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By Priyanka Dayal

A South Asian's Work with Trauma Victims

Part of the reason Siddharth Ashvin Shah can reach trauma victims is that he has felt what they are feeling.

Shah was in New York when the World Trade Center Towers fell. He had to tuck his emotions away and do his job as a physician-consultant, helping first responders cope with an immense tragedy so they could help others.

Shah, 36, is based in Washington, D.C., but he travels around the world to provide therapy to victims of trauma. The people he helps are not just victims, they are victims whose job it is to care for or interact with others: firefighters, paramedics, therapists and journalists.

“I noticed that the workers themselves would like to have some guidance and make sure they don't make mistakes that could do harm to vulnerable people,” Shah said in a recent telephone interview. “This is really an unmet need.... There's real effects when caregivers don't get what they need.”

Shah was speaking from Ahmedabad, where he was visiting family after spending time in Mumbai working with victims of the November terrorist bombings. He teaches as many as 15 different methods – such as yoga, prayer and exercise – to help people cope in the aftermath of brutal attacks or deadly storms. The workshops he led in Mumbai also included laughter therapy and role-playing.

Siddharth Ashvin Shah

When trauma victims are in a group, therapy can be more effective than in a one-on-one session, Shah says.

“One of the things that would help most is solidarity and sticking together,” he said. “When you're traumatized… being with people may feel dangerous…. After terrorism, people might feel like ‘I'm the only one.’ In numbers we have safety.”

People can be traumatized after events as big as the Mumbai bombings or a devastating tsunami, or even from a mugging. Some trauma is felt immediately, and sometimes it remains for generations.

Siddharth Ashvin Shah teaching Mumbai psychotherapists

In Mumbai during February, Shah met people who were hurt and angry. While wealthy people staying at the Taj Mahal or Oberoi hotels got a lot of attention after the attacks, Shah said, many of the people who witnessed the killings at CST Railway Station have very few resources and were overlooked.

“They are not the people who would go to psychotherapy or counselors,” he said. “Some of them are poor. Some are middle class…. They might not be as comfortable with the idea of psychotherapy.”

The challenges for Shah's clientele—first responders—are unique. “They themselves, the caregivers, are affected,” he said. “In the middle of doing the rescue efforts, your heart is also broken. How do you preserve yourself in that environment so you can do the best work possible?”

Normally, people can hold on to seven different things in their minds, Shah says, but a traumatized person can experience cognitive overload, and may not be able to deal with more than three things at a time.

For some caregivers, strong emotions can develop into an aversion to going to work.

Shah teaches that just because you have symptoms doesn't mean you're weak or ill. He has symptoms, too. He had them when he had to visit an office in a trade center building in Mumbai. The building's name and appearance reminded him eerily of 9/11.

“This was unconscious initially,” he said, “but I was avoiding this elevator (in the building). My mind was saying to me, ‘I don't want to be in this closed, prison-like elevator.’”

With clients and himself, Shah uses yoga as a form of therapy that can help relieve anxiety and elevate mood. When he was 21, a few family acquaintances introduced him to yoga. After moving to New York he continued to practice at studios there.

“I use a yoga perspective in just about everything, though I might not state it as yoga,” he said. “One of the goals of yoga is to bring a person into integration, rather than fragmenting parts of their life. I use breathing techniques for the most part.”

For example, he says, lengthening the exhale of a breath helps calm the mind.

Therapist Angela Cerkevich’s whole approach is through yoga. Cerkevich, a friend of Shah's, started doing yoga in college, when she was studying to be an actor. (She later became a therapist). She realized how much yoga was helping her ability to stay calm and concentrate when she needed to perform.

Yoga also increased her appreciation of global affairs. “Thousands of thousands of years of philosophy can really change your perspective of life,” she said.

Cerkevich has taught yoga at the Boys and Girls Club and Walter Reed Army Medical Center in Washington, D.C., where she is based. She also went to Rwanda for several months and established a yoga teacher training program, to reach out to genocide orphans now in their twenties. She's planning to visit Rwanda again this spring.

“(Yoga) is cheap, it's affordable, it's easily learned,” she says.

Of course, for Cerkevich and Shah, there are language barriers and cultural differences to overcome.

“That's the great thing about yoga—we were able to communicate other than just language, other than just verbal,” Cerkevich said of her clients in Rwanda. “You can still feel like there is an intimate personal relationship.”

Shah says he has to tweak his exercises depending on the country in which he is teaching. In India, for example, therapists tend to speak in a more indirect and polite manner than American therapists, but they still get the job done. And in India, it's acceptable to touch someone, on the arm, for example, while speaking with them. In the United States, therapists are much more guarded about when it's okay to touch.

Since the age of four, Shah knew he wanted to be a doctor. He was first impressed by the work of humanitarians when he was ten. As a young doctor, he figured out how to put those vocations together and make a life out of it. He founded Greenleaf Integrative Strategies, a trauma education and consulting firm.

Shah speaks English with an American accent, but he also speaks Hindi, Urdu and Gujarati. He grew up with Gujarati and picked up the other two languages when he took a year off before medical school and journeyed around India, “informally educating” himself on the country's trains, planes and buses. Since then, he spends a couple of months every year in India.

He has also worked in Ethiopia, Brazil, Pakistan and Sri Lanka and hopes to work in Sri Lanka and Pakistan again.

“Because of his medical background, he has the physiological evidence [for] why something works,” Cerkevich said. “He's one of the most knowledgeable people I've ever met in my entire life.”

Priyanka Dayal is a journalist in Massachusetts, who recently started practicing yoga.

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