A few days before Bessel van der Kolk arrived in Cairo to teach on Trauma in January, I was at the biennial conference of the Egyptian Association of Group Therapies in 6th October, and went to a presentation by a professor of psychiatry from Al Azhar University about the Zar and its psychosocial role. We were shown video footage of the professor in his youth watching a Zar as he talked us through its various components, which he, along with many Egyptians described as ‘exorcism’. I had been pleasantly surprised to find an al-Azhar medical doctor who appeared to have devoted much of his life to studying this unorthodox but very ancient, Egyptian ritual, and I waited eagerly for him to pick out for me the elements that validated it as an early traditional Egyptian form of group therapy, as the abstract to his talk had implied he would.
I was naive of course. When asked what the affliction of the protagonist of the Zar had been and whether her headaches had been alleviated, he snorted, as if it should have been obvious that nothing useful could come from such a practice; ‘Of course not. This is nothing more than superstition, a placebo. The girl’s headaches went away for a few weeks and then came back again. It never works.’ He also dwelt on the great expense of holding a Zar. Unfortunately there wasn’t time for further discussion, but I was left unsatisfied; why would an outlawed and very expensive traditional healing practice persist over millenia if it consistently failed to deliver any results? I also wanted to ask the professor why he’d devoted so much of his life to studying something that he wished only to discredit. I wondered privately to myself whether his own taboos did not allow him to acknowledge the potential validity of the practice even as his curiosity opened itself to it; whether there wasn’t some form of dissociation working at the heart of the apparent contradiction between his beliefs and his interests.
Then Bessel van der Kolk, one of the pioneers of trauma treatment over the last thirty years, arrived in Cairo. On his first day he taught 200 people at Cairo University medical faculty.
Much of what we learned from Dr van der Kolk that day, and in the much smaller workshop over the following days, was the scientific basis for why making music in groups, particularly with strong rhythms, and singing and dancing and moving together (and playing with wobble cushions and gym balls, and putting on theatre, or even watching it, and doing Yoga) are such powerfully healing practices in the treatment of trauma. Most cultures have some version of one or more of these in their traditions; practices that build connections, establish rhythms, find voices to express hitherto silent suffering, and in so doing restore people and communities to themselves, heal trauma, quieten people’s demons. Bessel was keen to discover Egyptian versions of this. So we took him to Makan, Ahmed Al-Maghrabi’s Centre for Culture and Arts, in Saad Zaghloul, for their regular Wednesday night Zar.
It was all there of course, the rhythm, the singing, the dancing, the ecstasy, the intimacy between performers and audience enhanced by there being no stage, with many in the audience sitting on cushions on the floor, and the offering of glasses of tea and hibiscus half way through. Some of the people in the audience moved their bodies to the rhythms as if the Zar was for them, but officially at least, the only element missing was a protagonist and the sacrificial chicken or fish. After the performance, Ahmad, who’d been told about our guest and his interest, received us in his gallery office overlooking the performance space, and we sat in the gloaming on mastabas and coffee shop chairs with the sounds of the audience and performers dispersing below, while our host layed out an exquisite dinner. Bessel’s first question, ‘What is the Zar?’ had me butting in impetuously; hadn’t I told him that already?
‘No,’ said Ahmed, ‘a Zar is not an exorcism. It is a reconciliation.’
‘What? But…’ hadn’t the ‘specialist’ psychiatrist from al-Azhar confirmed what I’d already half known from ‘common knowledge’, that a Zar was all about getting rid of the jinns? But no, and I looked at Bessel, who was already beaming with the recognition of where we’d come to as the penny slowly dropped in my own mind.
Zar as exorcism is a translation that fits very well into the conventional medical model; that there is something wrong and we can or must fix it, get rid of it, cut it out if necessary. Psychiatry, as a medical discipline, has a long and difficult history with this aspect of medicine. While it may often make sense to cut out a cancer, replace a damaged joint or suppress the painful and debilitating neurological symptoms of a chronic disease like Parkinson’s with medication, such an approach to schizophrenia, multiple personality disorder and depression has often led to criminally violent and irreversible treatments like lobotomies, or the often only temporarily effective ‘re-setting’ the system with electroconvulsive therapy (note that this temporary affect is apparently acceptable where that of the zar is not), or de-sensitizing patients to their triggers by exposing them again and again to the things that most torment them. At best, much of classical modern psychiatry seems to be about suppressing symptoms with medication rather than getting to the root causes of them – and along with these undesirable symptoms suppressing many of the feelings that make life worth living, so that patients are no longer suicidal or harming themselves, but are not able to live a full or fulfilled life either.
And yet since the beginnings of neuroscience there has always been another side to psychiatry – Pierre Janet’s recognition of the role of traumatic memory in mental illness and his development of hypnosis as a treatment, Freud and then Jung’s development of psychoanalytical work – and the whole field of psychotherapy now, as often than not divorced from psychiatry – all these are treatments where the focus has been more on an attempt to turn an unhealthy relationship with the client’s demons into a more healthy one – a reconciliation, if you like, or integration where there has been a splitting off.
Dr Bessel van der Kolk had a distinguished career as Professor of Psycho-pharmacy at Harvard. However, his insatiable curiosity, his commitment to testing what appears to work – however outlandish – in reproducible scientific studies, his deep distaste for any treatments that re-traumatise, and above all his desire to help his patients reclaim full, rich lives, led him to abandon that post and spend many years in the wilderness estranged from mainstream psychiatry. Only now as he hits his early seventies, is he recognized as one of the great pioneers of our understanding of what trauma does to the brain and how best to treat it, and one of the loudest voices in the field for recognizing trauma and particularly early developmental trauma as the basis for so much mental illness.
And having spent a few days in Cairo already, hearing people’s stories, beginning to understand the many levels on which trauma presents itself in Egyptian society, Bessel was delighted to discover this ancient practice of Zar holding within it so many of the elements that he’s come to recognise as healing of trauma. Pre-dating both Islam and Christianity by centuries, here was something truly Egyptian and potentially unifying to a divided society, where women play the strong roles as well as the men, commanding the respect and attention of a crowd for their sheer power and beating drums louder than armies; where men can dress up in strange rattling skirts and dance absurdly and mesmerizingly, all of them entering into relationship with the audience through the rhythms, musical notes, using their eyes, their voices and their bodies in dance. Bessel was delighted, but also dismayed then to learn that the Zar is not only frowned upon, but effectively outlawed; that those who would practice it as anything more than some sort of folkloric revival must do so in secret.
What is it about the Zar that is so threatening that it is a banned practice? Is it because it’s from a pagan past the modern Egyptian establishment is ashamed of and which must be excised from collective memory? Is it because the role of the Zar points to the existence of trauma, and acknowledging trauma is taboo for how it brings to light society’s darkest and most horrible secrets? Or is it that a practice that reconciles goes directly against the dominator culture we live in, the one whose colossal momentum humanity seems powerless to stop, despite all the evidence of its desperate failure. The culture where people’s contributions to society are valued in terms of how much money they make, how long and wide their red carpet is or how tall their pyramid, and where threats to the status quo are excised with tear-gas and raids, armies and bombs no matter what the human cost (think of all that trauma), rather than the mindful working of networks and dialogue and what Raimon Panikkar, when positing a model that could yet save the human race, described as the treading of ‘well-worn paths from house to house’. Reconciliation demands the more subtle, less grandiose work of finding out what lies at the root of the threat, or disease, or disquiet and working towards integration of the parts we are afraid of; the parts we wish we could cut out and ignore; the parts we dissociate from.
What Bessel had understood immediately, and what it took me a few minutes to appreciate was that this issue of translation, whether Zar is exorcism or reconciliation, cuts right to the heart of the crisis we face in modern civilization. Can we understand the difference between the two, and learn to work more with the gentler version, the one that requires such courage, patience and humility, or will we continue, consistently to leap reactively for the louder, tougher version that attempts to banish fear and breeds only more violence?