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Part 3 back.gif (2549 bytes) TO CONFERENCE

23. Optimising Working Relationships on Development Projects
Ridley, Donald
University of Hertfordshire, UK

24. Experience of Conflict Management Trainings with IDP children
Sarjveladze, Natalie
Foundation for the Development of Human Resources, Tbilisi, Georgia

25. Societal Trauma, the Phenomenon of Return and Aspiration for Re-Birth
Nodar Sarjveladze, Ph.D.
Foundation for Development of Human Resources, Tbilisi, Georgia

26. Involvement in national tragedy and its consequence on affective-emotional state
Sumbadze, Nana,Ph.D
Tbilisi State University, Tbilisi, Georgia

Hentschel,Uwe,Ph.D
Leiden State University, Netherlands

27. Psychodynamics of Post-Soviet Phenomena - Russian Case
Urbanovich, Yuri,Ph.D.
Center for the Study of Mind and Human Interaction, University of Virginia, USA

28. Psycho-rehabilitation and reconciliation – experience and perspectives
Kharashvili, Julia
The IDP Women‘s Association/UNV, Tbilisi, Georgia

29. The stress system affecting the IDP population
Sharia, Shermadin
Foundation for the Development of Human Resources, Tbilisi, Georgia

30. Facilitation Model of Protracted Social Conflict
Tsiskarishvili, Lela
Foundation for the Development of Human Resources, Tbilisi, Georgia

31. Some Problems of Public Health
Chkhikvishvili, Shalva, M.D.
Tbilisi State Medical Academy, Tbilisi, Georgia

32. Anorexia, Bulimia: Should we be concerned?
Ketevan Chanturia
Tbilisi State University, Tbilisi, Georgia

33. Guilt as a coping mechanism
Javakhishvili, Darejan
Foundation for the Development of Human Resources, Tbilisi, Georgia

 

Optimising Working Relationships on Development Projects

Ridley, Donald
University of Hertfordshire, UK

The political changes in Eastern Europe and the former Soviet Union during the early 1990s dismantled a range of social and economic structures, flawed or otherwise. These events left a vacuum not, as some might suppose of ideology, but one of "infrastructure" in its broadest sense. Alarmed by these changes and the potential for political, economic and social instability, the so-called "West", made efforts, for a variety of reasons, - some good, some bad, some indifferent - , to provide technical assistance to help with the development of infrastructure for countries from Eastern Europe and the former Soviet Union.

The provision and utilisation of funding addressing the development of skills and competencies in those responsible for managing the various societal institutions, both public and private has been a learningexercise for all concerned. Early models of funding for this purpose included visiting "western experts" to give "expert" advice in the recipient countries (often at salary and living expenses that were beyond the wildest dreams of their local colleagues) Generally speaking, andperhaps quite understandably, the "experts" had little real understandingof the recipient countries history and culture, current living conditions and the often difficult personal economic circumstances under which their colleagues from the recipient countries had to live. They sometimes applied mental representations, theoretical models and practical methods that were not necessarily appropriate for to the contexts in which they worked As a result lasting change was often minimal, despite the expenditure of significant sums of money on such projects. Similar problems were encountered both on schemes which were intended to provide an educational base for the development of expertise of professional managers in domains that, by and large, were related to business and economics and in the training and development programmes run by joint ventures of various types between recipient country organisations andwestern organisations.

Many factors impinge upon the success of the three types of co-operative activity mentioned above (expert advice, education, training) . Examples of such factors include (a) the provision of adequate funding targeted in a specific and appropriate manner, (b) the development of exit strategies for projects so that there is a focus on ensuring permanent development and change, (c) the development of a sense of ownership amongst colleagues from the recipient country and (d) ensuring that colleagues from the recipient country are true stake holders. One key factor in all of the above is the achievement of relaxed, open and productive relationship between the colleagues from donor and recipient countries, an issue that in practical terms receives little attention. For example the literature on Globalisation tends to concentrate upon multinational companies rather than the so called "aid sector" and it is questionable whether findings from the former might map onto the latter.

Studies conducted by the University of Hertfordshire between 1993 and 1999 address, amongst other issues, the working boundary between colleagues from donor and recipient countries. These studies can be utilised to create a framework, based upon empirical evidence, of the types of difficulties that can occur on either side of the relationship in this type of activity. These studies include (a) An evaluation of government funded aid project which set up advice and training centres in Organisational Development in Romania, (b) An investigation into organisational culture and management style in joint ventures between

Romanian/US companies and German/Russian companies in manufacturing and retail sectors respectively (c) Government sponsored comparative studies in management style and decision making between Russia and the UK (d) Government sponsored training and development in a Russian retail organisation (e) Development of organisational culture in the newly opened Prague office of a western consultancy and (f) Government sponsored co-operative development of training programmes with a Russian University.

The framework identifies the dimensions derived from both qualitative and quantitative data in the above studies. These apply to colleagues from both donor and recipient countries. The dimensions, that are not at this point mutually exclusive, are (a) Personal (b) Financial (c) Cultural (d) Experiential (e) Referent (f) Expectational and (g) Communications related. Generally the results from this sample of studies may be summarised by an unnecessary reticence and lack of confidence on the part of colleagues from the recipient country and a benevolent chauvinism coupled with over confidence in technical matters on the part of colleagues from donor countries. The reality is rather more complex and the degree to which it is possible to generalise from the organisations in these studies is a question that is currently being investigated. Using methods from Organisational Psychology, the framework can be used create a generic analysis of possible development needs for colleagues from both recipient and donor countries. This analysis may be customised and incorporated into project activities in a manner that will facilitate communications, avoid mismatches in expectations and promote the efficient and effective operation of project work in infra structure development aimed at improving the skills base in recipient countries.

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Experience of Conflict Management Trainings with IDP children

Sarjveladze, Natalie
Foundation for the Development of Human Resources, Tbilisi, Georgia

Conflicts are an inseparable part of IDP children’s life. Primarily due to the fact, that they became IDP’s as a result of the most violent expression of a conflict - a war. Apart from this, if one observes their social environment, one will discover conflicts of different degree and severeness on all stages of their relationships. This can be a quarrel between children, fight during distribution of humanitarian aid, disagreement between adolescents, latent sometimes even expressed negative disposition from representatives of local population, conflict between generations, and finally, crises connected with development and puberty period, that take place with expressed acuteness on the background of conflictual social environment.

Proceeding from the foregoing conflict management skills and training-seminars for the study of conflict’s nature and characteristics are especially important for psycho-social rehabilitation.

Basic strategic aims of this initiative are: Development of tolerant spirit in children and adolescents, attributing them with skills necessary for enhancing confidence in their possibilities during coping with problematic situations; seeking alternative ways of effective conflict management. This will support reinforcing their faith, that unresolvable and unmanageable critical situations do not exist, it is always important to mobilize our inner resources to transform an unmanageable situation into a manageable one.

Basic tactical objectives of training-seminars are:

1. Helping children and adolescents realize essence of conflict, broadening their understanding of conflict. Defining the concept of conflict has a crucial significance for IDP children. They constantly hear from parents and close social environment, that the reason of their misfortunes is a war conflict. But as we observed, for majority (especially for children) meaning of the word “conflict” is not clear. Because of this children might ascribe an exaggerated, negative and sinister meaning to the word, they might think that conflict fatally determines human’s life and it is irretrievable. This impedes to realization of importance of resources of conflict and conflictual situation.

2. Familiarizing with regularities and stages of conflict’s escalation and understanding the essence of enemy image - an extreme form of conflict’s expression. This has a vital significance for IDP children, on one hand for preventing future generations from sense of victimization and transmission of enemy image. On the other hand, realizing the mechanism of enemy image’s creation is a very important pre-condition for development of tolerant disposition towards others (There were cases of confrontation between IDP and local children, that had lamentable consequences).

3. Realizing existence of alternative reality, accepting the right of existence of different opinion, and understanding that denial of this right accutes and escalates any conflict. Development of communicational skills that make possible constructive expression of opinions and feelings in conflictual situations and help accept feelings and opinions of opposing side, even when there is a disagreement between the views of the two sides. While working on these problems we familiarize children with excerpts from children’s rights convention, that say about the right of freely expressing one’s opinion. At the same time we emphasize that other people have the same right. This supports development of tolerant tendencies in children.

4. Teaching of possible strategies of conflict management, understanding pro-s and con-s of each one of them. Acquiring skills for “win-win” outcome model of conflict management is especially emphasized. By this, collaboration oriented type of relationship is sustained. As we observed this is extremely important, because IDP children have an exaggerated tendency of escaping conflict situations. In this sense our joint session for IDP and local children about the ozone layer is very typical. Children had a discussion and worked on possible alternatives of problem’s resolution. Opinion of the group was divided in two. While local children talked about two possibilities (activating and strengthening of the movement of greens or letting fate decide what will happen), IDP children proposed an entirely different strategy - migration of earth’s population to a different planet, where according to preliminary data life exists. This strategy of conflict management - escape - is not bad, it is one of the alternatives of avoiding a danger, but it becomes harmful and alarming when it is perceived as the only way out. This blocks the possibility of analyzing existing alternatives and on the basis of analysis act effectively.

5. Developing the spirit of mutual support and collaboration. The leading form and basic characteristic of our activities is working with groups. Therefore we try to invite everyone who wishes to participate in our sessions, even children who due to their physical defects avoid uniting in groups of their coevals. Group work in it’s turn is based on the principles of team work - mutual assistance and caring. Most of the exercises applied by us show and prove to children that without unanimity and mutual support effective management of problems is very difficult.

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Societal Trauma, the Phenomenon of Return and Aspiration for Re-Birth

Nodar Sarjveladze, Ph.D.
Foundation for Development of Human Resources, Tbilisi, Georgia

1. Our society is a traumatised society. Georgia has experienced the bitterness of civil war, ethnic conflicts, criminal lawlessness, economical ruins. Traumatised society consists of traumatised people who do not know what to expect for tomorrow. The guaranties that a man determines perspectives for his future are lost. The Georgian State is in embryo. Building of civic society and democratic institutes proceeds painfully. The biggest trauma of the Georgian State is lost territories and distortion of territorial integrity. The country is scattered, people are disconnected from each other. Numerous political parties and political forces are furiously struggling for the power. The corruption rate is high and is spreading over as cancer and its metastasis. People live with fear and horror, their main goal being survival. Deep existential crisis is manifested. The rates of lethality and depopulation are high. The rate of suicide is also high. Every-day life stresses, difficulties of adaptation, stress of uncertainty and post-traumatic stress disorders have covered most layers of population. Here I would like to characterise those basic tendencies and catastrophic events which have determined present crisis.

2. Four main events could be distinguished:

3. We have identified four main traumas, one of which is healed and transformed and other three represent open wounds. What is the most wide-spread reaction to traumatic experience at the societal level ? Such a reaction should be revealed in an orientation. We will dare and name this typical orientation with one word - the "return". The return should be perceived as a phenomenon which is polyhedral and varied.

For IDPs "return" means to return to Abkhazia or South Ossetia. At the same time, the word "return" has various meanings regarding Abkhazia, if we look in the phases: 1. "Abkhazetis dabruneba" (return of Abkhazia) and 2."Abkhazetshi dabruneba" (return to Abkhazia). The former means restoration of territorial integrity and the latter emphasises the return of IDPs to their homes.

Working migrants, political emigrants or businessmen who reside abroad try to return and the Georgian society is waiting for their return. Many youngsters who are doing studies abroad try to return soon but there is no certainty about their employment here.

But the most interesting is ideological aspect of "return". Many people consider that the old times should return, they have nostalgia for soviet period life. Such feelings find support in many reactionist politicians.

The other pole of phenomenon of return is the position which can be named as "aspiration for re-birth". It is radical demand of rapid reforms and changes in life. Their maxim is: "the mentality should be changed". It is also an illusion. Both - the return and aspiration for rebirth - have one basic support which can be identified as non-acceptance of Self.

The healing process at the societal level should start with Self-acceptance.

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Involvement in national tragedy and its consequence on affective-emotional state

Sumbadze, Nana,Ph.D
Tbilisi State University, Tbilisi, Georgia

Hentschel,Uwe,Ph.D
Leiden State University, Netherlands

Past decade in Georgia was marked with the abundance of destructive events of a national scale. 9-th of April, the massacre of civilians by Russian troops and Abkhazian war were disasterous for all the nation and as such can be considered as events of a national tragedy. Although both stressful, experience of these two events is rather different.

The impact of 9-th of April and Abkhazian war were studied considering the degree of personal involvement in the events. Five weeks after the 9-th of April mood of male and female sample of inhabitants of Tbilisi was assessed by the Multiple Affect Adjective Checklist. The checklist has anxiety, depression and hostility scales. The affective-emotional state of wounded, non-wounded soldiers of Abkhazian war and male civilians were registered towards the end of the war by means of the Gottschalk-Gleser method, comprising of six anxiety scales, four hostility scales, and a hope scale differentiated as positive and negative.

Analyses revealed that the mood state of all the respondents after 9-th of April event was negative, but more negative state was registered by those who were not at the site of massacre. Emotional state of wounded soldiers proved to be significantly more negative than of civilians. Wounded soldiers expressed more death and mutilation anxiety and a covert hostility than civilians. Both wounded and non-wounded soldiers scored higher than civilians on ambivalent hostility.

The results of the two studies point on different effect of participation in national tragedy on the emotional-affective state. In case of 9-th of April the majority of its participants were not directly exposed to mutilation and death. It could be therefore assumed that worse emotional state of those who were not on site at that night was largely determined by the feeling of guilt and self-blame. Whereas in case of war the exposure to life-threatening situations, death, distraction, and concern about own health determined the emotional state of soldiers.

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Psychodynamics of Post-Soviet Phenomena - Russian Case

Urbanovich, Yuri,Ph.D.
Center for the Study of Mind and Human Interaction, University of Virginia, USA

The break up of the Soviet Union gave birth to fifteen independent states and to the dozens of expected and unexpected challenges that are usually described as post-Soviet phenomena. Understanding these phenomena requires in many cases an interdisciplinary approach, which may include applied psychoanalysis. Here I’d like to identify some of the phenomena in general terms and give a brief illustration of how a psychoanalytic approach can help understand them. In this attempt I am focusing on Russia, but many similarities can be easily found in any former Soviet republic.

“Identity Crisis”. Compared to the large European empires such as those of Britain or France, the Soviet Union was unique. More than 100 peoples of different ethnic origins, languages, and religions lived together for centuries, first within the Russian Empire and later within the Soviet Union. Ethnic Russians constituted around 50 percent of the Soviet population.

But unlike Britain and France, which had a distinct national identity prior to and independent of their colonies, there was not a clear division between Russia as a nation and Russia as an imperial power. Both evolved simultaneously from the 15th century, and Russia’s “colonies” lay not overseas, but next to or within Russia’s own borders. When one loses territory which had been “imprinted on the map” of a nation’s historical memory, it takes long time to mourn the loss.

Nostalgia for Socialism. The nostalgia for an ideal socialism is similar to people’s dreams about lost childhood. In ideal socialism, it is supposed that society would be structured as one big family, where the majority of the population is in position of children, or junior members of the family. They do whatever they are told to do, and for it they are complimented or punished, depending on the results of assigned work. On the other hand, they feel relatively safe since the responsibility for supplying their basic needs is fulfilled by the parents, or the senior members of the family - the ruling elite.

Relationship between the State and the People. State power in Russia has always been identified with masculinity, while the people of Russia are characterized as feminine. Almost always in Russia’s history this masculine dimension forcefully “penetrated” a conservative, generally stable, and feminine dimension of the Russian people, resulting in a relationship without love, mutuality or permanence. However there were periods of greater compatibility of the “married couple”. One of the longest periods, with its ups and downs, lasted approximately from the beginning of Soviet power and until the Brezhnevite era. Of course it wasn’t happiest period, especially for those, such as the intelligentsia, who thought independently, wanted greater freedom, and were compelled to seek the truth. But most of the Soviet Union’s average citizens perceived state authority as a real and a reliable “masculine dimension,” and although it was rude, they could envision no alternatives. Then came an amorphous period of stagnation, followed by the hope for Gorbachev’s “perestroika” that ended with total disappointment, and finally an outburst of the people’s love for a new democratic authority and hope for a long anticipated “happy marriage”. But a new “husband” (democratic leadership) happened to be an insidious seducer who soon broke his promises, abused his victim, and finally proved to be impotent himself. In the previous “marriage,” although there was no love in the relationship, the “bride” was at least respected. In the current marriage, after a short “honeymoon,” the husband put her out on the street. But a reasonable question in this case would be: “How did President Yeltsin manage to stay in power?”

The Gorbachev/Yeltsin Phenomenon. There are some Russians who cannot forgive Gorbachev for prematurely granting them freedom when they would have preferred to win it for themselves. In the collective perception, what Gorbachev did was not a manly act. He was more like a mother giving her children something instead of letting them struggle to obtain it for themselves. The significant role taken by Gorbachev’s wife also undermined his “masculinity” in the eyes of the people. There was too much of her in his political image and Russians felt anxious because he became “feminized”. It was very untraditional for Russia in general, and for a Soviet leader in particular to have such an active first lady. Gorbachev also talked too much and often vaguely, which was perceived as another characteristic of “femininity.” He was also perceived as always making political concessions to the West. He was a “giver”, not a “taker”.

How did Yeltsin manage to win? When he was humiliated by Gorbachev and the CPSU Central Committee, people perceived him as a “martyr”, and it is deeply internalized in the Russian culture that to suffer makes you better. To this day, even not particularly religious Russians will, in a bad situation, offer the proverb: “Christ endured and ordered us to endure too”. But the more important reason for Yeltsin’s victory is the fact that he never hesitated to grab power or to remind people who’s in charge. Even his recent decision to deploy a Russian contingent of peace-keepers ahead of NATO troops in Kosovo was perceived, and not only in Russia, as a risky but manly act. It is difficult to imagine that Gorbachev could have acted in the same fashion under these circumstances. Despite all his shortcomings and health problems, Yeltsin, unlike Gorbachev, has been perceived as manly leader - a “taker”, not a “giver”.

On the other hand, Yeltsin does not associate himself with any political party, parliamentary group or acting government. He changed five prime ministers and their cabinets during his tenure. He makes unpredictable decisions, promotes and fires people without regard to their reputation and merits. He actually rules the country in certain sense as a monarch who from time to time makes scapegoats of his “boyars” (corrupted bureaucracy). Yeltsin’s image fits the old Russian belief in a good czar or in a hero (“bogatyr”) who sooner or later will find a magic way out of difficult situations.

Suitable Targets for Projections. In the process of its evolution, the Soviet regime identified various groups that the people and government could use as targets for projection. At early stages of Soviet power they were “bourgeoisie element” and “counter-revolutionaries”. In the period of industrialization and collectivization it was “saboteurs” and “kulaks”; during Stalin’s purges it was “enemies of the people”; in the late 40s it was “rootless cosmopolitans” and so on. In the last decade of the Soviet Union, as nationalism grew in every Soviet republic, Moscow as the political center of the Soviet empire became the most suitable target for all kinds of projections. However, as soon as the Soviet Union ceased to exist, more suitable targets were found within every newly independent state. In many cases it was minority groups.

Conclusion. The list of post-Soviet challenges can be extended to include a dozen others. But the purpose of my presentation has been to illustrate how unconscious motivations influence developments especially during periods of big changes. Underestimation of these motivations in social analysis and prognosis leads to political mistakes.

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Psycho-rehabilitation and reconciliation – experience and perspectives

Kharashvili, Julia
The IDP Women‘s Association/UNV, Tbilisi, Georgia

The Association of IDP Women in Georgia has worked in the field of psycho-social support for internally displaced people (IDP) since 1994. The main focus of the work from very beginning was on children and women – victims of military conflicts in Georgia. The programme of the Association was oriented on creation of equal possibilities for IDP women, their re-socialisation and adaptation to new realities.

Practical experience, as well as theoretical considerations prove that recovery after received trauma is closely connected with reconciliation. Under the term “reconciliation” here we will understand whole complex of processes on the level of community, which include recognition of own fault, mourning, forgiveness, re-humanisation of enemy (changing of “image of enemy”). Building of new relationships is necessary condition of reconciliation.We saw necessity of different parts of this process on different steps of development of post-war community.

Women - beneficiaries of psycho-social rehabilitation programme under the facilitation of experienced facilitators went through self reflection groups. The idea was - to reflect together about past traumatic experience in presence of colleagues, who provide psychological support and help to cope with consequences of trauma. Women from the Georgian part of divided society express strong wish towards reconciliation and preparedness for bilateral contacts. They talked about similar psychological problems, which should have also Abkhazian women and expressed the opinion that similar pain can create the common ground for reconciliation.

During the last year military escalation in the Gali district, when a new wave of internally displaced people fled to the Zugdidi region, the question of internal reconciliation also became actual. The IDP who lost trust to all governmental actors, regardless of their state or national belonging, needed urgent assistance to survive in new community. Building of relationships inside of Georgian community, among IDP and local population, represented one of the most important tasks during the period of emergency situation in Western Georgia,

Good example of reconciliation and peace-building activities represents the UNV programme of the peace Children's Magazine, which is distributed for children from divided societies (Georgian, Abkhazian and Ossetian) and which is a tool of establishing of relationships. At the same time the Magazine works as tool for rehabilitation of traumatized children, because they can describe their trauma to "invisible friend" and it helps them to cope with their traumatic experience. Another example of connected rehabilitation and reconciliation activities are the peace camps for children from war affected societies.

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The stress system affecting the IDP population

Sharia, Shermadin
Foundation for the Development of Human Resources, Tbilisi, Georgia

Stresses affecting the IDP population can be divided into four categories. We will try to characterize each one of them.

1. First of all we would like to emphasize traumatic stress. On the basis of researches it appeared that more then 50% of IDP population have PTSD. But it should be mentioned that to some extent whole IDP population is affected by this stress.

Sudden, “shocking news” about beginning of the war, accelerated development of events and due to this loosing control over them; anarchy and involuntary evacuation of big masses of people; fear; destruction and burning of houses; physical and moral insult; witnessing physical distortion; These and other factors can become basis of trauma.

It should be noted that similar events took place during first period of evacuation and mass disorders in the country - especially near the conflict zone.

2. Life stress: - Absence of basic daily conditions, starvation, poverty, unemployment. (10-15 people were living in 1 room, they had to stand in a line for a cup of tea; everything had to be started from zero; young people were unemployed; a large part of them started consuming alcohol and drugs; interpersonal conflicts became more frequent.)

3. Adaptation stress: - The IDP population had to cope with daily and traumatic stress in an alien environment, in the places of involuntary migration, which itself was a stress factor. At first the local population was full of compassion towards the IDPs, but eventually relationship between the two sides became tense. Partially this was conditioned by protraction of IDP’s problems, on the other hand the local population was in hard socio-economic situation as well and couldn’t take care of itself. Very often one can hear sayings like “why did you arrive, you should have fought there”, “Who invited you”, “ Refugees destroyed our city”.

4. Stress of uncertainty, or stress connected with lack of information. This part of society was in informational vacuum in the past is in the same situation now, they don’t know when and how they will return in the future either. This fact creates the stress of uncertainty

The system of stresses mentioned above influences all levels of IDP’s personal functioning and determines frustration of such needs as: security, social bonds, self esteem, self-actualization and self-realization. But despite this fact IDP population still manages to cope with crisis on the basis of mutual support and understanding. This is well demonstrated during weddings or funerals of community members. This behavior is a result of Georgian customs and traditions. Despite frustration, difficult situation and distrust, this part of society is full of humane and affectionate support.

Finally we want to write an expression of one of the community members: - “We need help instead of sympathy, partnership instead of subordination, friendship instead of hostility, spiritual support instead of pity, love instead of hatred.”

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Facilitation Model of Protracted Social Conflict

Tsiskarishvili, Lela
Foundation for the Development of Human Resources, Tbilisi, Georgia

Protracted Social Conflict originates when communal groups (defined by shared ethnic, religious, linguistic, or other cultural characteristics) are denied their distinct indentity or collective developmental needs. PSC has it’s genesis dynamics and outcomes.

The genesis component identifies a set of conditions that are responsible for the transformation of non-conflictual situations into conflictual ones. Communal content of society is the most important factor related to PCS. If society is multi-communal, conflict will most likely arise. Individuals strive to fulfill their developmental human needs through formation of identity groups. Their survival is depended on satisfaction of material needs. Access to social institutions, active participation in society is a crucial determinant for satisying developmental needs. But in multicommunal societies distribution of political and economic power is unequal. Because of this minority communal groups tend to be marginalized. In many cases denial of access and deprivation of physical needs are rooted in the refusal to recognize or accept the communal identity of other groups.

The dynamics of PSC encompass communal actions and strategies, state actions and strategies and built in properties of conflict. These three factors activate an overt conflict. Communnal actions and strategies imply mutual distrust between the groups. The trigger may be a trivial event. The victimized group starts to draw attention to a broad selection of issues. This increases momentum for mobilizing resources and formulatin more diverse strategies. The state, on it’s part replies with it’s own strategies - coercive repression and instrumental co-option. Built-in properties of conflict comprise of the historty of experience in the conflict and nature of communication among hostile contestants.

There are no winners in Protracted Social Conflict, all the parties of these conflicts tend to be victimized in the process. These conflicts don’t clear termination point. Outcomes (military victories, agreements) insofar as they do not satisfy basic needs, contain latent conflict, which causes further cycles of manifest conflict. One element that paralyes parties the most is fear. Protracted Social Conflicts are rooted in fear of marginalization.

Conflict resolution entails both, the management of current disputes and planning for the future, so that further outbreakes of violence and destruction are prevented. Four elements constitute the core of effective management of Protracted Social Conflict:

  1. Conflict identification and tracking;
  2. Facilitation of breakthroughs in a conflict situation through problem-solving forums
  3. Promoting self-sustainin structural development;
  4. Adopting development diplomacy;

Here, we will concentrate only on facilitation. Folk diplomacy diplomacy refers to processes which parallel and ideally eventually hook up with track one diplomacy. The “problem solving” approach is based on the belief that violent and prejudicial, or peaceful and cooperative, thinking and behavior are learned phenomena, and that what is learned therefore can also be modified.

During problem-solving forums following factors are emphasized:
Environment. Problem-solving forum needs to provide a framework in which the parties can analyze and explore their perceptions of the origin and nature of their conflict and thus discover that they are pursuing similar goals through adversary tactics. The win-loose (zero-sum) environment of traditional diplomacy should be transformed into one of “win-win” where the possibilities for cooperation and mutual understanding are maximized.

Preparation. Conflict must be tracked and identified. Tracking means obtaining information about changes in the nature and extent of hostilities involved in each conflict situation. So that facilitators can determine trends and be better prepared to speak about the conflict at hand. Although during the forums there are only general ideas and conditions, facilitators must be flexible and innovative.

Discussion. Participants must be analytical. Facilitators draw participants’ attention to areas of agreement and differences. There must be a deep analysis of the nature and causes of the conflict by the participants, to achieve an understanding of each other’s view of the confict. Comperative method is very important for this model. Facilitator talks about other conflicts and discusses failures and breakthroughs in the process of it’s managing.

Participants. Ideal participants are those who are close to the key decision-makers and can influence them. But at the same time they must be able to explore alternatives.

Facilitators. Most important factor is knowledge of protracted conflict, especially psycho-social factors involved and cross-cultural experience and sensitivity. In track two diplomacy facilitators are effective, because they are perceived by the participants as non-biased. Success of the forums is depended on the lovel of trust and respect that participants have for the facilitators. Facilitators shouldn’t intervene in the discussion and must recognize both parties.

One of the most important elements of “problem-solving”model is follow-up communication. This has a psychological value, when participants and facilitators keep in touch and exchange letters, ideas, information related to management of conflict, trust increases and confidence between those involved improves.

The principles mentioned above have a vital meaning for folk diplomacy activities. Georgian - Abkhazian conflict is a Protracted Social Conflict. Now, when in Georgian - Abkhazian relations, certain “melting of ice” is noticable, these principals are especially important on the complicated path of building bridges of reconciliation.

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Some Problems of Public Health

Chkhikvishvili, Shalva, M.D.
Tbilisi State Medical Academy, Tbilisi, Georgia

Different types of headache (approximately 55-85% of the population), improper/or hyperdiagnosis (especially of such a disease as epilepsy - particularly in the regions, were doctors lack of equipment), unwholesome lifestyle (e.g. faulty nursing and/or feeding of infants) lack of knowledge of nursing of disabled people, complications of the poststress syndrome caused by civil war and conditions characterized of transition.

This is a short list of pressing problems that we face in Georgia and which covers the vast majority of country population. The list can be extended by limited ability of medical institutions, financial problems of the majority of population (that results in an inability to get proper medical care), outflow of young (full of motivation to self-development) medical personnel.

All above-mentioned is exceeding the pure medical problem and it is transformed into the medico-social problem.

The way to solve mentioned problems is to adopt the progressive experience of leading countries and instill the wholesome lifestyle and preventive mentality in population (particularly in the special groups such as refugees, families with many children etc.).

There are few ways to reach the target: training courses for doctors from the regions, for caregivers, for family members of physically and mentally impaired patients; editing and printing of bulletins and booklets to popularize healthy lifestyle and to direct the mentality towards understanding of priority of prevention etc.

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Anorexia, Bulimia: Should we be concerned?

Ketevan Chanturia
Tbilisi State University, Tbilisi, Georgia

An interest of investigators towards Eating Disorders (bulimia and anorexia nervosa) has increased since past decades. Traditionally these disorders were considered as the problem specific for Western industrialised society and related to newly developed standards and values. Subsequently, these disorders were supposed to be uncharacteristic for other societies – especially those where thinness does not represent the standard of eternal beauty.

Recent studies showed that eating disorders do not represent the privilege of Western societies and are equally spread in countries with different attitudes towards body shape. In particular, the prevalence of anorexia nervosa in females in late adolescence and early adulthood is 0.5-1% . These rates were found to be stable across different countries and did not change for the whole decade – from 1975-1985. On the other hand, bulimia nervosa is supposed to be more related to cultural attitudes and reflect the changes in cultural life. Thus, the prevalence bulimia has been found to increase by 90% in… Current opinion holds that the factors associated with bulimia include societal changes in women’s role, and the spread of dietary demands.

To our knowledge there were no studies of eating disorders in Georgia before. The population has very little information concerning these disorders, and the mental health professionals also need more training in this respect.

We presume that the prevalence of eating disorders in Georgia could be the same as in other countries. On the other hand, due to the lack of specialised services, the people with eating disorders often are treated by internists – and therefore are not diagnosed adequately. Even those visiting the mental health specialists – are diagnosed as suffering from depression, conversion disorder etc.

The aim of our work was to investigate the symptomatological profiles of bulimia nervosa in Georgian population. To collect as representative sample as possible, we are going to assess the patients treated by internists as well as by psychotherapists. The clinical manifestation of bulimia will be studied with respect to the age of onset.

We hypothesise, that the symptomatology of bulimia in young women (14-20 yr.) will be more marked than in older age group. This should have relation to the newly developed in Georgian society values and attitudes that has greater influence on the younger people. We expect that bulimia features will be associated with depressive complaints.

Our study will represent a part of cross-cultural study co-ordinated by the London Institute of Psychiatry.

The methods include: 1) Culture questionnaire; 2) Bulimia questionnaire BITE; 3) Eating Attitude Test EAT-26; 4) Eating and Weight questionnaire QWEB_R; 5) Self-esteem questionnaire; 6) Depression and Anxiety Scale HADS.

The sample will include the patients treated at somatic clinics (30 Ss), neurotic patients (30 Ss) and 30 healthy controls.

We expect to reveal the most frequent and specific symptoms of bulimia that characterise Georgian sample. We also hope to show the specificity of bulimia according to the culturally specific attitudes towards eating.

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Guilt as a coping mechanism

Javakhishvili, Darejan
Foundation for the Development of Human Resources, Tbilisi, Georgia

In cases of traumatic stress guilt is one of the important and disseminated symptoms. But guilt, intensified or emerged as a result of a trauma has an unusual function, in our opinion, it serves coping with anxiety towards future.

The destructive impact of traumatic stress isn’t confined by concrete traumatic experience (loss of a close person, serious illness, violence…). Trauma is a trauma to the extent it destroys person’s system of beliefs - beliefs about one’s self and surrounding world, it deforms the model of the universe. Feelings of helplessness and disability prevail, one has a sensation of unpredictable future and is incapable of managing one’s own life. This state, on it’s part, creates the basis for anxiety towards the future, and plays an important role in formation of the “numbness” symptom. So, a person starts attributing reasons of events on the surrounding world. If we apply the pendulum principle, guilt might be considered as a balancing mechanism directed on coping with anxiety connected with future and unpredictability of one’s own life. This is an important pre-condition of coping with traumatic experience.

This discourse will become clearer if we discuss an example from ourwork with internally displaced children living on one of the densely populated areas. During the work of rehabilitation group feelings of helplessness and perception of universe as a source of unpredictable, ill-fated events emerged quite often. For children this model of universe was so disturbing, that several times they proposed as a topic for discussion “what is depended on humans and what is not.” Despite the fact that majority of them defended the position according to which “nothing depends on humans, they live quietly for themselves, suddenly wars break out, arthquakes take place, other disasters occur and life is ruined”, their hidden appellation consisted of opposite opinion. The most interesting thing in this discussion was paradoxicallity of children’s view: On the one hand they had the feeling of helplessness, were searching for reasons of events outside of themselves and proceeding from this were trying to avoid responsibility, but at the same time they felt guilty, because of what had happened to them. In particular, children were denying that humans had the ability to manage events and were naming God as the delineator of their lives. But simultaneously they considered God as a punishing instance who’s mission is to punish people for their misdeeds. So the topic provoking children’s anxiety contained in itself it’s own annulment: If I’m to blame in something, then some things depend on me (and not only on external events), this means that I’m not as helpless, and most importantly, in order to avoid misfortunes, in future I will act differently.

Coping with traumatic experience is hindered if a person becomes “stuck” on one of the poles of pendulum. In case of staying at the “guilt pole” entire life energy will be directed on coping with guilt. This, naturally, limits other constructive activities. Extreme expression of guilt might urge a person to commit a suicide. If the opposite pole outbalances, a person has a feeling of life’s unmanageability, one becomes passive and goes with the flow.

Proceeding from the foregoing, in case of traumatic stress, guilt can be considered as one of the mechanisms and stages of coping with traumatic stress. Psychological intervention connected with it should be directed on changing it’s frame with constructive psychological correlate - altering it with responsibility. In this context it is very important to help a person realize what is depended on him/her and what is not. This will help a person take responsibility on one’s self and at the same time in get used to and accept whatever can not be changed.

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