The Continuing Role of Theravāda Buddhism in Khmer Healing and Social Development

TABLE OF CONTENTS

INTRODUCTION AND OBJECTIVES

METHODOLOGY

ETHICAL CONSIDERATIONS

RESULTS
Part I: The Compatibility of Buddhism, Healing, and Social Development
Anatomical Conceptualizations of Trauma and Mental Health in the Khmer Context
Buddhism as A Healthy, Sustainable Mode of Being
Healing, Recovery, and Development as Inherent Within Buddhist Tradition
Unity and Harmony: Healing and Development Within a Collectivist Society
Buddhism: A Source of Healing and Development in a World of Global Flows?
Translations of Karma: Perceived Fatalism or a Coping and Development Tool?

Part II: Buddhism and Spirituality in the NGO Sector: Examining Cultural Competencies
BUDDHIST-AFFILIATED NGOs
NON-BUDDHIST-AFFILIATED NGOs

DISCUSSION

LIMITATIONS OF NGOs AND RECOMMENDATIONS

CONCLUSIONS

RESEARCH LIMITATIONS

FUTURE RESEARCH

APPENDICES

BIBLIOGRAPHY

ACKNOWLEDGEMENTS

This work would not have been possible without the ongoing support of my research advisors and of the wealth of resources provided to me by the Center for Khmer Studies Junior Fellowship program. I extend my sincere acknowledgements to my professor Dr. Alberto Pérez-Pereiro, whose knowledge and experience in Cambodia helped me tremendously in refining my research focus, directing me to the appropriate resources, and in encouraging me throughout the research process. I also thank Mr. Natharoun Ngo, the director of the Center of Khmer Studies who provided guidance and reassurance throughout my research experience.

I owe many thanks to Ms. Tith Sreypich, the Program Officer for the Junior Resident Program who organized lodging and other logistical preparations for all of the Junior Research Fellows and whose care and support throughout the duration of the program, and during difficult times, were invaluable. In addition, I extend thanks to other members of the Program and Operation Team, including Ms. Samedy Suong, Head of Programs, and Mr. Samedy Top, Administrative Officer, and Ms. Vichny Yuong, Communication and Outreach Officer, for their support and assistance with my research endeavors while in Phnom Penh.

A large chunk of my research, which focuses on the role of Buddhism in healing and education today in Cambodia, would not have been possible without the generosity and wisdom of the monks at Wat Damnak and the Life and Hope Association (LHA) in Siem Reap, especially Venerable Loeurm Lha, Neou Nen, and Yim Sa Vann. My understandings of Buddhism and the importance it plays in Cambodia’s past and continual healing and social development were enriched immensely by your wisdom and experience. The work that you do in Siem Reap and the many projects you take on that have such productive and hopeful visions of Cambodia and the world are truly inspiring.

For supplementing my Buddhist education, I also thank Rem Sok, a retired monk and current teacher, as well as Mr. Virath, my Khmer language teacher, both of whom taught me more about the ways in which Buddhism continues to permeate Khmer values and guide the lives and outlooks of so many Khmers. I extend many thanks as well to Somony Long, a monk based in Phnom Penh who engages in equally inspiring work with the Social Monks Assembly Organization that is always guided by the Buddha’s teachings. Your enthusiasm for teaching and helping others, and also learning from others, is admirable. I also thank many of my fellow Khmer Junior Researchers who gave me their time and energy to share their knowledge and personal experiences with Buddhism, giving me an important and refreshing perspective.

An integral part of the research presented in this paper is that which focuses on the approaches and strategies employed by several national NGOs in Cambodia that focus specifically on psychological and psychosocial support provision or that provide psychological and psychosocial support as part of their interventions for survivors of trauma. I thank the various Program Managers and practitioners from these organizations who do such good work and who took the time to speak to me about what they do and how their organization operates.

These NGOs including the Transcultural Psychosocial Organization, Social Services of Cambodia, the Cambodian Women’s Crisis Center, Cambodia Action Against Child Trafficking, Cambodian Center for the Protection of Children’s Rights, and First Step Cambodia.

Finally, I also extend my thanks to Elena Lesley, a current PhD candidate at Emory University whose work in journalism and research surrounding the Khmer Rouge Tribunal and mental health in contemporary Cambodia allowed her to give me thoughtful, focused, and fascinating insight into my research topic which greatly supplemented it.

ABSTRACT

As a nation that recently emerged from genocide and that lacks a robust mental healthcare system, Cambodia exhibits one of the highest rates of what a Western diagnostic model would define as PTSD in the world. Trauma lingering from the Khmer Rouge era, combined with that resulting from contemporary societal issues and injustices including child sexual abuse, human trafficking, and gender-based violence (GBV), contribute to these unprecedented rates. These issues remain at times stigmatized, taboo, and misunderstood within Cambodian society, oftentimes hindering the healing process for survivors at the individual and community levels. NGOs analyzed in this study respond to these issues, as they seek to provide psychological and psychosocial support to those experiencing trauma, and concurrently promote awareness of and education on these issues. Considering the predominantly Western origins of national NGO donors, and also the complexities inherent in the provision of effective support for survivors of trauma in Cambodia, this study is one of the first to examine cultural competency in the context of national NGOs and trauma stemming from contemporary violence in Cambodia. This research examines the impact and sustainability of these organizations’ approaches toward supporting the holistic healing needs of those experiencing trauma or distress, with an eye toward how Theravāda Buddhist principles are incorporated into these support and development methods. Adoption of a Buddhist spiritual lens was informed and encouraged by both primary and secondary research that revealed the healing, coping, and social development tools immanent within Buddhist teachings and traditions. This study examines 1) the role that Theravāda Buddhism plays today in Cambodian society and the precise ideals and processes within the philosophy that are conducive to psychological healing and larger social development, and 2) the cultural competencies upheld by NGOs providing relief from trauma caused by the aforementioned issues, paying specific attention to ways in which these NGOs do and do not harness the healing powers and moral precepts of Theravāda Buddhism. Research findings suggest the fruitfulness of Buddhist-oriented approaches and understandings to psychological healing and social development in a country exhibiting high rates of undiagnosed mental illness and low mental health literacy in the rural provinces, where a majority of the Khmer population lives. A gradual yet targeted integration of Buddhist spiritual personnel and institutions with psychological and psychosocial support provided by national NGOs is a promising and worthwhile endeavor that would represent a crucial and efficacious step in enhancing the cultural competency of NGOs’ approaches while also extending the geographic reach of counseling efforts and resources in the country.

Key Words: Cambodia, Buddhism, Theravāda, spirituality, NGO, trauma, cultural competence, healing, gender-based violence, human trafficking, sexual abuse, psychological/psychosocial, support

GLOSSARY

Abbildung in dieser Leseprobe nicht enthalten

INTRODUCTION AND OBJECTIVES

Cambodia’s violent and tumultuous history combined with its systemic poverty and ongoing human rights violations are critical to analyze in any effort to understand the country’s widespread mental health problem. From 1975 to 1979, the country descended into a genocide perpetrated by the KR regime that killed about 25% of the population, during which Cambodians were subjected to torture, malnutrition, labor-induced exhaustion, and routine execution; in these years, existing mental healthcare infrastructure was completely destroyed. Civil war would ensue for nearly 15 more years after the fall of the KR in 1979, leading to the murder and displacement of over 600,000 Cambodians. And since the arrival in 1993 of UNTAC, human rights violations have endured under Prime Minister Hun Sen, who rules his country with violence, fear, corruption, and minimal regard for his constituents’ wellbeing.

Historicizing the unique combination of violent events and ongoing stressors in Cambodia helps contextualize the country’s current widespread mental health issues, which remain aggravated by various factors. Today, it is estimated that 40% of Cambodians have mental health problems, among which trauma figures significantly.¹ From a nationally representative sample conducted by the Royal University of Phnom Penh (RUPP) in 2012, the prevalence of PTSD in Cambodia was found to be seven times higher than the worldwide average, at ².7% of the total population aged 21 and older.² While over 60% of Cambodia’s population now was born after the KR, second-generational trauma caused by role-reversal parenting and the erosion of family ties has rendered children of KR-era survivors vulnerable to violence; according to Field,³ 47% of children from a national survey experienced physical punishment by parents and 14% were sexually abused.² And societal taboos surrounding such realities have given rise to severe mental health issues amongst survivors due to difficulties in family and professional reintegration. Relatedly, strong correlations between violence in society and violence in the home can be observed in Cambodia: domestic violence affects 20-25% of Cambodian women.² GBV has been linked to trauma, distress, and feelings of hopelessness and disempowerment.² In addition, human trafficking, for sexual and labor purposes, has flourished in Cambodia and affected men, women, and children in urban and rural areas, and their exploitation has produced longer-term mental health consequences.⁴

These mental health issues are exacerbated by an inchoate mental healthcare system, mental health services inaccessible to the poorer, rural populations, who constitute 77% of the population, and low mental health literacy.⁵ Mental health services represent only 0.02% of the national health budget, and the dearth of mental health infrastructure is particularly felt in rural areas, as most trained psychiatrists and psychiatric nurses are based in Phnom Penh, while transportation difficulties and other barriers facing those in rural areas inhibit their capacity to access the few provincial hospitals and clinics there are. Mental health is a key player in the cycle of poverty: many of those living in rural provinces face daily stressors including lack of work, food insecurity, and lack of access to education;⁶ at the same time, mental disabilities can lead to poverty, as most mental healthcare expenditures must be out-of-pocket. Also, many Cambodians will forego services while their symptoms fester. Because of government apathy toward building a mental healthcare infrastructure, NGOs such as TPO and SSC have stepped in as the primary providers of psychological and psychosocial services in rural villages, yet this approach is limited by finite funding and human and material resources, and as this study will show, sensitivities to Khmer culture. The responses of many Khmers to trauma and related stressors are embedded within Buddhist healing methods, which oftentimes fail to be taken into account in Western forms of mental health intervention.

Buddhism has remained a spiritual, cultural backbone of the Kingdom since the 5th century. As a fusion of Buddhist, Hinduist, Brahmanist, and animistic concepts, the Theravāda Branch of Buddhism encapsulates the moral routes to achieving merit and developing oneself socially, which for a majority of Khmers have become a natural mode of being. Many Khmers find not only their own individual and national identities vested within this spiritual tradition, but also moral affirmations that serve to reinforce the solace, compassion, and positive forces that inhere within the Buddha’s teachings, and that Khmers consequently aim to suffuse throughout their communities. Buddhism, as a spiritually-oriented set of precepts and ideals, in pre-modern Cambodia served a pivotal role in its contributions to the moral and political order, while refining Khmer ethnic and national identity and fostering community within the Cambodian population.⁷ Yet during the genocide Buddhism as a spiritual and cultural force became the subject of systematic destruction by the Khmer Rouge.

Important for analysis are the ways in which many Cambodians sought to restore their demolished Buddhism in the wake of the genocide. Peg LeVine (2010) delineates in her research on ‘ritualcide’ the spiritual harm inflicted by the Khmer Rouge during the genocide, a form of cultural violence that magnified and prolonged the suffering of victims and survivors by stripping them of their traditional means of finding meaning in their lives, as well as solace and a sense of security.⁸ LeVine highlights the need to recognize and examine how so many Cambodians navigated out of the “destructive chaos” that came to envelop them during the Khmer Rouge years.⁸ In the aftermath of the genocide, reconstructing Khmer society for many Cambodians signaled the reflexive and adaptive resurrection of Buddhist monks, temples, and traditions to help piece together what seemed at the time to be an irreparable country. Hence, despite the purposeful and irreversible destruction of Buddhist scholarship and traditions, most of Cambodian society still looks to Buddhism as a force that provides them order and meaning within what has become a less fractured world.⁷ The challenging yet passionate revival of Buddhism in Cambodia after such a mass atrocity speaks more largely to the adaptable resilience promoted by the spiritual teachings. This resilience provided the impetus for the first part of this study’s research to investigate more rigorously the precise healing and social development tools inherent within Theravāda Buddhist philosophy, and the role that Buddhism plays in healing and development today in Cambodia.

Indeed, studying the precise healing mechanisms within Buddhism sought out and utilized by much of the Cambodian population can be telling of the powers that Buddhist and local traditions have in assuaging the mind and helping individuals overcome the paralysis that can accompany traumatic or distressing events. According to Agger (2016), mass trauma in Cambodia as a result of the genocide provided the impetus for the importation of Western psychiatric and psychological approaches to trauma.⁹ Yet caution must be taken whenever treatment methods are transposed onto a society that originate in foreign contexts, belief systems, and paradigms. Agger (2016) raises the important point that mental effects of stress and trauma may be experienced very differently in divergent contexts, and oftentimes existing cultural frameworks, structures and systems need be studied, conserved, and utilized to enhance treatment efficacies.⁹ For example, Chhim (2013) illustrates the culturally-specific ways that Khmers experience and respond to trauma by expounding upon the ‘idioms of distress’ evident in Khmer culture.¹⁰ The case of Cambodia, among others, negates the assumed universality of PTSD, since many of the symptoms associated with PTSD from a Western perspective manifest in Cambodia in a local, cultural-based syndrome: baksbat, loosely translating to ‘broken courage’. Khmers experiencing baksbat demonstrate passivity, submissiveness, and mistrust of others;¹⁰ they also often default to avoidant coping mechanisms to prevent “thinking too much” or kut caraeun, a form of rumination that can engender negative physiological symptoms such as headache, dizziness, and lethargy.⁹ Research suggests that Khmers often prefer treatment rooted in local, spiritual Buddhist methods instead of or combined with cognitive and other therapies that originate from Western mental health models.¹⁰

The apparent point of contention between Euro-American and Cambodian views on the “semiotics of suffering”, mental health, and psychological treatment constitutes part of a larger trend toward the imposition of Western values onto Cambodian society.¹¹ Cambodians hold a unique understanding of trauma and mental health that is informed by their own cultural lexicon and inclinations toward healing and coping, a reality that is often overlooked and forgotten when treatment for psychological and psychosocial support becomes subsumed under the larger umbrella of “development”. Indeed development in Cambodia, propelled by the NGO sector, has remained governed largely by Western visions of progress and human rights, donors, and on-the-ground development workers. Even Cambodia’s civil society responses to healing for Khmer Rouge victims and to other human rights and development issues, which were initially local and Buddhist in origin, have become dependent upon foreign, Western donors.¹² Kent (2003) finds from her research that the development agenda and vision in Cambodia seems to frequently be at odds with the “matrix of local experiences, understandings and cultural resources” rooted in Buddhist approaches toward healing and solace (p. 3)7. Information from local NGOs, better attuned than international donors to Cambodian cultural sensitivities of mental health and trauma, reveal how international approaches to trauma relief and support are rooted in cognitive models of trauma and distress, and disregard Cambodian tendencies to seek spiritual help alone, and avoid thinking or speaking consciously about their past.¹³ This international pathologization of trauma connects to other global human rights discourses surrounding justice that circulate in Cambodia; they all belong to a paradigm in which trauma can be ‘cured’ and justice can be achieved through testimony and truth-telling, a healing process that adheres to psychopathological and juridical scripts that contradict Buddhist teachings of avoiding and often releasing the past.¹⁴

As Buddhist teachings and practices seem to remain fundamental to Cambodia, examining closely the role that Buddhist healing methods play amidst globalizing and other forces in Khmer society, and subsequently whether the healing tools of Buddhism are employed by NGOs that assist survivors of traumatic events today in Cambodia, appears important. This analysis could shed light on the question of whether survivors of contemporary violence in Cambodia, including gender-based violence, child sexual abuse, and human trafficking, among other sources of violence, are receiving culturally competent treatment and support that accounts for conceptions of trauma and healing that are rooted in traditional, spiritual perspectives. The question of cultural competence in healthcare and development settings remains a critical topic for research and discussion considering the urgency of care and support for survivors of contemporary trauma, which often arrives in interventions that are in many direct and indirect ways driven by Western values and institutions. Indeed, culturally-rooted belief systems of the etiology of illness and trauma, and of health and healing, as well as willingness to seek out help from NGO practitioners, are all valid reasons to exercise culturally competent approaches to healing to have some sort of positive impact on the survivor. Cultural competence, as an ongoing process, has been shown to enhance the efficacies of international NGOs through promoting greater awareness of contextual factors that can in turn foster a greater receptiveness of the target community to the establishment of relations with the NGO, and better communication between the NGO and target community in general.¹⁵

Little research exists on the cultural competence exhibited by NGOs which 1) have directors and PMs who originate from the culture of focus, yet 2) have international donors who are not present in day-to-day operations and implementations of projects. Examining cultural competence within a national context in Cambodia seeks to reveal potential cultural dissonances resulting from projects implemented by domestic NGOs that may have adopted Euro-Western notions of trauma, mental health, psychosocial support, and healing. This topic seems worthy of exploration especially considering how Euro-Western cultural perceptions of justice, healing, trauma, human rights, etc. have infiltrated Cambodia since the arrival of UNTAC in 1992, manifesting in government policies, education, INGOs, and significantly in NGOs that have been have been handed over to Cambodians. Moreover, little research has examined the cultural competence upheld in the NGO field of psychological and psychosocial support, let alone competence bearing a spiritual dimension. Indeed, cultural competence encompasses religious competence, since religious identity shapes client attitudes, values, and beliefs;¹⁶ scholars argue that rather than dismissing religious-related systems as incompatible with healing and recovery, NGO practitioners need study and capitalize on religious resources that can aid in restoring and instilling resilience and healing within the individual, group, or community.

I hope with my research to explore how many of the frictions between internationalized and local, Buddhist-related conceptions of mental health, trauma, justice, and healing observed in the aftermath of the Khmer Rouge era may still be apparent in Cambodia today. The first part of this study seeks to delineate through primary research sources the ways that Buddhism promotes healing and social development, and the ways that Cambodians today, old and young, turn to Buddhism, despite the increasing infiltration of Western globalizing and secularizing forces in the country. This part of the research intends to lay a foundation for the second part, which turns to NGOs active in the provision of psychological and psychosocial support to examine their approaches and whether or not they incorporate Buddhism in their strategies and project designs. How do Cambodians today who have faced traumatic or distressing events (GBV, child sexual abuse, and trafficking) respond to their traumas and realities? How do Buddhist forms of healing remain culturally embedded in Khmer society, and retain their power and sustainability amidst globalization and secularization patterns in Cambodia? How do NGOs in the country incorporate these questions and sensitivities into their strategies, and how does that affect the impact and sustainability of their work? The research aims to address this and other related questions.

METHODOLOGY

Research for this study was divided into two parts that each intended to address separate yet related inquiries surrounding Buddhism and healing in contemporary Cambodia. All research followed a qualitative, interview-based approach based on a purposive sampling model, and was conducted over a six-week period in July and August of 2018 in Siem Reap and Phnom Penh, Cambodia. In Part I of the study, research explored the healing and development tools inherent in Buddhist tradition, as well as the status of Buddhism in Cambodia’s recent past and present. This research was collected via interviews with five Khmer university students, a Khmer language teacher and professor of Buddhism in Siem Reap, three practicing monks and one previous monk-turned teacher from Wat Damnak temple in Siem Reap, and a teacher of yoga and meditation in Phnom Penh. With these interviews, research sought to explore the precise mechanisms within Buddhist traditions and practices that may be conducive and beneficial for healing and social development efforts. These initial interviews hoped to shed light on the level of importance that Buddhism continues to play in Khmers’ lives, and also shifts or adaptations in Buddhism that have recently developed. This segment of the research hoped to explain how and why the question of whether Buddhist traditions and values can help NGOs provide more culturally competent support to survivors of trauma holds relevance today.

Part II of the research study turned to NGO practitioners and personnel in the areas of psychological and psychosocial support for survivors of child sexual abuse, human trafficking, and GBV. Attention was paid to both Buddhist-affiliated and non-Buddhist-affiliated NGOs to provide a comparison of and distinction between spiritual and more Western approaches toward helping others heal. These NGOs included two Buddhist-affiliated social development NGOs, and six non-Buddhist-affiliated NGOs that provide psychological and psychosocial support to survivors of child sexual abuse, human trafficking, and GBV. Research with all of these organizations sought to examine how strategies to help individuals cope with their trauma are devised and deployed, and what types of cultural values drive and shape those approaches.

ETHICAL CONSIDERATIONS

All individuals interviewed for Part I of this research study participated voluntarily and were fully informed of the purposes of my research and where it would be located. No interviewee was mentioned by name. Informed consent for NGO directors and personnel was prioritized so that they were fully informed of the purposes of my research, where the information would be located, and how it would be used or analyzed. NGOs were mentioned by name, unless the interviewee explicitly requested that they and their organization remain anonymous. While I did not interview the clients of NGOs directly, it was important to remain sensitive to the fact that many of them originate from marginalized, vulnerable groups in Cambodian society. Ensuring that I asked informed, targeted questions that remained sensitive to the specific issue addressed by the NGO also remained a priority, even though research did not focus on the precise nature of trauma faced by each respective group.

RESULTS

Part I: The Compatibility of Buddhism, Healing, and Social Development

This segment of my research collected information from several Khmer individuals in an attempt to better comprehend how Buddhist perspectives on life and society may pertain to healing and development processes in Cambodia today. Several themes were recognized as common threads throughout the interviews. This effort to examine Buddhist traditions and their relevance to modern society aimed to provide a contextual framework for the ways Buddhism and the spiritual beliefs and values it encompasses can be viewed as healing and development tools, a framework that has helped to inform Part II of this research inquiry.

Anatomical Conceptualizations of Trauma and Mental Health in the Khmer Context

Considering the terror and inhumanity that overtook and devastated Cambodia in its recent past, it is logical for a Western audience to imagine and visualize the psychological consequences through a psychopathological lens of ‘trauma’, a word that does not directly translate to Khmer. Research obtained from interviews with several Buddhist monks and a meditation and yoga practitioner at Krama Yoga based in Phnom Penh help to deconstruct the concept of trauma and what it signifies, where and how it manifests, what it means in the Cambodian context, and the implications of these understandings for effective approaches toward support and treatment.

Research on the terminology and taxonomy of what western psychiatry views as ‘mental health’ reveals that trauma and related mental health issues are generally framed in ways that do not distinguish them from ailments and diseases that produce physical symptoms. A meditation and yoga practitioner shared with me that trauma, while often conceived of as baksbat in anthropological discourse surrounding Khmer Rouge survivors, in a more medical sense loosely translates in Khmer to chom ngu chet, ‘mind sickness.’A With this translation ‘trauma’ is seen as occurring and contained within the mind, and linked to internal processes and effects; it can accelerate into a severe disease of the mind because of its confinement. Findings seemed to echo those of Eisenbruch (1993) who reports that in Cambodia in general, the line seems to be blurred between diseases that affect the body and those that affect the mind.¹⁷

One monk reiterated to me how trauma and in general mental health illnesses constitute afflictions of the mind, an entity that belongs to us yet that is ‘beyond the physical’, and thus presents challenges for devising and applying practical treatment approaches.B Since trauma tends to be viewed as an illness, the implicit, subsequent step is to respond to it with some sort of treatment. Because of the physical inaccessibility of the mind, monks whom I interviewed stressed regular practice of meditation as an integral component of the process of healing from trauma and calming the mind from any ailments affecting it.B, C, D Meditation leads to concentration on the present moment and permits an individual to tune out extraneous stimuli and quiet the mind, which has a calming effect that can significantly allay suffering caused by trauma, distress, or other mental afflictions. These conclusions echo many others in the Buddhist scholarship field that illuminate the fruitfulness of meditation and its calming effects on the mind.¹⁸, ¹⁹ Eisenbruch (1993) notes that while there is no clear distinction to be made in Cambodia between local folk beliefs and traditional healers’ (kruu) takes on Buddhist notions of illness, monks who prescribe meditation to assuage the mind retain the respected role of spiritual healer in society.¹⁷

Buddhism as A Healthy, Sustainable Mode of Being

Several of the monks clarified that Buddhism represents a set of teachings that guide a particular mode of being and thinking lived and enacted in everyday life B, C ; the didactic and non-dogmatic nature of Buddhism serves to distinguish it from the Abrahamic religions such as Christianity, Judaism, and Islam, and also others, all of which are predicated upon deference toward a God or gods, reserved times for prayer, and a rigid set of rules that must be followed; obeying these rules is often propelled by an ultimate goal of achieving a preferable place in the afterlife, which is dictated by being “good” or “bad” according to the rules. Monks shared that to experience the psychological and other positive benefits that adopting the Buddhist philosophy can bring, the Buddha’s teachings must become integrated into everyday life and practice.C, D This notion represents another point of divergence from other religions in which explicit religious acts such as daily prayer and attendance of religious ceremonies and services are more compartmentalized in individuals’ lives. One Khmer university student interviewed perceives Buddhism as having become integrated into local thought and belief systems, and he analogized the philosophy to a language that frames thought and understanding.E He opined that the ‘rules’ are more like teachings in Buddhism, not strict as in other religions like Islam, and generally are commonsense and applicable to everyday interactions and activities.E Monks interviewed also seemed to concur that while the pagoda has remained a welcoming, inclusive, and spiritual place and refuge to which lay Khmers reflexively turn for comfort, support, and healing guidance, Buddhism can be practiced anywhere and with anyone, and adapted to an individual’s life.B, C, D

Monks in their explanations of Buddhism revealed the unconscious notion of Buddhist traditions and practices, which they view as reaping significant benefits for psychological health and general well-being. One thought that the act of meditation in Cambodia is generally not performed individually at home but usually with others at the pagoda.C It is widely known that meditation and Buddhist philosophy can cultivate mindfulness. Research circulates surrounding the importance of understanding Theravāda Buddhist concepts of mindfulness in the specific contexts and frameworks in which they originated.¹⁹,²⁰ Mindfulness, translated from the Khmer term sati, in Buddhist perspectives generally denotes a form of memory, indicating non-forgetfulness, cognizance, and presence;²⁰ understood to be a “wakeful, ethical guarding,”²⁰ mindfulness in the Theravāda tradition aims to cultivate “wholesome” qualities (wisdom, patience, compassion, loving kindness) and resist and reject “unwholesome” qualities (hatred, desire, materialism, lust, delusion).²⁰ Interviews in this segment of the research emphasized the soteriological underpinnings of Buddhism, and conveyed meditative mindfulness as a key tool in helping individuals understand and transcend their suffering, dukkha.

Two monks specifically reported the imperative of cultivating mindfulness in cases where individuals are oppressed or hurt by others, as the consciousness engendered by mindfulness discourages anger and ignorance (delusion), and allows the individual to distance themselves from the pain or oppression imposed on them.C, D Anger and ignorance are viewed as factors that cloud our judgment, corrode wholesome qualities of wisdom and clarity, and prevent the sense of inner peace and strength that can help further the healing process. From the clarity that accompanies mindfulness practice, monks stressed the ability of individuals to strategize themselves out of their suffering in order to transcend it.C, D A professor of Buddhism from Siem Reap shared in an interview that the distance individuals are able to keep from the external source of trauma is rooted in an acceptance of what has happened to them, which can promote equanimity and suppress the oftentimes impulsive urge to retaliate.F From his own observations having been a professor in Cambodia and the U.S., he contrasted the ‘fight back’ mentality in the West, where individuals from his impression generally exhibit intense reactions to provocation and events that bring them trauma and distress, with the more controlled and rational response seen in practicing Buddhists in Cambodia. With a more mindful, baseline mentality, many Cambodians in his view are able to exercise restraint in traumatic, stressful, or angering situations, achieving calm and sensibility which in turn can help them overcome or cope with the trauma they face.F

Two monks emphasized to me the longer-term health benefits of a commitment to cultivating this mindfulness, which can bring immense quiet and calm in the face of trauma, distress, and other afflictions of the mind.B, C Put into practice, mindfulness seems able to contribute to a healthier lifestyle in which many of the negative mental and physiological effects of anger, fear, and pain are minimized. One monk reported that regular meditation can increase longevity, arguing that just as healthy food can promote physical health, mindfulness and meditation can promote psychological health.D

Healing, Recovery, and Development as Inherent Within Buddhist Tradition

As revealed by interviews with monks who involve themselves in social development endeavors, Buddhism, the primary concern of which is the cessation of suffering, contains built-in elements that are conducive to processes such as healing, recovery, and progress, all of which tend to fall under the internationalized concept of “development”.B, C, D One monk reported that Buddhism seeks to address both the physical and mental issues that people face in the world, which seems to encapsulate many of the forms of violence, oppression, and injustice that the arena of development tackles throughout Cambodia and the world.C The EBM and links between Buddhist philosophy and social development values have been well-documented, and research revealed a few of the ways in which Buddhist ideals promote such values within the individual. A teacher who just recently left the monkhood noted that Buddhism supports and nurtures development at the individual level, as it stresses that while the world and the universe are in a state of flux, so is the individual.G The Buddhist teachings are in their own ways agents of human recovery, a process that can proceed in a constantly changing world. The monk who is the director of LHA described Buddhism as a force that can change lives, as the forward-thinking mentality encouraged by Buddhist philosophy can give people a sense of hope and purpose in their lives.H The same monk clarified that while Enlightenment remains unattainable for lay people, they can be inspired to work toward peace and strength in their lives, a process which can evolve in tandem with wider social development efforts; the Buddha’s teachings can be viewed collectively as a catalyst for social change, personal development, and community development.H Envisioning such individual development as a process that moves concentrically outwards toward community and societal development is a key aspect of the EBM, that views self-transformation and social transformation as “mutually necessary”.²¹

All of the monks described Buddhism as a process that contains within it many different processes that encourage consistent efforts toward bettering oneself through striving for peace, equanimity, and happiness, all of which can in turn breed compassion toward others.B, C, D, H When asked about the roles that monks play today in Cambodian society, specifically with regard to healing and development issues, one monk highlighted the integral role that monks continue to play in educating and in equipping lay people with the knowledge and practices they can use to heal and better themselves.C Interviews in the first part of the research suggested that monks continue to command an influential presence in Cambodia today, and their rhetoric and teachings remain respected by large proportions of society. According to the LHA Director, if more monks in Cambodia were highly trained and seasoned in the particularities of the Buddhist philosophy, it would be easier for the country to change and heal, as they could imbue society with qualities that are essential for healing and social development processes.H The monks interviewed interpreted the role of the Buddhist monk as that of teaching loving kindness, compassion, sympathy, and equanimity, and equality in the sense of equitable love for all humans. According to them, by imparting their knowledge and reciprocating the training and education that they have received, Khmers can better understand how to live peacefully, and in turn foster cohesive communities.

Unity and Harmony: Healing and Development Within a Collectivist Society

Interviews overall, through descriptions of family and community structures, and Buddhist ceremonies, emphasized the collectivist nature of Cambodian society. Returning to the contrast that the professor of Buddhism articulated between the West and Cambodia when it comes to reaction mentalities, he also established family and community values as factors contributing toward a general divergence in reflexive responses to harm or disruption.F In his view, the competition bred in the Western world tends to lead individuals down independent routes toward solving their problems and addressing their struggles. The pressure and competition promoted by Western society originates at a young age, and encourages young people to aspire toward this independence and to enter into such a competitive milieu. Out of this environment, the professor finds the phrase “I don’t need help” to be a common denominator for many individuals when they encounter any form of adversity or perturbation in their lives. He juxtaposes this tendency with that which he observes throughout Cambodia, namely in which Khmers reflexively seek out support from family, community, and the pagoda in times of struggle, opposition, and distress. The dismissive “I don’t need help” reaction is not compatible with the Buddha’s teachings.F Similarly, the LHA Director shared that isolation and loneliness, from others and also from the Buddha’s teachings, are not conducive to healthy responses to trauma.H Much of these findings relate back to widely-known Cambodian folk tales in which loneliness, isolation, or setting out on an uncharted path alone is viewed as unwise and/or dangerous.²²

Buddhism for many of the interviewees appears to be an axis about which many of these family and community-oriented values orient themselves. One of the Khmer university students affirmed that because of the highly Buddhist and also collectivist nature of Cambodian society, it is unlikely for individuals to enter or practice the teachings of the Buddha on one’s own, as it removes the social and interpersonal dimensions that are so integral to the upkeep and spread of the Buddhist philosophy.I In her eyes, Buddhism promotes a certain social process that brings people together, both physically at the pagoda, and also spiritually through acting as a bridge between present and ancestral generations.I The Khmer professor relayed how “let’s go the pagoda” remains a cultural impulse for many in Khmer society;F the university student felt that Buddhist ceremonies, including pchum ben, concurrently reinforce family ties and help allay the psychological suffering resulting from deaths of family members, ideas that Holt (2012) explores further in his research on Khmer methods of ritually caring for the dead.I, ²³ These unifying physical and spiritual aspects of Buddhism can in her view promote psychological health and healing processes, while also sustaining the collectivist facet of Cambodian society.

Healing with tools provided by and within a collectivist culture related to other research findings, namely that in which the Buddhist grounding in reason can be coupled with collectivist family and social values. The professor of Buddhism noted how family ties in Cambodia are especially strong relative to the West, as parents are often seen as embodiments of Buddhist wisdom, while gratitude is to be directed toward children as they are raised according to a Buddhist philosophy.F Family members can act as automatic sources of support for each other. As a force that continues to keep and gather people together, Buddhism, according to one of the monks, promotes individual thinking and action and rejects superstitious and mystical thoughts and belief processes.B Along these lines, while research findings from the Khmer university students acknowledge the individualized ways in which the Buddhist teachings can be observed and enacted today in Cambodia without necessarily going to the pagoda, the pagoda remains a space and environment that continues to provide refuge, solace, and community to individuals, especially in the rural provinces. What the LHA Director emphasized sums up much of these findings: in striving to promote a familial environment at their school, solidarities represent critical routes toward finding peace and happiness, and toward healing and development.H

Buddhism: A Source of Healing and Development in a World of Global Flows?

One interview question sought to examine the ways in which Buddhism has changed during the post-Khmer Rouge era, and what the impacts of those shifts, if any, are on the extent to which lay Cambodians today vest themselves in the healing traditions of the Buddhist teachings. Increasing patterns of globalization and urbanization in Cambodia were mentioned explicitly in the question. Several interviewees, including a Khmer university student and the professor of Buddhism, highlighted the critical role that Buddhism played in the healing of society and reconstruction of Khmer national identity and consciousness after the genocide, yet acknowledged the ways in which it was permanently altered.E, F One of these noticeable changes has been a decreased association between Buddhism and concepts such as education and learning, partly a result of the critical loss of Buddhist scholars due to the genocide, and also the increasing secularization of the education sector today.E Despite this growing divergence between education and the Buddhist institution on a larger scale, most interviews relayed how Buddhist traditions are more or less still pervasive in Khmers’ lives, albeit in increasingly different forms. One student revealed to me that Buddhism has become more tolerant of and compatible with less pious lifestyles, as healing traditions and other comforting aspects of Buddhist teachings can still be practiced by those bearing more agnostic attitudes, or those who may not explicitly identify as Buddhist.E While he himself identifies as agnostic, he has practiced some Buddhist traditions his whole life, and implicitly associates suffering and healing processes with Buddhism. Other students observed how Buddhist traditions have become more loosely practiced over time, while one finds in urban environments Buddhist traditions to be a bit more individualized.

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