Terror, silencing and children: international, multidisciplinary collaboration with Guatemalan Maya communities.

In recent years psychologists and other mental health workers have begun to document the effects of state-sponsored violence and civil war on civilians and to develop specific clinical and community interventions to address these issues. During the past decade between 50,000 to 100,000 Guatemalans have been murdered and at least 38,000 people disappeared. Over 400 rural villages were destroyed and the Guatemalan army's scorched earth policy forced hundreds of thousands who survived to flee, either to another part of the country or to leave Guatemala altogether. State-sponsored terror and silencing persists in Guatemala despite a return to civilian government. This article describes some of the problems encountered by Maya children in situations of ongoing war and state-sponsored terror and the development of one specific response, Creative Workshops for Children, an international, interdisciplinary program organized by mental health workers from Argentina, Guatemala and United States. The inadequacies of psychological theory based on a medical model that sees trauma as an intrapsychic phenomenon and conceptualizes its effects in situations of war as post-traumatic stress are described and a reconceptualization of trauma as psychosocial is proposed. The accompanying need to address the "normal abnormality" of war and state-sponsored terror through a community-based group process is presented. The model incorporates drawing, story telling, collage and dramatization in a group process that seeks to create a space and time in which the child can express him or herself, communicate experiences to others, and discharge energy and emotion connected to previous traumatic experiences. The work draws on existing cultural traditions (e.g. oral story telling and dramatization) and resources (e.g. nature, plants) of indigenous communities, offering additional resources to those seeking to collaborate in the development of mental health in their communities and suggesting alternative bases from which to understand the cultural and social psychological effects of war. Through participation in the creative workshop the child survivor enhances natural means for communication that will facilitate the expression of physical and mental tensions and the development of a capacity to construct an identity that is not exclusively subject to the dehumanizing and traumatizing reality of war. The strengths of this work and the limits of psychoassistance work within a context of war are enumerated and discussed.