The radio programs run by the NGO I’m visiting that are related to the Khmer Rouge Tribunals are really too interesting to not discuss in some depth, and the discussion surrounding them led to an intriguing conversation about justice and reconciliation, and how psychiatric concepts fit in the mix. This was an eye-opener for me, as I tend to be pretty skeptical about mental health professionals who claim to have some expertise in anything other than mental health, and particularly those who claim human rights as their bailiwick.
Both radio shows are run by Dr. Muny Sothera, a psychiatrist who has worked in the national mental health system as well as with a number of NGOs for years. He and his staff partner with a local radio station and audio engineering students at the Royal University of Phnom Penh to produce two shows a week. One show features public health information on reactions to trauma that Cambodians may have during the tribunals, trauma re-experiencing triggers, and possible related topics such as how increased stress may lead to increased alcohol use, domestic violence, and child abuse. Unfortunately, this show will end in July as funding has run out for the moment, but old shows will be rebroadcast on partner stations in “the provinces” (i.e., outside the main city of Phnom Penh). The other show is a call-in program. The call-in program is hosted by Dr. Sothera and gets about 20 calls a week with various questions about the Khmer Rouge Tribunals. The staff screen for the topic of the call (some are strictly legal questions), but record all numbers and call them back later to follow-up for potential counseling and support. Both calls regularly repeat two hotline numbers for those with questions about their or their family members’ or neighbors’ reactions to the tribunals.
Dr. Sothera explained to me that Cambodians don’t really trust that the Khmer Rouge Tribunals will produce justice because they know NGOs will eventually leave, and then corruption could allow the accused to go free. Dr. Sothera thinks of justice a bit differently. He told me that through the radio program he tries “to lower the expectation of justice and get meaning from the disclosure” of the accused. The court is the starting point to get the answer, not the end. His main goal is to turn peoples’ expectations from “the angle of justice to the angle of reconciliation.” This changes the focus of the court to the future, rather than the past.
“It is a long process to get Cambodians back from trauma. After the Khmer Rouge time, there was a long extension of trauma into the next era. There was no opportunity for Cambodians to express their full feeling, so people did not recover. The Communist government did announce a holiday, ‘revenge and anger day,’ for people to express their feelings. This happened two years. For more than 10 years after the fall of the Khmer Rouge in 1979, no one said anything. Then in 1993 we had democracy. Even after this, PTSD symptoms—not PTSD, just the symptoms—of avoidance continued because we don’t want to appear weak. There was mass personality change. Now there are still a large number of anxiety disorders and cases of depression, but PTSD is not high. But PTSD I think is hidden in the anxiety and depression.
“Before 1975, there was one mental health program at one hospital. From 1975 to 1979, this hospital was used as a killing center. It was not until 1991 that a Norwegian from the University of Oslo, Edvar Hauf, MD negotiated with the government to establish a training center in mental health concepts. I was in that class.”
Mental health professionals like myself can quibble over the diagnostic appropriateness of PTSD in Cambodia or related issues, but it strikes me that that discussion would be missing the point. I think the psychological issues in this conversation are ways of discussing larger social interactions, or really the lack of genuine social interactions when it comes to a shared narrative of Cambodia under the Khmer Rouge. Perhaps somewhat ironically the use of the language of Western clinical psychology with its focus on the individual is therefore appropriate—this “pathology” is ultimately individualistic. In any case, the current idiom of distress at the community- as well as individual-level is mistrust; and, if Dr. Sothera has anything to say about it, disclosure and discussion will be the interventions employed to breach that divide.