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Maslow's pyramid of needs. (Photo courtesy of Dalia Danish)
CAIRO: The political and economic aftermath of the Jan. 25 uprising have been the topic of discussion over the past year, however little attention has been given to its psychological repercussions.
Psychologist and neuroscientist Dalia Danish observed that after the Jan. 25 uprising, Egyptians were traumatized on some level or another. This was especially alarming, she says, since the country was flung into a stage that required its people to make important and objective decisions.
Danish explains that people are more likely to make the right and objective decision if they are provided with a self-help platform and tools to overcome their fears and trauma. Instead people were reacting to constant distractions, such as the Mubarak trial, rather than focusing on the “here and now.”
“Many of us needed to be reminded that we are active agents in our environment with intentionality, that we need to put our worries, fears and past in a box, invest in the present and open that box later when we are ready,” Danish says.
This is where psychologists’ role comes in. In therapy, Danish says, psychologists work on empowering the patients and reminding them that “the only power anything has over them is the power they allow it to have.”
“People weren’t told that they don’t need a leader and that they are in control of themselves. People are still making demands from the Supreme Council of the Armed Forces, which is paradoxical since SCAF got its power from the people,” she explains.
Danish used people’s fear of an Islamist takeover as another example. “You fear the Islamists will restrict your freedom? Well they can’t if you don’t allow them to.”
She likens it to a woman who got out of an abusive relationship but is still likely to attract and be attracted to the same type of man, explaining that this is “learnt behavior.”
“In this case, the government has been telling you [that] you cannot think for yourself.‘God gave me power over you and you have to do what I say’ … after you get out of it you have to work on empowering yourself but there was not enough time to do that.”
Danish points out that Egyptians cannot feel empowered until their basic needs are fulfilled.
Through her work in centers for abused women in the UK, Danish said that women could not be empowered psychologically unless they have their basic needs.
The same applies to the majority she has worked with in the slum areas in Egypt, who have no access to clean water, food, proper waste management or healthcare facilities.
Danish also observed that among the intellectuals and activists, the main fear is the lack of freedom, whereas among the majority of Egyptians the main fears and needs are physiological.
The main demands of the revolution, she explains, were initially bread, freedom and social justice – “and bread preceded freedom and social justice.”
She referred to the Maslow's Hierarchy of Needs, whose base is bread and water (physiological needs), followed by shelter and safety, which come before any other “abstract” need.
“Thus you cannot build the top of the pyramid if you don’t have a base.”
She recommended that all parties involved, including SCAF, political parties as well protesters “move away from the beautifully said ideological thoughts and focus on practicality: Bread … a basic need.”
Post Traumatic Stress Disorder
Nasser Loza, director of Behman Psychiatric Hospital, argued that the Jan. 25 uprising affected Egyptians’ psychology and behavior, giving them a sense of liberty they were not accustomed to — which he explained is a double-edged sword.
While Egyptians find the newfound freedom exciting, it also created “a new order of management and delegation that wasn’t there,” Loza says.
Because Egyptians lived under one structure that was suddenly dissolved, “some disorder is expected before order is restored,” says Loza.
This will only happen when people want it to, he adds.
“The general motivation should come from the people, who need to set the rule of law again and abide by rules and regulations in their day to day lives.”
However, he did not go as far as diagnosing the population with Post Traumatic Stress Disorder (PTSD), explaining that its symptoms develop on the long term.
He said that the people who experienced the violence first-hand may be the ones at risk of developing PTSD, “but you can’t get PTSD by watching television at home.”
He maintained, however, that being subjected to disturbing visuals and stressful situations affects people’s ability to concentrate and creates a sense of hopelessness.
Moreover, Hani Henri, assistant professor and graduate advisor at the American University in Cairo’s psychology department, says the threshold for trauma and stress varies from one person to another.
To say that Egyptians suffer from PTSD would be an unfair generalization, he says.
He maintains that shocking scenes such as “seeing bodies dragged to the trash and seeing people crushed under APCs” are likely to cause trauma, and may eventually cause people to develop PTSD.
But being in a constant state of fear may also lead to PTSD.
Other people, however, are “stress hardy,” making them less susceptible to the disorder. “It depends on how you perceive and interpret situations. If you remain optimistic and proactive, you have a higher threshold for stress,” he says.
P-Etienne Vannier, certified hypnotherapist, believes that alternative therapeutic modalities can help deal with the country’s turbulent conditions.
“I think alternative therapies certainly have their place in society in general, and in this revolution in particular,” he says.
Over the past few months, he observed that some of his clients showed a heightened level of stress, inability to sleep, difficulty to focus, and some repeated nightmares. Many clients would also cancel or postpone sessions because they felt they could not focus on themselves while other people were killed and hurt in clashes.
“The problem is that the violence that people have been exposed to in the past year or so has left many of them in a state of hyper-suggestibility, during which people's ability to have a critical view of the situation is affected. In hypnosis, we'd say that their critical mind is bypassed,” he explains.
Other techniques using hypnosis can provide both emergency relief, as well as help for trauma recovery on the long term, he says.
If volunteers in field hospitals were trained on hypnosis and “verbal first aid,” they could help reduce bleeding, reduce pain, help with breathing and cushion the blow of the overall trauma.
He cited a study published in the American Health Magazine which states that psychoanalysis allows for a 38 percent recovery rate after 600 sessions; 72 percent recovery rate after 22 sessions for cognitive behavior therapy; and 93 percent recovery rate after only six sessions of hypnotherapy.
“This is why I'm trying to get these techniques out there through awareness sessions and trainings,” he says,“I am not saying hypnotherapy is the only one therapy that should be used, very far from it. I'm just saying that in some cases, trauma relief and healing can happen much faster when the right techniques are combined and applied at the right time.”
Access to help
Lamenting the lack of knowledge, awareness and access to alternative therapy, Vannier offers one-on-one sessions, providing free awareness on hypnosis and the power of the mind. These sessions are offered for free for victims of violence by the police, army or thugs.
One of his trainees who learnt self-hypnosis, he recalls, said that it helped her through the toughest times of the revolution without being too emotional, allowing her to remain calm and in control.
Vannier is also currently working with First Medicines, directed by Timothy Trujillo, CHt, to organize trainings focusing on hypnotherapy for PTSD.
“I'm also hoping to organize trainings on emergency hypnosis, for health professionals, staff from the field hospitals in Tahrir, or any young person interested in learning useful and life-saving techniques that can be applied at home or in the middle of a protest,” he said.
Danish has also held awareness workshops around Cairo which attracted a high turnout, giving people the chance to voice their concerns regarding Egypt’s future and their own safety. The workshops, she says, were also a chance for people to realize they have access to help to get over their trauma.
She also launched an interactive website, www.tammenny.com, providing an online venue for those seeking treatment for trauma and offering psychological help both in Arabic and English.
She sees light at the end of the tunnel, asserting that Egypt is undergoing a “developmental stage.”
“We’re like a teenager who is discovering herself and her identity and rebels by dying her hair blue … this is all part of the process.”