Theoretical Articles

"I Have Never Worked With Victims so Victimized": Political Trauma and the Challenges of Psychosocial Interventions in Ecuador

Gina Donoso*a

Abstract

This contribution aims at investigating critically how and to what extent psychosocial interventions are key elements of comprehensive subjective recovery from political trauma. The paper is based on the analysed data collected during a research project in Ecuador from eighteen in-depth interviews with clinical and social psychologists who had direct and indirect work experience with political trauma survivors, and thirty-seven survivors who were invited to participate in focus groups sessions based on a voluntary basis. The analysis questions which elements psychotherapy and other forms of reparative processes should take into account to address victims of political trauma in an effective and sensitive practice. The study´s main conclusions are that trauma survivors are affected by secondary victimization and their comprehensive recovery is drastically diminished because of: (1) lack of awareness of the need of political trauma approaches; (2) psychosocial reductionisms on the interconnection between the subjective and the political; and (3) psychologisation of political issues.

Keywords: political trauma, psychosocial interventions, Lacanian Other, Ignacio Martín Baró, reparations, human rights

Journal of Social and Political Psychology, 2018, Vol. 6(2), doi:10.5964/jspp.v6i2.928

Received: 2018-01-31. Accepted: 2018-06-13. Published (VoR): 2018-09-17.

Handling Editor: Thomas Teo, York University, Toronto, Canada

*Corresponding author at: Garibaldi utca 4, Apt. 32/5, Budapest 1054, Hungary. E-mail: gina.donosoroman@ugent.be

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

“Because if the psychologist is not called to intervene in the socio-economic mechanisms that articulate the structures of injustice, he is called to intervene in the subjective processes that sustain and make viable those unjust structures” (Martín Baró, 1998b, p. 176)

This paper looks at how victims of gross human rights violations in Ecuador have experienced psychosocial interventions. The poor quality of these types of interventions is related to a lack of comprehensive perspective, i.e. without a multi-layered dimension - the political, the judicial and the psychological one. Similarly, the individual and collective elements of complex traumatic human right abuses have not been deeply interconnected to complement each other.

For the purpose of this paper, political trauma is understood as the psychosocial destruction of the individual and/or the social and political structures of a society. It impacts the subject but also affects whole communities. It often undermines the social relationships between individuals, as well as between individuals and society at large. In this sense, political trauma relates to a close, ongoing circular interaction between an individual's psychological state and his or her social environment (Donoso, 2013; Hamber, 2009). Political trauma is understood as a product of gross human right violations and of State violence against individuals or groups.

Research shows that studies on political trauma do not take into account the political context (Montiel, 2000). Usually, the effects of the political context are rudimentarily assumed, sometimes tangentially mentioned as ‘something in the political environment that caused subjective distress’. The contextual conditions are rarely articulated within the paradigms of trauma and the coping mechanisms.

This article aims to explore the development and challenges of the psychological interventions in cases of gross human rights violations within the Ecuadorian context and the necessity of comprehensive psychosocial processes.

To this end, Paul Verhaeghe´s (2004) conceptualisation of the central role of the Lacanian Other on trauma is examined in conjunction with Jessica Benjamin´s (2016) work of the third. Both psychoanalytical contributions are paralleled with Latin American Liberation Psychology´s author Ignacio Martín Baró (1994, 1998a, 1998b, 1998c, 1998d)i and his work on the field of critical political psychology, and the theorizations of committed psychoanalysts from South America who worked with victims of the 70´s dictatorships in the region and their families.

Likewise, the analysis shows how victims’ recognition process should be framed within a macro perspective as well as a micro or individual perspective, in order to ensure the highest level of wellbeing of victims, their families and communities, and to prevent secondary victimizationii (Hamber, 2008). The tension between macro and micro spheres is reflected in (1) a lack of awareness of the need of political trauma approaches; (2) lack or insufficient interconnection between the subjective and political/judicial elements throughout psychological interventions; and (3) psychologisation of political issues.

The paper analyses how central issues in political trauma interventions address (or fail to address) effectively and sensitively victims´ needs. Comprehensive and politically rooted psychosocial interventions should help victims to produce new symbolizations, integrating and providing new meanings to their experiences of horror. This study shows that precisely the opposite has occurred in Ecuador, resulting in broad levels of secondary victimisation. Specifically, I question which elements are missing or weakened in contemporary psychotherapy and other forms of reparative processes in Ecuador.

Positionality [TOP]

I am an Ecuadorian researcher in the field of political trauma. I study the deep subjective impacts that traumatic violence has had on victims and the potential ways of recovery. My focus is on how social recognition needs to address specific conditions to be effective in its role of achieving positive trauma reparation. Specifically, I have been engaged in the study of psychosocial processes conducted as a way of repairing victims of political trauma. Such psychosocial processes should not be understood only as a conventional clinical treatment but as a comprehensive and bonded alliance between the subject and the attending professional. During my previous years of work in different countries, including my work at the Psychosocial Unit of the Truth Commission of Ecuador, I learned that sometimes the implemented psychological support for victims of human rights abuses had resulted in re-victimizing actions for a variety of reasons.

During the course of the interviews conducted for the research of this paper, I met several well-trained and highly committed professionals. I learned from their stories and I was impressed by their humility and their hard work. Unfortunately, they were more the exception than the rule. I conducted interviews with psychologists after and during the focus groups I was conducting with victims. During my meetings with victims and their families, they recounted some of the negative experiences when they searched for psychological support. Some of the clinicians interviewed openly admitted their lack of training and some mistakes they made during their different interventions with victims (therapy, workshops, expert evidence reports, etc.). Others defended their actions.

A number of interviews were conducted with former colleagues, professors or professionals whom I met by the snowball method (Gile & Handcock, 2011). Some interviews became vivid but respectful conversations and discussions, especially the ones I conducted in the second stage of my research, which included focus groups with victims about their distressing experiences on recognition through justice and mental health processes (Bauer & Gaskell, 2000).

I felt the need to discuss or even to question some of the psychologists’ statements and problematize their positions or interventions. However, most of the time I found myself upset and frustrated, looking for respectful ways to dispute some of their accounts. In general, the data collection worked well, the interviewees were open and the discussions dynamic and interesting. The information gathered was helpful and I felt fulfilled, acknowledging that even when some of the interviews were not conducted in the most conventional way, my interventions honored the political background that any trauma intervention should have, building bridges between academia and clinical practice with the political realities and activism, on the premise that research is ethical if it aims to transform the reality it investigates.

As Martín Baró stated through all his academic work: “the scientist is required to situate his analysis within the framework of political confrontation and even to assume a personal position in relation to them, which draws him out of his traditional squares of academic asepsis” (Martín Baró, 1998b, p. 186).

Contextual Background: Latin America and Ecuador [TOP]

Massive atrocities, such as massacres and systematic use of torture and rape in contexts of dictatorships and violent, repressive States, not only impact deeply upon victims and communities but also have consequences in national and international political and legal arenas. As a result, mechanisms to prosecute and convict both individual and State perpetrators of these human rights violations have been designed (Van Boven, 2005). International law and various forms of transitional justice aim to assist and provide justice and acknowledgement to victims and societies in post-conflict scenarios (ICTJ, 2008). Different kinds of reparations have been designed as part of these processes, which may include economic compensations to victims and relatives as well as symbolic reparations such as memorialisation sites and monuments, scholarships, medical and psychological services, public apologies, among others. By 2017, nearly forty truth commissions had been launched around the globe: in South Africa, Argentina, Canada, Rwanda, Tunisia, Uruguay and the Philippines, to name but a few (ICTJ, 2008).

Most countries of the Latin American region experienced dictatorships and repressive regimes that perpetrated gross human rights violations during the 1970s and 1980s. In South America, the infamous Condor Operation was the epitome of State violence. The Operation or Plan Cóndor was a clandestine coordination of actions and mutual support among the leaders of the dictatorial or repressive regimes of Chile, Argentina, Brazil, Paraguay, Uruguay, Bolivia and sporadically Peru, Colombia, Venezuela and Ecuador - with the participation of the United States. This coordination officially involved monitoring, surveillance, detention, interrogation with torture, transfers between countries and disappearance or executions of thousands of people who were suspected of having affiliations with radical leftist movements considered by those regimes as subversive of the established order (Mc Sherry, 2005).iii

Numerous of these crimes have remained in impunity, squashing victim´s expectations of social validation and leaving them in despair and helplessness. The silence and the lack of effective official reparative mechanisms and institutions have generated a deeper traumatic sequence (Berinstain, 2010; Donoso, 2013; Lira, Becker, & Castillo, 1991).

At the time this article is written, the political scenario in Latin America seems complex. Latin America is a region with great economic inequality and the majority of people living in poverty (Bárcena, 2016). Although, dictatorships and repressive regimes that perpetrated gross human rights violations during the 1970s and 1980s in most countries of the region finished, and the democratic transition has made significant progress in the last quarter-century. Nevertheless, a new threat to democracy and human rights has emerged in Latin American in the last years. It is the so-called Lawfare which is a weapon for fighting political enemies, combining apparently legal actions and widespread media coverage (Zanin Martins et al., 2017). Through lawfare strategies the political enemies are ashamed of becoming extremely vulnerable to the baseless accusations and once weakened, they lose popular support and any power of reaction. This has been the case of Cristina Fernández de Kirchner in Argentina, Luiz Inácio Lula da Silva, Dilma Rousseff in Brazil and Rafael Correa, Jorge Glas in Ecuador (Zanin Martins et al., 2017).

The Truth Commission of Ecuador [TOP]

The Truth Commission of Ecuador (TCE) started its work in 2008. In June 2010, its Final Report “No Justice without Truth” was officially launched. The Commission received more than 600 testimonies that allowed it to open 118 legal cases, involving the violation of the rights to life, integrity and personal freedom, including cases of disappearances, extrajudicial executions, torture, sexual violence and illegal deprivations of liberty.iv Until the writing of this article, judicial proceedings have initiated in only seven cases of the TCE.v

The Reparations Program of the Ombudsperson Officevi officially started its duties in November 2014. Within this unit, the psychosocial component was emphasized, although the team is mostly formed by young and inexperienced members, who are trying their best to reach the whole universe of victims in the country. Likewise, as is the case of most of the academia and institutions in Ecuador, there is a structural lack of training and awareness to the complexity and specificities of the psychosocial work on political trauma scenarios (IRCT, 2014; Valencia, 2011). A member of one of the very few organisations working with traumatised victims in the country affirmed that the “demand is higher than the capacity of the centre to provide psychosocial rehabilitation” (IRCT, 2014, p. 49).

The Reparations Program has conducted reparatory activities in areas like education, culture, social inclusion, work among others. In the psychosocial sphere, it has provided psychological evaluations of the victims who have already accessed the program. This evaluation carried out in the Ombudperson's Office allows the Ministry of Health to have this input to initiate differentiated care for the victims.

The Directorate has also conducted a limited number of general training programs for health personnel to provide specialized care to victims of human rights violations, especially in the area of psychosocial or mental health care (Ombudsperson, 2015, p. 6).

During an interview with the Director of the Unit, she stated that she was glad about the results obtained with the preliminary work, and that she wanted the psychosocial team to receive mentoring and to have discussions about their work, just as the possibility to implement group therapy and to have supervision on difficult cases. These elements will be examined more in-depth in the Analysis section of this paper.

Psychology in Latin America and Ecuador [TOP]

Latin America is a region with great economic inequality with the majority of people living in poverty (Bárcena, 2016). In Ecuador, the last decade (2007-2017), the government drastically improved the public expenditures on education, health, infrastructure, etc. Ecuadorians have now better access to free and high-quality medical services than before. However, distant rural areas are not fully covered and the mental health and psychosocial services have always had less support in relation to other medical services (WHO, 2008). In 2014, the Public Health Ministry presented the National Plan on Mental Health, which intended to fill these and other gaps in the mental health situation in Ecuador (Ministry of Public Health, 2014).

Likewise, one of the interviewed psychologists told me “Only people with money can afford a psychologist, I don’t know where to send people without resources as referrals.” (Clinical Psychologist/Criminologist, interview #15)

Most of the Latin American psychology roots started from the European and American psychology and is still dependent on the theories that emerged in those continents (González Rey, 2009). Though, from Latin American Psychology emerged a few important thinkers like Martín Baró who brought critical insights on power and resistance to the discipline “[…] the misery of Latin American psychology is rooted in a history of [neo-] colonial dependence” (Martín Baró, 1998c, p. 287). As many other disciplines, most of Latin American psychology recreated Western models of clinical work without considering our own social realities, cultural values, and power structures, “I am not saying anything new in saying that our Central American universities are an effective instrument for the strengthening and perpetuation of the prevailing system, as well as a drainage of mediocre bureaucrats” (Martín Baró, 1998a, p. 135).

Martín Baró goes further in his analysis of the politics of the Latin American academia and, as we will see later in this paper, his ideas are confirmed by the current Ecuadorian reality: “The majority of professionals in psychology devote their attention predominantly, if not exclusively, to the wealthy social sectors, likewise their work tends to focus more on the personal roots of problems, casting in oblivion the social factors” (Martín Baró, 1998b, p. 167).vii

More specifically, contemporary Ecuadorian scholars, like Balarezo and Velástegui (2014) affirm that “the universities of our country, most of them, have become ways of perpetuating dominant positions. Most of the academic programs in Psychology in Ecuador are undergraduate level and one of the least developed points is that of research” (p. 134).

As one of the participants said it in one of the first focus groups:

Psychology in Ecuador has a social debt, as a psychologist, I am part of it. Having access to a psychologist is easy in the private sector, but the State has no programs that provide social and psychological assistance for traumatic situations as in other countries; here we have some things, very small and small mental health initiatives in certain hospitals but with workers who do not have a professional qualification. (Yoder, focus group, Sabanilla case).viii

Theoretical Framework [TOP]

Verhaeghe (2004) and other authors in the field of trauma (Buitrago, 2007; Herman, 1997; Hollander, 2013; Lykes & Mersky, 2008; Sveaass, 2013; Volkan, 2013) state that the presence or absence of social support is a key determinant in the appearance of PTSD.ix Verhaeghe provides the example of the Vietnam vets who suffered many more traumatic disturbances than the World War II soldiers. The latter were seen as heroes while the Vietnam vets were socially hissed and forced to keep quiet about their experiences.

Although PTSD has been commonly associated with war contexts and soldiers (Boscarino, 2006; Jones & Wessely, 2005; Magruder & Yeager, 2009), trauma may affect any subject who suffers an extreme experience. In his analysis, Verhaeghe (2004, p. 321) discusses the increase of separation anxiety in cases of child abuse and early parental separation. He holds that the traumatic experience drives the subject back toward the Other because his absence or dysfunction is linked to trauma.

Likewise, Verhaeghe (2004) states that in cases of collective trauma, “the processing will almost always happen in the group, which in it itself creates the possibility for the construction of a collective discourse” (p. 327). As I will argue later in this paper, the reality in (post) political conflict situation is that this is not always the case (Berinstain, 2010; Hamber, 2009; Henry, 2009). Fear, distrust, and imposed silence among communities do not allow easily elaborations in the group and the construction of a collective discourse. In the Kurdistan Region of Northern Iraq, for instance, during one of the psychosocial trainings conducted by this article´s author in early 2017, it was common that women survivors from ISIS captivity had only received individual therapy because of the stigmatization, fear and suspicion among them. Psychotherapists found it is difficult to work with groups at that time.

Verhaeghe (2004), employs the Lacanian concept of the Other to explain the problem of trust in trauma. “The heart of the matter is that trust in the Other is missing because she or he originally failed to respond or didn't respond sufficiently at the moment of the structural trauma. In its place, we find a distancing from or fundamental distrust of the Other.” (p. 333).

The Other is a central but multi-layered concept in the Lacanian thinking which concurrently refers to the symbolic order that rules social life, a language which structures and gives meaning to human experiences and orders our cultural life, and significant others like the primary caretakers. The Other determines the identity of the subject while at the same time leaving a possibility for change and choice as well. This possibility is there because both the subject and the Other are marked by a structural lack (understood as ‘symbolic castration’) which is a liminal space where discontent and anguish coexist with self-transformation and creativity (Bailly, 2009).

Following Verhaeghe and other relevant studies on the same topic, the central aim of the trauma treatment is the creation of a therapeutic relation via an Other that will enable the patients to take the active position. “Any approach that maintains or even puts the patient in the role of passive victim merely reconfirms the original structure” (Verhaeghe, 2004, p. 335). Verhaeghe (2004, p. 336) is clear and precise as far as trauma treatment is concerned:

It has become clear in the meantime that a classic psychoanalytic approach, directed toward the analysis of symptoms through interpreting the underlying conflict, doesn't work. […] the emphasis must be on the installation of an effective therapeutic relation, through which subject amplification can occur. In this respect, it is not so much a question of presenting the patient with the ‘correct’ signifiers as of creating a relationship in and through which these signifiers can be taken in and assumed from a guaranteeing Other.

Jessica Benjamin (2016) affirms that it is necessary to restore the primordial, affectively resonant third in order to turn the symbolic Other into a vehicle for insight. In her seminal work on the Palestine-Israel conflict, she has developed in-depth the psychological position of the ‘third space’. The moral third is the analytic position of compassionate witnessing “from which the violations of lawful behaviour and dehumanization can be witnessed or repaired. It is a fragile position, hard for both individual and collectives to maintain. It is from the position of the moral third that we acknowledge violations, suffering, indignities, and the debasing of some humans to elevate others” (Benjamin, 2016, p. 7).

Within a human rights framework, the State should be the guarantor of law and social order (Van Boven, 2005), the Other who occupies the position of the “third”. This study asserts that when this Other/State has not occupied its guaranteeing position, the presence of a committed third (researcher, lawyer, therapist) although they cannot wipe away the pain born of traumatic hardship, may help to set into motion the necessary processes for subjective restoration.

The human rights context of the clinical situation has implications for the healing process of the individual patient. Parallel with the psychological and medical challenge to apply and develop further efficient therapeutic techniques in order to relieve complaints and symptoms, the patient has a need for a moral rehabilitation that optimally implies justice through legal procedures and economic compensation (Sveaass & Lavik, 2000, p. 40).

This paper draws on Benjamin´s ideas on the position of the third as a psychological position and the concrete figure of the psychotherapist or other committed others. She states that the role of recognition is an important element in the recovery of trauma. Psychotherapists occupy this position and as Verhaeghe and Sveaass argue, their unique role does not reside in the technique but in the relational space.

More precisely Benjamin (2016) affirms: “For victims, the presence of the witness, feeling recognised, is essential to being able to step back into belief in the third, in the possibility of a lawful caring world that does not turn away and leave people to be killed […]. Here we must consider a central component of trauma: the failed witness” (p. 7).

Trauma therapists will experience strong negative feelings which will interfere irremediably with their work. This can be certainly applied to operators who work in the field of human rights and humanitarian action (Dalenberg, 2000; Donoso, 2018). For Verhaeghe, it is important to pay attention to the subject amplification and the creation of a trusted relationship. For Benjamin, it is important to “observe in ourselves continually the breakdown and restoration of the capacity to hold the connection with suffering, including our own” (Benjamin, 2016, p. 7)

How can this trust and connection be established? Drawing from the experiences of Latin American psychology and psychoanalysis during the repressive regimes during the 80´s in the region, I discuss Latin American psychology, specifically regarding its political and social ideas. It is not intended to conduct an in-depth analysis of the history or development of the discipline in this region, but it will provide the reader with an idea about Latin American Psychology´s contributions on political trauma. The analysis will bring up similarities and complementarities with the contemporary psychoanalytical approaches discussed and, more importantly, it will enrich the discussion with concepts, which were born or configured in the middle of politically charged contexts. This is important for two reasons 1) The social and political spheres become a central issue; 2) a potential theoretical euro-centrism is avoided in terms of examining Latin American issues from its own perspective.

Although there are a number of influential Latin Americans in the field of psychology,x for the purpose of this paper, I will focus on Ignacio Martin Baró´s work and Liberation Psychology, as well as specific theoretical and clinical developments of the South Cone that worked in the context of the most repressive regimes in Argentina, Uruguay and Chile.

Ignacio Martin Baró was a Salvadorian social psychologist murdered in El Salvador. He is the most prominent theorist on Liberation Psychology, which was part of a broad ideological movementxi that challenged the theoretical roots and goals of Latin American Psychology. Liberation Psychology advocates personal action and social freedom, ethical power relations, education, compassion and solidarity with the oppressed majority. According to this theory, collective trauma is psychosocially embedded, it is a normal consequence of a social system based on exploitation and dehumanizing oppression. He advocated for a psychology which takes into account the history, suffering and struggles of its people. He promoted a committed psychology, which contributes to the liberation of Latin American people, not only from a theoretical point of view but also in its practice (Martín Baró, 1998c, p. 295). This has usually taken the form of political action and different forms of psychosocial accompaniments.

In Western research traditions like Europe or the United States, the history of committed psychology is different and it frequently has other names and epistemologies. “When it has occurred, often it has been seen as outside the appropriate role for a clinician or a researcher. Indeed, at times, psychologists have been censored for their accompaniment and seen as having fallen outside the prescribed practices for the profession” (Watkins, 2015, p. 330).

Martín-Baró understands political violence as the rupturing of social relationships, meaning that the healing of post-conflict situations is necessarily linked to the restoration of trust and relationship (Martín Baró, 1994). One of the main challenges of any research with trauma survivors is creating a real trust bond (Berinstain, 2010; Herman, 1997; Lira, Becker, & Castillo, 1991) between the participants and the researcher or other care-provider staff. Martín-Baró’s theory is based on the premise that scientific discourse cannot avoid being involved in those same social phenomena that it studies, since the social and political circumstances that the scientist researches also affects him/her (Martín Baró, 1998d). The theoretical analysis should not be outside of the framework of political confrontation; even more so, it should imply a personal position of the researcher in front of it, which takes it out of its traditional academic asepsis boxes (Martín Baró, 1998b, p. 167). Martín Baró (1998c) argued that ethical and political asepsis is nothing more than a pretended inconsistency about the values and interests at stake in each situation. The social sciences are not and cannot be “pure” sciences. On the contrary, they are based on a philosophy which, in turn, expresses a way of conceiving existence coherent with certain needs and interests.

A number of political and social committed psychoanalysts arrive at the same conclusions (Edelman & Kordon, 2012; Kersner et al., 2002; Viñar, 2012), through their experience working as analysts together with a human rights organization in the middle of the repressive regime of the 1970s in Argentina. As Conte (2003) affirms, the magnitude of the social catastrophe was so intense; the committed psychoanalysts of that time “questioned, interrogated and requested new ideas from Psychoanalysis´ theory and method” (p. 182). The affected population needed a politically no neutral space to be able to develop a trusted therapeutic relationship, a tie of credibility and solidary protection. Socially committed psychoanalysts and human rights organization became a place of acknowledgement of the truth, a dispositive to recuperate the Other, law and order, and to restore a subjective legality (Conte, 2003).

Rincón (2012, p. 301) also found that one of the main challenges for the analysts in relation to their work with victims during and after the dictatorship was that neutrality was seriously compromised. ‘If we remained completely neutral, the person analyzed could imagine that we were on the side of the repressors; and if we let them know of our position, it was more difficult to critically attack conflicts related to activism’.

Similarly, Kordon and Edelman (2006), psychoanalysts who accompanied the Mothers of Plaza de Mayo in Argentina, highlighted the unfeasibility to separate the psychoanalytic practice form the political reality, therefore affirming that any neutrality is impossible. In this sense, a number of Latin American Psychology representatives have left a rich legacy of a committed discipline through their clinical practice and solidary accompaniments which were never separated from their political activism.

During the Dirty War some Argentinean psychoanalysts emerged from their analytic offices to accompany Las Madres de los Desaparecidos, the Mothers of the Disappeared, to bring awareness to the abduction and often killing of daughters and sons by the State. Viennese psychoanalyst Marie Langer (1991) went to Nicaragua (via Argentina and Mexico) to work with others to establish a community mental health system during the revolution. Spanish social psychologist and Jesuit Ignacio Martín-Baró (1994) accompanied Salvadorans by listening to and then documenting the human rights abuses and State sponsored violence aimed brutally against them (Watkins, 2015, p. 329).

As put forward by Verhaeghe, Martín Baró and Benjamin, the following section discusses how the contemporary approach of victims in Ecuador meets or not the above theoretical requirements.

In order to clarify the methodological approach, the research of this paper is part of a larger research project with the goal of studying how social recognition given to victims might help to produce new symbolizations, to integrate and to provide new meanings to their experiences of horror, filling a gap that remains largely unstudied in political trauma, specifically in Ecuador.

Within this broader framework, the main emphasis of the present study is to present the current harm suffered by trauma survivors who are affected by secondary victimization which dramatically diminished their comprehensive recovery.

Because this study is part of a bigger research project, a variety of instruments has been employed, for instance, individual interviews, focus, groups, validity checks, which will be described in-depth in the following section.

Methodology [TOP]

Focus Groups With Victims / Survivors [TOP]

During the first stage of the field research, I conducted seven focus groups with participants of different cases of the TCE. Each group consisted of 4 to 7 participants. Every group met once for an average duration of 2 hours. Because of the lack or limited structures of formal support to the participants at the time of the field research, I designed an inclusive approach intended to be a helpful tool for validation and therapeutic recognition.

On the second field research, validity checks were conducted with participants of the former focus groups. Validity check sessions were designed to provide feedback to the participants, to confirm data and preliminary conclusions, as well as involving them in the study. In short, to give them some voice. Another goal was to effectively check with the respondents if the research findings matched their reality and perceptions.

Group formation met the following conditions: (1) homogeneity among the members (were part of the same legal case or were victims of the same type of violation), (2) with different levels of legal achievements of their cases, (3) they know and trust each other, (4) the groups were based in different provinces of Ecuador.

Groups were conducted in Spanish (researcher´s and participants´ mother tongue). Focus groups were based on semi-structured questions about what helped them to cope with their experiences (e.g. justice, psychotherapy) and what they would have liked to happen (or still to happen in the future). All focus groups were facilitated by the author. At the beginning of each focus group, all participants were instructed about the objective and methodology of the study and they received information on the potential psychological effects of disclosing distressing situations. The respondents were also informed of their right to cease collaboration at any point. Based on this information, all participants signed an informed consent form. Each focus group session was audiotaped.xii At the end of each session, participants were offered the author's contact details in case they needed future assistance. The author made random calls to different participants after each focus group session to check their well-being. All participants agreed to continue and no incidents were reported.

In order to encourage participation and agency from the respondents, validity check sessions were implemented during the second field trip to Ecuador in 2015 (see Picture 1 below).

Picture 1

Validity-check session with participants form Damián Peña and Miners´Association ´10 de Enero´ cases. Cuenca, September 2015.

In these sessions, the author shared the most relevant ideas and conclusions of this paper and invited active participation and discussion. Two important facts emerged:

  1. Participants agreed with the key ideas and conclusions and they unanimously requested that their anonymity is waived in this essay.

  2. Participants explicitly requested this since they considered the research on their stories to constitute another form of recognition.

In-Depth Interviews With Psychologists [TOP]

A sample of participants was chosen based on a snowball methodology. Eighteen (18) subjects were invited to participate in this study on a voluntary basis. Participants were selected on the basis of the level of knowledge or experience on political trauma.

The researcher approached psychotherapists who had worked either therapeutically or had another type of professional involvement (research, training, expert evidence, etc.) with victims and survivors. Some of them were able to suggest other colleagues for a potential interview. The researcher also interviewed gatekeepers such as the Director of the National Committee of Victims of Human Rights Violations and Their Relatives - Truth Commission, the Director of the Truth Commission’s Unit of the Office of the Prosecutor, the Advisor of the Ombudsperson Office and former Executive Director of the TCE, and academics from two universities in Quito.

Individual interviews were conducted with every clinician. The interviews lasted an hour and half and were conducted in Spanish. They were based on semi-structured questions about what the respondents considered to have been helpful for the victims during the work or interventions the respondents had with them. The researcher explained to the participants the objective and methodology of the study. Confidentiality is preserved for all these participants. Some research findings are written in an autobiographical format in order to illustrate through personal experiences the results and statements coming from this study during the seven months field research in Ecuador. It is important to clarify that the institutions and individuals who are named in this paper were not interviewees of the study, some of the discussions or exchanges were public domain or expressed through open peers’ networks sites. The researcher´s autobiographical experiences are supported by email communications which are in author´s possession.

Analysis [TOP]

Data analysis started with a preliminary phase that included the transcriptions of the audio files of each focus group and the interviews with the psychologists. Transcriptions were conducted by two Ecuadorian transcribers and the researcher. Transcriptions were done in a literal format (including expressions, interjections, crutches, diction errors and vices of language) to preserve as much as possible the original narrative and interaction. All transcriptions were reviewed vis a vis with the audio-recordings in order to correct any mistake or omission.

Each interview was typed out verbatim and then methodologically processed. The interviews were analysed in detail and coded by the interviewer, using the qualitative research software NVivo (Richards, 2005). Thematic analysis (Braun & Clarke, 2006) was used to examining and recording patterns data sets that were associated to this study´s specific research question. After initial coding, which included thematic and inductive forms, the researcher reviewed the coding and resolved any discrepancies. With a view to comparison with theoretical concepts, codes were grouped into co-ordinating codes and matrixes, this meant that the results extracted from the data were grouped according their similarities and categorised into the three main categories and their subcategories. Attention was paid to central issues how political trauma interventions addressed (or fail to address) effectively and sensitively victims´ needs and which elements are missing or weakened in contemporary psychotherapy and other forms of reparative processes. The result was three different categories and their respective subcategories (see Table 1):

Table 1

Study Results: Categories and Subcategories Concerning Secondary Victimization on Psychosocial Interventions for Political Trauma Victims in Ecuador

1. Lack of Awareness of the Need for Political Trauma Approaches
1.1 Insufficient support from State to psychosocial policies
1.2 Poor academic level in relation to psychosocial processes
1.3 Poor civil society level in relation to psychosocial processes
2. Psychosocial Reductionisms in the Interconnection between the Subjective and the Political
2.1 Psychological, political and judicial discourses isolated and disputing each other
2.2 Lack of specific approaches to political trauma and psychosocial interventions
3. Psychologisation of Political Issues
3.1 Individual clinical models mistakenly extrapolated to political trauma treatments
3.2 No awareness about the specificities of transference and countertransference with trauma affected people
3.3 Politicisation of psychosocial processes

Note. Source: Author´s elaboration.

Lack of Awareness of the Need for Political Trauma Approaches [TOP]

Insufficient Support From State to Psychosocial Policies [TOP]

State policies, NGOs and other institutions do not provide or provide sufficient psychosocial support. Moreover, the policies of psychosocial rehabilitation are mainly being transferred to public hospitals and community centres with no properly trained staff.

The Ombudsperson Office has been highly criticized among the victims´ focus groups for their reparation policies. Victims, in general, feel that they were not consulted and the programs’ activities were not tailored to their real needs. As seen earlier, the Other-State has failed to respond again and victims of human rights abuses may react with a fundamental distrust of the Other and its initiatives. Suspicion and frustration are especially felt when victims have noticed that reparation processes are not sensitive or comprehensive.

Yoder: For the reparations, they came to see how we were psychologically and, on that basis, to see if we needed psychological treatment or not. They took some tests, like HTP and the incomplete phrases test. They asked about problems with our parents, etcetera… I do not have conflicts with my dad because he died years ago [laughs of everyone] (...) In other words, there was not an adequate assessment or an interview that allows us to explain our own expectations, something more comprehensive…. It is not that they are bad professionals. No…. The problem is that they are only 4 psychologists. They work with hundreds of cases. So, the problem is the planning they have. This has created conflicts and false expectations. And many people do not understand about all this psychological stuff and they keep thinking… maybe 'I'm crazy!'.

Manito: When they took me to the testing, the doctor arrived, handed me a paper…She said, draw this and respond that. I did everything, but then she said 'I'll call you'. I still did not get the results…. (Sabanilla focus group)

Likewise, relatives of the various victims of disappearances and other human rights violations in Ecuador have generally been able to count on very little access to any kind of emotional support to help them to manage their anguish and despair.

Back in 2006, Alexis Ponce (interview), former director of the Permanent Assembly of Human Rights in Ecuador (APDH) highlighted the State and civil society´s failure on the provision of comprehensive medical care and professional psychological support services for victims and relatives of human rights violations. He describes two forms of support mechanisms to give informal or "artisanal" support to the relatives of the victims by various human rights organizations. (1) Lawyers and activists in the midst of political-legal processes accompany victims during their legal battles. (2) Victims and relatives themselves who mutually support each other in more informal and friend-like forms. In this respect, it is interesting to highlight the creation of forms of informal accompaniment, such as the so-called adopting children. This initiative consisted of one or more young people approaching a relative of a disappeared person and supported him in the human, legal and informative aspects (Donoso, 2007). Without formal psychosocial support, many of the human rights defenders became the “committed others”, they occupied the position of the “third” that witnessed, recognized, and accompanied their grief and struggle.

At the time of this research (2016-17), the interdisciplinary within the human rights work in Ecuador has improved compared to ten years ago. For instance, the Office of the Prosecutor and the Ombudsperson Office have specific psychological units to work on gender-based violence and to work with persons deprived of liberty (Ombudsperson, 2015). In this sense, awareness on the importance of psychosocial interventions has improved in recent years, but as we will see in the following lines there are still many challenges to face.

Poor Academic Level in Relation to Psychosocial Processes [TOP]

Most of the interviewees agreed on the poor or even lack of specific training to treat political trauma. As one of them stated regarding the work of one of the leading academic programs in human rights: “They have lawyers working on the psychosocial dimension, it seems to me that there is a lack, by now, kind of serious” (Social psychologist/Academic, interview #7). There is an inadequate training in specific areas of psychological intervention for victims of violence and human rights more specifically. “There is no academic training, for that specific area …” (social psychologist/academic, interview #11). The poor quality of the few psychosocial initiatives is worsened by permanent tensions and institutional rivalries. In this sense, Ecuadorian academia in psychology has not escaped the colonized forms of knowledge and power relationships analysed by Martín Baró.

“It seems to me that there are institutional fears…Like, we have this, this is our thing,… and you have that out there, let’ s see if it is convenient for me to approach you… I think these kinds of things happen ... (Social psychologist/Academic, interview #7)

During my field research, I could verify the level of this institutional/politicized disputes. As an academic, working in the psychosocial field for several years, I had accepted an invitation to lecture at the course: Accompaniment and Repair: Psychosocial Harm and Human Rights Violations at the Andean University of Ecuador Simón Bolívarxiii, which is held as a university who had openly declared its political opposition to the former government of Rafael Correa.xiv After the invitation, I published an editorial in a national newspaper criticizing a report co-written by the person in charge of that course. In my editorial, I openly stated my political support of Correa´s government. I was not contacted ever again. When I asked for the reason I was told that I had refused to participate, which was contemptuously false.xv I understand this program has run for a couple of years and sadly only a few of the teaching staff had a PhD level in psychology and all of them share the same political position.

Poor Civil Society Level in Relation to Psychosocial Processes [TOP]

Psychosocial components were usually un-prepared and improvised. For instance, the Committee of Victims of Human Rights Violations and Their Relatives and the Andean Program of Human Rights of the Andean University of Ecuador Simón Bolívar, which certainly had a well-intended project to accompany victimsxvi offered a psychosocial workshop for victims with a team of psychologists who volunteered for this event. I had the opportunity to interview the psychologists, and they admitted having only limited knowledge of the topic and were not prepared to face the complexity of the topic. One positive element of this experience is the involvement of mental health specialists in human rights areas.

As in the academic field, civil society still needs to take care not only of their goals and techniques but of their relational space with victims and survivors as well. The role of a sensitive and acknowledging “third” is still limited.

“Then there was a fairly strong impasse because of ehm, probably, it was my mistake. The fact that we tried to do a workshop with the victims. The workshop´s goal was to help victims to process their bereavement, meaning, to help them so that their victimization could lead to another signifier. But ehm the mistake was that it was impossible at that time. It would probably take longer than a few sessions. ¨ … I have never worked with victims so victimized” (Clinical Psychologist/Academic, interview #3)

In explorative interviews with some of the gatekeepers who had also organized this activity, they said that victims had openly manifested their negative feelings with this activity. They said they felt that they were treated like children, they were not interested in drawing anything and they were angry with the psychologist who questioned their status as victims, participants ended up very upset, claiming that they felt delegitimized and disavowed in their victim´s identity.xvii

Something similar happened with a human rights organization, the INREDH.xviii I had requested an interview with the one who was in charge of the psychosocial area. I was re-directed to the social worker of the organization that also functioned as administrative president of the organization. The interview never happened because when I arrived on time, I was rudely communicated they had cancelled all the appointments scheduled for that day because the interviewee “had to leave to court, and when she has to go to court, all her appointments are automatically cancelled”. I was angry and requested more information regarding this sudden cancellation; more specifically, I was interested in how they communicate such sudden cancellations to the beneficiaries (some are from outside the capital), usually victims and organizations. I asked if this happened frequently. I was defensively informed, “if there are people who want to speak with somebody from the psychosocial area, the colleagues from the legal team, who know very well the psychosocial work can easily take over the task”.

Psychosocial Reductionism in the Interconnection Between the Subjective and the Political [TOP]

Psychological, Political and Judicial Discourses Isolated and Disputing Each Other [TOP]

Psychology, politics and legal discourses are isolated and disputing each other. The intrinsic interdisciplinary character of psychosocial work in complex areas such as human rights is challenged because it goes beyond the comfort of their own discourses and practices. Ethical responsibility as a clinician is thereby challenged.

The place of the victim also makes it impossible for them to have a sense of responsibility…meaning how and why they are in that position of victims. Although some people settle for the economic compensations, [judging tone] that is not going to fix the problem... (Clinical psychologist/Academic, interview #3)

For example, this is a quotation from an academic who conducted a workshop with a group of victims and survivors. During the interview with him, I also realized that he understood reparation mostly from a specific psychoanalytical (Kleinian) perspectivexix and he was under the idea that reparations only meant financial compensation. He acknowledged that he didn’t prepare well for this workshop “the error I assume is not having understood that it was a process that needed a broader vocabulary, to speak more on their terms” (Clinical Psychologist/Academic, interview #3)

Most of the clinicians interviewed acknowledged their lack or insufficient attention to the interconnection between the subjective and political and judicial elements throughout the different psychosocial interventions.

I think we should work on this ... something that is urgent here ... to concentrate much more on the articulation of the law with the psychological. It does not exist, practically. Lawyers have no psychological training and no psychological counselling. Eh, yes, then, that is a void and ... and that ... proves that there has been no reflection on how to address all these problems. (Psychoanalyst, interview #2)

Some of the gaps and secondary trauma experienced by the participants are the result of the lack of understanding by the clinicians of the contexts and human rights discourses; they stayed far too much in their limited therapeutic or even very personal understanding of legal concepts. In this sense, Martín Baró’s theoretical principles on political trauma have been absent. If social scientists or practitioners pretend to work on the transformation of determined phenomena, they need to understand first the political and social system behind it. If the macro-contexts are dismissed or poorly understood, the suffering and struggles of the subjects are only captured partially and much of its complexity will be lost.

“I think that it is very important that a team working on these matters, is a team in favour of human rights as ethics ... meaning that it should be clear that their work is to concentrate on the victims. If it is not like that ... they could be prone to disqualify people's feelings”. (Psychologist, interview #5)

Likewise, even when a few clinicians had some knowledge of human rights and general legal notions and procedures, most of the psychologists interviewed were confused about the legal and psychological connotations of the different working concepts. For example, the following quotation expressed by a clinician employed in forensic areas confuses the subjective pain that a policeman may suffer by following torture orders with the actual concept of torture.

...it is much easier to empathize with the policemen who acted as torturers ... because, unfortunately, they had to follow orders and their mandate was to follow orders. They were also tortured. For them, torturing others was a torture itself. For many of them, it was torture. But, they have been punished too. (Clinical psychologist, interview #14)

Torture, as a human rights violation, is understood as any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining information or a confession, punishing, intimidating or coercing, or for any reason based on discrimination of any kind, and such pain or suffering is inflicted by a public official (UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. 1984, Art 1).xx Equalizing the suffering of victims with the one experienced by police officers that tortured them is conceptually and legally wrong. From a psychosocial point of view, these types of conceptual mistakes may have important consequences at the practical and ethical level as well. Martín Baró (1998c, p. 300) states it very clear:

In the face of torture or murder, for example, you have to take sides, which does not mean that objectivity cannot be achieved in understanding the criminal act and its actor, torturer or murderer. Otherwise, we will easily condemn the death caused as murder for the guerrilla, but we will condone and even exalt death as an act of heroism produced by the soldier or the policeman.

Lack of Specific Approaches to Political Trauma and Psychosocial Interventions [TOP]

As we saw earlier, there is more awareness about the need for psychosocial interventions; however, training to work with trauma is not considered a priority by leading institutions. Even when some of the psychologists interviewed admitted there is such a need, there is no awareness of the importance of political trauma interventions.

Because, in fact, the level of anguish that one can have with these types of stories is frightening. One does not want to work with this kind of things because, if you want to do a serious job, you need specific training and therapeutic support, ... because, really, this work moves everything inside you, uh, it makes this field very unattractive ... (Psychoanalyst, interview #1)

This lack of understanding of the need to apply specialized trauma interventions is notorious in the Ombudsperson Office, which is the official institution implementing policies regarding reparations. The 2015 Ombudsperson Office Report (p. 2) states that five psychosocial workshops were carried out in relation to the following topics: 1) attention to victims, 2) emotional discharge, 3) neurolinguistic programming, 4) victim profile, 5) empathy and assertive communication. The report does not include any reference to trauma trainings, assessments or interventions. It does not refer the theoretical or methodological approaches used in their work. The report mentions that the psychosocial team held 862 individual meetings, but it does not mention the total victims they worked with, in what cities or the methodology.

It is not clear from the report if the treatments offered by the psychosocial team took place only in the capital Quito or it included other cities. The report either mentions whether group or family psychotherapeutic processes were offered. Finally, the report does not mention if the staff received any psychological support or if the psychosocial team held case supervisions. In order to clarify many of these uncertainties, on 27 October 2017, a questionnaire of 15 questions was sent to the Director of the Reparation Program of the Ombudsperson Office. Two subsequent reminders were sent, but until the date of writing, any response has been received.

Moreover, during my research stay in Ecuador in 2015, I agreed to voluntarily mentor the team and we scheduled several meetings. These were repeatedly cancelled for different reasons, because of the limited availability of the psychosocial team.

Likewise, given the lack of formal medical and psychological services, victims and family members contacted either private professionals or clinicians linked to the general public health system, with as a result that the treatments were even more isolated from the political and legal process. According to victim´s accounts, psychological consultations were experienced as counterproductive and not focused on the political space of the suffering, and often trying to solve without any preparation or orientation, their feelings of sadness, anger and guilt.

G.: How is your psychotherapeutic process?

Manito: I started almost a month ago, but I have only attended two sessions, due to work issues. […] The doctor has just taken only general data, nothing more.

G.: Is it in a hospital?

Margarita: Yes, it is a public institution.

Manito: But, it is far away. I do not have time. It is in Zamora, an hour and a half. It is also different. I am alone there. For me is more helpful to talk to all of you, to listen to everyone…

(Sabanilla, in-depth focus group, 2 October 2015)

Finding and receiving recognition from the other within a safe relational space is what represents the truly reparatory effects for victims. As Verhaeghe (2004, p. 327) has affirmed, “In cases where the Other doesn’t respond, all the subject can do is to take the guilt upon itself” (p. 327) which implies a truly long-term revictimizing process for the subjects.

Psychologisation of Political Issues [TOP]

The psychologisation of political problems is probably one of the most present categories in the approaches taken by the clinicians and it was referred as one of the main complaints from the victims and relatives during the focus groups (focus groups 1,4,7; interviews 1,7,8,13). This category is expressed via different forms as it is analysed below; it brings up the application of traditional approaches and resources in clinical psychology to deal with political trauma survivors and their families. Although we have revised some of these problems in this paper (e.g. individual v. family or community focus, medicalization, among others), this category points out specifically to psychotherapeutic techniques, for instance in the bereavement treatment which in trauma situations and in politically trauma interventions must be worked with a different approach because of its complexity (trust issues) and social-political implications.

I think we need someone ... very professional ... someone who can help us with our experiences ... I remember very well a psychologist who told me that the time to experience mourning was six months and that bothered me. I said ‘What! I have my own time’. Another psychologist told me ‘Well, in any case, we know how your situation is. Nobody can do anything to change what you have been through. You have to learn to live with what happened.’ I told myself, it's like this lady is thinking that she invented the warm water .... [Laughs] ... I know that's my reality, I'm learning to live with it. This is not news to me… (Sonia B., focus group, Damián Peña case)

A positive element was the capacity of agency shown by most of the victims and survivors. Most of them were able to realise that the approaches used were not helpful for them, and they as well stood up against these non-trusted nor supportive Others which is a remarkable sign of strength and agency, which are important elements for recognition and repair.

Individual Clinical Models Mistakenly Extrapolated to Political Trauma Treatments [TOP]

Most of the psychologists interviewed agreed that there is no real understanding and training to deal with political trauma, with as a result that they apply their traditional model without modifying their approaches.

Oh, well, I work with a plan, which I know it by memory. I work with a four stages plan: shock, emotions processing, and acceptance, normalizing and re-signifying. This plan works for everybody; it is the same for everyone. (Psychologist, interview #16)

Another problem is the over-emphasis on working with the individual, and not with the family or the group. The family and social problematics are barely considered. This a form of privatization of a social grief.

When we gave testimony at the Truth Commission, there were psychologists with me, it was individual. Since then, nothing else has happened. It was only the story, meaning I began to tell my story from my point of view. Since then, we haven’t had another support, some sort of guidance to be able to speak among us... (Jefferson, Sabanilla focus group)

Such a focus on individual approaches, leaving aside treatments who can be more group centred, is a real problem. Group work might be helpful to de-privatise the grief and would help to politicise again the core problem. The group breaks what the repression tried to establish, breaks the silence of the lived torture and allows rebuilding the trust in human beings. It may also be the space to share solidarity, acceptance and recognition.

One exception to this was the HIASxxi work methodology. While working on an individual basis, they also maintain two forms of group work. Reflection groups (open groups to share similar experiences) and Psychotherapeutic groups (closed and with persons who attend on regular basis and have previously received individual treatment) and they are involved in community work as well (offering psychological spaces in suburbs, hospitals, etc.).

As it has been put forward elsewhere (Donoso, 2018) group work is the best way to work with survivors of torture and political violence in order to create a conscious, political understanding of the traumatic events (Lira, Becker, & Castillo, 1991; Sveaass & Lavik, 2000). “For survivors of prolonged, repeated trauma, groups can be a powerful source of validation and support” (Herman, 1997, p. 157).

No Awareness About the Specificities of Transference and Countertransference With Trauma Affected People [TOP]

In an earlier work (Donoso, 2018), I discussed the prominence of (counter) transference in trauma intervention.xxii As Dalenberg (2000, p. 173) affirms: “The majority of trauma specialists note that anger and hostility are a major problem in traumatized populations and a major counteraction in trauma therapists.”

As for this article, it is important to highlight that the psychologists interviewed had a tendency to overlook countertransferential processes. With the exception of a few clinicians, many of the interviewed perceived the intense feelings of their clients as personal attacks. “Countertransference monitoring’ of negative feelings in the therapists may become key to ethical research and potentially have a partial reparatory effect” (Donoso, 2018).

“I was upset because, actually, ehm it seems to me that I was wrong, I should have taken into account more vocabulary and more time. Although I was annoyed too because dammit! I also believe that ... victims should be more open-minded if they remain in the place of victims, it is impossible to have a sense of responsibility...” (Clinical psychologist/Academic, interview #3)

Furthermore, this mismanagement on (counter) transference, besides affecting trust and impairing the development of a working therapeutic relationship, translates the clinicians´ own fear and anxieties in an unnecessary use of psychological testing, in emotional distancing and excessive medicalization.

“I felt uncomfortable ... because it seemed more like a ...educational psychologist ... specialized to deal with children because she started like this "please ehmm draw me a little house, draw me the little tree, draw me the figure of a child, a girl "... NO!!! ... I would have liked to draw my reality ... what I have inside ... my reality is so different.” (Sonia, focus group Damián Peña case).

To illustrate another example in relation to the medicalization and the use of non-political approaches to political trauma interventions. During an interview a few years ago, Don Pedro Restrepo,xxiii told me that he and his wife Luz Helena Arismendi had visited a psychologist looking for some help after the disappearance of their children. The advice they received back then from the psychologist was that their problem was “the lack of forgiveness towards the perpetrators”. Don Pedro and his wife were advised to forgive and to let go the offence committed, in order to feel better. They felt this was an over-simplification of a more religious approach they were not searching, and even within a religious context the question of forgiveness in relation to institutionalised violence might be considered very carefully. They also visited a psychiatrist during that long overwhelming time searching for the truth of what happened to their boys. Don Pedro recounts how his wife received a prescription for a strong anti-depressant, which ended up with causing even worse effects. Evidently, when I asked Don Pedro if he thought that Psychology had helped him in any way, he replied: "there is not and there was not back then a better therapy than the daily struggle for clarification of the disappearance of my children."

As in the case of Pedro Restrepo, many victims and their families searched support and guidance on psychotherapists and other psychosocial specialists. The rupture of trust, the failed Other are not only in the figure of the State but also de judicial institutions and the mental health workers and public health services in general.

Politicisation of Psychosocial Processes [TOP]

Hitherto, the main problem of the psychologisation of political issues has been discussed. Conversely, a more recent problem has been identified. There is a younger generation of psychologists who are more involved in national and international political issues. The young psychologists, as other segments of the society became involved in the political discussions as part of a social concern for the great economic inequality and the majority of people living in poverty that Latin American region had experienced, especially since the 1990´s (Bárcena, 2016). However, this well-intended political involvement seems to have overtaken the psychological aspects of their work. The subjective dimension is denied and absorbed by the political dimension. In addition, this political dimension was frequently a factional one, which usually resonates the psychologist´s own political position.

I am visiting communities that have suffered permanently political violence. A multinational corporation is stripping them of their territory. Psychotherapy or reparations or any external care is useless. The only useful resource here is the organizational strengthening. (community psychologist, interview #6)

I will use a real case to illustrate this category, that because of its complexity deserves a special consideration.

Case Study: Colectivo de Investigación y Acción Psicosocial de Ecuador

I had the opportunity to assess extensively psychosocial some reports authored by the Colectivo de Investigación y Acción Psicosocial de Ecuador. I publicly criticized these reports in two editorial opinions published in a national newspaper (Donoso, 2015a & 2015b). I argued that the reports are “basically a compilation of positions and facts (uncritical, undocumented, not collated and subjective) of a specific social group, which is politically opposed to the former Rafael Correa´s government. That most of these so-called psychosocial reports are in fact covered political-ideologically aligned documents under the label of neutral and committed “psychosocial” activists. The positions of other political groups, institutions, and State actors with opposing views are not collected. There was no proper documental research that complete or contrast the information received and there was no investigative methodology.“
The Colectivo defines itself as “a group of researchers, academics and activists who work for the defence of the human rights and the environment from a psychosocial perspective”.xxiv Officially, they stated neither a political affiliation nor where their funds come from, which is relevant to the issue of independence and impartiality, despite that they were publicly exhorted to do so. In reality, a number of members of this group were supported by political-social organizations and leaders, that are openly opposed to the government of that time (Donoso, 2015a).
In order to clarify the political context, the following lines will summarize key ideas of Rafael Correa´s government and the opposition groups. Rafael Correa Delgado was the President of Ecuador from 2007 to 2017. Correa is a PhD in Economics, who describes himself as a Catholic leftist and an advocate of "socialism of the 21st century". He took office in January 2007 and was re-elected in 2013. Polls consistently put his approval rating highly, making him one of the region's most popular leaders. (Miroff, 2014). Despite strong opposition from some environmental, indigenous, and right-wing conservative groups, and an attempted coup d’état in September 2010, Correa brought political and economic stability to the country after multiple external and internal macro-economic challenges the country faced before and during his mandate (CEPAL, 2016). His government sought to improve people’s quality of life (buen vivir) by strengthening public sectors such as education and health, consolidating the transformation of the judicial system, and promoting environmental sustainability (Senplades, 2013).
Correa´s political opposition parties have argued that he is an authoritarian figure who has concentrated all the powers, and who wasted the country´s oil revenues in unnecessary social programs and corruption. He has also been accused of silencing media and civil society organizations that challenge him although a number of these organizations were accused of stirring up rowdy and aggressive protests and hiding a funded a hidden political agenda (El Telégrafo, 2013). Correa argued that his detractors have used false or partial data to delegitimize his economic program. Correa and other left-wing leaders of the region have even accused directly to the media and other organizations of being covered political actors using the media power for informing citizens deceitfully in order to profit their own economic interests in the country and the region (Andes, 2017).
Likewise, I also argued that the documents published by the Colectivo mainly politicise the debate in a disguised way. There is no single information regarding the methodology they used. Although it incorporates a few quotes of scholars from liberation psychology, it comes down to a unilateral descriptive account, which does not seek to adopt an objective position in its analysis nor to clarify the different facts and scenarios. It disguisedly supports the political opposition perspective. The references are not triangulated, they refer only to the documents that media (without contrasting) or politically aligned groups have published.
One of the members of the Colectivo addressed my first editorial opinion via a psychologist’s network she and I are part of. She argued that the Colectivo’s document is not required to meet the principles a I stated because “the report does not pretend to be a doctoral research”, that she considered my editorial as “part of the strategies of repression [they] are denouncing”, and that they will suffer “collateral damage” because of my editorial opinion.xxv I would like to highlight that to the date this paper is written, the Colectivo has published several similar reports and has captured a good level of media attention without any physical, financial, or any kind of repression.
Finally, it is important to mention that in my editorial articles, I publicly stated my political support to the former government of Rafael Correa Delgado and although I was criticized as biased, I argue the opposite; it is important to state clearly from what political and epistemological position we are discussing. As a committed social scientist, it is necessary to clarify the theoretical, political, and ethical position from which we research and write.
It is especially important to understand that neutrality and objectivity in academia do not have the same meaning. As Martín Baró (1998d, p. 65) states very emphatically: "ethically the scientist cannot stop taking a stand against these phenomena, but the bias that always implies taking a stand does not have to eliminate objectivity. It is absurd and aberrant to ask for fairness to those who study drug addiction, child abuse or torture (...). It presupposes that in taking sides, it abandons scientific objectivity, thereby confusing partiality with objectivity."
Taking a political position, as in this case, does not mean per se that one has lost objectivity. You can be partial and at the same time analyze the phenomena with total openness to real data.
This is only one example of how psychosocial but also human rights and democracy discourses have become disguised political tools without acknowledging this position, whilst confusing neutrality and objectivity as discussed in the theoretical framework.

Conclusions [TOP]

State terrorism and impunity have left indelible marks on the victims. The goal of clinical interventions is not to erase their identity as victims but to provide an ethical and relational support to produce new symbolizations or understandings; new meanings to their experiences of horror through social validation and recognition.

From a Lacanian reading of trauma, the presence or absence of social validation by the Other (State, society/psychosocial processes) clearly influences trauma and recovery processes. Victims’ encounters with this Other via the State or any other committed professional working in the area of human rights may help to produce new narratives and understandings to their traumatic experiences.

Likewise, Liberation Psychology, a Latin America rooted psychology, entails a highly political and ethically implicated position in favour of the oppressed people and actively advocates social resistance. This position is pivotal to develop trust and confidence among victims, to install a reparative Other for the survivors.

In their early work, Breuer and Freud (1895/1957) argued that there are impressions or memory traces that may not acquire all their meaning at first, but only at a later period. They developed the idea that to constitute a trauma, two times are needed. A first event that goes beyond the capability of the subject to account for it at the time of happening; and a later one, where that first event retroactively acquires traumatic value. In the social traumatisms produced by State terrorism, roughly and schematically, one could say that the first moment is, for example, the torture or the disappearance of a subject, and the second moment the encounter by the subject with the State-caused impunity with respect to those acts when the Law does not act (Guilis, 2009, p. 286). Trauma is especially traumatic when it is repeated. My research demonstrates that secondary trauma or re-victimization is broadly spread, not only from the inevitable judicial battles and impunity, but also and paradoxically enough, as a consequence of psychological interventions.

The psychologists here instead of helping you they make you crazy... I am even afraid to go to a psychologist. When I went to one, he told me “…but your husband beat you, mistreated you [judging tone]”. I said to myself, I must never come back. I will not come back ... I will never come again…. They just ask many questions and oblige me to remember….I do not want to tell them everything. I do not want to remember anymore… They said to me: ‘but, you have to tell me everything, you have to remember everything, only then I will be able to help you’. And then they gave me valerian tea and that's it.” (Rosario, Miner’s Association ‘10 de Enero’ focus group)

A worrying effect of this problem is that impacts on second and third generations are widely overlooked. So far, research on transgenerational damage (aiming at specific therapeutic interventions for second and third generation) is absent. This is the central theme that needs more attention in the future. “The importance of the social context in the transmission of transgenerational damage, and the re-traumatising incidence of impunity in individual and collective bereavement constitute a matter of obligatory study which represents a legacy for future generations” (Bekerman, et al., 2012, p. 259).

The lack of an appropriate therapeutic handling of political traumas has had as a result distrust and suspicion from victims and survivors when they are suggested to attend to psychological interventions. On the other hand, lacking psychological support for many years developed in a few cases in the empowering of political and social actions and in positive coping mechanisms in the victims themselves:

For us, doing social action was like therapy. Solidarity activities, political organization were one of the things that helped us initially to appease the trauma (Miguel, Sabanilla focus group).

The role of psychosocial and psychotherapeutic processes is important as they may provide some partial effect of recognition as psychotherapists participate with the other in an active process of encounter. I would like to highlight the word “partial” because comprehensive reparation must happen inevitably in the socio-political, judicial levels. This study has focused on what is necessary for these encounters to be truly reparative for victims of human rights violations. In summary, the findings confirm that there is a need 1) to increase awareness on the importance of specialized trauma approaches for victims of human rights abuses 2) to tailor psychosocial programs according to victims needs and contexts 2) deep interconnection between the subjective, political and judicial elements throughout psychological interventions; (3) for an increased awareness of the need to design social and political frameworks for political trauma treatments, where the emphasis must be on the therapeutic relationship and work with groups and family models to complement any individual models. Gender, ethnic origin, social class and age are also variables, which should be taken into consideration, but all these are beyond the scope of this study.

The empirical analysis and the literature reviewed in this paper allow me to argue that interventions with an ethical focus on the subject may become not only a mean but a positive reparatory intervention by itself.

If we want psychology in general and psychotherapy in particular to make a significant contribution to our people´s history, if we as psychologists want to contribute to the social development of Latin American countries, we need to rethink our theoretical and practical background, with a focus on the lives of the victims and their context, their suffering, aspirations and struggles. As Martín Baró (1998d, p. 314) has stated:

The problem is more of an epistemological order than a conceptual one, more methodological than theoretical. What fails are not so much the Psychology´s concepts themselves as the dialectical moment of their connection; what ends up distorting the vision of reality is not so much the theory that is applied as the object to which it is intended to apply it.

Furthermore, psychology and human rights must be articulated to offer a comprehensive vision that allows testing new formulas for the reconstruction and repair of conflicts both within individuals and the society as a whole. Specifically, in Ecuador, psychology has the responsibility to respond to the needs of its political-social problems. It is necessary to question its field of action and to rethink its conception of the subject and its realities.

Any form of psychotherapy may work on individual symptoms, but in case of social pathologies, it is necessary to take into account the social roots. The rupture and the silences imposed on the individuals must be returned to the social. It is necessary to pass from the private and individual to the public and political sphere. Psychosocial interventions for victims and survivors of political trauma should involve a comprehensive perspective with a multi-layered dimension of the political, the judicial and the psychological. In this respect, a clear political positionality is a crucial element in order to avoid false dilemmas regarding objectivity and partiality. Similarly, the individual and collective elements of complex traumatic human right abuses must be deeply interconnected to complement each other and co-exist amid tensions and dilemmas.

In summary, this study´s worrying conclusions are that human rights victims in Ecuador have been broadly affected by secondary victimization and their comprehensive recovery is drastically compromised because of issues regarding to (1) lack of awareness on the need of political trauma approaches; (2) psychosocial reductionisms in the interconnection between the subjective and the political throughout psychological interventions; and (3) psychologisation of political issues.

Notes [TOP]

i) Martin Baró´s quotations cited in this article are all author´s translation.

ii) Secondary victimization refers to poor or inadequate attention received by a victim from the criminal justice system, health institutions or others (Campbell, 2005).

iii) Due to its clandestine nature, the precise number of deaths directly attributable to Operation Condor is highly disputed. Some estimates are that at least 60,000 deaths can be attributed to Condor, or even more. The number of killed and disappeared by country during the operation is, on estimated numbers that stand as the bare minimum, 7,000–30,000 in Argentina, 3,000–10,000 in Chile, 116–546 in Bolivia, 434–1,000 in Brazil, 200–400 in Paraguay and 123–215 in Uruguay (Grandin, 2001).

iv) The TCE’s analysis included serious human rights violations committed between 1984 and 2008. The study identified a State policy of human rights violations during the period 1984-1988 and stressed the need for structural changes in several public institutions where violations have continued until recent times. The prevalence of the type of violations was torture in 88% of the cases and unlawful deprivation of liberty in 68%. The main alleged perpetrators were the police and the military. After the closure of the TCE in 2010, the National Prosecutor’s Office opened a special office for the TCE’s cases.

v) a) Vaca-Cajas y Jarrín, b) José Luis Lema y otros, c) Damián Peña; d) González et al., e) Amada Suárez, f) Arturo Jarrín, and g) Terranova. As a result, current and former police and military officers are currently on trial.

vi) An interdisciplinary team of sociologists, psychologists and lawyers composes the Unit. External training, including informal meetings and interchanges with the researcher, has been helpful to delineate their working principles and guidelines.

vii) See also Layton, Gutwill, and Hollander, 2006, pp. 39-40.

viii) Unless otherwise stated all participants´ quotations in this study are author´s translation.

ix) Posttraumatic stress disorder is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, or other threats on a person's life (American Psychiatric Association, 2013). For the purpose of this paper, the concept of trauma is used to differentiate the medicalised, apolitical and Westernized DSM approach on trauma (Summerfield, 2001).

x) Enrique Pichón-Riviere, Jose Bleger, Arminda Aberastury Maritza Montero, Elizabeth Lira, Marcelo Viñar, among others.

xi) Liberation theology was developed within the Catholic Church in Latin America in the 1950s and 1960s, arising principally as a moral reaction to the poverty and social injustice in the region. Critical pedagogy and its foundational texts Pedagogy of the Oppressed written by Brazilian educator Paulo Freire (2005), who proposes a pedagogy with a new relationship between teacher, student, and society.

xii) Audios and transcriptions in author’s possession. Transcriptions were made in Spanish by two Ecuadorian transcribers under the researcher’s direct supervision. Relevant paragraphs were translated to English by the researcher for the purpose of this and other related papers.

xiii) http://www.uasb.edu.ec/oferta-academica?curso-abierto-impactos-psicosociales-y-violaciones-de-derechos-humanos&o=caracteristicas

xiv) Rafael Correa Delgado was the President of Ecuador from 2007 until 2017.

xv) Personal communication, 31 July 2014.

xvi) The accompaniments were included to offer physical, logistical, legal and political support to victims.

xvii) Preliminary meetings with gatekeepers, April 2003.

xviii) The Fundación Regional de Asesoría en Derechos Humanos is a non-governmental, non-partisan human rights organisation, founded in 1993. More information at: https://www.inredh.org/

xix) Space does not permit a close examination of this but, in general terms, the Kleinian concept of reparation refers essentially to the internal psychic process which explains the human urge and feeling of responsibility to “make good” to put right people who might have been harmed (Klein & Riviere, 1964).

xx) “Art. 1. For the purposes of this Convention, the term "torture" means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.”

xxi) HIAS (Hebrew Immigrant Aid Society) is a nonprofit organization that provides humanitarian aid and assistance to refugees. HIAS has offices in the United States and across Latin America, Europe, Africa, and the Middle East. In Ecuador, HIAS started its work in 2003.

xxii) Hollway and Jefferson (2000, p. 47) define countertransference as the “unconscious transferring of other emotionally significant relationships onto the therapist by the patient”. Countertransference is considered an important instrument of research on the patient’s unconscious and arises as a result of the patient´s influence on the analyst´s unconscious feelings (Freud, 1910/1957, p. 144-145). It refers to the “exploration of those elements in the observer’s feelings which seems to be determined by regular projections from family members” (Brown, 2006, p. 187).

xxiii) Pedro Restrepo is the father of two young brothers who disappeared under the responsibility of Ecuadorian police forces in 1983. For decades, the Restrepo family investigated, denounced and eventually found the truth behind this crime. The “Restrepo” became on the most paradigmatic cases of human right violations and resistance in the country. Personal interview, 31 October 2006.

xxiv) https://psicosocialecuador.org/

xxv) Personal communication, via GAC mailing list, 14 January 2015.

Funding [TOP]

I thank the National Secretary of Superior Education, Science and Technology (SENESCYT) of Ecuador and the Research Foundation of Flanders (FWO) for their support for this research study.

Competing Interests [TOP]

The author has declared that no competing interests exist.

Acknowledgments [TOP]

I would like to express my gratitude to Prof. Dr. Paul Verhaeghe (Ghent University), Prof. Dr. Stephen Frosh (Birkbeck Colleague), Prof. Dr. Bruna Seu (Birkbeck Colleague) and Dr. Oswaldo Ruiz-Chiriboga (Central European University) for their comments and suggestions. Many thanks to the survivors from the cases of the Truth Commission, I treasure the time and experiences you shared with me. I hope I can honour your braveness and strength with my work. My profound gratitude for the life lessons I learned next to you.

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