Testimonial Therapy

Among survivors of
Torture and Organized Violence
in India
Inger Agger, PhD, Psychosocial Adviser
RCT, Denmark
Lenin Raghuvanshi, Convenor,
Peoples Vigilance Committee for Human Rights, India
Peter Polatin, MD, Health Program Manager
RCT, Denmark
Presented at the Symposium:
Peacebuilding: Psychological Perspectives
European Congress of Psychology, Oslo, July 2009
A collaborative project of
• People’s Vigilance
Committee on Human
Rights (PVCHR),
Varanasi, India
&
• Rehabilitation and
Research Centre for
Torture Victims (RCT),
Copenhagen, Denmark
Testimony as a Brief Therapy
Intervention
 First project in Varanasi, India with the
human rights organization:
 People’s Vigilance Committee on Human
Rights (PVCHR):
Capacity building project on testimonial
therapy for Human Rights Organizations
in India
The objectives of the
project
 Context specific manuals for using the
Testimony Method developed
 Capacity built in using the Testimony
Method among human rights defenders
 Psychosocial wellbeing of survivors
enhanced
 Impact and outcomes analyzed through an
M&E system
What is Testimony?
 A testimony is a story or a narrative about an
event
 The story is usually told by a person who
suffered an injustice, or something painful or
terrible
 It is a “map of pain”, a trauma story, it tries to
“tell the truth”, convey what really happened
 In Hindi it is the “self-suffering story”
 It can be told in many different ways – in
words, music, art
What is testimony?
 It can be told to many different audiences: to
the family, to friends, to the community, to the
“world”, to a therapist, to a lawyer, to a priest
 It can be used for many different objectives: as
a record, as evidence, as an expression of
emotions, for advocacy
 Testimony in different variations has been used
by mankind for thousands of years
 Here we are using testimony as a healing or
psycho-therapeutic method
What is Testimony?
Has a double meaning (in English):
 Objective, legal, public, official
(evidence, attestation, proof)
 Subjective, cathartic, spiritual,
emotional, private (expression of
disapproval, condemnation,
protestation)
Interpretation of Testimony
(Dr. Jhawar , clinical
psychologist, Varanasi)
 T- Truth
 E- Emotions
 S- Sentiments
 T- Tortured
 I – Individual
 M- Magnifiable
 O- Operations
 N- Never
 Y- Yielding their rights
Testimony Model
Developed for India
Four sessions:
n Session one: Opening the story
n Session two: Closing the story
n Session three: Delivery ceremony
n Session four: Follow up

n Meditation and Mindfulness integrated

n Community-based delivery rituals introduced
PVCHR Human Rights
Work
 Investigate & Document Violations
 Advocacy
 “Folk Schools” in “People Friendly” model
Villages
 People can give testimonies and receive
support from the group
 Concerns of health and education
Manual
A manual on testimony therapy for community
workers and human rights defenders was
developed (published in English and Hindi):
Giving Voice Using Testimony as a Brief
Therapy Intervention in Psychosocial
Community Work for Survivors of Torture
and Organised Violence
Testimony Workshops
 Three two-week training-of-trainers
workshops conducted:
1. May 2008: 12 human rights defenders from PVCHR
2. January 2009: 14 Human rights defenders from four
states: Uttar Pradesh, Uttarakhand, Bihar and Madhya
Pradesh.
3. February-March 2009: 14 Human rights defenders from
three states: Jharkhand, Manipur and Chattisgarh
Schedule of Workshops
Two parts:
2. First week:
 Theory and exercises (through role plays)

2. Second week:
 Practise: Participants take testimonies with
survivors under supervision
Testimonies collected
 Period of data collection:12 months (May 2008 to
April 2009)
 On average the first testimonial session is held 1
year and 5 month after the date of the most
stressful event
 Average number of testimony sessions per victim:
2,39
Background of survivors
 A total of 85 primary and secondary victims of
which:
 Male: 64 (76 %)
 Female: 20 (24 %)
 Average age: 39,2 yrs; age-ranging: 16 - 70 yrs
Background of survivors
 Category of survivors
 Primary Victim: 59
 Secondary Victim: 24
 Secondary victims most often reported relation to
primary victim as either wife (29 %), father (14 %)
or brother.
Religion:
 Vast majority are Hindus (86 %, n= 72) followed
by christian (7 %, n=6).
Background of survivors
 Caste
 Upper Caste: 9 % (n = 8)
 OBC: 46 % (n = 39) (Other Backward Caste)
 SC: 21 % (n = 18) (Schedules Caste)
 ST: 24 % (n = 20) (Scheduled tribe)
Background of survivors
 Education
 No education: 28 % (n= 24)
 Primary education: 19 % (n=16)
 Secondary education: 19 % (n= 16)
 BA: 11 % (n=9)
 Other 24 % (n =20)
 high school, intermediate, BAMS
Background of survivors
 Occupation:
 Agriculture: 37 % (n =31)
 Business: 6 % (n =5)
 Household: 6 % (n =5)
 Public service, journalism, teacher: 6 % (n=5)
 Lawyer, doctor: 2 % (n=2)
 Government or political position: 2 % (n=2)
 Other 40 % (n = 34),
 primarily landless labour, or having own business such as
shopkeeper, tea stall, making plates or rickshaw driver
 Not working 2 % (n =2)
Background of survivors

 Activities:
 Humanitarian/ Solidarity: 29 % (n =25)
 Political: 6 % (n=5)
 Religious: 6 % (n=5)
 Trade Union: 2 % (n=2)
 Press: 1 % (n=1)
 No activities: 49 % (n=42)
Type of Violations

 Types of Human Rights violations:

 Psychological torture: 82 % (n=70)
 Physical torture: 48 % (n=41)
 Sexual torture: 4 % (n=3)
 Custodial death of primary victim: 2 % (n =2)
 Extra-judicial killing of primary victim: 1 %
(n=1)
Identity of Perpetrator
 Identity of perpetrator:
 Police: 80 % (n =68)
 Armed forces: 5 % (n =4)
 Intelligence Service: 2 % (n =2)
 Prison authority: 1 % (n =1)
 Other: 34 % (n =29),
 primarily neighbours, village leader and upper
caste
Injured Part of Body
 Most frequently injured parts of body
 one or both legs 25 % (n =21)
 back 24 % (n =20)
 one or both arms 20 % (n =17)
 one foot or both feet 15 % (n =13)
 face 13 % (n =11)
 head 9 % (n =8)
 chest/breast 8 % (n =7)
 not injured: 28 % (n =24)
 On average primary victims report 2,4 injured body parts
Nature of Injury
 Most frequently types of physical injuries:
 Pain 26 % (n=22)
 Loss of function 26 % (n =20)
 Loss of sensation 20 % (n= 17)
 Open wound 20 % (n =17)
 Loss of strength 18 % (n =15)
 Bruise 11 % (n=8)
 Fracture 9 % (n =8)
 Not injured 24 % (n=20)
Psychological Symptoms
 Most frequent symptoms
 Anxiety 54 % (n=46)
 Can’t sleep 53 % (n=45)
 Memories 52 % (n=44)
 Fear of going out 45 %
(n=38)
 Nightmares 41 % (n=35)
 Self isolation 32 % (n=27)
 Panic attacks 17 % (n =14)
 Depression 15 % (n=13)
Treatment before Testimonial
Therapy
 Legal aid: 33 % (n=28)
 Testimony before tribunal: 31 % (n=26)
 Public hospital: 19 % (n=16)
 Counselling: 19 % (n=16)
 Medication: 17 % (n=14)
 Private hospital: 11 % (n=9)
 Physiotherapy: 4 % (n=3)
 Surgery: 2 % (n=2)
 None: 29 % (n=25)
Use of Testimony

 Survivor wants:
 80 % want it published or used for human rights work
 Other interventions by PVCHR or other actors:
 Medical: 8 % (n=7)
 Social: 55 % (n=47)
 Legal: 60 % (n=51)
 Reading of testimony at Folk School Meeting: 53 % (n=45)
Changes in wellbeing
Changes in psychosocial wellbeing indicated
through the WHO5*:
 WHO5-average pre-TT score (n=84): 8,46
 WHO5-average post-TT score (n=38): 12,82:
*The higher the WHO5 sum the better (range 0-25)
Changes in Participation
(WHO Participation Scale)
Overall improvement in participation.
 17 questions
 Range 0-85
 0: same participation as peers
 1: No problem
 2: Small problem
 3: medium problem
 5: Large problem
 Pre-participation Scale mean value:
31,25* Post mean-value: 13,25*
Changes in Participation
(WHO Participation Scale)
 2,00 used as cut-point: Participation perceived as medium or large
problem. Most commonly found problems were in:
 P1: Do you have equal opportunities as your peers to find work?
 Mean: Pre: 2,61 Post: 1,85
 P3: Do you contribute to the household economically in a similar
way to your peers?
 Mean: Pre: 2,22 Post: 0,78*
 P4: Do you make visits outside your village/neighbourhood as
much as your peers do?
 Mean: Pre: 2,87 Post: 1,15
 P11: Do you move around inside and outside the house and
around the village/neighbourhood just as other people do?
 Mean: Pre: 2,25 Post: 1,15*
 All dropped below 2,00 post testimony
Types of Delivery Ceremonies

 At public demonstration in front of Government

Head Quarters
 At “Folk School” meetings

 At community meetings

 At street performances & singing

Delivery Ceremony at
Folk School Meeting
Delivery Ceremony
at Street Theatre Performance
Delivery Ritual at
Community Meeting
Out come of Professional
Consultation
Varanasi, India, September
2008
 Interesting part of this therapy is that it has both
Western element of Anger Management, Classical
Conditioning and Eastern approach of relaxation
methods and Meditation.
 A cost effective model of psychotherapy which does
not require clinics or hospitals but can be done
directly at the doorsteps of the victim, e.g., in his
house, in the community, in a forest etc.
 The economic costs of the whole approach seems to
be very less than regular psychotherapy session in a
clinic or hospital.
Facts
 There are around 3,000 adequately
qualified psychiatrists and 1000 clinical
psychologist in the entire country of India
with a population of more than one billion
people.

 The state of Uttar Prades , where PVCHR

works is the most densely populated state
in India with a population of more than 166
million people. However, there are less than
100 psychiatrists and 100 psychologists..