Abbey Kanzer is a psychotherapist and trainer at CVT’s St. Paul Healing Center.
In my work at CVT, I’m asking clients to do a very courageous thing: to sit and reflect on and speak about what happened to them. It takes great courage, especially because the harm was caused by other people. It’s rewarding for me to know that clients trust me with their story of the very worst thing that’s ever happened to them. They are bearing the unbearable. I can help them begin making that something they can live with.
I am about to reach my 10th anniversary with CVT, and I’ve been thinking about what’s important to me about this work. In school, I knew I wanted to be a psychotherapist. I became interested in working in torture rehabilitation because I saw that it combined a lot of the different reasons that I went into psychology. As a Jewish person, it’s important to me to think about others in the world, of how I live as a person in the world. I try to live by Tikkun Olam: the idea that we have a role in “repair of the world.” An important Jewish text teaches: “You are not obligated to complete the work, but neither are you free to desist from it.”
Before my career with CVT, I lived for a few years in Israel. This was a formative experience in my life. I was close to a number of refugee families whose stories and lives were important to me. These were Jewish families from Iran, Kurdistan, Ethiopia, Yemen. I tutored many of their children learning English. They often helped me as I was learning Hebrew! Our common connection was being Jewish. Some of them had been persecuted for this. It was within these relationships that I saw a lot of suffering. And now it felt personal.
When I think of what I do at CVT, my role is to sit with people. I listen to them very, very carefully. I give them this space and allow them the time and focus to find their way toward healing.
I sometimes struggle with the word “healing,” a word we use quite a bit here at CVT. In my work, there are moments of that. It is the goal. But when you’re in the day-to-day of sitting with people and hearing their stories, there is much more to it. People reflect on themselves and the reality of their lives. The moments of “not hope” are often much longer, much harder. Those moments are part of healing. It may sound contradictory, but it can be healing for a client to “abandon hope.” It’s an idea I learned from the writing of Pema Chödrön, a Buddhist scholar and teacher. The lesson is to stop focusing on hope for an unforeseen future. A lot of suffering comes from hope. As an example, many clients at the healing center lack permanent immigration status and live in uncertainty for years. They live separated from family members who remain back home, often facing the same dangers they fled. The healing work is about helping people to live with this reality and still focus on rebuilding and creating a life in exile.
The therapy relationship and work is complicated. I see it unfold with clients in different ways. Often, my job is to get out of the way. My job is to allow them the space to reflect on themselves and think through these aspects of their lives. My work is about bearing witness, listening and creating space for the complex task of healing.
After they undertake this work, I appreciate when clients tell me they’re getting better: they sleep better, they feel less afraid. We use a measurement at the beginning of treatment with clients that asks them to respond to things like: “I feel scared” and “I don’t sleep well.” I recently had a client who was stunned to see how much his responses had changed after only three months. The first time he answered the questionnaire, his response to almost all the items was “often.” Now, his responses included “sometimes” and “rarely.” It’s not that there was an absence of the anxiety or fear itself, but something was different for him. The details of a client’s daily life may be the same, and he or she still thinks about the torture, but how he’s carrying it is different now.
One of the most difficult aspects of the healing work is the barriers clients face. The long process of obtaining a permanent immigration status (political asylum) is one of them. With newer clients, at the beginning we can and often do help with acute symptoms of PTSD. Clients can have a huge improvement initially and then hit a plateau. What happens for them oftentimes is that they get to a place where they’ve improved, but now they’re waiting for asylum. Maybe they’ll be lucky. Maybe they’ll have an asylum interview in a year. But usually this is not the case. They wait two years. Three years. Then they get an interview. But then they wait again for two years, three years. There’s no response.
People have to live with unknown futures, with despair. They continue to be separated from loved ones; children are growing up in their absence. It’s very, very hard for them. It’s hard for us as therapists. We’ve come to be so connected. But at this point, what they need more than therapy is to be reunited with their family.
False hope can create suffering. As another example, I remember a client who told me that when he was a boy, his father had been arrested and disappeared. This was part of his family history; it was a very important story for him. This young man still kept thinking that he would be reunited with his father. At one moment in his therapy, however, he realized that this was never going to happen. In that moment, he was no longer a child. It was an important moment of healing. He wouldn’t have told me something like that the first or second time we met. I feel a real reverence when this happens in therapy. The next steps in this man’s healing journey are so sacred and important.
It’s a challenge to come to work every day and to say to myself “I am going to allow pain and suffering to happen for someone today.” It is so essential to the process. I don’t look for it, but I need to be ready for it. While a client is waiting, I can help her allow herself to take care of her heart. Clients may feel depressed, but they can be encouraged take care of themselves, to reduce their isolation, eat better, take a walk in the sun. In the cases of those waiting to be reunited with family, I tell them to do the work, relieve their suffering: suffering here doesn’t help family back home. Many clients then allow themselves to have something other than suffering. This can help them connect more to those back home – they tell me of communicating with their loved ones in their home country with more joy, more laughing. They are able to share more stories and to hear their family’s stories.
I feel honored to get to know people from all over the world. It’s such a privilege. There are many beautiful moments in this work. I don’t always know where they’ll come from. I had a client who had not had a lot of education. She still felt very afraid that the torturers were going to come and find her. She still had a very strong sense of location where she was from, even though she now lived thousands of miles away. She wasn’t thinking of continents and oceans and a state called Minnesota. I showed her a map. We talked about the distance. We talked about how the perpetrators can’t drive here. They can’t find her here. There are continents and oceans in between. She simply hadn’t looked at it in that way before. And then she laughed. The next week she told me she didn’t have another nightmare after looking at that map. Years later, she still swore this was true!
What I truly value is being able to help cultivate clients’ really deep attention to themselves – to their own hearts, minds and bodies. I help them look inside and see what they can do about what they’re feeling, what they can do about what they’re thinking. I help them be at home in their own bodies, their own skin. I help them look at part of themselves and be able to reflect and think about themselves in a way that requires that space.