Personal experience on Group Analysis and how it can be applied in Rwanda
This comes to highlight my personal experience on Group Analysis within the time frame of four years that include some Foundation and Intermediate courses. It was not an easy journey to begin with, but as time came in and getting used to it, it really was an amazing and do-able one. Together we will look at the way this approach can be still and applied in Rwanda based on some success stories attached to it.
During group analysis approach, we got a chance to learn about foundation and intermediate courses. The two very helpful aspects that made the entire analysis smooth enough.
In Foundation Courses, my personal experience was to get new knowledge about group analytic approach theories, to know about creating new groups, how to follow group rules, how to organize counselling rooms and arrange the chairs. Even though we came from different institutions as psychologists; we were able to share our own experiences or our life stories.
At these courses, the interesting part was to get healed first. Based on experience, most of the trainees were having some psycho trauma issues due to their past life journey, but during the process, they all managed to get healed first, then got the courage and capable enough to help others on their healing progressively.
In Intermediate Courses, the experience I got was to work with groups using group analytic approach as an intern, where I conducted a group of ten members; elderly genocide survivors whose all children and spouses were killed during the 1994 Genocide against Tutsi and they were left all alone (Incike).
This group was focusing on post traumatic syndrome disorder (PTSD), where all these widows and widowers live in same place/hostel dubbed ‘IMPINGANZIMA’ located in Western Province, Bugesera District, Nyamata Sector. Rwandan government took good initiative to accommodate these vulnerable old people.
I learnt that, though they all stay together, under the same roof, but no one could share his/her experience to others easily. Because, they keep their anxiety and anger in their heart without sharing. From this, I arranged a group of them all in which they shared their testimonies, hence enabled them to start healing. During this group, the selected survivors were healed according to this group analysis approach.
Not only that, but also from that training I learnt to write essay and do evaluation on my group based on the approach I learnt. From that, I wrote a 4000-words book that explains more about a group I conducted. This was very amazing to work with Genocide survivors and testify how fast and easily this approach healed them.
Normally, when it comes to training, both trainers and trainees attend the course with arranged note books and pens as well as prepared topics to talk about. For the group analysis training approach, there is no need to carry note books and pens since we had small groups of ten people, work groups of ten people, social dreaming groups of all trainees and large groups of all trainees (30 people).
During group analysis training/courses, there were ‘Small Groups’ in which ten participants could sit together and share their own experiences on life. The experience shared in group analytic approach is that ‘you should be strong enough, mostly psychologically and then be able to help the clients’.
Based on history of our country most of psychologists were affected by the 1994 Genocide against Tutsi and among them, most were also the victims of the Genocide, means, some of the psychologists were the Genocide survivors. Being a survivor and still be in position of helping so many fellow survivors was not an easy job to do. Because, counselling them sometimes could make the psychologist remember some of his/her past history based on the trainees’ stories, then struggle while providing the help still.
In the small groups, all participants were able to introduce themselves about the trauma they might have faced which bring them to psycho treatment in order to help others too.
There were ‘Work Groups’, where during the training I got an opportunity to hear and share the experience of my career mates/professional mates and colleagues, how they do their jobs in their perceptive institutions, then I learnt a lot from them, thus got an added value into my career as well.
Looking at ‘Social Dreaming Groups’, I learnt how I can be able to relate my dreams to my background then grow further in terms of thinking and psychologically as well.
At ‘Large Group‘, I was able to analyse what a group member expresses and relate to his/her background. In this group, every member was allowed to express his/her ideas without any limit or guidance. This helped me to know the best decision I could make as a group conductor whenever a group increases some different neither focused nor purposeful ideas of healing.
The experience got in the training is that, we may assemble people without topics to discuss, but group conductor may take care about group boundaries. The target of group analysis was to share the experience.
I got the experience, about how a conductor may take a role in group analysis, where a group conductor should not judge any client that she/he encounters with, be it in the group or aside, away from the group.
Another thing to know is that a group conductor may also obey all rules without breaking any; not feeling bossy or anything, she/he may not do sociability actions with his/her clients before the ending of the session as well.
To conduct the group using psychoanalysis approach by one group conductor has made me the efforts and motivation of conducting the group alone and I have seen that it is possible in group analytic therapy.
I was increasing my experience of working with the most vulnerable people who passed through difficult situation such as those elderly Genocide survivors, it has helped me to not be self-preoccupied for what I have passed through in my life and if I fall in any difficult problem, I directly think that there are other people who are passed through difficult situations than me.
How group analysis may be applied in Rwanda
This approach is very needed to be applied in Rwanda, because we have a gap and people who present psychological problems indeed.
Researchers also found that most interviewees are aware that mental health services are available but very few were interested in seeking them.
‘From here this group analytic approach should be applied at my country with more practices and more professionals.’
‘While new research is needed to find out why people who present mental health issues don’t seek help, focused on what the researchers found out include stigma, lack of awareness where some did not consider it an illness, while others have traditional beliefs that problem will be corrected by witch doctors’ said by Dr IYAMUREMYE ,RBC Psychiatric care unit.
‘This is the reason why the group analysis approach may apply in Rwanda, for purpose of creating a group of people who present the same psychological problem and share their experience in case of avoiding the stigma and help them psychological.’
Group analysis should be applied in RWANDA, because at 2017-2018 survey done of 20,000 individuals found that depression prevalence is at 11,9% in general population and 35,6% within 1994 genocide against Tutsi survivors.
In Rwanda country, there was Genocide against Tutsi in 1994 where more than one million of Tutsi were killed in one hundred days. Many families were killed and others were wiped where there left none stayed alive in those families. After the 1994 Genocide against Tutsi, The New Government of Rwanda sets measures to follow and took care of those who survived the genocide tragedy.
Different initiatives were made according to the survivors’ categories. Free education to all survivors in needs, building houses for poor Genocide Survivors and meet their basic needs, free medical aids as well.
However the category of elderly survivors were still in need of support because they didn’t have anyone left, (no children, no husband or wife) from the family who survived genocide against Tutsi, this group of elderly survivors are known as “Incike” which means the one whose whole family is wiped out.
Later on, the Incike name was changed and became “Intwaza” that means the one with resilience. On top of the psychosocial problems some of above mentioned elderly survivors had physical wounds as the negative results from the 1994 genocide against Tutsi, some others had somatically communicable diseases like; HIV/AIDS, Hepatitis B and Hepatitis C. Some also had non-communicable diseases; like: Diabetes, Hypertension, just to mention a few.
In July, 2018 the Government of Rwanda implemented the programme of taking care for the elder widows and widowers of the 1994 Genocide against Tutsi, it is in this regard, that the Rwandan Government through the UNITY Club, FARG, AVEGA Agahozo and other different organizations for survivors’ benefits and support, built many Hostels across the country for those elderly widows and widowers of Genocide against Tutsi.
Life of living together may bring positive effect resulting from care benefitted from the Impinganzima hostels. This initiative intended to help concerned group of people to live together and also for the best way of giving them help since more of them had experienced the effects of Genocide such symptoms of depression, post traumatic disorder syndrome (PTSD), loneliness and some more.
According to director of Psychiatric care unit at Rwanda Biomedical center roughly 223,500 people sought consultation in public hospital for mental health related treatment, 10% of those are new comers, 35.6% are survivors of 1994 genocide against Tutsi cause of traumatic events they passed during genocide. This is why this Group Analysis must apply in Rwanda to help this number of clients.
Group Analysis must be useful in Rwanda, in collaboration with mental health institutions, with some adding or increasing knowledge from people who have trained about it in order to irradiate in all places of country.
In 2009 nationwide study revealed the post traumatic syndrome disorder with 28, 54% of the adult population, the comorbidity of depression was 53, 93% of population with PTSD.
This is why; as clinical psychologist, who started to use the group analysis approach at our work institution, knows the psychological best impact of use it, the good product of use it in our group therapy, to treat PTSD, depression, and other mental health issues.
Truly speaking, this approach of group counselling is very fruitful in group, where it started to work. But as the country which is in its development process, this method of counselling is not popular in our culture, due to different habits or routines of counselling.
As usual in Rwandan context, the Team Leader may not do the assembly/meeting or training session without a prepared agenda and topics to be discussed on during the meeting.
The best things is to get more knowledge on new approach, get a big number of people who are qualified at group analysis, get the opportunities to go abroad to get more experience where they started before us, in order to know which challenges they may meet and how they were able to resolve them.
The approach of Group Analysis may continue and start where is not available for being useful in Rwanda with objectives include to promote the Rwandan community care in mental health, provide quality health availing well the trained and qualified in group analysis, create of care because there is gap, prevention regarding psychological problems in children, teenagers, genocide survivors and other Rwandan general population may present mental illness.
As trained student and Rwandan psychologist, I found this group may sustain in country via collaboration of group analysts professionals with ministry of Health and Rwanda Biomedical center.
Reference:
https://www.who.int/mental health/evidence/atlas/profiles 2017/RWA.pdf