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Traumatic Stress and Syrian Cultural Conceptualizations

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Defining traumatic stress is a complex task because it incorporates so many different presentations, triggering events, brain developments, resources, and can be individual or collective (van der Kolk, et al., 1996). Non-traumatic stress differs primarily in that it is an almost unavoidable aspect of daily human life, and while it can range from small stressors to significant stressors, and can occur from both positive and negative situations, this stress can range from annoyances to exacerbating or experiencing mental health issues – or propel us forward and give us motivation and positive outcomes (Yeager & Roberts, 2003). Stress also releases certain biological responses and hormones, such as a temporary increase in cortisol production (Richter-Levin & Sandi, 2021). However, in the case of traumatic stress, cortisol takes longer and longer to revert to normal – in some cases that are chronic and severe, this may lead to constantly high levels of cortisol, which can further progress to the point that cortisol is completely depleted and unable to be created, leading to adrenal fatigue.

When one has been exposed to significant non-traumatic stress repeatedly, and does not have adequate coping skills, this can develop into acute stress disorder or post-traumatic stress disorder. However, Richter-Levin and Sandi (2021) write that the most “common reaction to stress is resilience, indicating that resilience is the rule and stress-related pathology the exception” (p.1).

While non-traumatic stress can develop into traumatic stress, traumatic stress itself is usually defined by exposure to a traumatic event with which one is unable to process or cope with (Foa, et al., 2009). Commonly considered forms of traumatic events include such things as war, violence, rape, childhood abuse, natural disasters, and other experiences which dramatically shake one’s sense of safety (van der Kolk, et al., 1996). But what constitutes a sense of safety can vary dramatically, and previous exposure to traumatic stress can make one more susceptible to further traumatic stressors. PTSD is most often viewed as a response to a specific, singular event – however, new research and understandings are evolving on complex trauma, such as in cases of ongoing childhood abuse which dramatically impact the lifelong behaviors, thought patterns, and emotional states within the brain development of those children.

The DSM, used to diagnose psychological disorders, has fairly strict, black and white, guidelines on what symptoms need to be expressed for a diagnosis. However, van der Kolk et al. (1996) point out that these symptoms are manifested in vastly different ways for different people. And culture also frames how we experience these symptoms and behaviors. Western societies, namely the USA, tend to shift towards individualism and place blame often on victims in order to maintain a sense of safety within society, and tends to follow the medical model (such as the use of the DSM) of checklists of symptoms to determine a diagnosis, with emphasis placed on the psychopathologies and mental illnesses in terms of the mind. A century or so ago, individuals used more somatic descriptions in their symptoms of PTSD, which, aside from a few authors pushing research on this topic today such as van der Kolk and the recently developed somatic therapies, is not the mainstream. In many other cultures, mental distress of any sort is often described somatically.

Syrian refugees, like many war-exposed refugees, have been exposed to major levels of traumatic stress – within Syria, during migration, and post-migration all carry their own different circumstances which constitute extreme levels of stress, much of which is traumatic (Mahmood et al., 2019). Syria is a collectivistic society, so cultural trauma is felt very deeply within the interconnected web of individuals, damaging the sense of self dramatically (Matos et al., 2021) and is worsened by the separation of family members and communities as refugees find asylum in different countries or from internal displacements (Kakaje et al, 2021). Furthermore, mental illness has been stigmatized within Syria even prior to the onset of the war, with very limited clinicians and resources available, relying mainly on medical staff without mental health training for supports (Kakaje et al., 2021). This worsened even further as medical facilities have been explicitly targeted to be bombed in the war. Syrians tend to express mental illness, including PTSD, in terms of somatic complaints such as insomnia, headaches, and stomach or chest pain (Borho et al., 2021). Because Syrians express trauma in ways that are different from the Western model, some authors have questioned the efficacy of other studies, even when they use “adapted” Western-made diagnosis instruments (Barkil-Oteo et al., 2018).

References

Barkil-Oteo, A., Abdallah, W., Mourra, S., & Jefee-Bahloul, H. (2018). Trauma and resiliency: A tale of a Syrian refugee. American Journal of Psychiatry, 175(1).

Borho, A., Morawa, E., Schmitt, G.M. et al. (2021). Somatic distress among Syrian refugees with residence permission in Germany: analysis of a cross-sectional register-based study. BMC Public Health 21, 896. https://doi.org/10.1186/s12889-021-10731-x

Foa, E.B., Keane, T.M., Friedman, M.J., & Cohen, J.A. (2009). Effective Treatments for PTSD. Practice Guidelines from the International Society for Traumatic Stress Studies (2nd ed.). New York, NY: The Guilford Press. 

Kakaje, A., Al Zohbi, R., Hosam Aldeen, O., Makki, L., Alyousbashi, A., & Alhaffar, M. (2021). Mental disorder and PTSD in Syria during wartime: A nationwide crisis. BMC psychiatry, 21(1), 2. https://doi.org/10.1186/s12888-020-03002-3

Mahmood, H.N., Ibrahim, H., Goessmann, K. et al. (2019). Post-traumatic stress disorder and depression among Syrian refugees residing in the Kurdistan region of Iraq. Confl Health 13(51). https://doi.org/10.1186/s13031-019-0238-5

Matos, L., Costa, P.A., Park, C.L., Indart, M.J., & Leal, I. (2021). ‘The war made me a better person’: Syrian refugees’ meaning-making – Trajectories in the aftermath of collective trauma. Int. J. Environ. Res. Public Health, 18. https://doi.org/10.3390/ijerph18168481

Richter-Levin, G. & Sandi, C. (2021). Labels Matter: Is it stress or is it Trauma?. Transl Psychiatry 11, 385. https://doi.org/10.1038/s41398-021-01514-4

Van der Kolk, B.A. & McFarlane, A.C. (1996). Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society. New York, NY: The Guilford Press. 

Yeager, K. & Roberts, A. (2003). Differentiating Among Stress, Acute Stress Disorder, Crisis Episodes, Trauma, and PTSD: Paradigm and Treatment Goals. Brief Treatment and Crisis Intervention, 3. 10.1093/brief-treatment/mhg002.

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Presentations and Videos

Sway Presentation: Traumatic Stress & Syrian Cultural Conceptualizations

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International Psychology & Division 52 video

In this video, I explain my understanding of why international psychology is important and what it means to me, and what drew me to join APA Division 52, and what other students may gain from joining the division.

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Social determinants of mental health in a global context

The readiness of a woman for pregnancy can impact the mental health of both the mother and child.  This is not necessarily related to age – in the U.S., teenage pregnancy is seen as a problem, but it is not in many other cultures (Sorel, 2013). However, socioeconomic factors can be a major influencer.  Poor nutrition increases risk of birth defects, as does exposure to toxins – both of which are increased among those living in poverty, in addition to lack of education around pregnancy needs and medical checkups, as well as abstaining from tobacco, alcohol, and drugs. Additionally, to create the best environment for mental health, the CDC suggests that the mother should be in a safe environment, have healthy behaviors, and a strong support system, and recommends counseling to understand genetic risks, mental health issues, and domestic violence.

In early childhood, a strong bond between the mother or parent to the child is critical to healthy social and emotional development (Sorel, 2013).  If the primary caregiver suffers from depression, this can impact the formation of this bond. Breastfeeding reduces risk of later obesity in children, protects infants from illness and infection, and breastfeeding for 6 months or longer reduces risk of mental health issues later in life. Children who are breastfed longer have less behavioral problems.  Socioeconomic factors in here as well – “mothers who breastfed for less than six months were younger, less educated, poorer, and more stressed and were also more likely to be smokers than the mothers who breastfed longer.  They were also more likely to suffer from postpartum depression…” (Sorel, 2013, p. 80).  In the U.S., Mexican-Americans and White mothers, higher incomes, and mothers over 30 increased the likelihood that a baby was breastfed.  African Americans have a much lower rate, likely connected to the stigma of breastfeeding from historically being forced to be wet nurses during slavery. And throughout childhood, the environment plays a large role in development of mental health, and again often is connected to socioeconomic status.

Even without a diagnosable mental illness, people can fall anywhere along the spectrum of mental health and mental illness (Sorel, 2013). Some people are able to function while having some mental illness, while others are not.  Some people are subject to environmental and social factors which impair their ability to maintain good mental health, and impede their ability to avoid mental illness.  There is a strong link between mental health and physical health, both impacting the other. Other factors include low quality or unstable housing, violent relationships, poor nutrition and adequate food, job insecurity, high crime rates, and alcohol and drug use (p.85). Factors which contribute to positive mental health include: “intact family, maternal attachment, public safety, social support and inclusion, housing quality, food security, quality education, employment, income security, access to quality health care, religiosity, and moral values” (Sorel, 2013, p.85). The inverse of these increases risks for mental illness.

In addition to the factors above, it must be reiterated that the biggest structural driver of social determinants of mental health is poverty. This also connects to an individual’s location – often those in poverty are forced to live in areas with limited access to resources, from public transportation to health care to recreational opportunities (Sorel, 2013, p.88).  They also are more likely to have poor quality housing, high crime rates, gangs, poor education, and unemployment, among other things. “These inequalities in the allocation, distribution, acquisition, and utilization of resources affect mental well-being and create conditions of unequal hardship and opportunity, racism, discrimination, and stigmatization, all of which result in negative mental health outcomes” (Sorel, 2013, p.88). In order to change these conditions, governments as well as individuals will need to challenge them and actively work to improve the allocation and utilization of resources.

The best promotion of good mental health is prevention.  To do so takes both external and internal support for the community.  Internally, people can be trained in parenting education and then become trainers themselves for others in their community, for example (Sorel, 2013).  Schools can develop policies which build their relationship with parents, increase parental involvement, and provide information on the emotional and cognitive needs of their kids. Sorel (2013) outlines numerous ideas for the government to improve social determinants for mental health.  Some of these include: reducing inequalities in education, economic status, housing, and health care, utilizing welfare systems to help people find and keep jobs, make college education more affordable, including personal economics classes as part of the core curriculum in schools, using tax credits and incentives to promote positive social determinant factors, expanding healthcare policy to include mental health and meet the needs of those who need it most, and focus on prevention, using employee assistance programs to provide needed mental health care to workers, and including mental health promotion programs in emergency and crisis response.

References

Carr, S. C. (2003).  Poverty and psychology: An introduction.  In S. C. Carr, & T. S. Sloan (Eds.), Poverty and psychology: From global perspective to local practice (pp. 1-15).  New York, NY: Kluwer Academic/Plenum Publishers 

Collins, P., Patel, V., & Joestl, S. S. (2011).  Grand challenges in global mental health.  Nature, 475, 27-30. 

Knifton, L. (2012).  Understanding and addressing the stigma of mental illness with ethnic minority communities.  Health Sociology Review, 21(3), 287-298.

Sorel, E. (2013).  21st Century global mental health.  Burlington, MA: Jones & Bartlett Learning. Chapter 4, p. 73-94.

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Psychological Impacts of Terrorism

Tanielian and Stein (2006) write about the impacts on and needs for addressing the psychological impacts of terrorism. While terrorism is an act which is marked by physical destruction, loss of life, economic collapse, violence, and political aims, it is also intended to provoke fear in the population. It has psychological effects additionally through targeting “the social capital of a nation – cohesion, values, and ability to function. Therefore, successful counterterrorism and national continuity depend on effective interventions to sustain the psychological, behavioral, and social functioning of the nation and its citizens” (Tanielian & Stein, 2006, p.690). However, this aspect is woefully under addressed and not well understood.

Emotional and psychological responses to terrorism, even by those not immediately affected or witness to the event itself, can be present from no reaction at all, to mild symptoms, to development of severe mental illnesses (Ursano, Morganstein, & West, 2020). Distress reactions include changes in sleep, reduced sense of safety, isolation and avoidance, and irritability and distraction. Health risks include increased behaviors of smoking, alcohol, becoming overly involved in work or other tasks, separation anxiety, and fears about traveling nationally, internationally, or even outside one’s neighborhood or home. Psychiatric disorders can include anxiety, PTSD, acute traumatic stress, depression, and complex grief. In others, or in initial stages of a “honeymoon period” following an attack in those who later develop symptoms of mental distress or illness, there may be a sense of resiliency, of bonding, of heroism, and optimism. There can also be a reaction of anger and wanting retaliation. This can lead to pressure to develop harsher policies toward a broad group perceived to be associated with an attack, such as in the case of anti-Muslim policies in the U.S. following 9/11 and leading to the “Muslim ban” implemented by former President Trump (Haner, et al., 2019). This can also lead to a reaction of building of a group identity, framing those with any perceived association with the attack as bad and devaluing their humanity, and leading to the formation of extremist groups, further escalating conflict (Staub, 2012).

Tanielian & Stein (2006) discuss the need for further support and research of psychological reactions and distress from terrorist attacks. They note that “little national or local policy has focused on the importance of addressing psychology or mental health” as a part of the counterterrorism funding, policies, and response in the U.S.  Many research articles have studied the frequency, type, and intensity of psychological and mental health consequences of terrorism and natural disasters such as earthquakes. Both indirect and direct victims of a terrorist attack can experience psychological symptoms, but the most heavily affected are those who were directly affected, in the immediate area, or first responders. Vulnerable populations are also heavily impacted, “such as children, racial and ethnic minorities, and those with an existing psychiatric illness” (Tanielian & Stein, 2006, p.693). The article specifically details impacts on children, and how the interactions between parents and children can either increase symptoms in children, or possibly increase parents’ reporting of distress in their children. The article does make a cross-cultural reference to studies in Israel and compares it to studies in the U.S.

The article does also mention that there may be differences in reactions between ethnic and cultural groups, identifying disparities in increases of PTSD and lower utilization of medications and mental health services among Black and Latino people compared to White people (Tanielian & Stein, 2006). This is attributed to “various cultural factors, including valuing self-reliance, expressing emotions in certain ways, and having reservations about sharing emotions with others” (Tanielian & Stein, 2006, p.694). Considering this article was written in 2006, there was a lot less awareness of structural and systemic racism than there is today in 2021 in the U.S. I would argue that what is missing from this analysis of disparities in seeking services is the general distrust of the medical – inclusive of mental health – systems among Black communities due to a history of being abused by such services. This includes experiments done on slaves, and the infamous Tuskegee Syphilis study (Wells & Gowda, 2020). Other factors to consider in this population is the severe lack of Black physicians which are much preferred by the Black community, White physicians lacking cultural competency, history of segregated cities, and socioeconomic barriers.

Additionally, Latinos are the least likely ethnic group in the U.S. to utilize mental health services (Barrera & Longoria, 2018). Reasons for this also include socioeconomics, acculturation issues for immigrants (such as language barriers or not understanding the health care system), cultural stigma towards mental illness, and distrust of the medical and mental health systems due to “past experiences of discriminatory treatment or ineffective care” (Barrera & Longoria, 2018, p.3). The article by Tanielian & Stein (2006), while it touches lightly on the disparities and the need for increased cultural competence in delivering mental health services following a terrorist attack, does not fully account for such deep-rooted issues, which could limit much needed mental health care. Understanding the depth of these systemic factors are incredibly important for not just improving mental and physical health for minority populations in general, but even more so after an acute event such as a terrorist attack.

Tanielian & Stein (2006) note that one of the most important and beneficial strategies for reducing psychological distress after a terrorist attack is to build and strengthen community relationships. They also suggest that response strategies target the needs of specific groups such as victims, vulnerable groups, and first responders. They discuss the use of psychological first aid, and how the Red Cross has recently (as of the time of the article in 2006) begun a Disaster Mental Health program to specialize in and provide these services following disaster incidents, including terrorist events. The authors do note that there may be still problems with this, however, with a lack of cultural-specific training and training specific to terrorist attacks. I am a Disaster Mental Health volunteer with the Red Cross, and I find this absolutely to be the case – I did not receive any training for how to change services or tactics dependent on the type of disaster, nor any training on how to work with people of different cultural groups.

Tanielian & Stein (2006) focus their article on working on the psychological distress with victims following a terrorist attack. However, they fail to include broader implications in preventing the victimized groups developing their own group identity and resorting to retaliatory violence and extremist ideologies, dehumanizing anyone who might be perceived, often incorrectly, of having some association to the terrorists. This potentiality can build into exacerbated group conflict and encourage a cycle of dehumanization and violence towards the ‘other’ (Staub, 2012). While addressing mental health issues both short and long term for victims of a terrorist attack is incredibly important, I think it is also important to incorporate prevention plans to mitigate the growth of retaliatory group identities and future conflict. Finally, any mental health interventions must include comprehensive cultural training for professionals providing aid, including understandings of implicit bias and systemic factors.

References

Barrera, I., & Longoria, D. (2018). Examining cultural mental health care barriers among    Latinos. CLEARvoz Journal, 4(1).

Haner, M., Sloan, M. M., Cullen, F. T., Kulig, T. C., & Lero Jonson, C. (2019). Public concern       about terrorism: Fear, worry, and support for anti-Muslim policies. Socius, 5,   2378023119856825. https://doi.org/10.1177%2F2378023119856825

Staub, E. (2012). The roots and prevention of genocide and related mass violence. Chapter 2 in    Anstey, M., Meerts, P. & Zartman, I. W. (eds). The slippery slope to genocide: Reducing identity conflicts and preventing mass murder. New York: Oxford University Press.

Tanielian, T. & Stein, B.D. (2006). Understanding and preparing for the psychological        consequences of terrorism. McGraw-Hill Companies, Inc., 2006.             https://www.rand.org/pubs/reprints/RP1217.html.

Ursano, R.J., Morganstein, J.C., & West, J.C. (2020). Essential issues on terrorism: Planning for      acute response and intervention. In Vermetten, E., Frankova, I. Carmi, L., Chaban, O.,   Zohar, J. (eds). (2020). Risk management of terrorism induced stress. IOS Press.

Wells, L., & Gowda, A. (2020). A Legacy of Mistrust: African Americans and the US Healthcare      System. Proceedings of UCLA Health, 24.

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Instigators of group conflict & genocide

Staub (2012) identifies multiple instigators in group conflict and genocide. First is difficult life conditions which includes “severe economic problems, great political disorganization with a society, or great, rapid social changes and their combinations” (Staub, 2012, p.3). Difficult life conditions disrupt and exacerbate connections with others, self-identity, and safety and security. The social impacts of this may lead to a desperate attempt to identify with a group. Often these groups create a bond and identity through devaluing other groups and scapegoating others. This can give rise to ideologies which aim for changes which will improve the difficult life conditions, but do so in ostracizing and blaming others. While it is possible for these group initiatives to be positive and constructive, most often this pattern can elevate negatively, leading to mass violence against the “other.”

Another instigator is the “[c]onflict between groups, especially identity groups” (Staub, 2012, p.3). Disagreement and devaluing of other groups can lead them into conflict with one another, and as they become increasingly violent, this can spur on acts of genocide. Basic needs and resources can be a part of this, but the devaluation of other groups is still often combined with this. Ideologies of superiority justify actions against another group. Additionally, groups that have been devalued, are different from the mainstream, or are less privileged may begin demanding equal rights which can give rise to violent action. In the past, territorial conquest and colonization have been accomplished through violent means, including genocide. When group conflict escalates to war, genocide becomes further justified by one of the groups towards the other.

Reference

Staub, E. (2012). The roots and prevention of genocide and related mass violence. Chapter 2 in Anstey, M., Meerts, P. & Zartman, I. W. (eds). The slippery slope to genocide: Reducing identity conflicts and preventing mass murder. New York: Oxford University Press.

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The role of bystanders in group conflict

Staub (1999) investigates how bystanders can both normalize and perpetuate violence in group conflict but can also provide interventions which can end such violence. Bystanders can be internal, as in within the country or group, or external, such as in humanitarian aid organizations or other nations. In either case, my understanding is that bystanders are ones who bear witness to the conflict, but may not be directly involved in it, at least for a time. Passive bystanders are explicitly described by Staub (1999), but active bystanders are not named, although there are descriptions of active bystander interventions.

The involvement of other external bystander states are most often passive, unless they see an opportunity for self-gain in their involvement, such as in relation to “power, wealth, or influence. They have not seen themselves as moral agents with responsibility for the welfare of people outside their borders” (Staub, 1999, p.316). Furthermore, it is not uncommon for some countries to “actively support perpetrators” (Staub, 1999, p.308).

Internal bystanders also tend to remain passive (Staub, 1999), and while this might apply to much of the bystander population, I can think of many examples where internal bystanders have become active and attempted to intervene through various methods, such as both peaceful and violent protests. However, passive bystanders further create divide between groups, by the repeated messages by one group or government reinforcing the scapegoating of another group. Over time, these become ingrained beliefs in the civilian population – “it distances them from and leads them to increasing devalue victims. It diminishes their capacity to empathize with those in distress and their sense of guilt about their inaction. In the end, they go along with and frequently even support persecution and violence…” (Staub, 1999, p.308).

A current conflict showing many examples of the role of bystanders is the Syrian Civil War. The war has endured since 2011, and its length may have been significantly affected due to bystanders. It is a complicated war with many different sides triangulated against one another. The Assad governmental regime, the rebel groups opposing it, ISIS, the Kurds, Shia Muslim militias, and Hezbollah are the primary internal groups in conflict (BBC, 2017).  President al-Assad is himself from a minority group in Syria, the Alawites, and since coming to power he has systemically and actively encouraged discrimination towards many of Syria’s other ethnicities and religions. Thus, divisions were created between groups, as Staub (1999) identifies as part of the initial stages towards group conflict. When some protested this discrimination in Syria, the government took violent action, and conflict escalated quickly. Furthermore, Staub (1999) points out several cultural risk-factors contributing towards capacity for group conflict, and according to Hofstede Insights (n.d.), Syria has a number of these factors, including high power distance – which is tolerant of authoritarian systems, and high uncertainty avoidance. Another factor which perpetuates conflict is trauma, which can be imparted on multiple generations, and may make traumatized individuals more likely to have feelings of insecurity and react to real or perceived persecution with “defensive aggression” (Staub, 1999, p.310). Syrians have experienced high rates of individual and collective trauma, both in the internally and externally displaced, from not just the conflict, but also forced labor, human trafficking, and discrimination and violence by host communities where refugees seek asylum (Gerson, 2018).

Syria’s rise of internal active bystanders are comprised of several capacities, from armed militia rebel groups resisting and fighting back against the human rights violations of the government on civilians, and also groups like the White Helmets who avoid any active conflict, but take dangerous risks in order to rescue and provide medical care to those injured in attacks from both sides. Passive bystanders might include those civilians who have aligned themselves to the Assad regime, such as other Alawites, Christians, and the wealthy, and those in fear that the fall of the government would allow terrorist groups such as ISIS to take over (Christian Science Monitor, 2011). Both violent active and passive bystanders could be perpetuating the conflict through an overall increase in retaliatory violence on both sides, and in upholding discriminatory, divisive beliefs and institutions about the “other.”

External active bystanders have been many, and likely are the largest contributors to the ongoing conflict. Supporters of the Syrian government include Russia and Iran (BBC, 2017). Russia has carried out air strikes and provided political backing on behalf of the Assad regime at the UN (BBC, 2017), and this seems to be highly motivated by their own self-interest in being a major source of power in the Middle East and is concerned that regime changes could create even further instability – and a loss of Russian power, in addition to the benefits of their naval base and $5 billion in weapon sales to Syria (Calamur, 2013).

External bystanders on the side of the rebels include Turkey, the Gulf Arab states, and the U.S. (BBC, 2017). Under the Obama administration, the U.S. intervened by suppling some arms and troops to the rebels, but these were comparatively minimal (Gerson, 2018). While the U.S. claimed it was becoming an active bystander based on the human rights abuses by the Syrian government, it limited its aid because of hopes to make a nuclear deal with Iran, who supports the Syrian government. Under President Trump, the U.S. troops with withdrawn from Syria and ended all support to the rebels. It has been speculated that this decision was largely motivated by Trump’s intention to be on Russia’s ‘good’ side, with Russia backing the Syrian government.

There are many more examples and instances of how the war in Syria has been accelerated and worsened through complicated international bystanders, and also from within through internal bystanders. All of these examples are much too complex to lay out in full within this assignment, but I do hope this gives an overview of how Staub’s (1999) roles of bystanders in group conflicts has had a significant impact on the Syrian civil war.

References

BBC. (April 7, 2017). Syria war: A brief guide to who’s fighting whom. BBC News. https://www.bbc.com/news/world-middle-east-39528673

Calamur, K. (August 28, 2013). Who are Syria’s friends and why are they supporting Assad? NPR. https://www.npr.org/sections/parallels/2013/08/28/216385513/who-are-syrias-friends-and-why-are-they-supporting-assad

Christian Science Monitor. (September 14, 2011). Why many Syrians still support Assad. https://www.csmonitor.com/World/Middle-East/2011/0914/Why-many-Syrians-still-support-Assad

Hofstede Insights. (n.d.). Country comparison: Syria. https://www.hofstede-insights.com/country-comparison/syria/

Gerson, M. (April 2, 2018). Would you trust America? The Washington Post.  https://www.washingtonpost.com/opinions/would-you-trust-america/2018/04/02/5fc5b854-369e-11e8-8fd2-49fe3c675a89_story.html

Staub, E. (1999). The origins and prevention of genocide, mass killing, and other collective violence.  Peace and Conflict: Journal of Peace Psychology, 5, 303-336.

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Leadership & its influence on trauma in the Philippines

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President Duterte has been noted for his aggressive approach to the war on drugs, to the extent that many people are killed without any legal or judicial proceedings, considered a human rights violation (TomLantosHumanRights, 2017). Mr. Kine of Human Rights Watch noted that the reality is actually a “war against the poor.” Mr. Carlos, who leads the human rights protection agency in the Philippines iDEFEND, said that this war on drugs is an attempt at social cleansing of the most vulnerable.  Furthermore, the police have been known to hire hit squads to carry out killings, are are so filled with corruption that they are not trusted among the Filipino people (Sheena, 2018). “Yet [Duerte’s] gangland approach to combating crime and drugs has largely endeared him to Filipinos who have suffered high rates of violent crime and who see him as a refreshing change from the sophisticated but out-of-touch elite who have ruled this country for most of the last three decades” (Paddock, 2017, par.17). Duterte has rejected the elitist way of life common to government officials and instead lives simply, which aligns him with the majority of Filipinos. Despite his violent nature, he has shown compassion towards sick children particularly.

It is hard for me to not compare President Duterte with U.S. president Trump. Not all may agree, but Duterte’s narcissism, deflection from traditional politics and diplomacy, his support of violence, his boasting of womanizing, his blatant disrespect for journalists, hypocritical (in Duterte’s case, with his addiction to drugs while aggressively waging a war on drugs), a tendency to humiliate those he dislikes, and his “outrageous remarks” (Paddock, 2017, par. 75) all strike me as similar to Donald Trump’s behaviors. It is not surprising that Trump praised Duterte for his success in the war on drugs (Sheena, 2018).

“Leadership in the Philippines even from the grassroots point of view is full of challenges considering that crisis penetrates all sectors of society. Political and educational crises are the most publicized because they affect the economy. It is common knowledge that the country’s economy is primarily supported by remittances from overseas foreign workers” (Cimene & Aladano, 2013). This is also a topic explored in the documentary film (Watt, 2015), where the women, who are mostly all mothers, say that they are seen as heroes because they are providing for their families and boosting the economy in the Philippines. “However, this condition has resulted in the disintegration of families in particular and society in general. The greatest leadership challenge for the government then is to provide employment for its people so that they don’t have to work abroad” (Cimene & Aladano, 2013).

According to Hofstede Insights (n.d.) The Philippines has a power distance score of 94, meaning that people generally accept an inequal distribution of power, and have a hierarchical societal structure. “This means that people accept a hierarchical order in which everybody has a place and which needs no further justification. Hierarchy in an organization is seen as reflecting inherent inequalities, centralization is popular, subordinates expect to be told what to do and the ideal boss is a benevolent autocrat” (Hofstede Insights, n.d., par. 3). When viewed in this manner, it is understandable why a strong and decisive leader, such as President Duterte is popular, and why there may have been a general acceptance to the dictatorship of Marcos (Reyes, 2018). The Philippines is also a collectivistic society with a score of 32 (Hofstede Insights, n.d). Relationships and loyalty are highly valued.

The collectivistic nature and family-oriented culture of the Philippines values leaders in the workplace which foster close interpersonal relationships with employees, which gives a sense of belonging and builds intense loyalty (Cimene & Aladano, 2013). Successful leaders bond with their staff, spend time with them both in and outside of the work environment, and attend celebrations together, which are loved in Philippine culture.  Hard work is valued because it is a way of giving one’s family a priority of ensuring their financial needs. However, the flip side of this is that it is not uncommon for organizational leaders to engage in nepotism and corruption which puts their own family members ahead of others. Ultimately, it is the culture of the organization which is encouraged by leadership which allows them to be strong leaders.

Relationships with others are highly valued, and so the use of networking in order to gain and advance a leadership role is critical (Cimene & Aladano, 2013). Building accomplishments within an organization can also establish a reputation in the community, which builds further support for a leader. High self-esteem is valued as a trait of leaders (Cimene & Aladano, 2013), which could also explain some of the popularity of Duterte.

Cimene and Aladano (2013) stress that an indigenous Filipino approach to leadership and management is preferred. They reject those who would attempt to apply purely Western methods of business and leadership which force systems to be inappropriately contextualized to a non-Filipino culture.

It is interesting to note that the Philippines has already had several women as presidents, such as Corazon C. Aquino (1986-1992) and Gloria Macapagal-Arroyo (2001-2010) (Guthrie-Jensen Consultants, 2017). We also must acknowledge the leaders who have fought against the government for the sake of human rights, such as Joker Arroyo (Reyes, 2018). This was explored in more depth in our previous module discussions.

References

Cimene F.T.A., Aladano A.N. (2013) Leadership Perspective from the Philippines: Its Implications for Theory, Research and Practice. In: Rajasekar J., Beh LS. (eds) Culture and Gender in Leadership. Palgrave Macmillan, London. https://doi.org/10.1057/9781137311573_4

Hofstede Insights. (n.d.). Country comparison: Philippines. https://www.hofstede-insights.com/country-comparison/the-philippines/

Guthrie-Jensen Consultants. (2017). 7 Philippine Presidents, different leadership styles. Insights: The Guthrie-Jensen Blog. https://guthriejensen.com/blog/7-philippine-presidents-different-leadership-styles/

Paddock, R. (March 21, 2017). Becoming Duterte: The making of a Philippine strongman. The New York Times. https://www.nytimes.com/2017/03/21/world/asia/rodrigo-duterte-philippines-president-strongman.html

Reyes, O. (2018, October 8). The Defense Rests: The Joker Arroyo Story. Esquiremag.Ph. https://www.esquiremag.ph/long-reads/profiles/joker-arroyo-bio-a1542-20181008-lfrm5

Sheena, M [username]. (2018, March 20). The Philippines Deadly War on Drugs | BBC FULL Documentary . YouTube. https://www.youtube.com/watch?v=LF8ysVBSxwM&t=1769s

TomLantosHumanRights [username]. (2017, July 20). The human rights consequence of the war on drugs in the Philippines . YouTube. https://www.youtube.com/watch?v=jHzcJGjtTvQ

Watt, G. [username]. (2015, September 13). BBC HardTalk on the road in the Philippines. YouTube. https://www.youtube.com/watch?v=A0XUQa55OhI&t=12s

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Papers, Docs, and Essays

A Cultural Comparison Between The Philippines and the San Luis Valley, Colorado, US

The area I currently live in is called the San Luis Valley.  When Zebulon Pike first saw the landscape, he wrote “[t]he great and lofty mountains . . . seemed to surround the luxuriant vale, crowned with perennial flowers, like a terrestrial paradise, shut out from the view of man” (Encyclopedia Staff, 2020, par. 12)

It is a large high-altitude desert valley about the size of Connecticut (roughly 8,000 square miles) in south-central Colorado, extending into the northernmost areas of New Mexico (Encyclopedia Staff, 2020). The arid, cold conditions with the extremities of high altitudes make the San Luis Valley’s climate a sharp contrast to the humid, lush, and tropical climate of the Philippines (Borlaza, 2020).

The Valley is and isolated place, bordered in nearly 360 degrees of mountains (Encyclopedia Staff, 2020). It is a very rural area, with tiny towns spread out across the Valley, typically in multiples of 7 miles – as the steam trains which brought developments to the area needed to stop every 7 miles to refill their water tanks. The land originally was occupied as sacred hunting grounds for at least 10,000 years by at least 13 different indigenous tribes, with the strongest recent presence being the Ute and the Navajo, whose sacred mountain of the east is a prominent feature on our landscape. Agriculture and ranching of sheep and cattle are the major industries.  The Philippines also is primarily agricultural (Borlaza, 2020). The San Luis Valley is poverty-ridden, with some families lacking electricity and running water even today – which is almost unheard of in the United States today. The Philippines poverty is comparably more severe, with an estimation that 1 out of 4 residents of the city of Manila is a squatter, living on the banks of rivers or in garbage dumps (Baringer, n.d.).

Spanish Conquistadors invaded the Valley in 1598, wrestling for control with the indigenous peoples, enslaving them, until 1821 (Encyclopedia Staff, 2020). The Spanish ‘claimed’ the valley for King Phillip II – just as it was for the Philippines (David & Nadal, 2013). In 1821, after Mexico gained its independence from Spain, the Valley became Mexican territory, and land grants were established (Encyclopedia Staff, 2020). Conflicts with Native Americans continued. In 1848, the United States took control of the San Luis Valley in the Mexican-American War. With the coming of the railway, more European Americans moved into the area, which created conflicts and skirmishes with the Latino and Native American populations due to a clash of cultures. Embedded historical trauma from colonialism impacts both the San Luis Valley and the Philippines (David & Nadal, 2013)

The largest town in the San Luis Valley is Alamosa (Encyclopedia Staff, 2020).  I live in Sanford, about 20 miles away from Alamosa, with a population of around 800 people. Sanford is a significantly Mormon town, and predominantly white (EchoHawk, 2012).  The Amish and Mennonite also have a strong presence in the area (Schrader, 2010). This is in stark contrast to another Valley town I lived in 5 years ago, Antonito, which is heavily Native American, Latino and Mestizo (mixed Aztec and Spanish) (Bonilla et al., 2004).  The Spanish language here is unchanged 1500s Spanish, a dialect unique in the modern world (Lozano, 1994).

Most of these small towns are highly protective of each other, and extremely resistant to trusting outsiders. Change is extremely slow (Encyclopedia Staff, 2020). High-speed internet only became available a few years ago, for example, but is still not available in some communities. Each town has its own unique personality This can be compared to the differences in culture in different islands and geographic regions of the Philippines, which have some distinctions, but also are united under a broader culture (Baringer, n.d.), as it also is in the San Luis Valley.

The Latino community in the San Luis Valley is for the most part Catholic, as it is also in the Philippines (Montiel & Teh, 2004). However, I can only assume that the ‘flavor’ of the religious beliefs are different between these places, as they have very different cultural worldviews. However, a similarity to the Philippines is that the family is the central support system and are tightly knit (Maria, 2012). Oral storytelling was predominant for most of the settled history of the San Luis Valley, often concerning witchcraft and treasure hidden in the mountains (Sangre de Cristo National Heritage Area, 2019). Stories were passed down from fathers to sons. These stories often re-enforce traditional values based on Catholicism, but portrayed through the lens of Mexican, Native American, and Spanish frames. Strange occurrences are common, such as cattle mutilations, people disappearing under mysterious circumstances, and sightings of UFOs, which were even referenced by the Utes (O’Brien, 2014).

Art is also a part of the culture in the San Luis Valley. Murals depicting historical scenes, Native Americans, and wildlife are painted on buildings and silos in every town (Sangre de Cristo National Heritage Area, 2019). Sculptures are also prominent, mostly depicting religious figures. Weaving and fiber arts are also a strong tradition, passed down from Native American styles and traditions.  The Philippines also have a history of weaving and oral storytelling (Cole, 1916).

Indigenous culture also influences the Philippines, with a modern-day population of around 12 million, or around 14% of the population (De Vera, 2007). However, some indigenous peoples of the Philippines maintain their cultural practices as they live primarily in the mountainous regions which had little encroachment from Spanish and later, American, colonization (Valdeavilla, 2018), and the indigenous peoples of the San Luis Valley, Colorado have been forced off their lands onto reservations and undergone cultural ethnic cleansing. The Lumad tribes in the Southern Philippines are known for their music, and the instruments which they make for it (Valdeavilla, 2018).

It is quite interesting to see how many similarities there are between the culture of the rural San Luis Valley in Colorado, U.S. to the culture of the Philippines. That being said, it would be faulty to consider that these cultures are in themselves similar, but rather carry some similar traits.

References

Baringer, S.E. (n.d.) The Philippines. Countries and Their Cultures. https://www.everyculture.com/No-Sa/The-Philippines.html

Bonilla, C., Parra, E. J., Pfaff, C. L., Dios, S., Marshall, J. A., Hamman, R. F., Ferrell, R. E., Hoggart, C. L., McKeigue, P. M., & Shriver, M. D. (2004). Admixture in the Hispanics of the San Luis Valley, Colorado, and its implications for complex trait gene mapping. Annals of human genetics, 68(Pt 2), 139–153. https://doi.org/10.1046/j.1529-8817.2003.00084.x

Borlaza, G.C. (October 23, 2020). Philippines. Britannica. https://www.britannica.com/place/Philippines

Cole, M.C. (1916). Philippine Folk Tales. A.C. McClurg & Co.

David, E. R., & Nadal, K. L. (2013). The colonial context of Filipino American immigrants’ psychological experiences. Cultural Diversity and Ethnic Minority Psychology, 19(3), 298-309. doi:10.1037/a0032903

De Vera, D.E. (2007). Indigenous peoples in the Philippines: A country case study. Presented at the RNIP Regional Assembly, Vietnam. http://www.iapad.org/wp-content/uploads/2015/07/devera_ip_phl.pdf

EchoHawk, D. (2012). Struggling to find Zion: Mormons in Colorado’s San Luis Valley. University of Colorado Denver.

Encyclopedia Staff. (2020, March 13). San Luis Valley. Colorado Encyclopedia. https://coloradoencyclopedia.org/article/san-luis-valley

Lozano, A. (1994). San Luis Valley Lexicon: Relics and Innovations. Confluencia, 9(2), 121-127. http://www.jstor.org/stable/27922222

Maria, M. (2012). The Philippines. In J. Arnett (Ed.). Adolescent psychology around the world (pp. 133-148). New York, NY US: Psychology Press.

Montiel, C. J. & Teh, L. A. (2004). Psychology in the Philippines. In Stevens, M. J. & Wedding, D. (Eds.), The Handbook of International Psychology, 443-456.

O’Brien, C. (2014). Enter the Valley: UFO’s, Religious Miracles, Cattle Mutilation, and Other Unexplained Phenomena in the San Luis Valley.  St. Martin’s Publishing Group.

Sangre de Cristo National Heritage Area. (2019). Cultural Arts. https://www.sangreheritage.org/cultural-arts/

Schrader, A. (August 14, 2010). Amish settle in Colorado’s San Luis Valley, diversifying to support families. The Denver Post. https://www.denverpost.com/2010/08/14/amish-settle-in-colorados-san-luis-valley-diversifying-to-support-families/

Valdeavilla, R. (April 25, 2018). A guide to the indigenous tribes of the Philippines. Culture Trip. https://theculturetrip.com/asia/philippines/articles/a-guide-to-the-indigenous-tribes-of-the-philippines/

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Papers, Docs, and Essays

Based on the Filipino context, what are the strengths and challenges for collaborating with local businesses to support corporate social responsibility for trauma-based initiatives?

A strength of collaborating with local businesses in the Philippines to support corporate social responsibility for trauma-based initiatives is the growth of interest and towards supporting populations in developing countries which provide incomes in addition to overall development (Nielson & Samia, 2008). These types of developments can also be a support to mental health, such as in the case of SAFFY (SAFFY, 2019).  However, challenges which are mentioned in Nielson & Samia (2008), and also in my talks with SAFFY, is the difficulty in selling products at local markets where they earn little for their products and be unable to reach a larger scale of consumers.

Other significant challenges are the lack of a country-wide system and structure to focus efforts on small local businesses rather than large corporations (Nielson & Samia, 2008). Furthermore, initial training in leadership and management, marketing, and having upfront capital are needed, in a somewhat ironic cycle, for a business to prove its viability and usefulness, upon which they may be able to gain additional funding such as from government programs or NGOs, but often the initial stages must come from the grit and pockets of the founders themselves. This can be challenging in areas where people are severely impoverished, and because of social-economical factors which perpetuate themselves and prevent the poor from moving up, many may struggle with appropriate education, or even basic literacy.

Another issue to consider is both the large amount of overseas workers who have been “exported” from the Philippines, due to lack of economic viability within their own country, causing the loss of these intelligent and hardworking individuals who could instead be participating directly in the Philippine workforce (Watt, 2015). In the Philippines, however, these workers are seen as heroes who sacrifice their desire to remain with their family in order to instead send back money which can support family members and also build the economy within the Philippines.

Furthermore, there is a large section of workers in the Philippines who constitute the informal sector (Ofreneo, 2013). These workers are not formally employed by a company, but often hustle in various capacities to earn a daily living, and do not pay taxes to the government. While these workers must certainly have strength of determination, creativity, and adaptability, many times they lack an organized network, additional funding, or the training to implement a movement from these informal skills to creating a viable business. Ofreneo (2013) argues that a “rights based’ approach to social protection, via the passage of protective labor laws for the vulnerable, is insufficient to secure such protection, given the weakness of the economy” (p.421). Therefore, policies and laws for these protections are not completely invaluable, but rather do not target the whole picture of needs to move the economy forward for these workers, in addition to addressing the social transformation and mental health needs of both individuals and communities who have undergone collective trauma.

A strength in the above regard is that there are already organizations which aspire to empower and build people up who might not otherwise have opportunities to do such, such as the work of SAFFY, Pakisama, and Solidarity with Orphans and Widows.  There is a definite need for these types of organizations, and it is inspiring to see their work carving out grassroots efforts to address the above problems, while simultaneously addressing implications and effects of longstanding, as well as immediate, trauma.

References

Nielsen, C., & Samia, P. M. (2008). Understanding key factors in social enterprise development of the BOP: A systems approach applied to case studies in the Philippines. Journal of Consumer Marketing, 25(7), 446-454. doi:10.1108/07363760810915662

Ofreneo, R. E. (2013). Precarious Philippines: Expanding informal sector, “flexibilizing” labor market. American Behavioral Scientist, 57(4), 420-443. doi:10.1177/0002764212466237

SAFFY. (2019). About Us. http://www.saffyinc.com/about-us/

Watt, G. (2015, September 13). BBC HardTalk on the Road in the Philippines . YouTube. https://www.youtube.com/watch?v=A0XUQa55OhI&t=504s