The Seeds

Just in case if readers ponder why I titled my last blog “Wearing My Other Hat”, I am a person with many hats of trades. Besides being a medical doctor, I am also a counselor and art therapist. It all dated  back more than 10 years ago when I was working in Hong Kong with many underprivileged patients in a government housing estate. Numerous of them were suffering from mental or emotional problems, but due to financial reasons and insufficient services provided by the government, they had limited access to counseling /psychotherapy. In order to care for my patients in a more holistic fashion, I undertook a Master Degree in Counseling. As time went by, I realized that there were some blind spots with verbal psychotherapy or counseling, especially for children, people with language barriers, speech problems or simply those who do not express themselves well with words. Art therapy seemed to be another helpful treatment modality for me to put into my armarium. Consequently, I went to do a postgraduate diploma course (Master degree equivalent) at the  Toronto Art Therapy Institute in Canada. Therefore, working in the mental health field is wearing my other hat in  addition to my regular obstetric-related job.

In a community where it feels like everyone knows everyone, or knows someone that knows someone, I understand why one would have concerns about seeking professional help for mental or emotional issues, especially from an Ethiopian counselor. There are also myths about mental illness being the curse of  devils. Seeking help is  a sign of weakness. All these deter patients from obtaining help.

It cannot be more obvious that the actual demand for mental health services in Ethiopia is enormous while supply is limited. Similar to the medical health care with shortage of trained doctors and nurses, primary care is usually provided by health workers with some training. Counseling is usually done by community counselors (paraprofessionals) who will try to help with simple problems and more complex issues will be referred to psychosocial counselors.

It is now coming into recognition the importance of mental well being and the Ethiopian universities have started psychology as a new subject. They just had their first batch of new graduates in 2011. There are additional  increase in job postings in the newspaper from NGOs hiring psychologists, counselors and social  workers, especially for projects working with with  women and children from violence, physical and sexual abuse, and HIV.

Likewise with all other “new” professions in developing countries, the challenges these fresh graduates face are: lack of supervision and guidance from experienced seniors. They have to explore their own way.  The students were taught all the theories in the classroom but had not gained the actual working experience through practicums. Often they are overwhelmed and intimidated by the heavy workload and complex case scenarios in the workplace. On top they have the extra pressure of being “seniors” to teach  their juniors in 2-3 years time. Lack of access to textbooks and training materials is another major obstacle for continuing further education to advance in the field.

One other frustration for the psychologists and counselors are misconceptions of their job nature and scope of work by the uneducated public. They were often mistaken as “social workers” who can help solve issues about money, food and housing which are of extreme importance to satisfy the basic human needs. Clients will turn down appointments once they discover they cannot be assisted in those arenas.

In order for any foreign aid assistance program to be sustainable in the long run, it is of utmost importance to educate and train the local staff to deliver the services to their  own people. Besides conducting individual art therapy sessions, I also teach students and educate related staff about mental health and art therapy. (Ironically, art therapy is often interpreted by the locals as ART therapy-the antiretroviral therapy for HIV)

I am very surprised to find 3 young psychologists in Bahir Dar, one is working at Grace Centre for Children and Families, one for Alem Children Support Organization (ACSO), and one sadly (like many Ethiopian university graduates) is still unemployed. I am very happy to share with them my knowledge and skills and give them support and supervision with their work. Hence I started up a weekly 3-hour training program in art therapy and counseling with both didactic and practical components.

Topics that were covered include the theories and principles of counselling and art therapy, developmental stages of children- Erik Erikson’s stages of psychosocial development,; motor cognitive theory; Viktor Lowenfeld’s artistic developmetal stages etc., psychoanalytical theories of Freud, …to very practical, work related subjects such as aggression in children , stealing behavior, practical tips in setting up for an art therapy session.

The experiential practical portion of the training session gave the students hands-on experience using the different art materials, experience of using artwork for expression and exploration, learning the different art therapy techniques and mastering some directives such as those used in projective art therapy assessments.

Here are my 3 psychologist students (left to right): Hiwot Yared, Anteneh Abun, Tadesse Haile (future pioneers in the Psychology field in Ethiopia!)

These three young brilliant people are a delight to teach. They are very enthusiastic and keen to learn. They actively engage in  discussions and ask plenty of astute questions. They make full use of their experiential sessions and are very willing to share their reflections on their artwork. Tuesday evenings usually pass by without being aware of time. The three of them are encouraged to form a peer support  alliance for themselves to share and discuss their work experiences and hopefully will expand their network to other parts of Ethiopia and globally to the rest of the world.

Performing the Ulman’s maneuver.

  Just to close this blog with a fancy note. My students were so proud and happy that they were told to be great- great grand students of Sigmund Freud.  Freud is considered by many to be the Father of Psychology. Dr Martin Fischer, the founder of both Toronto Art Therapy Institute and Vancouver Art Therapy Institute, was a student of Freud. All my teachers and supervisors from TATI were taught and trained by Dr Martin Fischer. Thus my students can rightfully claim to be  Freud’s students of the 4th generation down the line. I hope I had sown some seeds of art therapy and counseling in Ethiopia, Africa. I do have faith these brilliant and passionate young people will make the profession  bloom in their country.