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From NPR, this is in Bizzeria.

0:27

So when I first heard about today's story,

0:29

I was like wow,

0:32

so many communities are facing

0:34

this problem. And

0:36

it's a problem. We hear a lot about

0:39

these days. Immuno trauma ratio

0:41

cultural trauma.

0:42

Generational trauma. Inter generational

0:44

trauma. Trying to get your head around

0:46

it.

0:46

This is not something that person

0:49

chooses. I'm

0:49

in the aftermath rejection

0:51

-- Of a big catastrophe.

0:53

-- abandonment. It's kind

0:54

of like an invisible elephant in

0:56

the room.

0:59

But

0:59

it's one thing to acknowledge knowledge, that trauma

1:02

is real, and another

1:04

to figure out, okay.

1:06

So what do we do about it?

1:09

That's something Stephanie Fu has done

1:11

a lot about. She's a journalist

1:13

who wrote book called what my bones know

1:16

and then more of healing from complex

1:18

trauma. She writes about having

1:20

complex PTSD, the science

1:22

behind the diagnosis, and the various

1:24

therapies and treatments used to heal from

1:26

it. And while researching

1:29

her book and how to heal herself, She

1:31

found a story about what it looks

1:34

like to heal the community.

1:37

A quick heads up. Stephanie will be

1:39

talking about genocide. war,

1:41

domestic violence, suicidal ideation,

1:44

and child abuse.

1:46

Alright. Here's Stephanie.

1:49

I grew up

1:51

in a place called the Valley of Hearts

1:53

Delight, specifically San

1:55

Jose, California. It

1:57

got that name because it's beautiful.

2:00

Seventy five and sunny most of the time,

2:03

streets lined with cherry and citrus trees.

2:05

air that smells of eucalyptus,

2:08

maybe why so many of our parents flocked

2:10

there. My

2:12

community was full of immigrants, all

2:15

of our parents had accents.

2:17

My high school was majority minority.

2:20

There was a huge Vietnamese population, lots

2:23

of alpino, Mexican, Korean,

2:25

and Chinese kits

2:26

like me.

2:28

The local hangout spot was literally called

2:30

the Great Mall. Though we also

2:33

played a lot of DDR at Golfland

2:36

every party featured King Yangirl,

2:38

if you know, you know.

2:42

But in this paradise, something

2:44

darker was happening. You'd

2:47

catch glimpses of it when report cards

2:49

came out. when

2:50

we got caught wearing skimpy dresses at

2:52

homecoming, when someone's secret

2:54

boyfriend got found out, because

2:56

that's when we could expect the

2:59

abuse at home.

3:02

Look, it

3:03

didn't happen all of us. Lots

3:05

of us had loving supportive parents.

3:08

but it happened to a lot of us, most

3:11

of my close friends.

3:14

At

3:14

home, we were neglected, beaten,

3:17

and yelled at so much that it

3:19

was normalized in my community. My

3:21

trauma wasn't just personal. It

3:24

was shared with a lot of my friends'

3:25

traumas mirroring my own. and

3:28

we are still affected by it every

3:30

day.

3:32

A lot of things have changed since I was in high

3:34

school fifteen years ago. and

3:36

I was hopeful that this abuse

3:38

had lessened in that time. But

3:41

when I went back to my old high

3:43

school and I talked to the new counselor there,

3:46

She said, it's still happening.

3:49

That she's so many students that are being physically

3:51

abused at home. She can't even

3:54

count them. When

3:56

I found this out, I wanted to figure out

3:58

if there was a way to fix this to

4:00

make

4:00

it stop. For

4:02

years, I went to therapy and

4:04

that helped me. But that was

4:06

never an option for my parents generation.

4:09

I believe that my parents abused me and

4:11

eventually abandoned me. because

4:13

they were hurting so deeply

4:15

from their own wounds. And

4:16

they never sought help for those wounds because

4:19

they told me that therapy

4:21

was for crazy people.

4:23

and they weren't crazy. This

4:26

stigma prevented most of my friends parents

4:28

from getting help too. So

4:31

I set out to see if there was a way

4:33

to heal our parents. And

4:35

in doing so, even heal

4:37

ourselves.

4:37

agriculture

4:40

Alright. Thank you. Oh, I love this room.

4:43

And that's how I heard about this community

4:45

clinic in my hometown. I was

4:47

trying to solve the same problem. and in

4:49

the process found themselves in the

4:51

middle of a ghost story.

4:55

When something comes at you that you don't know what

4:58

it is, Don't make any assumptions.

5:00

This is doctor Darren Richter.

5:03

He's

5:03

a white dude who kinda looks like doctor

5:05

House. if doctor House was

5:07

really intercepting. And about

5:09

twenty years ago, Darren was a young

5:11

psychiatry resident, moonlighting at

5:13

Gardener Health Services, a community

5:16

clinic that was providing mental healthcare to

5:18

the local cambodian community. But

5:20

shortly after starting this job, Darren

5:23

noticed

5:23

something strange. At the time,

5:25

I think we had close to two hundred Cambodian

5:28

patients here. I think we had like a hundred

5:30

and eighty people and we kinda

5:32

got a spreadsheet and realized that almost

5:34

all of them, maybe a

5:36

hundred and sixty of them were on antipsychotics.

5:39

I mean, think about that. That's ninety

5:42

percent. So

5:45

Darren immediately thought that

5:47

cannot be right. ninety

5:49

percent of a population cannot

5:51

be psychotic. That's

5:53

just not how mental illness works. And

5:55

if these clients were on the wrong medication, it

5:58

could have scary consequences.

5:59

Antis psychotic medication is

6:02

super dangerous. The

6:04

new generation antipsychotic put

6:06

people at risk for head blood pressure, obesity,

6:08

diabetes. What are cambodian

6:11

Americans at risk for? Blood

6:13

pressure, diabetes. And so

6:15

we're giving them a medicine that puts them even at

6:17

higher risk for something that's already a

6:19

terrible risk for them. Darren

6:22

was stumped, so

6:24

he

6:24

asked for help. I got hired not because

6:26

I had a psychology degree. I got hired

6:29

because I know component culture

6:32

is a culture specific program.

6:34

This is Bob Paul Penn, a Cambodian

6:36

therapist who had recently been hired

6:38

a Gartner. your mind's me of a big

6:40

soft teddy bear with eighties looking

6:42

wire rim glasses and a little mustache.

6:45

He provided case management counseling

6:48

and medication support to Cambodian

6:50

clients. And Darren

6:52

thought, in order to get to the bottom of

6:54

this mystery, he

6:55

and Bob Paul needed to reevaluate every

6:58

single client together.

7:01

So together, they start with one

7:03

client and pretty quickly She

7:06

starts telling the two of them about how

7:08

she sees ghosts at night.

7:10

Luckily, I have football in the room, so

7:12

I'm able to say, is this symptom what she's

7:14

talking about, what the heck

7:16

is she psychotic? What's going on in Bhopal

7:18

said, oh,

7:18

no. No. It's sevens all the time. And

7:20

I was like, Are you psychotic? Like, what are

7:22

you talking about?

7:27

In our culture, we believe that that

7:30

when you are waking up on my sleep,

7:32

you would see this big black

7:34

shadow that sit on you, pinning

7:36

you down, you cannot wake up, you cannot sleep,

7:38

you cannot move your bodies.

7:40

I think in the western world, they

7:42

call that sleep paralysis.

7:45

Sleep paralysis. The

7:46

feeling you get when you can't move is

7:49

you're waking up

7:49

or falling asleep.

7:51

Darren and Bill Paul talk to the clients one

7:53

by one. over and over,

7:55

it was confirmed all

7:58

these patients had sleep paralysis.

7:59

It

8:00

happens a lot in people who are stressed and

8:03

not getting enough rest. like these

8:05

Gartner clients who are often not

8:07

getting more than two hours of sleep per night.

8:09

In

8:09

the end, only

8:11

about four out of the

8:13

one hundred and sixty patients were

8:15

suffering from actual psychosis.

8:18

So Darren started weaning the clients

8:20

off antipsychotics. which,

8:23

sure, was a relief, but also

8:24

worrisome

8:26

that the practitioners had

8:28

so dangerously misunderstood the

8:30

ghosts on their clients' chest.

8:31

If I don't take it

8:34

seriously, you know, I can make a misdiagnosis,

8:36

but also I can miss an important part

8:39

of someone's real lived

8:41

experience and just really

8:43

not be as good of a psychiatrist.

8:44

Darren said, dismissing people's experiences

8:47

felt condescending. even

8:48

kind of racist. You know, silly little

8:51

person, there's no spirits. I know better

8:53

because I'm scientist,

8:55

whatever. And there was another

8:57

lingering question.

8:58

Why were so many of the clients suffering

9:01

from sleep paralysis? If it's

9:03

caused in part by lack of sleep, then

9:06

why wasn't anyone sleeping?

9:09

Darren had a hunch.

9:10

As he paged through stacks of hundreds of

9:12

charts of Cambodian patients, he

9:15

noticed a red flag.

9:16

None mentioned

9:17

the cambodian genocide. Every

9:21

cambodian patient I've ever worked

9:23

with has been affected by pulp

9:26

seeing that the word pull potter, the

9:28

word kimaruge, or the word trauma

9:30

in those charts. Right? Like, how can you not

9:32

ask about trauma when

9:34

you're Working with a Cambodian patient.

9:37

No

9:39

wonder these practitioners had totally

9:42

misread their clients. They had no

9:44

idea what their clients had gone through,

9:46

but Paul did.

9:48

And he looked into his own story.

9:51

for

9:51

clues on how to make the ghosts go

9:53

away.

9:53

Frankly, I did not know

9:55

what could be going,

9:57

but I knew that I had to survive. I

9:59

had

9:59

to live. and not

10:02

die. That's

10:03

after the break.

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11:28

them

11:29

What was it like for when you were really

11:32

young and, you know, You

11:35

were

11:35

happier.

11:37

What?

11:39

But Paul was born in Cambodia. He

11:41

lived with his parents and nine

11:43

siblings. And he said, the thing that he

11:45

remembers about his early childhood

11:47

was but

11:48

then I remember that I was able

11:50

to play. I

11:52

could make my own kite using

11:55

old newspaper, catch crickets

11:57

in a field or fighting

11:59

fishy. But in nineteen seventy five, when

12:02

Bob Paul was just ten years old,

12:04

The Cambodian communist guarillas,

12:07

also known as the Kamere Rouge,

12:09

took

12:09

over the

12:10

country. Under the

12:11

dictator poll pot, Achomarouge

12:15

systematically

12:15

murdered hundreds of thousands

12:17

of people.

12:18

They forced most of the surviving

12:20

population in a farm work and manual labor,

12:23

which is ten years old. Popeaul

12:25

was separated from his family

12:27

and forced to work the fields

12:29

from Don to dusk. He only

12:31

got two small bowls of rice poured

12:33

today, so he was

12:35

often looking for food.

12:36

Whether it's wild fruits,

12:39

rats, frogs or whatever

12:41

fish, anything that I

12:43

I could catch, I would eat

12:45

them. Nighttime was

12:47

hardest for football. He

12:49

says that some cambodians believe when

12:51

you hear the cry of a barn owl, it

12:53

means that someone has died and the owl

12:55

is there to take away their soul. he

12:57

would hear these owls crying all

13:00

night in the darkness. Tell if

13:02

I have you hear them cry for a ten

13:04

year old or eleven year old?

13:06

because you know that people are dying.

13:10

Roughly two

13:13

point two million people, about

13:16

a order of Cambodia's population died

13:18

as a result of these policies.

13:20

In

13:22

the aftermath, four of Bhupaul's

13:24

nine siblings had either gone

13:26

missing or were dead.

13:30

after a few years in refugee camps in

13:32

Thailand and the Philippines. An eighteen

13:34

year old Wilpaal made it to America with

13:36

his parents and remaining siblings.

13:40

Things were better, but

13:41

far from perfect.

13:43

But Paul's parents turned to him for support.

13:45

A lot of support. They needed

13:47

him to fill out forms for social services.

13:50

They needed him to translate to the

13:52

hospital because they had a bunch of chronic medical

13:54

conditions. On top of that,

13:56

football's parents had mental health issues

13:58

and struggled with alcohol.

14:00

Even something like an unlocked door at night could

14:02

make his parents and siblings

14:03

panic. They're still anxious

14:05

at nighttime when nighttime

14:07

is the scariest time because it will

14:10

our body remember that

14:12

when Douglas sat in, the dog has to be

14:14

close and lock. My

14:17

mom, my dad, my older siblings,

14:19

All of them is like, oh, don't leave a

14:22

dialogue. Somebody's gonna come in and slit your

14:24

throat.

14:27

Maybe

14:28

that's why Bob Paul ended up studying

14:31

psychology and college. Oh my god.

14:33

Start to understand human behavior and what

14:35

we've gone through. and

14:36

that's how in the early two thousands after

14:38

getting the job at Gartner. But

14:40

Paul found himself trying to figure out

14:42

not just where the ghosts on his clients'

14:45

chest had come from,

14:47

But what to do about them?

14:50

The ripple effects

14:52

of the Kamere Rouge were everywhere in

14:54

this community,

14:54

refugees suffered from high rates of

14:57

anxiety and addiction plus other health

14:59

problems like heart disease, kidney failure,

15:01

gang violence was a big issue

15:03

too. Tenaclar County had been trying

15:05

to support this community with mental health

15:07

services, but retention rates

15:09

were miserable. Success

15:10

rates even worse. Psychiatrists

15:12

even called their patients treatment

15:16

resistant, but Cyonuclear

15:18

had just decided to pump a lot more

15:20

money into a new movement of

15:22

culturally responsive programming at places

15:24

like

15:24

Gartner, which

15:26

meant hiring a bunch of Cambodian

15:29

practitioners, like BOPAL, and telling

15:31

them basically have at

15:33

it, do what you think will help

15:35

your

15:35

community heal.

15:38

Cool. But BOPAL

15:40

had no idea where to

15:42

start. So

15:44

he literally looked back at his psych

15:47

textbooks from college. And

15:49

step one was assess the

15:51

client and find the right diagnosis,

15:54

which for these komaruq survivors

15:56

was post traumatic stress disorder,

15:59

or PTSD.

15:59

Symptoms

16:01

like chronic nightmares, trouble

16:03

sleeping,

16:04

extreme fear. He

16:05

expected for this to be kind

16:08

of turning point. Like, they

16:10

get their diagnosis and realize, oh,

16:12

wow. This is serious. I need

16:14

to get help. But as he saw in

16:16

his sessions with clients, diagnosing

16:19

people with PTSD meant

16:21

nothing

16:21

to them. Someone

16:22

didn't even know what

16:25

PTSD. Mhmm. But all

16:27

they know is that you scan all the time,

16:29

you vote it all the time,

16:30

And when he tried going home and diagnosing

16:32

his own parents, it didn't

16:34

work with them either. Did you try going up

16:36

to your mom and saying, Mom, I think you

16:39

have PTSD.

16:39

Yes. But

16:42

there's no terminology in in

16:44

most Asian language. Mhmm.

16:46

Yeah. There's no term in

16:48

Cambodia to Tahoe. oh, this is

16:50

major depression. This is schizophrenia.

16:52

This is PTSD. Right. But

16:54

you can say that you scan

16:56

all the time because of your trauma from

16:58

your past. Mhmm. when there's

17:00

a lot of noise and some something happened,

17:02

you you just shake and and all of these, and you

17:04

describe a symptom. Yeah.

17:06

So you explained it

17:06

to your parents? I did. and

17:08

how did it go

17:09

over? Why? It's tough

17:13

because parents, they

17:15

don't listen to kids. Of course. why

17:17

would they listen to their

17:19

son? Yeah. My parents did not

17:21

understand mental health or they did not think that

17:23

they're having mental illness.

17:25

So what could he do next? In

17:28

school, Bobaal had learned to ask new clients

17:30

open ended questions. Like,

17:33

so, what are you

17:34

in here for? Then a

17:36

patient might say, well, I've

17:39

been feeling really depressedly and

17:41

anxious or I haven't been able to

17:43

sleep. But well, Paul's

17:45

kambodian clients, they'd

17:47

say. You're the doctor. You know

17:49

everything. I

17:51

don't need to tell you you should know

17:53

what what I need. Right?

17:56

Still,

17:56

but Paul tried. sitting

17:58

in his office, he used some

17:59

classic talk therapy techniques

18:02

like, tell me about your

18:04

past. Let's process what happened.

18:06

How is that showing up in your day to day?

18:08

But as clients were

18:10

hesitant?

18:10

For Cambodia, this a

18:12

problem that said, if you have an open

18:15

soul on your body, why don't you give it a

18:17

stick to cause more bleeding?

18:19

For instance, I talked to a woman I'm

18:22

calling c to protect her

18:24

privacy. She's sixty years old

18:26

with dyed brown hair and

18:28

gentle eyes. She told me early

18:30

visits with Hopal and Darren, aka

18:32

doctor Richardor, weren't

18:34

exactly pleasant. Me

18:37

i'll be the hammer

18:39

before,

18:42

whenever I saw doctor Richard,

18:44

I was scared of him, even

18:47

just seeing him. Scare me.

18:49

Were you

18:49

scared of him because he's white?

18:53

No. Why people have

18:56

not scaled them? It

18:59

was because I

19:01

saw him typing into his computer he

19:04

talked to me and he would look

19:06

like the people at the Camerux

19:09

tribunal, my mind

19:11

just go there. During the

19:14

Comerus, people had been interrogated

19:16

about their pasts and their education to

19:18

determine whether they should live or die.

19:20

So when

19:22

clients came into Bob Paul's office and saw

19:24

his notepad and

19:25

computer, they didn't see a

19:27

friendly face or shared experiences.

19:30

they saw a threat. Kinda like throwing

19:33

up in in session, the kind of was some

19:35

scam. So they don't wanna

19:37

talk. They don't wanna be reminded about the

19:39

killing field. obviously, why do I

19:41

do that? Well, when I'm talking

19:43

about it, it costs

19:45

more more granular, more granular, headache,

19:47

more and

19:48

stuff. So

19:51

to zoom out a bit, lots

19:53

of trauma treatments focus on

19:56

exposure therapy. It

19:58

asks clients to retail or relive their trauma

20:00

and hopefully get better by becoming

20:02

desensitized to that trauma. But

20:04

this treatment can sometimes do more

20:06

harm than good. People can get

20:08

triggered and shut down or even drop out of

20:11

therapy because it's so unpleasant, which

20:13

is what Paul

20:13

was noticing with his clients at

20:16

Gartner. It

20:17

felt like everything he knew about therapy

20:20

just wasn't

20:20

working. For years,

20:22

he went to conferences, did a lot of

20:24

research, tried different modalities,

20:27

Even his

20:27

cultural knowledge wasn't really helping.

20:29

He didn't know

20:30

how to heal his friends, his family,

20:33

let alone his clients.

20:35

How could he help anyone if they didn't wanna talk

20:38

to him? If the word

20:40

trauma didn't even mean anything to

20:42

them. He felt like he was falling

20:44

short, which ISN'T

20:46

SURPRISING BECAUSE BOPAL

20:48

AND MOST THERAPICTS AROUND HIM

20:50

WERE NEVER TOT TO TREAT

20:52

COMMUNITIES LIKE THIS. After

20:54

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has a world full of places

22:02

to start. For

22:03

years, Bhupol struggled to reach his clients,

22:05

to help them feel safe enough to

22:07

open up, but something started

22:09

to shift in his practice.

22:12

To understand how I want to introduce you

22:14

to s. Chase fifty

22:16

nine has dark eyes surrounded

22:18

by tattooed eyeliner and

22:20

her whole body starts rocking like she's

22:23

transported when she talks

22:24

about her past.

22:26

Whenever

22:29

April comes around, my kid

22:32

no. Their

22:32

mom will have heartbreak. They

22:36

say,

22:37

the heartbreak

22:38

again. Cambodia in

22:41

New Year happens in April. Her

22:43

favorite holiday as a child But

22:45

in nineteen seventy five, just after

22:47

Cambodia in New Year when S was twelve,

22:50

Penang Pen fell to the Camerux.

22:53

Es had to watch as the Kamere Rouge

22:56

murdered thirteen people almost

22:58

her entire family right

23:00

in front of her. Of

23:01

course,

23:05

that story. There are times when you can

23:07

put it out of your mind. But

23:09

how can you forget about it? The blood,

23:11

the people's throat being cut?

23:14

My parents' throat

23:15

being slit right in front of my eyes.

23:17

Oh, you're not

23:20

Years later,

23:22

she came to the United States as a

23:24

refugee, and she thought she'd be safe.

23:26

But when she got here, the

23:29

violence continued. Her

23:31

husband also a survivor became

23:33

extremely abusive He threatened her with a gun when she

23:36

was pregnant, beat her so

23:38

badly that she's covered in scars.

23:40

When she tried

23:41

to take adult education classes,

23:43

He to her and scream at her.

23:45

She endured his

23:46

abuse for over twenty

23:49

years.

23:50

It

23:54

was almost going insane,

23:56

saying things that were off the mark,

23:59

sitting somewhere, and then just drifting

24:02

away. I was

24:05

at zero, not

24:08

even number one.

24:10

Absolute siro. As

24:16

decided to divorce her husband, but

24:18

she didn't have any of the resources to do

24:21

it. No way to file paperwork. No way

24:23

to support herself or her

24:25

kids financially. McMeyer Rouge killed

24:27

almost the entire educated class

24:29

of Cambodia, killing teachers,

24:31

soldiers, doctors, artists,

24:33

and writers. That meant that most

24:35

refugees couldn't read or write

24:37

somewhere, making it exceptionally hard

24:39

for them to learn English. They

24:41

had trouble navigating the systems around them for support, like

24:44

school

24:44

or healthcare. For

24:46

us, it

24:47

was hard to survive little on

24:50

heel. and she was losing

24:52

hope. I

24:53

was at the

24:56

end of my

24:58

life. When you're at the

25:00

end of your line with no physical

25:03

strength and no emotional strength,

25:05

you just want to die

25:07

And then

25:07

someone suggested she talked about Paul

25:10

at

25:10

Gartner.

25:15

As a

25:16

story, her trauma and her abuse

25:18

at home,

25:19

unfortunately, it wasn't uncommon among

25:22

Boba's clients. And Boba

25:24

was

25:24

slowly realizing that

25:26

the reason he'd been hitting wall was because his

25:28

clients didn't have the mental space to process

25:30

the past. And so many of

25:32

them

25:32

were struggling to meet their basic needs

25:35

in the present. To

25:37

feel

25:37

safe, they had to be safe.

25:39

And so when

25:41

Bob Paul met s, and

25:43

heard about her abusive husband. He immediately helped

25:45

her file paperwork for her divorce and

25:47

found her sectionate housing and welfare,

25:50

so she could escape her household. Yeah.

25:55

I didn't know that in this

25:57

country, I have rights. I

25:59

didn't

25:59

know. the

26:02

people that check-in on

26:04

you. Well, Paul started doing this kind of

26:06

thing for every client.

26:07

Remember, well, Paul was hired to do

26:10

counseling and casework for Gartner. So

26:12

even though he was still struggling

26:14

as a therapist, he started going

26:16

way above and beyond as a

26:18

super involved

26:19

worker social worker. He

26:20

wasn't just booking them healthcare or welfare

26:23

appointments. He was also

26:25

accompanying his clients to

26:27

every single one.

26:28

I was driving my clients

26:30

everywhere. I told them to see every doctor out there,

26:32

every specialist out there,

26:34

legal services that they need,

26:36

housing, social services wherever.

26:39

he

26:39

translated and advocated for his clients at every

26:42

appointment. He knew how necessary this

26:44

was because of the years he'd spent doing the

26:46

same thing for his parents when he was

26:48

a teenager. And there

26:50

was an unexpected upside to these

26:52

drives. He got to spend

26:54

hours with his clients.

26:57

there

26:57

in the car, not in a scary

26:59

office with the ominous computer.

27:01

His client started looking

27:04

forward. to their time with football. So why

27:05

driving you get a lot

27:07

more information? Because it's not

27:10

like conventional therapy

27:12

uses driving. It's gonna house your life,

27:14

your family. Yeah. And all this

27:16

motor will talk along the way. Right? And then

27:18

you get to adopt You flip out for

27:20

me, you wait to be seen like thirty minutes

27:22

an hour. You talk more and more.

27:24

They open up a lot more that way.

27:27

In that

27:27

car, in those doctor's offices, in

27:29

their homes, where Bobaal sat at their

27:31

kitchen tables, people

27:33

started to trust him. Finally,

27:37

but this was

27:38

not a quick process.

27:40

Sometime, it take a year to

27:42

a year and a half just to earn

27:45

their trust. to be able to To tell

27:47

you the truth, against you, a year

27:49

to two years.

27:51

For a

27:52

practitioner to take two

27:54

years to address trauma. That's pretty

27:56

unique. But Wopaul had to

27:58

build a remarkably close

27:59

relationship with his clients. before

28:02

they could even consider being a little bit vulnerable with

28:05

him. That's what

28:06

surprised me. Generally,

28:08

Our mental health care

28:11

system discourages these kinds of

28:13

super close relationships. There's

28:15

usually more professional distance but

28:18

our system didn't work for Bhupaul's

28:21

clients. Driving around, buying them

28:23

sandwiches, becoming a part of

28:25

their lives That did

28:27

help. They don't see me

28:27

as accounts or they see me as a friend or a

28:30

brother or a father, I don't mind with

28:32

the terminology if they

28:34

feel uncomfortable seeing me as a

28:36

brother, then call me a

28:38

brother. It was

28:39

then and only then

28:41

once they were family,

28:44

that the real therapy could

28:46

begin. Clients

28:47

would open up to him about how they

28:49

felt, about their anger, their fear.

28:52

And there was one thing kept saying.

28:54

An idea that Paul worried was keeping

28:56

them from healing, that

28:58

they deserved their pain.

29:00

when a person survives something like

29:03

this, something truly

29:05

unspeakably awful, It's

29:08

natural to wonder why did this

29:10

happen? How could something

29:11

like this take place? It can't be

29:13

random? There has to be a reason.

29:16

And the reason what Paul heard from many of his Buddhist

29:19

clients was Karma.

29:20

Karma. Client

29:22

think

29:22

that you cannot change utterable.

29:26

Meaning, whatever the hell, it's

29:28

there. They felt like they had

29:29

probably done something horrific in their

29:32

past lives and were being punished in

29:34

this

29:34

life. Like, take

29:37

see. She's the

29:37

woman with the gentle eyes who was at

29:39

first scared to open up because the process

29:42

reminded her the Komaru's tribunals.

29:44

When

29:44

Bhupaul metzy, she was dealing

29:47

with trauma from watching many people in her

29:49

family die during the genocide. and

29:51

she was also heartbroken.

29:54

When C was granted the ability to move to

29:56

America, she had to leave her

29:58

husband behind in a refugee

30:00

camp. Eventually, he got remarried

30:02

and started a new family. The

30:04

fact

30:04

that sea would obsess over for

30:07

decades. But even born, How

30:13

the failure of my relationship

30:15

with my husband ring ring in the

30:17

form of me constantly thinking about

30:20

him, missing him, loving

30:22

him. That was my

30:24

bad camera.

30:25

Her trauma and her belief that she

30:28

was doomed made her

30:30

incredibly anxious. For

30:32

years, she barely left her

30:34

house. She'd have panic

30:36

attacks constantly Her stress

30:37

got so bad that she

30:39

had a stroke. But Paul

30:42

wasn't religious and at this point

30:44

didn't know much about Buddhism

30:46

or Karma but

30:47

it was coming up all the time with his clients.

30:49

So he bought books on Buddhist

30:52

psychology and partnered with a local

30:54

Cambodian Temple where he learned from

30:56

the monks. And he realized there was

30:58

another way to understand the

31:00

concept of karma that

31:02

could maybe help

31:02

his clients. Karma is not

31:05

paying us suffering. Karma just act anything

31:07

that you do. Mhmm. It's

31:09

like the freeway. If

31:12

you own that freeway of suffering, you would

31:14

just go along the freeway. but

31:18

every freeway has an exit and

31:20

that exit requires a

31:22

choice. So sending

31:24

the comma there's

31:26

always

31:26

a choice along the way.

31:29

But Paul really

31:32

wanted to teach his clients

31:34

that they had agency, that

31:36

there was hope for change. And

31:39

so he decided to try mixing

31:41

Buddhist philosophy with a

31:43

technique he thought might help CBT

31:45

or cognitive behavioral therapy.

31:47

It centers around identifying

31:50

negative or unhelpful thoughts. and

31:52

trying to practice better reactions in

31:54

the

31:54

future. We don't say, oh, let's let's do

31:57

CPT. We would say,

31:59

okay.

31:59

And it in in Buddhism. You

32:02

know, how do you commit

32:04

Karma? Buddhist

32:05

thought you can

32:06

commit Karma through your words and actions.

32:09

but you can also commit it through your thoughts

32:11

by thinking more positively,

32:13

which Papal

32:14

thought was kinda like

32:17

CBT but more intuitive for

32:19

his clients like sea. She tried

32:22

Bhopal's hybrid of Buddhism and

32:24

CBT.

32:24

She liked

32:25

it. This idea that

32:27

she was improving her camera all the

32:30

time. Just by trying to let go,

32:32

some of her repetitive thought patterns around her

32:34

ex husband.

32:36

Now

32:39

not thinking about him,

32:41

not being reminded about

32:43

him, not loving him anymore.

32:46

I think this means that I don't have

32:48

that kind of camera anymore.

32:50

I think

32:50

that camera can change. Change

32:53

because of our action.

32:55

the way that we think. In

32:57

moments of crisis, sea would

32:59

head to Gartner, to the room where they

33:01

treat kambodian patients. It

33:03

has a basket of plastic grapes and

33:06

rhombotons, tea sets, and a

33:08

small altar with a lot of

33:10

boudas, then see would sit

33:12

across from the giant wall of windows bathed

33:14

in

33:14

light, and Bob Paul

33:16

would breathe with her.

33:26

At

33:26

first, every time closed her

33:27

eyes, she'd see a man coming towards

33:30

her,

33:30

grasping for her throat.

33:34

it was

33:35

difficult inside my body.

33:38

I was unable to breathe.

33:41

But

33:41

every time they breathe together, she could

33:43

keep the man away for a little longer.

33:47

Eventually, with the help of medicine and

33:49

meditation, She started leaving her house,

33:52

volunteering at the temple, and learning

33:54

to make new friends. Plus,

33:56

she went from sleeping two hours a

33:59

night. to eleven or

33:59

twelve. Feel fresh. You know?

34:02

Mhmm. Feel

34:04

feel good in the morning. Yeah. Feel good

34:06

in the morning. Like, I'm

34:08

a lie. I'm a lie.

34:11

You know? But Paul

34:14

was figuring out what culturally

34:16

responsive care actually looked like for his

34:18

clients. But what

34:20

about the people around them? Their

34:22

kids

34:22

kids

34:23

their grandkids. After the

34:26

break, Vopal takes on

34:28

inter

34:29

generational healing.

34:32

This

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message comes from NPR sponsor,

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Subscribe now. Where

35:18

I

35:19

grew up

35:20

in San

35:21

Jose, so many of our

35:23

parents had fled to conflict and

35:25

poverty, just like Bob Paul's

35:27

clients. They were refugees and sometimes

35:29

veterans of the Vietnam and

35:31

Korean wars, Chinese parents that had escaped

35:33

the cultural revolution where some had been

35:35

in labor camps. My own

35:37

parents were born during the Maligne

35:40

Emergency, a brutal war that targeted ethnic

35:42

Chinese and caused my grandfather to be

35:44

imprisoned for

35:46

five years. and maybe that pain was

35:48

trickling down to the

35:50

kids. Like in my

35:51

case, I

35:53

endured really extreme up.

35:56

My

35:57

parents held knives to

35:59

my

35:59

throat for talking back. I was

36:02

beaten

36:02

so severely that

36:04

I thought I might die. my parents abandoned me for

36:07

other

36:07

families by the time I

36:09

was a teenager.

36:12

So even though Bilpao was finally helping survivors

36:14

cope better with their trauma,

36:16

there was still one critical

36:20

problem that I was most curious about, the

36:22

question that could have helped

36:23

me. How could he

36:25

help his clients stop

36:27

passing their trauma down to

36:29

their

36:30

kids. c,

36:32

for instance, the woman with the gentle eyes

36:34

who missed her husband For a long

36:36

time before meditation, therapy,

36:39

and medication, she

36:40

struggled with her children.

36:42

One

36:50

children, we can't

36:53

hear discipline them. But here, we

36:56

cannot. If we hit

36:58

them or something like

37:00

that, there will be

37:02

problems, legal. It

37:04

is difficult to raise them. At

37:07

one point, she was estranged

37:08

from all five of her grown

37:12

children. OPHAL WOULD HEAR ABOUT WHAT

37:14

HAPPENED IN OTHER HOMES, TOO.

37:17

CORPORTER:

37:17

EMOTIONAL ABUSE. YOU'LL MOM AND DADS

37:20

GREAMING, Yelling, all day on night

37:22

long, a lot of stress. And, you know, that's not a

37:24

good feeling. This

37:25

is tea. His

37:27

parents were kambodian genocide refugees

37:29

in San Jose. and to cope with

37:31

the chaos at home when he was growing up, he turned to a

37:33

different community. So instead of

37:36

coming home,

37:36

you stay after school,

37:39

and you're out in the streets pretty much I pretty

37:41

much got involved with gangs. You know, I had a

37:43

lot of friends that end up going to

37:45

jail, doing life in prison. Some

37:47

of our friends died. When

37:49

parents would hear about their kids

37:51

joining gangs, they

37:52

couldn't understand how this had

37:54

happened.

37:55

Wait, they thought. We

37:57

escaped a war zone just so you could

37:59

replicate one here, but

37:59

that's what happens when

38:01

trauma goes untreated. It

38:04

can ripple out others.

38:08

I've met so many Asian

38:09

parents who have fled

38:12

conflict and who don't like to talk about their pasts, the

38:14

whole not poking the wound thing.

38:16

But also, they believe they can

38:18

protect us from that trauma by not

38:22

sharing it. I had never even heard

38:23

about what my grandparents had gone through in

38:25

the Maligne Emergency. Until I

38:27

started researching

38:28

it for my book, when

38:31

I was thirty one years old. Most of my friends didn't know

38:33

the details of

38:33

the Vietnam or Korean

38:36

wars either. And

38:38

we definitely didn't learn about the Kumeruz in my school in

38:41

San Jose. Our parents were

38:43

failing us, but what

38:46

was missing was why. We had no

38:48

context, the had no context and

38:50

neither did a lot of Copel's clients.

38:53

So one day,

38:54

when a young woman complained about

38:57

Paul, my mom is nagging again.

38:59

She's so crazy.

39:00

It was like, you know,

39:02

Just for your information, your mom

39:05

is not crazy. Anyway, I'm prepping

39:07

for this young lady's life. where

39:10

you're talking about, you know, where I was like, you know, what

39:12

your mom been through is killing

39:14

field of war and stuff. I

39:17

started to about a memorial history, opened up her

39:20

mind a little bit. The woman

39:22

was

39:22

shocked, and Papal realized

39:25

These kids had to know what

39:27

their parents survived. So for

39:29

ten years, football volunteered at a

39:31

Saturday school for Cambodian children

39:33

to teach them read and speak Kemer and to learn about

39:36

their culture, including lessons

39:38

on the Kemer Rouge. In

39:41

T's case, when he learned his parent story, it changed the

39:43

way he saw them. Once I was

39:45

able to hear

39:46

what my found went through and then

39:49

I kinda like Understood. Like, you know, it's not really their fault.

39:51

You know? And so it it gave me a sense of

39:54

healing. You know what, hey, my parents aren't

39:56

bad. My parents

39:58

had problems. and they didn't

40:00

know how to cope with it. You know, they

40:02

tried their best. Eventually,

40:03

he left the gang and turned

40:05

his life around. He got his degree and joined Gartner,

40:07

where he worked for years as a counselor to youth

40:10

and games. And when he told

40:12

them about their

40:14

parents history,

40:14

they see more empathy, you know, for

40:16

for the parents, and then they start just to

40:18

maybe say, you know, I'm just putting more hurt on

40:21

my parents when they've been through a lot already. And

40:23

here I am, messing it up for them.

40:26

Of course,

40:28

just having that context is

40:31

not necessarily enough. When I learned

40:34

about the Malayan emergency, I had more

40:36

empathy for my parents, but

40:38

one-sided empathy can't heal

40:40

a relationship. Obviously,

40:41

the most important change that needed to

40:44

happen was for parents to parent

40:46

better. So in order to

40:47

truly repair these leaderships,

40:50

but Paul helped survivors learn to parent

40:52

in a

40:52

healthier way. Like

40:54

he told many parents, hey,

40:56

instead of hitting your kids,

40:59

maybe

40:59

tried taking away

41:02

privileges. And he tried helping people like

41:04

see better communicate with

41:06

their kids.

41:07

One story.

41:12

A daughter that lives far -- I

41:14

miss her. -- I gave

41:16

my only and I want her to

41:18

visit me. Because she said that she is working and

41:21

doing more school, So

41:24

then I asked her

41:25

once, twice, but

41:28

she still didn't have time.

41:30

So

41:30

I wanted to scream Oh

41:33

god. Just visiting your mother is impossible.

41:36

But after

41:37

learning from what power, I

41:40

didn't scream. I instead compromised

41:42

with her and said,

41:44

when are you free to

41:46

come visit me? Did you know

41:49

that I miss you and

41:51

say in kangibles. Like

41:56

asking nicely and

41:57

not aggressively demanding what I

42:00

want. Then suddenly,

42:01

she was still and

42:03

didn't say anything.

42:06

within two

42:08

days later, she visited me

42:10

as a surprise because I

42:13

talked, asked in a new

42:15

way, she came to see me.

42:17

Her relationships with

42:18

most of her children have

42:20

been improving steadily ever since.

42:24

Bopaul and his team have now been practicing techniques at Gartner

42:26

for about twenty years. And

42:28

Darren, who now specializes in

42:31

creating culturally responsive treatment programs

42:34

for refugees, he says he still

42:36

hasn't seen this level of success in

42:38

any of his other programs anywhere.

42:41

Lots

42:42

of other programs implement things like prioritizing social

42:44

work, relationship and community building,

42:47

being respectful of

42:49

cultures and religions. But

42:51

Gartner still stands out.

42:54

Clients

42:54

stick around for decades. Many

42:56

find community at Temple. Some

42:59

have fewer nightmares. Others graduate from

43:00

their program altogether. Yes. It's

43:02

a hard

43:03

job though. But I feel

43:05

that my skill I

43:07

could relate with them. I could help them.

43:10

Therefore, this is the place

43:12

for me. This is the place where I keep coming

43:14

year after

43:16

year. I did not move up. I did not move on. I'm just staring

43:18

the way I have.

43:20

Both c

43:21

and s recommend Bo Paul to anyone

43:24

who and

43:26

have convinced some of their friends to come to Gartner.

43:29

I mean, to any

43:31

Asian kids of immigrants seriously.

43:34

two sixty

43:35

year old immigrant women insisting to

43:37

all their friends that

43:39

they need therapy. My

43:43

friends, when they

43:46

looked at me before, they could see

43:48

that I was sick

43:50

every day. But

43:52

now, these past two

43:54

years, how could I become

43:56

cheerful and agreeable and not

43:58

be sick? I

43:59

would tell them

44:02

that this place is not the place for

44:04

crazy people. This is a

44:06

place for healing. The warmth

44:10

and comfort from them constantly checking

44:12

in on me. It protected

44:14

me.

44:16

This place

44:16

is a safe space. Even if

44:19

you want to die, they

44:20

won't let you die. They wouldn't

44:23

let

44:23

me hurt myself.

44:25

This

44:25

is where people live. It

44:28

helped me survive. It gave

44:30

me hope.

44:32

My side. It's a

44:34

year. Honestly,

44:40

honestly I got emotional

44:42

listening to these testimonies

44:44

and conveyed this to see, the woman

44:46

who was able to convince her daughter to

44:48

visit her in healthier And me

44:50

personally, I really wish that my

44:53

parents had gotten help,

44:55

so I could have a

44:57

better relationship with them. I

44:59

think it's like a beautiful act of love for your kids that you

45:01

are taking care of yourself.

45:04

Your

45:08

parents

45:09

have family issue too. I

45:12

haven't talked to my mom since I

45:14

was thirteen.

45:14

because of

45:20

conflicts. Is

45:23

she still around? Maybe she need

45:25

treatment counseling. It has a lot

45:27

of it. It

45:30

has. Yeah.

45:32

She doesn't wanna go, but

45:34

I'm so proud of you for going.

45:37

In interviewing

45:38

C and

45:40

S, I

45:40

thought often about what would have happened to me and

45:42

my classmates. If our families had

45:45

participated

45:45

in a program like

45:48

loopholes, What if my parents had gotten those parenting lessons?

45:50

What if they'd learned how to

45:52

better manage their own pain? Maybe

45:54

they could have fought less with each

45:56

other. Maybe

45:58

I wouldn't be estranged from both of them

45:59

now. Maybe we could have all

46:01

felt a little

46:04

bit safer. maybe

46:05

I would have been loved like

46:07

I deserved. What a dream.

46:10

Right? Or for any of

46:12

that to have happened. My parents

46:14

would have needed to be okay with getting

46:16

help. They would have needed to

46:18

understand that going to therapy didn't mean

46:20

that they

46:22

were crazy. which

46:22

makes me wonder if I dared to keep dreaming,

46:25

what if going to therapy

46:26

wasn't walking into someone else's

46:30

office? What if it was about opening

46:32

a door for someone to walk into your life? To help you learn how

46:34

to love and be loved in ways that made

46:36

sense to your culture and your community,

46:40

What if your trauma wasn't yours alone to

46:43

carry? I

46:45

think that world's have

46:48

a lot more joy in it.

46:50

At one point in

46:53

my conversation with

46:56

c, she got tired of talking about her trauma and just

46:58

wanted to show me and both all cute pictures

47:00

of her grandkids. And I

47:03

just want you to see my

47:05

daughter. You're gonna show me more pictures.

47:07

Yep. Pay two. Pay two.

47:09

Pay two. Very cute. I know.

47:11

Good cambodian. Remember

47:13

how hard the cambodian

47:15

New Year could be because it

47:17

marked the week? McMeyer Rouge

47:20

came to power, but c

47:21

brought up colorful pictures of this

47:23

year's celebration. I want

47:26

to show you the New

47:28

Year. New Year.

47:30

Look at the temper?

47:32

Mhmm. Yeah.

47:33

New Year can be happy again. Oh my

47:36

god. So happy Bipoll

47:38

sits and

47:39

watches smiling. And that's

47:42

the moment you go like, you know,

47:44

yeah, I feel good.

47:54

That's Stephanie

48:00

Phil.

48:00

You can check

48:03

out Stephanie's book about her

48:05

own mental health journey. It's called what my bones know and then

48:07

more of healing from complex

48:10

trauma. And one thing we want

48:12

to note Stephanie

48:14

told us that, Opel's success with his clients would

48:16

not have been possible. If Santa

48:19

Clara County didn't invest in

48:21

culturally responsive practitioners, twenty

48:23

years ago, the kind of labor

48:26

intensive care that Boba has

48:28

provided, treating people

48:29

over many years,

48:31

treating entire family spending time in the car

48:33

with them. That all costs lots of

48:36

money. But in recent

48:38

years, even

48:38

Gartner has based budget

48:42

cuts. And Boba and his team

48:43

have been forced to significantly reduce the number

48:45

of clients they're able to serve.

48:47

It's something they're hoping will change in

48:49

years to

48:52

come. This episode

48:56

was produced

48:56

by Lee Hale. Ariana

48:59

Garrett Lee, Phoebe Wang,

49:00

Nick m Neves, and me, Yohe Shah.

49:02

This season

49:03

of InvisibleShield

49:04

was also produced by Kiamyak

49:06

in a tease, an Abby Wendell,

49:08

With more production support from Claire Marie Schneider Andrew Mambo,

49:11

our intern with Sarah Long,

49:13

our supervising producer is

49:16

Miana Symmstrom, and her

49:18

supervising editor is Nina

49:20

Patak. Fact checking by

49:22

Jane Drinkard, translation and

49:24

interpretation by

49:26

Ryan Boone, Voiceovers by Sonya Khalil and Tavy

49:28

Wall. Additional research helped from David

49:30

Good Hertz and Lauren Beard,

49:32

Mastering by

49:34

Josh Newell, and legal and standard support from Micah Ratner Tony

49:36

cabin. Special thanks to

49:38

the many survivors at Gartner who

49:40

were so generous with their time.

49:42

Additional

49:44

thanks to Sofia ROTH, Susan Simons, Carmel

49:47

Roth, Redo Chatterjee, seven

49:49

TAP, Mooyo, Asian Americans

49:51

for community involvement, Melanie

49:54

Young, venerable Avid Ratana,

49:56

the San Jose Cambodian Buddhist society,

49:58

Jennifer Schmidt, Louise

49:59

Tres, Adelina

50:02

Lanzini's, Gregory Warner and Katherine St. Louis of Neon

50:04

Media. Our technical director

50:06

is Andy Luther.

50:07

Our deputy managing editor

50:09

is Shirley Henry, and

50:12

her Senior Vice President of Programming is Anja Gutman. Theme

50:15

music by Infinity Knives,

50:17

and additional music in

50:20

this episode provided by Ramtine Arabui, Connor

50:22

Lefit, Infiniti knives, Magnus

50:24

Moon, courtesy of Cribe of Noise,

50:26

and special thanks to Peels,

50:28

courtesy of thrill jockey and by

50:30

arrangement with bank robber music. Okay.

50:37

We will

50:38

see you

50:40

next week.