What working in Cambodia Taught Me About Suffering and Healing.

(6-8 minute read)

When I went to University for the first time to study Health Sciences, I chose to take a subject that required travelling to Cambodia to “assess their access to healthcare and resources”. We were sent to a brand-new Military Handicap Development Centre, which supplied accommodation and healthcare to veterans and their families from the Khmer Rouge – the decimation of the local population by their own Government. The location was 45 minutes outside of one of the countries major cities, Siem Reap. Every day we would travel through the countryside of tall palm trees that the locals would climb up with ease, rural farms with a wide array of animals, some freely roaming, roadside shop stall selling goods that even included uncovered fish sitting in the sun.  

We were the first Westerners for the local children to set their eyes upon, let alone talk to in person (via a translator). An experience that would be hard for us in developed countries to fathom. Shock turned to delight when we introduced an array of sporting equipment we had brought them from town, and an hour or so of all-out play ensued. A number of other first that took place included taking pictures with a digital camera and seeing themselves in them for the first time, playing a musical instrument, and learning to speak basic English (which was incredibly important to them so that they could work in the cities, which are geared towards tourism).  

What really struck me in my time there was that the people were incredibly generous despite barely having any possessions at all. Children kicking around a crumpled piece of cardboard instead of a soccer ball, giggling and having the time of their life with their brothers and sisters, being watched over by the grandparents and parents in the background. Nearby the same scene was a river that was full of mosquitoes supplying Malaria to the locals. Due to a lack of education they would tell us that Malaria came from a range of things, such as some local fruits. This is something that in any Western context would be easily accessible information that would contribute to our health and wellbeing. However, they also had a lack of access to clean drinking water so it’s understandable that Malaria was actually a secondary concern for them, survival being the daily reality for them.  

When we did home visits around the Community Centre we encountered a man with bullet shrapnel stuck in his brain that was causing him to let out bouts of aggression on his family wife and children on a regular basis. The family shared one bucket of water per week that had to be used for everything from washing themselves to cleaning dishes. Another man had an amputated leg that had festered and he did not have a wheelchair to get around easily. The doctor who was meant to be providing healthcare to the community was over 100 meters away. The ‘doctor’, we found out, had studied nursing for a year and wasn’t really a doctor. No medicines could be stored because there was no electricity in the area so any treatment that they really needed would require regular transport back to the city, which was not affordable for them.   

This experience shocked me into an encounter with the harsh realities of living without the safety and cushioning of modern life in the West. It challenged me to see what was present in our modern lives that is often taken for granted, but it also opened my eyes to what we are often missing in more affluent countries.  

When I returned from this trip I was shocked again...people all drove in straight lines very neatly merging and stopping correctly at traffic lights, electricity wires were not a bundle of a buzzing mess constantly having issues all around the city, everything was in it’s proper place and clean. It’s not perfect of course but the stark reality of modern life in a Western context for most people is that we have a lot in terms of material possessions and privileges that I wouldn’t have considered, such as electricity and clean drinking water whenever we want it. And yet despite this, we still suffer, a lot. The rates of people accessing mental health care services in recent years has increased due to a decrease in it being a taboo topic in society generally. While access has increased, it is more clear now than ever that a lot of people are struggling, and that it can’t be fixed easily.  

Astoundingly, the locals were the friendliest people I have ever met. They would generously invite me into their homes and offer me what they could when they barely had anything – a gesture that I thought I seldom experienced even back hom ein Australia. These were a people ravaged by genocide in their recent past, having parents even be affected by the Khmer Rouge in which a quarter of Cambodia’s population was killed. This was a country trying to rebuild after an unimaginable disaster. This was a people who wanted to learn from their experiences, look grief in the face and work together to be harmonious despite the inhumane injustice inflicted upon them and their families.  

When trauma and unrelenting grief are a daily companion in our lives, there are existential questions thrust upon us, “How do I rebuild my life? What is the point? What for? Why me?”. In the face of this, many will crumble, and others will grow through it over time, their experiences acting as a crucible for transformation. I’m not trying to sound idealistic when I say this. Who would willingly choose to go through that kind of suffering? And yet suffering has led many people to seek a way of life that is fulfilling, authentic, religious even. It is powerful Grist for the Mill.  

People seek answers in their suffering because it forces us to face tough questions in order to survive and perhaps even thrive. There is only so long that we can come up against the same problems, challenges, and dilemmas, and not look at how we are at the center of them. This makes sense since we would likely blame ourselves, berate, shame, feel guilty for past actions, for who we are, which is crippling to our sense of self. We may literally feel crumpled over in our body, anxious about being seen, heard, and felt by someone throughout our everyday. So how do we rebuild? Why? What for? Why us? 

While we have to ask ourselves this question in order to get an answer, there is also a way in which suffering may hold a path towards the answer. It forces us to confront what we have been avoiding in ourselves, what we feel like cannot be contained in ourselves, what we haven’t wanted to acknowledge for a range of fears – that we may have to entirely change the way we live our life, who we relate to, how we relate to them, how we are as a person in the world. Do I dare allow myself to fully experience this feeling? Do I dare choose a different career and disappoint my family? Do I dare have this boundary with my friend who might cut me off if I do so? What we might find in that questioning is that we are terrified, petrified that we will reexperience our core wounds.  

“I am... 

Not worthy of love or acceptance 

Disgusting 

Worthless 

Shameful 

Hopeless 

Stupid...” 

The core wounding is a part of us, perhaps even the only part of us that feels real. When it rears it head we panic and get wasted on drugs and alcohol, get stuck in relationships that don’t serve us or damage us further, compounding the way that we feel about ourselves further.  

Rebuilding requires tending to this wound in a way that will take us to that place in ourselves and fully experience the pain and grief that is held in us. This is potent to experience in the presence of someone else who can reinforce that we are worthy, loveable, acceptable, not broken, damaged, or disgusting. Seeing the real us that no one else is allowed to see from being hidden away from ourselves even, is the beginning of changing the way that feel about ourselves. Our relationships are mirrors through which we have learned to identify through. Our childhood uprbringing is a powerful shaping force of who we become in the world though we are also greatly influenced by relationships throughout our life. Some people are lucky enough to have multiple or even lots of people they can attribute to their positive feelings about themselves. Some people may have none. Some people may think they have none until they can let down their guard enough in the right circumstances to let care from someone else touch them. Even if it happens once, it may be so raw that they don’t allow it to happen continuously. The wounding will continue to affect how we show up in the world and in our relationships unless we do “the work” on a regular basis.  

The next step is to explore what is left, what do we need, what do we want, truly? This may have been a question we have never really known how to answer. This is a daunting question to face when we don’t know how to answer it. We may ask people, peruse YouTube and books endlessly, trying to reconstruct a sense of what feels true to us, to no avail. We have practiced being disconnected from ourselves for so many years that there may be little of us to feel into at first. With practice, the sense of being embodied, of knowing how we feel, becomes knowing what we want and need. If we don’t know what it is to feel ‘safe’ enough to allow ourselves to feel vulnerable, we will continue to fluctuate into disconnection.  

Reestablishing connection comes in many forms. This can be the hardest thing to achieve since we will constantly be challenged to fall into the same traps when it all feels too hard – drinking, eating, sex, shopping, self-harm. And we will be challenged to face the same confronting reality over and over every time we make a slip up no matter how large or small.  

“I’m worthless 

Disgusting 

Unloveable 

Broken...” 

But eventually, it becomes a little easier to tolerate the experience and not allow it to define ourselves and our actions. Each little win becomes self-reinforcing that we might actually be able to change. This internal battle may not even be one that other people are aware of. Perhaps the people around us actively try to keep us in our old ways. Perhaps we come up against the realisation that they don’t want us to change for the better, even after talking to them about it. This can be an isolating experience that is difficult enough to stop people going further. But you’re more aware now and there is only more suffering if you turn back. This loop can get people stuck for years, perhaps even a lifetime.  

But when it starts working and we feel the first bit of momentum build, we have found an access point to real change. We start to feel different about ourselves in a way that we may not have any memory of, we feel like a different person, yet it feels true to who we are. We start to feel like we have built a capacity to move through the world without being dictated by our fears and intense feelings. Courage and discipline are key to the art of living a life that aligns with our values, wants, and needs.  

So, how do we rebuild? What do we rebuild? What for? Why? 

For some people it might look like listening to your body and what you can feel when you check in with yourself throughout your day. Feeling anxious? What is happening in your body? Are you moving really fast, drinking too much coffee, feeling overwhelmed with tasks to complete in your day but can’t see how to get them done and not feel anxious at the same time?  

When this happens it can be hard to keep our prefrontal cortex online. In other words, you can’t ‘think straight’. We can increase our ability to do this under stress if we can tune into our body and allow ourselves to feel. You might notice, for example: 

Buzzing in your head or a headache 

A pit in the stomach 

Tension in the shoulders 

Clenched fists 

Racing thoughts 

Disconnection to everything and everyone around you... 

One method is called ‘box breathing’ in which you breathe in slowly for 4 seconds, hold your breath for 4 seconds, breathe out for 4 seconds, then wait for 4 seconds until the next breath (adjust according to what is comfortable for you). You will still likely need to continue with what you’re doing but you are working on increasing your capacity to tolerate the distress. If it is a situation when the stressor is short lived then you can likely stop long enough while doing this to ask yourself “what do I need right now?” and receive an answer such as: 

“Lie down for 5 minutes” 

“Go for a short/long walk” 

“Eat something” 

“Call someone for support” 

If the stressor cannot be avoided then the principle will be similar but will need to support you to tolerate the situation as best as you can until it is over. For example: 

“Move slower” 

“Lower my voice” 

“State a boundary” 

“Make a request” 

“Communicate my distress appropriately” 

These are likely to require a certain level of regulation to put into place, but it could also be that they are required in order to achieve a certain level of regulation as a byproduct/consequence. It may be seen from these examples that we need to learn how to adapt to the moment, which can be very difficult when we are used to reacting in our usual, habitual ways.  

The people of Cambodia were inspiring to me, a Westerner who thought he could offer profound help in a situation where I could actually learn a lot from them.