by Annie Sampson
The sight of the snow-capped, majestic, proud Himalayas as I fly into Kathmandu excites me, inspires me, gives me hope. Nepal has captured me; its people, culture, spirituality and landscape have led me to return again and again. Leaving Nepal feels like I’ve had a limb amputated, returning feels like I can breathe again. I’m at home.
What started as a one-off visit in 2011 has now turned into a commitment to Nepal. I meet friends, we talk and talk, drink cups of masala tea, cook and eat, visit with families, and I slide into Nepali time which doesn’t have anything to do with clocks or watches. I also work in this land and culture. NGOs help to keep the country running, bringing much needed skills to social, environmental, medical and justice projects. I have worked with several NGOs which support and counsel victims of torture and issues relating to women. Now I return to work with Kopila-Nepal, an NGO which works with women and children who are disempowered and abused.
Life in Nepal
The town of Pokhara, where Kopila-Nepal has its offices, is a beautiful area with a large lake as its focus. This attracts tourists, along with trekkers to the Annapurna Himalayas. Pokara is a seven-hour bus ride from Kathmandu but only a 20-minute hop by small commercial plane.
In Nepal there is a sense of resignation rather than a direct anger about the difficulties of daily life. Petrol rationing, power outages of up to 12 hours a day (in the winter), no heating in the houses, dangerous roads. On one major road leading to the Tibetan border, the bus delivers you to the landslide, you climb over rocks and rubble, always with the possibility of being hit by more rocks in the ever-present landslide. Another bus collects you on the far side, and the journey continues. Vehicles are swept off the roads towards raging rivers hundreds of meters below. There are no trains in Nepal so everything is carried by colourfully decorated trucks. They’re better decorated than mechanically maintained! Once off the roads, pack animals, as well as men and women, carry what is needed up the steep mountain paths to the remoter villages.
Western-type healthcare and medicine are expensive and hard to access and there is a sense of being helpless in the face of a corrupt government. The urban and the remote regions support the patriarchal culture which has existed for centuries. Eighty-five percent of marriages are arranged, with wives living with their husband’s family. They are subjected to the rule of their in-laws which sometimes results in severe abuse and loss of life, apart from loss of any property they may have owned. There is still a high infant mortality rate and life expectancy is around 62 years. Earnings are at subsistence level, with €250 a year being normal. Most of the population lives in the remote regions of Nepal where it takes a day’s bus journey and then two or three days walking to get to the village. Changes are happening which lessen the hardships of life but they are slow. Working to survive, either as a self-sufficient farmer or in tourist-affiliated work, takes all the hours of the day, every day, no holidays.
Trekking is a major industry and having completed three treks I would say it is the best form of therapy. The guide is your companion, your map, but also your saviour. If an accident or illness puts you out of action, the guide carries you to the nearest village! If trust is an issue then this is a real testing ground. I walked along paths which are less than the width of my foot, leading me across steep mountain sides and over landslides. The treks take you across raging streams with slippery stepping stones, up high, steep, rough stone steps, hundreds of them, and for hours and hours on end, across mountain trails at altitudes of 4,000 meters, while it rained and got colder and colder. Oh, and very steep paths, with the gravel slipping under your feet and the edges crumbling away.
Counselling services and training in Nepal
Agencies offering counselling are few but the need is great. The country has just emerged (since 2008) from 10 years of civil war, with all the trauma that entails. There are also the usual issues people face: depression, addiction, physical and sexual abuse; and for women and children living in a traditional patriarchal society, there are added difficulties of disempowerment and often violence. For men, the eldest son is expected to feed, shelter and support his parents while feeding and educating other siblings. This often leads him into personal poverty and therefore with little hope of making a good marriage. Women hope their in-laws will treat them as daughters rather than slaves.
Counselling is in its infancy in Nepal. The focus is on psychosocial counselling, the training being of short duration, usually six months and with no personal development of the counsellors. Some of the counsellors I met are extremely competent and have learnt their craft through their experience rather than training.
Kopila-Nepal train counsellors to work with their clients. They also train counsellors working in other agencies, making training groups of 20 people the norm. I worked on the psychosocial counselling training in Kopila-Nepal with several different groups. It’s been a wonderful, a frustrating, a humorous and moving experience which has affected me both personally and professionally.
Teaching in a different culture
I approached working in an unfamiliar culture, without the language, with excitement and anxiety. It presented me with problems and I had to learn quickly or sink! The cultural aspect made me reflect on my philosophy of therapy and why I worked as a therapist. I believe in supporting clients to express and work through repressed emotions, supporting them not to act out of the past but to be themselves in the present and fulfil their potential, supporting them to form healthy relationships. From my social interactions I knew that some of the strong emotions, such as anger, are not acceptable and are repressed in Nepal. A friend referred to anger as tension and stayed isolated, away from family and friends, for days when feeling angry. He could not share his anger or talk about it, it felt shameful. Another friend had stopped training as a healer as he felt responsible for upsetting the clients. The aim of counselling in Nepal is to manage emotions so they do not affect the client or those around them, in fact, to contain or get rid of them.
The major difficulty of working with groups of trainees was the language. I designed the three-hour sessions, five in group facilitation and three in peer counselling, to start at 6am each morning. This enabled the trainees to go to their workplace after training and do a full day’s work. I quickly realised that the training I had hoped to complete was going to take at least twice as long as I had anticipated. Everything had to be repeated and translated either for my benefit or the trainees. Translation made discussion stilted and difficult. I could pick up a few words but had to wait for my gallant translator to relay what was being said, sometimes the discussion had moved on or there was an abrupt stop! I rely a lot on body language, my somatic responses and countertransference when I am training. It was harder to isolate where my responses and feelings belonged. Were they mine, generated from the work or was I picking up feelings generated from the group?
Nepali body actions were different from what I was used to and the actions and energy generated by participants were hard for me to read. Some trainees felt training was an unimportant activity and if a participant’s mobile rang then they had to answer it and respond. Energy often felt low to me but in fact this meant that participants were fully engaged rather than tired or bored. When I crossed my arms as a listener, to demonstrate a closed posture, there was disbelief. In Nepali culture, crossed arms denote feeling comfortable! When training I look for signs that the participants understand the material, one sign being nodding. To indicate ‘yes’ in Nepal, the head is moved from shoulder to shoulder while the face faces forward but when I saw this in my peripheral vision it looked more like a ‘no’. Disconcerting!
An experienced translator makes the job easy but I had an experienced Nepali counsellor, not a translator. We spent time getting to know each other, having long chats by the lake over tea, Dahl bhat (rice, lentil gravy, curry) and wine. This was in the belief that the better we knew each other the easier it would be to work together. Sadly that isn’t the case when
A community within the Kathmandu valley. The city is ringed by mountains and the legend says a king brought his sword down, slicing a gap which let the water flow out of the valley as a river.
translating, but we did become good friends. Translation is a skill and an art. Training and experience make the good translator.
My translator was a competent, experienced therapist who was trained to summarise and that’s what he did when translating. The summarising led to long periods when one group member talked and the translator listened, while I became impatient to know what was being said while keeping an eye on the group. Other group members became bored, leading to a distracted group who at times were almost unavailable to be trained. In giving material to the group I would deliver a sentence and wait for the translation, but I usually had to prompt him to translate as he was so caught up in the training material. I needed sentence-by- sentence translation. We kept at it, finally hitting something that sort of worked – shorter summaries!
I still had the difficulty of other group members feeling left-out and bored, fiddling with mobiles, chatting amongst themselves, leaving the room, but it was better. I found I couldn’t respond spontaneously even when the summaries were shorter. I’d try to hold the main points of the translation so that I could address them, but if I needed clarification that required more translation and more interaction it was difficult for me to hold. I also had to remember what was said so I found my white board filling with notes to myself as well as the training material. This kept some of the group occupied trying to work out what I’d written! A month of training and I would have become fluent in Nepali. Most of the training skills that come as second nature to me were severely challenged but my translator was impressed with my abilities and improvisation!
Training in supervision
The introduction to supervision training was delivered to three different groups, three days per group. The two counsellor training groups were engaged, lively and fun. The other group supervised outreach workers and they had me tearing my hair out! This third group was made up of men and women of different professional backgrounds and skills. To some of these participants, their answer to a struggling supervisee was to do the job themselves, this was supervision. This group of professionals were astonished to hear that supervision includes the restorative, formative and normative tasks (Proctor, 1988). Due to the time and translation difficulties I had to quickly revise the training programme to give the trainees the skills and understanding of supervision which would be most relevant to them. The outreach workers’ group were amazed that supporting supervisees (the restorative task) could lead them to become more competent workers. My translator remarked, ‘How do you manage to change the training programme so quickly?’ It was more a feeling of a need to survive.
In this group one of the men developed a difficulty with me. Patriarchy came to bite me. He found it difficult to have a woman in a seemingly powerful place and be instructed by her. He challenged nearly everything I said and tried to dominate the group and the work. He also threw me work scenarios, which he fully expected me to collapse under. One of my usual responses is to encourage other group members to come in with their experiences and so stimulate group discussion. The person monopolising is therefore managed by the group. In this case it was much more difficult, as due to translation I couldn’t react quickly to cut him off and encourage others to participant. He engaged the translator in his asides so I had to keep checking what was being said and try to support the translator not to get caught into this game!
Don’t imagine this work was only full of difficulties, we had fun and lots of laughs and jokes. The groups quite rightly laughed at me when I tried my limited Nepali on them but they were laughing with me. Training groups in Kopila-Nepal always break twice a day for fun-time, songs, dancing, jokes, where everyone joins in. I introduced them to bio-energetic exercises which more than often produced howls of laughter and disbelief. Why would we indulge in such movements when the Nepalis sit cross-legged all day and are constantly squatting!
There is a dearth of current information and knowledge about counselling in Nepal. I had to keep concepts simple and concentrate on basics. I decided to let the trainees decide
A view down the main street in Thamel from a rooftop cafe. The electricity wires hinder the view and often fall, sometimes catching fire or hitting a passerby. Electricity, produced by hydro power, is rationed with power outages of up to 10 hours a day in the dry season.
what was useful to them in their work and culture rather than me trying to decide what was culturally appropriate for them. I brought books with me that I’d got cheap on Amazon – the start of the Kopila-Nepal counselling library.
There was also a different concept of learning. I had come across this when I had taken a week-long language course. Rote and repetition is the normal learning method in Nepal, all done by verbal repetition. I need visual input for my learning. The trainees wanted me to tell them what to do, the questions were – ‘how do you…?’, ‘what do you do when…?’, ‘what do you say…?’ Not providing the answer was sometimes frustrating for them but they put up with me. I encouraged them to use their experiences to understand their practice and find the solutions. Most were unfamiliar with reflective practice and I gave them a simple practice to follow. The participants varied in their willingness to take on reflection as a learning tool. To generalise, the younger and enthusiastic group members were more open while the older group members seemed less interested in changing their way of working. I wondered how my teaching style, which is based on forming a collaborative learning community, fitted with the Nepali learning style. This is still to be investigated and answered.
I have supervised practitioners in Nepal and know they struggle with working with strong emotion, often having no experience of expressing their own. Counsellor training has no personal development input, so I gave a three-day workshop on peer counselling, which I hoped they would employ to support themselves in the work as well as start to look at their own issues. Wages in Nepal are low, one of the lowest in Asia, and poverty is rife, so engaging in counselling while training is not a possibility.
Looking back, it’s amazing what we achieved. The different groups developed some skills in facilitation and peer counselling as well as an understanding of being a supervisor. With some trepidation I checked the evaluations and feedback from the training. Not surprisingly the language difficulty presented as an issue but the main feedback was the usual, ‘not enough time’.
I am working with Kopila-Nepal to start a professional supervision course adapted from the course I run in Ireland. With trained and experienced supervisors, one day more professional counselling training can be run. Trained supervisors will encourage the development of practitioners and therefore enhance the clients’ experience of the work, no matter what field the supervisee works in.
When I return to Nepal in the summer, I shall be starting the supervision course. I will continue my one-to-one Nepali language lessons and spend my days off with my friends. I’ll hike around the valley (Kathmandu is in a valley surrounded by mountains), visit my favourite places, chill out and deal with the monsoon, heat and heavy rain. It will be hard to leave as always but I’ll keep going back until I run out of energy or until they don’t want me.
Annie Sampson MSc, MIAHIP, MIACP, works in private practice in Limerick as a psychotherapist and supervisor. She also works as a trainer in the Tivoli Institute in Dublin and on the MA in Humanistic Psychotherapy in UL. Annie is a trainer of supervisors and course director on Super.Vision Training, Limerick. Contact details are www.super-vision.ie or 087-2320525.
Proctor, B. (1988). Supervision: A co-operative exercise in accountability. In M. Marken & M. Payne (Eds.) Enabling and Ensuring. Leicester: National Youth Bureau.