Instructor’s Manual for CHILDREN OF THE CAMPS RACISM, CULTURE AND TRAUMA: THE JAPANESE AMERICAN INTERNMENT by Satsuki Ina, PhD children of the camps © Copyright 2001, Satsuki Ina, Ph.D. All rights reserved. Pages may be reproduced for classroom use only. Any other use requires written permission from the author. Satsuki Ina, PhD Family Study Center 2716 X Street Sacramento, California 95818 916.452.3008 [email protected] Racism, Culture, and Trauma: The Japanese American Internment A Instructor’s Manual for the Children of the Camps Documentary Published and Distributed by: The Children of the Camps Documentary and Educational Project Funding for this project was made possible by: The California Endowment The California Endowment’s mission is to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians. and California State University, Sacramento Pedagogy Enhancement Award 2 Psychotherapy.net ACKNOWLEDGEMENTS I would like to acknowledge the many family, friends and colleagues who have provided emotional and material assistance and inspiration to make the Children of the Camps Documentary and Educational Project possible: my mother and father, Shizuko and Itaru Ina my brother and fellow internee, Kiyoshi Ina my friendly critic, Mary Stroube my gentle editor, Britt Alkire my cultural teacher, Iko Miyazaki my quality, qualitative analyst, Cheri Araki my precious sons, Dylan and Adrian Tomine and my beloved husband and compassionate witness, Carey Covey. I also want to thank Lee MunWah, who brought me to my edge, Audrey Kasho-Wells who convinced me to take the leap, Stephen Holsapple who took the project to unimagined heights, Emery Clay III who captured the beauty, and my niece, Kim Ina, whose love and dedication was a constant reminder of our responsibility to the future. I am gratefully indebted to the pioneering work of Donna Nagata, Ph.D. and Amy Iwasaki Mass, two Japanese American women scholars whose work has laid the foundation for the research and study of the longterm psychological effects of the internment. I have drawn heavily from their scholarly work for this Instructor’s Manual in order to explain the experiences of the many children of the camps I have worked with in workshops and clinical settings. And finally, to the six individuals who courageously agreed to share their stories so that others might learn, Bessie Masuda, Toru Saito, Marion Kanemoto, Howard Ikemoto, Ruth Okimoto, Tatsuo Nagaoka, you are the ones who gave life to this project; to you, I am deeply grateful. 3 children of the camps Table of Contents Prologue 5 Introduction 6 I. The Social and Historical Context Uprooting and 7 Physical Conditions 10 Family Stressors 11 Psychological Stressors 12 Questions, Discussion and Learning Exercise 13 II. Racism as Traumatic Abuse Culture and Indications 15 Trauma of 15 Unresolved Trauma 17 The Abuse Dichotomy 19 Posttraumatic Stress 20 Cognitive Distortions 22 Altered Emotionally 26 Dissociation 32 Impaired Self-Reliance 28 Disturbed Relatedness 36 Avoidance 39 Questions, Discussion and Learning Exercises 41 III. Children of the Camps: Trauma and Healing Children of the Camps Documentary and 44 Educational Project The A merican Public: National PBS Broadcast 45 Viewer’s Guide 47 The Japanese A merican Community: Community Education Forums 49 Mental Health Providers: Cultural Competence 57 and IV. The Beginning Discussion Questions 58 for Clinicians 58 Earn Continuing Education Credits for Watching Videos 64 More Psychotherapy.net Videos 66 4 Psychotherapy.net Prologue: The Rice Ball Dilemma I learned early on as a child growing up in San Francisco that rice was not something just to be eaten to fill my stomach. At every family meal, the children waited respectfully while the first portion of rice was placed on the altar in front of the Buddha, and the second portion of rice was served to my father. Rice was the main staple of the meal to be eaten with small morsels of pickles or pieces of fish. We were admonished never to leave one grain of rice in our bowls, and any left over rice always found some secondary use. It could be dried and fried and mixed with honey for dessert or it could be saved and used as paste for art projects when needed. My two brothers and I especially loved the rice balls our Mother would make when we went on family fishing trips. As I watched her take the steaming rice out of the pot with the bamboo spatula and gingerly shape them into graceful balls for our picnic lunch, she would remind me that if you made these rice balls too big, people would think you were a country bumpkin; on the other hand, if you made them too small, people would think you were stingy. As children we relished the discovery of whatever little pickle surprise our mother would tuck inside the center of each rice ball. How we looked forward to our rice ball lunches! On occasion, my mother would put these rice balls in our school lunch boxes; and the rice balls we loved so much suddenly became an enormous burden for us. My brothers and I often spoke of the different ways we dealt with the “rice ball dilemma” in our lives. My oldest brother would throw his rice ball in the gutter before he got to school. He decided that he would rather go hungry than be different. As a middle child and one who could never give up a good meal, I would wait for the lunch bell to ring and run as quickly as possible to hide in the alley behind the red chimney; there I would choke down my rice ball before anybody saw me. My youngest brother would slowly take out his rice ball in the middle of the schoolyard and watch vigilantly for any negative responses. He sometimes ended up punching someone who hadn’t even noticed what he was eating. Today, my brothers and I laugh and tease each other about our different “rice ball solutions.” We also remember vividly the pain of our struggle for acceptance. 5 children of the camps Introduction The documentary, Children of the Camps, (Ina, S. & Holsapple, S., 1999) follows the journey of six Japanese Americans who were interned as children in American concentration camps during World War II. The culmination of racism, wartime hysteria, and the failure of political leadership (CWRIC, 1997), the internment of 120,000 persons of Japanese descent provides a powerful lesson for understanding the ramifications of the trauma of racism and its lasting effects. The purpose of this Instructor’s Manual is to: • provide the social-historical context for the documentary, • explore the psychological consequences of the internment and mitigating cultural coping mechanisms, • describe how the documentary was used as a community intervention to address the unresolved legacy of the internment trauma, • and to offer classroom activities to increase student awareness, empathy, and insight regarding the effects of racism. Although the target audience for the Children of the Camps documentary is broad, this Instructor’s Manual is designed specifically to be used as a tool for undergraduate, graduate, and professional level training. Instructors teaching Ethnic Studies, Sociology, History, Psychology, Counseling may find this guide appropriate for understanding the Japanese American internment experience as a case study of the interactive effects of racism, culture and trauma. It may also be used as part of a comprehensive training program for mental health providers seeking to understand the effect of racism and culture on the mental health of diverse client populations. 6 Psychotherapy.net The Social and Historical Context There was no possible way of separating the loyal from the disloyal, insisted the Attorney General: “…when we are dealing with the Caucasian race we have methods that will test the loyalty of them…But when we deal with the Japanese we are in an entirely different field and we cannot form any opinion that we believe to be sound.” Attorney General, Earl Warren, in M. Weglyn, Years of Infamy In order to understand the context in which the imprisonment of Japanese Americans was sanctioned by the United States government, it is helpful to examine the level of social anxiety extant in America prior to the bombing of Pearl Harbor by the Japanese in 1941. The report of the Commission on Wartime Relocation and Internment of Civilians (CWRIC 1997) provides a rich historical account of the Japanese American experience. A brief summary is presented here. California in the early 1800s was at the center of American discrimination against the Chinese and, later, against the Japanese. A great many of the Chinese immigrants were recruited as railroad laborers. When the transcontinental line was completed in 1869, the Chinese were no longer needed. They were summarily discharged, leaving almost 10,000 unemployed Chinese in a depressed labor market. Anti-Chinese sentiment became widespread. The financial recession of the 1870’s was blamed on “cheap Mongolian labor,” and protests were directed against the Chinese. The Chinese threat, first characterized as unfair labor competition, eventually included claims of “racial impurity and injury to western civilization” (Daniels, 1962, pp. 16-19). By 1882, pressure mounted for the federal government to prohibit Chinese immigration, and the Chinese Exclusion Act of 1882 was passed. Following the Exclusion Act, the need for cheap agricultural labor led to the recruitment and immigration of Japanese from Hawaii and Japan. Japanese laborers were sought when the Alaska gold rush of 1897-99 left the Pacific Northwest in need of labor for linking Seattle 7 children of the camps and Tacoma by railroad with the eastern half of the United States. By 1908, 127,000 Japanese had entered the United States. During the time of the Great Depression and the war on the European continent, an atmosphere of uncertainty and fear threatened the country. In the meantime, Japanese immigrants had cultivated unwanted land in the Central Valley of California and converted it into fertile and successful truck farms. In addition, Japanese fishermen were developing successful fishing enterprises along the southern coast of California. Although forbidden by law to own land, these immigrants began to gain an economic foothold nonetheless, and they came to be viewed as a serious economic threat to mainstream agricultural and fishing interests (McWilliams, 1945). The hostile reception and treatment of Japanese immigrants on the West Coast can be understood as the historical prelude to the exclusion and evacuation of the people of Japanese descent during World War II. The institutionalization of racism was reflected in specific anti-Asian legislation such as the federal immigration and naturalization laws, anti-miscegenation laws, the Alien Land Law, and the segregation of public schools. Public perceptions and misconceptions about the Japanese were shaped by myths and stereotypes that characterized Asians as different and inferior people. The fear of “the yellow peril” and negative interpretations of Japanese cultural values further fueled the intolerance for differences. Remarks by political leaders such as Mayor James Phelan of San Francisco expressed the prevailing feelings of the early 1900’s: The Japanese are starting the same tide of immigration which we thought we had checked twenty years ago…. The Chinese and Japanese are not bona fide citizens. They are not the stuff of which American citizens can be made…. Personally we have nothing against Japanese, but as they will not assimilate with us and their social life is so different from ours, let them keep at a respectful distance (Daniels, 1993, p. 9). The Commission on Wartime Relocation and Internment of Civilians (CWRIC, 1997) concluded, “Resentment of effective economic competition also inflamed public feeling and, combined with 8 Psychotherapy.net differences of language and culture, left the small minority of Japanese Americans on the West Coast comparatively isolated - a ready target at a time of fear and anxiety” (p.28). As the level of anxiety pervaded the United States, and a need to bind the untenable anxiety increased, America was poised to target the people of Japanese descent as scapegoats. The unjust and inhumane treatment of Japanese Americans would continue to be justified by their purported racial inferiority. Pearl Harbor rekindled the fears and prejudices and the long years of anti-Asian sentiment. Anger against the Japanese as they swept through the Philippines and down the Malay Peninsula to Singapore, and reports of American battlefield deaths together lit sparks in one community after another up and down the West Coast, where fear of invasion was very real (CWRIC, 1997). However, a five-year study conducted by United States Naval Intelligence had confirmed that in spite of the increasingly strained Japan-US relations, Japanese Americans were loyal citizens and did not, in fact, pose a threat to national security. In the face of this objective evaluation of the risk to national security, the decision to evacuate, segregate, and imprison Japanese Americans on the West Coast was, instead, fueled by racism and fear. As the perceived threat to American society increased, innuendoes and accusations were rampant. Fanned by the flames of politically biased journalism, Japanese Americans became indistinguishable in the eyes of the American public from the “Jap” invaders. Stereotypes were used to explain how the sneaky, unconscionable, monkeylike people would betray America for the Japanese Emperor. By arousing fears that Japanese Americans were potential saboteurs, public attention was shifted away from the high-ranking military personnel responsible for protecting America from foreign attack. The inflammatory statements by those in power who publicly decried, “A Jap is a Jap” (CWRIC, 1997, p. 66) served to redirect the escalating anxiety. On February 19, 1942, President Franklin D. Roosevelt, signed 9 children of the camps Executive Order 9066. This action ultimately led to the incarceration of 120,000 innocent people in spite of the fact that the United States government had in its possession proof that not one Japanese American, citizen or not, had engaged in espionage, nor had one committed any act of sabotage (Weglyn, 1976). Nagata and Takeshita (1998) describe in detail the stressors faced by the internees. These research findings are summarized here and illustrated by the experiences of participants in the Children of the Camps workshops. Uprooting and physical conditions Within hours of the attack on Pearl Harbor, West Coast Japanese Americans were given a week’s notice of their removal to unknown destinations, taking with them only what they could carry. Thousands of families were initially placed in temporary encampments such as fairgrounds and racetracks. Most were moved at least one more time. Former internees participating in the Children of the Camps workshop recounted the disruption and uncertainty caused by the forced separation and uprooting from their familiar surroundings. In the documentary, Marion describes the painful childhood memory of being separated from her family and taken to Japan, a foreign country, as part of the prisoner exchange program where Caucasian Americans held captive overseas were exchanged for Japanese from America. Others have described the pain of having to leave behind friends, beloved pets, and familiar neighborhoods for an unknown destination. One man told the story of being a child in the hospital for a tonsillectomy at the time his parents received their evacuation notice. He joined his parents in camp directly from the hospital and never saw his home again. The physical stressors associated with confinement in deserts and swamplands during freezing winter and in the blazing desert heat and sand storms of summer impacted the health and well being of the internees. Whole families lived in cramped, single room living quarters with eight thousand or more internees in a camp. Military 10 Psychotherapy.net style communal toilets and laundry facilities, mess hall dining and inadequate medical care typified each site along with constant visual reminders of imprisonment such as guard towers, soldiers with guns, and barbed wire (Nagata & Takeshita 1998). In describing some of the physical hardships endured, participants in one of the Children of the Camps workshops were moved by the every day traumas of one woman whose husband was imprisoned elsewhere, as she described her struggle to care for her two small children in camp. She talked about having to carry them both to the mess hall to stand in line for meals three times a day. She said, “You have to realize, I didn’t have a stroller in camp and because there was no privacy, I had to do anything I could to keep the children from crying or making noise.” family stressors Families suffered multiple hardships. Within hours of the Pearl Harbor bombing, 1300 Issei (Japan-born, first generation) men, community and church leaders were arrested and imprisoned by the FBI. Disintegration of the family began as Issei fathers lost their status as head of household and primary breadwinner. Once interned, mess hall dining led to the Nisei (American-born, second generation) youth spending more time with peers than with families. Many of the families were separated and prison life, defined by military living conditions in barracks and meals at mess halls, led to the breakdown of the traditional family structure. The “loyalty” questionnaire, that required internees who were 17 and older, to foreswear loyalty to the Japanese Emperor and to be willing to bear arms to defend America, divided families and generations. Some internees answered “no-no,” disillusioned by a country that had turned its back on them while others answered with “yes-yes” in order to serve in the military to prove their loyalty (Nagata, 1998). Bessie’s painful recounting of her father’s arrest represents the experience of many families who suffered from the absence of the father and separation from extended families. Toru’s relationship with his abusive stepfather illustrates the intensity of the frustration, hopelessness and despair that can be turned against even more 11 children of the camps vulnerable members of the family. The impact on the family did not end with the release from prison. Tatsuo described the overwhelming fervor with which his father returned to his life, determined to create security and acceptance for his family in the face of the hostility and racism that was ever present. psychological stressors Traumatic events are extraordinary because they overwhelm the ordinary human adaptations to life’s problems. Fear and anxiety pervaded the camps. There were no guidelines for the treatment of prisoners of war interned by their own country. Many workshop participants described the daily uncertainty about when they might be reunited with family members, what would happen when the war ended and how long they would be imprisoned. Rumors, accusations of disloyalty to the community and the stressors of living in a confined space over an extended period of time with no known end in sight were the order of the day. The most insidious stress resulted from the humiliation and psychological assaults that internees suffered. Tagged with numbers like prison inmates, many experienced feelings of shame or self-blame. Not unlike victims of rape, they felt somehow responsible for their fate. The indignities of the daily lack of privacy in all aspects of their lives took its toll. However, the racism underlying the suspicions of disloyalty caused the broadest psychological assault. Stripped of their civil liberties and denigrated because of their ethnicity, the fact that race was a primary factor behind the internment, magnified the feelings of helplessness of the Japanese Americans (Nagata, 1993). The pain of the injustice, impersonally based on the color of one’s skin, is reflected in the documentary when Howard describes his lifetime quest, “I was abandoned and I needed to know why. Why I was being thrown away!” For many former internees, it was difficult to find meaning in their suffering. Jensen (1997) reports that the suicide rate for internees after camp was double that of the national population with evidence suggesting this 12 Psychotherapy.net may have been as much as a four fold increase over pre-incarceration rates. She concludes that psychological anguish along with increased cardiovascular disease were some of the long-term consequences of the internment. Acts of racism are generally impersonal, based not on who the victim is or what the victim does, but on the very fact of his/her existence as a person of color. The psychological sequelae of being accused, demeaned, and then stripped of freedom because of one’s race, however, is a particularly difficult trauma to bear. Inherent in this dehumanization process is the threat of death or serious injury, and its ensuing fear and helplessness. With the suspension of their protection under the Constitution of the United States, and in the absence of any organized advocacy on their behalf, the Japanese Americans were defenseless and without recourse. The author recounts in the documentary, her mother’s diary entry, “I wonder if today is the day they’re going to line us up and shoot us.” Questions for Self-Reflection 1. What was the social-historical context in which you grew up? 2. With what social group/community did you identify as a teen and as a young adult? 3. To what social group/community did you attribute negative characteristics as a teen and as a young adult? 4. What do you think might have been sources of anxiety within your sub-group? 5. What actions did you or people with whom you identified take to distinguish your group from the group with negative characteristics? Questions for Classroom Discussion 1. How are today’s so-called “hate crimes” similar to or different from institutionalized racism? 13 children of the camps 2. How would you explain the rise in organized hate groups today? 3. What stereotypes are attributed to recent immigrants to America such as Russians, Middle Easterners, Filipinos, Mexicans, Southeast Asians? 4. What can today’s counselors, educators, and social workers do to address the problem of racism? Learning Exercise: Bridging Differences The purpose of this exercise is to expand the student’s capacity for empathy by gaining a deeper, more personal experience of another person’s sub-cultural context. Have students select a cultural or ethnic group with which they have little familiarity and attend a cultural, social or religious activity of that group. Have students discuss in class the reasons for their selections. They are then to find one member of that sub-group, and interview the individual about his/her family history and their immigration experience. Prior to the interview, working in small groups, students should develop at least 10 questions to guide their interview. Students should be encouraged to include questions regarding the subject’s experience with racism/discrimination. Debriefing: Describe your experience of the activity in which you participated. What, if anything, happened to your stereotypes about the group? How did members of this group respond to you? What were your feelings before, during, and after the activity? Describe your interview experience. What did you learn from your interview experience that changed or didn’t change your view of the interviewee’s group? 14 Psychotherapy.net Racism As Traumatic Abuse Insidious trauma is characterized by repetitive and cumulative experiences. It is perpetrated by persons who have power over one’s access to resources and destiny, and directed toward persons who have a lower status on some important social variable. Maria Root, Reconstructing the Impact of Trauma on Personality The previous section of this Instructor’s Manual described the social-historical context in which the internment occurred and the physical, familial, and psychological stressors faced by the internees. Information for this section of the Instructor’s Manual is drawn from clinical observations, personal interviews, and empirical data to describe some of the long-term psychological consequences of the internment on former internees. This information can provide a useful perspective for understanding the interplay of culture, racism, and trauma regarding the experiences of other oppressed groups. Reference will be made to two different settings in which information was gathered from former internees. The Children of the Camps Workshops were three day intensive group sessions in which up to ten former internees participated. It is one of these workshops that is seen in the Children of the Camps documentary. The Children of the Camps Community Forums were educational events offered in various Japanese American communities and were open to the public. At these forums the Children of the Camps documentary was shown and group discussions were facilitated. These forums ranged in size from 10 to 250 people in the audience, most of whom were Japanese Americans. Culture and Trauma Several contributors to the hallmark text, Ethnocultural Aspects of Posttraumatic Stress Disorder, (Marsella, Friedman, Gerrity & Scurfield, 1996) have identified cultural variations in the expressive and phenomenological dimensions of the experience of trauma. In particular, Jenkins and Karno (1992) explain, 15 children of the camps Culture is thought to provide an orientation of a people’s way of feeling, thinking, and being in the world, and is the context for experience, interpretation, and action. Culture may place differential emphasis on particular symptoms, assign unique attributions to the intensity of experience as well as expression, and shape the general tone of emotional life to which a person should aspire. In addition, what coping and defense mechanisms are used and how, what is perceived, accentuated, or glossed over, how the information pertaining to the stressful event and its effect is processed are, in part, influenced by cultural factors (p. 165). Thus, culture influences the perception of the traumatic event itself and also influences the various steps attempted to counteract the effects of the associated stress. For the Japanese Americans, Japanese cultural values and life as an ethnic minority in America led to the embracing of a unique coping style in response to the internment trauma. Nagata and Takeshita’s (1998) study of resilience factors influencing the Japanese American internees’ coping responses suggests that their prior experience with racism and specific cultural values provided valuable strategies for coping with the internment. The authors found that as a disempowered ethnic minority group who experienced consistent and significant stressors related to discrimination from before the war, Japanese Americans were not unfamiliar with hardships, social hostility, and second-class citizenship. They conclude that previous exposure to past discrimination helped some internees to cope. Nagata and Takeshita (1998) also found in interviews with former internees, and consistent with comments made by Children of the Camps workshop participants, that the two values most directly linked to positive coping was gaman, the ability to endure or persevere under adverse conditions, and shikata ga nai, which is an attitude of the acceptance of events as they are. Together, gaman and shikata ga nai provided a cultural framework for internees to cope with the immediate physical hardships of being uprooted and imprisoned. The authors point out, “Even though many Nisei (second generation Japanese Americans) felt frustration and a sense of injustice at their treatment by the government internally, the cultural emphasis on acceptance and stoicism guided their outward 16 Psychotherapy.net behavior and immediate coping response” (p. 596). The Japanese focus on interdependence stresses group harmony (Fugita & O’Brien, 1991), a strong avoidance of public confrontation (Kawashima, 1963; Kiefer, 1974), and an aversion of anger (Markus & Kitayama, 1991). Conformity, within the Japanese culture is not viewed as a negative behavior, rather as Markus and Kitayama (1991) point out, “it can signify a willingness to be responsive to others and to adjust one’s own demands” (p. 247). Values of resourcefulness, strong family ties and education were demonstrated in the internees’ ability to normalize life in the camps to the extent possible, developing strong friendships and organizing dances, sports, scouting and religious events as well as providing schooling. While families suffered from the stresses of separation, guided by family commitment and filial piety, most managed to maintain strong ties (Modell, 1973). Indications of Unresolved Trauma There are, however, indications that the psychological assaults of the underlying racism and consequent injustice have remained unresolved. The withdrawal of society’s confidence and public accusations of misconduct challenged the Japanese American’s most honored values of loyalty and belonging. While Japanese culture promotes collectivity, being banished from the group is considered a deeply humiliating consequence of an unspeakable act, to be accused of disloyalty, an unspeakable crime. Where “family” is the center for ancestral and intergenerational identity, to be torn apart and separated was a terrible tragedy. With the suspension of their constitutional rights and determination of their guilt based on race, Japanese Americans were subjected to an insidious form of trauma. There was not an identifiable perpetrator, but rather an amorphous, ominous force working to deprive them of their rights. The extent to which they would be punished was uncertain and the duration of their prison sentence was unknown. Internees were confined under harsh physical conditions, some living behind barbed wires for up to six years (Fukuda, 1990), separated from other family members and never certain of the future . 17 children of the camps Former internees have maintained considerable silence about the personal consequences they suffered (Weglyn, 1976; Hallenberg, 1988; Nagata, 1993). Japanese cultural constraints against the public expression of personal suffering and anger may account for this silence, as well as the fear that former internees might compromise their fragile acceptance in society if they spoke against the government. In many ways, the years of silence of the Japanese Americans mirrored the silence of the larger social, educational, and political context. The internment trauma was minimized, discounted and distorted to the extent that some of the internees believed that it was “for their own good.” When an event is traumatic, normal coping responses become overwhelmed and defensive strategies are devised to minimize the stress. However, the continuation of adaptive responses when the threat is no longer imminent is an indication of post-traumatic effect. Japanese American cultural prescriptives were socially acceptable to the larger society while synchronous with psychological repression. Avoidance of conflict and confrontation, respect for, and acquiescence to authority, and silent endurance of suffering coincided with the government’s minimizing of the impact of the internment and the absence of political advocacy. Many former internees, like other victims of oppressive trauma, responded with defensive strategies of denial, distortion, internalization and repression for many years. In both the Children of the Camps Workshops and the Community Education Forums, this author observed that many internees were adept at adjusting to the physical hardships of the internment, but cultural constraints of forbearance, fatalism, and emotional restraint may have, at the same time, hidden the true nature of the psychological trauma for some. Many workshop and forum participants expressed surprise at the intensity of emotions that was evoked by the film and the discussion. For many participants, previously unexpressed and unresolved grief was released. Some of the lasting effects were reflected in the internee’s stories regarding ruptured family relationships and issues of self-esteem. 18 Psychotherapy.net The Abuse Dichotomy When abuse occurs at the hands of someone who is needed and depended upon, a psychological double bind is created. The victim’s anger about the mistreatment must be suppressed in order to maintain the relationship, however painful, with the perpetrator. Briere (1992) describes the classic abuse dichotomy as an internal conflict that compels the victim to manage the dissonance between the two conflicting beliefs that the perpetrator is needed and the perpetrator intends harm. Maltreatment by a parental figure, whom one is dependent on and fearful of, results in the child’s attempts to make sense of the maltreatment by using self-blame, denial or minimization. Although distortions such as minimizing and denying the harm may seem illogical and reflect passivity, self-blame and low self-esteem, such strategies are often a heroic effort on the part of the victim to maintain his/her attachment to the depended upon perpetrator. Examining the parallel relationship of an oppressed minority group and a dominant power structure with that of a powerless child and an abusive parent, Briere’s definition of psychological abuse can shed light on the consequences for victims of racism. He describes abuse in terms of various types of parent or caretaker behaviors to include, rejecting, degrading, terrorizing, isolating, corrupting, exploiting, denying essential stimulation and unreliable and inconsistent parenting. The United State government justified the violation of the rights of an entire community of people based on race. This “racism” trauma then, similar to victims of abuse, affects the person’s sense of self and results in specific conflict and confusion. Research exploring the issue of racism as traumatic stress indicates that victims of racism must deal with issues of internalized negative self image, confused self identity and other psychological symptoms associated with victimization (Allen, 1986; Parson, 1990; Penk and Allen, 1991). Typical of victims of abuse, Japanese American internees found themselves faced with the psychological conflict of being dependent upon the very source of their abuse. In order to manage this abuse dichotomy, defensive responses are called into action. Briere (1992) identifies seven major characteristics of the long-term impact of abuse trauma that can be applied here to better understand the trauma experienced by former internees. These include, posttraumatic stress, cognitive distortions, altered emotionality, dissociation, impaired self-reference, disturbed relatedness and avoidance (pp. 9-10). 19 children of the camps Posttraumatic Stress Psychological defense mechanisms serve the immediate purpose of keeping the individual from being overwhelmed and psychologically disorganized, particularly when neither resistance nor escape is possible. When trauma is severe and sustained, victims will maintain their defenses even when the immediate source of the threat is no longer imminent. Consequently, repressing, denying, and rationalizing the significance of the trauma can prevent the resolution of the traumatic experience. More specifically, Traumatic events produce profound and lasting changes in physiological arousal, emotion, cognition, and memory. Moreover, traumatic events may sever these normally integrated functions from one another. The traumatized person may experience intense emotion but without clear memory of the event, or may remember everything in detail but without emotion. Traumatic symptoms have a tendency to become disconnected from their source and to take on a life of their own (Herman, 1997, p. 34). Judith Herman (1997) further comments on the specific experiences of people who were held in captivity, “…although the prisoner may appear as though he has returned to ordinary time, the discontinuity between present and past frequently persists even after the prisoner is released” (p. 89). Studies of Nazi concentration camp survivors (Jaffe, 1968) and other prisoners of war (Krystal, 1978) consistently remark on their refusal to speak of the past. Many Japanese American internees, not unlike other former captives, have consciously suppressed or avoided talking about of their captivity. One elderly Japanese American man’s reaction illustrates how, for some, the long-term trauma of the internment had still not been integrated into the person’s ongoing life story and sense of self. At a Children of the Camps Community Forum, the man complained that he was there just to “tag along” with his wife, but felt that it was unnecessary to “keep digging up the past.” He was adamant that he “survived camp and that was that.” After the viewing, the same man was seen leaving the building carrying several copies of the video that he had apparently purchased. He was gently stopped and asked what he thought about the documentary. Visibly shaken, he said, “You know, these stories are a lot like my own, nothing 20 Psychotherapy.net exceptional, just like everyone else who was in camp. I realize that for some reason I can’t talk to my children about it, so instead, I’m going to send each of them a copy of the video.” Some former internees described sudden memories and associations with the camp experience as mildly upsetting, while others reported more severe reactions. A 78-year-old participant had taken his granddaughter to the zoo. Approaching the sheep and goat barns, he was overtaken by a wave of nausea and remembered the repugnant smell of the mutton that he had to eat while in camp. Another former internee who had lived as a child with her six young brothers and sisters in crowded barracks with limited privacy from the other families talked about her life long struggle with anxiety. She was unable to enter crowded elevators or to be comfortable in any confined space. She remembered being told, “If you cry or fight, everyone in camp will know what bad kids you are.” Nagata and Takeshita (1998) found that the age of the individual at the time of internment influenced the varying effects and retrospective assessment of the experience. This was also confirmed in the Children of the Camps clinical interviews and workshop/forum self reports. In examining the long-term physical and psychological health consequences for the internees, Gwen Jensen (1997) concludes, “… traumatic stress was buffered by culturally constructed coping mechanisms that were less inculcated in the youngest prisoners. They reported more post-traumatic stress symptoms of unexpected and disturbing flashback experiences than those who were older at the time of incarceration” (p.v). Early theorist, such as Freud and Janet in the early 1900s, observed that some trauma victims have a need to re-enact the experience in a symbolic way as a means of integrating and overcoming the feelings of helplessness associated with the event. Briere, (1992) also describes this phenomenon; “There is something uncanny about reenactments. Even when they are consciously chosen, they have a feeling of involuntariness. Even when they are not dangerous, they have a driven, tenacious quality” (p. 41). In the Children of the Camps documentary, Ruth’s disturbing, yet poignant images of American flags juxtaposed onto little girls with broken bloody dolls portray her own healing process. Her decision to represent her childhood experience of camp led her to create many images with the repeated theme of the betrayal of her innocence. Ruth recounted a period 21 children of the camps when, at the behest of her adult children, she attempted to paint subjects that were not related to the internment. She agreed to do just that, but in spite of her conscious decision and desire to do so, she would find herself, once again, painting the characteristic red, white, and blue images. Ruth’s replication of her experience can be understood as both a conscious and unconscious effort to gain mastery over an overpowering past trauma. Cognitive Distortions Navarre (1987) points out that trauma is not limited to the assault upon the physical body but upon the individual’s cognitive perception of the self as valuable and competent, and on the individual’s cognitive perception that the world is a beneficent rather than innately hostile place. When the American government took the stance that all people of Japanese ancestry on the west coast presented a risk to national security, a political and psychological double bind was imposed on the Japanese Americans that race determined loyalty. Herman (1997) uses the term, “doublethink” to describe ways in which people in captivity cope with an unbearable reality. Doublethink means the power of holding two contradictory beliefs in one’s mind simultaneously, and accepting both of them (p. 87). This cognitive process results when the perpetrator uses power and fear to obscure the true nature of the abuse. In order to exaggerate the threat presented by the Japanese Americans and to minimize any negative perception of the imprisonment, the government officials used confounding euphemisms such as “evacuation” and “relocation” of “non-aliens” to “pioneer” communities. These were the terms used to describe what was in fact, mass incarceration of American citizens in concentration camps. The following statements made in various Children of the Camps Workshops and Forums illustrate the contradictions. I am a loyal American citizen, but by virtue of my race I am the enemy. I’m told that I’m being put in a prison for the good of the country and for my own protection, so why were the rifles aimed inside the camp? I didn’t commit any crime, but I am treated as if I am guilty. 22 Psychotherapy.net I pledged my allegiance to the American flag in my school room behind barbed wire. I thought it couldn’t have been bayonets. We were just little kids. While I was in camp, my son gave his life in the war for democracy. I was abandoned by my own country, and I wanted to know why. Barbed wire was all around us, so why was this called “internment,” “evacuation,” “relocation,” when it really was imprisonment and punishment? It’s like admitting that you did something wrong when you know damn well you didn’t. I was accused of being a spy for Japan, why would I do a thing like that? I’m an American…I’ve never even been to Japan. I was asked to declare my loyalty to a country that put me and my ailing parents in camp for something we didn’t do. The psychic dissonance created by the injustice and disruption required internees to employ psychological defense mechanisms similar to those elicited in victims of traumatic abuse. These defensive responses require the individual to split off parts of their awareness and aspects of the experience to act “as if” there is a singular truth rather than a contradictory duality. Although providing temporary relief from the dissonance, it can also lead to suppression or denial of the emotional response to the trauma. Amy Iwasaki Mass (1986) a social worker and former internee, refers to the experiences of those second generation Japanese Americans who were teens or young adults in camp, “As traumatic experiences threaten the basic assumptions about personal invulnerability and self worth, the internment harshly challenged the assumptive world of the Nisei who believed their citizenship would protect them from an internment” (p. 160). The Nisei developed a variety of cognitiveemotional strategies to reduce the dissonance. Analogous to the reaction observed by mental health professionals in children abused 23 children of the camps by their parents, some Nisei responded by pledging their complete loyalty to the United States, hoping that a display of cooperativeness would demonstrate their patriotism. Abused children may diligently comply with their parents’ every request, hopeful that their good behavior will lead their parent to treat them well. Other Nisei were seen as displacing their hostility toward the government onto fellow Japanese Americans. This was reflected in the intense intra-group conflicts and accusations against fellow internees who were suspected of collaborating with the government. The government demanded loyalty and espoused values of liberty and equality. Adults who were children at the time of internment describe the pain and confusion of such a contradiction. In the documentary, Marion, an American citizen by birth describes the painful identity confusion she suffered when she arrived in Japan, “I didn’t ever feel that I was Japanese, because the classmates that I had addressed me as Amerikajin. Meaning that I was a foreigner. They never accepted me, and the Japanese culture never accepted my style or my beliefs.” Toru’s vivid memory of seeking solace from his teacher when he complains to her about the taunting from other children further illustrates the cognitive dissonance experienced, “I went crying to my teacher and told her that those kids were calling me a Jap. And she looked at me and said, ‘Well, you are aren’t you?’” Cognitive emotional strategies develop as a defensive response in order to manage untenable, double bind messages. The resulting cognitive distortions leads to a negation of a threatening event that has occurred as well as negation that one even has negative feelings about the event (Janoff-Bulman and Frieze 1983). Such denial can be conscious or unconscious. Horowitz (l986), for example, states that cycles of denial and the intrusion of memories of negative events are common in response to traumatic stress. Denial in the former internees took various forms. Some individuals minimized the significance of their losses or the trauma they had experienced, while others acknowledged the significance of the injustice but stated they did not retain lingering emotional responses to it. 24 Psychotherapy.net At one of the community screenings of Children of the Camps, a man in his early eighties stood up and adamantly insisted, “ Camp was not a bad experience. In fact, I had fun in camp. I learned martial arts, got to be with my friends, and I didn’t have to labor in the field.” All the while he was talking, he seemed unaware of the tears streaming down his face. At a similar event, a woman in her seventies declared that she had never experienced discrimination, even after her release from camp as a young adult. She went on to say that she began her job search by calling potential employers, letting them know from the beginning that she was Japanese American “ in the event they had a problem with that.” She said that several people did in fact say that they don’t hire Japanese Americans, “so I just kept calling until I found employers who were willing to interview me.” The woman’s matter of fact presentation somehow belied the underlying emotions. Whether it was the pain of rejection, or the anger about the injustice, it was all somehow submerged and intellectualized. Mass (1999), a Japanese American social worker eloquently described the abuse dichotomy and the resulting consequences experienced by many Japanese Americans. I tried to understand why so many Americans, Japanese and others, were able to rationalize, justify, and deny the injustice and destructiveness of the whole event. I came to realize that we lulled ourselves into believing the propaganda of the 1940’s so that we could maintain our idealized image of a benevolent, protective Uncle Sam. We were told we were being put away for our own safety. We were told this was a patriotic sacrifice necessary for national security. The pain, the trauma, and the stress of the incarceration experience was so overwhelming, we used the psychological defense mechanism of repression, denial, and rationalization to keep us from facing the truth. The truth was that the government we trusted, the President we idealized, the country we loved, the nation to which we pledged our loyalty, had betrayed us, had turned against us. Our natural human 25 children of the camps feelings of rage, fear, and helplessness were turned inward and buried. Experiencing and recognizing betrayal by a trusted source leads to a deep depression, a sense of shame, a sense that there must be something bad about me. Our greatest loss was the loss of our sense of honor and worth. Altered Emotionality Traumatic events are by their very nature, occurrences outside of the range of normal daily life. Because trauma is experienced as a threat to one’s well being, emotional responses are often intense and confusing and may last for sustained periods of time. When abuse trauma is unacknowledged, psychological healing is inhibited and emotional states of depression and anxiety may continue over time. Depression In discussing the psychological losses endured by people held in captivity, Herman (1997) describes the resulting tenacious state of depression. She reports that protracted depression is the most common finding in virtually all clinical studies of chronically traumatized people. The chronic hyper-arousal and intrusive symptoms of posttraumatic stress disorder fuse with the vegetative symptoms of depression. The dissociative symptoms of the disorder merge with the concentration difficulties of depression. The paralysis of initiative of chronic trauma combine with the apathy and helplessness of depression. The disruption in attachment of chronic trauma reinforces the isolation of depression. The debased self-image of chronic trauma fuels the guilty ruminations of depression. And the loss of faith suffered in chronic trauma merges with the hopelessness of depression (p.94). Due to the underutilization of formal mental health resources by Japanese Americans, there is very limited clinical assessment data regarding the mental health of former internees; however, retrospective self-report and interview studies provide some indication of the emotional effects of the internment experience. Kiyoko Hallenberg’s (1988) doctoral study examined the internment 26 Psychotherapy.net experience of Japanese American elderly and their emotional adjustment. With the use of retrospective interviews and instruments to measure presence of depression and anxiety symptoms, she found that participants who reported not talking about the internment had higher depression scores than those who talked. Given the strong propensity for silence by former internees, and the known effects of suppressing emotions associated with trauma, these results may indicate the possible presence of depression in many other former internees. Certainly, underlying sadness, fear of risk taking, and lack of assertiveness, and self esteem issues were prominent themes for many who participated in the Children of the Camps intensive group process. Jenson’s (1997) earlier cited report of the suicide rate during internment as twice that of the general population and likely four times that of pre-internment rates indicate that depression was significant. Manifestations of depression and anxiety were also found in clinical cases seen by the author where instances of child abuse, spousal abuse, sexual abuse, gambling and alcoholism reportedly occurred during confinement. Workshop participants described unremitting anxiety of their unknown future and the fate of husbands and sons fighting overseas, as well as the indignity of being suspected of disloyalty. Traumatic situations often involve some degree of enduring loss. For internees, feelings of despair and futility resulted from the severe economic distress of losing jobs, farms and homes after years of hard work. Workshop participants often described the intangible losses of childhood. Ruth mourns the loss of her childhood and “the freedom to cross the streets without barbed wire.” Toru holds in his hand marbles that he buried in camp and retrieved fifty years later - a symbol of his lost childhood. Several internees who were children at the time of incarceration, shared painful stories of leaving their best friends and beloved family pets behind. Many of these stories represent losses that were never fully acknowledged and grieved. Participants in the Children of the Camps Workshop often reported 27 children of the camps problems with asserting themselves at work, resulting in job and relationship dissatisfaction. One Sansei participant reported, “I have difficulty handling paper work, official forms, bookkeeping, business information, and documents. I am easily distracted from priority work. I procrastinate. I am tentative and unclear as to my life’s primary work.” Although initially unable to label his feelings and understand the roots for his chronic state of depression, with the support of the group, this man was eventually able to recognize the depth of his feelings. His experience as a child internee, the anxiety that his parents felt during the internment, and the subsequent discrimination and displacement led him to choose an acceptable career to ensure his security and status in society (Ina, 1997, p.194). The intense anger of the imprisoned person adds to the depressive burden. Similar to victims of other forms of abuse trauma, the pain of unexpressed rage against all those who remained indifferent or failed to help was also evident in stories shared by participants in the workshops. In the documentary, Toru describes the multiple traumas of living in confinement with a stepfather who physically abused him and a mother who did not protect him. Toru and Howard struggle to understand each other’s different responses to the injustice and the pain of abandonment that surfaced in the dialogue. Some form of this very confrontation between the two men occurred repeatedly in many of the workshop intensives and may well reflect the suppressed, collective anger that has persisted over the years, misdirected toward one another, rather than directed toward the true perpetrator. anxiety Because unjust imprisonment is by its nature, threatening and disruptive, it is likely that victims of such maltreatment are prone to feelings of fearfulness and anxiety, even well after the trauma has transpired. One internee shared the story of his family’s frantic efforts to resettle after the internment. His teachers advised the child’s mother to change his first name from Tadashi to Tad to demonstrate his identity as an American. When he decided to reclaim his Japanese 28 Psychotherapy.net name forty years later, as an adult, his Nisei-Kibei (second generation Japanese Americans who were educated in Japan) mother vehemently opposed his decision, saying that it was too dangerous to do so. Very few clinical case studies regarding Japanese Americans who were interned have been available in the literature; however, one detailed case study is cited in Ethnocultural Aspects of Posttraumatic Stress Disorder (Marsella, et al, 1996). This case study illustrates the anxiety that results from trauma. Fifty years after his release from camp, “Pat,” who was 15 at the time of his release, was faced with the destruction of his home and personal possessions during a major flood. This event triggered common signs of posttraumatic stress. As the federal application process to repair his home became increasingly complicated by bureaucratic procedures, Pat experienced overwhelming anxiety. The cognitions associated with his anxiety included suicidal ideation, helplessness, and the existential angst of questioning who he was and where he belonged. The governmental procedures precipitated a reactivation of the intense psychological sequelae of the internment: feelings of mistrust, shame, alienation, and a tenuous sense of identity. (Gusman, Steward, Young, Riney, Abueg, Blake, 1996, p. 440). In Emmy Werner’s (2000) book, Through the Eyes of Innocents: Children Witness World War II, graphically telling accounts are described detailing how the war experience shaped the lives of young children, including Japanese American children facing internment. The stories provide repeated examples of the child’s multiple traumas when parents are rendered helpless by trauma and the unbearable sense of vulnerability when the protective role of the parent is lost either through separation or incapacitation. Anxiety was pervasive in camp and children can sense their parent’s distress. In the video Toru describes how he was affected by his mother’s trauma, “She went through hell, and I remember that hell through my Mother’s eyes. You know when you see your mother suffer… you suffer.” In the workshops and forums, participants recounted the anxiety experienced when fathers were indefinitely separated 29 children of the camps from their families, leaving the mother and children imprisoned in separate camps. Bessie describes the shock of watching her father being disempowered as he is removed from his home taking only a toothbrush and a comb. Having retrieved her letter from the government over fifty years later, she reads the letter she wrote as a child, appealing to the President of the United States in an effort to reunite her family. “…I am writing this letter for the sake of my mother. She always worries a lot, and I don’t want her to worry because she has been ill so many times. I am asking you again to please release my father. He hasn’t done any harm to this country.” The person’s subjective experiences of any form of maltreatment, and, particularly, racially motivated maltreatment, may be associated with perceptions of danger and fears of retribution. Several workshop participants described the need for a constant state of vigilance and the fear of unpredictable racial bias or hatred. Participants recognized that because they must rely on their government and their fellow citizens for their well being, feelings of insecurity and uncertainty about what they are entitled to are ever present. The dehumanizing impact of hostility based on racism threatens the victim’s very existence. Fear of continued victimization requires vigilance and constant need for security. One internee reported that whenever Japan-America relations show any sign of conflict, he becomes anxious and fearful. He reported that he is vigilant about Japan’s economic situation and any other world event that might cause him to be viewed as the enemy. He was able to name specific events such as the rise of the Japanese automobile industry, Japanese whaling conflicts, and even the recent Firestone tire recall as potential “red flags” for him. Many workshop participants discussed their rising concerns whenever issues of national security are targeted at individuals of color such as Iranians, Arabs, and most recently, in the case of the Chinese scientist, Wen Ho Lee. Nagata, Trierweiler, & Talbot (1999) analyzed a national survey that investigated the long-term effects of World War II internment on family communication, ethnic preference, and confidence in personal rights. The authors conclude that the sustained level of 30 Psychotherapy.net trauma and the intergenerational transmission of emotional anxiety and depression is the legacy for subsequent generations Japanese Americans. They found that compared to non-interned Sansei (American-born, third generation), interned Sansei exhibited greater in-group ethnic preference, less confidence in their civil rights, and a greater level of family silence about camps. Many interviewees identified lasting psychological effects in their fathers and mothers, reflected in either an enduring sense of insecurity or a loss of selfesteem. They further found that this impact was transmitted to the Sansei as well and that negative effects included their own sense of self-esteem and identity. This manifestation of the lasting anxiety was striking in the documentary when Toru and Howard confront their differences about their identification and social involvement with the “safe” Japanese community. Howard expresses the dialectic of this experience when he says, “As a matter of fact, the Japanese community was a safe haven. As a matter of fact, I felt limited in that safe haven. I wanted to go to China, I wanted to go to Istanbul…and I was going to deny myself that because someone put me in a prison camp?” Dissociation Briere (1992) defines dissociation as a defensive disruption in the normally occurring connections among feelings, thoughts, behavior, and memories, consciously or unconsciously invoked in order to reduce psychological distress (p. 36). A number of writers and researchers relate the onset of such behaviors to psychologically traumatic events, most notably trauma that occurred in childhood (Kluft, 1986; Putnam, 1989; van der Kolk, 1987; Herman, 1997). The pervasive and long-term silence about the internment reflects the protective psychological defense of “dissociation” - the splitting of consciousness between the reality of the event and the experience of the event. In this author’s discussions with former internees, there were repeated, and sometimes extraordinary experiences of a person stating emphatically that they were not affected by the camp experience, and yet within minutes, they would share, without emotion, a memory that to any outside observer, would be considered disturbing and even traumatic. 31 children of the camps One woman who was a young teen in camp reported that she could not relate to the stories presented in The Children of the Camps because she had a “great time” as a teenager in camp. When asked if she would mind sharing a memory from that time, without any awareness of the painful contradiction in her story, she went on to say that her family remained in Tule Lake after it was identified as the segregation camp for “disloyals” who answered the loyalty questionnaire with “no-no.” She explained that although her parents had answered the loyalty questionnaire with “yes-yes” they remained in the “disloyals” camp in order to be with their Issei grandparents. Her family had gone to the mess hall to eat and be seated at their regular place. When they arrived, they found that someone had tied string to some beef bones and hung them above their table from the ceiling. When she asked her father why, he told her angrily that it was to mark the family as “inu” (dogs). This was a derogatory term used to label and vilify internees who were suspected of spying for the administration. This was a disturbing story illustrating the conflicts, internal strife, and rampant rumors that were part of every day life in camp. However, what was particularly striking was the way in which this former internee shared the story without any awareness of the contradiction in her initial statement. Impaired Self-Reference The development of a sense of self is widely understood to be one of the earliest tasks confronted by the infant and young child (Bowlby, 1988; Mahler, Pine, and Bergman, 1975; Johnson, 1994). Because this process unfolds in the context of attachment and the internalization of important others’ perceptions and expectations, early childhood experience is viewed as essential in influencing the child’s growing awareness of self. Early trauma may interfere with the child’s access to a sense of self – the ability to refer to and operate from an internal awareness of personal existence that is stable across various contexts and experiences. Regarding abuse victims, Briere (1992) concludes, “Without such an internal base, the survivor is prone to identity confusion, boundary issues, and feelings of personal emptiness” (p. 43). In addition, Herman (1997) asserts that traumatic events “… 32 Psychotherapy.net shatter the construction of the self that is formed and sustained in relation to others” (p. 5l). Herman further describes how the specific trauma of prolonged captivity produces profound alterations in the victim’s identity. The psychological structures of the self – the image of the body, the internalized images of others, and the values and ideals that lend a person a sense of coherence and purpose are invaded and systematically broken down. She further states, “This dehumanizing process is carried to the extent of taking away the victim’s name. In concentration camps the captive’s name is replaced with a nonhuman designation, a number” (p.93). The result, for most victims, is a contaminated identity. Victims may be preoccupied with shame, selfloathing, and a sense of failure. Madsen (1964) further elaborates that if in fact the trauma is a result of a racist act, that any one individual may have a multicultural identity or several self-conceptualizations that may or may not form a unified, culturally coherent identity. Tatsuo describes the burden of his childhood feelings, “I used to feel so ashamed of being Japanese. That somehow I envisioned that I was responsible for WW II.” His efforts to become invisible and to disidentify with his family and the Japanese American community are reflections of his efforts to resolve the abuse dichotomy. He reflects on his early years saying, “I recall having to find ways to make my family wrong, and people who looked like me wrong, because I felt wrong.” The victim of abuse often concludes that somehow if he or she could be different, the perpetrator would stop the victimization. This is poignantly reflected in Tatsuo’s early wishes as he looked in the mirror, “If I could only change these lips or eyes so that I could fit in.” Toru states adamantly, “Sure, you may try to convince yourself…I’m an American…intellectually, rationally, I know I’m American. But do they treat me like an American? Hell no…because I’m not Caucasian.” This identity split illustrates the impaired self-reference specifically of victims of racism. Identification with one’s nationality may be as equally intense a struggle as any personal identity confusion when an individual has been excluded from the rights and privileges of that 33 children of the camps identity. This author has observed in several of the group discussions that self-reference is strongly associated with a sense of belonging. The desire for attachment and belonging is requisite to achieve a stable sense of self, however the answer to the implicit question of, Who am I? depends on one’s self-reference, e.g. I am an American. When the referent source finds you unacceptable and abuses you, your identity is called into question and can lead to increased reliance on others to define one’s self. The focus on this need for belonging and the confusion surrounding it was evident in several statements made in the documentary: “There was no place I could get validation.” “They were going to demand with their lives, a place for themselves.” “This is my country, my home and nobody is going to take that away from me.” “What are you doing here?” “This was their place, their home.” “They’re going to put me in my place.” “Because there hasn’t been a place where you could really be angry.” Abuse victims are often seen as characterized by their continuing inability to define one’s self in contradistinction to the needs or views of others. Such an over-reliance on the dominant culture’s definition of the Japanese American sense of self can be seen in the phenomenon of the “model minority.” The model minority characterizes Japanese Americans as heroes of the bootstrap philosophy, the noncomplaining, quiet Americans, who have succeeded in spite of their subordinate minority status. Such myths minimize the impact of the oppression that was suffered and by implication, defines the problems of other minority groups as a result of some inherent lack of motivation or character. The internalization of this success myth presents many stresses for younger Japanese Americans. Sansei workshop participants spoke of the overwhelming intensity of the pressure they felt from their internee parents to succeed and to fit into American society. Some gave up preferred career goals in deference to their parents’ need to attain some assurance of security 34 Psychotherapy.net and acceptance in American society. One woman who had dreams of being an artist and musician described her life with poignancy, “I’m realizing now that I became a medical doctor because that’s what my parents needed as some kind of insurance against discrimination, against…being imprisoned again, not because that’s what I really wanted to do.” Tatsuo further illustrates this point well when he talks about how as a child, he felt overwhelmed by his father’s expectations of him, “I used to worry all through my childhood, would I be able to live up to his expectations?” Marion describes her father’s hard work and determination as a model for how she should live her life, “I had to kind of live up to that. And I think that really helped me because I can’t let him down.” Mass (1978) described this “model minority” striving as a means of gaining acceptance by accommodation, and the lasting effects of the internment. She concludes, “Such a defensive strategy is often at the expense of the individual’s sense of true self worth. What is sacrificed is the individual’s own self-acceptance while placing an exaggerated emphasis on surface qualities like a pleasant non-offensive manner, neat grooming and appearance, nice homes, new cars, and wellbehaved children. Though we may be seen by others as model Americans, we have paid a tremendous price for this acceptance” (p. 63). Feelings of fear, guilt or shame contributed to many Nisei’s postwar disassociation of their cultural heritage and increased desire to assimilate. Takezawa (1989a) describes the Nisei’s identity struggle, “The self-contempt and feeling of being second class citizens, the desire to prove themselves good Americans, and their aspirations to be successful, compounded by the total economic loss, the dispersal of the community, and all other factors derived from the internment and discrimination…” were added to the striving for Americanization (pp. 18-19). For some Nisei, this press toward assimilation took an extreme form, resulting not only in a desire to blend into the mainstream but also in efforts to be 120% super-Americans” (Maykovich, 1972, as cited in Takezawa, 1989a). 35 children of the camps Nagata and Takeshita’s (1998) study affirms the intergenerational affects that the Sansei’s felt emanating from the internment experience. Children of former internees, whether they themselves were interned or not, expressed a shared sense of shame or humiliation, a feeling of “assumed rejection,” and they expressed less confidence about their rights in this country. They also felt the pressure to achieve and do well as a way of continually proving one’s entitlement to citizenship. The Sansei felt pressure within their families to Americanize and assimilate into mainstream society, which may account for the inordinately rapid loss of language and culture in the subsequent generations. Thus, feelings of self-worth have been greatly influenced by the mass rejection to which their parents were subjected. Disturbed Relatedness The interpersonal consequences of abuse is often seen in relational issues such as distrust of others, anger or fear of those with greater power, concerns about abandonment, perceptions of injustice, and low self-esteem. Briere (1993) states that former abuse victims tend to assume that the world is a hostile environment, where nothing is inherently deserved and thus nothing is ever freely given. Two African American psychiatrists, Grier and Cobbs (1968), labeled this form of vigilance and defensiveness against vulnerability, as “paranorm.” This term describes the African American’s tendency to be hyper-vigilant and mistrustful – a necessary norm of paranoia that is required to survive in a hostile environment. Rather than the confident expectation of the secure individual, s/he must constantly assess the relative safety of the environment, whether at home, school, or work. Sustained use of such a defensive strategy could impact the individual’s overall ability to form intimate relationships. For Japanese Americans, the cultural value of silent forbearance and conflict avoidance could well intersect with the traumatic defenses of silence and emotional distance. As Nagata and Takeshita’s (1998) studies revealed parental expectations, family communications, ethnic preferences and ethnic 36 Psychotherapy.net identification were significantly effected by the internment experience. This author’s clinical experience with Japanese American clients indicates that for some, the internment trauma has had some bearing on Sansei marital problems regarding intimacy and communication. Family Communication Nagata (1993) states that a particularly important area of observed intergenerational trauma is that of family communication. Not unlike many Holocaust survivors, Nagata and other scholars report a similar silence has been observed among former Japanese American internees (CWRIC, 1997; Hosokawa, 1969: Miyoshi, 1994). Her study of the third generation Japanese Americans concluded that Sansei who were interned at an early age differed from non-interned Sansei primarily in their reports of family communication and family distance. Respondents reported their parents as being evasive, cryptic, or entirely non-communicative about their internment experiences. Trauma specialists view this silence as the psychological defense of compartmentalizing the trauma. More specifically, Herman (1992) describes the loss of communication within families as an indicator of traumatic withdrawal. The experience may be so traumatic that the victim avoids being emotionally overwhelmed by avoiding any thoughts, feelings, and communications about the trauma. However, not passing on information to the next generation about past suffering can create heightened anxiety in the family who may sense the intensity of the experience and yet not know how to prevent its reoccurrence. Nobu Miyoshi (1994) a Nisei social worker and family therapist has been conducting intergenerational family sessions with Japanese Americans for over twenty years. In describing her work with former internees and their families, she notes, “For the Sansei the lack of communication regarding their forebearer’s camp experience represents a symbol of an intergenerational ethnic and personal gap” (p. 8). Nagata (1993) found that virtually all Sansei reported that their parents maintained a silence about their experiences in the camps; a silence which inhibited communication generally within some families and created a sense of foreboding and secrecy about the 37 children of the camps internment in most. Culturally this silence could be defined as appropriate coping mechanisms of stoicism and internalization, a cultural prescription of self-restraint and endurance in order that painful personal experiences are not discussed publicly (Doi, 1980). Due to the language barrier and traditional Japanese values of shame associated with having emotional problems, the Issei were more likely to cope with personal problems by relying on their religious beliefs and drawing on the cultural coping mechanisms of stoicism, privacy, fatalism, and family support (Maykovich, 1972). Issei interned in the camps during the war typically did not talk about the shame and humiliation they experienced, nor of the guilt they may have felt about their children who had to be imprisoned because of their parents’ nationality (Kiefer, 1974). Traditional loyalty, propriety, and fear of retribution were also likely factors that inhibited complaining or being openly critical of the government (Kitagawa, 1967). However, Nagata suggests that the lack of communication surrounding the internment may have created a feeling of emotional distance between the Sansei and their parents and that as a result, Sansei felt a gap between their personal and family identities. Miyoshi (1994) attributes this silence to the need of the parents to protect their children from the realities of their experience as well as the cultural constraints against the expression of strong feelings. Bessie who was a teen in camp revealed that until she participated in the group workshop, she had never spoken to anyone about her internment experience, and especially not to her own daughters. Sharing her experience with others and particularly with her own children allowed Bessie to bridge an emotional and relational gap that had existed for years, “I feel better knowing that I can talk about it…because I wasn’t alone. So just being able to share is a blessing.” Marion describes her reluctance also, “I didn’t want to put my story onto anybody…for the first time I had this opportunity … that people would listen to me.” In the Children of the Camps workshops, siblings and spouses often respond with surprise to learn of a family member’s actual experience and feelings related to life in camp. Some were tragic stories of family 38 Psychotherapy.net disequilibrium and mental illness; others seemed less traumatic, yet replete with grief. A 78-year-old woman revealed to her siblings for the first time that her first name was really “Hatsuye” and not “Lillian”. None of her younger siblings knew of the name she had to forsake because her teacher told her that she would never be a true American unless she had an American name. Avoidance Trauma victims often minimize, forget, distract themselves, or anesthetize themselves with substances in order to avoid the painful memories of abuse. These defensive strategies temporarily reduce the psychic tension associated with the extremely negative affect. These include self-loathing and guilt, intense depersonalization, feelings of helplessness, or painfully fragmented thought processes. Briere (1993) sees these behaviors as abuse-related tension-reducing behaviors, to cope with the anxiety. Although the absence of research data makes it impossible to confirm the extent of this problem, it is interesting that Miyoshi (1994), in considering the psychiatric casualties among the Issei and Nisei since internment, believes that there may be some correlation to “…the puzzling drug addiction problem among the Sansei in Southern California to their way of dealing with their untenable camp legacies” (p. 46). Nagata (1993) quotes an interviewee who reported that many of his friends have had severe problems that included drug abuse. One interviewee reported, “I remember one summer there was something like 35 people that were Japanese Americans overdosing on drugs…” (p. 140). A recent documentary video by Janice Tanaka, (1999) When You’re Smiling, explores the experiences of Japanese American youth in South Central Los Angeles during the anxiety-ridden post internment resettlement period. Tanaka interviewed Sansei who describe their own experience and those of their friends abusing drugs. She also describes efforts by the Japanese American community to suppress information regarding Sansei deaths by suicide and drug overdose. She suggests that local Japanese American newspaper stories and Japanese American death certificates were written in such a way as to 39 children of the camps protect the families and the community from being exposed. Another form of avoidance by some Japanese Americans is the active dissociation from things related to the internment. Understandably, survivors of trauma typically avoid situations that serve to reactivate emotionally disturbing thoughts and feelings. However, today, particularly following the successful movement for redress and reparations in 1988, opportunities to visit historical sites, art exhibits and community events highlighting the camp experience have flourished. Though many attend and seek healing from re-visiting the experience, many have also vowed not to participate or be involved, and some have actively discouraged dialogue regarding the camp experience not just in their families, but in the community as well (Nagata & Takeshita, 1998). Silence is a powerful avoidance mechanism. Nagata, et al. (1999) has confirmed that silence was the predominant response of the parents who were interned. The fact that Sansei whose parents were interned were least likely to have discussed the internment as a central topic, in contrast to Sansei whose parents were not interned, may reflect a posttraumatic avoidance of unpleasant associations from the time. Mixed responses were received from Japanese Americans who participated in a video screening and discussion of the Children of the Camps. Some reported a sense of profound relief listening to others express feelings that they themselves felt and had suppressed for 50-plus years. Others were offended and embarrassed by the personal disclosures and expressions of anger and grief and, what one gentleman referred to as, “touchy-feely” closeness. To conclude this section, values of respect for authority, saving face, loyalty, forbearance, and acceptance of fate were clearly effective in the service of positive adaptation. However, these values along with the continued threat of individual and institutional racism, may have served as a factor in the continued legacy of the unresolved trauma (Mass, 1978; Nagata, 1993; Ina, 1997; Jensen, 1997). Adherence to familiar coping responses such as the internalization of emotions and the avoidance of dwelling on the past, along with an intense 40 Psychotherapy.net need for acceptance can contribute to an unhealthy psychological accommodation that further hinders the resolution of the trauma. Nagata & Takeshita point out, “…positive adaptation to trauma should not be equated to resolution of that trauma. New information continues to shape resilience over time and we must be careful not to diminish the internment’s enduring effects by treating it simply as a past racial victimization” (p. 603). Questions for Self-Reflection 1. How would you imagine yourself coping with life in the camps? 2. If you were imprisoned behind barbed wires for up to four years, what would be the most difficult aspect of your life? 3. How would you imagine that your family would be affected as individuals and as a group? 4. What strengths and weaknesses do you and your family have that would play a part in coping with prison life? 5. What are common lessons or messages that were passed down in your family about how to live your life? In the face of being victimized, how would these lessons serve you or not? Questions for Classroom Discussion 1. Almost 60 years have passed since the internment. Why do you think people are still dealing with its after effects? 2. Could internment ever happen again? Why or why not? 3. Under what conditions do you believe the suspension of Constitutional rights of a specified group is justified? 4. If “silence” is a coping mechanism for trauma, what are its possible long-term effects? 5. Describe how you think “effective” as well as “ineffective” coping strategies might be passed on to the next generation? 41 children of the camps Learning Exercise: A Subjective Experience The purpose of this exercise is to help students identify personally with the experience of the Japanese Americans. Rather than using a detached, historical perspective, students are encouraged to imagine themselves in the experience. By identifying their own values and their own family structure within the confines of an oppressive, unjust process, students can gain some understanding of the intersection between culture, oppression, and trauma. List five distinctive physical characteristics about yourself. List five of your most important values. Now imagine that you and all people who have the very same distinctive physical characteristics and hold the same values are identified as “undesirables.” You now have 24 hours before you are placed in segregated prisons away from society. Assume that at least 10,000 others like you will be confined together and surrounded by barbed wire and armed guards. Staying consistent with your values and your “family” as it exists today, write about the experience, in first person dialogue. Allowing one paragraph for each topic. 1. Taking only what you can carry, what would you bring with you? 2. What is the most important thing that you would have to leave behind? 3. Based on the requirement that only those with the same physical characteristics and values as yours will have to be interned, which family members would have to go and which family members would not have to go 4. What are your thoughts and feelings as you settle into your life in confinement? 5. What will be your greatest challenge and greatest strength as you 6. determine how you will survive the experience? 42 Psychotherapy.net 7. What values might you have to modify in order to insure your survival? 8. How would you imagine you would spend the time? 9. Upon your release four years later, what would be your greatest fears? And your greatest hopes? 10.At the end of your life, how might you look back on how you survived this experience? 11.What would you want your children to learn about the experience? Debriefing: What was the most difficult part of this exercise for you? Why? To what extent did your five values serve you well or work against your well-being? What feelings did you experience as you wrote? What insights did you gain about the experience of the Japanese American internees? 43 children of the camps Children of the Camps: Trauma and Healing Remembering and telling the truth about terrible events are prerequisites both for the restoration of the social order and for the healing of individual victims. Judith Herman, Trauma and Recovery The intent of this last section is to summarize and describe how the Children of the Camps documentary was used as a community intervention to promote healing from the trauma of racism. Pressures applied to the American government by third generation Japanese American attorneys, politicians, and community activists led to government acknowledgment of the wrong that had been perpetrated against the Japanese Americans during WW II. In 1988 Congress passed Public Law 100-383, known as the Civil Liberties Act of 1988, providing for a presidential apology and monetary redress of $20,000 for each former internee. The full impact of the redress is yet to be measured; however, if extrapolations can be made from abuse trauma and systemic theory, a profound healing process can take place when the victim group, with the support of the compassionate witness, (in this case non-Japanese Americans) is able to confront the perpetrator with its wrong-doing and exact some form of reparation for the harm caused. When the truth is finally recognized and publicly acknowledged, victims can begin their recovery. They can be freed to tell the truth about what happened, label the suffering and express the sorrow and anger. They can share the burden of the pain with others and convert their losses in a generative way to prevent future incidents of mistreatment. The Civil Liberties Act of 1988 gave voice to the victims of a shameful event in American history. One former internee, an 82 year old woman, attending a Children of the Camps workshop, responded to the discussion of redress, “I know I didn’t do anything wrong, but somehow I felt I had lost face and now I have my face back.” 44 Psychotherapy.net The increasingly open and public dialogue being voiced within and beyond the Japanese American community is an indication of the healing. To varying degrees the victims, in the face of their powerlessness, often unconsciously identify with the perpetrator, seeking to blame wrongdoers within their community, becoming extreme in their patriotism or dissidence, and criticizing the solutions others chose to cope with the trauma. Although conflict was suppressed within the community for years in order to avoid further vulnerability, the intensity with which various Japanese American groups or individuals are now expressing themselves is indicative of a healthy process. As former internees retrospectively evaluate their experiences before, during, and after internment, a richly diverse, controversial, and sometimes contradictory story has emerged. In addition to individual reparations granted to internees, the Civil Liberties Act allocated funds to develop educational resources available to the general public and to educational institutions. Availability of these materials can serve to counter the emotionally charged ideology and the behavior, which stems from racism. An enlightened society is more likely to be realized when an informed public is no longer able to stand silent in the face of injustice, but rather, are willing to speak out and take action to assure that an injustice, such as the WW II internment of Japanese Americans, will never be permitted to happen again. Children of the Camps Documentary and Educational Project During a ten-year period this author conducted several weekendlong group therapy sessions for former internees. During the course of the ten years, the repetition of themes and issues that surfaced were remarkably similar across workshops. Many of the participants reported that going through this process helped them to better understand themselves and the ways in which they and their family members were impacted by the internment over their lifetime. Following the workshop, participants often described a profound sense of release they experienced from being able to identify and 45 children of the camps acknowledge the trauma that they had suffered. The motivation to capture this healing process on film was based on the hope that many more Japanese Americans and other victims of racism could benefit from viewing this process. Consequently, a group of six former child internees were invited to participate in a documentary filming of the Children of the Camps group process. There were no scripts or rehearsals, and most of the participants had never met one another before the weekend filming. For specific details regarding the group process developed for this purpose, the reader is referred to “Counseling Japanese Americans: From Internment to Reparation,” (Ina, 1999 in Multicultural Issues in Counseling, Ed., C. Lee, pp. 189-206). The treatment approach, with some necessary cultural accommodations, was primarily based on abuse trauma and systemic theory. The Children of the Camps Documentary and Educational Project was awarded funding from The California Endowment, a private foundation with a mission to expand access to affordable, quality health care for under-served individuals and communities and to promote fundamental improvements in the health status of all Californians. Racism was identified as a symptom of an unhealthy social system and the goal of the project was to develop materials to be used to educate specific populations about the damaging effects of such personal and social victimization. In an effort to facilitate healthy systemic change, the Japanese American internment experience was used as a case study to examine the traumatic abuse effects of racism. The three target populations for this educational intervention included the American public, the Japanese American community, and mental health providers. To foster relevant insight and dialogue, the documentary video was used as an emotional and intellectual stimulus for discussion. Different de-briefing formats were designed for the specific needs of each group. The goals of the Children of the Camps Documentary and Educational Project were the following: 1. educate the American public about the historical injustice experienced by Japanese Americans and 46 Psychotherapy.net provide a humanizing perspective on the damaging effects of personal and institutionalized racism. 2. provide a culturally sensitive context for healing for members of the Japanese American community to safely share with others their experiences and feelings about their internment experience. 3. increase the cultural competence of mental health providers by educating them about the long-term psychological and familial impact of racism and the cultural implications for treatment of the trauma. The American Public: National PBS Broadcast and Viewer’s Guide The education of the American public is a crucial element of the systemic healing, for it was the American public in 1942 that was witness to the mass removal of innocent Japanese Americans from their homes. The absence of organized protest and outrage by individuals and groups who were aware of the injustice, reflected the abrogation of civic duty necessary to support a healthy, welldifferentiated social system. In their collective silence it can be said that the American public, caught up in the wartime hysteria, implicitly joined the perpetrator against the victim group. Judith Herman (1997) makes the point that the witness/bystander is thus unavoidably drawn into the trauma dialectic. Following the television broadcast, correspondence and email via the Children of the Camps website was received from several European Americans who themselves, or their parents, were actual witnesses to the internment. The unresolved legacy of the witness trauma was evident in the selfrecrimination and guilt about the internment expressed by some. One woman wrote about her 90 year old father who had recently passed away. She explained how he often talked with heartfelt regret about not standing up for fellow co-workers who were being fired from their jobs because he was afraid to be identified as a “Jap lover.” Letters of condemnation and racial hatred were also received; however, more typical, was the emotion-laden, uninformed comments. One of these 47 children of the camps letters closed with, “After all, look what you guys did in Nanking. The camps were the right thing to do then and now. Let your hearts bleed then sit and wait for the rest of your organs to follow suit!” The dehumanization process that effectively justifies inhumane treatment is at the core of racist thinking. Self-differentiation of the witness from the perpetrator occurs with increased understanding and empathy for the victim. This increased self-differentiation can contribute to the healing. By presenting the very personal and real stories of six people who were children behind barbed wires, the injustice suffered is “humanized” and serves to educate individuals who possess inaccurate and out-dated information. Children of the Camps will be broadcast across the country on public television broadcasting stations for three years and will also be nationally distributed to community colleges and universities, and mental health agencies. For the television viewers, a Viewer’s Guide (Ina, 2000) was made available and distributed without charge to the public. Guidelines for discussion were provided along with specific suggestions for dialogue with former internees. For classroom use, this Instructor’s Manual is being made available to any individual or educational institution that purchases the video. The Children of the Camps website (www. children-of-the-camps. org) was also designed to further disseminate information about the internment experience. Responses and requests from as far away as Russia, Israel, Japan, and all parts of the United States have been received. Funding received from The California Endowment made it possible to conduct a statewide outreach effort to publicize the national PBS television broadcast of Children of the Camps. In addition, educational workshops for schools, churches, civic groups, and similar organizations throughout California were funded. Donations from private citizens have made it possible to conduct similar educational workshops throughout the United States and Japan. 48 Psychotherapy.net The Japanese American Community: Community Education Forums Rationale: The Children of the Camps group sessions were informal gatherings that generally took place by “word-of-mouth” communication. Often, a weekend retreat was organized by a small group of friends, colleagues, or church members who shared an interest in exploring their camp experience. Over time it became evident by the intensity of expressed feelings, the commonality of the themes, and the need to share one’s story, that the experience of internment remained unresolved for many. The shame of victimization, the ostracism from society, and the suppression of feelings had left some former internees silenced and isolated. The issues permeated the community, the family, and the individual’s life in America, and yet, former internees continued to be reluctant to discuss their internment experience. The concept of community trauma, introduced by clinicians working with survivors of political repression, war, or natural disasters recognizes the widespread effects of trauma upon entire communities (Lira, Becker, & Catillo, 1988; Herman, 1997). For the Japanese Americans living in a tightly woven family and community network in small “Japan towns” or rural farming areas in 1942, the mass exclusion of all people of Japanese ancestry from the West Coast, resulted in a collective trauma. One significant aspect of the community trauma that persists today is the resulting intra-group polarization and conflict. Where there was no “question of loyalty” in the Japanese American community prior to internment, the implementation of the government’s exclusion order created a perceived “crisis of loyalty” which resulted in accusations, suspicions, in-group scapegoating, power struggles and sometimes violent conflict. Internees, like other victims who were powerless, internalized the perpetrator’s accusations. Issues of loyalty then served to divert attention away from the injustice of the internment. In reality, this so-called “crisis of loyalty” masked the true, but indefensible, “crisis of faith” that Japanese American’s were confronted with regarding the country they had called their home. 49 children of the camps Rigid boundaries of self-definition continue today as former internees refer to themselves and others as either “yes/yes” or “no/no” boys depending on how they responded to the two questions on the socalled loyalty questionnaire years ago. Internees who responded “no” to the question of forswearing loyalty to the Emperor of Japan, and “no” to the question of their willingness to bear arms in defense of America, were identified as “disloyals” and were eventually segregated and placed in the Tule Lake Segregation Camp. For most, “no-no” answers were statements of protest about their unjust treatment, rather than true statements disavowing loyalty. Identification as “loyal” or “disloyal” served to replace the previously shared ethnic pride and identity as Japanese Americans. Protests against the violation of constitutional and human rights, were now confused with disloyalty inside the prison camps. The resulting polarization and conflict reflects the complex trauma perpetrated on a community that values harmony and interdependence. Silence and secrecy are also prominent aspects of trauma. The internees’ silence about their internment experience created, for some, disconnection in the family and the continuation of defensive coping mechanisms. These consequences can have negative health effects and ultimately hamper the mastery and resolution of the trauma. Pennebaker, Barger, & Tiebout (1989) reported that the active constraint of behavior or emotional expression can cause an increase in autonomic processes. These researchers reasoned that if trauma victims are unable to discuss their experiences, they could suffer the cumulative effects of stress on the autonomic nervous system. In their study of health variables of Holocaust victims, the researchers concluded, “Disclosing an extremely traumatic event over 40 years after its occurrence has apparent positive health benefits” (p. 586). Goals: Herman, (1997) identifies the primary goal of recovery from traumatic experiences as the psychological task of “mastering” the past trauma. This mastery is necessary in order to overcome the suppressed, yet continued fear of vulnerability. To create opportunities for safe community dialogue where differences of opinions could be heard 50 Psychotherapy.net and respected, Community Education Forums were designed to enable Japanese Americans, in the comfort and familiarity of their own community, to share their stories. They could review their camp experience, increase understanding of their own and other’s experience, increase communication between family members, and open the door for further exploration of the impact of their experience on their current lives. All activities developed for the forums were designed to facilitate movement towards psychological healing and mastery. The forums were sponsored by local Japanese American churches and by community and civic organizations. The members of the audience viewed the documentary, listened to a presentation, and then were encouraged to share their experiences and insights. The educational presentation provided a framework for examining the impact of the internment experience that included: 1. the possible traumatic and long-term effects of the internment and the underlying effects of racism. 2. Japanese American culture and its positive and negative mediating influence on recovering from the trauma. 3. the generational and personal variations in coping responses to the internment experience. This community-based, educational format provided a culturally acceptable environment and made it possible for some former internees, their friends and family to view the very personal experiences of other former internees from the vantage point of the observer. Following the lecture that places the internment in the context of a societal problem, internees were encouraged to share their stories and perspectives. Community Response: The Community Forums were well attended by former internees who were now in their 70’s and 80’s as well as those internees who were children of the camps, now in their 50’s and 60’s. In addition, children and grandchildren as well as other relatives and friends of former 51 children of the camps internees were in attendance. In order to create a sense of safety and familiarity, the events were held in local churches and community centers. The audience, primarily Japanese American, often included a small number of non-Japanese people. These individuals, ostensibly representing the “witness” in the victim-perpetrator-witness abuse triangle, often provided the healing presence of the informed compassionate witness. An elderly European American gentleman spoke up following one of the video screenings, “I was reluctant to attend this event, but my very dear Japanese American friend passed away recently and I realized how little I knew about his experience during the war, so I decided to come even though I’m not a member of your church. Of course I knew about the internment, but I never really grasped the meaning and the pain of the whole thing. I’m so sorry for what you had to endure and so moved by your strength to survive.” The members of the audience were visibly moved by this man’s heartfelt acknowledgement. Nagata and Takeshita (1998) explored the various ways that the Japanese Americans demonstrated resilience in dealing with the internment. They found that, for some internees the developmental change in older adulthood toward acceptance of their internment experience contributed to the resilience that enabled them to let go of the past. For others, becoming more aware of aspects of their experience contributed to a form of resilience by providing external information on which to build a previously unarticulated sense of injustice. Though the intensity of the community discussions varied from group to group, viewing the documentary and listening to the experiences shared on screen, enabled many to gain new insight about themselves or someone in their family. One former internee reflected this resiliency while maintaining his awareness of the injustice, “What happened to us was wrong, and it was especially hard for my Issei parents, but one thing I gained from that terrible time is my life-long friends, many of them are right here in this room today. And for that I am eternally grateful.” Compartmentalization of affect and the absence of a viable frame of reference inhibit the mastery of a traumatic experience. Viewing 52 Psychotherapy.net the Children of the Camps video offered the therapeutic benefit of reviewing the traumatic experience from an observer’s safe place. Unlike the group process depicted in the video, where affective responses are fully encouraged and examined, in the Community Education Forum, the facilitator acknowledges the emotional impact of the video while carefully guiding the audience to a more cognitive level in order to allow for discussion and dialogue. The purpose of the lecture, which follows the viewing, is to offer a cognitive frame of reference. Viewers are then able to re-construct a personal perspective of the internment in light of the trauma, the racism, and the Japanese American culture. This reframing allows participants to confront and challenge their deeply felt sense of shame. With sensitivity for cultural values of stoicism and avoidance of public display of emotions, the discussion of the experience, stimulated by the video, permits participants to modulate their emotions and examine the experience with some distance. Further, the facilitator identified the silence and the divisions in the community as consequences of the victimization; and former internees and their family members were encouraged to share their stories, as part of an intergenerational healing process. In this way, the educational forums provided an opportunity to confront some of the painful and lasting effects of the trauma. Responses varied from extremely objective intellectual commentary to tearful acknowledgment of painful losses. It was evident that positive identification with the internees seen in the video facilitated personal insight into the previously unspoken trauma. Family members of former internees listened to stories shared by others and learned about the personal struggles that they never heard from their own parents or grandparents. One young man in his twenties expressed his appreciation for the documentary and the opportunity to hear former internees’ stories since he never took the opportunity to talk to his own grandfather before he passed away. There were some who were offended by the emotions and personal vulnerability expressed by the participants in the video; others denied that they suffered at all during the internment, while some followed up requesting information regarding Japanese American mental 53 children of the camps health providers who might help their family resolve remaining internment issues. For the most part, the grief shared in these community gatherings was palpable, and several people who were silent later wrote letters to us describing the ways in which they benefited from being present while others in the audience shared their stories. One man stood up, tears in his eyes, thanked the audience and said, “My father recently passed away. He never talked about his life in Tule Lake so this video and your stories are the closest I will ever come to knowing what it all meant for him.” Outcome: People attending the Community Forums shared their diverse points of view and disclosed previously untold stories. One Nisei man told about how he was able to get his Issei parents inland to Minnesota to avoid the internment; but after several months of social isolation, unfamiliarity with their surroundings, and fear for their future, they begged him to take them to camp to be with their family and friends. Sadly, all three traveled back to one of the camps, were admitted and interned for three years during which time the father died. To have other Japanese Americans bear witness to one another’s experience was a powerful opportunity for former internees and their families to share their burden. Bessie described her initial reluctance to participate. Because of the silence in her family and in her community, she too believed that she should remain silent. She shared her relief in discovering that, “I’m not the only one who suffered; others had their hard times.” Another 70-year-old internee when asked what her tears were about said, “I’m crying because I didn’t know that others felt the same shame and sadness that I have felt all these years.” As dialogue emerged between generations, this culturally meaningful educational setting afforded elders the opportunity to educate younger members of the audience about the internment. Herman (1997) concludes that, “The trauma story is part of the survivor’s legacy; only when it is fully integrated can the survivor pass it on, in confidence that it will prove a source of strength and inspiration rather than a 54 Psychotherapy.net blight on the next generation” (p. 207). A fourth generation Yonsei spoke of her new found pride in learning about the internees’ stories, “I feel so grateful to my parents and my grandparents for what they endured in order that I could have the life that I have today. I have never been so proud to say that I am a Japanese American.” Herman believes that empowerment and reconnection are the core experiences of recovery from trauma. It was evident that the Community Education Forums helped to empower individuals by placing the internment in the context of the dysfunction of the broader social system and by facilitating communication and connection within families, across generations and between conflicted groups. Mental Health Providers: Cultural Competence The third objective of the Children of the Camps Documentary and Educational Project is to increase the cultural competence of mental health providers by educating them about the long-term psychological and familial impact of racism and the cultural implications for treatment of the trauma. The examination of the internment experience from a systemic perspective requires that mental health professionals consider the pathology, not just of the victim, but also of the contextual social system in which oppression is sanctioned. The Diagnostic and Statistical Manual-IV (1994), the primary psychiatric diagnostic system used by practitioners in mental health, is largely non-contextual, placing people of color and other oppressed groups at a disadvantage when personal history of discrimination and oppression shape a worldview that is context-driven. Without the consideration of context, clinicians will be limited in their ability to determine the extent to which behavior, affect and cognitions are situation-specific, or trait characteristics, or normal responses to environmental conditions of devalued status. Racism trauma, when understood as a complex societal process, includes the interaction between the perpetrator, the victim, and the witness. The training workshops for mental health professionals include an introductory lecture followed by the viewing of the documentary. 55 children of the camps Critical incidents in the video are then used as illustrations of key concepts. These include the systemic perspective of racism trauma as well as cultural mediators of perception, symptom presentation, and coping responses to trauma. The Children of the Camps video demonstrates a group process designed specifically to identify the internalized blame, shame, and self-hatred resulting from the internment experience. The film puts the experience in the context of victimization by racism. In a safe, supportive, and empathic environment, participants share their stories, eventually identifying their losses, self-recriminations, and their means of coping with the trauma. The healing process is woven with culturally meaningful symbols and rituals that give rise to expressions of culturally embedded beliefs and values. The spontaneous group recollection of a faintly remembered childhood song in the language of their parents is illustrative of the power of the group to provide a safe journey back to a painful childhood. The trauma-laden secrets and culturally constrained expression of emotions are gently confronted to avoid the risk of loss of face. The trauma is confronted directly, and defined concisely as victimization from racism and social injustice; this is done in order to mitigate the minimization and denial previously imposed by the perpetrator. Culturally conflict-avoidant, yet caught in the grips of the “loyalty” polarity, the Japanese American participants are guided through a respectful conflict resolution process. Wide variation of emotional expression is accepted and acknowledged. A father’s expression of love, the loss of face, the experience of shame, and the resulting identity confusion are identified as culturally meaningful and, as such, provide resonance and congruence for members of the group. Following the viewing of the documentary, the mental health professionals are helped to examine the ways in which trauma and minority status interact to produce a heightened sense of isolation and disenfranchisement. Further, they are encouraged to consider how individuals who grow up and live in a context that is not congruent with aspects of their cultural identity often experience conflicts centered on belongingness, trust, and safety. Discussed in depth 56 Psychotherapy.net are the negative effects of experiencing racism on self-esteem and identity, particularly for children who are more likely to personalize the maltreatment. Clinicians are challenged to examine their own responses when issues of racism are raised or ignored by the client. In addition to having empathy and understanding in order to work effectively with individual victims of racism, mental health professionals can facilitate the reversal of institutionalized racism by directly addressing issues of their own bias and intolerance. In the workshop they are asked to examine their reluctance to confront clients, colleagues or others who make racial slurs or hold prejudicial stereotypes. They are also challenged to examine the degree of ethnocentrism implicit in their clinical approach that may limit their ability to provide culturally relevant treatment. Therapists, specifically, are urged to avoid the replication of the abuse by minimizing the trauma of racism or remaining silent about the client’s experience of racism. The familiar stance of “therapeutic neutrality” is challenged as a failure to assist the client in actively searching out and accurately labeling the experience of racism. Such neutrality inhibits the differentiation of self from the victim-witness–perpetrator triangle. Active empathy-driven involvement by the therapist is essential to strengthen the victim’s sense of self. By challenging the silence of neutrality, the therapist also differentiates him/herself from the perpetrator. The powerful presence of this compassionate witness offers dignity to the distress and offers safety and containment for the work. Only then will the client be able to retrieve memories, discharge suppressed emotions, and integrate the racism trauma, and ultimately transform the victimization experience into one of self-empowerment. Cultural competence requires that mental health professionals understand the context of oppression and their own position in that context. Those who are committed to developing such competencies can serve as powerful healing agents, not just for the individual client, but for families, communities and society as well. 57 children of the camps The Beginning For some Japanese Americans the shame of being unjustly imprisoned has inhibited the telling of their stories. The truth was sacrificed for acceptance and reintegration into the human community. In sharing their stories, Bessie, Toru, Ruth, Howard, Marion, and Tatsuo, challenge the unspoken pact between the Japanese American community and the larger society to keep the personal, emotional and psychological wounds of that event a deeply buried secret. It is our hope that through the courage of these six children of the camps that others may proclaim injustice aloud and contribute to the healing of all forms of oppression. Discussion Questions for Clinicians 1. What was it about this workshop that made it safe enough for the participants to take emotional risks and have a new experience? 2. What specific interventions or approaches did Dr. Ina use that stood out for you as having an impact on one or more of the participants? What about her approach here do you see yourself integrating into your clinical work? 3. What aspects of Dr. Ina’s work did not fit as well for you? What made you uncomfortable or seemed like something you would be uncomfortable using in your own work with clients? Talk about why you answered these questions as you did. 4. What are the most important aspects of this video for you as a therapist? In what ways do you see this approach as relevant to therapy outside the context of working with Japanese Americans who were in camp as children? 58 Psychotherapy.net References Allen, I. (1986). Post-traumatic stress disorders among black Vietnam veterans. Hospital & Community Psychiatry, 37, 55-61. Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books. Briere, J. (1992). Child abuse trauma: Theory and treatment of the lasting effects. Newbury Park: Sage Publications. Commission on Wartime Relocation and Internment of Civilians, (1997). Personal justice denied: Report of the commission on wartime relocation and internment of civilians. Seattle: University of Washington Press. Daniels, R. (1962). The politics of prejudice. Berkeley: University of California Press. Daniels, R. (1993). Prisoners without trial: Japanese Americans in World War II. Canada: HarperCollinsCanada Ltd. Diagnostic & statistical manual of mental disorders, (1994). Washington, D.C.: American Psychiatric Association. Doi, T. (1980). The anatomy of dependence. Tokyo: Kodansha International, Ltd. Fugita, S.S. & O’Brien, D.J. (1991). Japanese American ethnicity: The persistence of community. Seattle, WA: University of Washington Press. Fukuda, Y. (1990). My six years of internment: An Issei’s struggle for justice. San Francisco: The Konko Church of San Francisco. Grier, W.H. & Cobbs, P.M. (1968). Black rage. New York: Basic Books, Inc. Gusman, F., Steward, J., Young, B. Riney, S., Abueg, F. & Blake, D. (1996). A multicultural developmental approach for treating trauma. In A. Marsella, M. Friedman, E. Gerrity, & R. Scurfield (Eds.), Ethnocultural aspects of postraumatic stress disorder: Issues, research, and clinical applications (pp. 439-457). Washington, DC: American Psychological Association. Hallenberg, K. (1988). Internment experiences of the Japanese/American elderly and their emotional adjustment. Unpublished dissertation,Oregon State University. Herman, J. (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books. Horowitz, M. (1986). Stress response syndromes (2nd ed). Northvale, NJ: 59 children of the camps Jason Aronson. Hosokawa, W. (1969). Nisei: The quiet Americans. New York: William Morrow. Ina, S. (1999). Counseling Japanese Americans: From internment to reparations (pp. 189-206). In Lee, C.C. (Ed.), Multicultural issues in counseling: New approaches to diversity. Alexandria, Va.: American Counseling Association. Ina, S., (Producer) & Holsapple, S. (Director) (1999). Children of the Camps: The Documentary. Distributed by: National Asian American Telecommunications Assn. 346 Ninth Street 2nd Fl., San Francisco, CA 94103. Ina, S. (1999). Children of the Camps Viewer’s Guide. National Asian American Telecommunications Assn. Jaffe, R. (1968). Dissociative phenomena in former concentration camp inmates. International Journal of Psycho-Analysis, 49, 310-312. Janoff-Bulman, R., & Frieze, I. H. (1983). A theoretical perspective for understanding reactions to victimization. Journal of Social Issues, 39, 1-18. Jenkins, J.H. & Karno, M. (1992). The meaning of expressed emotion: Theoretical issues raised by cross-cultural research. American Journal of Psychiatry, 149(1), 9-21. Jensen, G. (1997). The experience of injustice: Health consequences of the Japanese American internment. Ann Arbor: UMI Dissertation Services. Johnson, S. (1994). Character Styles. New York: W.W. Norton & Company. Kawashima, T. (1963). Dispute resolution in contemporary Japan. In A.T. von Mehren (Ed.), Law in Japan: The legal order of a changing society (pp. 41-72). Cambridge, MA: Harvard University Press. Kiefer, C.W. (1974). Changing cultures, changing lives: An ethnographic study of three generations of Japanese Americans. San Francisco: Jossey Bass. Kluft, R.P. (1986). Childhood antecedents. New York: Oxford University Press. Kitagawa, D. (1967). Issei and nisei: The internment years. New York: The Seabury Press. Krystal, H., (1978). Trauma and affects. Psychoanalytic study of the child, 33, 60 Psychotherapy.net 81- ll6. Lira, E., Becker, D. & Catillo, M.I. (1988). Psychotherapy with victims of political repression in Chile: A therapeutic and political challenge. Paper presented at the meeting of the Latin American Institute of Mental Health and Human Rights, Santiago, Chile. Madsen, W. (1964). The Mexican-Americans of south Texas. G. Spindler & L. Spindler (Eds.), Case studies in cultural anthropology [Monograph Series]. New York: Holt, Reinhart, & Winston. Mahler, M., Pine, R., & Bergman, A. (1975). The psychological birth of the human infant. New York: Basic Books. Markus, H.R. & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, & motivation. Psychological Review, 98, 224-253. Marsella, A., Friedman, M. Gerrity, E., & Scurfield, R. (1996). Ethnocultural aspects of posttraumatic stress disorder: Issues, research, and clinical applications. Washington, D.C.: American Psychological Association. Mass, A. I., (1978). Socio-Psychological effects of the concentration camp experience on Japanese Americans. Bridge: An Asian American perspective. Winter, pp. 61-63. Mass, A. (1986). Psychological effect of the camps. In S. Taylor, R. Daniels, H. Kitano (Eds.). Japanese Americans: from relocation to redress (pp. 157 -167). Salt Lake City: University of Utah Press. Mass, A. (1999). Unpublished paper presented at the Japanese Cultural and Community Center Conference, San Francisco, CA. Maykovich, M.K. (1972). Japanese American identity dilemma. Tokyo: Waseda University Press. McWilliams, C., (1945). Prejudice. Boston: Little, Brown & Company. Miyoshi, N. (1994). Identity crisis of the Sansei and the concentration camp. Alameda, CA: Sansei Legacy Project. Modell, J. (Ed.), (1973). The Kikuchi diary: Chronicle from an American concentration camp. Urbana: University of Illinois Press. Nagata, D. (1993). Legacy of injustice: Exploring the cross-generational impact of the Japanese American internment. New York: Plenum Press. Nagata, D. & Takeshita, Y. (1998). Coping with resilience across generations: Japanese Americans and the World War II internment. Psychoanalytic Review, 85, 557-613. 61 children of the camps Nagata, D., Trierweiler, S.J., & Talbot, R. (1999). Long-term effects of internment during early childhood in third-generation Japanese Americans. American Journal of Orthopsychiatry, 69(1) 19-29. Navarre, E.L. (1987). Psychological maltreatment: The core component of child abuse. In M.R. Brassard, R. Germain, & S. N. Hart (Eds.), Psychological maltreatment of children and youth (pp. 45-56). New York: Pergamon. Parson, E. (1990). Post-traumatic psychocultural therapy (PtpsyCT): Integration of trauma and shattering social labels of the self. Journal of Contemporary Psychotherapy, 20, 237-258. Penk, W. & Allen, I. (1991). Clinical assessment of post-traumatic stress disorder (PTSD) among American minorities who served in Vietnam. Journal of Traumatic Stress, 4, 41-66. Pennebaker, J.W., Barger, S.D., & Tiebout, J. (1989). Disclosure of traumas and health among Holocaust survivors. Psychosomatic Medicine, 51, 577-589. Putnam, F. (1989). Diagnosis & treatment of multiple personality disorder. New York: Guilford Press. Root, M. (1992). Reconstructing the impact of trauma on personality. In L. S. Brown & M. Ballou (Eds.). Personality and psychopathology (pp. 229265). New York: Guilford. Takezawa, Y.I. (1989a). Breaking the silence: Ethnicity and the quest for redress among Japanese Americans. Unpublished doctoral dissertation, University of Washington, Seattle. Tanaka, J. (1999). When you’re smiling. Los Angeles, CA: Visual Communications. van der Kolk, B.A. (1987). The role of the group in the origin and resolution of the trauma response. In B.A. van der Kolk (Ed.), Psychological Trauma, (pp. 153-172). Washington, D.C.: American Psychiatric Press. Weglyn, M. (1976). Years of infamy: The untold story of America’s concentration camps. New York: William Morrow and Company, Inc. Werner, E. E. (2000). Through the eyes of innocents: Children witness World War II. Colorado: Westview Press. 62 Psychotherapy.net Earn Continuing Education Credits for Watching Videos Psychotherapy.net offers continuing education credits for watching this and other training videos. It is a simple, economical way for psychotherapists—both instructors and viewers—to earn CE credits, and a wonderful opportunity to build on workshop and classroom learning experiences. • Visit our CE Credits section at www.psychotherapy.net to register for courses and download supplementary reading material. • After passing a brief online post-test you will receive your Certificate of Completion via email. Voila! • CE Approvals: Psychotherapy.net is approved to offer CE courses for psychologists, counselors, social workers, addiction treatment specialists and other mental health professionals. • CE Available for your Organization: Our CE courses can be used for staff training; contact us for details. Psychotherapy.net also offers CE Credits for reading online psychotherapy articles and in-depth interviews with master psychotherapists and the leading thinkers of our times. To find out more, visit our website, www.psychotherapy.net, and click on the CE Credits link. Check back often, as new courses are added frequently. 63 children of the camps More Psychotherapy.net Videos New videos are added frequently. Visit us at www.psychotherapy.net or call (800) 577-4762 for more information. The Ackerman Institute Constance Ahrons Ellyn Bader & Dan Wile Insoo Kim Berg Stephanie Brown James Bugental Tian Dayton Albert Ellis George De Leon Pamela Dunne George J. DuPaul & Gary Stoner Bruce Ecker John Edwards Stephen Feldman Arthur Freeman Linda Gask The Glendon Association Kenneth V. Hardy Susan Heitler Karin Heller & Bill Domonkos Harville Hendrix Evan Imber-Black Arnold Lazarus Steve Lerner 64 Couples and Infertility Gender Differences in Depression Making Divorce Work Couples Therapy: An Introduction “I’d hear laughter” Irreconcilable Differences Treating Alcoholism in Psychotherapy Existential-Humanistic Psychotherapy in Action James Bugental: Live Case Consultation Healing Childhood Abuse through Psychodrama Trauma and the Body Coping with the Suicide of a Loved One Rational Emotive Behavior Therapy for Addictions The Therapeutic Community Exploring Narradrama Assessing ADHD in the Schools Classroom Interventions for ADHD Down Every Year: A Demonstration of Depth Oriented Brief Therapy Tools and Techniques for Family Therapy Legal and Ethical Issues for Mental Health Professionals Cognitive Therapy for Depression Suicide and Self-Harm Invisible Child Abuse Sex, Love and Intimate Relationships Voices About Relationships Voices of Suicide The Psychological Residuals of Slavery The Angry Couple Coming Out Harville Hendrix on the Healing Relationship Family Secrets Arnold Lazarus: Live Case Consultation She’s Leaving Me Psychotherapy.net Ronald Levant Hanna Levenson Marco J. D. Maida Rollo May Monica McGoldrick Donald Meichenbaum Scott Miller Jacob Moreno Zerka T. Moreno Rod Mullen Frank Ochberg George Papageorge Erving Polster Ron Scott (Producer) Martin Seligman Erik Sween Lenore Walker Irvin Yalom Harry Wexler Effective Psychotherapy with Men Time-Limited Dynamic Psychotherapy Jacob Levy Moreno: His Life and His Muses Rollo May on Existential Psychotherapy The Legacy of Unresolved Loss Mixed Anxiety and Depression: What Works in Psychotherapy Moreno Movies The Zerka T. Moreno Series Encounter Groups for Addictions Explaining PTSD PTSD and Veterans The Counting Method Connecting with Our Kids Psychotherapy with the Unmotivated Patient Psychotherapy with Gay, Lesbian and Bisexual Clients Positive Psychology and Psychotherapy Becoming a Therapist The Abused Woman The Gift of Therapy Irvin Yalom: Live Case Consultation Understanding Group Psychotherapy Therapeutic Communities in Prisons couples therapy with the experts series Jon Carlson & Mary Arnold Culture-Sensitive Therapy Sue Johnson Emotionally Focused Couples Therapy Pat Love Imago Couples Therapy Gus Napier Experiential Therapy Richard Schwartz Couples Therapy Brief therapy for addictions series Bruce S. Liese Cognitive Therapy for Addictions G. Alan Marlatt Harm Reduction Therapy for Addictions Barbara S. McCrady Couples Therapy for Addictions William R. Miller Motivational Interviewing John C. Norcross Stages of Change for Addictions Robert E. Wubbolding Reality Therapy for Addictions Joan Ellen Zweben Integrating Therapy with 12-Step Programs 65 children of the camps Child therapy with the experts series Jon Carlson Adlerian Parent Consultation Janet Sasson Edgette Adolescent Family Therapy Gerald Koocher Psychotherapy with Medically Ill Children Terry Kottman Adlerian Play Therapy Stephen Madigan Narrative Therapy with Children Bruce Masek Cognitive-Behavioral Child Therapy John J. Murphy Solution-Focused Child Therapy Violet Oaklander Gestalt Therapy with Children David Scharff Object Relations Child Therapy Anin Utigaard Person-Centered Child Therapy Robert E. Wubbolding Reality Therapy with Children PSYCHOTHERAPY WITH THE EXPERTS SERIES Insoo Kim Berg Solution-Focused Therapy James Bugental Existential-Humanistic Psychotherapy Jon Carlson Adlerian Therapy Mary Goulding Transactional Analysis Kenneth V. Hardy Family Systems Therapy Allen Ivey Integrative Therapy Jeffrey Kottler Integrative Counseling John Krumboltz Cognitive-Behavioral Therapy Arnold Lazarus Multimodal Therapy Donald Meichenbaum Cognitive-Behavioral Therapy Natalie Rogers Person-Centered Expressive Arts Therapy Ernest Rossi Mind-Body Therapy Jill Savege Scharff Object Relations Therapy Lenore Walker Feminist Therapy Robert E. Wubbolding Reality Therapy 66 Psychotherapy.net 67 children of the camps 68
© Copyright 2024 Paperzz