Working with
Trauma-Healing and Trauma-Sensitivity

Global Grassroots began its exploration of post-traumatic stress in Rwanda with its first site visit in April 2006, during Kwibuka, the official period of Remembrance of the 1994 Genocide Against the Tusti. In early 2010, we began to integrate a mind-body practice called Breath-Body-Mind (BBM) to address post-traumatic stress. Since that time, our founder and our Conscious Social Change practitioners in the US and East Africa have trained approximately 1,000 people in BBM, most of whom go on to share elements of the practice with others, reaching 10,000+ more. Following, we offer our insights on the use of holistic, mind-body trauma-healing practices in a post-conflict context, and considerations for working with trauma-sensitivity to do no harm. 

The Rwandan Genocide 

On April 6, 1994, a plane carrying Rwandan President Habyarimana was shot down, sparking the swiftest genocide the world has ever seen. One hundred days later, an estimated one million Tutsis and moderate Hutus had been brutally murdered by their neighbors and countrymen. The UN estimates that 250,000 - 500,000 women and girls were raped, 67% of whom, Amnesty International reports, contracted HIV.  Countless children witnessed the slaughter of their parents, often by people they had previously known as friends and neighbors. 

Individuals who experience or witness traumatic events, especially war, genocide and sexual violence, very often undergo deep psychological stress, otherwise known in Western psychology as complex post-traumatic stress disorder. According to the Diagnostic Statistical Manual V, in the definition of post-traumatic stress disorder (PTSD):  The person had an exposure to death, threatened death, serious injury, or sexual violence in one (or more) of the following way(s): direct experience, witnessing firsthand, learning a relative or close friend was exposed to a trauma, and/or repeated or extreme exposure to aversive details of trauma. There was the presence of one (or more) intrusive symptoms associated with the traumatic event(s) after the event(s) occurred like recurrent distressing memories, nightmares, flashbacks, or disassociative reactions. Further, there is avoidance of stimuli associated with the trauma, such as avoidance of distressing memories and external reminders of the trauma. There are negative alterations to mood and cognition, such as inability to remember important aspects of the trauma, blaming oneself or others for the trauma, persistent negative emotional states, diminished interest in activities, feelings of detachment, and an inability to experience positive emotions. Finally, there are alterations in arousal and reactivity, such as irritability and angry outbursts, self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration and difficulty sleeping. 

Following are our key lessons on the value of trauma-healing work, as well as the critical importance of trauma-sensitivity while working in any modality in such a context:

Key Lessons:

• Trauma-healing is aided by restoring connection between survivors and community, including empowerment by enacting political or social change.

• Empowerment, connection and self-sufficiency can support trauma-healing especially when traumatic events involved terror and helplessness.

• Avenues for social justice recourse, that emphasize the value of survivor ideas and skills to create change within society, support agency and trauma-healing.

• Social venture teams enable support groups to meet without mental illness stigma.

• Trauma-healing aids social enterprise and personal future planning by helping survivors move beyond hypervigilance and present moment survival orientation.

• Trauma-healing skills that are transferrable enable local women working on behalf of other vulnerable populations to spread impact over time.

• Trauma-healing benefits the next generation.

Benefits of Mind-Body Trauma Healing Programs, especially BBM, in mass disaster environments:

• Offer direct physiological benefit that can be felt immediately

• Can be taught safely to lay people with basic training to practice on one’s own

• Allow for greater personal agency

• Require minimal, if any expense

• Require few props or technology

• Prevent triggering the facilitator who may also be a survivor

• Can be shared easily without a long-term therapeutic relationship

Do No Harm Considerations and Trauma Sensitivity: 

• Grounding

• Choice

• Setting Expectations

• Validate and Be Present

• Manage Time for Introspection

• Physiological Impact

• Honor Privacy, Confidentiality and Consent

• Support Local Agency

• Respect Religious and Cultural Differences 

• Consider Language Barriers

• Minimize Mental Health Stigma

• Ensure Accessibility

• Facilitate Transferability

• Provide Immediate Efficacy

• Consider Long-Term Support 

• Customize Impact Measurement Methods

• Self-Care

Holistic Healing Post-Conflict and Among Women

The effectiveness of holistic approaches that integrate an individual and community healing component may be due to the impact of complex trauma from war and sexual violence and the unique role of women in the post-conflict reconstruction process. Women tend to bear a significant burden related to the psychosocial impact of war and trauma.  In particular, the widespread use of sexual violence as a tool of war during the Rwandan genocide targeted women as the essential fabric of society.  At the end of the genocide, the government estimated women made up nearly 70 percent of the population. Not only were they grieving the loss of their husbands, parents and children, they now served as the heads of households as well as communities, taking on the traditional leadership roles of men in addition to continuing to serve as the caretakers of their families. This naturally required that women set aside their own psychosocial needs for the sake of their children’s needs.

When women serve in greater roles of responsibility in post-conflict reconstruction, they are critical in defining priorities for families and communities.  Further, women’s active participation in peace-building, governance, security, justice, reconciliation, and social and economic wellbeing ensures that the failures of society that allowed for violence against women will be considered in the process of reconstruction. However, when society has failed to protect a survivor from harm, the situation involves a dissolution of trust in the fundamental aspects of one’s relationship to society and community. And any level of post-traumatic stress will directly impact their capacity to rebuild.

In Judith Herman’s book, Trauma and Recovery, she explores the elements and stages of recovery from trauma, which include not only an individual process of healing but also one that involves “restoring the connection between survivors and their community,” often through endeavors that give survivors a voice in the context of political or social change. This is an element critical not only to individual psychological healing but also to the effectiveness of post-conflict reconstruction.  

Because the techniques used to establish control over another involve disempowerment and disconnection in order to instill terror and dependency, we can argue that efforts to support empowerment, connection, and self-sufficiency can repair the damage from violence that causes psychological trauma.  Judith Herman states about the healing process of rape victims, “…we do know that women who recover most successfully are those who discover some meaning in their experience that transcends the limits of personal tragedy. Most commonly, women find this meaning by joining with others in social action”. 

We propose that endeavors that not only give a voice to the disempowered but also allow for the survivor to identify her value to community-- and, even further, to realize her capacity to change the aspects of community that failed her-- provides a tremendously powerful path for both individual and community healing.   

Download the printable PDF with footnotes by clicking here.