Andria Spyridou PhD, Dr.Nat.Sc., Psychosocial Support for Refugees in Conflict Zones

My guest today is Andria Spyridou PhD, Dr.Nat.Sc.,  Her Doctorate is in Clinical Psychology from the University of Konstanz, Germany. Dr. Spyridou is presently the regional mental health and psychosocial support (MHPSS) coordinator for UNICEF’s Latin America and Caribbean Regional Office. Currently, Andria lives in Panama.  She emphasized that the opinions expressed here are her personal views and do not necessarily represent her employer’s.
UNICEF in 2018 estimated that more than 29 million babies in 2018 were born in conflict zones such as Afghanistan, South Sudan, Syria, and Yemen or on perilous journeys to escape fighting.
In 2016 Andria joined an international humanitarian organization in the response to the refugee crisis in Greece as a psychosocial support  (MHPSS) coordinator. Since her work in Greece she worked in similar positions in Syria (2017-2019) in  Iraq, Lebanon, Democratic Republic of Congo. During the Covid-19 outbreak she joined  Federation of the Red Cross and worked in the Bahamas and in Latin America.
As an expert trainer in Narrative Exposure Therapy for PTSD she worked in the Democratic Republic of Congo, Lebanon, Iraq, Syria, Colombia and in Cyprus. I asked her to tell me what is Narrative Exposure Therapy and what benefit did the people in those countries derive from it?
In 2018 Andrea wrote a very interesting paper, Variation in Caesarean Section Rates in Cyprus, Italy and Iceland: An Analysis of the Role of the Media. A fascinating subject that we discussed at length. We discussed her own family background that may have contributed to her interest in this subject as well as more existential issues such as what would she like to be most remembered for.
My guest next week will be Dr. Bob Rosenberg  who received his PhD in the history of science and technology from Johns Hopkins University. He has contributed a chapter on Precognition to Irreducible Mind (2007) and Beyond Physicalism (2015). He will discuss with me Precognition. Please tune in.

If you liked this podcast

• please tell your friends about it,
• subscribe to this podcast wherever you listen to podcasts and/or write a brief note on apple podcasts,
• check out my blogs on Psychology Today at

https://www.psychologytoday.com/intl/contributors/thomas-r-verny-md

Transcript

Unknown Speaker  0:00  
This is Pushing Boundaries, a podcast about pioneering research, breakthrough discoveries and unconventional ideas. I'm your host, Dr. Thomas R. Verny. My guest today is  Dr.Andrea Spyridou. She received her doctorate in clinical psychology from the University of Konstance, Germany.  Dr. Spyridou is presently the regional mental health and psychosocial support coordinator for UNICEF, Latin America and Caribbean regional office. She will discuss with me how conflict shapes birth experience, child development, and parenting. As well as what the role of the international academic community is in this respect.
UNICEF in 2018 estimated that more than 29 million babies in 2018 were born in conflict zones, such as Ghana, stat South Sudan, Syria and Yemen, or a perilous journeys to escape fighting. Welcome, Andrea.

Unknown Speaker  1:34  
Thank you so much. Nice to be here. And thank you for the invitation.

Unknown Speaker  1:39  
You're welcome. I'm interested in your experiences starting in 2016, when you decided to join an international humanitarian organization, in response to the refugee crisis, I believe it was in Greece as a psychosocial support coordinator, because we can start by you telling me what is a psycho social support coordinator.

Unknown Speaker  2:09  
I know it's a big word. And it's actually a mental health coordinator, which is a compose a term that is being used a lot since 2007. The international standing committee for for mental health decided that this is the right term to use when it comes to responding to mental health needs, within mergency settings in conflict or natural disasters. And it actually responds to, you know, the levels the different levels of support that people need to receive when they are in these situations. Because, you know, we use what is called the The I asked pyramid from the initials of the InterAgency Standing Committee. And this pyramid is very similar to the public health pyramid, where you have at the first level, all the basic needs and need for security that all people affected by any any type of emergency have, then on the second level, you have a smaller group of people that might need more specific support, always within the psychosocial spectrum of support. Then on the third level, we're talking about more targeted vulnerable groups in the in the community that would require more specialized support. And here we are talking about psychological interventions, we're talking about psychological first aid, or, or people that require, let's say, interventions that are linked to a certain disability or whatever. Their condition requires more more focused support. And then on the top of the pyramid, we have that smaller number of people that would require really specialized services. And then we're talking about psychiatric services, and medical services linked to mental health. And then you would require also to have those professionals other specialized like psychiatrists or mental health professionals that are trained to respond to those needs. So these

Unknown Speaker  4:25  
May I just stop you for a second. Oh, that makes perfect sense, of course. But where are these people going to come from? I mean, if you are looking, for example, at Afghanistan or South Sudan or Syria or Yemen, or the war in Ukraine right now, all those people that you're talking about who are necessary, are just simply not available.

Unknown Speaker  4:47  
Well, that's true. And that's  why all the humanitarian aid has been developed from for decades for centuries, or at least at the start of the 19th century. When we had, you know, the UN coming in the International Red Cross coming in. And that's what conflict and natural disasters do it, it impacts directly the infrastructures of a country and this in the basic services that need to be present, especially in times of need. And that's why there are these organizations that are already responding from the very beginning. They're also national organizations. So the national, the national societies of the Red Cross are present in 192 countries. And they, their role there is to respond to these kinds of situations. The problem is that when when a conflict, like in Ukraine or Syria or many other parts of the world breaks, then you have a lot of destruction of the services and a lot of people fleeing. So this makes the growing needs of the people makes the response more urgent. And that's why within this mental health and psychosocial support response, we already have taking into consideration that the community has a role to play. And that's why we always look to find, you know, the existing capacities that the communities have to respond to crisis. And we take, you know, the, the resources within our community to train people, people that might be volunteers, or teachers or nurses that might not have any capacity to respond to a psychosocial need, with with a little bit of training, they could do that. So for example, psychological first aid is a very good example. Because we can train in PFA community members in less than a day in even three, four hours on how they can respond to those basic needs, because it's a first response. So yeah, it's not ideal. But in terms of responding to immediate needs, we can and should always take into account the available resources in the community

Unknown Speaker  7:09  
In which part of the world of all the places you have been to has it been most effective? Where has this approach really worked?

Unknown Speaker  7:22  
Well, it's a bit difficult to say, because my experience has been very different depending on the country. Yeah. For example, in Syria. Now, let me start from Greece, because in Greece, it was really, I've seen with my own eyes, people, volunteers, elderly people, grandmothers being trained in how to provide PFA in two hours. And then you'd have the boats with the refugees coming in the islands, with people that you know, they have already suffered a lot to leave their country, but also they have been at risk of death in the journey in the boat. And some of them arriving that you know, in a boat, you could have children who had died, mothers who lost their children on the way. So we're talking about really urgent needs of people that are coming in with a lot of psychological distress. And you will see this, this grandmothers that have received this information on how to do PFA, they've received basic information of where services are available to whom they need to refer, if someone comes in and they need medical attention, for example, they've been told when the people coming over them water and a safe place to sit. So they will do these grades. And they will be really effective. 
Because it's more or less things that are innate in us that we are we are as human beings, as empathic human beings, we are already predisposed to treat people in that way. So it just needs a bit of they just needed a bit of information and structure or how they should do this response. And they were doing it amazingly. So that really worked well. And then, in my experience in Syria, where it was a protracted conflict, where you had really long term impact of the conflict, which meant mothers and separated by from their husbands and therefore losing on the protection system, economical dependency was not there. They had to raise their children, children were out of school. So all the needs were were exacerbated by the time and by the displacement. So in this case, as PFA is not enough. In these cases, you need to unfortunately, rebuild the services rebuild the structures that that are needed to respond to the multiple needs that have been created. 
And when we talk about children, especially children out of school, four years of school children I'd have never been in an education system, the developmental milestones are not reached. And therefore you have really to start from scratch when these when these families or these women with children reach your community center. And, and that's when, when I was in Syria, we had community centers that were really multitasking and trying to respond to all these needs to the psychological distress, many times to the PTSD, depression and anxiety that we will see in women, but also to the educational needs and developmental needs of their children. 
And this is the norm like this is what was more common, but then you will have some smaller groups of children that had already developmental disability or delays in their development or cognitive disability, that was exacerbated by the fact that they will not receiving no education, they will not receiving positive parenting and care, they will not growing up in a safe environment. And these children in a in a place like Montreal, or in Panama, they will probably be able to receive the support to reach their potential to eat to improve their their situation, to the maximum possible, taking into account their condition, but in a place, or any conflict area where the services are not available. Their children are doomed, because they always say that the services then the care, they will never reach their potential.

Unknown Speaker  11:34  
This is all very interesting and very new to me, and  I assume to most of our listeners. So can we go back? When you arrive, let's say in Syria, you don't speak Syrian. 

Unknown Speaker  11:52  
When I arrived, I was spoke a few words Arabic. Because of the proximity, because I'm from Cyprus.

Unknown Speaker  12:03  
Okay, but by and large, you would have difficulty. Yeah, about scientific terms like trauma and depression, and anxiety. I would imagine you speak sort of kitchen Arabic? Like I'm hungry. I want to sleep. Thank you. So, when you arrive,  how do you first of all put out the word that you're looking for volunteers? How does that happen?

Unknown Speaker  12:32  
Well, in my role in Syria, I was coordinating a very big team of Arab speaking people, Syrians Oh, so my role was not and it was the mission with the organization I joined was there for 10 years already, because they start their presence, BRAC refugee influx back in the in the rocky world. So my role was to coordinate to understand the need to improve the services to build capacity of the staff that was working on the ground. And then as a psychologist, because we trained people, in some interventions that have another evidence base and can function in all settings, like narrative exposure therapy, the net has been implemented in many places in the world and in Syria has been really effective, as well. So my role would be to train them always with the support of interpreters and, and then supervise them and the supervision part was the hardest part, because in the clinics, we wouldn't have an interpreter. So normally, I would sit in and observe my counselors that were doing the therapy, and then another counselor would sit with me and, and translate to me, by that time, I would catch more words, I would have learned a bit more Arabic. But I mean, there are ways if you if you really want to do a good work and quality and provide quality services, you need to be on the ground, even in your role. As a coordinator, you need to see them and observe and give feedback and try to support your colleagues. And we would find a way to do it. Yeah.

Unknown Speaker  14:16  
Would you not run up against some resistance? I mean, here's this foreigner telling us what to do.

Unknown Speaker  14:23  
You know, no, it was really, my team was really embracing everything because by the time I arrived there were so tired. Imagine that. I'm talking about a team of 50 people were who were officers and trainers in the in working to support the field teams. And then in the field teams, we have hundreds of people working. And these people 90% of them have been impacted by the conflict. They have been displaced. They've lost people. And at the same time, they were trying to support others. So you can imagine During the burden they were having. So they were very happy to receive new tools to receive new techniques to get next to them to see it and say, you know, let's do this and get some guidance and supervision. So actually, it was very hard for me to leave Syria, I didn't mean in my own way, I have to say, I was other conditions that forced me to leave. But after two and a half years, my team was my family. And I felt that they had embraced me like family, I would have colleagues, mothers sending me Tupperware with food at the office, get invitation for the traditional breakfast every friday from different people. So it was it was when you when you get there, of course, you need to go with a very humble. And you know, it's so new, you need to learn how do you need to understand how these people have been surviving for so long? And what are their needs and their dreams, how young people dreams that have capacity, Syria had the highest alphabetization rating in the whole Arab world, on my team had bachelor's degrees, master's degrees, PhD degrees, they're really high qualified people who had the dream like many, many other people in Europe to travel abroad to study more in other universities. And they had no they had really no possibility because of the of the embargo and the difficulty to travel. So you need to be able to take on all that all that frustration. And understand that these people need support as well. They're not only support providers and service providers, they need to be

Unknown Speaker  16:49  
Sure. Who heals the healers is the question, right? 
Exactly, yeah. 
And  you said sometimes in two hours,  perhaps in four, or a whole day, you could impart a lot of important information? In a nutshell, what would you tell these grandmothers? What should they do with the refugees?

Unknown Speaker  17:12  
We tell them to look, listen and link.

Unknown Speaker  17:20  

Unknown Speaker  17:22  
These are action principles. And when we're talking about look, it means that you observe, you don't just look but you really observe, you look for people who are most vulnerable people who might have have been injured people who are very agitated. You look for, for younger children, for teenagers, for elderly people, people with disabilities, you're trying to identify among the group, the community you're trying to help, who has the most urgent needs. Yeah. And then, with Listen, we're talking about active and empathic listening, because we are trying not to do therapy, this is not a therapy intervention, but it's identifying the need, and trying to respond most adequately to this need. So when we talk about Listen, we are really trying to understand from a very specific conversation, where we're trying to collect basic information, we are not trying to do a debriefing. We're not trying to go into the details of what happened. No, we're just trying to understand what are the basic needs, and really listen and try to find the solution to the person or to these people we're trying to help. And then with Link, we're referring to linking people to the adequate services available. 
And in every emergency, normally, you'd have different agencies of different organizations or the civil society coming in to provide help. And that's the most difficult part to have a clearer understanding and mapping of the services who is doing what and when and where, so that you can link people to the to the services. And when you're doing a referral and you're trying to link it needs to be a sensitive refer, I refer that is not victimizing the putting at risk the person and the refer that ensures that the person reaches and receives the service, which is sometimes very complicated in an emergency setting. And then of course, yeah, the basic needs that can be covered at the moment by the PFA provider would be water, something warm or something to cool them down depending on the situation, ensuring that people who have lost their family members or their children are brought back together with their family, children who are alone, they're being together and put in a safe environment to avoid any other harm. So these are the basics.

Unknown Speaker  19:57  
Very logical and very beneficial. I'm Sure. So speaking of the children, what have you observed in terms of delayed development and personality and health problems in these children?

Unknown Speaker  20:13  
Well, the impact depends a lot on the time of  the event, you know, as developmental perspective, we know that different milestones are reached in different time in our development. And it really depends also on the response and the recovery. So if your child is impacted, for example, the age of five, and there is a regression to previous developmental stages, then in this child reaches a safe place and receive services and support and leaves in a loving environment, then more or less easily, they can recover and will go on and ahead with their development. The problem is mostly when the when conflict and emergencies are protracted, and not only in conflict, but also in developing countries or countries that are four years under poverty or continuous internal conflict, like, for example, the Democratic Republic of Congo, the eastern part. And places where schooling is not available, children are not in a safe environment they are, you know, you see things that you shouldn't see in this world, like you see children growing up on the side of the streets with no parents around and they, they're on a survival mode. That's not thriving, that's just surviving. 
You can imagine, you know, what the future of the children could be? It's not long, for sure, it's not long. And so yeah, I think that you can see impact on their language on their learning skills on their cognitive capacities. physical impact, we know that, that exposure to stress for a long time can be really toxic, and it can result to you know, health issues like like diabetes in an elderly, when you get older, you diabetes, even types of cancer have been linked to chronic exposure to stress. So there are so many there are so many different impacts depending on the on the developmental stage or the child is exposed and the time and the duration of the exposure to the stress.

Unknown Speaker  22:39  
Another thing that I read in your biography is that you have trained as a narrative exposure therapist for PTSD. Can you tell me a little bit about that? What is that? What does it involve? What do you do?

Unknown Speaker  22:55  
Yeah, I was lucky enough to be trained with, with the people who developed the net, some decades ago with Thomas Elbert and maybe shower and Elizabeth Kaiser. And I was, I did my PhD in the University of Constance, where it still holds the outpatient clinic for design. And the net is a beautiful and really humanitarian approach to PTSD. It considers that it needs to be brief. So we work on on, we explore we do exposure, not they give exposure to specific traumatic experiences that the person has identified in their life, we start with the lifeline. And the person is leading each insertion and deciding and placing the traumatic events in their lifetime their entire lifetime from the first event they remember. And then we also place flowers in this symbolic lifeline to identify the positive and resources and then the people that have been in the involved in their lifetime that have supported them. And then the exposure sessions where they're very guided through the traumatic event in a way that they feel really accompanied, and they are encouraged to overcome the fear and the avoidance that is involved in PTSD when talking about the event. 
And normally, you would see you know, you walk them through the event and you would use all the elements that are included in a in a life experience, which would be the the community of the the physiological part, the cognitive, the cognitive senses and their understanding of the event and then the physiology the physical arousal that comes with the event. And and then what you will try to do is to connect the different elements of the event what we call the cold memory, which is what happened, where it happened, what were you able to see and observe with what was happening in you. So what was the emotional reaction, the physiological reaction. And by connecting this, this to cold and hot memory, as it's called, we manage that person has a recollection of the event in a more structured way, in their mind that they can talk about the event. And they get habituated, and they don't feel aroused anymore. 
Once this happens, and for people with complex trauma, which means that they have experienced many types of events in in many occasions in their lives. Very beneficial, because trauma is a memory, it works and impacts the memory in a way that many times one single event can be confused with many other events or with similar similar nature. And the person is all the time, in an effort of avoiding any memory that brings back those events. By doing this, we structure and we put an order in the event and the person gets to write when we are doing the right narrative exposure therapy, we are writing the narration, as an autobiography for the person to receive this at the end and decide what they will do with their life story,

Unknown Speaker  26:23  
When you say “we are writing” who is writing?

Unknown Speaker  26:27  
So the therapist or a co therapist is writing everything that the person is saying in the first person. So I, Andrea, when I was five years old, I had a bike accident and these and these and these happen in detail of what had happened. And then we put all the events in the life story in the biography of the person in the right order, so that the person has, has not doesn't have that confusion anymore. And then I mean, net has a lot of evidence around it. There are many, many studies that support that is one of the evidence based interventions for PTSD along with CBT, or trauma focused CBT or EMDR. And and what is nice about what I like about the net is can be used at any place it has been used in in Africa, of course, in many countries in Europe, even in Canada, there is a group that is being working and has been trained in these in in Arab countries like Iraq, Lebanon, Syria, and people from any language and culture can be trained. And with a little bit of supervision, they can implement it. And I think that's what's very nice about it, that it can be really culturally adapted. And the testimonies, which is these autobiographies that patients receive these testimonies have even been used in Courts of Human Rights for people to or asylum seekers for people to claim as I know, or to or to have a legal process against those who have tortured them, or those who have caused them to flee or conflicted any type of violence against them.

Unknown Speaker  28:12  
Amazing. Sounds good. So do you also do that privately? Or just for UNICEF?

Unknown Speaker  28:18  
Well, actually, I'm not allowed to be doing it privately. Because as I'm working for UNICEF, I cannot be right now. I would need a special permission. But my job is not allowing me that extra time. And for UNICEF, we are we are still trying to find the best way to do that. Because it would require a country and the community and there's an existing service that that would demand that that would come and say, Okay, we're ready to implement this type of service. Because we are not working units of works with partners and with governments. So we need to be integrating whatever we are suggesting. And, and responding to the needs that are identified by the government or the community or the implementing partner in each country. But hopefully soon, that's that's something that we're trying were discussing, and hopefully we'll be able to implement in this in this region as well. So

Unknown Speaker  29:21  
Well, it sounds like a really good approach. And since there are so many millions of people who suffer of PTSD, I think it's very necessary.

Unknown Speaker  29:31  
Yeah, I also agree and it's growing. It's really growing and many people from different parts of the world married psychologists and researchers are working really hard to get this, this exposure to have met and yeah,

Unknown Speaker  29:50  
In 2018, you wrote a very interesting paper, Variation in C-Section Rates in Cyprus, Italy and Iceland: an analysis of the role of the media. So this is a whole new approach. A whole other aspect of you. Tell me about that, like what is the effect of the media?

Unknown Speaker  30:16  
Well, I will tell you about that maybe I should just mention that this area of perinatal mental health is really my passion. It was my research. In my research for my PhD, I tried to bring together the trauma and psychosocial support in relation to the perinatal period. And I have been so lucky to be representing my country as a as a committee member for to action cos actions, which are funded, European Union funded projects, for the collaboration between researchers and practitioners in the from different countries in Europe. We are focusing on birth related trauma. And with the colleagues that you've seen in that paper, but also other colleagues from Spain and other places we've been working in researching on in this area. And actually, before that paper we published we did a literature review of existing testimonies of qualitative studies of women talking about how empowering an experience of birth can be without any intervention. And that was, I think, the  nicest research I've done because it was for me as a woman as well empowering to see that if we manage to have non medicalized care and treat and treat birth as a physiological experience, it can be so empowering for women, this paper. Yeah, you know, I'm from Cyprus, and probably you don't know this, but Cyprus has the highest rate of cesarean sections in Europe, and one of the top three highest in the world,

Unknown Speaker  32:21  
Really higher than South America?

Unknown Speaker  32:22  
60%. Of  births in Cyprus are C-Sections. And, and, yeah, we wanted to see with these colleagues from the different countries, what would be the impact of media as a as a source of communicating and educating people many times in this area and sections and we've and we and we were able to see that and the way that media communicate any anything related to labor, birth, pregnancy, breastfeeding has really an impact on the decision making that women take as well on the one that says area and or physiological birth. But it's so complex, that it's this is only one aspect, the media impact, then you have the impact of education of doctors, nurses, midwives, I was teaching there another psychology for midwifery monsters inside pros, and our midwives who are already doing their training, they will tell us horrible stories of how they would be treated by gynecologist in their practice, because they were the ones that you know, they should be making all the decisions and many times against what the woman would want and many times breaking their oath to Hypocrates and not giving them all the information they would need to take an informed decision. 
And this is really bad because you know, when you have an invasive birth against your will, 
in most of the of the cases you will suffer obstetric violence, which will lead to pause postnatal depression or post partum PTSD, it will affect the way you interact and connect with you baby. It has detrimental impact in your life as a mother but  also in the development of your child. So this is something that I am advocating for me and many, many other colleagues, And, and there's no need to do something about it because the medical world has this patriarchy embedded in it when it comes to women's health. 

Unknown Speaker  34:38  
I totally agree. When I was an intern, I actually delivered 26 babies, and I was seriously thinking of becoming an obstetrician. Although up to that time I was thinking of becoming a psychiatrist but my professors discouraged me. So,  I started to think that perhaps I would be better off as an obstetrician. But I absolutely hated the way the obstetricians treated women. I could not stand the way they were talking to them, and yelling at them, you know, push, push, you know, that kind of stuff. And so that's when I changed my mind and switched intoPsychiatry. I totally agree with you. I think the attitude of obstetricians and  the nurses assisting obstetricians.  Some of the nurses are just as bad as the obstetricians, you know, they have sort of bought into the same kind of mentality. 

Unknown Speaker  35:49  
I'm sure you would have made a very good obstetrician. 

Unknown Speaker  35:58  
Well, anyway, in terms of you, was there anything in your own background that  made you become interested in this whole subject that we have been talking about, you know, helping, people who are in distress and helping women have better births.background?

Unknown Speaker  36:20  
Well, in my background, personally, in terms of helping women, I think, helping in general has always been a calling for me. Since a very young child, I was getting into trouble. I remember in school because I would stand up and defend my classmates that were not being treated well. 
I remember very clearly, I had a classmate who had developmental delay and then cognitive disability and she was abused and maltreated by our teacher. One day, in front of the whole class she,grabbed this poor girl by her the hair and threw her out of the class. And I got up. I was so angry. I grabbed a ruler made of wood. Yes. And I was so angry. I completely lost it. And I took the ruler and started hitting our teacher on the back until I broke the ruler.

Unknown Speaker  37:28  
How old were you?

Unknown Speaker  37:29  
I think I was 11. I don't know if it's wonderful. I they called my parents and my dad when he came because he always used to defend my values a character you because I took it from him probably. So when he came he said, What are you calling me for? If I was there, I would have done the same you should expel this teacher. So it I don't know, I think I have this feeling of what is just and unjust. And I cannot stand it. It makes me furious. Which is something I tried to contain and not keep using a ruler against people. But maybe becoming an advocate or becoming as educated in a position that I can make a change was a way to do it. But it still impacts me a lot. So when the refugee crisis started, and I come from a family of refugees, my great grandfather was expelled from from his meal with the problems with in 1922 when the problems between Turkey and Greece the first time happened and many Greeks were expelled. I never met him but I heard stories about him and the way he came, he lost his mom, he came only with his dad. He had a very interesting story and, and people who knew him always talk to me about him. I felt that I knew him without him ever meeting him. But I think that kind of stories are embedded in our DNA as well. I always felt that becoming a refugee is one of the worst things that can happen to you because you are leaving everything behind and are forced to live your life in a strange country.

Unknown Speaker  40:31  
When the refugee crisis started, and I will see these horrible images of refugees coming into Greece, and from a place so close to us from Syria, you know, just across the sea, when I was in Syria, when we were going with the car towards Damascus, I would hear Cypress radio. Is that close? So I felt like I was back then working at the university teaching and I felt like this is not where I should be right now. That's when I decided to go and, and the same applies for obstetric violence and women's right in birth and women's right in general. It's just that I was involved more in research and, and I took testimonies of women that have refugee women are experiencing obstetric violence in a country other than their own, where they don't speak the language and they're so vulnerable. And for me, I always question the medical world, and doctors and nurses, anyone involved in patient care? How can we improve on human and commoditize? The way we are treating patients? How is it possible that the patient could use in Greek, the word patient is nice, as nice as the knees, which means a person without strength, that's what the word means. So I was I was always telling my medical students when I was teaching, teaching them medical psychology, I was telling them, you cannot, you know, when you're treating a patient, because the patient doesn't have strength, you have to remember that what patient means. The first thing you need to do as a good doctor you want to be is to give them the strength is to find ways that you empower them, and you make them feel stronger than what they are. So I'm really worried I'm extremely worried how the medical world and certain professionals of course, not everyone, and I hope that it's only the minority of health professionals are, you know, doing the contrary, or taking advantage of their position of power, to disempower and to put the patients in worse conditions? And when they come?

Unknown Speaker  42:59  
Do you have children?

Unknown Speaker  43:01  
No, I have dogs and cats. And I don't have children yet. And I'm not sure if I want to have children.

Unknown Speaker  43:09  
okay. Tell me please, tell me about the three most influential people in your life.

Unknown Speaker  43:17  
Wow, okay. The most influential

Unknown Speaker  43:21  
impacted your life, you know, how they changed it? If at all? 

Unknown Speaker  43:27  
Well, I think the most influential people in our life, we take all our life, it's our parents. And I have, I have both my parents still alive. And they have both impacted me in different ways. They've both taught me things mostly by their, their way of being their, their, their mentality and personality. And by observing things that you know, I could be taking from them and things I shouldn't be taking. Yes. Which has been a lesson for me has been approached. And it's very interesting. Apart from that, I think my professors from University of content, I consider Thomas Albert, one of the most intelligent and empathic and supportive professors anyone could have. He actually has won many times I think the price of German best mentor or something. I feel very, very lucky that I was able to to know Him and be supervised by him. Right. And also, yeah, other colleagues that I've met on the way like Bonnie ALSA or Ibanez pair, another psychiatrist and neonatal psychiatrist and Perinatal psychiatrist and she is a huge advocate for women's rights and she supported women, even in lawsuits against doctors. In cases of obstetric violence, and I really admire her her passionate dedication to this. But there are so many if I start thinking there, there are so many people I had the fortune to cross paths with and learn from them.

Unknown Speaker  45:17  
So if you could have, if you could have coffee with any historical figure anybody in the past, who would it be?

Unknown Speaker  45:28  
Oh, wow.

Unknown Speaker  45:32  
I think Bob Marley,

Unknown Speaker  45:34  
Really, okay, that's a new one. 

Unknown Speaker  45:37  
Marley, because I've recently been in Jamaica, and I used to use music as a teenager. And when I was in Jamaica, I went back into his philosophy and life and life examples, and I visited his museum. And I feel that he's the love that he had for his people, the love that he had for all people and creatures, and the way he wanted to fight for unity as a way of bringing peace in his country. Apart from him being a great musician, I think it's, I would love to have and sit and have coffee with him and meet him. And another person that I would be only one, I could only have one.

Unknown Speaker  46:23  
Okay, let's add another one. Sure. Another one.

Unknown Speaker  46:28  
Another person I would love to meet is probably Freud.

Unknown Speaker  46:33  
Okay, that could be interesting. As long as you are not allergic to cigar smoke.

Unknown Speaker  46:38  
No, because I would love to, I would love to understand better. And I mean, I'm not afraid. I'm not a psychoanalyst. And but I find I wanted to discuss with him and learn from him. There are many things that he said Indeed, that I'm not, you know, in agreement with and agreement with, but still feel that we are an interesting person to talk with.

Unknown Speaker  47:05  
Yeah, well, you know, that's how I decided to become a psychiatrist at the age of 13. I read Freud's interpretation of dreams in Vienna, in German. And when I read that, I said, that's for me. I love the way this guy's mind works.

Unknown Speaker  47:22  
Yeah, it was he was a pioneer for sure. 

Unknown Speaker  47:27  
What was the most fun trip that you have ever taken?

Unknown Speaker  47:38  
Oh, fun trip. I think, the most reckless and fun trip and I say reckless because it was a time where I still hadn't realized how tough life can be. It was I was very young, I was 25 or 26. And I had come to Peru to do my research. And after six months of interviewing women and hearing really horrible stories, I decided to take a few months off, to take care of myself. And I was backpacking in Latin America, most of the time alone and meeting Rich, poor eating places that are amazing, like the Salado unit in Bolivia, Machu Picchu, then crossing to Ecuador, and then taking a bus of 29 hours from Quito to meta gene, reaching the Caribbean and seeing these things for the very first time. With a young eye and an open heart. He was really, really amazing.

Unknown Speaker  48:42  
So going back to that trip, what did you learn about yourself during that trip?

Unknown Speaker  48:50  
Um, I think I confirmed because I always felt I was very independent and very, very adventurous. And I would say yes to everything, almost everything. I felt that there was a power as a woman traveling alone in Latin America, and crossing borders that people would say, oh, that border is very risky. And there's a lot of noise of drug trafficking and, and I would do it and it was okay, maybe I had to be a bit alert, but then I will do it. And then traveling and meeting people from nowhere, like new people I would I made a very nice friend. He's Australian, and we met in a bus and then we ended up doing you know, popping from beach to beach and getting to know parts of Colombia together. And then meeting another person and so many years ago, I still have contact and I met their children and just for spending a few days together in a new experience for both was enough to keep you know this relationship. 
What I learn is that we need to learn to trust people and then the good in people. Of course, there is a lot of bad people out there that could cause harm. But I don't  us as human beings to lose to trust people, because that would be very sad. It would be believing that the world is a dangerous place, and it shouldn't be like that.

Unknown Speaker  50:23  
What would you like to be most remembered for? 

Unknown Speaker  50:31  
I think of being kind. I want to be remembered as a kind person, a person that was always avoiding to do harm and always trying to help. That's it.

Unknown Speaker  50:46  
I think that should not be too difficult for you.  I don't think  anybody would come to a different conclusion about you. 
My last question, which I ask all my guests is, what does being human mean to you? I know it's a bit difficult, but take your time.

Unknown Speaker  51:14  
It's difficult. You know what, because if you had asked me this 10 years ago, I would have said something very easy and but now, as I told you, I have seen pain I have seen suffering and, and it's hard for me to say what human being is, for me can be the most wonderful and beneficial creature on earth that can make the best change in everyone's life and the world. And at the same time, it can be the worst, most dangerous creature on this earth. So it's sad, but these are the faces of the same coin. And I just hope that the most prevailing and most frequent face that we will meet in the world is the positive side, it's the beneficial side of humans.

Unknown Speaker  52:18  
Yes, very well said, you have given us a lot to think about. Thank you for being so generous with your time and your knowledge. Thank you for that  spirit of yours and a most stimulating and informative discussion. Thank you. 

Unknown Speaker  52:35  
It was a pleasure being with you, and the time passed by very fast.

Unknown Speaker  52:40  
I just want to say something about next week's program. My guest next week will be Dr. Bob Rosenberg. who received his PhD in the history of science and technology from Johns Hopkins University. He spent two decades at Rutgers University and then spent some time at John Wiley and Sons. He is the author. He has contributed chapters to two books, irreducible mind and beyond physicalism. He will discuss with me precognition, which confounds our sense and understanding of time, please tune in. 
And friends. Be sure to subscribe to this podcast, wherever you listen to podcasts. So a little bit of advertising there. Thank you. And that was really fun and wish you good luck in all your enterprises, whatever you do.

Unknown Speaker  53:34  
Thank you so much. Very nice being with you. Thanks.

Unknown Speaker  53:37  
Take care.

Unknown Speaker  53:38  
Thank you. You too. Bye bye.