What motivates TTI co-founder Katy Robjant?

Katy Robjant, one of TTI’s founders and currently it’s Narrative Exposure Therapy (NET) Lead, provides some insights on her work and experiences

What made you interested in psychology to start with, and the particularly sub-field of working with survivors of conflict-related violence?

When I was younger I learned of an  incident within my family of extreme brutality instigated by those who are supposed to protect people. The details I won’t go into as I don’t want to counter other's confidentiality, but I learned a lot that day about  (in)justice.  I also watched the ripple effect that secrecy has on trauma, and also about how this compounds stigma and I think from that day on I realised something important about how silence makes trauma worse.

Is there something you find particularly rewarding about the work?

I like treating traumatised people using Narrative Exposure Therapy (NET). The results are really powerful. Not only do the trauma symptoms reduce, people redefine their memory, re-know their identity, and are able to make decisions about how to move forward with the rest of their lives, knowing that they have given testimony to the human rights abuses they have endured. The therapy takes a Lifeline approach and treats trauma within the context of that person's life, including taking account of the socio-political context. The manner in which the trauma processing is done is also unique and there is a strong emphasis on emotional attunement and establishing a very human connection through giving testimony. NET has a strong evidence base and is a very robust treatment with excellent treatment efficacy. In my experience, NET can enable recovery in people who have suffered very extreme trauma and who are severely affected. The testimony aspect of the treatment is empowering. Similar to other trauma focussed treatments but more so in NET as a result of the unique re-living style, the therapy involves going into the depths of every worst moment with survivors, only this time, there you are -by their side. This is a very powerful healing tool. I also enjoy training others to deliver NET and I love being involved in the ongoing development and research about the approach so that we can share ideas and keep learning from survivors. 

Of all your field-based work, which experience did you find most challenging and why?

One of the most challenging experiences was when I was working with vivo International in The Democratic Republic of the Congo (DRC) and there was an Ebola outbreak in the Kivu regions where we were working. There was a real fear of Ebola reaching the city because of the wider implications that would have (Goma is a border town) and at the same time a real horror about the high rates of Ebloa cases in rural areas that were not well supported with medical facilities. Cultural beliefs about Ebola complicated the emergency response and ongoing insecurity directly interfered with treatments and prevention when armed groups destroyed field hospitals and clinics. For our clients, often former child soldiers, former combatants, or survivors of extreme violence at the hands of armed groups, this was particularly triggering. This was another lesson for me in the fact that there is no trauma treatment in isolation, everything is connected to the cultural, economic and political picture.

Can you give an example of a piece of work that you're most proud of, and why?

In DRC, we (vivo international together with the University of Konstanz), were recruiting participants into a trial to treat former combatants and we learned of a village where a rebel group (M23) tore through and abducted children to fight in the conflict. We made a decision to visit and see if the need there justified that it should be an intervention site. We held a community meeting (hosted by Congolese colleagues) where women told us about their release from this group and their life since, how they were made to feel on return to the village as outcasts, how they felt 'ruined', how they were regularly beaten up, and also how they regularly assaulted others as a result of their experiences. I immediately decided we should begin our intervention there as the cycle of ongoing violence caused by trauma was so stark. The proud moment though - is when we returned to a community meeting 6 months after the intervention. The change I cannot describe easily, but it fundamentally touched me. Among the women there was an agency, and an ownership within the meeting, these women were not going away, they were not going to be silenced. They were going to speak openly about what had happened to them. They could do this because the treatment had freed them from the silencing impact of trauma. I will never forget the words of the women and girls in that meeting, who spoke openly and freely about their experiences and demanded their place within the community. Previously they had described being labelled as 'kisigira' (in Swahili - meaning worthless), and in this meeting they were discussing that this phrase "did not apply" to them. 

You are recognised as an expert in Narrative Exposure Therapy (NET) - can you explain what it is, how it was started, and why you think it is a useful approach?

NET takes a Lifeline approach to understanding trauma. Every emotional event, positive or negative, builds on the last. With trauma, those accumulative experiences lead to a neural network in the brain that carries it all, and it is easily triggered, causing the individual to experience all of those events again, as if they are happening right now. In NET, we work on contextualising each event within the context that it occurs. The approach not only treats PTSD but also takes testimony and seeks to understand the context of the events. This approach understands that trauma happens within context, and acknowledges the human rights abuses that have occurred, quite unlike other approaches. New developments of NET target reductions in violence at individual and community level and promote peace building.

Can you give an example of how NET works, from your field work?

There are many examples. where trauma hits, we have to understand the survivors experience within context. Within their life, within their community, their society, their country, the global context. We have to acknowledge this and we have to help the individual alleviate their suffering while at the same time we have to give testimony to what has happened. Then we have to work with this, in communities in societies, and advocate at a political level. This is where NETfacts, a new community intervention that we have developed at the University of Konstanz comes in. In this intervention we look at how we can share the experiences we learned about through the individual NET treatments to work with whole communities to enable reintegration and promote peace. 

If people/organisations are interested in this kind of therapy, where can they get more information? How can people get in touch with you?  

People can contact me anytime through info@tt-intl.org