability. And this is this feeling of constant instability that is a killer. People just become unable to think or manage how to stay safe, how to keep children away from violence, and how to plan for future. This is because suicide attacks can happen anywhere at any time. They have this element to dash people’s hopes and wreck their nerves.

It is true that our people have shown resiliency and that is how they survived. However, it has come with a heavy cost that we must not ignore. Along this painful journey, relationships have shattered. Extremism has become stronger. Violence has become more prevalent.

Therefore, the mere element of resiliency in people doesn’t mean the government stop taking proper measures to put an end to these attacks or at least manage them in an efficient manner. The simple yet compelling question is: how can we expect our children, the next generation, to be non-violent, open-minded, and law-abiding citizens whereas they are exposed to such horror and trauma too much and too often?

Men are blind and need to be healed. Women's mouths are sealed and those seals must be broken. Violence is not a woman's fate. Ali Shahidy

Gender violence plagues Afghanistan and my family is no exception. The patriarchal structure of our culture makes it rampant. The pervasive silence makes it everlasting. The pain of gender violence is a nightmare that haunts many Afghan families. My most tragic childhood memories are ignited every time my dad raises his voice in a violent way. The fear of seeing my mom beaten in front of my eyes incites panic. I was raised in a culture of violence. War was only part of it.

I wasn’t only the son of a victim and an abuser. I became an abuser. The cycle of abuse continued as I began to beat my sisters and harass girls in the street. I used to restrict my sisters’ mobility, their appearance, their associations, and more. Afghan customs taught me that the honor of my family was more important than the physical and psychological wellbeing of my sisters. I made vulgar comments and gazed salaciously at random girls in the street. I was following accepted cultural norms without shame.

During the same time, my younger sister, Roya, was forced to abandon school and marry against her will. She became another victim of domestic violence in her wretched and abusive marriage. Living in Iran, her life was a silent prison of suffering and pain. Her husband beat her during her pregnancy, threatened their infant son with a knife, and tortured her on a regular basis. His drug addiction fueled his rage. The scars on her hands and her drastic weight loss were the only things that spoke of her horror. Like my mom and many other Afghan women, Roya quietly and dutifully accepted her fate.

When we learned about the five years of Roya’s suffering, we immediately took action. To rescue her, we were confronted with torrents of challenges — financial difficulties, distance, laws that maintain gender norms, social stigma, and relatives who opposed and condemned us. These obstacles made me realize how wrong and devastating our culture was. It was the first time I studied about women’s rights. I had to fight with Mullahs and our elders. I had to struggle with practices, beliefs, and values that filled my life since birth. When Roya’s husband discovered our plans, the intensity of his violence escalated. Concerns about Roya’s safety filled my thoughts at work, at home, and during my studies. Her life was in danger and I was her only hope.

I doubled my efforts, saved more money, learned more about women’s rights, and gained the assistance of more friends. Finally, we brought Roya and her baby home. She was safe… and my world view had changed forever.

Reading and studying more about the plight of Afghan women, I realized that gender discrimination and inequality are wrongly ingrained in our culture. Everywhere I went I saw women like Roya — women quietly accepting their fate. I knew I had a responsibility to fight for their rights and rescue them from their prisons. All women should have the same freedom as my sisters. Women should not be viewed as servants, property, or sexual commodities. Men are blind and need to be healed. Women’s mouths are sealed and those seals must be broken. Violence is not a woman’s fate.

I am strongly involved in advocacy work and fighting for women’s rights. I am a vocal opponent of violence against women. I actively support victims and encourage people to talk about violence. Through speeches, global digital action campaigns, public awareness events, community discussions, and more, I am encouraging people to break the cycle of violence. Step-by-step, I am removing barricades and changing men’s views towards women. Through tears and determination, my sisters and I changed our fate. We broke the cycle of abuse in our family.

Together, men and women will stand hand-in-hand, raise their voices, and challenge the dominant and parochial beliefs of our culture. Together we will end violence against women.

This article first appeared in Huffington Post on 03/07/2013. 

Photo by http://www.un.org

According to the estimates, over 60% of Afghan population suffers from psychological problems.

How do we define mental health?

A person who is considered ‘mentally healthy’ is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realize their potential; and make a contribution to their community. However, your mental health or sense of ‘wellbeing’ doesn’t always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person’s ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories – neurotic and psychotic.

Neurotic conditions are extreme forms of ‘normal’ emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person’s perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

What causes mental illness?

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

Some experts say that only relying on medical approaches underplays the social and psychological causes of distress.

When is someone thought to be mentally ill?

A mental illness can not be ‘tested’ by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient’s symptoms and monitoring them over a period of time.

To diagnose a mental health condition, psychiatrists in the UK (as well as in Afghanistan) may refer to the World Health Organisation’s International Classification of Diseases (ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.

Source: BBC

Photos: http://allhealthcare.monster.com, http://dworkinassociates.wordpress.com

We can usually see such scams in Afghanistan, too. Perhaps too often!

How many of you have already met faith healers or watched them perform on stage, or at their own residence in the guise of traditional healers using (or abusing?) faith to manipulate people, deceive them, and make a huge amount of money out of it? It doesn’t matter if you are a Muslim, a Christian, a Jew or somebody from another faith. There are always people who want to abuse people’s faith to become millionaires.

In this interesting documentary “Miracles for Sale” provided with Farsi subtitles, Derren Brown shows how these so-called healers in Christian faith (and this can apply to many other religions, including Islam) use different techniques to impress and deceive their audience and collect large sums of money in the name religion.

Photo from: http://derrenbrown.co.uk

Natural disasters and other catastrophic events, such as motor vehicle accidents, plane crashes, nuclear meltdowns, and terrorist attacks (especially suicide attacks in Afghanistan), are extraordinarily stressful—both to survivors and observers. 

Such disasters shatter your sense of security, making you feel helpless and vulnerable in a dangerous world. Whether or not you were directly impacted by the traumatic event, it’s normal to feel anxious, scared, and uncertain about what the future may bring.

Usually, these unsettling thoughts and feelings fade as life starts to return to normal. You can assist the process by keeping the following in mind:

People react in different ways to disasters and traumatic events. There is no “right” or “wrong” way to think, feel, or respond. Be tolerant of your own reactions and feelings, as well as the reactions and feelings of others. Don’t tell yourself (or anyone else) what you should be thinking, feeling, or doing.

Avoid obsessively thinking about the disastrous event. Repetitious thinking about fearful or painful experiences can overwhelm your nervous system trigger making it harder to think clearly and act appropriately.

Ignoring your feelings will slow the healing process. It may seem better in the moment to avoid experiencing your emotions, but they exist whether you’re paying attention to them or not. Even intense feelings will pass if you simply allow yourself to feel what you feel—and you’ll feel better afterwards.

Talking about what you feel may be difficult, but it will help you heal. Just as you may find it difficult to face your feelings head on, you may also find it difficult to express those feelings to others. But getting them out is essential. Talking with a calm, caring person is best, but expressing your feelings through journaling, art, and other creative outlets can also help. [A supportive family and community can also be another source of help in Afghanistan or other Afghan communities. However, it depends how much open and sharing you want to be about your feelings and emotional experiences as well as how mush strong the stigma about such problem is in the community].

©Helpguide.org. All rights reserved. Helpguide.org is an ad-free non-profit resource for supporting better mental health and lifestyle choices for adults and children.

Photo from www.donmilton.ne

©Helpguide.org. All rights reserved. Helpguide.org is an ad-free non-profit resource for supporting better mental health and lifestyle choices for adults and children.

Feature Photo: http://www.mary.havering.sch.uk/psychology.html

Esmael Darman 

For as long as you’re married, there can be disputes and conflicts with your partner here and there. So forget about a totally conflict-free life, because that would be asking for impossible and searching for something that doesn’t exist in the first place. However, the good news is that many studies as well as experience show that the most successful couples are those who effectively resolve disputes. The other good news is that one can learn conflict-resolution techniques.

For instance, highly respected and famous researcher in marriage and parenting John Gottman (1995) showed that if there are five positive behaviors for each negative behavior in the family, then relationships are still healthy and they can function well. Therefore, family conflict shouldn’t always be considered a negative issue or a problematic pattern. Rather, problem-solving techniques should be promoted and people should be encouraged to learn and implement them.

However, there are three elements that should be considered crucial, because they are the building blocks for maintaining a healthy relationship in addition to learning problem-solving techniques.

The first and most important element is communication. This is vital, because if there is no communication, the relationship loses its meaning and value. Whenever there is a lack of communication, assumptions arise, speculations take form, and misunderstanding grows further. For example, when the husband avoids talking to his wife, or when the wife leaves the house and prefers to communicate with her husband through their children, any or all these problems can take shape and turn into a more serious and complicated problem that the couple will not be able to solve on its own.

The second important element is respect. What I mean by “respect” is not an up-to-down look, or the type of respect we usually pay for the elderly because of their age, or the type of respect some students show to their teachers, or the type of respect some children show to their parents out of fear and distress. What I mean by respect is that two people accept each other for who they are and as a result generate a feeling of esteem, confidence, and appreciation in each other.

The third important element is understanding. I am not trying to define “understanding” from a cognitive or philosophical perspective here. Here, understanding simply means a genuine attempt to find out how the other person is feeling or trying to say in the here and now. Take understanding out of the environment between the couple, and there walks in anger, frustration, and resentment. And since marital relationship is not a temporary encounter, such feelings and emotions can seriously wear out the couple in the long run.
It is crucial to know that in marital conflicts, there is no winner, champion, or hero! The husband or the wife may feelthat s/he has won the argument, but we are talking about a marital relationship and that obviously indicates there are at least two people involved, so there are always two scenarios:

1. One partner is sure that s/he has won the argument and therefore feels good about it (even though temporarily) whereas the other partner is left with frustration, anger, resentment, and worry. More importantly, the problem remains unresolved and unattended.

2. Both partners work together and generate a win-win situation, because they realize that living together is not about competition but it is about working together, solving problems together, enjoying each other’s company, reaching their goals together, and supporting each other in the process and along the journey. I am sure by now you know what that “journey” is. That journey is life itself!

When it comes to Afghan couples, I can see that usually one, two, or all three of these elements are missing, especially that our culture encourages us to confront the problems indirectly, to imply things instead of speaking openly, and to suppress our feelings instead of expressing them. What I suggest, however, is that it doesn’t have to be a very non-Afghan method. Even within our own culture, there are ways to put these elements into the problem-solving process and gradually address issues that give rise to conflicts.

In the upcoming articles, I will explore other dimensions and requirements of conflict-resolution in the family.

References

Gottman, J.M. (1995). Why Marriages Succeed or Fail. New York: Simon & Shuster.

Photo: http://education.byu.edu

Photo by www.goodreads

Peace, Social and Emotional Health Through Music: The Gift of Afghanistan National Institute of Music to the Afghan Youth 

In early February 2013, for the first time in the history of Afghanistan, the young Afghan musicians of the Afghan National Institute of Music (ANIM) visited the United States and performed historic concerts at the John F. Kennedy Center for the Performing Arts in Washington, DC and the Carnegie Hall in New York. 

The ensemble of the Afghan National Institute of Music (ANIM). Photo courtesy of Mirwais Rahmani

ANIM (http://www.afghanistannationalinstituteofmusic.org/) was founded by Dr. Ahmad Sarmast in 2009 and inaugurated in 2010. ANIM’s aim is to focus on and provide support to the most vulnerable and disenfranchised population of the Afghan society, namely the young orphans and street-working children. By offering them music education, Afghan children and adolescents acquire a vocation through which they can reach their full potential.

The positive impact of music education on the well-being of human beings had long been established through research. Long-term positive consequences of early exposure to music have been observed in the area of social, economic, and emotional health. It is not surprising to note that ANIM’s major donors include the World Bank and UNESCO. Both organizations associate music education with poverty reduction in developing nations. When young Afghan orphans no longer have to be the sole breadwinner of their families by working on the streets, and have access to education, especially vocational education, a sustainable and hopeful future can be seen on the horizon.

As a psychologist and mental health professional, I found the performance by the young Afghan musicians to be extremely encouraging and one of the major steps toward the healing of the psychological wounds that resulted from the long lasting and devastating wars. More than 30 years of war and political conflict have left Afghan children with devastating conditions, and as a result, the country has been ranked at the bottom of the world’s human development index. The calamity of war has brought devastating effects to the overall health of Afghan children, especially their emotional and mental health.  Data on Afghanistan from 2010 indicated that out of one thousand Afghan children, one hundred and fifty die before the age of five, putting Afghanistan in second place from the bottom and with the highest infant mortality rate. Fifty-four percent of Afghan children are stunted and 40 percent are underweight. This can have severe developmental consequences, including the underdevelopment of the brain, thus compromising children’s intellectual growth. (http://www.who.int/countries/afg/en/). This is of particular concern in Afghanistan, because 42 percent of the population is fourteen years old and younger.

Like many children in conflict zones worldwide, Afghan children are the most vulnerable and perhaps the most invisible populations in the Afghan society.  This is due to several factors, including lacking social status in the society, living in a patriarchal social environment, and extreme illiteracy, which is associated with a limited understating of child development.

Although reliable data is unavailable about the psychological consequences of chronic war and conflict on Afghan children, it is a fact that millions have witnessed and/or experienced psychological trauma, including violence and aggression directly, the killing and deaths of their loved ones, or they have been told about the occurrences of such violent acts committed against their family members and members of their communities. In all cases, there is an increased risk that children’s psychological well-being be compromised.  Symptoms typically range from mild distress and anxiety to severe emotional disturbances due to chronic and complex trauma.

Female instrumentalists of ANIM. Photo: Mirwais Rahmani

In addition, families have been uprooted, sometimes repeatedly, disrupting social support and functioning networks, creating loss of trust and reliable communities and often the loss of one or even many family members. The United National Children’s Fund estimated that almost one-third of school-age children are engaged in challenging daily work, serving as their families’ sole breadwinners. This is not surprising for a country driven by war, poverty, and lack of social and economic stability, as well as inadequate security. As a result of this economic instability, many Afghan children are also threatened by illegal trafficking.

In a study on the psychosocial health of Afghan children, conducted by UNICEF Save the Children in 2003, Afghan children residing in Kabul reported worries about poverty, domestic violence, and family relationship. Many Afghan children reside in orphanages as a result of losing one or both parents due to political violence, or poverty. Children, as young as five, are in many cases the sole breadwinner for their families, selling goods on the streets.  This, in turn, increases the risk for their continued vulnerability, including compromised security, being victimized, and not having access to primary education.

Despite sobering estimates on the psychological well-being of Afghan children, to date, there have not been any specific and direct interventions to address the psychological and psychosocial needs of Afghan children. However, the establishment of the Afghan National Institute of Music maybe an encouraging first step to improve Afghan children’s and youth’s social and emotional health through music education. As many as 140 Afghan children and youth are registered at ANIM to study music and learn one or more musical instruments.  Afghan girls comprise one third of these children. The positive impact of music on the social and emotional wellbeing of children has long been established and studied in the field of psychology.  When watching the young Afghans perform, one could not help but to notice their self-confidence, a sense of inner peace and emotional balance, and pride. Music can offer incredible healing powers on the survivors of psychological trauma and adversity.  But how can music achieve that, one would ask?

When a child is introduced to learn a musical instrument, a set of relationships is established in the process. The child not only develops a relationship with the instruments, but also with the music. Further, he or she starts establishing a trusting relationship with other children, but in particular with his or her teacher. Making music itself is a multidimensional activity with the unique involvement of the whole child – physically, socially, intellectually and emotionally. In addition, music can help children and adolescents improve their social skills. Since playing music is carried out for other people, it therefore plays an important role on improving and promoting interpersonal skills.  These skills involve one’s ability to cooperate and collaborate with peers (in the case of playing music in a group, as an ensemble), showing responsibility, communicating verbally or non-verbally, and sustaining attention.  These skills were visible as I was observing ANIM’s children and youth playing music at the John F. Kennedy Performing Art Center for the Performing Arts in Washington, DC on February 7, 2013. The young Afghan girls and boys exhibited a sense of cooperation, mutual respect for one another, and positive interpersonal relationships with each other, which are the major components of healthy interpersonal and social development, and ultimately the basis for their positive self-esteem and self-confidence.

A young instrumentalist of ANIM. Photo: Akmal Khaliqi

Through music education, I believe that ANIM is not only training most talented young Afghans who can have promising futures, but it is also providing them with an opportunity to create peace within themselves and with others through music, which in turn help them develop positive social interactions, incorporating positive attitudes, consequently bringing a balance to their social and emotional health. I strongly believe that if Afghan children and youth, who comprise 42 percent of the population, are given the opportunity to express themselves through music and heal their emotional wounds through arts and other performing means, we will soon have a healthy generation that can take charge of their country and promote its economic, social, and cultural stability on a long-term.

References:

Catani, C., Schauer, E. Elbert, T., Missmahl, I., Bette, J.-P., Neuner, F. (2009). War trauma, child labor, and family violence: Life adversities and PTSD in a sample of school children in Kabul. Journal of Traumatic Stress, 22, 163–171

Panter-Brick, C., Eggerman, M., Gonzalez, V., & Safdar, S. (2009). Ongoing violence,  suffering and mental health: A school-based survey in Afghanistan. Lancet, 374, 807- 16.

Safe the Children & UNICEF (2003). Children of Kabul. Discussions with Afghan Families. New York

Dr. Nahid Aziz is a contributor to Rawan Online and Associate Professor at the American School of Professional Psychology (ASPP) at Argosy University, Washington, DC.

Feature image of the Afghan National Institute of Music (ANIM), courtesy of Mohammad Akmal Khaliqi.

As soon as I posted some questions on the Facebook page of Rawan Online the other day, asking the members whether or not they found the website and its contents useful, one of the readers suggested there should be more articles on marital conflicts, particularly among the Afghan couples who immigrate to the West. In fact, there have been dozens of articles as well as a number of video shows on this subject on Rawan Online; however, I also agree that more information needs to be shared with our readers.

There are of course many factors behind marital conflicts. Some of these factors get resolved as time passes by and the husband and wife become more mature in dealing with their differences and emotions. Some of them result in separation and divorce, and some of them cause long-lasting unhappiness, misery, discontent, emotional blackmailing, and even violence.

It appears that one of the most visible and significant factors of marital conflict among Afghan couples is a shift in status. Afghans have a patriarchal society. Particularly those who are brought up in Afghanistan, or among families that hold a stronger traditional value system, men get better education and employment opportunities. Therefore, they have a stronger and upper social status. Women, however, are usually expected and encouraged to bring up children. These traditional roles are of course changing, but the process is very sluggish.

Once these couples immigrate to the West, their status may obviously change. Usually husbands can no longer get equal opportunities they used to have in Afghanistan. That can be discouraging. It can also make them increasingly inflexible, leading to a growing disappointment at the system.

The situation, however, can be different for wives. Not having competitive jobs back home or being overly concerned about status, they can be more open to change, thus getting more opportunities. As a result, a shift in status soon happens and the power struggle can give rise to conflict and violence in the household. Of course this doesn’t usually happen to every single couple.

The important thing here is to understand what is happening in the process of change and help these couples deal with the challenge in an effective manner. If the problem is not very serious, a simple intervention and raising awareness might be helpful. Nevertheless, professional intervention in the form of family and cultural counseling is often needed. Once the couple, particularly the husband, realizes that the main goal of living together is to enjoy the company and prosper together as two equal human beings, he would become more open to the concept of change in the family dynamic. It is easier said than done, but it is worth the effort!

Esmael Darman is the founder and editor-in-chief at Rawan Online.