In June 2011, Greet Cassiers, Ernst Knijff and myself were approached by Nepalese psychologist, Shambar Thapa, to support him in building a psychotherapy institute in Kathmandu, Nepal. The institute would provide psychotherapy and counselling in the region, alongside a Gestalt psychotherapy training programme, according to the international standards of the EAGT (European Association for Gestalt Therapy), for a group of psychologists and counsellors who work in the care of children, refugees and victims of sexual abuse and torture.
We, of course, agreed, and decided to go to Nepal in July 2011 with three main goals: to gain a better understanding of mental healthcare, culture and the socio-economic climate in Nepal; to provide a two-day introduction workshop on the Gestalt approach for those who were interested in following the four-year training programme; and to explore the motivation, needs and competencies of the psychologists and counsellors who wanted to be involved with the institute. And, of course, to explore our own motivation. We stayed in Nepal for about three weeks, working hard to build the basic structure for the organisation and the training programme.
In April 2012, we began the programme with eighteen students, and lay the foundations for the Himalayan Pathway Psychology Institute. Now, almost six years later in March 2018, the first group have completed their training, two other groups have begun, and we will start a further process group this month. We also extended the core team last year, welcoming Beatrix Wimmer from Austria, and Giovanni Turra from Italy. The institute has become a professional home, where professionals can find knowledge, experience and support.
Greet, Ernst and I are involved as founders and core trainers of the training programme. We provide supervision, lectures and shorter workshops or seminars for schools, colleges and universities. We’re also training the first Nepali graduates to themselves become educators in the field. Since 2013, we have a new Nepalese coordinator, Minakshi Rana, taking over from Shambar Thapa who immigrated to the US.
We work very closely with local initiatives and organisations such as the counselling centre for burn survivors, a centre for young people with autism, a shelter for street children, and the Transcultural Psychosocial Organization Nepal (TPO Nepal). This is one of Nepal's leading psychosocial organisations. It was established in 2005 with the aim of promoting psychosocial wellbeing and mental health of children and families in conflict-affected areas and other vulnerable communities. Some of our students work there as psychologists. Alongside these organisations, we cooperate with many other psycho-social projects in remote areas, and our students are directly involved in community work, particularly in the region of Sindhupalchok.
The mental healthcare situation in Nepal is what truly motivated us to set up and support this project. We were shocked by how under-developed mental healthcare is in this country, and how difficult it is for people who are in need of counselling or therapy to get the help they need. Many people go to priests or guru’s, because they believe that their mental problems come from mistakes or wrong behaviour in this life or previous lives (Karma), or they look for witchcraft.
We were also impressed by how psychologists, psycho-social workers and counsellors in Nepal undertake vital and difficult work, often taking care of vulnerable children, refugees and victims of torture, and have little support and/or professional education. They need, and are entitled to, a solid level of professional education and support. Past experience shows how important it is for workers in this field to have a professional home, and at the Gestalt Institute Nepal, they are supported by other professionals and have the chance to share experiences, receive supervision, and indeed a decent education.
The final goal of this project is to establish a self-supported, independent Nepalese Gestalt institute, which combines psychologists, counsellors and trainers who provide therapy, counselling and training for clients and students in the region.
A project like this can only succeed if there is a balance of giving and receiving, of investment and gain for all participants, as well as support for organisations such as MultidiMens and the European Association for Gestalt Therapy.
As trainers, we gain a lot from this programme, not least because it improves our ability as Gestalt trainers and therapists by being confronted with such a severe socio-economic situation, and the existential crises which are so commonplace in this country. We’re challenged to implement the Gestalt approach in a country and culture that is totally new to us, and the project deepens our understanding and thinking of other cultures and mental health around the world. It also deepens our understanding and thinking of the concept of psychotherapy, of counselling in general, and particularly of Gestalt as an important approach within this context.
Psychotherapy is about contact, and Gestalt therapy is the therapy of contact. This project challenges us to explore, and possibly reconsider, the basic concepts of psychotherapy in all its possibilities and limitations.
The Gestalt approach is almost totally opposite to the culture of Nepal, perhaps even the whole of Asia. Whereas the Gestalt approach is focused on making the implicit explicit, this culture is characterised by keeping things as implicit as possible. Where the Gestalt approach endeavours to increase awareness of emotion, the culture in Nepal is focused on keeping emotions out of awareness.
One of our students undertook some research on how counsellors deal with anger from clients. The research found that most try to support the client in mediating or breathing the anger away, very few would work with the anger, and only one claimed they would provoke the anger if he or she assumed it to be surface level.
Many emotions are repressed, and therefore we noticed that the contact mechanisms of retroflection and deflection are strongly present. In that sense, we ensure to mention to new students that Gestalt training may be difficult in the beginning; to become aware of many repressed emotions and patterns in their personal and family life, not to mention their professional life, may be difficult.
While introducing the concept of the Gestalt approach may have been slightly demanding, there have been very few language barriers as most young Nepalese people speak good English. Of course, this means that our students are not working in their native language, so with some experiments, we ask students to first explore it in their own language, and bring their findings to us in English.
Nepal has two sides: on the one hand, it is a beautiful country with very friendly people; as long as they are not stuck in traffic! On the other hand, it is a country like so many, where corruption is a part of daily life, and un-sustainability is the leading motive. We know that our students are extremely motivated and devoted to the training, and still, some (mostly the ones with money) were asking if they could skip payment.
Attendance was also an issue, particularly with our first group, when often only one out of five students would turn up. However, it is important to bear in mind that most of our students - particularly the women - would have been up since 4am preparing food, cleaning the house and getting children to school, before undertaking an hour and a half travel time, sometimes by foot, to get to the training. Some even have classes at their respective college or university from 6am until 10am before they come to us.
Nepal has not really recovered from the earthquakes. Because of all the corruption, a lot of the money that was donated from all over the world has disappeared, and never reached the victims. However, it was fantastic to see how groups of young people took the initiative to go to the areas most affected to help to rebuild villages and schools.
Almost all students involved in the training programme are psychologists or psycho-social counsellors who work with local organisations. After the 2015 earthquake, many have been involved in trauma counselling in remote areas of Nepal, where the damage and suffering was enormous. Some students have started a private practice, which is rather new in this country.
Pragya, Psychological Counsellor:
“As a counsellor, I used to focus only on the client, his feelings and his story. The content of the clients’ story affected me as well, but I rarely expressed my feelings during a counselling session. The most interesting thing in Gestalt psychotherapy for me, is that I share with the client how his feelings affect me as a counsellor. I am surprised how it makes the client more aware of his problem. There are still so many things to learn and experience in Gestalt psychotherapy. It’s a never-ending process!!”
Hashana, Psychologist at ‘Voice of Children’:
“I work with street children and survivors of child sexual abuse (CSA). Street children are unaware and unsure of their surroundings, emotions and strengths. Survivors of CSA are in great confusion, suffering from feeling of self-guilt, fear and strong emotional disturbances. They find it very difficult to come through this traumatic event. Gestalt psychotherapy is helping me to support them through awareness, acceptance and realisation. As they are the strong survivors, I help them learn to celebrate their life.”
Ruban, Clinical Psychologist:
“I work with street children and shelter children, supported by an organisation. The children have anxiety, low self-esteem and are often aggressive due to their history, and worry about their future. I love working with these children, even though it is very difficult to support them in overcoming their traumatic situations. Gestalt psychotherapy is helping me to encourage awareness about their present situation, their qualities and strengths, as well as to help them to celebrate their life in the present.”
Pratima, Psychosocial Counsellor at Kathmandu Engineering College:
“I am working as a counsellor in a college, where I counsel bachelor students. The students are dealing with difficulties during their studies: frustration, heartbreak, depression, family problems surrounding high expectations, working beyond their limits, excessive day dreaming and anxiety. I am a student of the first Gestalt education in Nepal, and believe Gestalt to be one of the best approaches to psychology. In my country, people are not aware of their feelings, thoughts, or existential issues, though they have a lot of psychological problems. Being a therapist, I want to contribute to psychological support and want to be the best Gestalt therapist.”
Nima, Psychological Counsellor:
“I come from the Sherpa community, where concepts like psychology, counselling or therapy are almost non-existent, and this ignorance towards mental health could well be the reason behind my interest and inclination toward psychological counselling. Out of several trainings I attended Gestalt training, which proved to be the most effective and successful as I could learn more about myself, my strengths, and my weakness. This self-awareness has also facilitated in helping my clients to deal with their problems. I am glad that I have enrolled myself as a trainee in Gestalt Therapy.”
“I have worked with women who have suffered various forms of violence, including incest, physical torture, family violence and sexual abuse with the Saathi organisation. I’ve also worked with children who are experiencing psychological disturbances such as ADHD, depression, trauma, abuse and family loss with the ISIS Foundation, and people with drug and alcohol addictions with the Wisdom Foundation. Most of my clients are focused on what was, what might be or what could or should have been, rather that what is being done, thought and felt at the present moment. I have experienced that Gestalt Therapy is helping the client to become more fully and creatively alive and to become free from the blocks that diminish satisfaction, fulfilment and growth and to experiment with new ways of being. I myself have found drastic change within me since experiencing Gestalt therapy. One of my dreams is to work with mentally challenged and disabled persons, too. As a Gestalt Therapist, I would like to create a space in which my client can recover his or her capacity for living. In this way, a person can learn to be aware of himself and aware of his or her interactions with others in the moment and assume responsibility for their actions.”