Fifteen years ago, psychotherapist Jeffrey Kottler never imagined he’d be stuffing nine duffel bags full of antibiotics and suture kits for a return trip to Nepal. Or that he’d become so familiar with the long, arduous journey through dozens of trips after what was supposed to be a one-time visit to study maternal mortality rates in one of the country’s poorest regions. But this time, as the plane descended into Kathmandu, the scene was startlingly different from anything Kottler had ever seen before. Hundreds of makeshift tents peppered the ground below. “Holy crap,” he remembers thinking. “It looks like a nuclear bomb just went off.”
On his first visit, Kottler had trekked through southern Nepal’s thick jungles, mustard fields, and ramshackle villages, many of which had never been visited by a psychotherapist. Along the way, a chance encounter with a young Nepali girl changed the trajectory of Kottler’s life forever. During his visit to a remote school, the principal pointed to one of the female students, barely a teenager, and matter-of-factly explained to Kottler that, like dozens of other girls in her class, she was destined to be sold by her impoverished family into a life of sex slavery in neighboring India. Kottler was speechless. A paltry 50 dollars---which the girl’s parents would have otherwise received for selling her---was all it took, he recalls, to set her free.
In order to sustain his anti-trafficking efforts, Kottler founded Empower Nepali Girls (ENG) to provide scholarships to at-risk children, returning to the country several times each year since then with a small team. The organization now monitors nearly 300 girls in more than a dozen villages, using mentoring programs to stave off alternatives that might otherwise swallow them up: backbreaking labor, early marriages, and sex slavery. But Kottler’s program goes a step further in preparing these girls for a different life, priming them for careers in medicine, engineering, and teaching.
As a psychology professor at California State University at Fullerton, Kottler has brought along hundreds of students on these trips---everyone from aspiring medics to pharmacists and hospital administrators. But Kottler’s manner of interacting with the locals is the real driving force behind ENG’s success, and a far cry from the daily routine most clinicians know, an uncommon blend of therapy, relief work, and social justice advocacy.
A crucial component of Kottler’s work involves visits to homes and schools. After following leads about struggling families---many with single-parent households, whose fathers either died or abandoned the family altogether---he interviews principals, teachers, and mothers to determine girls’ scholarship eligibility. After evaluating overall household stability and a girl’s academic talent, Kottler collaborates with her guardians on a game plan for the prospective journey through school and legitimate work. “So many of us work with middle-class people dealing with middle-class issues,” Kottler says. “These are life-and-death issues.”
But Kottler’s work in Nepal took a sharp turn on May 12. The day he returned, a magnitude 7.3 earthquake struck outside the capital of Kathmandu, nearly two weeks after a magnitude 7.8 earthquake had killed nearly 8,800, injured almost 23,000, and left more than two million homeless. Lacking earthquake-proof infrastructure, many of the country’s buildings---including half a dozen schools Kottler had been assisting—simply crumbled. With roads obstructed by rubble, UNICEF put out a special request for desperately needed resources: clean drinking water, temporary shelter, and psychological support.
“There is no training for this,” Kottler says, recalling the scene of infants crushed by buildings and headless bodies being tossed into ambulances. “The work becomes a matter of taking care of basic needs where there’s no hospitalization, no drugs, and no clean water. It’s not even third world. It’s fourth world.”
Like Kottler, Elaine Karas, executive director of the Trauma Resource Institute in Claremont, California, believes that what therapists can offer isn’t so much standard-issue therapy, but their skills at human connection. Her work is grounded in helping distressed people learn to reregulate their nervous system by having them tap into and articulate bodily sensations---which she says isn’t dependent on cultural upbringing.
Karas remembers some of her most formative career moments being in her work as a Lamaze teacher and doula, nearly 30 years ago. It was here she learned about the body’s resilience and the psyche’s vulnerability. But when two of her clients’ babies died, Karas’s focus shifted to understanding psychological resilience. “Our childhood education courses didn’t prepare us for this,” she says. “They prepared us for the joy of birth, not the suffering of losing a child.”
She decided to open a clinic for grieving mothers shortly afterward, and eventually decided that many of the approaches she’d learned to help mothers cope could also be applied in countries recovering from war and natural disasters. In 2006, she founded TRI, taking small teams everywhere from China to Darfur to Turkey.
Like Kottler, Karas is quick to point out that work with traumatized people isn’t for the faint of heart, and recalls feeling personally shaken, even years into her trips abroad. While seeing a client break through the fog of trauma is in itself a reward, the fact remains that doing this type of work requires immense emotional fortitude, a quality that wavers in even the most skilled therapist. So who protects the protectors?
“Our philosophy is that we’re all in this together,” says Jim Gordon, who directs Washington DC’s Center for Mind–Body Medicine (CMBM) and does relief work abroad several times a year, including teaching mind–body skills to thousands of traumatized Gaza residents, victims of the recurrent conflicts between Hamas and Israel. Like Kottler, Gordon sees something primal in this type of work. “We’re speaking a universal language,” he says. “These small group circles are how human beings have gathered to help and heal each other since time immemorial.”
So what sets these therapists apart? Perhaps it’s their willingness to commit to a job that’s never truly finished. Later this year, Gordon plans to work with Tibetan refugees in India, and again with displaced Palestinians in Gaza. This summer, Karas plans to travel to Nepal to assist with earthquake recovery efforts. Kottler plans to return there in December.
“This is the single greatest thing I’ve ever done in my life,” Kottler says. “Nothing comes close to this.”This blog is excerpted from “Therapists without Borders." Want to read more articles like this? Subscribe to Psychotherapy Networker Today!