The Birth of an Evolution in Thailand Healthcare & Psychology

On Nov 6th, while in the Had Yai province of Thailand, I had the honor of witnessing the birth of an evolution in psychology and health care effectiveness in Thailand. The people in attendance were:

  • Waraporn Wanchaitanawong (“Jip”) , the director of the Baromarajchonanee College of Nursing, Chiang Mai.
  • Jip’s Research Unit Head, Pleumjit Chotiga  (“Jo”)
  • Orawan Quansri, the Assistant Director of the ASEAN Institute for Health Development (
  • Tipawadee Emavardhana and Ladda Kitivipart, both well known psychologist professors in Thailand.
  • America-based psychologists Laura Dodson, PhD, and Maureen Graves

Jip has been working with the directors of the other 29 nursing colleges in Thailand, and administrators at the Nursing Institute (which is inside the Ministry of Public Health). She has their support in creating a new nursing certificate program – a Nursing Counselor Certificate. Nurses currently are required to take one course on counseling in nursing school, for formal training on how to take care of the patient’s emotional needs. It is based on an approach of teaching basic counseling to and by nonprofessionals called “micro counseling”.

Micro-counseling was introduced when HIV became rampant in Thailand in the 80’s as a method to teach counseling to health care workers. Through the years, it was adopted as the predominant theory of counseling for all professionals, even though it is “micro” in nature, and is limited in the situations in which it is effective.

Tipa has been working for twenty years to add more breath and depth to the therapist/client relationship in Thailand. Since the concept of the Nursing Counselor is not limited to only micro teaching of counseling, she sees this as an opportunity to put more breath and depth into the counseling training available to nurses.

Jip, Jo, Orawan, and Tipa asked Laura and Maureen to train professors who will teach students in getting their certificate. It will be a one-year program that consists of three weeklong training workshops. There will be reading, practice, supervision, support group, and participant-led meetings in between the weeklong trainings.

There was a lot of excitement in the room as the year long training was planned. The next step is for Jip and Jo to write an official proposal to get funding. There was a high level of confidence that with the support already present for this new program, it will be approved.

As of this date, I was notified that the funding is approved. Now it is in the process of getting paper work ready and the date set for the project to begin is April, 2013. Toni and I have been invited to return for the trainings that will take place. We are hopeful we will be able to help with at least one of them.

A Day of Waging Peace in Thailand

We supported a lot of grassroots peacemaking last week. While the workshop in Bangkok was mostly professionals – doctors, nurses, professional psychologists, teachers, etc… the workshop in the south has over 50% participants that are less educated villagers. Here is a cross section of people that are attending:

– Four Muslim village widows from the religious violence. Some are peer counselors, helping families through crisis, including death
– There are about a dozen nurses from a few different nursing schools throughout Thailand, including the head director from two schools
– A 14 year-old boy, whose father passed away from cancer when he was four, and acts out to the point where his older brother hits and kicks him. His mother also came on the second day, after he asked her to come. He loves soccer.
– The six village children I wrote about in the previous post, who have lost a parent in the violence
– An old Muslim crone village healer
– A village community volunteer who works very hard to make sure his children have a better life than he. His eldest son was killed in one of the earliest violent events in the south
– The director of the ASEAN Institute for Health Development

The workshop went very well. Here is what I wrote up about one of the days:

Today, Laura Dodson, the primary facilitator, worked with all six kids and their teacher. Laura coached the teacher into talking to the kids as a person about their anger and fear, rather than lecturing them as a teacher. She had a workshop participant role play each of the kids’ anger and fear – there were 21 people being directly impacted. Now that they are better able to deal with their anger and fear, they are less likely to engage in violence themselves.

After lunch, Toni and I played with the kids in the pool again, while Laura helped the woman who had recently lost her daughter cope with her grief. In the later afternoon, Maureen Graves invited me to work with her to help a 14 year-old boy who lost his father to cancer when he was 4, and his mother. We created new possibilities between them that should lead to more peace at home, and more peace in the village.

I have been in awe of the way Laura works with so many different kinds of people, showing them the peace within them, and helping them be more effective in their work to make the world a better place. I was also impressed with the work Maureen did today. Last, I was happy I was able to utilize the ten years I have been developing my own capability to show people how to find peace, today here in Thailand. At one point, when the boy looked at me, I knew we had enriched each other’s lives, and the experience would not be forgotten.

In a future post, I’ll write about the evening meeting that occurred to begin a new evolution in how health care will help patients heal their emotional wounds, as well as physical.

It was a good day for waging peace.

Speaking Through a Translator – Lessons from Thailand

The workshops in Thailand are primarily in Thai. The facilitators are the only native English speakers. So, we use translators all the time.

Speaking through a translator has helped me crystallize some thoughts about how to communicate. I first started thinking about this from the lens of public speaking to large groups. And then realized that the same lessons applied to the one-on-one conversations I’ve had through a translator. Here is what I’ve learned:

Eye Contact When Speaking: Is very important while you are talking. It is also important to keep eye contact with your audience while the translation is occurring. And while the translator is repeating your message in another language, I like to repeat what I said with my mind’s voice to help project the message.

Eye Contact When Listening: When you are listening to someone, I have found it more effective to keep eye contact with them while their message is being translated. Don’t look at the translator. Stay engaged with who you are talking to.
Simple Message: Dumb everything down. Don’t make it stupid, mind you. But say things as simply as you possibly can and with as few words as possible. One reason is simply to save time. Using a translator doubles the length of time for a conversation, at best. And if you say something complicated, you are going to spend much more time trying to simplify your complicated message.

Find a Good Translator: Like most everything, translation is a skill. For one of the pieces I taught (Ways of Perceiving the World), I used a first-time translator. It did make it more difficult to get the learnings across. I knew it was more difficult, because an experienced translator told me so.

I am grateful for the opportunity to be working in a foreign language, as well as a foreign culture. And though using a translator can be seen as a pain in the ass, it can also be rewarding and in and of itself a learning experience.

Non Verbal Communication – Lessons from Thailand

At the workshop here in Hat Yai, there are six children – three boys and three girls. Abdulah, Jaeama, and Asuan are the boys. Safeera, Rokiyoh, Hameesa are the girls. They are all nine or under. They have all had a parent killed in the religious violence. They came with their school teacher, also named Abdulah.

They were getting a bit antsy in the middle of the first day, and rightfully so in a room full of adults talking about how to better cope with life’s difficulties. So Toni and I took them to the swimming pool after lunch. We played with them for over two hours. Between the two of us, we know about 10 Thai phrases. Between the six of them, the know how to count to six in English and how to say “swimming”. We had an absolutely splendid time.

The exchange that happened by throwing them around, playing the motorboat, and other various frolicking was palpable. We definitely grew closer to them in that time. We learned very accurately how to say each others’ names, so there was some verbal interaction. But by and large it was all visceral and kinesthetic.

I got totally lost in the play, without any care in the world as I dove into the children’s world. I think the ability to not communicate with speech, and therefore barely making any other sounds, helped me get absorbed. It reminded me of just how much we all say to each other that doesn’t involve any words to communicate.

Bangkok and Meditations on Peace

Our journeys this weekend and the workshop to come led me to an inquiry meditation today. On Sunday, Toni and I had a wonderful day being shown around southern Thailand with one of the workshop participants from last week. Her nickname is “Lee”, and she brought along her brother-in-law, “Huong”, to drive. They picked us up at our hotel at 9 in the morning on Sunday. We drove an hour north to the Ayutthaya province. Ayutthaya used to be the center of trade for Siam. It is a port city, even though it is a bit far inland – the Chao Phrya is a large river that connects it to the sea.

There are many temple ruins throughout the city – in it’s heyday, there were 300 temples in the city. The temples have the same look and are from the same era as Angor Wat in Cambodia. They are beautiful. They are available to the public, and aren’t protected by fences or guardrails, so you can freely touch them, and wander wherever you want throughout the ruins. Some have active Buddhists temples as part of their complex and are cared for by monks.

We then had another amazing lunch at a street-side stand, this one had covered seating. I had to insert myself to be able to pay for the meal, as our gracious hosts wanted to treat us to everything. Two course lunch for four, including iced coffee, was $7.50 (that includes the tip).

Next, we stopped at some street vendors and bought some nice ceramic hand-painted goods to give as gifts. Then, we went to the “Japanese Village”, a small plot of land with a museum honoring the Thai/Japanese relationship. The museum really had a great overview of the history of Siam, what the Thailand region was called in the early trading days. It explained the diversity of Asian cultures that peacefully exist in Thailand.

I have been reflecting on the peaceful diversity as we sit in the airport to fly to Hat Yai today. Tomorrow begins a three-day workshop in that southern province, which has a large Muslim population. Thailand is 95% Buddhists, and here in the south there is a much more even distribution of Muslims.

There are many Muslims coming to the workshop that have had relatives killed in the Muslim/Buddhist religious clashes in the south. I don’t know the full history yet, but there are many “Malay Muslims” – Muslims who would rather be a part of Malaysia, Thailand’s southern neighbor, which is a primarily Muslim country. And particularly in the past 8-10 years, the violence has been bad. In that time, the death toll is in the thousands.

So, why is there such acceptance of different cultures, and then this violence in the south? Is it due to religion? Is it because the Muslim culture is so much more different that the other cultures here? Is it because of the demographics? I’m sure it’s a combination of many factors, and an explanation cannot be boiled down to one “root cause”.

There will be about 50 people in attendance. Virginia Satir used to say that you change one person, and you change a system. Hopefully we can have some impact on what is happening overall, while improving individual and village lives.

Hotel Conservation Tip – Lessons from Thailand

In Thailand hotels, there is a great system in place for energy conservation. We have thus far stayed in 4 hotels here. Everyone of them uses a metal key, and on the keyring is a magnetic card. You have to insert the magnetic card into a slot on the wall just inside the door for any electricity to make it into the room.

Once you pull the card out, electricity stays on for about three minutes, and then everything goes off – every light, the air conditioner, all sockets, everything.

What a great way to save energy use. The only inconvenience I’ve seen so far is that electronic devices couldn’t charge unless you are in the room. When it’s really hot out, it does take the room about 5 minutes to start to feel cool as well. I’m more than okay dealing with this.

Could you imagine if a system like this were in place in every hotel in the US? That must have the potential to save many tons of coal burning every year.

Amazing Thai – Lessons from Thailand

The first ingredient of any workshop is the people who attend. I am awed by the people attending the workshop we have the pleasure of facilitating alongside Laura Dodson and Maureen Graves in Bangkok this week. They are doctors, health administrators, therapists, organizational consultants, NGOs, and more. They are so hungry for new ways of being in relationship and learning how to work more effectively in the world.

There are about 90 Thai in attendance. About 20% have attended a workshop with Laura and Maureen in the past. About 30% speak english, and everyone of them are more than happy to act as translators. Toni and I missed the first day, due to technical plane details leaving Chiang Mai. Laura, who is the lead facilitator, integrated us into the leadership team today, and together Toni and I taught the Satir stances of communication to the group. I was impressed with the types of questions that were asked during the session and after words in one-on-ones. Everyone was really trying to figure out how to use this new tool we just taught to make their lives better and do better work.

The workshop is put on by the ASEAN – The Association of Southeast Asian Nations (, and is being held at Mahidol University ( A large majority of the participants are young – in their 20s and 30s. It is encouraging that these are not only leaders of today, but leaders of tomorrow, that are working to create a better future with as clean and clear collaboration as possible – making it easier to create sustainable change with real impact.

The nation has a slogan they’ve been using to promote tourism – “Amazing Thailand”. I can now say I know from first hand experience that the land would be nothing without the Amazing Thai People.

The Power of One Syllable, Lessons from Thailand

In Thai, the way you say thank you takes three syllables. If you are a woman, you say “kop koon kah” if you are a man you say “kop koon krahp”. When you say it, the “kop koon” is said quickly, quitely, and without accentuation. The “kah” and “krahp” both have the “ah” sound extended. For men, the “p” at the end is also hardly audible. So, essentially, “thank you” has been symplified to one syllable – “ah”, and it has made appreciation easy to express.

As an example, we were at the most beautiful buddhist temple I have had the pleasure of visiting yesterday. The Doi Suthep temple sits on the Doi Suthep mountain peak outside of Chiang Mai. An elephant actually chose the location in the 1300’s. From the road there are 300 steps to get to the temple grounds. The steps are about ten feet wide, and flanked on each side by one long green-scaled Asian dragon, about 4 feet in diameter, whose head is at the bottom and end of tail is at the top.

There are a couple points on the stairs where there was a group of teenagers or young adults that held out a box and were asking for donations for a cause. They would explain their cause in Thai, and whenever a donation was made (which happened quite often), the group of people would all sing out “kaaaaaahhhhh” in unison.

The simpler the message, the more effective it is. You can’t get much simpler than one syllable. It made for a great soundscape as we traveled the path to the temple.

Thailand Day 2 – Shanties, Thai Nuns, and Our New Favorite Sport

Today we woke about 6:30 and were down for breakfast less than an hour later. They serve what we Americans would think more of as lunch food at breakfast. There was an awesome rice noodle dish with cabbage and a little red chili flake heat. There was also chicken curry. And of course steamed rice and fried rice. They had eggs and french toast available as well. And really good fresh papaya, watermelon, and pineapple.

Then we decided to take a walk. We looked at a map and had a destination in mind, but it was more about the journey. On the walk we saw lots of traffic, lots of little shrines, outside eating areas with cheap food sold by street vendors, Thai shanties along the rivers, and we met a Thai nun.

We also got a quick glimpse into a Thai shanti town by missing a set of stairs and walking underneath a busy traffic bridge. The sound of the traffic became a dull hum when our ears were below bridge level. It was all covered by corrugated tin and fiberglass roofs, with very little sunlight coming through (I’m sure it would also keep all the rain out). The ground was all dirt, even inside the shops we past. We realized we should not be there (though we didn’t feel like we were in danger), so we turned around and found our way back.

On street level, we then met Ying, the Thai nun I mentioned. One thing led to another, and she wound up showing us her temple (it was in on the fifth floor of a mostly empty office building) and talking to us about meditation as way to not do everything “automatically”, but with your mind present.

We never did reach our intended destination, but we did see it from the temple window. We caught a cab back to the hotel, packed, and caught another cab to the airport to fly to Chiang Mai.

In Chiang Mai, we discovered our new favorite sport – crossing the street! There are few traffic signals – we walked in Chiang Mai for seven hours today and came across one. Intersections consist of cars and scooters merging and negotiating with each other over who has the right of way. Crossing the street sometimes means you run against traffic as you weave across the lanes. It was fun when you realize that’s what you have to do.

We did some shopping and had an amazing dinner of chicken larb – we bought it from a street vendor who had a dozen woks on display on the street – each full of delicious looking Thai food. They were flanked on either side by vendors with fresh cut fruit, whole cooked chickens, fried chicken legs, sushi, you name it. It was served to us in a bag with a bag of rice, which was interesting. We also found the most amazing mango and sticky rice I’ve ever had, also right on the side of the street.

We did learn how to say hello – “sawatdee krab”, and how to say thank you – “kop koon krab”. Thank you has been a real challenge for me to remember, which is interesting because I like to express appreciation.


Day 1 in Thailand: Mystery Meat

Our first day in Thailand was educational and entertaining. We flew into Bangkok last night and arrived at our hotel at about midnight. It was only 10AM in our original time zone, so we weren’t ready for bed. We heard some live music from outside our hotel’s sixth floor window and decided to go check it out. We are not near downtown Bangkok, more on the outskirts, so it’s not like the streets were full of people. But the receptionist said it was very safe and no need to worry.

We made our short walk around the corner to the bar. The band had finished by the time we arrived. It was an outdoor bar with a big screen TV and pop Thai music playing. When the waitress came up and gave us menus, we realized that we hadn’t yet learned any words in the Thai language. It made ordering a couple beers interesting. The waitress knew enough to say”kitchen closed” when we tried to order some french fries – the only item that appeared in english on the menu.

When the guy on the motorcycle pulled up with his street food vendor cart attached on the side, we decided to go check it out. Again, not knowing one iota of the language made ordering a bit of a guessing game. The street vendor had on ice a bunch of different kinds of meat on a stick.

Toni was paying for the beers we ordered, so I went up and chose a few that were underneath a sign of paperboard packaging that said “Chicken” in english, even though it suspiciously did not look like chicken. I also chose a stick with squares on it that looked like tofu, and one stick with balls on it that was the biggest mystery of them all. I picked them all out of the ice myself and put them in a little green square basket, the kind of basket I could imagine french fries being delivered in.

He put them all into a little fryer. Toni came up and she pointed out the items she would have picked, which were exactly what I picked. We had a good smile over that. The vendor put our fried pickings into a paper bowl and drizzled red chili flake sauce over the top. We returned to our table and had our beer while we guessed at the mystery meat we had just received, which neither of us liked very much.

After our time at the outdoor bar, which we enjoyed, we went to the corner grocery store right next door. We saw packages of the meats we ordered, and they were all labeled as “fish meat”. Except for the squares, which were tofu/fish meat. From other packaging we saw, it’s likely the “fish meat” was from cuttlefish – which isn’t quite fish, but more squid-like creatures. Now I understand why we didn’t like it. We would up leaving our leftovers for a pack of street dogs on the corner.