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the appropriateness of a formal counselling service/model for the Amani client
population,
the ways in which the counselling was affected by the surrounding climate of
ongoing violence and political uncertainty,
given that each client was only to be offered a one-off session, what were the
resources inherent in their narratives that might be mobilised to enhance a
healing process,
and in what ways were these healing processes enhanced by the experience
through counselling of active witnessing and validation.
Brief summary of the literature
This study has been influenced by our reading of similar literatures in relation to the psychological
and social effects of the trauma resulting from organised violence and torture. While we will not
be reviewing that literature in depth in this report, it does seem important to note that there is a
large body of literature relating both to similar experiences elsewhere in the world and also within
the specifically Zimbabwean context. The consensus from cumulative international work would
seem to suggest that the psychosocial trauma caused by OVT is characterised by symptoms
characteristic of Post Traumatic Stress Disorder (PTSD), which might include clusters of the
following: depression, anxiety, sleep disorders, fatigue, intrusive thoughts and emotions,
nightmares, irritability, withdrawal and startle reactions (Kinsie et al 1984), and may well have
multigenerational effects within the families of victims, as well as within the societies in which
these upheavals are experienced (Danieli 1986). This latter is an important point since it would
add weight to the view that appropriate interventions now might well reduce the risk of severe
multigenerational transmission. Danieli’s work should also alert us to another truism of the OVT
literature; namely that survivors often censor themselves in retelling their experiences in order to
avoid traumatising their listeners. However, Summerfield (2000), among others, warns against
applying models of pathology to populations displaying normal distress reactions in the face of
severe and violent social events. He stresses that healing lies primarily in the development of
political cultures of human rights and social justice, and appeals for research into resilience
factors.
Zimbabwe has been the site for some important research on the epidemiology of common
mental disorders(defined as non psychotic disorders involving elements of anxiety and
depression) in community populations which has suggested that between 30 –40% of clinic
attenders are suffering from some form of common mental disorder (Patel, Todd & Winston
1997/1998). Subsequent studies indicate that in around 10% of the population chronic common
mental disorders may be attributable to experiences of organised violence and torture (Reeler,
Mbape, Matshona, Mhetura & Hlatywayo 2001). It is important to note that these studies predate
the outbreak of the current wave of organised violence prior to the Constitutional Referendum in
AMANI Trust: At the boiling point of the pain. Report of a pilot study examining the eficacy of psychotherapy for torture
survivors.