Majestic Majete, Psychotherapy Perusings

6 November 2016

We just returned from two nights in Majete Wildlife Reserve. We stayed at Thawale Lodge, a carefully planned resort up a small hill from a waterhole. The waterhole is set in a grassland dotted with trees and there is very little underbrush. You can see animals approaching the waterhole from a distance as they emerge from the thickets surrounding the area. There are 6 tented “chalets” and one more luxurious two bedroom “chalet” (Try not to think Switzerland!), with terraces and bathrooms. widely spaced in a crescent for privacy. Widely spaced enough that animals regularly pass between them. Animals like impala, baboons, warthogs, elephants, Cape buffalo, and so forth. A hyena gave a loud, deep, and rather terrifying bark-growl Friday night nearby our chalet; we saw the tracks in the morning, about 50 feet from where we slept.  The waterhole is illuminated at night, when a lot of the shy animals visit. A herd of 30+ Cape buffalo hung out there last evening.  We surmised from the synchronized moans that went on for over an hour that one was giving birth. During the day the area looks a bit like Eden, since the cats (lions and leopards) and dogs (hyenas) weren’t around; baboons, warthogs, and all variety of antelope were drinking and mingling, as diverse as a cocktail party in Berkeley. What other animals, you ask? Elephants, Cape buffalo, zebras, impala, nyala, kudu, and many of the 300 bird varieties found in Majete.  Sitting on the terrace watching the scene was incredible, as were the game walks, drives and boat rides up the Shire River. A herd of elephants swimming in single file, babies included, across the river, hippos  happily immersed in it, crocodiles on the banks looking for an opening to get some protein. And spectacular birdlife, from chestnut-vented tit-babblers (a real bird in Africa) to ruby-nippled bed thrashers (a bird of my adolescent fantasies!). Actually, weavers and bee eaters and kingfishers and waxbills and drongos and egrets, herons, and ibis, the African hoopoe, osprey (migrated from Scotland), and African grey hornbills. And many more.

Of the latter, we thought the mother elephant’s threatening displays represented the acme of protective devotion until we learned that the mother African grey hornbill molts all her feathers to construct the mattress within the nest on which to lay her eggs. She then cannot fly, so the male seals up the entrance to the nest with mud, leaving only a little hole through which he passes her food for the time it takes the eggs to hatch and her to re-grow her feathers. If something happens to him, the mother and chicks perish. Hopefully the parents were getting along well before this process got underway!

Majete is 700 sq. kilometers, all fenced to keep the animals in and the poachers out. It was a barren area, without birds or animals in the 1980’s until African Parks took over its management. AP is a noteworthy non-profit committed to preserving wild areas and wild animals in Africa; they now have over 1 million hectares of park and reserve lands under management in various countries in Africa. We were fortunate enough to meet and dine with one of the board members who has been involved since the beginning. Michael Eustace is a South African birder with great interest in and commitment to African wildlife. And AP is doing a fabulous job of preserving and displaying. One interesting idea AP is floating concerns rhino horn. Asians, Chinese especially, prize it for medicinal qualities so that a kg sells for $60,000!  Poaching has taken a terrible toll on rhinos in Africa, despite the fact that its transport and sale are forbidden. But AP has a stockpile of the stuff and rhinos can grow 1kg of horn back a year, so tranquilizing the rhinos and dehorning them periodically and then selling the horn is a fantastic way to discourage poachers and support the parks. However, international animal protection folks seem to think a better approach is to change the attitudes of the Chinese people (only 500 million want to use rhino horn) who have used it as medicine (for thousands of years). You know how hard it is to stop eating a doughnut now and then? Well—.

On a more professional (my profession) note, it turns out there are no child therapists in Malawi. (I knew there weren’t any other child psychiatrists.) There is apparently a counselling program at Chancellor College in Zomba, into which I shall inquire. But trying to find a source in this city of over a million people for the referral of unhappy, troubled, even suicidal teens is proving very difficult. So with Linda’s prodding—We had a dust-up about it and she, actually, was right.—I’m going to start a non-degree, non-certificated study group of school counsellors and others who work with children and are so inclined to learn how to sit with and listen to kids. How to try to refrain from giving advice (in most instances). How to do crisis intervention. How to encourage, in the context of a relationship, a teen or child to be curious about themselves and to put their curiosity and understanding into words (and even action!). I envision a case presentation format after some basic introductory learning. I’m searching for a name that doesn’t suggest we are a psychotherapy group practice for youth and children but is substantial and flexible enough to convey some meaning. Like the Blantyre Child and Adolescent Psychotherapy Study Group, but what a horrible mouthful that is! Blantyre Child Study Group? Association? Any naming suggestions would be much appreciated.

My beef with Linda was that she said, “If, as you say, you just sit and listen to them, why can’t you teach someone who likes kids and wants to work with them to do that?” Because that isn’t what I do. Not all that I do. And I’m listening with a particularly trained ear. Even though that is what I told you I did.  Hm. It turns out I’m not very good at explaining what I do and how I do it, at least to her, when it comes to psychotherapy with kids.  I have done it pretty well supervising younger therapists. I’m pretty sure it doesn’t mean that I don’t know what I am doing, as I do feel like I’m on top of the work when I do it or at least I know enough to know that I am not. It doesn’t fit, for me, into a neat paragraph. But if I am to lead this group, I’ll need to be explicit.

It has come to a head as I have been inundated with referrals from a single source, an excellent private high school here. A student there committed suicide and it caused a lot of unhappy kids, mostly from broken families, to come forward. And the school has been very supportive of the teens in the best ways, but they don’t have a trained psychotherapist for referral. And I don’t want to set up a private practice or a two-tiered system of care, since I am working in the public sector, mostly teaching. But how do I see those I have evaluated in therapy? Because when I am in clinic I am supposed to supervise the 4th year medical students doing evaluations of patients. And that is a frenetic, busy job. So, I’ve decided to try 25 minute sessions and see how that goes. This is calling for a kind of flexibility I’m not sure I have. That is, to compromise my standards of what is good. But what is good here, where the resources are non-existent, may be very different from what is good in Berkeley, where I had adequate time. I find I’m gritting my teeth as I write this. I really don’t like the pressure of time on therapy. I’ve generally felt that therapeutic ambition—-here it would be to do the work in a much shorter period of time—is the death of therapy.  That has a nice ring to it but may be rubbish, given where I am working. So, I have to try to train some folks.  Which feels like a great relief to me, to imagine there may be others who can help out. I cannot stand to have a child need therapy and not be able to get it. I have always been able to refer to someone or to do the work myself.  Not here. It feels like a very visceral crisis to me.

This is a hodgepodge of a posting, I’m afraid. Perhaps that’s why the weekend at Majete was so wonderful; I was coming off of two weeks of uncertainty about what to do with the children I’m seeing who need to see a skilled person in therapy. So I was able to put it all behind me. Here it is again, surprise!

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