Making Hearts Stronger

by Zinta Aistars

Published in LuxEsto Spring 2014

Kalamazoo College alumni magazine

LuxEsto Spring 2014 Issue

When the mind and the spirit are in pain, the body often expresses that pain in a physical ailment. Heal the mind, heal the spirit, and, often, the body follows suit.

Sue Johnston ’78 understands this mind-body connection in her private psychotherapy practice and as a cross-cultural mental health consultant in Minneapolis, Minnesota. She works with Karen women, an ethnic group from Myanmar (Burma). Many of these women suffer from post-traumatic stress syndrome (PTSD) and other forms of trauma and often come to Johnston on the recommendation of their primary care physicians at health care clinics.

In Karen culture the notion that emotional or spiritual dis-ease may manifest physically is not prevalent, according to Johnston.  “Emotional pain doesn't exist. There is no word for depression, for instance,” she adds. “So I talk with them about emotional pain in physical terms, which they understand.  I tell my clients who are working on PTSD: ‘We are making your hearts stronger.’”

The Burmese army has been engaged in civil war and ethnic cleansing of the Karen people since 1949, the longest running civil war in the world. Women were raped, their families killed, their homes destroyed. More than 150,000 Karen people are currently living in protracted refugee situations in Thai refugee camps. 

“I visited one of the camps about three years ago,” says Johnston. “While no one can truly understand what these women have been through, visiting the camps has given me an idea of the environment they are coming from before they came to the United States.”

Working on PTSD triggers, Johnston says, she gradually exposes the women to the noises they have come to associate with the horrors back home. “Loud noises of any kind remind them of the booming of artillery and the rumbling sounds of an approaching army,” Johnston says. “Most of them are Christian, but they have trouble attending church here, because in Burma, the army would burn down churches on Sunday mornings while the people were worshiping.”

Along with her work with the Karen women, Johnston supervises Somali mental health practitioners providing children’s therapeutic services through Somali Youth and Family Services and Volunteers of America. She specializes in psychotraumatology for adults, adolescents, and children.  

“I also work with police officers, fire fighters, paramedics, and people who have survived childhood sexual  and/or physical abuse—anyone who has gone through some kind of trauma and is now exhibiting symptoms of PTSD,” says Johnston.

Much of her work is with the Karen women, but all her clients share things in common. “Police and fire fighters are people who are not often fond of mental health professionals or the idea that an emotional response to traumatic events, left unexplored, can have physical health consequences,” she says. “They tend to come from a tightly-knit culture of their own, and often their appointments with me are part of an involuntary screening protocol. Whenever a police officer has discharged his or her weapon at work, for instance, or has been under unusual duress, they are sent to me to be screened for trauma.”

Crossing these cultural boundaries, however, is something Johnston does extraordinarily well, and she attributes that skill to her Kalamazoo College education. A native of the St. Paul area, it was Johnston’s mother who pointed her in the direction of K.

Johnston laughs. “My mother just loved to read college catalogs,” she says. “She found K and thought it was a good fit for me. She was right. I was a fairly non-traditional kid in high school, an activist even then.”

Johnston majored in political science, and her studies at K augured the career choices she made later. Study abroad took her to Madrid, Spain, for international studies, and she based her Senior Individualized Project on her work during her freshman summer as a paid union with migrant workers and her internship in Atlanta, Georgia, evaluating the impact of federally funded block grant programs on minorities.  Both programs involved research— on policies developed in response to issues that affect minority groups and on organizing methods women use for self-empowerment.

“All instances in my career hearken back to my days at K,” she says. “Bill Pruitt, my African history professor, had worked for the Peace Corps, and that planted a seed in me to join.  As a Peace Corps Volunteer, I worked with a rural health unit to provide maternal and child health services in the Philippines.

“And Dr. [John] Spencer, from whom I took only one religion class, provided the framework I use today to work with those who are suffering. He taught me how to face suffering.”

Johnston continues to use a book discussed in that religion class as a guideline in her practice. Man’s Search for Meaning by the psychiatrist Viktor Frankl is a memoir of the author’s experience in four Nazi death camps, where he lost his entire family, including his pregnant wife. From that background, along with what he learned from those he treated in his own practice, Frankl argues in his book that suffering is unavoidable. We can only choose how to cope with it, how to find meaning in our suffering, and how to move forward in life with purpose. Happiness is not our primary pursuit in life, according to Frankl, finding meaning in our lives is what drives us most.

“I will be forever grateful to K for introducing me to that book as a fabulous example of a liberal arts approach to education,” says Johnston. “I wouldn’t be equipped with all the tools I have today to help others if it weren’t for my years at K.”

Johnston earned a master’s in social work at the University of Minnesota. She worked for many years as a clinical social worker in community services, mental health clinics, and children’s hospitals and clinics. She coordinated the crisis intervention response for emergency service personnel following the Interstate-35W bridge collapse in Minneapolis. She led a six-person crisis response team to Biloxi, Mississippi, following Hurricane Katrina, and managed and provided clinical oversight and crisis intervention services for a peer support program for law enforcement, fire, emergency medical, and emergency dispatch professionals.

“Kalamazoo College was much more useful to me than grad school,” says Johnston. “Grad school is very specialized, but K teaches you how to live a life.”

It is a result of a quality liberal arts education, Johnston insists, that she has been able to look beyond her experiences and enter into those of others with a measure of understanding and compassion.

“K taught me to move into other world views,” she says. “While the people I work with come from different cultures, I have learned to see the world through their world view. I actually take on/switch into a different world view when I am working with them. And with what I learned at Kalamazoo and through Frankl’s book about finding the meaning in life, I can help people put into context their experiences and their pain.”

Johnston described an emergency medical technician who had done everything possible to save a dying child, but had lost the child nevertheless. “Even with a terrible outcome, I try to help that person see that he or she served that child and that child’s family well.”

In addition to assisting the refugees in healing from PTSD, Johnston must also provide advocacy on behalf of clients with public assistance and health care and assist immigrants to adjust to their new homes in the United States.

“They often tell me they don’t understand the American system,” Johnston says. “I tell them, I don’t either!”

Laughing together can help heal. As does yoga, rhythmic and calming movements, and art therapy. She facilitates a Karen women’s therapy group  in which one of the healing modalities is creating colorful mosaics, and the beauty created from broken pieces is an apt metaphor for their lives. Johnston approaches healing from all angles, and always with an open heart that makes the hearts around her stronger.

When her own heart begins to feel overwhelmed from the anguish around her, she relies on another lesson from her K days. “I listen all day to the stories of the horrible things that people do to each other,” she says somberly. “And I apply what Frankl said to myself, too. We have to look suffering in the eye, find its meaning, and then we can cope. If you believe in what you are doing, you keep going.

“And something else, another K lesson I’ve taken with me. When I was in Spain on study abroad, I studied with a professor who took us to the Prado once every week. I knew nothing about art. I still don’t,” she smiles. “But I know to balance pain with beauty. To this day, when the pain we deal with at my practice gets to be too much, I go to the art museum. I look at beautiful paintings until I have that balance once again.”