FEATURES

Supervisor Ko Bol Bol Lwin has been involved with AAPP since 2003. CREDIT Lwin Maung Maung

o Kwin Moe Myint, a student activist involved in the

democracy uprising in 1988
said he never feared arrest.
Even after being jailed for seven months
in 1991, his spirit was unbroken.
We [activists] have strong minds and
strong spirits, Ko Kwin Moe Myint said
in an interview with Mizzima Business
Weekly at the Assistance Association
for Political Prisoners (Burma) office in
Yangon.
We thought: If we can face the military government, we can face anything.
He was re-arrested in 1999 for his
16 | May 22 | 2014

involvement in organising a 9-9-99

movement and sentenced to 29 years
in prison, of which he served 12 years
before being released under amnesty in
2012.
I had a different feeling after being
in prison for so many years; the fearlessness was gone, said Ko Kwin Moe Myint.
Honestly, I was afraid of being released.
I didnt have a job. I had nothing to do. I
couldnt bear my life.
After being released, he learned that
his poverty-stricken family had sold
his house in Yangon years earlier and
was unable to support him. His support

system dissolved completely when he lost

contact with former activist colleagues.
I didnt have the money to travel to
meetings with other activists; I slipped
away from politics, he said.
Last year, he learned about a counselling programme offered by the newly-opened Yangon office of the Assistance
Association for Political Prisoners, based
in the Thai border town of Mae Sot. After
receiving counselling, Ko Moe Myint
trained to become a counsellor.
I understand the trauma of political
prisoners, he said. After three meetings
they [the client] start to trust me and

www.mzineplus.com

Counselling
a trauma
society
We have a really unique opportunity
to help people

By Portia Larlee

open up.
In February 2013, AAPP members
were trained in Mae Sot by faculty
members of Johns Hopkins University in
the United States to provide therapy to
former political prisoners suffering from
anxiety, depression and trauma. Trainees
became supervisors and brought their
skills to Yangon where they continue to
train counsellors.
The AAPP Mental Health Assistance Project in Yangon is beginning to
accept clients for counselling who are not
former political prisoners, said co-supervisor Ma Khin Nyein Chan Soe.

Funding has been provided for the

project by the US Agency for International Developments Victims of Torture
Fund and will continue until September
2014, she said.
Since 2004, JHU faculty have partnered with local organisations in countries and regions with limited health care
resources, including Kurdistan [northern
Iraq], the eastern Democratic Republic
of the Congo and the Thai-Myanmar
border, to identify mental health issues
and design appropriate responses.
JHU, in partnership with AAPP,
Social Action for Women, Burma Border

Projects and the Mae Tao Clinic conducted research on the mental health needs
of Myanmar migrants in Mae Sot from
2010 to 2012.
After the research, JHU, AAPP and
Mae Sot-based Social Action for Women
used the Common Elements Treatment
Approach, a mental health intervention
developed by JHU and the University of
Washington in Seattle for use in areas
with limited resources and few counsellors.
Social Action for Women continues
to provide counselling and training for
new counsellors at Mae Sot and nearby
May 22 | 2014 | 17

FEATURES

The Mental Health Assistance Project team at the AAPP office in Yangon. CREDIT Lwin Maung Maung

Phop Phra district, and AAPP works in

Mae Sot, Mandalay and Yangon.
Rather than providing training for
treating diagnoses individually, counsellors with CETA training treat components of trauma, depression and anxiety.
Technically, we try not to think so
much in formal diagnosis but rather
look at each individual and problems
they may present with, said Dr Laura
Murray, from the Johns Hopkins School
of Public Health, who co-developed the
CETA approach.
Many former clients have recommended that their families and friends
also seek counselling, indicating a
positive response to the CETA approach,
Dr Murray, a clinical psychologist, told
Mizzima Business Weekly in an email.
Supervisor Ko Bol Bol Lwin has two
brothers who are former political prisoners and has been working for AAPP
since 2003. Most of his current clients are
referrals from former clients.
Political prisoners and their families
are all connected, he said.
18 | May 22 | 2014

Encouraging clients to think differently known as cognitive restructuring

is a CETA technique used by Ma Khin
Nyein Chan Soe and her team. Counsellors can help clients understand that
their thoughts may be inaccurate and
unhelpful and encourage them to shift
their thinking.
Ma Khin Nyein Chan Soe said
sadness, anger and fear associated with
difficult memories can be reduced if a
client openly discusses them.
Former political prisoner Kyaw Soe
Win, now clinical supervisor with the
Mental Health Assistance Project, trained
to be a counsellor at Mae Sot in 2010.
One of the most difficult things we
face is talking with people about their
specific traumatic events such as imprisonment, torture, rape, and witnessing
the killing of a family member, he wrote
in Rebuilding Burma, a monograph
published in Intervention journal, a
Netherlands-based publication focused
on mental health, psychosocial work and
counselling in areas of armed conflict.

I asked myself, Can the people really

speak out about their experience and will
this really help them? Although it was
difficult, we actually found that people
were able to talk about these experiences.
Clients are also taught relaxation
techniques such as deep breathing and
meditation to help them cope with stress,
said Ma Khin Nyein Chan Soe. Counsellors are also expected to ask clients often
if they have had thoughts of suicide and
a safety team, including an on-call psychiatrist, has been formed for self-harm
emergencies, she said.
Supervisor Ko Chit Ko Lin said there
were no suicides among the MHAP
clients who sought counselling in Yangon
and Mandalay in 2013.
Many of us [former political prisoners] are Buddhist and the rules [against
suicide] are very strict, he said. This
[committing suicide] is the wrong way
for the next life.
However, supervisor Ko Htin Aung
said he knows of former political prison-

www.mzineplus.com

ers whose struggles with mental health

issues led to suicide.
We have a really unique opportunity
to help people, said Ko Htin Aung. We
help them [the clients] navigate lifes challenges with confidence, calm thinking
and optimism.
In 1990, when Ma Khin Nyein Chan
Soe was eight months old, her father, U
Soe Myint, was charged under section
17(1) of the Unlawful Associations Act
for his involvement in the Burma Communist Party and sentenced to jail for
seven years.
U Soe Myint and National League for
Democracy co-founder, the late U Win
Tin, shared time together at western Bago
Regions Tharrawady prison, which was
notorious for unusually harsh treatment.
Ma Khin Nyein Chan Soe said her father
and U Win Tin wrote on paper with
small pieces of brick to record their experiences in Tharrawady prison, for which
another seven years was added to their
sentences in 1996.
With limited funds to make the 80mile (125-kilometre) trip from Yangon to
Tharawaddy, Ma Khin Nyein Chan Soe
and her mother were able to visit U Soe
Myint in prison only once every one or
two years.
I didnt cry when I visited him
because I believed in him, said Ma Khin
Nyein Chan Soe. My father was a hero.
Ma Khin Nyein Chan Soe understands stigma. She experienced discrimination and was ostracised during her
school days because her father was in
prison. Former political prisoners also
experience stigma when seeking therapy,
she said.
They [former political prisoners]
feel like if they get counselling, they are
ill, said counsellor Ko Kyaw Saw. Their
attitude is, We cannot accept counselling
because we are strong; we are political
prisoners.
A client who asked not to be named
said he has told some of his former prison mates but not his family that he is
receiving counselling.
He joined the Burma Communist
Party after his family was displaced by
the military from their home village in
Rakhine State and was arrested in 1988.

Supervisor Ma Khin Nyein Chan Soe at the AAPP office in Yangon.

CREDIT Lwin Maung Maung

Before I started the counselling sessions, I thought, Nobody cares about me,
he said. After I met with the counsellor,
I realised my thinking was wrong. Now I
feel like I have hope and a future.
The AAPP Mental Health Assistance
Project in Myanmar has trained another
13 counsellors since January. There are
now four counsellors and one supervisor
in Mandalay and 15 counsellors and five
supervisors in Yangon. They provide
counselling to more than 100 clients.
The counselling programmes are
from eight to 12 weeks and Ma Khin
Nyein Chan Soe meets five or six clients a
week. She meets them at a tea shop or at
their home, if privacy is preferred. Until
January, Ma Khin Nyein Chan Soe said
she was followed by a plainclothes intelligence officer to each of her appointments.
They [the government] have the
data and information on all political
prisoners, she said. They know about all
of our [Mental Health Assistance Project]
activities.
Ko Htin Aung said many of his
clients were uncomfortable about intelligence officers eavesdropping on their
conversations from a nearby table.
Eventually, I became friends with
the officer because he was always there
[at meetings], he said. If the meeting is
very serious, we will meet at the clients
home.
Ma Khin Nyein Chan Soe said she
hopes the programme will expand to
provide counselling in Kayin and Kachin

states as well as to former members of the

Tatmadaw, who have also been traumatised by their experiences.
Burma is a trauma society, which
includes soldiers, children, government
servants, everyone, she said. During
fifty years of military rule, there were no
resources, no education opportunities
and no chance. This is a type of torture
and its still happening.
Ms Laura Merchant, the assistant
director of the Harborview Center for
Sexual Assault and Traumatic Stress at
the University of Washington in Seattle,
provided CETA training in Yangon
in February. In an email to Mizzima
Business Weekly, Ms Merchant said an
assistant hired for the training requested
to meet a counsellor.
They [the assistant] practiced the
skills at home between classes and they
saw the benefit for their own post-traumatic stress symptoms, she said While
there is still a hesitancy to talk about
mental health problems [in Myanmar],
people like learning the new skills and
having new ways to think that help them
overcome their troubling symptoms.
Another client who wished to remain
anonymous was arrested in June 2008
after two decades of activism.
This [mental health programme]
is needed in our society; experiences
of torture and imprisonment effect
our minds, he said. Counselling is
teaching ways to relax and feel relief;
everyone needs this.
May 22 | 2014 | 19